Directorate General of Health Services
Bangladesh sees rise in Covid infections; 41 more die
Amid the growing trend in both the Coronavirus infections and fatalities, Bangladesh logged 41 more deaths, pushing up the death toll to 12,660.
Besides, health authorities detected 1,765 new cases after testing 18,250 samples during the period.
The country’s daily death record remained below 40 since May 25 while it stayed below 50 since May 9.
With the new cases, the total caseload rose to 8,02,305, said a handout of the Directorate General of Health Services (DGHS).
The daily infection rate slightly increased to 9.47 percent from Monday’s 9.41 percent while the mortality rate remained static at 1.58 percent.
The country has so far tested 59,65,763 samples.
Read:Covid: WHO renames UK and other variants with Greek letters
The DGHS handout says 92.50% of the people infected till now have recovered, including 1,779 who tested negative during the period.
Bangladesh reported its first Coronavirus cases on March 8 last year and the first death on the 18th of that month.
Covid-19: Bangladesh’s total caseload crosses 8 lakh; 36 more die
As Bangladesh’s fight to stem Covid-19 continues, it recorded 1,710 new cases in 24 hours until Monday morning, raising the total caseload to 8,00,540.
During the period, the deadly virus also claimed 36 more lives.
With the fresh death toll, the total number of fatalities rose to 12,619.
Read:Local admins can enforce lockdown, says Cabinet Secretary
The new cases of infections were detected after carrying out 18, 178 sample tests, said the Directorate General of Health Services in a handout.
The positivity rate dropped to 9.41% from Sunday’s 10.11% while the death rate remained static at 1.58%.
Until now, 7,40,372 people recovered from the virus putting the country’s recovery rate at 92.48%.
The country has so far completed testing 5,947,513 samples.
Among the deceased, 12 are from Chattogram and eight from Dhaka divisions.
Besides, nine died in Rajshahi, six in Khulna and one in Sylhet divisions from Covid-19.
Bangladesh reported its first Coronavirus cases on March 8 last year and the first death on the18th of that month.
Read:Lockdown in Chapainawabganj extended for another week
Border closure continues
Bangladesh on Sunday announced an extension of border closure with India by another two weeks from June 1 to June 14 as the coronavirus situation hardly shows any sign of improvement.
The border with India will remain closed till June 14 but the movement of cargo-carrying goods will remain uninterrupted.
"We've extended it (border closure) for 14 more days and will evaluate the situation further," a senior official at the Ministry of Foreign Affairs told UNB on Sunday.
Bangladesh decided to close its border with India for any kind of movement except that of cargo on April 26 which was later extended till May 31 to control the spread of Coronavirus as the situation in the neighbouring country deteriorated.
The cross-border movement of people between Bangladesh and India has remained suspended since then.
Bangladesh confirmed its first case of the Indian Coronavirus variant on May 8 this year.
Lockdown in Chapainawabganj extended
The local administration has extended the ongoing lockdown in Chapainawabganj for another week due to the worsening Covid-19 situation.
The restriction will remain in force from June 1 to June 7, said Deputy Commissioner Mohammad Manjurul Hafiz at a press briefing at his office on Monday noon.
Read: Global Covid-19 cases cross 170 million mark
Meanwhile, Bangladesh’s ongoing lockdown period has been extended another week until June 6 to control the virus.
Besides, district administrations have been given the authority to enforce lockdown in their areas if the Covid-19 situation deteriorates there, the cabinet secretary said on Monday.
Covid-19 claims 38 more lives in Bangladesh; new cases 1,043
Bangladesh registered 38 more Coronavirus-related deaths in 24 hours until Saturday morning, pushing up the total fatalities to 12,549.
Besides, 1,043 more people came out positive in 13,184 sample tests carried out during the period.
The mortality rate remained static at 1.57 percent while the positivity rate declined to 7.91 percent from Friday’s 9.30 percent, the Directorate General of Health Services said in a handout.
Among the deceased, eight died in Dhaka division, four in Chattogram, seven each in Rajshahi and Khulna, five in Sylhet, four in Rangpur, two in Mymensigh and one in Barishal.
With the news cases, the total caseload reached 7,93,386 while the total number of recoveries is 7,37,408, including 1,187 in the last 24 hours.
Bangladesh reported its first coronavirus cases on March 8 last year and the first death on the 18th of that month.
READ: Bangladesh loses 31 more lives to Covid-19
Vaccination drive
Bangladesh launched its vaccination drive on February 7 with Oxford-AstraZeneca doses bought from India's Serum Institute.
