Africa is in the middle of a full-blown third surge of COVID-19, with cases already near the peak of its first wave, the head of the World Health Organization (WHO) African regional office warned today, as she pressed countries on the continent to step up their public health measures.

In other developments—and with much of the world struggling with scarce vaccine supplies—Germany-based CureVac yesterday reported disappointing efficacy findings for its mRNA COVID vaccine.

Variants only one factor fueling surge

At a briefing today, Matshidiso Moeti, MBBS, who leads the WHO's African regional office, said cases rose last week by 20% in 22 African countries, with the Democratic Republic of Congo, Namibia, and Uganda reporting their highest weekly cases since the pandemic began. In urging countries to scale up their case finding, testing, treatment, and contact tracing, she said, "The sobering trajectory of surging cases should rouse everyone into urgent action. We’ve seen in India and elsewhere just how quickly COVID-19 can rebound and overwhelm health systems."

Factors fueling the outbreak are varied and involve the lack of adherence to public health measures, the onset of cooler weather in southern Africa, and the circulation of more transmissible variants.

Moeti said the Delta (B1617.2) variant has been found in 14 African countries, and the Alpha (B117) and Beta (B1351) variants have been detected in 25 nations.

Though Africa is struggling with scarce vaccine supplies, she said vaccine rollout is picking up speed, with 5 million doses delivered over the past 5 days. However, Moeti added that some countries are struggling to administer the doses they have—23 have given only half of the doses they've received so far, including 4 that are experiencing resurgence.

"The rise in cases and deaths is an urgent wake up call for those countries lagging behind to rapidly expand vaccination sites, to reach priority groups for vaccination and to respond to community concerns," she said.

In related developments, Ugandan officials said the country's oxygen supplies are under pressure and increasing numbers of younger people are getting sick, according to the Washington Post. Also, Tanzania has asked to join the COVAX vaccine-access program, signaling stepped up efforts to control the virus now that the country is under new leadership following the March death of its former president, who was skeptical about the virus and the vaccine, according to Reuters.

CureVac details disappointing efficacy results

In an announcement yesterday, CureVac said an interim analysis of the phase 2b/3 trial of its candidate mRNA vaccine showed an efficacy of 47% against disease of any severity and did not hit its success goal.

The company said the trial involving about 40,000 people in 10 countries in Europe and Latin America took place during a challenging time when 13 SARS-CoV-2 variants were circulating among the study population. Of 134 COVID-19 cases assessed, viruses from 124 cases were sequenced, only 1 of which involved the original wild strain.

CureVac said its analysis found efficacy in younger participants, with not enough data to gauge efficacy in people older than 60.

Chief executive officer Franz-Werner Haas said demonstrating efficacy against the backdrop of diverse variants is challenging, and the company will continue with a final analysis, which will include 80 more cases, which could change the findings and affect the next regulatory steps. "In addition, the variant-rich environment underlines the importance of developing next-generation vaccines as new virus variants continue to emerge."

The company is working with GSK on second-generation COVID vaccine candidates that have an mRNA backbone and could include variants in multivalent formulations.

In other vaccine developments, Australia regulators updated the country's vaccine guidance to recommend the Pfizer-BioNTech vaccine as the preferred formulation for people younger than 60, due to concerns about the risk of blood clots with the AstraZeneca-Oxford vaccine, according to the Washington Post. And Indonesian doctors are raising concerns after more than 350 of them got sick with COVID after receiving China's Sinovac vaccine, adding to broader concerns about its efficacy.

More global headlines

• Afghanistan's COVID surge is spiraling out of control, threatening to swamp the country's healthcare system, which was already under pressure from years of armed conflict and other disasters, the International Federation of Red Cross and Red Crescent Societies warned. It said hospital beds are full in many areas and oxygen supplies can't keep up.
  
  
• Japan is easing the state of emergency in Tokyo and eight other prefectures, officials announced today, according to Reuters. However, the country will keep some measures, such as limiting the number of spectators at the Olympic games that begin on Jul 23.
  
  
• In a commentary in The Hill yesterday, two public health experts raised concerns about the Olympics becoming a superspreading event and said the recently released final version of the International Olympic Committee's playbook still doesn't recognize that aerosol inhalation is one of the most important routes of transmission. The authors include Lisa Brosseau, ScD, a research consultant and industrial hygienist, and Annie Sparrow, MD, MPH, a pediatric critical care doctor and global health expert. They again called for the WHO to convene an emergency committee to address interventions needed to prevent aerosol transmission.
  
  
• New surveillance data from Public Health England suggest that the number of COVID reinfections are very low at 0.4% of cases. For their analysis, they looked at more than 15,000 possible reinfections reported up to May 30. It encouraged all people to be vaccinated to reduce the risk of reinfection.
  
  
• The global total topped 177 million and is now at 177,022,372 cases with at least 3,832,652 deaths, according to the New York Times.