Is Omicron showing us the path ahead?

This article briefly discusses how the understanding of Omicron variant may affect the response to the pandemic, highlighting that vaccines are the game changers. This new reality motivated by the emergence of the Omicron variant is relevant only for those who are fortunate enough to have access to effective COVID-19 vaccines and booster doses.

Resilience of HIV activities during COVID-19 pandemic at health facilities in africa

Background: The COVID-19 pandemic has impacted healthcare access due to travel restrictions, fear of exposure at health facilities (HF), changes in national policies and redirection of resources. We aimed to examine the impact that COVID-19 had on specific HIV activities including HIV testing, antiretroviral therapy (ART) initiation and viral load (VL) testing and suppression (VLS) at President's Emergency Plan for AIDS Relief (PEPFAR)-supported HF in 11 African countries. Methods: Retrospective routine data collected quarterly (Q) [Q1:October- December 2019;Q2:January-March 2020;Q3:April-June 2020;Q4:July- September 2020] from 1059 ICAP-supported HF in Angola (HF=17), Burundi (HF=88), Cameroon (HF=73), Cote d'Ivoire (HF=145), the Democratic Republic of Congo (HF=199), Eswatini (HF=42), Ethiopia (HF=31), Kenya (HF=1), Mozambique (HF=59), South Sudan (HF=20) and Zambia (HF=384) were analyzed to determine quarterly trends along the HIV testing and treatment cascade. Results: Overall, there was a 3.3% decrease in the number HIV tested from Q2 (572,845) to Q3 (553,780) (Figure 1). This change varied by country ranging from a 57% decrease in Kenya (5,460 to 2,364) to a 104% increase in Cameroon (45,940 to 93,735). The number testing HIV-positive in all countries declined by 5.0% from Q2 (22,662) to Q3 (21,553) with little change in yield (4.0% vs. 3.9%). In Q4 the number HIV tested increased by 10.6% (to 612,646) from Q3, and the number testing HIV+ increased by 9.0% (23,457) with little change in yield (3.8%). New ART initiations declined by 9.8% from Q2 to Q3 but increased again by 9.8% in Q4 (Q2:24,918;Q3:22,469;Q4:24,665). In every quarter, the number of patients currently on ART increased-Q1:419,028;Q2:435,852;Q3:454,208 and Q4:476,010. The number receiving a VL test also increased (Q1:255,290;Q2:276,001;Q3:297,876;Q4:312,869) with slight increases in the percentage with VLS (Q1:87.5%;Q2:88.6%;Q3:89.7%;Q4:90.1%). Conclusion: In this large study, with the of COVID-19 pandemic acceleration from Q2 to Q3, the number HIV tested decreased along with declines in number of HIV+ persons identified and new ART initiations. However, rebound was brisk as the pandemic progressed (Q4), demonstrating remarkable HIV program resilience. The number on ART, VL testing and VLS continued to increase throughout the period. This may have been, in part, due to recent expansions of non-HF-based differentiated service delivery models that include more diverse groups.