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Rapid responses to health questions for fact-checkers and journalists.
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Rapid responses to health questions for fact-checkers and journalists.
The prioritization of initial COVID-19 vaccinations varies widely from location to location, with decisions being made at the federal, state, county and facility level. Emergency medical services (EMS) personnel are often included among the groups receiving the highest priority for the first shipments of the COVID-19 vaccine. Since the initial supply is not sufficient to vaccinate everyone within the highest priority groups, however, difficult decisions are being made about who is to receive the COVID-19 vaccines first. Some places are choosing to include EMS personnel outside of hospitals, such as in the fire department, in the first wave of COVID-19 vaccinations. Other places are distributing their first shipments of the COVID-19 vaccine straight to hospitals first. Decision-makers for each location can set priorities by taking into account public health guidance as well as data about their specific context regarding what resources are available and what are the most urgent needs. Several public health frameworks exist and have informed decision-makers, including the U.S. Centers for Disease Control and Prevention (CDC), as they set their vaccination priorities for COVID-19. In John Hopkins University’s framework for COVID-19 vaccine priority groups, Tier 1 includes front-line EMS personnel and Tier 2 includes other essential workers such as personnel in fire and police departments. In the National Academies of Medicine preliminary framework for equitable allocation of the COVID-19 vaccine, Phase 1a’s earliest “jumpstart phase” includes first responders like EMS, police and fire personnel. Depending on which public health frameworks are used, there can be differences in the recommendations for when to include EMS personnel outside of a hospital, such as in a fire department. Additionally, the U.S. CDC previously made suggestions for sub-categorization of Tier 1 vaccine distribution when there is an “extremely short supply” during a pandemic of other diseases, such as influenza. The proposed ranking of groups within Tier 1 in this situation is: 1. Front-line inpatient and hospital-based health care personnel caring for sickest persons; health care personnel with highest risk of exposure 2. Deployed and mission critical personnel who play essential role in national security 3. Front-line EMS 4. Front-line outpatient health care personnel, pharmacists and pharmacy technicians, and public health personnel who provide immunizations and outpatient care 5. Front-line law enforcement and fire services personnel 6. Pregnant women and infants aged 6 -11 months old 7. Remaining groups within Tier 1, including but not limited to: inpatient and outpatient healthcare personnel not vaccinated previously; public health personnel; other EMS, law enforcement, and fire services personnel; manufacturers of pandemic vaccine and antiviral drugs While this guidance can be a point of reference for some locations seeking to decide how to allocate vaccinations to EMS personnel outside of hospital settings (who in this case might be categorized in group 3 or 7, depending on their involvement in front-line care), there are some notable differences that should be taken into account for COVID-19, compared to influenza. For example, COVID-19 has been especially deadly for older adults in long-term care settings, which is why long-term care residents and personnel are among the top tier priorities for COVID-19 vaccinations according to U.S. federal recommendations. While the specific prioritization of EMS personnel outside of hospital settings may vary depending on the location, it is important for decision-makers to have a plan for how to vaccinate non-hospital-based EMS personnel and communicate this plan with transparency.
A recent surge of coronavirus cases in London and surrounding areas of Southeast England is thought to be linked to a new, fast-spreading variant of the COVID-19 virus. The new variant was detected in samples taken in late September in the Southeast English county of Kent, and now accounts for approximately 60% of COVID-19 cases in London. Aptly named “Variant Under Investigation,” or VUI-202012/01 for short, there are insufficient data and too many unknowns at this time to draw any conclusions about the new variant, according to the UK government’s New and Emerging Respiratory Threat Advisory Group (NERVTAG) and Science Magazine. Until scientists and public health officials run rigorous laboratory experiments and checks, they cannot provide definitive answers about the new variant. They stress the importance of care providers, public health practitioners, researchers, and policymakers keeping a vigilant eye on the new strain to learn more about its behavior and potential impacts on disease burden and spread. Importantly, media channels report that there is no indication that the Pfizer-BioNTech and Moderna coronavirus vaccines will be less effective in protecting people from contracting this mutation of the virus. Additionally, there is no definitive evidence to suggest that the new variant is more deadly or linked to more severe illness. All viruses mutate and in the case of COVID-19, researchers have observed thousands of tiny modifications of since March 2020. However, the new variant of COVID-19 raises alarm for three primary reasons: 1 ) Early evidence indicates with “moderate confidence” that the new variant is significantly more transmissible than previous versions. One study from Imperial College London suggests that it is up to 70% more transmissible. Another way scientists measure virus transmission at a population level is by looking at the virus’ R0, or “R naught”, which describes the number of people one person can infect. A higher R naught is an indicator of pandemic growth, though actual growth depends on public health actions taken by the public. In recent weeks, the R naught in the region with the mutation is thought to have increased by 0.4 with the emergence of the new variant. From early laboratory experiments, scientists studying the new coronavirus variant have identified up to 23 changes to its genetic makeup, according to multiple sources. It is unprecedented to see the coronavirus seemingly acquire more than a dozen mutations at once, according to Science Magazine. One of these mutations demonstrated improved ability to infect human cells. This change is linked to the rapidly growing number of infections in Southeast England that, unabated, may only continue to rise. 2 ) Many of the mutations altered an important part of the virus called the spike protein, a crown-like structure encasing the viral genetic material and giving the virus its name. One such change alters a key piece of the spike protein, known as the “receptor-binding domain,” that binds to and unlocks the entryway into human cells. The new variant’s uncanny skill at entering and infecting cells likely gives it a leg up over other strains. This novel behavior may in part explain why the new variant has been detected in the majority of new cases in London, ousting other strains that may be less skilled in this mechanism. 3 ) The fact that the new variant has begun to rapidly replace other versions of COVID-19 as seen across testing centers in parts of England puts scientists on high alert. Virus mutations have the potential to introduce new and possibly aggressive behaviors, as well as increased transmission. For this reason, it is critical that scientists keep a close watch. These early research findings together suggest that the new variant is highly contagious, more so than previous strains. Its rapid dominance remains particularly concerning especially as it may take months to accurately capture how the new variant will take hold. However, it’s also important to not panic before we have more data and a more complete picture of this variant and its implications.
