The Johnson & Johnson vaccine pause, likely to last another seven to 10 days while a federal advisory committee evaluates a possible link to a rare but severe blood clotting disorder, may deal a blow to vulnerable populations -- the homebound, homeless and incarcerated among them -- because it had been easier to get those individuals one shot than two, health experts said.
In addition to being a single dose, the J&J vaccine "is easier to store than the two mRNA vaccines that require freezing," said Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at Columbia University. "That adds to the complexity of trying to set up vaccinations in settings that are not clinical."
"The reality is, not every site is equipped to handle the mRNA vaccines," added Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and ABC News contributor. "J&J is a really important vaccine for those who are most vulnerable to the consequences of this virus."
"That's the concern I have," he added. "There's going to be barriers to access that come from this pause."
At George W. Hill Correctional Facility in Pennsylvania, a for-profit facility run by the GEO Group, Thursday was supposed to be vaccine day. A mass vaccination event had been scheduled for the roughly 1,300 people incarcerated there -- all were to be offered a Johnson & Johnson shot. Tuesday's pause to examine the vaccine more closely put those plans on hold indefinitely.
"We certainly hope that that the pause is a temporary one," Kevin Madden, chair of the jail oversight board and a Delaware County council member, told ABC News. "If that pause lasts too long, then perhaps we can revisit the conversation with GEO about moving to an alternative vaccination."
Compared to a state prison, George W. Hill's population is more transient. A sizable portion of those incarcerated likely will leave the facility in the next 25 days, making Johnson & Johnson shots a better option, Madden explained. The two-dose vaccines "create a logistical challenge," he said. "Not an insurmountable one, but one you've got to work through to schedule a second shot."
The delay comes after a year in which prisons have been the site of repeated COVID-19 outbreaks -- since March 2020, at least 392,595 people in prison have been infected and 2,515 have died, according to The Marshall Project, which is tracking prison data from all 50 states and from the Federal Bureau of Prisons.
Ninety of the 100 largest COVID-19 clusters occurred in prisons and jails as of August 2020, according to the COVID Prison Project.
Many prisons are chronically overcrowded, dormitory settings with shared toilets and showers.
"Social distancing is impossible," said Claire Shubik-Richards, executive director of the Pennsylvania prison society, a nonprofit prison advocacy group. "All the mask-wearing and hand-washing in the world will not keep the virus from spreading in a congregate care setting like a prison."
But despite those factors, many states have been slow to vaccinate incarcerated populations, in part because it's not a politically sympathetic group, Shubik-Richards explained.
While there's no official tracking system for vaccinations in correctional settings, 137,064 people in state or federal prisons had received at least one dose of the COVID-19 vaccine as of April 1, out of roughly 2.2 million incarcerated people nationwide, according to an article published in the journal Health Affairs, which used COVID Prison Project data.
Before the Johnson & Johnson pause, in Pennsylvania "very few county facilities had even begun to start vaccinating incarcerated people," Shubik-Richards said. The pause may push that timeline back even further, she added, and that delay could have serious consequences. "Prison outbreaks are going to be one of the handful of events that will prolong or deepen this fourth wave."

An advisory panel to the Centers for Disease Control and Prevention declined to make any new recommendations on the use of the Johnson & Johnson Covid-19 vaccine, which will remain paused as the investigation into rare reports of severe blood clots continues.
Many of the experts on the committee said they did not have enough information at this time to make a decision, particularly while the other two Covid-19 vaccines authorized in the U.S. are widely available and have no such safety concerns.
It will be at least a week until the panel is scheduled to reconvene.
"We do need to better understand the risk, which we know is going to be very rare, very low, but we really don't know exactly how low," or how best to treat the cases, Dr. Beth Bell, a member of the advisory panel and a clinical professor in the department of global health at the University of Washington in Seattle, said during the meeting Wednesday.
Most experts agreed that the continued pause on Johnson & Johnson's use should not be indefinite, and would like to reconvene within the coming weeks to make a decision.

Richard J. Sylvia Jr. did not get an annual flu shot, so he wondered, why take the coronavirus vaccination? He understood Covid-19 was far more contagious and deadly, but as someone who had worked at a data center in a health clinic, he also knew that clinical trials for vaccines always took longer than the trial phase for the Covid-19 vaccines, given the moniker Operation Warp Speed.
So Sylvia decided to ride out the coronavirus.
Sylvia’s apprehension illustrated a larger hesitancy to get the vaccination — at first. In December, 52 percent of Black Americans said they would “wait and see” before signing up for a vaccination, while only 20 percent said they wanted the shot as soon as possible, according to the Kaiser Family Foundation. At the time, the share of Black people who were skeptical about the vaccine was higher than white respondents (36 percent) and Latinos (43 percent). These figures have been shifting in recent months overall, but particularly for Black Americans.
In a March survey by KFF, 55 percent of Black respondents said they wanted the vaccination as soon as possible or were already vaccinated. Twenty-four percent were still holding back to wait and see about the vaccine’s effects. Meanwhile, Republicans and white evangelical Christians were the most likely groups to say they will not be vaccinated, according to the survey.

Fifteen Nigerian Governors elected under the platform of the Peoples Democratic Party (PDP) yesterday condemned what it called the alarming drift of the country, which it said if allowed to persist will make Nigeria a failed state under the watch of the President Mohammadu Buhari-led APC government. Besides, the governors called for urgent devolution of powers and restructuring of the country to bring about the desired unity that the nation yearns for. Chairman, PDP Governor’s Forum and Governor of Sokoto State, Aminu Waziri Tambuwal, who briefed journalists at the end of the meeting at the government house in Makurdi, expressed deep concern of the forum at the deteriorated relationship among the different ethnic groups in Nigeria, which he noted has given rise to ethnic and tribal tensions, religious divisions, various forms of social and political cleavages. He noted that the country is in dire need of leadership at the federal level to avert the looming disaster.
“The meeting noted and condemned the alarming drift of Nigeria which if allowed to continue, will make Nigeria a failed state under the watch of the APC government. “Consequently, the governors reaffirmed their conviction that an urgent devolution of powers and restructuring of the country in a way that brings together various groups and tendencies in the country appears to have become imperative and timely now as Nigeria cannot afford another civil war”. The governors said the time has come to take advantage of the ongoing constitutional amendment process to decentralise the security architecture of Nigeria and involve states and local governments.
They called on the Revenue Mobilisation Allocation and Fiscal Commission (RMAFC), to send a new revised allocation formula that would allocate more resources to states and local governments to the President for onward transmission to the National Assembly for immediate action, saying it was a scandal that 21 years after the 1999 constitution came into being, no new formula has been put in place and stressed the need for a more transparent and accountable running of operations of the Nigeria National Petrol Corporation, NNPC.
The meeting which condemned the intimidation of PDP governors by Buhari’s administration, using weapons like security agencies, unequal access to federal resources, promotion of divisions in the opposition political parties, with fake promises and falsehood, condemned what it called the double standards being applied by the President to intimidate PDP-controlled states.
“To this end, we called on the federal government to lift the so-called no flight zone and other intimidating tactics imposed on Zamfara and other states with similar security challenges like Benue, Kaduna, Borno, Katsina, and Yobe, describing them as politically motivated to ensure that the governors defect to the APC. The governors decried the poor performance of the APC since it came to power, regretting that Nigeria has the highest unemployment rate in the world with 33 per cent, a development the governors maintained has ranked the nation second highest poverty country in the world.

Following the numerous controversies trailing the COVID-19 vaccine and the perceived reluctant of many people to take the jabs, the Senior Pastor of Trinity House Church, Pastor Ituah Ighodalo has called for the creation of more awareness, stressing that knowledge, and information were needed to address the fears of every person and then encourage as many as possible to take these vaccine.
Speaking yesterday as a guest on ARISE NEWS Channel, a THISDAY broadcast arm, Ighodalo cited a quotation where the Bible said the "my people are destroyed for lack of knowledge."
The revered cleric, who spoke on the role of the church in the current vaccine drive to address the current pandemic faced around the world, noted that the problem of whether or not to take the vaccines is a problem of knowledge.
"So, I think that the first thing that needs to be done is to compel the church and also the leaders of our nation to educate the masses enough on the issue of vaccines, answering the questions of the people, who are thinking that the vaccine is a deliberate effort to wipe out the human population. We need to prove that this is not so. "Other people think it is the sign of 666 dragons in the Bible. We need to address that and prove that this is not so. Other people think that the vaccine will have a negative effect on people's health; we need to address that and prove scientifically that this is not so."
Ighodalo explained further that the problem right now was that a lot of questions were not being properly addressed, adding that there were so much rumours flying all over the places.
"As for some churches, they believe in divine healing and would not support taking of the vaccines but if they check well, they would also know that God provided knowledge for healing. God said: 'Is there no balm in Gilead; why are my people sick? It means that God knows that from time to time, you need a balm; you need some medicine. So, God himself provides divine knowledge for healing".
He said therefore that there was an urgent need to speak to the fears of people.
"We need to speak emphatically and explain to people what these vaccines are all about so that people can now out boldly and get these vaccines.
Ighodalo who had personally taken the jab, noted further that: "I prayed about it, thought about it, considered it and then one day I woke up and said I am going to take the vaccine. It was a clear direction from God to go and take the vaccine and I have explained to people in the church that God provides knowledge so that we have to deal with knowledge and understand what is going on and end all the rumour mongering and the little gossips here and there."
The cleric further appealed to his fellow pastors to do proper research, get the knowledge and stop misinforming people or improperly educating people on guess work, instinct and position.
"And then let the researcher prove to us what they have done within this one year to ensure that the vaccines they got out there can do what it needs to do and let them also tell us if it can give us 70 or 60 per cent protection, or even 50 per cent protection. Let us understand that and let us know what we are getting", he added.
Ighodalo also debunked the claims by the federal government that churches in Nigeria flouted COVID-19 protocols, insisting that the government should rather focus on educating the vast number of citizens who moved about without masks and sanitizers.
"To speak to the issue of whether the churches are the ones going against COVID-19 protocols, I regret to say that I don't quite agree. I think the government has bigger fish to fry," Ighodalo said.
"If you go to any of the markets, any of the bus-stops, any of the busy places, people don't even wear masks. So, those gatherings of people are much more than the gatherings you have in any church from time to time, and in fairness to most churches they have tried; a few no doubt, have flouted the rules here and there but most of them have tried to keep to the COVID protocols."
"So, the huge churches did their best to observe these things. Therefore, it's not fair to say that it is the churches that are flouting COVID-19 guidelines", he added.

