Click here to subscribe to the daily brief.

July 7, 2020 - Brief Issue 73

The Coronavirus Daily Brief is a daily news and analysis roundup edited by New America’s International Security Program and Arizona State University.

[ONLINE at New America] - Crisis Conversations — Live From Better Life Lab - Join BLL for an interactive conversation on why the next bail out should focus on Black women and women of color - Jul. 10, 2020 from 1:00 pm - 1:30 pm EST - RSVP here.

Subscribe or listen here to get the top weekly stories as a podcast at the start of each week.

Top Headlines

32 States See Increasing Coronavirus Infection Rates; Florida and Texas Surpass 200,000 Cases (Health & Science)

New Study Finds Neanderthal DNA Linked to Why Some Patients Experience Severe COVID-19 Symptoms (Health & Science)

Over 230 Scientists Endorse an Open Letter Discussing the Importance of Preventing the Spread of Aerosolized Coronavirus Droplets, and They Want the WHO to Listen (Health & Science)

New Study From Spain Shows Greater Herd Immunity, Even in the Hardest Hit Countries, May Not Be Realistic (Health & Science)

Smell Tests May Be Better Designed to Check Potential Coronavirus Cases in Public Settings, Compared to Temperature Checks Alone (Health & Science)

Clinical Trials Wasted Effort and Money Because of Lack of Coordination, Reports STAT; U.K.’s RECOVERY Trial Offers “Lessons for Other Megatrials,” Says Science; Use of Unproven Treatments Outside of Clinical Trials Is a “Wasted Opportunity,” Say Doctors; WHO Drops Hydroxychloroquine and HIV Antiviral Cocktail from Solidarity Trial (Health & Science)

Brazilian President Bolsonaro Shows COVID-19 Symptoms, Awaits Test Results (Around the World)

Peru Cases Top 300,000 as Country Reopens (Around the World)

India Becomes Third-Worst Hit Country with 700,000 Cases (Around the World)

Australia Closes State Borders (Around the World)

Iraq Sees Massive Surge in Cases (Around the World)

European Commission Issues Dismal Economic Outlook (Around the World)

Bipartisan Group of 57 Government Scientists and Health Officials Criticize Trump’s Virus Response (U.S. Government & Politics)

ICE Issues Guidance for Foreign Students; Forbids Student Visas for Online Only Classes (U.S. Government & Politics)

Goldman Sachs Lowers Third Quarter U.S. Economic Outlook (U.S. Economy)

Uber Purchases Postmates for $2.65 Billion (U.S. Economy)

Harvard to Conduct All Fall Semester Classes Online (U.S. Society)

Health & Science

As of Tuesday morning, there have been 2,938,624 coronavirus cases in the United States, and 131,306 people have died (Johns Hopkins). Around 1,062,542 people have recovered, and the United States has conducted 36,032,329 tests. Worldwide, there have been 11,626,759 confirmed cases of coronavirus, with 538,190 deaths. At least 6,315,864 people have recovered from the virus.

32 States See Increasing Coronavirus Infection Rates; Florida and Texas Surpass 200,000 Cases

The United States Center for Disease Control and Prevention (CDC) reported 52,228 new cases on Monday, bringing the national total to more than 2.7 million confirmed cases and 129,000 deaths (Johns Hopkins). The spike in new cases has not led to a significant increase in the death rate, as young people between the ages of 18 and 50 account for 60 percent of new cases (Guardian). At least 32 states are reporting increased infection rates, with 21 states halting their reopening plans (USA Today). Experts report that the U.S. is still experiencing the worst of the pandemic, with large outbreaks spread between Florida, Texas, Arizona, and California (WaPo). “We are in free fall,” said Dr. Rochelle Walensky from Massachusetts General Hospital of the state of coronavirus in the U.S (CNN). 