There has been research suggesting that SARS-CoV-2, the virus that causes the disease COVID-19, does not survive long on copper surfaces. However, this does not mean that copper products are always effective in protecting against COVID-19. In fact, many copper-based products currently on the market do not contain a sufficient concentration of copper for significant antimicrobial effects. One study that is commonly used as evidence on the effectiveness of copper is an April 2020 publication in the New England Journal of Medicine, which found that “no viable SARS-CoV-2 was measured after 4 hours” on copper surfaces. It is important to remember that this study in a controlled laboratory setting does not mean all commercial products with copper are able to protect against COVID-19 in real life. Products containing copper can vary widely and many products have not been designed, manufactured, and tested properly to ensure effectiveness. Furthermore, copper does not act instantaneously against microbes such as viruses, with research findings showing that copper can take 45 minutes just to reduce the amount of virus on a surface by half. Dr. Lindsay Marr, an aerosol scientist from Virginia Polytechnic Institute and State University (Virginia Tech), suggested in a New York Times article that copper-based face coverings could potentially “come in handy for people who mishandle their mask,” assuming that “a hefty dose of copper could diminish the chances of viable virus making it into the eyes, nose or mouth via a wayward hand that’s touched the front of a mask.” Unfortunately, if a copper face covering does not contain sufficient copper, the product “won’t confer any more benefit than just regular masks” according to Dr. Karrera Djoko, a biochemist and microbiologist from Durham University. Additionally, Dr. Djoko also warns that there could be issues with durability of copper products, particularly for face masks that may be repeatedly disinfected, because many common household cleaners have compounds that can strip copper ions from a surface. There can be some promising uses of copper to protect against COVID-19, such as using copper surfaces in healthcare settings to help reduce risk of hospital-acquired infections. That said, health experts warn against relying on commercially sold products with copper, such as copper face coverings, which are not carefully regulated and have not been rigorously tested for effectiveness.
Despite ongoing claims that masks do not work, research shows that masks do work to help prevent transmission of respiratory diseases like COVID-19 and influenza (flu). A recent lab study conducted by the U.S. Centers for Disease Control and Prevention found that by wearing two masks, people's protection against virus in the air (also called aerosolized particles) was dramatically increased. The study demonstrated that wearing any kind of mask provides significantly more protection against infectious aerosols than not wearing a mask. Additionally, when dummies who wore two masks - like cloth face masks over surgical masks - were exposed to infectious aerosols, their level of protection was roughly 92%. (The group now recommends fitting a cloth mask over a medical procedure mask, and knotting the ear loops of a medical procedure mask and then tucking in and flattening the extra material close to the face. However, the U.S. CDC does not recommend wearing two disposable masks at one time or another mask on top of a KN95 or N95 mask.) Research before the COVID-19 pandemic had already shown the effectiveness of masks in healthcare settings, in homes of infected people, as well as in public settings during previous outbreaks of diseases like severe acute respiratory syndrome (SARS). Research during the COVID-19 pandemic has provided more evidence that masks are effective for reducing community transmission and saving lives. Many governments that responded effectively to the COVID-19 pandemic and lost fewer lives as a result, such as Taiwan, have used policies that include wearing masks in public settings. Beyond health research on the benefits of wearing masks for reducing transmission and saving lives, economic research has also shown links between wearing masks and improved long-term business/economic outcomes. For example, research by Goldman Sachs suggests that adopting a national mask mandate requiring the public to wear masks in the U.S. could potentially reduce the need for renewed lockdowns that "would otherwise subtract nearly 5% from GDP (Gross Domestic Product)." As there are many different types of masks in the market, it is important to remember that masks can differ in effectiveness. For example, now that healthcare workers have a better supply of personal protective equipment (PPE) such as medical-grade N95 respirators and surgical masks, some public health professionals are now calling for the general public to also wear more effective medical-grade masks. Previous recommendations focused on fabric face coverings for the general public, in order to ensure supply of medical-grade masks for healthcare workers. Now that the supply chain has improved in response to the COVID-19 pandemic, community transmission may be reduced further by encouraging the public to switch to more effective medical-grade masks when possible. Some European countries have moved to require medical-grade masks in public settings. Similarly, some public health professionals suggest that the public can increase the effectiveness of fabric face coverings by wearing multiple layers to filter out more respiratory particles. Dr. Anthony Fauci, a leading doctor and scientist for the U.S. COVID-19 response, has encouraged doubling up masks to increase the protection offered by porous fabric face coverings. In summary, masks do work and this is supported by research, although different types of masks vary in their effectiveness and masks alone are insufficient to respond to the COVID-19 pandemic (other public health measures, like maintaining physical distance and hygiene, are also needed). Experts suggest now focusing on how to make wearing masks in public even more effective.
Like other vaccines, COVID-19 vaccines contain an active ingredient that aims to teach the body how to recognize the virus, so that the defend itself when exposed. There are multiple ingredients in vaccines in addition to the active ingredient. The Pfizer-BioNTech and Moderna COVID-19 vaccines both use mRNA as the active ingredient and also contain ingredients like potassium chloride, monobasic potassium, phosphate, sodium chloride, dibasic sodium phosphate, and sucrose. Potassium, chloride, and phosphate are minerals that are commonly found in foods and medications. Sodium chloride is another name for salt, and sucrose is a type of sugar. All of these ingredients are commonly used in vaccines to deliver the medication as a liquid solution, and to maintain stability and pH levels. Unlike other vaccines, mRNA vaccines use very small fats (lipid nanoparticles) to deliver the mRNA into your body. Once in the body, these fats protect the mRNA, so that the mRNA can make it to cells, where it helps the body develop immunity. Once the mRNA is delivered to the cells, the lipids dissolve and are removed from the body. One part of the lipid nanoparticle is something called polyethylene glycol (PEG), an ingredient used in many toothpastes, shampoos, and other products as a thickener, moisture carrier, and solvent. PEG is also used in medications, including as laxatives, and in biopharmaceutical products. PEG has occasionally resulted in severe allergic reactions in some people. PEG has not been used in an approved vaccine before. Some scientists have suggested that PEG could be the reason for the allergy-like reactions that a small number of people have had following COVID-19 vaccination. However, this speculation has not been confirmed, and there remains considerable debate about whether or not PEG may have caused these reactions. The US National Institute of Allergy and Infectious Diseases is currently working with the US Food and Drug Administration to study how people respond to the mRNA vaccines when they have a history of allergic reactions or have high levels of antibodies against PEG. Severe reactions to vaccines can happen, but reactions to the mRNA COVID-19 vaccines have been rare (as of February 2021). In general, vaccination is both recommended and safe for most people.
As of February 19, 2021, the World Health Organization (WHO) has approved the Pfizer/BioNTech COVID-19 vaccine (December 31, 2020) and two versions of the AstraZeneca/Oxford COVID-19 vaccine (February 15, 2021) under its Emergency Use Listing (EUL). The Sinopharm inactivated virus COVID-19 vaccine is being developed and produced in conjunction with the China National Biotec Group and the Beijing Institute of Biological Products. The vaccine is in phase three trials in Argentina, Jordan, Egypt, Bahrain, and United Arab Emirates. Sinopharm is pursuing emergency approval and, according to WHO records dated January 20, 2021, Sinopharm submitted study data and safety, efficacy, and quality information to the WHO in December 2020. The assessment is ongoing and a decision could be made as early as March. Another Sinopharm COVID-19 vaccine is being tested in conjunction with the China National Biotec Group and the Wuhan Institute of Biological Products. This vaccine is currently in phase three trials in Jordan, Egypt, Bahrain, Morocco, Peru, and United Arab Emirates. According to WHO documentation dated January 20, 2021, there has not been a pre-submission meeting or further pursuit of emergency approval for this vaccine.