The National Primary Health Care Development Agency (NPHCDA), the focal agency responsible for the deployment of the COVID-19 vaccines, has said that the country will not stop the use of Astrazeneca vaccine.
In a statement by NPHCDA's Head, Public Relations Unit, Mohammad Ohitoto yesterday, the agency said many countries around the world are administering the Oxford/AstraZeneca vaccine, including much of Europe, and United Kingdom which have administered the most doses of AstraZeneca globally.
The statement said: "Nigeria is continuing in the process of administering roughly 4 million doses of the Oxford/AstraZeneca vaccine, beginning with our frontline health workers and vulnerable individuals. There has been no change to current plans or supply."
He said the World Health Organization, (WHO), British and European health regulators all have continued to advocate for the use of AstraZeneca.
"AstraZeneca's strong effectiveness against COVID-19 has been demonstrated in clinical and human trials: it has been shown to be 76% effective at preventing COVID-19 and 100% effective at preventing severe disease and hospitalization.
"Nigeria's health authorities followed closely recent pronouncements from Europe's regulator, the EMA. The head of the EMA stated that, according to scientific knowledge, there is no evidence to support restricting the use of the vaccine in any population," he said.
According to NPHCDA, priority is still given to the health and safety of the Nigerian people.
"Ourr decisions and advice are guided by best practice and scientific evidence. We are confident in AstraZeneca's ability to save lives," he said.

The United States has hit a major milestone in the battle against Covid-19 — more than 100,000,000 Americans have now gotten at least one dose of vaccine, the federal government reported Friday.
And nearly 58 million have been fully vaccinated, according to the latest figures from the Centers for Disease Control and Prevention.
One year after the pandemic hit the U.S., 101.8 million have gotten their first Covid-19 vaccine shot, which is a little over 30 percent of the total U.S. population.
The overwhelming majority of the 157.6 million shots, which is the combined total of first and second doses, that have been administered have gone to people who been hit hardest by the deadly virus — senior citizens ages 65 and over, the CDC figures showed.
The U.S. leads the world with 30.7 million confirmed Covid-19 case and nearly 556,000 deaths, according to the latest NBC News numbers.

As a surge of migrants cross the U.S.-Mexico border, Direct Relief is supporting health facilities providing care to patients on both sides of the southwestern border.
This weekend, Direct Relief staff hand-delivered multiple caches of emergency medical supplies to the San Diego Convention Center, where Rady Children’s Hospital is providing medical services and shelter to unaccompanied minors that have crossed the border.
The hospital was called on by the federal government to provide a safe place to stay for hundreds of underage female migrants who would otherwise be housed in makeshift emergency shelters or border patrol facilities, which the Biden administration has deemed unfit for children.
Sunday’s delivery included supplies to treat trauma-related injuries, over-the-counter medications, and hundreds of individual kits containing soap, shampoo, menstrual products and other hygiene products.
In addition to providing emergency aid, Direct Relief is sending routine shipments of medical aid to community health centers straddling the southwestern border, including San Ysidro Health, La Maestra Community Health Center, and Jewish Family Services, many of whom care for migrant patient populations. Direct has equipped providers with personal protective gear and supported patient-care with chronic disease medications, nutritional supplements, and personal care items.
Direct Relief also supports providers working to treat patients south of the border, including UC San Diego’s International Health Collective–a student-run organization that holds monthly medical clinics in Tijuana. Since 2015, the group has been crossing the border to provide care to hundreds of patients using Direct Relief supplies, including personal protective equipment, chronic disease medications for high cholesterol and hypertension, and prescription drugs to treat severe infections.
Direct Relief staff is in communication with several groups responding at the border and will continue to monitor needs as the situation develops.

The end of the pandemic may be in sight, but we’re not quite there yet: Coronavirus cases in the United States are on the rise again. Over the past week, the U.S. has reported an average of 61,583 new COVID-19 cases a day, which represents a 12% increase from two weeks ago. That’s a long way from January’s peak, when the country averaged 250,400 new cases a day, but it’s trending in the wrong direction.
Scientists attribute the rising numbers to two things: the spread of more communicable coronavirus variants and state and local governments prematurely loosening measures designed to slow the spread of the virus. The variant known as B.1.1.7, now widespread in the United States, is at least 50% more transmissible than earlier variants, and public health officials are now in a race to roll out vaccines before the variants cause a new wave of infections. The existing vaccines protect against all of the coronavirus variants currently widespread in the United States, but may be less effective against B.1.351, a variant identified in South Africa.
Epidemiologist Bill Hanage of the Harvard T.H. School of Public Health told the New York Times the disconnect between scientist’s predictions and the government’s response reminded him of the early days of the pandemic. “People waited for them to be a problem before they took action—and then too late, they took action,” Hanage said. Still, there’s at least one silver lining: compared to previous coronavirus surges, these new cases may result in fewer deaths and hospitalizations, because many of the most vulnerable people have now been vaccinated.

The National Primary Health Care Development Agency has not received any official report of serious adverse effects from the 215,277 people who have received the first doses of the Oxford AstraZeneca vaccines.
The NPHCDA Executive Director, Dr. Faisal Shuaib, disclosed on the agency’s official Twitter handle.
“As you are aware, AstraZeneca/Oxford COVID-19 vaccines have been distributed to all states except Kogi and the first phase of our vaccination focusing on frontline health workers and others on essential duties have begun in earnest,” he said.
He said the 215,277 vaccinated people were from 32 states and the Federal Capital Territory.
Faisal also said no vaccination have been recorded in Kebbi, Zamfara and Oyo States.
“Kogi is yet to receive vaccines because its cold chains for preservation of the vaccines are under repair,” he said.
The agency said the proportion of Nigerians vaccinated is 5.5 per cent.
The Executive Director said Nigeria proposes to vaccinate 70 per cent of eligible population by 2022 to reach herd immunity and exit the pandemic.
The agency stated that five states have the highest number of vaccination, with Lagos getting 58,461, followed by Bauchi with 23,827; Jigawa, 20,800; Ogun, 19,257; and Kaduna, 14,527.
It noted that the state with the lowest vaccination figure were Ebonyi with 77, followed by Sokoto 98 and Akwa Ibom with 127.
The FCT, where the vaccination was launched, has 8,616 people vaccinated.
NAN reports that Nigeria took delivery of nearly four million doses of the Oxford-AstraZeneca COVID-19 vaccine as part of an overall 16 million doses planned to be delivered to the country in batches over the next few months.
The vaccines are being provided by COVAX, an unprecedented global effort to ensure equitable access to COVID-19 vaccines.
COVAX aims to deliver over 1.3 billion vaccine doses to over 90 low- and middle-income countries by the end of the year, covering up to 20 per cent of their populations.
The country also received 300,000 doses of the Oxford-AstraZeneca vaccines from MTN Nigeria.
Upon arrival, all vaccines samples were handed to NAFDAC, the Nigerian food and drug regulatory agency, for further examination.