The administering of the first dose of the vaccine has remained suspended since April 26.
Also, the country, the prime recipient of Oxford-AstraZeneca vaccines, has suspended the registration for Covid-19 jabs due to vaccine shortage amid a delay in the arrival of shipments from India.
However, recently two other vaccines, Russia's Sputnik V and China's Sinopharm, got approval from the Directorate General of Drug Administration (DGDA) for emergency use in Bangladesh.
The administering of the first doses of the Sinopharm vaccine started Tuesday.
READ: COVID-19: Bangladesh to receive over 1 lakh Pfizer vaccine on Sunday
Bangladesh records lowest Covid deaths in over two months
Bangladesh logged 17 more Covid-related deaths in 24 hours until Wednesday morning, the lowest number in 68 days.
The country saw 16 Covid-19 deaths on March 18 last.
Besides, 1,497 new cases were recorded taking the total caseload to 7,93,693, said a handout of the Directorate General of Health Services (DGHS).
The Covid-19 positivity rate declined to 9.11 percent from Tuesday’s 10.08 percent while the mortality rate remained static at 1.57 percent, the handout said.
Health authorities recorded the new cases after testing 16,434 samples in the last 24 hours.
With 1,056 recoveries in the past 24 hours, the country's recovery rate now stands at 92.46.
As of now, 7,33,866 people have recovered from the disease.
Eight of the 17 deaths recorded today are from Chattogram and five are from Dhaka divisions.
Also read: Bangladesh braces for worst Covid outbreak by June-end: Experts
One each died in Khulna, Barishal, Mymensingh and Sylhet divisions.
The country so far carried out 58,71,353 sample tests since reporting its first coronavirus cases on March 8 last year and the first death on March 18, 2020.
Focus on black fungus as it adds to woes, says DGHS
As ‘black fungus’ keeps on spreading in different Indian states amid the Covid surge, Bangladesh remains alert so that this fungal disease cannot put any extra strain on the country’s medical system, says DGHS.
Speaking at a virtual press briefing, Dr Nazmul Islam, a spokesman of the Directorate General of Health Services (DGHS), said, “Many patients have been diagnosed with black fungus or mucormycosis in different Indian states, including Maharashtra Gujarat, Delhi and recently in West Bengal.”
He said this rare fungal disease has been declared as an epidemic in different states of India. “In Bangladesh, we’re keeping a close eye on it so that it can’t create extra pressure on our health system.”
The Indian states are declaring the “black fungus” an epidemic since it has increased in patients recovering from Covid-19.
Read: Vaccination in Bangladesh: DGHS says online registration is a must
According to experts, black fungus affects patients initially in the nose and then it can spread into the brain. Often it can be treated by major surgeries removing the eye or part of the skull and jaw.
More than 7,000 people in India have already been reported with the fungal disease and 219 have lost their lives. Many of those being infected with the disease are coronavirus patients, or those who have recently recovered from Covid-19, whose immune systems have been weakened by the virus or who have underlying conditions, including diabetes.
Dr Nazmul Islam said they have already talked about the preventive measures of the fungal disease at their different forums.
He said the members of the national technical advisory committee are working on the issue and they will finalise their guidelines and suggestions in this regard through discussions. “We’ve also talked about the issue. We’ve also sent warming messages to different districts.”
The DGS officials said they will formally give specific guidelines on the treatment protocol management of the rare fungal disease.
Read: Covid vaccination in Bangladesh to start in first week of Feb: DGHS
About the Covid vaccine, he said, the government’s stock of AstraZeneca vaccine is about to deplete at the end of this week.
Dr Nazmul said 15 lakh people who received the first dose will not get the second dose in time as the stock is going to be exhausted.
He urged all to wait with patience until the new consignment of vaccine arrives. “It’s also necessary to maintain hygiene rules.”
The DGHS official said the government is trying to collect vaccines from the United States and the United Kingdom and other sources. "We’re hopeful that somehow we’ll be able to collect vaccines from these sources as per our demand.”
Replying to a question, he said no decision has been taken yet on the use of mixed vaccines.
As the highly transmissible Indian variant has been detected in the country, Dr Nazmul said people must wear masks and strictly maintain health safety rules and social distance to keep them safe.
Covid-19: Bangladesh again sees steep rise in deaths, new cases
Bangladesh on Wednesday witnessed 37 more Covid-19 related deaths in 24 hours until Wednesday morning.
The death tally now stands at 12,248 while the mortality rate remains static at 1.56%.
Besides, the country saw 1,608 new cases with an increased number of tests as 20,538 samples were tested during the period, said a handout of the Directorate General of Health Services (DGHS).