The Oxford-AstraZeneca COVID-19 vaccine (AZD1222) does not contain human cells or tissues. The AZD122 (ChAdOx1 nCov-19) is a weakened version of an adenovirus—a harmless virus that usually causes the common cold in chimpanzees— and is used as a way to transport the vaccine's ingredients into the human body. This type of vaccine is called a "vector vaccine," because the adenovirus serves as the vector (or vehicle) for getting the drug into human cells. The adenovirus can stimulate a response from a person's immune system when their body detects it in cells. Essentially, the vaccine helps train human bodies to detect and eliminate a real COVID-19 infection through showing it mock spike proteins, before COVID-19 can cause any severe symptoms or a severe infection. During preclinical research, MRC-5 cells were used to determine how effective the vaccine may be in human clinical trials, but the MRC-5 cells are not used in the manufacturing process for this vaccine. There are different processes used to make vaccines. Often, when vaccines are being made, viruses are propagated (grown in the lab) in special laboratory cells, and the viruses are then collected to make the vaccine. To make this COVID-19 vaccine, the virus is propagated using another type of cells, the HEK 293 cell line. However, there is no evidence that these cells are present in the vaccine itself. The cells are removed through a filtering and purification process that breaks down the cellular pieces and remaining DNA before a vaccine is deployed to humans. The HEK 293 cells and MRC-5 cells (mentioned above), as well as many other research cell lines, were collected from fetal tissue in the 1960s and 1970s. Since then, labs have reproduced those cell lines for some medical purposes, including research and vaccine development. These cells are not part of the vaccine. It is also important to distinguish between fetal cells and cultured (lab grown) cells. Fetal cells are not used in vaccine production.
The Pfizer vaccine is being developed and produced by Pfizer, Inc. and the biotech company BioNTech SE. It is a genetic mRNA vaccine (mRNA-1273) currently in Phase 3 clinical trials across the globe. Here is a breakdown of everything you need to know so far about this vaccine’s development. \*\*Collaborators: \*\*Biopharmaceutical company Pfizer Inc, based in New York City, and BioNTech, biotechnology company based in Mainz, Germany, are collaborating on vaccine development and testing for the mRNA-based vaccine candidate BNT162b2. \*\*Latest information on how well the vaccine works:\*\* On November 30, 2020 with primary efficacy analysis data from its Phase 3 trial, Pfizer announced its experimental COVID-19 vaccine to be 95% effective 28 days after the first of two doses. Out of approximately 44,000 total study participants, 170 contracted COVID-19. 162 who got infected were from the placebo group—meaning they didn’t receive the vaccine—and only 8 who got infected were in the group that was vaccinated with the Pfizer vaccine. Ten of the COVID-19 cases were severe. Nine of those people were from the placebo group. One severe case was in the vaccinated group. This suggests the vaccine has high protection for severe COVID-19 cases, at 95% efficacy, meaning that if 100 study participants were the vaccine doses, 95 patients would not contract the disease and 5 would. There have been no reported COVID-19-related deaths in the study. These new results of 95% efficacy are higher than the vaccine’s first interim analysis conducted during the study (announced on November 9th, 2020), which reported 90% efficacy based on an analysis of 94 COVID-19 cases among trial participants. Based on a study published in February 2021 in the New England Journal of Medicine, the Pfizer-BioNTech vaccine was found to appear to be highly effective against the more transmissible variant of the virus first detected in the U.K. (B.1.1.7) (virtually no drop from 95% efficacy). However, the vaccine showed a decreased ability to neutralize the strain first detected in South Africa (B.1.351). Specifically, they found that there was about a two-thirds drop in neutralization power (antibody power) against this variant compared to other forms of the SARS-CoV-2 coronavirus. It’s important to note that the vaccine was still able to neutralize the virus, and likely still may protect individuals from getting severe forms of the virus. In addition, these are initial lab experiments that are difficult to extrapolate results from. Pfizer has said that evidence is needed to understand how the vaccine works against the variant in real life. The company stated, "Nevertheless, Pfizer and BioNTech are taking the necessary steps, making the right investments, and engaging in the appropriate conversations with regulators to be in a position to develop and seek authorization for an updated mRNA vaccine or booster once a strain that significantly reduces the protection from the vaccine is identified.” \*\*Approvals:\*\* As of December 2, 2020, the U.K. authorized the distribution of Pfizer and BioNTech’s COVID-19 mRNA vaccine BNT162b2 for emergency supply, making the vaccine the first in the world to achieve authorization for COVID-19. Two days following the U.K.’s authorization, Bahrain approved the emergency use of the Pfizer and BioNTech vaccine, making it the second country in the world to do so. Five days following on December 9, Canada’s regulatory agency Health Canada approved the vaccine. On Friday, December 11, 2020, the U.S. Food and Drug Administration (FDA) authorized the Pfizer and BioNTech vaccine. Soon after, Pfizer and BioNTech bega rolling review processes with other global regulatory bodies, including in the U.S., Europe, Australia and Japan, and has been submitting applications to other regulatory agencies around the world, primarily in the Global North, with a range of approvals. \*\*Distribution timeline:\*\* Following the U.K.’s emergency approval on December 2, 2020, the companies began delivering the first doses to the U.K. nearly immediately, starting on December 8, 2020. Canada is set to receive 249,000 doses before the end of December to distribute across 14 different vaccination sites throughout Canadian cities. Following the U.S. approval of the vaccine on December 11, 2020, the U.S. will initially distribute approximately 2.9 million doses to all 50 states. The distribution timeline for other countries undergoing the approval process will depend on the distribution decisions made by regulators there. Some countries are already coordinating pre-approval distribution and in many of these regions and countries, logistics surrounding the supply chain of the vaccine are being decided upon and run through so that when there is an approval, distribution can begin immediately. \*\*Distribution plan:\*\* In projections, Pfizer hopes to produce and supply up to 25 million vaccine doses in 2020 and 100 million doses before the start of March, with an estimated total distribution of up to 1.3 billion doses in 2021. Four of Pfizer’s facilities are part of the manufacturing and supply chain; St. Louis, MO; Andover, MA; and Kalamazoo, MI in the U.S.; and Puurs in Belgium. BioNTech’s German sites will also be leveraged for global supply. Each of these sites are important links in a global supply chain being assembled to tackle the massive logistical challenge of distributing COVID-19 vaccines around the world. Jurisdictions primarily have the responsibility of determining who receives the vaccine in what order. For instance, within the U.S. each state will receive a certain number of doses of the vaccine based on residential populations. States have been asked to create their own plans for who will get the first doses. In the U.K., British front-line health-care workers, as well as care-home staff and residents, are receiving the first doses. Bahrain has said that they plan to inoculate everyone 18 years and older at 27 different