Some 122,410 people have so far been vaccinated with the Oxford AstraZeneca jabs in Nigeria with available records indicating no serious adverse incidents since the commencement of the exercise on March 5, 2021. 
Meanwhile, the Federal Government has warned against mismanagement and diversion of the vaccines, stressing that decisive action would be taken against any offender. 
It has also struck a partnership with regulatory and anti-corruption agencies to strengthen accountability besides putting in place mechanisms to ensure seamless vaccine rollout across the federation. 
Executive Director of the National Primary Healthcare Development Agency (NPHCDA), Dr Faisal Shuaib, who disclosed this at the briefing of the Presidential Task Force (PTF) on COVID-19 yesterday in Abuja, clarified that no Nigerian had developed any reported severe side effect except some mild symptoms like pain and swelling at the site of the vaccination in addition to body pains and little fever. 
He noted said full vaccination of eligible Nigerians was on in 32 states with only exception of Kogi, Kebbi, Zamfara and Oyo. 
He said: “It is important to note that it is possible for you to take the vaccine and have other diseases that are completely unrelated to the vaccination process. We shall continue to collaborate with the NAFDAC’s Pharmacovigilance team to monitor the administration of the vaccine and document any adverse reaction with COVID-19 vaccine to assure Nigerians that government is honest and transparent in its choice of this vaccine for the purpose of protecting the citizens against COVID-19. 
“Some of the information reaching us from the states is that there are reports of alleged vaccine mismanagement in some vaccination sites like the one reported at the Police Clinic, Falomo in Lagos State. The matter is being investigated and the report will be made public. We anticipate that decisive actions will be taken against anyone found culpable of subverting the vaccination process in the country.” 
Shuaib observed that the PTF was closely monitoring vaccine accountability in all states to check mismanagement. 
The NPHCDA boss stated that the results from the long awaited U.S. trial of the vaccine confirmed that it is both safe and highly effective.
In his remarks, Minister of Health, Dr. Osagie Ehanire, said Nigeria had witnessed reduction in confirmed daily cases, promising sustained testing.
He disclosed that Nigeria recently received additional 300,000 doses donated by MTN.  
Also speaking, the task force’s Chairman and Secretary to Government of the Federation (SGF), Boss Mustapha, stated that that Nigerian scientists had produced at least two local COVID-19 vaccines currently awaiting clinical trials and certification.

Baltimore church closed last week for COVID violations holds Sunday services, defying health department orders

A week ago, health department officials ordered a Baltimore-based megachurch to close its doors over coronavirus-related violations.
Baltimore City Health Department inspectors said parishioners weren’t wearing masks as required and weren’t social distancing to slow the spread of COVID-19.
Since then, however, operations at Greater Grace World Outreach Church in Northeast Baltimore’s Frankford neighborhood have largely carried on as normal. The church welcomed worshippers in person again for its services Sunday morning, while also livestreaming them online, flouting the closure order.
There were baptisms, talk of the Easter play to come, and congregants sharing coffee at the church cafe between services.
On Wednesday, Baltimore police stopped by with health officials, but a service that night carried on to its conclusion. All was quiet Sunday morning, with no police presence.
About a hundred worshippers at a time gathered inside the church for Sunday services, and many did not wear masks. One section of the church was roped off for social distancing and mask-wearing, and about 30 people sat there at a time. Masks are required in all indoor spaces in Baltimore, with few exceptions, such as if individuals are eating or drinking.

The director-general of World Trade Organisation (WTO), Dr Ngozi Okonjo-Iweala said Nigeria's COVID-19 response has been commendable.
This is even as she promised that the world trade body would work to reduce export restrictions among member states, especially with regards to medical supplies in the wake of COVID-19 pandemic.
The WTO boss stated this when she met with members of the Presidential Task Force on Coronavirus (COVID-19) pandemic at the Office of the Secretary to the Government of the Federation, yesterday in Abuja.
The WTO DG, who said she was on a thank you visit to Nigeria and the ECOWAS for the support she received in the run up to her elections into the trade body, stressed that in a pandemic, an economy cannot be advanced until the health sector was taken care of.
According to her: "The main reason we are here is really to see how the WTO can support Nigeria, in improving its economy and part of doing that is the health. We are in a pandemic and of course, you cannot advance the economy until you take care of the health aspects.
So what the Secretary to the Government office is doing along with the presidential Task Force is laudable, and we wanted to just discuss with them, one, what is happening, the arrival of the COVID vaccines, how that is being distributed, the challenges, opportunities on the way of that and what the WTO can do.
"Interestingly, trade is very instrumental in access to medical supplies and equipment, because how do they get from one place to the other? It is through trade. And part of the challenges we've had in this pandemic is the fact that some of our member countries put export restrictions on the movement of medical supplies, equipment, and even supplies to make vaccines.
"So one of the things that WTO can do is to work with members to reduce these export restrictions. If you take vaccines, for instance,
I'll just give you one number from the manufacturer of Pfizer, the Pfizer BioTech vaccine. We had a meeting with the manufacturers a couple of days ago in Geneva and their representative said that it takes 280 components to manufacture their vaccine. And it's in a supply chain that involves 19 countries. So in the supply chains, so many of our products, medical products are global. And so when a country puts export restrictions on one, it means that you slow the production everywhere, that's where the WTO comes in. Because, we have certain rules that members should abide by, with respect to these restrictions. And we play a fundamental role in making sure that medical supplies and equipment and vaccines circulate.

Influenza-associated aspergillosis, or IAA, is uncommon in ICU patients in the United States, with a prevalence of 0.3%, according to an analysis of health insurance claims data.
Researchers said the low frequency of IAA in hospitalized patients might reflect underdiagnosis.
“We had heard from our European colleagues that severe influenza is an emerging risk factor for invasive aspergillosis (IA). IA is a sometimes-fatal mold infection that commonly affects patients who are immunocompromised from conditions like organ or stem cell transplant or cancer, but influenza is not typically considered an immunocompromising condition,” Mitsuru Toda, MS, PhD, an epidemiologist in the CDC’s Mycotic Disease Branch, told Healio.
For example, Toda mentioned a study from 2018 that showed that up to 19% of ICU patients with influenza in Belgium and the Netherlands had evidence of IA, and half of these patients did not have any known immunocompromising conditions.
Toda added, “Only a few cases of IA/influenza coinfection have been reported in the United States, so we wanted to study a large population to try to understand if this phenomenon is emerging in the U.S., too.”
Using data from the IBM MarketScan Commercial Claims and Encounters database, Toda and colleagues assessed the proportion of ICU patients who developed IA after influenza or non-influenza viral respiratory infection between 2013 and 2018.
Among approximately 64 million patients with any health care encounter during that time, around 7 million patients were hospitalized. Of those hospitalized patients, 948 (0.01%) had IA codes recorded. Among the approximate 1.5 million ICU patients included in the study, 341 (0.02%) had IA without influenza or another viral respiratory infection.
Researchers restricted the study to a 3-month window and found that IA occurred in 25 (0.3%) of 7,672 ICU patients with influenza and in 45 (0.3%) of 14,673 ICU patients with non-influenza viral respiratory infection. After restricting the window to 2 weeks, they found that IA occurred in 15 (0.2%) of 7,672 ICU patients with influenza and in 37 (0.3%) of 14,673 ICU patients with non-influenza viral respiratory infection.
Additionally, the median age range — 56 to 59 years — was similar among patients with IAA, non-influenza viral respiratory infection-associated aspergillosis and IA. Chronic obstructive pulmonary disease was the most common (51% to 60%) underlying condition in all three groups.
“Although relatively few patients were identified with influenza and aspergillosis, this number was substantially more than the dozen or so U.S. cases reported in the literature,” Toda said, adding that although researchers did not find many ICU patients with both influenza and aspergillosis, it does not mean that influenza-associated aspergillosis is not a problem in the U.S., given that Aspergillus testing is limited.
“Given other evidence that testing for Aspergillus in U.S. ICU patients with influenza is uncommon, prospective studies are needed to examine how common influenza-associated aspergillosis truly is in the United States,” Toda said.