The infection rate rose to 7.83% from Tuesday’s 7.55%.
Also read: Govt approves proposal to import Sinofarm vaccine
The country reported 30 deaths from the virus on Tuesday and 32 on Monday.
Among the latest fatalities, 24 are men and 13 are women.
Bangladesh logs 30 more Covid-19 deaths; infection rate rises to 7.55 pc
Bangladesh registered 30 more coronavirus-related deaths in 24 hours until Tuesday morning, pushing up the total fatalities to 12,211.
Besides, 1,272 new cases were detected during the period after testing 16,855 samples, the Directorate General of Health Services said in a handout.
The daily infection rate rose to 7.55 percent from Monday’s 6.75 percent.
With the new cases, the total caseload reached 7,28,129 while the total number of recoveries stood at 7,24,209, including 1,115 in the last 24 hours.
Now the recovery rate stands at 92.59 percent.
The country has so far carried out 57,34,918 sample tests since reporting its first cases on March 8 last year and the first death on the 18th of that month.
Bangladesh has been seeing below 50 daily deaths from May 9 and the number stayed mostly below 60 from the beginning of May.
The country experienced a surge in Covid-19 cases in April, recording its highest single-day cases of 7,626 on April 7. It witnessed over 100 deaths during April 16-19 and on April 25.
Second dose of vaccine running out
The second dose of Covid-19 vaccine will run out within seven to ten days, Health Minister Zahid Maleque said Monday.
Also read: Administering of Chinese Covid-19 vaccine to begin on May 25/26: Health Minister
Five lakh doses of Covid-19 vaccine, donated by China, arrived in Dhaka last week.
The vaccine will be given to those who need it most, said the minister.
Administering of Chinese Covid-19 vaccine will begin later this month, he said.
“We talked to the US, China, Russia and the UK and some progress has been made. Hopefully you will get good news soon. As per contracts, we’ve got only seven million doses out of 30 million. We’re also worried about the second dose,” he added.
US to actively consider Bangladesh’s vaccine request
The United States has said it is actively considering the request made by Bangladesh over the supply of Covid-19 vaccine doses to meet the country’s immediate needs.
Bangladesh will get a reply of the letter, sent to US Secretary of State Antony Blinken by Foreign Minister Dr AK Abdul Momen, within the next couple of days, said State Minister for Foreign Affairs M Shahriar Alam on Monday after his meeting with US Ambassador Earl Miller.
Meanwhile, White House spokeswoman Jen Psaki said on Monday, the United States will send an additional 20 million doses of US-approved Covid-19 vaccines overseas, reported AP.
The additional doses will put to 80 million the United States will provide to other countries by the end of June.
Also read: Bangladesh seeks at least 2 mln doses of AstraZeneca vaccine from Canada
Vaccination drive
Bangladesh launched its vaccination drive on February 7 with Oxford-AstraZeneca doses purchased from India's Serum Institute.
The government signed an agreement with Serum for 30 million doses. But a record number of cases in India has made the delivery of the doses uncertain.
The administering of the first dose has remained suspended since April 26. Also, the country, the prime recipient of Oxford-AstraZeneca vaccines, has suspended the registration for Covid-19 jabs due to vaccine shortage amid a delay in the timely arrival of shipments from India.
In the last 24 hours, no one received the first dose of the vaccine while 64,377 have received the second dose, said the health directorate.
DGHS urges holidaymakers to return to Dhaka after 14 days
The Directorate General of Health Services (DGHS) on Sunday urged the Eid holidaymakers to return to the capital after 7-14 days if they do not have any urgency as there is a need to check mass gatherings.
Speaking at a virtual press briefing, DGHS spokesperson Dr Nazmul Islam also issued a warning that there is no room for complacency in the declining trend in infection rate since Bangladesh is still in the middle of the second wave of Covid-19.
“The government advised us not to leave our respective dwellings (in cities) and stay there during this Eid. But we’ve seen, a large number of people went back to their village homes in various ways ignoring the advice,” he said.
Also read: Mad rush of homebound people at Paturia terminal
Dr Nazmul said, “We humbly request those who’ve gone home to return at least 7-14 days later if their offices are not yet reopened and if they don’t face any losses for being late.”
Besides, he said, those who have Covid symptoms must undergo RT-PCR tests at the nearest health complexes or district sadar, specialised or medical college hospitals.
The DGHS official said they also must maintain cent percent health safety rules during their way back to the capital.