medical facilities, hoping to be able to vaccinate 10,000 people a day; so far, they have the second-highest vaccination rate in the world behind Israel. In general, the most likely distribution plan is for the vaccine to first go to emergency department clinicians, outpatient clinicians, testers at symptomatic sites, other high-risk health care workers, immunocompromised individuals, EMTs, and potentially essential federal employees, followed by the rest of the general population. Vaccination distribution in some countries is moving more slowly than anticipated. In the U.S, for example, just 2.6 million individuals were vaccinated by December 31, 2020 compared to the 20 million goal by the end of 2020. In response, scientists and public health practitioners are considering vaccination tactics that differ from those that the FDA and other country’s health regulatory bodies approved. The tactics being considered are primarily halving doses of vaccines and delaying second doses to get first doses to more individuals, but also include reducing the number of doses and mixing and matching doses. Health officials in the UK have already decided to delay second doses of two vaccines, one made by AstraZeneca and one made by Pfizer and BioNTech, and to mix and match the two vaccines for the two doses under limited circumstances. This decision has received mixed responses from scientists and public health practitioners, many of whom are concerned about the lack of data, particularly with regards to a mix-and-match approach. The U.S. FDA critiqued the idea of halving the doses of the Moderna vaccine, saying that the idea was “premature and not rooted solidly in the available science.” Studies are underway to determine whether doses of the Moderna COVID-19 vaccine can be halved to 50 micrograms in order to double the supply of the vaccination doses in the U.S., according to the National Institutes of Health and Moderna. \*\*Vaccine storage conditions:\*\* Storage requirements are important to consider for new vaccines. In order for vaccines to be safe and effective, they must be held at the correct temperature during distribution and storage in health centers, pharmacies, and clinics. Maintaining the correct storage temperature can be difficult, especially if the vaccine’s temperature requirement is very cold. The Pfizer and BioNTech vaccine can be stored for five days at refrigerated 2-8°C (36-46°F) conditions (refrigerators that are commonly available at hospitals); up to 15 days in Pfizer thermal shippers in which doses will arrive that can be used as temporary storage units by refilling with dry ice; and up to 6 months in ultra-low-temperature freezers, which are commercially available and can extend the vaccine’s shelf life. With regards to transit, Pfizer is using dry ice to maintain the recommended temperature conditions of -70°C±10°C (-94°F) for up to 10 days while in transit. However, Pfizer and BioNTech have determined that the vaccine can be moved only four times. \*\*Type of vaccine:\*\* The mRNA-1273 vaccine is what scientists are calling a genetic mRNA vaccine. This type of vaccine works by using genetic information from the coronavirus, which is injected into the body. The genetic information enters into human cells, instructs the body to make special spike proteins like the coronavirus, and causes the immune system to respond. \*\*Dosage:\*\* In the current Phase 3 clinical trial, participants receive two injections of 30 micrograms each into their upper arm muscle. The injections are given 21 days apart. Once an individual gets the first dose, they must get the second dose three weeks later in order to complete the vaccination. If approved, researchers expect that the same dosage and schedule will be prescribed to the public. A recent Israeli study that released results in February 2021 by the Lancet found that a single dose of the Pfizer vaccine was 85% effective against COVID-19 infection between two and four weeks after the first dose, and that the overall reduction in infections was 75%, including asymptomatic cases. Public health practitioners are enthusiastic about this finding of high efficacy after just one dose; However, the authors cautioned that the low numbers of COVID-19 cases in the study, and the fact that the study was conducted at one hospital, make it difficult to reach exact estimates and that these findings should be interpreted with caution. The study also does not determine the length of protection. Pfizer did not comment on the data, stating that “the vaccine’s real-world effectiveness in several locations worldwide, including Israel.” Studies out of the U.K., which has been the quickest to inoculate its population, have also found that a single dose of the Pfizer vaccine could avert most COVID-19-related hospitalizations, though investigators stated it was too early to give precise estimates of the effect. \*\*How the vaccine is being studied:\*\* Vaccines are tested and studied in multiple phases (phased testing) to determine if they are safe and work to prevent illness. Before a vaccine is tested on humans, which is known as the preclinical phase, it is tested on laboratory cells or animals. Once it is approved for human research, there are three phases that take place before the vaccine can be considered for approval for public use. During the first stage (Phase I), the new vaccine is provided to small groups of people—the first time the vaccine is tested in humans to test safety (primarily) and efficacy of the vaccine. The second stage (Phase II) involves testing the vaccine on people who have similar characteristics (such as age and physical health) to the target population, or the group for which the vaccine is intended. The goal of this stage is to identify the most effective doses and schedule for Phase III trials. The final stage (Phase III) provides the vaccine to thousands of people from the target population to see how safe and effective it is. Once the vaccine has undergone Phase 3 testing, the manufacturer can apply for a license from regulatory authorities (like the FDA in the US) to make the vaccine available for public use. Once approved, the drugmaker will work with national governments and international health organizations to monitor vaccine recipients for potential side effects from the vaccine that were not seen in clinical trials (this is called surveillance). This phase also helps researchers understand how well a vaccine works over a longer time frame and how safe it is for the population. \*\*How Pfizer looked for COVID-19 cases in their trials:\*\* Researchers have standard definitions for routinely detecting COVID-19 cases for both symptomatic and asymptomatic individuals. For symptomatic individuals, there are three definitions considered for defining a COVID-19 case for the study. The first two are for regular cases, and the third is for severe cases. The first definition is the presence of at least one COVID-19 symptom and a positive COVID-19 test (such as a PCR test) during, or within 4 days before or after, the symptomatic period, either at the central laboratory or at a local testing facility. The second definition is the same, but expands the definition to include four additional COVID-19 symptoms defined by the CDC (fatigue; headache, nasal congestion or runny nose, nausea). The third definition, which defines severe COVID-19 cases for the study, is a confirmed COVID-19 test per the above guidelines in addition to one of the following symptoms: clinical signs at rest indicative of severe systemic illness, respiratory failure, evidence of shock, significant acute renal, hepatic, or neurologic dysfunction, admission to an ICU, or death. The Pfizer research protocol states that for individuals who do not clinically present COVID-19 (that is, asymptomatic individuals), a serological test is used for defining a case, which measures the amount of antibodies or proteins present in the individual’s