New daily cases in Florida reached 11,458 on Sunday, nearing the highest daily record of 11,571 reported in New York in April (NBC). Almost all new cases are Florida residents, as Governor Ron DeSantis maintains the order to encourage, but not require, face masks in public spaces. Both Florida and Texas have now surpassed 200,000 total cases, with many Texas cities running out of hospital beds as the statewide surge continues (NYT). Arizona is reporting some of the highest hospitalization rates in the country, with limited testing sites causing wait times of up to 8 hours (ABC). In response to the increasing cases, some Florida counties closed public beaches for Independence Day, while Florida, Texas, Arizona, and California rolled back reopening plans and extended stay-at-home orders (NBC). 

Local leaders have expressed frustration with conflicting orders coming from both state and federal officials. In Florida, Democrat lawmakers have urged Governor DeSantis to mandate masks in public, while the Governor claims the surge is due to increased testing capacity (NBC). Phoenix, Arizona Mayor Kate Gallego expressed frustration at the Federal Emergency Management Agency (FEMA) moving away from community-based testing while wait times continue to increase. Houston, Texas Judge Lina Hidalgo criticized Governor Greg Abbott for the state’s early reopening, saying “wishful thinking is neither good economic nor public health policy” (ABC). In Texas and other states, city public officials do not have the authority to implement the shelter-in-place orders they feel are necessary, as state officials push to reopen businesses. Local leaders are urging citizens to remain vigilant, as the White House continues to downplay increasing cases and people begin to think the virus is no longer a threat (WaPo). And, according to a New York Times analysis, cases are decreasing in Washington, D.C. and New Hampshire. Bonus Reads: “U.S. Coronavirus Cases Are Rising Sharply, but Deaths Are Still Down,” (NYT) and “Pooling Coronavirus Tests Can Spare Scarce Supplies, But There's A Catch,” (NPR) and “As Coronavirus Surges in U.S., Some Countries Have Just About Halted It,” (WSJ).

New Study Finds Neanderthal DNA Linked to Why Some Patients Experience Severe COVID-19 Symptoms

According to a new study posted as a preprint manuscript on bioRxiv from researchers affiliated with Max Planck Institute for Evolutionary Anthropology in Germany, Karolinska Institutet in Sweden, and Okinawa Institute of Science and Technology in Japan, a portion of DNA that has yielded severe COVID-19 in parts of the population is directly tied to Neanderthals that were in existence 60,000 years ago. According to Princeton University geneticist Joshua Akey, “This interbreeding effect that happened 60,000 years ago is still having an impact today.” The New York Times notes that this six-gene piece on Chromosome 3 is common throughout South Asia, where “one-third of people have inherited the segment,” and in Bangladesh, “63 percent of people carry at least one copy.” Eight percent of Europeans have this, and four percent of East Asians, and almost no one in Africa. Scientists theorize that this variance may have been helpful to those populations that have it over the past several thousand years, and speculation about what this genetic variance means regarding COVID-19 is still being studied. Other genetic theories, such as blood type, have also been researched during the coronavirus crisis. In previous briefs, we noted that research had been released regarding Type A blood and Type O blood, where those with the former may be more susceptible to COVID-19 symptoms than those with the latter type. However, last week, the COVID-19 Host Genetics Initiative released new data that shows blood type may not be as influential as originally thought. The data found “an even stronger link between the disease and the Chromosome 3 segment,” reports the Times, and “people who carry two copies of the variant are three times more likely to suffer from severe illness than people who do not.” Hugo Zeberg, one of the co-authors of the preprint manuscript found that the Neanderthal version of Chromosome 3 (which “raises people’s risk of severe Covid-19”) was “the same version found in a Neanderthal who lived in Croatia 50,000 years ago.” Researchers are continuing to study patients to see if this finding is consistent across cases.

Over 230 Scientists Endorse an Open Letter Discussing the Importance of Preventing the Spread of Aerosolized Coronavirus Droplets, and They Want the WHO to Listen

