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Coronavirus Files: Virus Surges, Pfizer and Biden Rise to the Challenge

Coronavirus Files: Virus Surges, Pfizer and Biden Rise to the Challenge

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Since April, The Center for Health Journalism has been publishing a special newsletter geared to journalists as they report on one of the biggest and most complex stories of our times. Each Monday, while the pandemic runs its course, The Coronavirus Files will provide tips and resources and highlight exemplary work to help you with your coverage. This week, The Center for Health Journalism’s Coronavirus Files Monday newsletter is curated and reported by CHJ content editor Ryan White and community editor Chinyere Amobi. Have a suggestion or a request? Write us at editor@centerforhealthjournalism.org.

 

U.S. shatters COVID-19 records

The situation has gone from bad to worse, with many dismal milestones in recent days and no signs of slowing:

  • The number of COVID-19 hospitalizations in the nation overtook previous records on November 10, and stood at nearly 70,000 on Sunday.
  • The U.S. surpassed 10 million infections total last week, the first nation to hit that number, and quickly advanced to 11 million by Sunday.
  • Texas is the first state to exceed 1 million confirmed cases as of November 11, a fact experts interviewed by the Houston Chronicle blamed on conflicting messages from politicians. California hit the same threshold on the 12th.
  • The U.S. reported more than 165,000 new cases in a single day on Saturday. “It will not surprise me if in the next weeks we see over 200,000 cases a day,” Michael Osterholm, a leading epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told CNN’s Anderson Cooper.

It’s hard to even define which region is hardest hit, reports The New York Times; El Paso, Texas, and the Navajo Nation are among those struggling the most. In The Hill, Joseph Choi notes the situation is so dire in North Dakota that the state will permit infected health care workers to stay on the job as long as they’re not symptomatic.

The latest surge is largely fueled by small, casual get-togethers, according to Karin Brulliard at The Washington Post. But the Los Angeles Times’ Deborah Netburn writes that it’s still possible to minimize the winter’s toll, from what might be more than 500,000 COVID-19 deaths to something closer to 100,000-plus. “Is it even worth trying to fight it?” she asks. According to prominent experts interviewed by Netburn, “the answer is an emphatic yes.”

Many states are implementing new restrictions, cutting back on indoor restaurant service and implementing curfews and limits on indoor gatherings, even as they attempt to avoid total lockdown. As Colorado Gov. Jared Polis told his constituents, “Colorado, I love you, but this is an intervention. Cancel your social plans for the next few weeks.”

A beacon of hope, with caveats

Pfizer offered much-needed good news with last week’s announcement that its vaccine candidate was more than 90% effective. That’s based on preliminary data — the trial is ongoing — and raised as many questions as it did champagne flutes. (Full disclosure: I’m a subject in Pfizer’s trial.) And today, Moderna reported similar efficacy rates.

STAT’s Helen Branswell offers an analysis of why Pfizer’s announcement is great news: The vaccine was way more effective than many experts predicted, suggesting such shots will be an effective tool against the pandemic. The FDA had earlier said a vaccine just needed to hit 50% efficacy in preventing symptomatic COVID-19. And other vaccines, targeting the same piece of the virus, are likely to work well too. (Expect results from Oxford/AstraZeneca by years’ end).

But as Natalie Grover, writing for the Guardian, points out, key questions await answers: How safe is this shot? Does it prevent the most severe forms of the disease, and does it stop transmission? Will it work in diverse age groups? And how long will that protection last?

Distribution presents a big challenge. Pfizer’s vaccine requires shipping and storage at minus 94 degrees Fahrenheit. According to ProPublica, many states are unprepared to handle this so-called “cold chain,” and rural areas will have the most difficulty.

Moderna’s vaccine, which seemed to stymie severe disease in preliminary data, requires a comparatively balmy minus four Fahrenheit, and can be stored in a regular refrigerator for a month or room temperature for half a day.

Who gets it when?

If these vaccines receive emergency approval over the next month, high-priority groups could get vaccinated in December and January, with enough vaccine to give all Americans by spring. Frontline health care workers head the list for early access, and the federal Advisory Committee on Immunization Practices has pointed to essential workers, people 65 and older, and those with medical conditions that can worsen Covid-19 as high priority as well. Some have also suggested people with severe mental illness should be high on the list.

Experts are also considering prioritizing hard-hit communities of people of color. “I think it’s an ethical imperative,” Lawrence Gostin, an expert in global health law at Georgetown University, told STAT’s Nicholas St. Fleur. But some people in those communities may distrust the vaccine. “Will Black people even take it once it’s available to them?” asks Bruce C.T. Wright in NewsOne.

The president-elect hones his plan

Meanwhile, President-elect Joe Biden is crafting his pandemic approach. He continues to build his advisory response team, and has hired Ron Klain, President Barack Obama’s “Ebola czar,” as his chief of staff. He’s promised to appoint a national supply chain commander and pandemic testing board, an approach that’s been likened to FDR's actions during World War II. He plans to use the Defense Production Act to stockpile supplies such as medications, ventilators, masks and gowns. He’s also expected to coordinate more tightly with state governments, which Trump has been reluctant to do.

Biden’s election could also usher in pandemic-related changes for schools, according to the Washington Post. Biden wants to put billions toward schools to fund protective equipment, update ventilation systems, and keep class sizes small. He’s also promised “clear, consistent, effective national guidelines” for reopening schools.

Biden is already in conversations with drugmakers participating in the current administration’s Operation Warp Speed, and is unlikely to make changes to that effort, reports Riley Griffin in Bloomberg. However, Biden’s team has not had full access to the distribution plan due to Trump’s contesting of the election results. While Pfizer is not part of Warp Speed (Moderna is), its results add a new political wrinkle because the deployment will straddle two vastly different administrations, as laid out in an Atlantic piece titled “The Lame-Duck Vaccine.”

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