blood, and a positive case is defined as the presence of antibodies in an individual who had a prior negative test. By using these four definitions, researchers are able to detect COVID-19 cases in both symptomatic and asymptomatic individuals. However, the pharmaceutical company has stated that there are more data on the vaccine’s safety and efficacy for symptomatic cases, and that more data is needed to better understand the vaccine’s safety and efficacy for asymptomatic cases. \*\*Preclinical testing:\*\* Before testing could begin on humans, the trial vaccine was tested on primates at both 30 micrograms and 100 micrograms. On September 9, 2020, results were published demonstrating that the Pfizer vaccine had strong antiviral protection against the virus SARS-CoV-2. As a result, the Pfizer and BioNTech were permitted to advance the vaccine into human clinical trials by the FDA in the form of through the Investigational New Drug application (IND). \*\*Phase 1 trial:\*\* 45 healthy adults 18–55 and 65–85 years old were randomly assigned to either the placebo group or the vaccine group to receive 2 doses at 21-day intervals of placebo or either of 2 mRNA-based vaccines (BNT162b2 or BNT162b1, which was one of several RNA-based SARS-CoV-2 vaccines studied in parallel for selection to advance to a next trial). Participants received either 10, 20, or 30 microgram dose levels of BNT162b1, or BNT162b2 on a 2-dose schedule, 21 days apart. Both participants and observers working on the study were “blinded,” or not aware of which participants were receiving the active vaccines (and which ones) versus the treatment, in order to help prevent bias. Both with 10 micrograms and 30 micrograms of vaccine BNT162b1, and t 7 days after a second dose of 30 micrograms of the BNT162b2 vaccine, “SARS-CoV-2–neutralizing antibodies” were elicited—special proteins that disable viruses in the body—in younger adults (18-55 years of age) and older adults (65-85 years of age). Younger participants had 3.8 times more antibodies than people who had recovered from the virus. In older adults (65-85 years of age) the vaccine candidate triggered antibodies at 1.6 times the volume of those who had recovered from the virus in the same age group. Vaccine BNT162b2, now known as the “Pfizer vaccine,” was associated with fewer reactions (such as fever and chills), and was therefore selected for Phase 2/3 trials. In terms of safety and tolerability of vaccine BNT162b2, reactions were still reported. Study participants reported pain at the injection site, headache, fatigue, muscle pain, chills, joint pain, and fever. Most of these reactions and symptoms peaked by the day after vaccination and resolved by day 7. \*\*Phase 2/3 trial: \*\*In an effort to speed up the trial, Phases 2 and 2 of the Pfizer vaccine were combined. This phase continued off of Phase 1 and also contained a placebo group as a control with patients randomly assigned into either the placebo group or vaccine group for vaccine BNT162b2. As with Phase 1, the observers and participants were also “blinded.” The first 360 participants enrolled made up the “Phase 2” portion, with 180 randomly assigned to receive the active vaccine and 180 to receive the placebo, stratified equally between 18 to 55 years and >55 to 85 years. Phase 3 enrolled 43,538 trial participants overall, half of whom were randomly assigned to receive the vaccine and half of whom were randomly assigned to receive the placebo. Out of 170 cases of COVID-19 among the study participants,162 cases of COVID-19 were observed in the placebo group versus 8 cases in the vaccine group, indicating 95% efficacy of the vaccine. No serious safety concerns were observed. Data collection is ongoing. \*\*Reported side effects and safety concerns:\*\* The study’s Data Monitoring Committee did not report any serious safety concerns related to the vaccine based on the trial data. Adverse events at or greater than 2% in frequency that were reported were fatigue at 3.8% and headache at 2.0%. Potential allergic reactions occurred in 0.63% of those who received the vaccine, compared with 0.51% of those who received the placebo. On December 9, one day after the Pfizer and BioNTech vaccine began being distributed to individuals outside of the clinical trial in the UK, UK regulators advised that individuals with a history of anaphylaxis to a vaccine, medication, or food should not receive the vaccine. This warning was issued in response to two reports of anaphylaxis (severe allergic reaction) -- both among individuals with histories of severe allergies -- and one report of a possible allergic reaction since distribution in the UK began. Pfizer and BioNTech have stated that they are working with investigators to better understand the cases and causes of the reactions. Within the clinical trial, individuals with a history of severe allergic reactions were excluded from the trials, and doctors were asked to look for such reactions in trial participants who weren’t previously known to have severe allergies. UK regulators also required health care workers to report any negative reactions to help regulators collect more information about safety and effectiveness. In addition, four people who received the vaccine during trials later developed Bell’s palsy at 3, 9, 37, and 48 days after vaccination, respectively. Because these trials were so large, however, this is not more than we would expect to develop Bell’s palsy in a group of this size by chance. Bell’s palsy is a weakness or paralysis of one side of the face which is usually temporary. Any cases of Bell’s palsy and any other potential side effects or adverse reactions will continue to be monitored and evaluated for as the vaccine continues to be rolled out to the public. \*\*Impact on different populations:\*\* Pfizer and BioNTech both say they aimed to make their trials as diverse as possible to understand the vaccine’s effect on different populations. The trial participants are approximately 30% U.S. participants and 42% non-U.S. participants from across 150 trial sites globally. The participants are reported to have racially and ethnically diverse backgrounds. In the trials, 41% of global and 45% of U.S. participants are 56-85 years of age. Efficacy was reported to be consistent across age, gender, race and ethnicity demographics. Notably, the observed efficacy in individuals over 65 years of age was observed to be greater than 94%. In September 2020, Pfizer and BioNTech expanded Phase 3 enrollment to approximately 44,000 participants. This expansion allowed for the enrollment of new, more diverse, populations, including adolescents as young as 16 years of age, and individuals with chronic, stable human immunodeficiency viruses (HIV), Hepatitis C, or Hepatitis B infection. In October 2020, Pfizer and BioNTech received permission from the FDA to enroll adolescents as young as 12. Their explanation for these expansions is to enable better understanding of the potential safety and efficacy of the vaccine in individuals from more ages and backgrounds.
Large gatherings of people in close contact for a prolonged period of time does increase risk for transmission of respiratory viruses. Outdoor protests allow for natural ventilation, and the additional use of masks, eye protection, and social distancing efforts can help reduce risk. While it is unknown if protests will lead to a large increase in the number of cases, it is possible there will be additional cases in the 2 weeks following protests.
There have been multiple studies looking at ivermectin to prevent or treat COVID-19. The drug has not been approved for COVID-19 by the World Health Organization (WHO), the U.S. Food and Drug Administration (FDA) or the European Medicinces Agency (EMA). The current US National Institutes of Health recommendation states that "there are insufficient data for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of ivermectin for the treatment of COVID-19."