He said the government is sending them to institutional quarantine those who are returning from India through different land ports. “We’re getting help from law enforcers and local administrations in this regard. Even though, we’ve seen many of the returnee patients and their attendants are trying to either flee the institutional quarantines or evade the quarantines to rush back to their homes. It’s not logical behaviour as if anyone flees quarantines with the Indian variant as it may harm the entire nation.”
Nazmul said those returning from India should not avoid the institutional quarantine breaking the law. “Don't risk the lives of others by doing so. We should not harm our country knowingly.”
Replying to a question, he said, “We’re regularly checking those returnees who have symptoms…We’ve identified the Indian variant through the genome sequencing of the positive samples of the returnees. Those identified with the Indian variant, we kept them in quarantine strictly and allowed them to return home after they have recovered.”
Nazmul said six people have so far been identified with the Indian variant and five of them have already recovered fully from the virus. “We didn’t find any infected patients in those who came in contact with the positive cases.”
Also read: Homebound people flock at launch and bus terminals dreading ‘lockdown’
The DGHS spokesman said the lowest number of patients was detected on Saturday as the sample collection was low.
“We think it may happen due to the Eid holidays. We’ve no reason to be complacent about such a small number of infections. We’ll be able to heave a sigh of relief if we see such a small number of cases day after day continuously. Unless it happens, we’ve to keep it in mind that we’re still in the middle of the second wave. We’ve not yet gotten rid of the second wave. So, we all should remain alert.”
He said genome sequencing tests are being carried out at 20-26 laboratories every day to know the prevalence of different Covid variants in the country.
Nazmul said it is now important to conduct tests as much as possible and encourage people to go under the Covid tests. “The more tests we can conduct, the more cases will be detected. The more cases we can identify, the more we’ll have the opportunity to do genome sequencing. It’ll help us to know the existence of new variants and work out what is necessary to do.”
He said the infection rate was between 10-8 percent over the last week though it was very low on Saturday. “So, we’ve no reason to be very satisfied.”
Only 261 Covid cases were reported on Saturday after examining 3,758 samples.
Nazmul said when the total number of Covid patients was 21, 629 in January, it increased to 1,30,957 in April. “A total of 20,664 cases have been detected over the last 15 days. Still, 15 days are left of this month. So, we must maintain the highest level of caution.”
He said there are adequate oxygen cylinders, high-flow nasal cannula and oxygen concentrators in hospitals across the country. “As per the statistics we’ve now, there’re more empty beds than the admitted patients.”
In Dhaka city, Nazmul said there are 3,440 beds in government hospitals and 2,785 of them now remain empty.
Besides, he said, 1,663 out of 1801 beds in private hospitals are now available for Covid patients. “The same way, isolation beds are also empty. “But if we don’t change our behaviour and ignore the health safety rules, we may see the opposite scenario.”
Vexed over vaccines
The Directorate General of Health Services announced this week that Bangladesh’s stock of Covid-19 vaccines was running out, with only some 1.4 million jabs remaining in government hands. Given the current crisis in India, there is little to no hope of receiving the next consignment in accordance with the contract signed between Beximco Pharmaceuticals and the Serum Institute of India anytime soon.
Speaking at a virtual press briefing, DGHS spokesperson Robed Amin said, “We had around 10.02 million vaccine doses in our hands…around 8.8 have already been administered as the first and second doses. Now we have some 1.4 million doses in stock.”
He went on to warn that there would be a vaccine crisis if a fresh consignment does not arrive in the country before the existing stock is exhausted. Robed said around 5.8 million people have so far received the first dose of the vaccine while 3 million of them have got the second, booster dose to complete their course of the Oxford University-AstraZeneca vaccine. That leaves 2.8 million people yet to complete the course, of which 1.4 million can be covered from the current stock, since the government has stopped registering any new recipients through the Shurokkha app.
Clearly, the priority has shifted to covering these people rather than reaching a situation where a large number of them are left in limbo, considering the uncertainty over when Serum may resume supplies. As reported before, the government is now looking at alternative suppliers, something they would possibly have been well-advised to do earlier, from Russia and China, as well as others. But in the absence of any clear data yet on whether the vaccines can be mixed or matched, concentrating the remaining doses on letting as many people as possible complete their course is only the right thing to do.
Till Eid, which is about when supplies are estimated to lost, you’re unlikely to see any new faces popping up on your social media feed with their ‘vaccine selfie’. Unless they skipped it the first time, which is unlikely.
From pillar to post
Reaffirming that the government is making all-out efforts to collect Covid-19 vaccines from different sources, Health Minister Zahid Maleque on Thursday (May 6) said they are now “at the stage” of signing a deal with Russia to procure the Sputnik V vaccine.