In Nigeria, it is one thing to approve budgetary allocations for the various ministries, departments and agencies, yet it is another thing for such allocations to be released in full. With the Nigeria Centre for Disease Control allotted an otherwise small amount for the entire 2021 despite the enormous work before it, including the management of COVID-19, Lassa Fever and the looming resurgence of Ebola Virus Disease in nearby African countries, Martins Ifijeh writes that there is need for the proposed allocation to be released in full and as at when due
Last year, not many ministries and agencies of the Nigerian government got up to 50 per cent of their budgetary allocations at the end of the year. For some, the most they got was 30 per cent for the entire year, while some lucky few got up to 60 per cent, which on the surface value means these government bodies were presumed to only meet 30 to 60 per cent capacity of what was expected of them for 2020. In general, indications even showed that only about 54 per cent of the national budget of N10.59 trillion was released for the entire year by the government, which represents just a little below N6 trillion for 2020.
While many may argue that the poor release of funds by the government in 2020 was due to COVID-19 lockdown and the inactivity caused by restrictions and the stay-at-home order of the federal and state governments, indications show that since the return to democracy in 1999, the pattern has been the same; a habit that has affected the nation negatively in no small measure leading to an almost predictable outcome whereby some sectors of government only end up spending their meager released allocation on powering generators and running impresses as against the type of engagements and developments expected of them when the proposed budgetary allocation was made.
For the Nigeria Centre for Disease Control (NCDC), which in recent times has become one of the most important agencies of government considering its role in addressing the present COVID-19 pandemic and securing national health for the over 200 million inhabitants in the country, experts believed it is a no brainer that every budgeted allocation to the agency in 2021 is released as at when due and in full; as this would represent a consolation that despite the allocation not being the ideal budget for a country's centre for disease control, the little allotted funds get to the agency and is utilised as designed.
To be clear, this year, the federal government approved N1.4 billion as the capital budget for NCDC, representing a significant increase from last year's budget of N700 million. But despite the increase, it is believed the amount will be insufficient to run the generators in one of the centre's laboratories let alone running the entire agency for a full year.
Sharing his thoughts on the need for full release of all budgeted allocations for disease prevention and management this year, an epidemiologist and public health analyst, Dr. Rufus Ogbejiele is of the opinion that no matter what the government does this year, it must not starve the organisation in charge of national health security of its allotted funds, stressing that a little strain in funding could spell doom for the nation.
Ogbejiele told THISDAY in an interview that, although it was commendable that the federal government increased the agency's budgetary allocation by almost 100 per cent, the present budget was too small for the agency; hence the need to, at the least, ensures that it is released and utilised to the fullest.
He said: "We live in a country where many governors and their legislative houses are still at a loss to why they should fund disease prevention and control. They don't see the need to fund a project that appears abstract. It is not a road or bridge project, so they still find it difficult to invest in what they presume isn't an infrastructural development they can point to as an achievement when they leave office. This is one reason the federal government must ensure the little it has budgeted is released and as at when due, because only few states like Lagos, Kaduna, Edo, Rivers, among others would cushion federal government's efforts in preventing and managing disease outbreaks.
"You can see what is happening in Kogi State where the governor has continued to play down on the presence of COVID-19 in his state. Such a governor will not fund COVID-19 prevention and management because he does not believe the disease exists. There are many other governors like him, but for fear of being criticised they have refused to publicly tow the path of Kogi governor, Yahaya Bello. And unfortunately, if anything goes wrong in these states, it will be counted as a minus for NCDC because their mandate cuts across all states. States should support efforts of federal agencies working against the tide to make the country's health secure."
He called on state governments to set aside certain amounts for disease prevention and control, noting that if epidemic hits states, it would in turn affect their economy, as well as smooth running of the states.
Recall that last year, the federal government budgeted a meager N1, 673, 486, 127 for the nation's health security; an amount it magically hoped was enough for epidemic preparedness, detection and response to infectious disease outbreaks and public health emergencies for the entire population, and across the 36 states of the federation, including the Federal Capital Centre (FCT). Save for the emergency funding released by the government and support from various bodies, especially the Coalition Against COVID-19 (CACOVID) for tackling COVID-19, the country would have been overwhelmed when the pandemic hit it.
Per adventure the entire money was released in 2020, it would mean the Nigerian government spent eight naira per person last year, which amounts to 66 kobo per month, an unrealistic amount it magically hoped would have prevented Nigerians from contracting or dying from the myriads of epidemics currently being battled or lurking around the corner.

Sokoto — Sokoto State government has taken delivery of consignments of the Oxford-AstraZeneca COVID-19 vaccines from the Federal Government.
Sixty eight thousand six hundred and sixty doses were delivered to officials of the state government at the Sultan Abubakar III international airport.
Sokoto state commissioner for health and chairman of the COVID-19 taskforce Ali Iname says the state have adequate storage facilities as well as marshalled out plans for sensitization of members of the public on the importance of the the vaccine.
He says on the priority list to be vaccinated are health workers in the front line of fight against COVID-19 as well as other health workers in all the health facilities across the state
According to him political leadership in the state as well as traditional rulers and religious leaders wikl follow on the list of persons to be vaccinated
Reacting to the vaccine, Mohammedden Fall, Chief of Field Office, UNICEF, Sokoto Field Office in charge of Sokoto, Kebbi and Zamfara State said the development was a commendable one.
According to him, making the vaccine available goes to show that the president of Nigeria is comitted to good health for all Nigrians.
He also noted that President Muhammadu Buhari's action of publicly taking the Covid 19 vaccine goes to remove every doubt in the minds of Nigerians.
Meanwhile locals in the state have continue to insist that they will neither take the vaccine nor allow their wards to vaccinated. Their reasons, was simply that Nigeria and especially the north is faces with more serious Covid 19 of insecurity than the conventional ailment.

Coronavirus cases are trending downward across the United States as the country’s vaccine rollout picks up speed. But despite the large drop in new infections since early this year, the U.S. death rate remains at nearly 1,500 people every day. That number still exceeds the summer peak, when patients filled Sun Belt hospitals and outbreaks in states that reopened early drove record numbers of cases, though daily deaths nationwide remained lower than the first surge last spring. The number of new reported cases per day remains nearly as high as the summer record.
At the same time, officials in Texas and Mississippi have lifted mask mandates while other states are ending capacity limits on businesses.
Most experts believe that the worst days of the U.S. coronavirus outbreak are behind us. About 66 million Americans have been at least partially vaccinated, and the rate of doses administered has risen to about 2.3 million per day from around 1.2 million per day in late January and continues to grow.
Combining the numbers of those vaccinated and estimates of those who have already had the virus could mean that about 40 percent of U.S. residents now have some protection from the virus, according to one analysis. And President Biden on Thursday called on states to make vaccines available to all U.S. adults by May 1.
But experts also warn the country is not in the clear yet: Variants of the virus that are more contagious threaten to drive cases upward again, especially if there are fewer measures in place to control transmission. And states where any new surges are starting from a higher point could be at particular risk.
The average number of new cases per day has dropped more than 75 percent since the peak on Jan. 8, but the drop in deaths started a few weeks later and has not been as steep. Reported Covid deaths often lag positive cases by up to several weeks, which could help explain why the death rate nationally still exceeds its summer peak while new cases do not.
“While these trends are starting to head in the right direction, the number of cases, hospitalizations and deaths remain too high and are somber reminders that we must remain vigilant as we work to scale up vaccination efforts,” said Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, in a White House Covid response briefing on Wednesday. “We must continue to use proven prevention measures to slow the spread of Covid-19. They are getting us closer to the end of this pandemic.”
A C.D.C. study from last week offered new evidence that prevention measures work to stop transmission: Mandating masks was associated with a drop in cases and deaths, while an increase in cases and deaths was associated with opening in-person dining. Dr. Walensky called the report a warning against prematurely lifting control measures.

PARIS -- The U.S. economy will accelerate twice as fast as expected this year as the coming passage of President Joe Biden's $1.9 trillion stimulus plan, combined with a rapid vaccine rollout, ignites a powerful recovery from the pandemic and helps lift global growth, the Organization for Economic Cooperation and Development said Tuesday.
But countries that are stumbling in the pace of their vaccination campaigns, especially in Europe, risk falling behind as a failure to beat back the spread of the virus delays a reopening of businesses and prevents people from returning to their normal lives.
In its interim outlook, the economic organization laid out an uncomfortable reality facing governments as vaccine campaigns around the world make uneven progress: Simply pumping money into an economy is not enough for a revival; countries will need to offer both economic stimulus and an effective vaccine rollout.
"Stimulus without vaccinations won't be as effective because consumers won't go out doing normal things," Laurence Boone, the the organization's chief economist, said at a news briefing. "It's the combination of health and fiscal policy that matters."
The organization urged countries to go faster on vaccination campaigns to reopen their economies and said more doses are needed to reach low-income countries -- otherwise, parts of the developing world would remain under prolonged lockdowns or closed to travel, delaying a rebound.
In the United States, the steady supply and distribution of vaccines, together with a reopening of the economy and fiscal stimulus, are expected to "significantly boost the recovery as people are able to return to shop, dine and travel," Boone said.
More than 60 million people in the United States have received at least one dose of a covid-19 vaccine. And Biden's rescue package, which the House is expected to give final congressional approval today, includes direct payments of up to $1,400 to hundreds of millions of Americans and the extension of a $300-per-week supplemental unemployment benefit until September.
Economists have generally expected that the sudden and deep pandemic-induced recession that swept across the globe last year would be followed by an upswing in growth as businesses reopened and people returned to normal lives. But the report released Tuesday adds to a growing body of forecasts suggesting that the United States in particular could experience a post-covid boom.
The organization said the United States, the world's largest economy, would grow 6.5% this year, up sharply from a 3.2% forecast in December. The surge will help generate enough momentum to lift global output to 5.6% -- up 1 percentage point from the December forecast, after a 3.4% contraction in 2020.
China, which contained the virus outbreak more quickly than the United States and other countries, will continue to benefit with growth of 7.8% forecast for this year. The government has poured money into infrastructure projects and extended loans and tax relief to support business and avoid pandemic-related layoffs. India's economy is expected to grow 12.6% after a 7.4% fall in 2020, the organization added.
Still, the duration of a global recovery will depend on the race between vaccines and emerging variants of the virus, the organization added.
In Europe, and Germany and France in particular, a mix of poor public health management and slow vaccination programs is weighing on a recovery, despite billions in government support.
Such spending "won't be fully effective as long as the economy doesn't reopen," Boone said.
The euro-area economy, made up of the 19 countries that use the currency, is expected to grow 3.9% this year, slightly more than forecast in December but slower than the United States. In Britain, which sped a national vaccination rollout late last year, the economy is expected to grow 5.1%, up from a 4.2% forecast.
Even with the improved outlook, the pandemic is widening gaps in economic performance between countries and between sectors, the report said.
The divergent pace risks increasing social inequalities, especially for young people and those working in sectors hard-hit by the pandemic, such as tourism and hospitality. These vulnerable groups face long-term damage to job prospects and living standards.
"Particular attention needs to be paid to supporting young people and the less skilled to avoid a repeat of the long-term damage caused to the job prospects of these vulnerable groups after the financial crisis of 2008," the report said.