An open letter by 239 scientists from 32 countries that will be published in the journal Clinical Infectious Diseases states that the World Health Organization (WHO) should acknowledge “the role of airborne spread of Covid-19 and the need for governments to implement control measures,” reports the Guardian. Further, in a report by CNN, the letter reads, “Most public health organizations, including the World Health Organization, do not recognize airborne transmission except for aerosol-generating procedures performed in healthcare settings. Hand washing and social distancing are appropriate, but in our view, insufficient to provide protection from virus-carrying respiratory microdroplets released into the air by infected people.” However, according to members of the WHO’s infection prevention committee, “introducing new measures to guard against aerosol transmission was unfeasible and unlikely to make much difference to the spread of infection, reports the Guardian. The scientists who endorse the open letter believe that the WHO and other health oversight bodies have underplayed the importance of aerosolized spread, especially in enclosed spaces such as the outbreaks at meat processing plants and bars. They write, “There is significant potential for inhalation exposure to viruses in microscopic respiratory droplets (microdroplets) at short to medium distances (up to several meters, or room scale), and we are advocating for the use of preventive measures to mitigate this route of airborne transmission,” (CNN). As we’ve noted in previous briefs, these microdroplets can come from talking, sneezing, coughing, and even exhaling (Reuters, NYT). University of East Anglia professor in medicine and member of the WHO infection prevention committee Paul Hunter says of WHO guidance, “Aerosol transmission can occur but it probably isn’t that important in the grand scheme of things. It’s all about droplets” adding, “Controlling airborne transmission isn’t going to do that much to control the spread of Covid-19. It’s going to impose unnecessary burdens, particularly in countries where they don’t have enough trained staff or resources already” (Guardian). The scientists call for, among other things, ultraviolet lights to kill the virus, effective ventilation in enclosed settings, and high efficiency air filter systems (CNN). Bonus Read: “Hospitals Struggle to Contain Covid-19 Spread Inside Their Walls,” (WSJ).

New Study From Spain Shows Greater Herd Immunity, Even in the Hardest Hit Countries, May Not Be Realistic

According to a recently published report in The Lancet, data from Spain shows that “just 5% of its population has developed antibodies,” furthering theories that herd immunity may not be realistic, reports CNN. The findings indicate that 95 percent of Spain’s population is still “susceptible to the virus.” As we’ve noted in previous briefs, herd immunity occurs when enough people in a population are immune, it becomes difficult for the virus to spread, and thus helps protect those people who are not yet immune (Johns Hopkins). This particular study in Spain consisted of over 61,000 participants, and is likely the largest serological study to date, according to the European Center for Disease Control (CNN). According to the Lancet’s commentary authors, “In light of these findings, any proposed approach to achieve herd immunity through natural infection is not only highly unethical, but also unachievable.” As we’ve noted in previous briefs, it is still unknown what having antibodies means for long-term protection against COVID-19 and how many antibodies are sufficient for protection. According to the study’s lead author and National Center for Epidemiology director Marina Pollán, “Some experts have computed that around 60% of seroprevalence might mean herd immunity. But we are very far from achieving that number.” Spain has over 250,000 coronavirus cases and 28,000 have died from COVID-19. Bonus Reads: “A guide to R — the pandemic’s misunderstood metric,” (Nature) and “Coronavirus Antibody Tests Have a Mathematical Pitfall,” (Scientific American).

Global Pandemic Could Result in Over 1 Million Additional Deaths From Other Diseases

The World Health Organization (WHO), Stop TB partnership, and Imperial College London predict that over 1 million additional deaths could result from a lack of treatment and preventative measures for AIDS, tuberculosis, and malaria patients during the pandemic (CNN). The International AIDS Society released a report on the impacts of SARS-CoV-2 to other communities impacted by disease in advance of its 23rd International AIDS conference, taking place this week. According to International AIDS Society president Anton Pozniak, “The social distancing efforts and lockdowns to control the spread of it [coronavirus], have disrupted HIV prevention and treatment programs and put vital HIV research on hold.” As we’ve noted in previous briefs, the coronavirus has halted many vaccination and disease treatment programs all over the world, from measles to malaria to polio, cancer, and AIDS. The Global Fund to fight AIDS, Tuberculosis and Malaria released survey information in June that found “across 106 of the countries it works in, 85% reported disruptions to their HIV services and 78% and 73% to tuberculosis and malaria services, respectively. Nearly 20% reported severe disruptions for all three diseases.” The Joint United Nations Programme on HIV and AIDS (UNAIDS) and the WHO believe that “a six-month interruption in health services and treatment medications caused by the coronavirus could result in an additional 500,000 deaths from AIDS and related diseases in sub-Saharan Africa in 2020 and 2021 (WaPo). As CNN reports, “This would take progress in HIV control back by more than 12 years.” Thirty-eight million people worldwide live with HIV and in 2019, 690,000 people died from AIDS-related complications (WaPo). The Stop TB partnership believes that “a two-month global lockdown followed by two-month recovery…could result in more than 1.8 million extra cases of TB globally, and more than 340,000 extra deaths by 2025. This is again on top of the 10 million typically infected and 1.5 million who die each year based on 2018 WHO figures,” reports CNN.