Speaking at a virtual discussion arranged by Bangladesh Private Medical College Association, he said they are also trying to procure the Oxford–AstraZeneca vaccine from other countries besides India – AstraZeneca has licensed production in some 15 countries already.
Also read: Russian Vaccine Sputnik V: Things we should know to fight COVID-19
“We’ve been using the AstraZeneca vaccine as we had placed an order for 3 crore (30 million) doses of it. We’ve got only 70 lakh (7 million) jabs in addition to 30 lakh (3 million) that came as a gift…but now we don’t have that much vaccine in our stock and whatever is left will be given as the second dose,” the minister said.
He said the prime minister, Health Ministry, Foreign Ministry and other relevant ministries are making joint efforts to procure vaccines from other sources.
“We’ve already made a huge progress in discussions with Russia over procuring its vaccine … now we’re at the stage of signing a deal in this regard,” Maleque said.
He said they are also in talks with China to have Sinopharm’s Covid vaccine. “They informed us that five lakh (500,000) doses will arrive in Bangladesh by May 12. We’ve also sent a letter to them seeking more vaccine doses.”
The minister said the Chinese government is now assessing the possibility of vaccine export to Bangladesh. It must be observed that it sounds like an uncharacteristically conservative offer from Beijing, for which the episode back in August 2020 comes to mind, when it all seemed very close to an agreement with the Chinese for vaccine supply, before the government seemed to get cold feet.
Getting back to Maleque, he was desperate to explain the government’s all-out efforts to get the vaccine. “Even, we’re trying to have AstraZeneca’s vaccine from other countries as it’s being manufactured in different countries. So, every effort is there to bring vaccines. We hope our efforts will yield good results, and we may be able to give you good news over the vaccine very soon,” he said.
The minister also said they will encourage the private sector if it tries to manufacture vaccines in Bangladesh. “If anyone can produce vaccines, we’ll provide all-out support, and it’s my commitment.”
Speaking at the same programme, State Minister for Disaster Management and Relief Dr Enamur Rahman said there is no alternative to vaccinating people to control the coronavirus. He too tried to assure everyone the government is working sincerely on procuring vaccines from Russia, China and other sources as there has been a crisis of AstraZeneca’s jabs in India.
Also read: What does it feel like to get COVID-19 after taking the vaccine?
He gave some hint as to what the government is looking at as a way to get past the pandemic, saying that all the pandemics that emerged in the world earlier had been brought under control through vaccination, although that’s not entirely true. “We hope we’ll be able to control the corona pandemic by vaccinating 60-80 percent of our people.”
What sort of timeframe they’re looking at to achieve that is up in the air, but it could be a good 2 years. Cases have been coming down in Bangladesh recently, but you never know when there can be another wave. The lesson we must heed going forward, is that never to close out any options during this crisis. And not to rest on our haunches. In that, the public has a role too, most evidently in maintaining the public health guidelines we’re now getting used to.
A shot at salvation?
It is of course well-documented by now that the pandemic has exposed some dangerous inequities between the rich world and the rest. The kind of problem the Bangladeshi authorities are dealing with today is scarcely seen in the West. While one in four citizens of rich nations have had a vaccine, just one in 500 people in poorer countries have done so, meaning the death toll continues to climb as the virus remains out of control. According to Oxfam, an international NGO, epidemiologists are predicting we have less than a year before mutations could render the current vaccines ineffective.
One of the reasons Pharma companies have been able to generate such large profits is because of intellectual property Last week, 175 former heads of state and Nobel Prize winners, including Gordon Brown, Ellen Johnson Sirleaf and Francoise Hollande wrote to President Biden to support the temporary waiving of intellectual property rights that restrict production to a handful of companies (those that develop the vaccine and others who obtain the license from them), to enable the rapid scale up of vaccine production across the world. They join the 1.5 million people in the US and other nations who have signalled their support for a People’s Vaccine.
Over 100 low- and middle-income nations, led by India and South Africa, are calling at the World Trade Organisation for a waiver of intellectual property protections on COVID-19 products during the pandemic, a move that had so far been opposed by the US, EU and other rich nations.
In a major shift, the Biden administration in the US this week joined the calls for more sharing of the technology behind COVID-19 vaccines to help speed the end of the pandemic, a shift that puts the US alongside many in the developing world who want rich countries to do more to get doses to the needy.
Also read: Can you mix-and-match COVID-19 vaccines?
US Trade Representative Katherine Tai announced the government’s position, amid World Trade Organisation talks about a possible temporary waiver of its protections that would allow more manufacturers to produce the life-saving vaccines.