President Muhammadu Buhari had his first COVID-19 vaccine shot on Saturday, part of a bid to boost public confidence as Nigeria attempts to inoculate 80 million people this year.
Vaccinating Nigeria’s 200 million people, and those in other developing countries, is seen as key to stemming the spread of the coronavirus, but getting doses across the vast nation, with its pot-holed roads and lawless areas, is a huge challenge.
Not all Nigeria’s states have functioning airports, rail networks are limited, and authorities also have to overcome public distrust around the vaccines.
“As a demonstration of leadership and faith in the safety and efficacy of the vaccines, I have received my first jab and I wish to commend it to all eligible Nigerians to do the same so that we can be protected from the virus,” Buhari said.
“The vaccine offers hope for a safe country free of coronavirus,” the 78-year-old president added after he was vaccinated live on Nigerian television.
On Friday, a doctor became the first person in Nigeria to be vaccinated against the coronavirus.
Nigeria, with 158,042 confirmed cases of COVID-19 and 1,954 deaths, has not been as hard hit as first feared, but aims to vaccinate 40% of its people this year, and another 30% in 2022.
“I urge Nigerians ... not to listen to any conspiracy theories,” Boss Mustapha, who chairs Nigeria’s presidential task force on COVID-19, said at Buhari’s vaccination.
Nigeria took delivery of 3.92 million doses of the Oxford/AstraZeneca vaccine on Tuesday through COVAX and expects 84 million doses via the scheme for poor and middle-income countries this year.
The scheme is co-led by Gavi, the vaccine alliance, and the World Health Organization, with UNICEF an implementing partner.

The United States, India, Australia and Japan are in talks to provide coronavirus vaccines to Asian nations in an effort to battle both COVID-19 and a Chinese push to extend its global influence through vaccine diplomacy.
The discussions come as wealthy nations build stockpiles of the vaccine while low- and middle-income countries struggle to obtain shipments of their own. Secretary of State Antony Blinken spoke with counterparts from the three other nations on Feb. 18, a State Department spokesperson said in an email Thursday.
“We are deeply focused on the issue of expanding global vaccination, manufacturing, and delivery, which will all be critical to end the pandemic. These are issues the United States is regularly discussing with allies and partners to encourage additional action and find areas of collaboration,” the spokesperson said.
The talks were first reported by the Financial Times on Wednesday.
China is shipping millions of doses of vaccines its scientists have developed to nations in Asia, Africa and Latin America, part of a concerted campaign to leverage soft power to win influence around the globe.
A woefully underfunded vaccine distribution plan overseen by the World Health Organization and the vaccine alliance Gavi recently got a boost when President Biden said at the meeting of the Group of Seven leaders last month that the United States will kick in $4 billion, and billions more are included in the $1.9 trillion coronavirus relief package working its way through Congress.
Health experts say wealthy nations that made big vaccine investments early in the pandemic are likely to find themselves with surplus doses that can be shipped to other nations where the need remains substantial. A report last month from the ONE Campaign found that five nations and the European Union are on track to stockpile more than 1.2 billion extra doses beyond those sufficient to cover their population.
The United States alone is headed toward stockpiling 453 million surplus doses, more than the country’s population of about 330 million.
Biden has said the United States will have a sufficient number of doses to vaccinate the entire adult U.S. population by the end of May. When more doses come in, the United States may turn to its own form of vaccine diplomacy to counter China.
“Rich countries can donate the excess vaccines to poorer countries,” said Gyude Moore, a senior fellow at the Center for Global Development and Liberia’s former minister of public works. “They’re going to have way more supplies that they paid for than they can use.”
China has announced it will donate vaccines to 53 countries, a Chinese state-run newspaper reported. Beijing said this week it would donate 50,000 doses to Lebanon, while Uzbekistan’s government signed off on a vaccine developed by Anhui Zhifei Longcom Biopharmaceutical. Chinese-made Sinovac vaccines began going into arms in the Philippines on Monday.

At last, the much-awaited COVID-19 vaccines are now in the country and President Muhammadu Buhari and other top leaders are expected to be vaccinated publicly on Saturday.
But there are still questions regarding the state of the health sector. For instance, on the lips of most Nigerians are: What would Nigeria have done without the free donation of vaccines by the COVAX facility? Nigeria took delivery of COVID-19 vaccines made in India. What does that say of Nigeria’s health sector and capacity to play in global health platforms? If India, which used to be at the same level as Nigeria could put its act together to produce vaccines in a few months, why not Nigeria?
Public health physician/epidemiologist and a member of Lagos State COVID-19 Response Team, Prof. Akin Osibogun, told The Guardian that the cost of research and development to rapidly produce the vaccines in rtcord time has been high. “Pfizer must have received almost a billion dollars in advance orders or research support from United States (US) and European governments,” he said.
Osibogun said without support from the World Health Organisation (WHO), Global Alliance for Vaccine Initiative (GAVI), through the COVAX Initiative, it would have taken longer for developing countries to access the vaccines. He said that India has been able to produce the vaccines under license, which is evidence of its level of technological capability. “By the way, India is a nuclear power, it produces its own trains and cars. The basis for comparison between the two countries is limited,” Osibogun said.On what Nigeria would have done without the free donation of vaccine by COVAX facility, President, National Association of Resident Doctors (NARD), Dr. Okhuaihesuyi Uyilawa, told The Guardian: “It leaves a lot to ponder about our failing health institutions. As we speak, Nigeria does not have a vaccine production centre. What we have in Yaba, Lagos Nigeria is a facility that has been abandoned. We are aware that about N10 billion has been put in to revamp our local production but a lot more money is still needed to meet the world best standard vaccine production facility.
“Should we not have got this vaccine today we will still be hoping to buy from the top vaccine producers.”
On importing vaccines from India, Uyilawa said: “It is true Nigeria in yesteryear’s was a health tourist nation but that was in the past. According to the International Medical Travel Journal (IMTJ) in 2018, Nigeria spent about 200 million US dollars on medical tourism to India alone. Now, let us ponder on this amount and what it has done to the health institution in India; that’s a lot of money. So, India sat down and grew its health sector, so we should copy from them. There is no shame in that; let us sit down, use their template and rejig our health sector. Recall that India currently has one of the world’s largest vaccine production facilities. It is a resolve by the government of India to grow its health industry. COVID 19 has shown us how weak our health institutions are. We call on governments from federal to state, local government to sit up and brainstorm with major policymakers to revamp her health care institutions or face more gory days ahead.”
A consultant pharmacist and medical director, Merit Healthcare, Dr. Lolu Ojo, said: “We probably would have bought the vaccines ourselves, either through direct negotiation with the manufacturers or through the facilitation of international agencies like WHO.
“There has been some unconfirmed report about the Federal Government’s plan to spend over N400 billion on vaccines and vaccination logistics. I know somehow, we will find the resources to get our people vaccinated.”
On importing vaccines from India, Ojo added: “We have said it over and again that Nigeria, as a nation, a resource-rich nation for that matter; has sub-optimised her potentials through lack of visionary leadership.
“India is what it is today because her leaders, over the years, made a plan for it. India is becoming the pharmaceutical headquarters of the world and this is apparent in the supply of Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) drugs and now, COVID-19 vaccines.
“We seem to be contented with our status as a ‘consumption’ nation. Other nations are all over the place in Nigeria to get their share of our large consumer market. The Asians are in the top league in this regard.”
On whether Nigeria could have financed its vaccine needs from the 2021 budget, the pharmacist said: “The total allocation to the Federal Ministry of Health as proposed by the President in the 2021 budget is N547billion, about 7 per cent of the total. Out of this amount, N380.21 billion or 69 per cent is for recurrent expenditure and the balance is for capital projects. I don’t see where COVID-19 vaccines are accommodated in the budget.”
MEANWHILE, India penultimate week made its first shipment of a locally made COVID-19 shot to the WHO-backed equitable vaccine distribution network COVAX.
The World Health Organisation last month paved the way for the Oxford University/AstraZeneca vaccine’s global roll-out by approving emergency use of the product produced by the Serum Institute of India (SII), the world’s biggest vaccine maker, and SK Bioscience of South Korea.
SII will also soon start producing the Novavax vaccine mainly for poor and middle-income countries.
India, the world’s biggest maker of vaccines, has shipped over 17 million vaccine doses to more than two dozen countries - including around six million as gifts to partners such as Bangladesh and Nepal. For its own campaign, New Delhi has so far only ordered 31 million doses.

