COVID Booster: WHO molnupiravir recommendation, green COVID recovery, and booster waning against Omicron

WHO recommends molnupiravir for high-risk COVID-19 patients

The anti-COVID drug molnupiravir has this week been recommended by the WHO for use in patients with non-severe COVID-19 who have a high risk of hospitalisation.

This could include elderly patients, people with chronic disease or weak immune systems, and unvaccinated people.

The decision was based on moderate-certainty evidence from six randomised controlled trials suggesting that molnupiravir can reduce the risk of hospital admission and speed up recovery.

However, the drug is not yet recommended for treating COVID-19 in young and healthy patients or for pregnant or breastfeeding women.

Molnupiravir joins certain monoclonal antibodies, corticosteroids, and IL-6 receptor blockers on the list of COVID-19 treatments currently recommended by the WHO for some patients.

Did we miss our chance for a green economic recovery from COVID-19?

A meta-analysis from Johns Hopkins University has found that global COVID-19-related economic stimulus packages failed to prioritise climate change.

The research team looked at economic recovery packages from 19 countries plus the European Union from 2020 to 2021, finding that most money was spent on projects that would make no difference to greenhouse gas emissions.

“These economic recovery packages provided an opportunity for countries including the United States to really envision what they want their economies to look like going forward,” said co-author Scot Miller, an assistant professor of environmental health and engineering at Johns Hopkins.

“The pandemic could have been an opportunity to push countries toward greener economies and a lot of governments have failed to do so.”

Only 6% of the more than $13 trillion of stimulus packages in the study was spent on projects likely to reduce such emissions – such as electric vehicles, renewable energy and transit infrastructure – while 3% was spent on initiatives that would likely increase emissions.

South Korea and the EU directed the largest proportion of their stimulus money to green projects (more than 30% each), while the US, Japan, Russia and the UK all spent less than 5% of their packages on helping the climate crisis.

“These 2030 climate goals are coming faster and sooner than we think and we can’t put off thinking about climate change until the pandemic is over,” says Miller.

Booster vaccine protection against Omicron begins to wane after 10 weeks

A UK study has estimated that the effectiveness of COVID booster vaccines against any symptoms from Omicron infection begins to wane after 10 weeks.

The researchers looked at data from over 880,000 people infected with Omicron, over 200,000 infected with Delta, and over 1.5 million people who tested negative for COVID-19. When it came to preventing all symptomatic disease, they found that vaccines were generally more effective against Delta than Omicron.

Receiving two doses of the AstraZeneca vaccine was found to have no impact on preventing symptoms from Omicron infection 20 weeks after vaccination, while two doses of Pfizer were only 8.8% effective.

Booster shots fared better against the Omicron variant, but their effectiveness against symptomatic infection began to wane after a couple of months. Efficacy of boosters against any symptoms dropped to 40-45% for Pfizer, and 60-65% for Moderna, after 10 weeks.

The findings only relate to vaccine effectiveness against any disease symptoms, even mild cases. “Boosters will probably offer even greater levels of protection against severe and fatal disease,” the authors write.

Some common medications may affect our response to COVID-19 infection

Common pain and fever medications are a mixed bag when it comes to their effects on the course of infectious disease, a new review led by the University of Sydney suggests.

“Our review shows some of the common pain and fever medications may work with the immune system to fight infection, whereas others work against it and increase the risk of contracting or responding badly to infectious diseases,” says lead author Christina Abdel-Shaheed.

For example, morphine was found to suppress certain immune cells, increasing people’s risk of infection.

This is of particular concern as many cancer patients, who are vulnerable to COVID-19, are given morphine for pain relief.

The research team also highlighted that taking paracetamol or ibuprofen immediately before or after vaccination to relieve mild fever or headache might reduce the body’s immune response to the vaccine.

Co-author Ric Day, a professor at UNSW and St Vincent’s Hospital, said that the immune impact of common medications had been under-recognised.

“From community use to hospital and acute care, these classes of pain and fever medications are among the most popular drugs worldwide but we need to consider the significant impact these can have on our immune system and our response to infectious diseases, including COVID-19.”

City green spaces help mental health during the pandemic

Researchers from the University of Colorado, Denver in the US have found that access to green space was associated with lower levels of anxiety and depression during the COVID-19 pandemic.

The study surveyed people living in the city of Denver about their mental health before and during the pandemic and their perceived access to green space. These survey data were combined with aerial imagery to measure objective green space.

Unsurprisingly, the researchers found that depression scores were significantly higher during the pandemic than before, and anxiety scores significantly higher during the US’s so-called ‘fall wave’ of COVID-19 in late 2021.

However, spending time in green space was significantly associated with lower anxiety and depression, after controlling for sociodemographic factors and pandemic-related stressors.

Interestingly, both objective and subjective measures of green space abundance near people’s homes were associated with lower depression scores.

However, no significant association between green space and stress was identified.