“The Administration believes strongly in intellectual property protections, but in service of ending this pandemic, supports the waiver of those protections for COVID-19 vaccines,” Tai said in a statement.
She cautioned that it would take time to reach the required global “consensus” to waive the protections under WTO rules, and US officials said it would not have an immediate effect on the global supply of COVID-19 shots.
In a tweet, the director of the Africa Centres for Disease Control and Prevention, John N. Nkengasong, said the Africa CDC welcomed the waiver and called the decision “leadership in action.” He added: “History will remember this decision as a great act of humanity!”
Tai’s announcement came hours after WTO Director-General Ngozi Okonjo-Iweala spoke to a closed-door meeting of ambassadors from developing and developed countries that have been wrangling over the issue, but agree on the need for wider access to COVID-19 treatments.
The WTO’s General Council took up the issue of a temporary waiver for intellectual property protections on COVID-19 vaccines and other tools, which South Africa and India first proposed in October. The idea has gained support among some progressive lawmakers in the West.
More than 100 countries have come out in support of the proposal, and a group of 110 members of Congress — all fellow Democrats of Biden — sent him a letter last month that called on him to support the waiver.
Opponents — especially from industry — say a waiver would be no panacea. They insist that production of coronavirus vaccines is complex and can’t be ramped up by easing intellectual property. They also say lifting protections could hurt future innovation.
Stephen Ubl, president and CEO of the Pharmaceutical Research and Manufacturers of America, said the US decision “will sow confusion between public and private partners, further weaken already strained supply chains and foster the proliferation of counterfeit vaccines.”
Dr. Michelle McMurry-Heath, chief executive of the Biotechnology Innovation Organization trade group, said in a statement that the decision will undermine incentives to develop vaccines and treatments for future pandemics.
“Handing needy countries a recipe book without the ingredients, safeguards, and sizable workforce needed will not help people waiting for the vaccine,” she said.
Also read: More support easing vaccine patent rules, but hurdles remain
Pfizer declined to comment on Biden’s announcement, as did Johnson & Johnson, which developed a one-dose vaccine meant to ease vaccination campaigns in poor and rural areas. Moderna and AstraZeneca didn’t immediately respond to requests for comment.
The companies have made some efforts to provide vaccine doses to poor countries at prices well below what they’re charging wealthy nations.
For instance, Johnson & Johnson agreed last week to provide up to 220 million doses of its vaccine to the African Union’s 55 member states, starting in this year’s third quarter, and agreed in December to provide up to 500 million vaccines through 2022 for low-income countries via Gavi, The Vaccine Alliance.
Shares of Pfizer, AstraZeneca and Johnson & Johnson — huge companies with many lucrative products — fell less than 1% on the news. But Moderna, whose vaccine is the company’s only product, fell 6.2% in late-afternoon trading before gaining back two-thirds of a percent in after-hours trading.
It remained unclear how some countries in Europe, which have influential pharmaceutical industries and had previously shared U.S. reservations about the waiver, would respond.
WTO spokesman Keith Rockwell said a panel on intellectual property at the trade body was expected to take up the waiver proposal again at a “tentative” meeting later this month, before a formal meeting June 8-9. That means any final deal could be weeks away at best.
Authors of the proposal have been revising it in hopes of making it more palatable.
Okonjo-Iweala, in remarks posted on the WTO website, said it was “incumbent on us to move quickly to put the revised text on the table, but also to begin and undertake text-based negotiations.”
“I am firmly convinced that once we can sit down with an actual text in front of us, we shall find a pragmatic way forward” that is “acceptable to all sides,” she said.
Co-sponsors of the idea were shuttling between different diplomatic missions to make their case, according to a Geneva trade official who was not authorized to speak publicly on the matter. A deadlock persists, and opposing sides remain far apart, the official said.
The argument, part of a long-running debate about intellectual property protections, centres on lifting patents, copyrights and protections for industrial design and confidential information to help expand the production and deployment of vaccines during supply shortages. The aim is to suspend the rules for several years, just long enough to beat down the pandemic.
The issue has become more pressing with a surge in cases in India, the world’s second-most populous country and a key producer of vaccines — including one for COVID-19 that relies on technology from Oxford University and British-Swedish pharmaceutical maker AstraZeneca.
Michael Yee, a Jefferies Group biotech analyst, wrote to investors that the key access issues for developing countries aren’t patents or price, but an inadequate supply of the materials needed and the know-how to produce the vaccines and keep quality high — which one of Johnson & Johnson’s contract manufacturers in the U.S. failed to do, ruining millions of doses.