President Biden said on Tuesday that the U.S. will produce enough vaccines for every adult in the U.S. by the end of May, while making a fresh push to vaccinate school staff over the next month.
"We're now on track to have enough vaccine supply for every adult in America by the end of May," Biden said, crediting his administration's efforts to boost production and moving up the timeline from the end of July, which is what the president was saying just a few weeks ago.
As announced earlier in the day, Biden said his administration is invoking the Defense Production Act to boost production of the Johnson & Johnson vaccine, which received emergency use authorization from the Food and Drug Administration over the weekend.
In an unusual partnership between two pharmaceutical competitors, the administration is helping to ensure that Merck facilities can help Johnson & Johnson boost its production.
Biden also called on states to prioritize teachers and school staff as essential workers in the vaccination schedule, calling for every grade-school employee and child care provider to receive at least one dose of a vaccine by the end of the month.
"As yet another move to help accelerate the safe reopening of schools, let's treat in-person learning like an essential service that it is. And that means getting essential workers who provide that service — educators, school staff, child care workers — get them vaccinated immediately. They're essential workers," the president said.
Biden said that already at least 30 states prioritize educators in the queue for vaccines, but he was "using the full authority of the federal government" to direct all states and the District of Columbia to do the same. Biden said the change will go into effect next week to move pre-K through 12th-grade school staff ahead in line. He also said the federal government would use its program that ships vaccines to local pharmacies to help facilitate doses for educators.
Reopening schools for in-person learning has been among the more prickly debates to emerge within the coronavirus pandemic, and it's something Biden has prioritized. There's broad scientific consensus that young children are far less prone to the more dangerous effects of the coronavirus and are less likely to spread the virus. But young adults like high school and college students, as well as school staff, are at higher risk.
"What a tremendous relief to have a president who is meeting this moment of crisis. Vaccinations are a key ingredient to reopening schools safely, and this is the administration taking the steps to ramp up vaccinations for educators, which is great news for everyone who wants in-school learning," American Federation of Teachers President Randi Weingarten said in a statement.

WASHINGTON, D.C. (AP) — Just five weeks ago, Los Angeles County was conducting more than 350,000 weekly coronavirus tests, including at a massive drive-thru site at Dodger Stadium, as health workers raced to contain the worst COVID-19 hotspot in the U.S.
Now, county officials say testing has nearly collapsed. More than 180 government-supported sites are operating at only a third of their capacity.
“It’s shocking how quickly we’ve gone from moving at 100 miles an hour to about 25,” said Dr. Clemens Hong, who leads the county’s testing operation.
After a year of struggling to boost testing, communities across the country are seeing plummeting demand, shuttering testing sites or even trying to return supplies.
The drop in screening comes at a significant moment in the outbreak: Experts are cautiously optimistic that COVID-19 is receding after killing more than 500,000 people in the U.S. but concerned that emerging variants could prolong the epidemic.
“Everyone is hopeful for rapid, widespread vaccinations, but I don’t think we’re at a point where we can drop our guard just yet,” said Hong. “We just don’t have enough people who are immune to rule out another surge.”
U.S. testing hit a peak on Jan. 15, when the country was averaging more than 2 million tests per day. Since then, the average number of daily tests has fallen more than 28%. The drop mirrors declines across all major virus measures since January, including new cases, hospitalizations and deaths.
Officials say those encouraging trends, together with harsh winter weather, the end of the holiday travel season, pandemic fatigue and a growing focus on vaccinations are sapping interest in testing.
“When you combine all those together you see this decrease,” said Dr. Richard Pescatore of the health department in Delaware, where daily testing has fallen more than 40% since the January peak. “People just aren’t going to go out to testing sites.”
But testing remains important for tracking and containing the outbreak.
L.A. County is opening more testing options near public transportation, schools and offices to make it more convenient. And officials in Santa Clara County are urging residents to “continue getting tested regularly,” highlighting new mobile testing buses and pop-up sites.
President Joe Biden has promised to revamp the nation’s testing system by investing billions more in supplies and government coordination. But with demand falling fast, the country may soon have a glut of unused supplies. The U.S. will be able to conduct nearly 1 billion monthly tests by June, according to projections from researchers at Arizona State University. That’s more than 25 times the country’s current rate of about 40 million tests reported per month.
With more than 150 million new vaccine doses due for delivery by late March, testing is likely to fall further as local governments shift staff and resources to giving shots.
“You have to pick your battles here,” said Dr. Jeffrey Engel of the Council of State and Territorial Epidemiologists. “Everyone would agree that if you have one public health nurse, you’re going to use that person for vaccination, not testing.”
Some experts say the country must double down on testing to avoid flare-ups from coronavirus variants that have taken hold in the U.K., South Africa and other places.
“We need to use testing to continue the downward trend,” said Dr. Jonathan Quick of the Rockefeller Foundation, which has been advising Biden officials. “We need to have it there to catch surges from the variants.”
Last week, Minnesota began urging families to get tested every two weeks through the end of the school year as more students return to the classroom.
“To protect this progress, we need to use all the tools at our disposal,” said Dan Huff, an assistant state health commissioner.
But some of the most vocal testing proponents are less worried about the declines in screening. From a public health viewpoint, testing is effective if it helps to quickly find the infected, trace their contacts and isolate them to stop the spread. In most parts of the U.S., that never happened.
Over the holiday season, many Americans still had to wait days to receive test results, rendering them largely useless. That’s led to testing fatigue and dwindling interest, said Dr. Michael Mina of Harvard University.
“It doesn’t exactly give you a lot of gratifying, immediate feedback,” Mina said. “So people’s willingness or interest in getting tested starts to go down.”
Still, U.S. test manufacturers continue ramping up production, with another 110 million rapid and home-based tests expected to hit the market next month.
Government officials long assumed this growing arsenal of cheap, 15-minute tests would be used to regularly screen millions of students and teachers as in-person classes resume. But recent guidelines from the Centers for Disease Control and Prevention don’t emphasize testing, describing it as an “additional layer” of protection, behind basic measures like masking and social distancing.
Even without strong federal backing, educational leaders say testing programs will be important for marshaling public confidence needed to fully reopen schools, including in the fall when cases are expected to rise again.
“Schools have asked themselves, justifiably, ‘Is the juice worth the squeeze to set up a big testing effort?’” said Mike Magee, CEO of Chiefs for Change, a nonprofit that advises districts in more than 25 states. “Our message to the school systems we work with is: ‘Yes, you need to stand up comprehensive testing because you’re going to need it.’”

Africa's first non-sovereign bond of 2021 shows that prospects for Nigeria's economic growth can pull in investors, Ecobank Nigeria managing director Patrick Akinwuntan tells The Africa Report.
The bank last week priced its $300m London-listed bond maturing in February 2026. The issue was more than three times oversubscribed and drew “significant” international interest, says Akinwuntan.
“The strength and depth of the book demonstrated global investors’ strong appetite for the Ecobank franchise in Nigeria.”
The sale shows that appetite for corporate African debt has survived the Zambia sovereign debt default in November 2020.
Ecobank Nigeria is the largest single-country operation of the Ecobank Group, which operates in 33 African countries.
The Africa Continental Free Trade Agreement (AfCFTA), which came into effect at the start of January, gives Ecobank the opportunity to become a Nigerian leader for pan-Africa and global trade and payments, says Akinwuntan.
Bond bounty
The bond will be used to provide “stable medium-term funding for our pan-Africa and international trade transactions,” he says. “Our issuance shows that successful African corporates can raise funds via the international bond market.”
Many African currencies are weak in comparison to Western currencies, so yields need to much be higher to attract international investors, says Akinwuntan.
The yield of 7.125% represents the lowest ever yield achieved by a Nigerian financial institution for a benchmark bond transaction, he adds.
Ecobank chose London for the bond as its gives “access to a wider spread of international investors,” explains Akinwuntan.
Still, debt markets in Africa are “gradually improving, and we believe the capacity to finance debts of this magnitude is available.”
Oil recovery limits bad loans
Ratings agency Fitch has a B- issuer rating on the Ecobank Nigeria bond, and Akinwuntan says this reflects its expectation that “capitalisation will remain resilient,” over the next 12 to 18 months, with the bank “maintaining adequate buffers over the minimum regulatory requirements”.
Fitch says that around 22% of the bank’s oil and gas exposure was impaired at the end of the third quarter.
Still, the agency says that a gradual recovery in oil prices and economic activity will prevent loan losses from increasing substantially this year.
The agency expects Ecobank Nigeria to remain profitable this year.
Nice surprise
Nigeria’s economy surprised on the upside by exiting recession in the fourth quarter. An increase of GDP of 0.1% for the year was a sharp rebound from the contraction of 3.6% in the third quarter.
Akinwuntan is bullish on the broader prospects for African corporate and sovereign bonds. He sees a series of factors that make African debt attractive:
A rapidly growing population and middle classes;
Opportunities for diversification, industrialisation and added-value processing across sectors and countries;
Untapped natural resources and uncultivated agricultural land;
Likely growth in national and regional supply chains as global corporates seek to diversify their sources to reduce risk.
Ecobank Nigeria is also preparing to launch the Ellevate programme, designed for businesses which are led by or focused on women.
The bank’s commercial arm is allocating 10% of its loan portfolio to women’s businesses. The programme will provide loans with favourable interest rates and reduced collateral requirements, says Akinwuntan.
Bottom line
Strong African corporates can raise funds at competitive rates on international markets during the Covid-19 pandemic.