In previous briefs,we noted that the Measles & Rubella Initiative said of a decrease in vaccinations in the midst of the coronavirus, “As COVID-19 continues to spread globally, over 117 million children in 37 countries may miss out on receiving life-saving measles vaccine” (JAMA). The World Health Organization (WHO) released a statement on April 27 that 41 countries across sub-Saharan Africa will not have malaria vaccines available this year. This lack of vaccines may nearly double the number of deaths related to malaria across those countries. Polio vaccines across Africa have also stopped, directly impacting up to 12 million children (NYT). In May, Imperial College London released models indicating malaria deaths could be double what they were in 2019, resulting in over 760,000 deaths worldwide (CNN). UNICEF reported that vaccinations in countries across South Asia are impacted due to lockdowns and residents’ fear of taking their children to healthcare facilities (UNICEF).

Smell Tests May Be Better Designed to Check Potential Coronavirus Cases in Public Settings, Compared to Temperature Checks Alone

Temperature checks may not be the best way to determine coronavirus cases in public settings, but smell tests might fill the gap, reports STAT. The inability of temperature checks to truly identify accurate coronavirus patient counts in public settings is supported by United States Transportation Security Administration (TSA) head David Pekoske, when he told reporters, “I know in talking to our medical professionals and talking to the Centers for Disease Control is that temperature checks are not a guarantee that passengers who don’t have an elevated temperature also don’t have Covid-19” because a fever can be caused by myriad reasons (CNBC). In previous briefs, as early as March, formal statements were being made by global health experts that a sudden loss of sense of smell could be a determining factor for coronavirus infection. A recent study by Massachusetts General Hospital (MGH) and King’s College London, published in the journal Nature Medicine, crowdsourced information via an adapted smartphone app, and found that the most reliable symptom for the coronavirus is loss of taste and smell. The published study collected data from 18,000 patients who were tested for SARS-CoV-2 and found that 65 percent of those who reported symptoms listed loss of taste and smell as one of their top symptoms, in addition to fatigue, a persistent cough, and a loss of appetite (Harvard). Further, a Monell Chemical Senses Center analysis of 24 different coronavirus studies found that of 8,438 COVID-19 patients from 13 countries, 41 percent had a loss of smell. According to STAT, “There is no definitive study on the predictive value of temperature checks for Covid-19” and, “Covid-19 can be contagious even before an infected person runs a fever, which makes missed cases more likely.” Therefore, smell tests may be a more effective way to flag possible coronavirus cases. What’s lacking at the moment is knowledge on “a smell test’s ‘negative predictive value’: If someone has a normal sense of smell, the chance that he or she is nevertheless infected and likely contagious.” Now, the University of California San Diego Health team is doing just that: asking about a loss of smell and taste before guests are permitted to enter their facilities. One possible test that could be used is the University of Pennsylvania’s Smell Identification Test (UPSIT) that uses 40 scents and takes 10 to 15 minutes to complete.