“Manufacturing supplies, raw materials, vials, stoppers, and other key materials are in limited supply for 2021,” and may still be next year and beyond, Yee wrote. That’s partly because it takes time to make all those components, and Moderna and Pfizer have commitments to buy them “from major suppliers in huge bulk over the foreseeable future.”
He added that Pfizer previously sought authorization to sell its vaccine to India, which rejected its application and asked that additional studies be run. The U.S., European Union and many other countries have given that emergency authorization.
Proponents, including WHO Director-General Tedros Adhanom Ghebreyesus, note that such waivers are part of the WTO toolbox and insist there’s no better time to use them than during the once-in-a-century pandemic that has taken 3.2 million lives, infected more than 437 million people and devastated economies, according to Johns Hopkins University.
“This is a monumental moment in the fight against COVID-19,” Tedros said in Wednesday statement. He said the U.S. commitment “to support the waiver of IP protections on vaccines is a powerful example of American leadership to address global health challenges.”
Additional reporting by Masudul Hoque and AP.
Can you mix-and-match COVID-19 vaccines?
The Directorate General of Health Services announced on Wednesday that Bangladesh’s stock of Covid-19 vaccines is running out, with only some 1.4 million jabs remaining in government hands. Given the current crisis in India, there is little to no hope of receiving the next consignment in accordance with the contract signed between Beximco Pharmaceuticals and the Serum Institute of India anytime soon.
Speaking at a virtual press briefing, DGHS spokesperson Robed Amin said, “We had around 10.2 million vaccine doses in our hands…around 8.8 have already been administered as the first and second doses. Now we have some 1.4 million doses in stock.”
He went on to warn that there would be a vaccine crisis if a fresh consignment does not arrive in the country before the existing stock is exhausted. Robed said around 5.8 million people have so far received the first dose of the vaccine while 3 million of them have got the second, booster dose to complete their course of the Oxford University-AstraZeneca vaccine.
That leaves 2.8 million people yet to complete the course, of which 1.4 million can be covered from the current stock. In the absence of any clear data yet on whether the vaccines can be mixed or matched, concentrating the remaining doses on letting as many people as possible complete their course is probably the right thing to do.
But that still leaves 1.4 million people that current stocks cannot cover. In case a new stock of the same vaccine cannot be procured in time, is it advisable to mix vaccine doses?
The prospect of mixing vaccine doses offers a chance to bolster vaccine rollouts and, potentially boost the immunity provided, but evidence around the wisdom of this approach is scarce when it comes to Covid-19. However it is “nothing new” to medical science, according to Dr Pierre Meulien, executive director of the Innovative Medicines Initiative (IMI), an EU and European pharmaceutical industry partnership.
“We have decades of experience in pre-clinical and clinical (work), especially in HIV, using these approaches,” Dr Meulien told EU Horizons.
Also read: Covid vaccine stock running out: DGHS
Indeed, the measure has already been introduced by France and Germany for people who received a first dose of the AstraZeneca vaccine but are in age groups for which that vaccine is no longer recommended in those countries due to rare instances of blood clotting.
On 1 April, Germany advised that those under 55 receive an mRNA vaccine alternative, such as the Pfizer and Moderna vaccines, as a follow-up shot. Soon after, France recommended the same for people under the age of 60.
All of the Covid-19 vaccines widely available, with the exception of Johnson & Johnson’s (J&J) one-and-done jab, require two doses. The first dose primes the immune system and the second dose (usually administered a few weeks after the first) boosts it.
The US Centers for Disease Control and Prevention has warned against the mixing of vaccines unless there are “exceptional situations”, such as a shortage of the first-dose vaccine because of production or distribution problems.
In the UK, Public Health England has taken a similar stance. After the government delayed second vaccine doses for up to 12 weeks so that more people could get their first jab and at least some protection, health officials acknowledged that, in exceptional circumstances, mismatched doses may be given to those who come in for their second booster only to find that the vaccine they originally had is not available.
Some experts are wondering whether flexibility in allowing mixed-dose vaccination might help people get fully vaccinated faster. Others have argued that mixing two different vaccines could actually do a better job of protecting against Covid-19 than sticking to the same one for all doses.
Covid-19 vaccines prime the body’s immune system to target the coronavirus spike protein but target different parts of the spike.
Also read: Bangladesh approves emergency use of Chinese Covid vaccine
AstraZeneca’s adenovirus vaccine uses a weakened version of a common cold virus found in chimpanzees (ChAdOx1) to present the spike protein to the immune system, while Pfizer’s mRNA-based vaccine delivers genetic instructions for making the spike protein and encourages human cells to produce it, triggering an immune response.