Yusuff Adebayo Adebisi knows that a vaccine that offers 70% protection against COVID-19 could be a valuable tool against the coronavirus pandemic in Nigeria — especially if that vaccine is cheap and doesn’t have to be stored at extremely cold temperatures. But what if another vaccine — one that is more expensive to buy and to store — was 95% effective?
“Should we send the less-effective vaccine to Africa? Or should we look for a way to strengthen the cold storage?” asks Adebisi, director for research at African Young Leaders for Global Health, a non-profit organization based in Abuja.
These are the kinds of question facing researchers and government leaders worldwide, as they take stock of the emerging selection of coronavirus vaccines and try to decide which will be most useful in putting an end to a pandemic that has already taken nearly 2.5 million lives. It is a decision shaped by limited supplies and hampered by limited data, says Cristina Possas, a public-health researcher at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil. “It is not possible to compare these vaccines at this point,” she says.
In Bangladesh, health economist Shafiun Shimul at the University of Dhaka worries about the risks if governments delay vaccinations for months to build cold-chain infrastructure. “If you want to control infection, you have to rely on something that is contextually doable for you — it’s not only about effectiveness,” he says. “If they wait for perfection, I think it will be a long wait.”
The ‘best’ vaccine
Given the demand for speed amid limited supplies, any effort to rank the vaccines must take into account not only their reported effectiveness, but also supplies, costs, the logistics of deploying them, the durability of the protection they offer and their ability to fend off emerging viral variants. Even so, many people might find it hard to look away from clinical-trial results that suggest an efficacy gap. So far, more than 200 million doses of coronavirus vaccines have been delivered, and data have been rolling in from clinical trials in several countries. The top-line results from those studies suggest a range of protection: from 95% efficacy for a vaccine made by Pfizer of New York City and BioNTech of Mainz, Germany, to about 70% suggested by initial results on a vaccine made by AstraZeneca of Cambridge and the University of Oxford, both in the United Kingdom.
It might be tempting, but it simply isn’t possible to directly compare the effectiveness of vaccines on the basis of those results alone, cautions David Kennedy, who studies the ecology and evolution of infectious diseases at Pennsylvania State University in University Park. Each measure of efficacy comes with a degree of uncertainty, and trials might have differing definitions of important criteria, such as what constitutes a ‘severe’ bout of COVID-19 compared to a ‘moderate’ one.
Added to this are the demographics of each trial: in the case of the Oxford–AstraZeneca vaccine, for example, the developers collected few data about the vaccine’s efficacy in people over 65. This led Germany to authorize the vaccine only for those under 65, even though the European Medicines Agency recommends it for all adults.
And the vaccines were studied at different times in various countries. Each trial can only offer a snapshot of protection against the viral variants that were dominant in that time or place, says Kennedy. “That number relates to a particular point in time,” he says. “How that translates into protection over one to two years is not the same.”
This point is particularly relevant as the world grapples with emerging coronavirus variants, some of which seem to evade aspects of the immune responses stimulated by vaccines. Researchers first spotted one such variant, called 501Y.V2 or B.1.351, in December in South Africa, where it now accounts for the majority of new coronavirus infections.
That variant has since been identified in countries around the world, and the extent to which it might reduce vaccine efficacy remains unclear. Laboratory studies and clinical-trial data suggest that most vaccines will still provide significant protection. But the AstraZeneca vaccine faltered badly: in an analysis1 of about 2,000 people in South Africa, it did not protect against mild or moderate COVID-19 due to the variant. .
Faced with those results, the government of South Africa announced on 7 February that it would place the rollout of the AstraZeneca vaccine on hold, despite the shot being significantly cheaper than Pfizer’s vaccine, and easier to store. AstraZeneca and the University of Oxford have granted permission to generics makers such as the Serum Institute of India in Pune to crank out doses as quickly as possible, and the vaccine had been considered the best hope for Africa, says Joia Mukherjee, chief medical officer of Partners in Health, a charity based in Boston, Massachusetts, that operates in 11 countries. “But if it isn’t effective against the South African variant, we’re going to have to switch tactics,” she says. “To march forward and use it when we know that the variant is spreading through Africa, particularly southern Africa, is malpractice on a global scale.”
However, some regions in Africa could still benefit, says infectious-disease specialist Loice Achieng at the University of Nairobi. The 501Y.V2 variant has not yet become dominant in Kenya, she says, and it’s still possible that the AstraZeneca vaccine could protect against severe COVID-19 caused by it. “I think it’s probably something that shouldn’t be written off,” she says.
Better options
There are hopes that more suitable vaccines will become available to fill some of the gaps. Johnson & Johnson in New Brunswick, New Jersey, for example, is developing a single-shot vaccine that would dramatically simplify vaccine roll-outs. But it completed clinical trials only in late January, and it is not yet clear how quickly or smoothly the company will be able to start producing millions of doses, says Jerome Kim, director-general of the International Vaccine Institute in Seoul.
The world is still waiting for crucial data about the vaccines that are being rolled out now, says Kim. Medicines do not always perform as well in the real world as they do within the strict confines of a clinical trial. Early data from Israel’s massive vaccination campaign suggest that the Pfizer vaccine results are holding up, but it will take months to collect similar data about other vaccines.
Researchers are also starting to test a range of doses, schedules and combinations of vaccines. They still do not know how long vaccine-mediated immunity will last, or how well the various vaccines reduce coronavirus spread — all factors that could shape which is considered the ‘best’. “It’s not just a matter of getting them out as fast as possible,” says Mark Jit, a vaccine epidemiologist at the London School of Hygiene & Tropical Medicine. “It’s making sure that as we get them out, we are putting in place the surveillance studies to see how well the vaccines are doing in different situations.”
Eventually, it might be possible to be more strategic about which vaccines to use in which settings, says Kim. But for now, the data simply aren’t there. “You’re watching these things change in real time,” he says. “In the next month, we could think something quite different.”

The Federal Competition and Consumer Protection Commission (FCCPC) is to collaborate with the National Agency for Food and Drug Administration and Control (NAFDAC) on COVID-19 vaccine information dissemination and education.
The Executive Vice Chairman of FCCPC, Mr Babatunde Irukera, disclosed this while speaking with the News Agency of Nigeria (NAN) in Abuja on Sunday.
He said the commission would also use its platform to address questions around the vaccine indecisions.
“We are opening a collaboration with NAFDAC to address the appropriate channels for COVID vaccination.
“To advise the public about not accepting vaccinations that are not coming from the appropriate and proper government channels and have gone through the normal process to ensure that the vaccinations are safe.
“And we would also be using our platform to support addressing questions around vaccine hesitancy meaning that once it has been determined that the vaccines are safe, we will join in the citizens’ education to let people know the safety of the vaccination,’’ he said.
On protecting consumer rights on the African Continental Free Trade Agreement (AfCFTA) policies, Irukera said the FCCPC would monitor negotiations for effective consumer protection.
“We are looking at our own laws to make sure that any broad regional understanding still doesn’t violate the law that is created to protect our market.’’
He assured consumers that the commission would continue to protect their rights’ in line with the laws.

Severe winter weather this week caused delays in shipments of more than 100,000 doses of the coronavirus vaccine in Virginia and Maryland, and officials are urging residents to check the status of their appointments.
Multiple vaccination events were postponed in Virginia because of the likely delay of about 106,800 doses, and a mass-vaccination site at Six Flags America in Prince George’s County was closed Friday. Those appointments were automatically rescheduled, officials said.
Storms slowed the arrival of vaccines in all 50 states, the White House announced Friday, delaying the distribution of 6 million doses just as vaccination clinics were beginning to hit a groove.
Icy conditions, road closures and power outages stalled the distribution chain, forcing officials to cancel appointments and causing ripple effects that will delay second doses weeks from now.
Maryland officials expected 130,000 first and second doses to arrive Tuesday and Wednesday, but as of Friday afternoon were still checking with providers to determine how many had arrived, said Michael Ricci, spokesman for Gov. Larry Hogan (R).
Six Flags appointments set for Friday were rescheduled for March 3 at the same time of day; second-dose appointments will be March 24, according to the governor’s office. Patients do not need to take action to keep their previously scheduled appointments.
In Virginia, multiple vaccination clinics set for the next few days were postponed, and providers will contact patients with information about when and where appointments will be rescheduled, the Virginia Department of Health said in a statement Thursday.
Vaccine and supplies needed to administer the doses produced were delayed, the statement said.