There is no scientific evidence to support using home or traditional therapies to prevent COVID-19 at this time. The World Health Organization (WHO) and other international health leaders say that caution is needed when considering “traditional remedies” as preventative measures or treatments for COVID-19, because they have not been widely studied and may cause harm in some cases. There are many traditional remedies and home remedies that have been promoted to prevent COVID-19 infection. People have suggested using mouth or nasal washes, sprays, and creams (or fats) could prevent the virus from entering the body or kill the virus in the nasal cavity (nose) and throat before it has a chance to spread. **Nasal (nose) washes:** There is no scientific evidence that suggests rinsing the inside of your nose will prevent COVID-19 infection. Additionally, for patients with COVID-19, researchers have raised a concern about using contaminated nasal rinse bottles (as well as surfaces and rinse fluids), suggesting they could be a source of exposure. **Nasal (nose) sprays:** Ongoing studies seek to learn more about how saline, iodine, special soaps, and other ingredients used as nasal washes and sprays may help improve virus symptoms and decrease the spread of COVID-19. One Israeli study published in November 2020, and recently re-released with updates as a pre-print in January 2021, shows promising results for a nasal spray known as Taffix. Taffix is a nasal inhaler approved for sale and used for the prevention of respiratory viral infections in Israel and some other countries. The 2020/2021 study analyzed 243 members of a Jewish ultra-orthodox synagogue community during a high holiday, in which individuals were gathered and praying throughout the day. At the two-week follow-up mark of the event, the study investigators found that the individuals who used Taffix had a reduction in odds of COVID-19 infection by 78%, compared to those who did not use Taffix. Eighteen members out of the total 243 were infected with COVID-19, 16 in the no-Taffix group and 2 in the Taffix group, both of whom did not adhere to the recommended use. Studies are ongoing to test over the counter and other types of nasal sprays for protection against COVID-19, with some showing early promise in lab and animal studies. **Mouthwash, rinses, and gargle solutions:** Like nasal washes and sprays, there is no scientific evidence that suggests using mouthwashes, rinses, and gargles will prevent COVID-19 infection. Ongoing studies seek to learn about how special antiseptic mouthwashes may help prevent COVID-19 (see the Experimental Therapies section below). So far, many studies have explored these treatments in laboratory cells, and data on humans is limited. **Alcohol, chlorine, or disinfectant spray:** Alcohol, chlorine (e.g. bleach solutions), or disinfectant sprays should never be sprayed or applied to your nose, mouth, or eyes, and doing so may cause serious harm. Drinking alcohol will not prevent or treat COVID-19. **Fats or oils:** This includes coconut oil, ghee, sesame oil, shea butter, petroleum jelly, and others. There is no scientific evidence that nasal treatments or mouth rinses with different fats will prevent, treat, or cure COVID-19. While many types of fats or oils (like coconut oil, sesame oil, and others) have been shown to kill or stop bad bacteria in cell-based laboratory studies, most of these studies have focused on how these ingredients may be used to prevent bacterial growth on food to improve food safety. Studies have not looked at the effect of fats on prevention of viral or bacterial infections in humans when applied in the nose or used as a mouth rinse. There is no scientific evidence that supports the theory that using these oils would improve health or prevent illness. In addition, though rare, it is possible that inhaling fats from the inside of the nose can cause lung problems. **Steam inhalation:** Though inhaling steam may help to thin mucous or relieve congestion (stuffy nose), there is no scientific evidence to suggest that inhaling steam will prevent or treat COVID-19. Contact with steaming hot water can cause burns, and inhaling steam can burn the inside of your nose. **Experimental therapies:** There are ongoing studies using nasal sprays (and rinses) and special mouthwashes to prevent COVID-19, such as the Taffix study discussed above. Much of the current scientific evidence is based on animal or laboratory cell studies. For humans, efficacy and safety studies are ongoing, and most treatments are not recommended for the public at this time. Currently, studies seek to understand if nasal rinses (using saltwater, special soaps, and other ingredients) may help to improve symptoms and decrease the viral load in patients with COVID-19 (with the thought that decreasing the viral load could decrease how much an infected person may spread the virus). Researchers are also studying whether gargling or rinsing with special solutions (e.g. povidone-iodine) may help prevent healthcare workers from contracting COVID-19. A pre-print study or a nasal spray medication (INNA-051) has shown good results in preventing COVID-19 in ferrets, but human studies have not yet begun. Human study results for Taffix nasal spray and its pre-existing approval for prevention of respiratory viral infections makes it feasible for human use in protection against COVID-19; however, it is not a replacement for mask use and physical distancing. To prevent COVID-19 infection, health authorities continue to recommend avoiding crowds, practicing social distancing measures (at least 6 feet/2 meters apart), frequent and careful handwashing, wearing face masks (wearing a cloth mask over a surgical mask is recommended by the U.S. Centers for Disease Control and Prevention), staying home when possible (especially if you are sick), clean high-touch surfaces often, and avoid touching your nose, eyes, and mouth.
Blue surgical masks are safe to wear and are made with non-woven fabric.
You do not need to have any kind of COVID-19 test before you are vaccinated. It is recommended that you do not receive a vaccine until you are free from a prior COVID-19 infection for 90 days.
The U.S. C.D.C. recommends that fully protected people should continue to wear masks in public, stay six feet apart and avoid crowded and poorly ventilated spaces. Fully vaccinated people can gather indoors with other fully vaccinated people without wearing masks. Fully vaccinated people can gather indoors with one household of unvaccinated people if they are at a low-risk of severe COVID-19 illness. After exposure to COVID-19 infected person, quarantine and testing are not needed unless symptomatic. However, those living in group settings need to quarantine and get tested after a known COVID-19 exposure. The CDC recommends avoiding medium or large gatherings, delay domestic and international travel, or follow CDC requirements and recommendations if you must travel.
Health Desk provides on-demand and on-deadline science information to users seeking to quickly communicate complex topics to audiences.
In-house scientists provide custom explainers for critical science questions from journalists, fact-checkers and others in need of accessible breakdowns on scientific information. Topics range from reproductive health, infectious disease, climate science, vaccinology or other health areas.
Meedan's Health-Desk.org makes every effort to provide health- and science-related information that is accurate and reflects the best evidence available at the time of publication. To submit an error or correction request, please email our editorial team at health@meedan.com. All error or correction requests will be reviewed by the Health Desk Editorial and Science Teams. Where there is evidence of a factual error or typo, we will update the explainer with a correction or clarification and follow up with the reader on the status of the request.
Our scientists, writers, journalists, and experts do not engage in, advocate for, or publicize their personal views on policy issues that might lead a reasonable member of the public to see our team’s work as biased. If you have concerns or comments about potential bias in our work, please contact our editorial team at health@meedan.com.
Health Desk provides on-demand and on-deadline science information to users seeking to quickly communicate complex topics to audiences.
In-house scientists provide custom explainers for critical science questions from journalists, fact-checkers and others in need of accessible breakdowns on scientific information. Topics range from reproductive health, infectious disease, climate science, vaccinology or other health areas.
Meedan's Health-Desk.org makes every effort to provide health- and science-related information that is accurate and reflects the best evidence available at the time of publication. To submit an error or correction request, please email our editorial team at health@meedan.com. All error or correction requests will be reviewed by the Health Desk Editorial and Science Teams. Where there is evidence of a factual error or typo, we will update the explainer with a correction or clarification and follow up with the reader on the status of the request.
Our scientists, writers, journalists, and experts do not engage in, advocate for, or publicize their personal views on policy issues that might lead a reasonable member of the public to see our team’s work as biased. If you have concerns or comments about potential bias in our work, please contact our editorial team at health@meedan.com.