Former FDA Commissioner Says the U.S. Needs to Build up COVID-19 Antibody Therapy

On Sunday, former U.S. Food and Drug Administration Commissioner Scott Gottlieb appeared on CBS’ “Face the Nation” and said, “We need a more coordinated national strategy around this.” Gottlieb was referring to antibody therapies for COVID-19, and the need for “building up reserves for therapeutic antibodies,” reports Bloomberg. Further, Gottlieb explained, the U.S. government should be planning for dispersing antibody therapies once they’re available, and making sure there are enough supplies to support that distribution. As we’ve noted in previous briefs, many companies are now working on antibody therapies to fight the deadly disease that is triggered by the coronavirus. According to Bloomberg, Eli Lilly & Co. and Regeneron Pharmaceuticals Inc. are “in the lead of developing so-called neutralizing antibodies that can mimic immune responses to the virus.” Eli Lilly has collaborated with Canada’s AbCellera and China’s Junshi Biosciences on two of these antibody treatments. Eli Lilly and Abcelleara began their human trials on June 1 (CNN). As we noted in a brief from last week, other companies, such as Switzerland’s Novartis, are using previous research to pivot efforts to use monoclonal antibody treatments for COVID-19. Novartis is in a Phase 3 trial for its interleukin-1beta blocker drug called canakinumab. This drug is already U.S. Food and Drug Administration approved for auto-inflammatory syndromes, reports CNN. To see our previous briefs that break down the antibody therapy trials, click here and here. In a report by CNN on Monday, Regeneron has started its Phase 3 trial of its antibody therapy. The trial includes 2,000 United States residents and will be implemented across 100 locations. Regeneron says the trial “will assess its ability to prevent coronavirus infection among uninfected people who have had close contact to an infected person, such as a patient's housemate,” reports CNN. Further, Regeneron has moved into the Phase 2/3 of two trials focused on 1,850 hospitalized and 1,050 non-hospitalized COVID-19 patients in the United States, Brazil, Chile, and Mexico. 

Clinical Trials Wasted Effort and Money Because of Lack of Coordination, Reports STAT; U.K.’s RECOVERY Trial Offers “Lessons for Other Megatrials,” Says Science; Use of Unproven Treatments Outside of Clinical Trials Is a “Wasted Opportunity,” Say Doctors; WHO Drops Hydroxychloroquine and HIV Antiviral Cocktail from Solidarity Trial

Since January, researchers in the United States and worldwide designed 1,200 clinical trials to test treatment and prevention of COVID-19, according to the U.S. government database ClinicalTrials.gov, but lack of coordination between studies wasted much effort and huge financial resources, reports STAT. Out of all the studies, two have yielded almost all the actionable data: the U.K.’s RECOVERY megatrial and a study on remdesivir by the U.S. National Institutes of Health (NIH). One in six trials focused on the antimalarial drugs hydroxychloroquine or chloroquine; among those trials, patients to be enrolled totaled 237,000, or 35 percent of the 685,000 patient volunteers to be enrolled in any study. Small trials must often compete for patients, and since such volunteers are “one of the scarcest resources in medicine, this means that other potential treatments, such as ivermectin or favipiravir, were not studied,” writes STAT.  Of the 1,200 trials, almost 40 percent involved fewer than 100 patients, and thus are unlikely to yield clear results. Large, randomized trials are the accepted gold standard for demonstrating whether a treatment works: “Everybody has the first part about ‘randomized,’ but they omitted the ‘large’ part,” says Ana-Maria Henao Restrepo, a medical officer at the Emergencies Programme at the World Health Organization (WHO). “Every clinician, every researcher wants to help and then they end up having a trial with 300 or 400 patients that cannot come up with conclusive evidence” (Science).

“It’s a huge amount of wasted effort and wasted energy when actually a bit of coordination and collaboration could go a long way and answer a few questions,” said Martin Landray, a professor of medicine at Oxford University and one of the lead researchers on the RECOVERY study (STAT). As we noted in last Wednesday’s brief, the U.K.’s RECOVERY trial yielded actionable data for the third time in a month, showing that “two drugs used to treat hospitalised COVID patients throughout the world, hydroxychloroquine and lopinavir-ritonavir, do not improve survival, whilst one drug that was not recommended, dexamethasone, saves lives” (BioCentury, RECOVERY). The RECOVERY trial is large, with 12,000 patients, but also innovative, flexible, and fast. As a multi-arm trial, it studies several drugs at once, with the same methods and goals, so there is an apples-to-apples comparison of the data on different drugs. RECOVERY is also an adaptive trial: a data monitoring committee “reviews results as they come in, allowing the trial to drop the ones that don’t work, or even add new ones,” writes Wired. Clinical trials can cost around $10 million up to hundreds of millions of dollars, writes STAT, but RECOVERY was funded by a grant of about $2.5 million, says Landray, although hospital costs may raise the total. The trial’s unique approach stripped down the data requirements and focused mainly on whether patients lived or died, in order to enable frontline researchers to collect the data. 