West African film-streaming service IrokoTV will seek to list on London’s Alternative Investment Market within the next 12 months, CEO Jason Njoku tells The Africa Report.
The sale would aim to raise between $20m and $30m, and would value the whole business at between $80m and $100m, Njoku says from his base in Accra. Discussions with brokers will start in the coming weeks, says Njoku, who holds a stake of 18% in the debt-free company.
Iroko has the world’s largest online catalogue of Nollywood films. Njoku has redefined the company’s strategy to target diasporic markets in Europe and North America, rather than growth in its main West Africa markets of Nigeria, Ghana and C?te d’Ivoire.
He points to the weakness of the region’s currencies and reduced levels of disposable income as a result of Covid-19 as factors that prompted the shift.
“Consumer confidence has essentially collapsed,” he says. “The macro has dominated us in Africa.”
The company closed its offices in New York and London, and cut jobs last year to reduce costs.
When Iroko started in Africa in 2015, an annual subscription fee of N3,000 was worth $18, he says. That has since declined to $7.5 at the official naira exchange rate and $6.4 on the parallel market. Iroko responded to the economic crisis in December by raising prices by 3.5 times in Nigeria and Ghana.
It means the company is targeting a smaller, more affluent market. Njoku says Iroko can afford to lose 70% of customers in Nigeria and Ghana at the new price.
Prices for diasporic customers, meanwhile, were increased to $60 per year from $25. The increase was pushed through without any impact on international customer numbers, says Njoku. That reflects the lack of streaming service alternatives for the West African diaspora, he says.
The number of international subscribers increased last year without the company concentrating on targeting them or spending any money, he says. The company has even been attracting Caribbean subscribers in New York.
“An international subscriber base is much more sustainable,” says Njoku. The number of international users and average revenue per user are both set to increase in 2021, he adds.
Currency woes
It’s a major turnaround for Njoku, who in May 2020 wrote that Iroko’s strategy “seemed pretty simple and logical. The belief went that our exit value was directly proportional to our ability to demonstrate to potential investors or acquirers the size, scale and fantastic unit economics of the African entertainment opportunity.”
Successive naira devaluations and the risk of more to come have prompted the shift. The IMF this week said the naira is 18% overvalued and that further devaluation is needed – advice rejected by the Nigerian government.
A weaker currency, Njoku says, pushes costs up while reducing revenue. The best solution, he says, would be to “set the naira free”. That would lead to a weaker currency in the short term, but the lack of forward visibility on the naira is even more critical than its level, he says.
The current system of multiple exchange rates makes it impossible for businesses to plan beyond three to six months, he says.
“Let the market decide, and then people can decide how to make it work.”
Bottom line
Iroko’s strategic shift gives it a much better chance of achieving a stock market listing.

Nigeria’s Centre for Disease Control (NCDC) says it has closed an unnamed test centre in the capital, Abuja, that was issuing fake COVID-19 certificates to travellers.
Chikwe Ihekweazu, the director-general of the NCDC, said they had found evidence that the lab was collecting samples and money from unsuspecting travellers, but failing to test them.
Instead, they issued certificates claiming they had tested negative for the virus, enabling them to travel.
Mr Ihekweazu added during the organisation’s weekly briefing on Monday that a full list of accredited labs was available on the NCDC’s website and encouraged members of the public to only get tested at those centres.
He said that they were working on a platform where every lab in Nigeria could publish their test results which could then be easily verified by airlines or other countries wishing to check whether a result was genuine.
He did not specify when this platform would be ready.
The authorities in Nigeria recently suspended flights from the Emirates airline because the carrier wanted passengers from Nigeria to take a rapid Covid-19 test four hours before flying, in addition to the standard polymerase chain reaction (PCR) test.
Setting up a fake COVID-19 testing center is a very unethical behavior and must be severely cracked down.

Nigeria’s Kaduna state has signed a deal with Zipline that will allow drone shipment of Covid-19 vaccines without significant state investment in cold-chain storage, the company stated, as per Reuters report.
Kaduna’s partnership with Zipline, which delivered more than 1 million doses of other vaccines in Africa over the past year, will also enable on-demand delivery of blood products, medications and other vaccines.
Zipline said its end-to-end cold chain distribution capability, which can safely deliver even the Pfizer vaccine, would allow Kaduna health facilities to bypass purchases of ultra-low freezers and enable on-demand deliveries of precise amounts of Covid-19 vaccines.
The company said it is working with a “major Covid-19 vaccine manufacturer” to enable access to Covid-19 vaccine deliveries in all the markets where it operates. It currently offers drone delivery of blood, vaccines and other medical equipment in Ghana, Rwanda, and the United States.
Zipline is also in talks with other states in Nigeria.
Kaduna services are slated to begin in the second quarter from three distribution centres with 30 drones each.

Although school feeding programmes are a lifeline for millions of boys and girls, nearly 40 billion in-school meals have been missed during the COVID-19 pandemic, according to a report published on Thursday by the UN Children’s Fund (UNICEF) Office of Research: Inocenti, and the World Food Programme (WFP).
The study found 370 million children worldwide, many of whom rely on school meals as a key source of their daily nutrition, have missed 40 per cent of in-school meals, on average, since the crisis began.
The authors warned this looming nutrition crisis could put a whole generation at risk.
Reliable nutrition
“Despite clear evidence that schools are not primary drivers of COVID-19 infections, millions of children are facing school closures around the world”, said Henrietta Fore, UNICEF Executive Director.
“Children who depend on schools for their daily meals are not only losing out on an education but also on a reliable source of nutrition. As we respond to the COVID-19 pandemic and await vaccine distribution, we must prioritize the reopening of schools and take action to make them as safe as possible, including through renewed investments in proven infection prevention measures like clean water and soap in every school around the world.”
Some 24 million children are at risk of dropping out of school due to the pandemic, the report said, which would reverse global progress made on school enrollment.
School feeding programmes can provide incentives for the most vulnerable students to return to the classroom, especially girls and those from the poorest and most marginalized communities.
Jeopardizing the future
“Missing out on nutritious school meals is jeopardizing the futures of millions of the world’s poorest children. We risk losing a whole generation”, said David Beasley, the WFP Executive Director.
“We must support governments to safely reopen schools and start feeding these children again. For many, the nutritious meal they get in school is the only food they will receive all day.”
WFP has been supporting governments to adapt their school meals programmes with more than 70 countries delivering take-home rations, cash transfers or food vouchers during school closures.
Additionally, more than 13 million children received WFP school-based support during the first nine months of 2020, compared to 17.3 million the previous year.

Countries are tightening borders to evade virus variants. A hospital refrigerator malfunction in Seattle led to a frenzied overnight inoculation drive.
The Centers for Disease Control and Prevention has issued an order requiring travelers in the United States to wear masks as part of a new initiative aimed at stemming outbreaks of the coronavirus.
According to the 11-page order issued on Friday, travelers entering and transiting throughout the country will be required to wear face coverings in all transportation hubs, which the C.D.C. defines as including any “airport, bus terminal, marina, seaport or other port, subway station, terminal, train station, U.S. port of entry or any other location that provides transportation.”
The language of the order largely puts the onus on transit operators to enforce the rule.
“Conveyance operators must use best efforts to ensure that any person on the conveyance wears a mask when boarding, disembarking and for the duration of travel,” the document said.
The new mandate, which comes as the country surpassed 26 million cases, is part of a string of executive orders and directives that President Biden signed on Thursday that aimed to ramp up the new administration’s ambitious goals of containing the latest surge and accelerating vaccine distribution.
A similar order was proposed during the Trump administration, but the White House Coronavirus Task Force, led by Vice President Mike Pence, blocked the effort.
“Requiring masks on our transportation systems will protect Americans and provide confidence that we can once again travel safely even during this pandemic,” read the order, signed by Dr. Martin Cetron, director of the C.D.C.’s Division of Global Migration and Quarantine. “Therefore, requiring masks will help us control this pandemic and aid in re-opening America’s economy.”
A footnote in the order states that the C.D.C. reserves the right to enforce the order “through criminal penalties.” But a spokesman for the agency said that the order relied heavily on voluntary action to enforce the mandate.
“C.D.C. strongly encourages and anticipates widespread voluntary compliance as well as support from other federal agencies in enforcing this order, to the extent permitted by law,” he said. “C.D.C. will be assisted with implementation by other federal partners, including D.H.S. and D.O.T.,” referring to the Department of Homeland Security and the Department of Transportation.
The establishment of a national mask mandate for travelers was hailed by public health officials as a necessary step to fix the patchwork of local regulations that at times have let travelers move freely without facial coverings, in spite of ample data showing that mask wearing is key to preventing the spread of the virus.
“You needed this kind of coordinated response for quite some time,” said Dr. Melissa J. Perry, a professor of environmental and occupational health at George Washington University. “So, uniform, across the board, everyone, everywhere, being required to wear masks will get us more soon to the end of the pandemic.”