Nat Gyenes, MPH, leads Meedan’s Digital Health Lab, an initiative dedicated to addressing health information equity challenges, with a focus on the role that technology plays in mediating access to health through access to information. She received her masters in public health from the Harvard T. H. Chan School of Public Health, with a focus on equitable access to health information and human rights. As a research affiliate at Harvard’s Berkman Klein Center for Internet & Society, she studies the ways in which health information sources and outputs can impact health outcomes. She lectures at the Harvard T.H. Chan School of Public Health on Health, Media and Human Rights. Before joining Meedan, Nat worked at the MIT Media Lab as a health misinformation researcher.
Megan Marrelli is a Peabody award-winning journalist and the News Lead of Health Desk. She focuses on news innovation in today’s complex information environment. Megan has worked on the digital breaking news desk of the Globe and Mail, Canada’s national newspaper, and on the news production team of the Netflix series Patriot Act with Hasan Minhaj. She was a Canadian Association of Journalists finalist for a team Chronicle Herald investigation into house fires in Halifax, Nova Scotia. On top of her role at Meedan Megan works with the investigative journalism incubator Type Investigations, where she is reporting a data-driven story on fatal patient safety failures in U.S. hospitals. She holds a Master of Science from the Columbia Journalism School and lives in New York.
Anshu holds a Doctor of Public Health (DrPH) from the Harvard T.H. Chan School of Public Health, and a Humanitarian Studies, Ethics, and Human Rights concentrator at the Harvard Humanitarian Initiative. She is a Harvard Voices in Leadership writing fellow and student moderator, Prajna Fellow, and the John C. and Katherine Vogelheim Hansen Fund for Africa Awardee. Anshu’s interests include: systemic issues of emergency management, crisis leadership, intersectoral approaches to climate risk resilience, inclusion and human rights, international development, access and sustainability of global health systems, and socio-economic equity. Anshu has worked at the United Nations, UNDP, UNICEF, Gates Foundation, and the Institute of Healthcare Improvement.
Dr. Christin Gilmer is a Global Health Scientist with a background in infectious diseases, international health systems, and population health and technology. In the last 15 years, Christin has worked for the WHO, University of Oxford, World Health Partners, USAID, UNFPA, the FXB Center for Health & Human Rights and more, including volunteering for Special Olympics International’s health programs and running health- and technology-based nonprofits across the country. She obtained her Doctor of Public Health Degree at the Harvard T.H. Chan School of Public Health, her MPH at Columbia, and spent time studying at M.I.T., Harvard Kennedy School, and Harvard Business School. Christin has worked in dozens of countries across five continents and loves running programs and research internationally, but she is currently based in Seattle.
Dr. Jessica Huang is currently a COVID-19 Response and Recovery Fellow with the Harvard Kennedy School’s Bloomberg City Leadership Initiative. Previously, she worked and taught with D-Lab at MIT, leading poverty reduction and humanitarian innovation projects with UNICEF, UNHCR, Oxfam, USAID, foreign government ministries and community-based organizations across dozens of countries. She also co-founded a social enterprise that has provided access to safe drinking water to thousands in India, Nepal and Bangladesh. Formerly trained as an environmental engineer, she earned a Doctorate of Public Health from Harvard and a Master’s in Learning, Design and Technology (LDT) from Stanford. Her projects have won multiple awards, including the top prize in A Grand Challenge for Development: Technology to Support Education in Crisis & Conflict Settings, and led to her being recognized for Learning 30 Under 30. She enjoys being an active volunteer, supporting several non-profits in health, education, environmental sustainability and social justice.
Jenna Sherman, MPH, is a Program Manager for Meedan’s Digital Health Lab, an initiative focused on addressing the urgent challenges around health information equity. She has her MPH from the Harvard T.H. Chan School of Public Health in Social and Behavioral Sciences, with a concentration in Maternal and Child Health. Prior to her graduate studies, Jenna served as a Senior Project Coordinator at the Berkman Klein Center for Internet and Society at Harvard Law School, where she worked on tech ethics with an emphasis on mitigating bias and discrimination in AI and health misinformation online. Previous experiences include helping to develop accessible drug pricing policies, researching access to quality information during epidemics, and studying the impact of maternal incarceration on infant health.
Nour is a Global Health Strategy consultant based in Dakar (Senegal) and specialized in health system strengthening. Most recently, she worked with Dalberg Advisors focusing on Epidemic Preparedness & Response and Vaccination Coverage and Equity across 15 countries in Sub-Saharan Africa. Her previous work experiences include researching the clinical needs in point-of-care technology in cancer care at the Dana-Farber Cancer Institute in Boston; and coordinating the implementation of a colonoscopy quality assurance initiative for a colorectal cancer screening program at McGill University in Montreal. Nour has a Master of Public Health from the Harvard T.H. Chan School of Public Health, a Master of Arts in Medical Ethics and Law from King’s College London, and a Bachelor of Science from McGill University. She is fluent in French and English.
Shalini Joshi is a Program Lead at Meedan and formerly the Executive Editor and co-founder of Khabar Lahariya - India’s only independent, digital news network available to viewers in remote rural areas and small towns. Shalini transformed Khabar Lahariya from one edition of a printed newspaper to an award-winning digital news agency available to over ten million viewers. She has a sophisticated understanding of local media and gender, and the ways in which they can inhibit women from participating in the public sphere in South Asia. Shalini was a TruthBuzz Partner & Fellow with the International Center for Journalists (ICFJ). She is a trainer in journalism, verification and fact-checking. She has designed, implemented and strengthened news reporting & editorial policies and practices in newsrooms and fact-checking organisations. Shalini set up and managed the tipline used to collect WhatsApp-based rumors for Checkpoint, a research project to study misinformation at scale during the 2019 Indian general elections.
Mohit Nair currently serves as Partnerships Director at FairVote Washington, a non-profit organisation based in Seattle, WA. Previously, he worked with the Medecins Sans Frontieres (MSF) Vienna Evaluation Unit and with MSF Operational Centre Barcelona in India. He has conducted research studies on diverse topics, including the drivers of antibiotic resistance in West Bengal and perceptions of palliative care in Bihar. Mohit has also worked as a research consultant with Save the Children in Laos to identify gaps in the primary health system and develop a district-wide action plan for children with disabilities. He holds a Master of Public Health from the Harvard University T.H. Chan School of Public Health and a Bachelor of Science from Cornell University.
Seema Yasmin is an Emmy Award-winning medical journalist, poet, physican and author. Yasmin served as an officer in the Epidemic Intelligence Service at the U.S. Centers for Disease Control and Prevention where she investigated disease outbreaks. She trained in journalism at the University of Toronto and in medicine at the University of Cambridge. Yasmin was a finalist for the Pulitzer Prize in breaking news in 2017 with a team from The Dallas Morning News and received an Emmy Award for her reporting on neglected diseases. She received two grants from the Pulitzer Center on Crisis Reporting and was selected as a John S. Knight Fellow in Journalism at Stanford University iin 2017 where she investigated the spread of health misinformation and disinformation during epidemics.