RECOVERY “offers lessons for the few other megatrials, organized by WHO and other bodies, which have been slow off the mark” writes Science. Like RECOVERY, the WHO’s multi-arm, international Solidarity trial has a straightforward design, but rolling out the trial in dozens of countries meant regulatory delays, which in turn lowered the number of potential patient volunteers. “When countries were ready to sort of start, the epidemic was under control in many ways,” says John-Arne Røttingen, who heads the steering committee of Solidarity (Science). In contrast, RECOVERY was able to take advantage of the United Kingdom’s outbreak, the largest in Europe. “They have been able to recruit well, because they have had a lot of hospitalized patients,” Røttingen says. A distinguished group of five doctors, including Chris Whitty, chief medical officer for England, directly encouraged hospitals to participate and wrote that using treatments outside of a clinical trial was “a wasted opportunity to create information that will benefit others” (Science).

In addition to the lack of coordination among the majority of clinical trials, the widespread use of treatments outside of randomized trials in the U.S. and elsewhere means that doctors still lack information on whether those treatments actually work. “Since March, more than 20,000 COVID-19 patients in the U.S. alone have been treated with convalescent plasma through an FDA expanded access program, yet we still don’t know if it confers benefit, does nothing or is harmful,” writes Luciana Borio, former director for Medical and Biodefense Preparedness Policy on the National Security Council and former acting chief scientist at the U.S. Food and Drug Administration (FDA), as we noted in last Wednesday’s brief (BioCentury). RECOVERY, she says, “may be our best hope to establish whether there is a role for convalescent plasma in the treatment of COVID-19,” while the “U.S. is trying to fight a 21st century pandemic with prehistoric clinical trials -- and achieving the kind of efficiency you might expect.” 

For example, on Saturday, the WHO discontinued hydroxychloroquine and the HIV antiviral cocktail lopinavir/ritonavir from the Solidarity trial because the interim results of that large, randomized, controlled trial showed the treatments failed to reduce deaths in hospitalized COVID-19 patients when compared to the standard of care (Reuters), results that are in line with those of the RECOVERY trial on hydroxychloroquine. In contrast, a study published Wednesday in the International Journal of Infectious Diseases analyzed over 2,000 COVID-19 cases in Detroit and found that hydroxychloroquine (alone and in combination with azithromycin) was linked to lower COVID-19 mortality: the study received some press attention (CNN, WSJ), but as an analysis of past cases, without randomization and without a control group, it does not carry the same weight in changing medical practice. An editorial in the same journal pointed out several confounding factors that, if taken into account, may alter the study’s findings, for example treatment of some patients with steroids like dexamethasone. The authors said it is “very sobering to note that the number of patients in this single observational study would have made a substantive contribution to any randomized controlled trial” (IJID). It is “a failing of healthcare systems and research infrastructure,” they say, that it is “exponentially easier” to give “unproven therapies” than to participate in “pragmatic randomized controlled trials.” 

The lack of results from the U.S., which has often led such global efforts and which is undergoing the world’s largest COVID-19 outbreak, is “surprising and a bit disappointing,” says Røttingen (Science). “The lack of leadership around a clinical trial agenda in the U.S. is one of the failures of the U.S.’s pandemic response,” Walid Gellad, director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh, told STAT. “If we had taken the U.K.’s strategy of a set of large pragmatic trials, prioritizing recruitment in those trials, we could have all the answers now that we’re waiting for.”