Royal Melbourne Institute of Technology (RMIT) vaccine researcher Dr Kylie Quinn has described Covid-19 vaccines as vehicles delivering cargo – the vehicles may be different, and they may drop off their payloads by different means, but the spike protein cargo is the same. Because the cargo is identical, the vaccines should, in theory, work well together.
It does make some simple sense that sparking more than one arm of the immune system could boost immunity on the whole, according to an article published on the website of Clinical Trials Arena, a publication focused on the pharmaceutical industry globally.
Mount Sinai Hospital epidemiologist and assistant professor of medicine Dr Dana Mazo explained to US-based website HealthLine that, in some cases, one type of vaccine can indeed enhance the effectiveness of another.
“There are two different types of pneumococcal vaccines that have different mechanisms of action, and in certain situations we recommend boosting one with the other,” she said.
Also read: Bangladesh approves local production of Russian, Chinese Covid vaccines
The Sputnik V Covid-19 vaccine produced by Russia’s Gamaleya Research Institute already uses the theory over its two-dose course. Unlike the other vaccines, its first and second doses actually differ, by harnessing two kinds of adenoviruses in its prime and booster doses to deliver genetic instructions to the immune system. The first jab uses a harmless common cold virus (Ad26) and the second, given 21 days later, uses another safe but scientifically engineered cold virus (Ad5).
Using an alternative vehicle to deliver the cargo allows the vaccines “genetic payload” to skirt any inadvertent immune response to the first shot. The kind of immune response they're trying to avoid here is not dangerous, but rather one that "could dampen the vaccine’s effect", according to Pia Dosenovic, an immunologist at Sweden's Karolinska Institute, which awards the Nobel Prize in Physiology and Medicine.
The method paid off, and Sputnik V has been found to be one of the most effective vaccines at 91.6% and has been rolled out in Russia and 56 other countries. Health Minister Zahid Maleque on Thursday (May 6) said they are now “at the stage” of signing a deal with Russia to procure the Sputnik V vaccine.
The most important unanswered question is whether mixing vaccines from different manufacturers will cause unwanted adverse reactions.
Testing the mix-and-match theory
Currently, in the UK, an eight-arm study assessing the mix-and-match theory is underway, according to the BBC. The ambitious University of Oxford-run trial called Com-COV2 is testing various combinations of the vaccines currently approved in Britain – Pfizer-BioNTech, AstraZeneca and Moderna, as well as Novavax’s candidate, which is expected to be approved in the coming weeks.
The trial will enroll 1,050 adult subjects aged 50 years or older who received their first dose of a Covid-19 vaccine in the past eight to 12 weeks.
Recipients will have received either the Oxford-AstraZeneca or Pfizer vaccine and will be randomly allocated to receive either the same vaccine for their second dose or a dose of Novavax or Moderna’s jabs. If more vaccines are approved over the coming months, they may also be added to the trial.
While announcing Com-COV, University of Oxford associate professor in paediatrics and vaccinology and chief investigator on the trial, Dr Matthew Snape, cited experiments in mice in which combinations of the Pfizer and AstraZeneca vaccines boosted immunity better than two doses of either one alone. Now this cocktail and others are being tested in humans.
“If we can show that these mixed schedules generate an immune response that is as good as the standard schedules, and without a significant increase in the vaccine reactions, this will potentially allow more people to complete their Covid-19 immunisation course more rapidly,” Snape told the BBC.
“What I’m hoping is that we won’t rule out any combinations. That’s how we need to look at it: are there any combinations we shouldn’t be giving, because they don’t generate a good immune response? And I’m hoping that won’t be the case,” he added.
Results of the trial are expected in June.
Gamaleya and AstraZeneca have registered a pair of clinical trials in which volunteers will receive a dose of AstraZeneca’s vaccine and another of Sputnik V. One trial in Azerbaijan is underway, and a second in Russia is still under review by the country’s ministry of health.
Meanwhile, Norway is awaiting the results of a clinical trial assessing the effectiveness of mixing vaccines before making a decision. Government researchers in Spain said they will study the effects of mixing Covid-19 vaccines in response to the shifting guidelines on the safety of the AZ shot.
For now, it’s too soon to tell whether mixing and matching vaccines is effective, more effective or safe. The world is watching these trials closely to see the outcomes. Mixing the platforms would not seem to contain any obvious, inherent risk, but the main concern is it is not very well tested yet.