Dr. Saskia Popescu is an infectious disease epidemiologist and infection preventionist with a focus on hospital biopreparedness and the role of infection prevention in health security efforts. She is an expert in healthcare biopreparedness and is nationally recognized for her work in infection prevention and enhancing hospital response to infectious diseases events. Currently, Dr. Popescu is an Adjunct Professor with the University of Arizona, and an Affiliate Faculty with George Mason University, while serving on the Coronavirus Task Force within the Federation of American Scientists, and on a data collection subcommittee for SARS-CoV-2 response with the National Academies of Science, Engineering, and Medicine. She holds a PhD in Biodefense from George Mason University, a Masters in Public Health with a focus on infectious diseases, and a Masters of Arts in International Security Studies, from the University of Arizona. Dr. Popescu is an Alumni Fellow of the Emerging Leaders in Biosecurity Initiative (ELBI) at the Johns Hopkins Bloomberg School of Public Health, Center for Health Security. She is also an external expert for the European Centre for Disease Control (ECDC), and a recipient of the Presidential Scholarship at George Mason University. In 2010, she was a recipient of the Frontier Interdisciplinary eXperience (FIX) HS-STEM Career Development Grant in Food Defense through the National Center for Food Protection and Defense. During her work as an infection preventionist, she managed Ebola response, a 300+ measles exposure resulting in an MMWR article, and bioterrorism preparedness in the hospital system. More recently, she created and disseminated a gap analysis for a 6-hospital system to establish vulnerabilities for high-consequence diseases, helping to guide the creation of a high-consequence disease initiative to enhance readiness at the healthcare level.
Ben Kertman is a behavior change scientist and public health specialist who became a user research consultant to help organizations design experiences that change behaviors and improve human well-being. Impatient with the tendency of behavior change companies to use a single discipline approach (e.g. behavioral economics) and guard their methods behind paywalls, Ben spent the last 7 years developing an open-source, multi-discipline, behavior change framework for researchers and designers to apply to UX. Ben is an in-house SME at Fidelity Investments and consults for non-profits on the side. Ben holds a masters in Social and Behavior Science and Public Health from Harvard.
Emily LaRose is a Registered Dietitian and Nutrition and Global Health Consultant who, in addition to her work with Meedan, currently works as a Technical Advisor for Nutrition for Operation Smile. She has been a dietitian for more than 18 years and, over the past 10 years, she has worked for the World Bank, Global Alliance for Improved Nutrition (GAIN), Médecins Sans Frontières (MSF), PATH, Johnson & Wales University, and Children’s Hospital Los Angeles. In her work, she has conducted analytical research and written specialty reports on infant and young child malnutrition, health misinformation, global human milk banking practices, and innovative food system programs; developed tools and protocols for clinical nutrition care delivery in humanitarian hospitals; taught university-level nutrition courses; and provided nutritional care for critically ill hospitalized patients. Emily earned her Doctor of Public Health (DrPH) degree with a Nutrition and Global Health Concentration at the Harvard T.H. Chan School of Public Health, her Master of Science in Dietetics at Kansas State University, and her Bachelor of Science in Culinary Arts Nutrition at Johnson & Wales University.
Bhargav Krishna is a Fellow at the Centre for Policy Research in Delhi, and adjunct faculty at the Public Health Foundation of India and Azim Premji University. He previously managed the Centre for Environmental Health at the Public Health Foundation of India, leading research and teaching on environmental health at the Foundation. He has been a member of Government of India expert committees on air pollution and biomedical waste, and has led work with Union and State governments on air pollution, climate change, and health systems. His work has been funded by the World Health Organization, Rockefeller Foundation, Packard Foundation, Environmental Defense Fund, and others. He holds bachelors and masters degrees in Biotechnology and Environmental Science respectively, and graduated recently from the Doctor of Public Health program at the Harvard T. H. Chan School of Public Health. Bhargav also co-founded Care for Air, a non-profit working on raising awareness related to air pollution with school children in Delhi.
Dr. Christine Mutaganzwa is a medical doctor pursuing a Ph.D. program at the Université de Montréal in Biomedical Sciences. She holds a Master of Medical Sciences in Global Health Delivery (MMSc-GHD) from Harvard Medical School, Boston, MA, and a Master of Sciences (MSc) in Epidemiology and Biostatistics from the University of Witwatersrand, Johannesburg, South Africa. She graduated from the University of Rwanda with a degree in General Medicine and Surgery. Christine has worked with referral hospitals in Kigali, the capital city of Rwanda, during her medical training and after graduation. In addition, she has extensive experience working with rural communities in the Eastern province of Rwanda, where she organized clinical and research activities in active collaboration with colleagues within and outside Rwanda. Her research portfolio cuts across maternal and child health to infectious and chronic diseases. Christine is an advocate for children's healthcare services, especially for underserved populations. She is part of a community of scientists translating scientific findings into understandable and accessible information for the general population. Christine is an avid reader and a lover of classical/contemporary music.
Ahmad is an experienced physician, who earned his medical degree from Cairo University, Faculty of Medicine, in Egypt. He practiced medicine between 2012 and 2017 as a general practitioner where he was involved in primary care, health quarantine services, and radiology. He then taught medicine in Cairo for two years prior to starting his MPH program, at the Harvard T.H. Chan School of Public Health, where he supplemented his experience with knowledge on epidemiology, health systems and global health issues. Additionally, Ahmad has an interest in nutrition, which started as a personal curiosity to how he can improve his own health, then quickly saw the potential for public health nutrition in the prevention and management of multiple, lifelong diseases. His enrollment at Harvard started his transition towards learning about food, and public health nutrition. Ahmad now combines the knowledge and experience of his medical career, with the learnings of his degree to navigate public health topics in his writing and his career. He is a life-long learner and continues to gather knowledge and experience, and works towards maximizing his impact through combatting misinformation through his work with Meedan.
Dr. Uzma Alam is a global health professional working at the intersection of infectious diseases and healthcare delivery in the international development and humanitarian contexts. She focuses on the use of evidence and innovation to inform strategies and policies. Her work has appeared globally across print and media outlets.She has international experience with roles of increasing responsibility across the science value chain having served with academic, non-profit, corporate, and governmental agencies, including advisory commissions and corporate counsel. Uzma is the former secretary of the Association of Women in Science and editor of the Yale Journal of Health Policy, Law, and Ethics. Currently she serves on the Board of the Geneva Foundation. She also leads the Biomedical and Health Sciences Portfolio of the Developing Excellence, Leadership and Training in Science in Africa program (DELTAS-Africa). A US$100 million programme supporting development of world-class scientific leaders on the continent. Plus heading the African Science, Technology, and Innovation (STI) Priorities Programme. A programme that engages Africa’s science and political leaders to identify the top STI priorities for the continent that if addressed, offer the highest return on investment for Africa’s sustainable development.