Around the World

Americas

Brazilian President Bolsonaro Shows COVID-19 Symptoms, Awaits Test Results

Brazilian President Jair Bolsonaro has undergone another test for coronavirus and had his lungs scanned after local media reported he was displaying symptoms related to COVID-19 (Guardian). The president’s office said that test results were expected on Tuesday and according to CNN Brazil, all official events have been cancelled for the day. After returning from the hospital, Bolsonaro told supporters "I've came back from the hospital now, I've done a lung screening, my lung is clean, OK? I went to do a Covid exam a while ago, but everything is okay” (CNN). He was also wearing a mask and told people not to get close to him. Bolsonaro has had at least three separate exams where he has tested negative for the coronavirus, administered between March 12 and March 17, according to earlier media reports. Brazil’s death toll from COVID-19 has risen to over 65,000 and the country is second only to the United States in terms of confirmed cases, with over 1.6 million cases so far. Bolsonaro has repeatedly downplayed the seriousness of the pandemic, fought against preventative measures for the country, and criticized any sort of lockdown measures that would hurt the economy. 

Peru Cases Top 300,000 as Country Reopens

Peru is beginning to slowly reopen its economy even as the number of cases jumps to over 300,000, the fifth-highest number in the world (Reuters). The country went into lockdown in March and many health experts praised the quick response of the government, but officials then struggled to enforce the lockdown as many residents faced economic hardship (Devex). Now, Peru’s death toll is at 10,589 and President Martín Vizcarra began easing restrictions this month. Shopping malls have reopened with a limited number of customers allowed and domestic air and land transport will be resumed in mid-July.

Asia and Oceania

India Becomes Third-Worst Hit Country with 700,000 Cases

On Monday, India overtook Russia to become the third-worst hit country in terms of coronavirus cases in the world, logging over 700,000 cases (Reuters). India is now behind only the United States and Brazil. According to the country’s health ministry, there were 23,000 new cases on Monday, down slightly from Sunday’s record increase of 25,000 new cases. There have been almost 20,000 deaths since the first case was recorded in January. But India’s death rate per 10,000 people is still low at 0.15, compared with 3.97 in the United States and 6.65 in the United Kingdom. As we noted in a brief from last week, the case count in India could actually be higher, Nature warns. India “has an incomplete death-registration system, which means that not all deaths are recorded and the documented cause is often incorrect.” 

Australia Closes State Borders

For the first time in over 100 years, the border between Australia’s two most populous states is closed as authorities try to contain an outbreak in the city of Melbourne (Reuters). The last time movement between the two states was restricted was in 1919 during the Spanish flu pandemic. While closing the border will strike a blow to the country’s economic recovery, the number of cases in Melbourne has surged in recent days and authorities say the border closure is necessary. The Australian state of Victoria reported 127 new cases overnight, the biggest one-day spike since the pandemic started, prompting Victoria Premier Daniel Andrews to tell reporters that closing the border “is the smart call, the right call at this time, given the significant challenges we face in containing this virus.” 

China Dominates Medical Supply Market, Now and for the Foreseeable Future

China has come to dominate the medical supply manufacturing sector, producing their own supplies of masks, gowns, test kits, and other supplies that are sorely needed for the fight against the coronavirus pandemic. Now, other countries are setting up their own factories to try to deal with this outbreak and future pandemics, but those factories may struggle to survive in a way that China’s won’t, since China has laid the groundwork for being the biggest player in the protective equipment and medical supply market. The Chinese government provides cheap land for factory owners in addition to loans and subsidies. Chinese hospitals buy almost exclusively from local suppliers, providing a captive and steady market. “The Chinese have been successful weaving global personal protection equipment dominance with supply-chain command and control,” said Omar Allam, a former Canadian trade official who has been trying to establish production of in-demand N95 medical respirators in his country (NYT). Leading up to the pandemic, China exported more respirators, masks, goggles, and protective gear than the rest of the world combined, according to the Peterson Institute for International Economics. After the pandemic began, China’s mask production increased 12-fold in February alone -- 15 times the output of U.S. companies even after they increased production.

Japan’s Mortality Rate is Unexpectedly Low, Probably Due to Face Masks

Japan saw fewer deaths in the early part of 2020 than average, in spite of the coronavirus outbreak and the 1,000 “excess deaths” attributed to COVID-19 during the time period (BBC). Some even predict that overall deaths for 2020 will be lower than in 2019, puzzling scientists and health experts. Japan has more elderly people per capita than any other country, its population is densely packed into large cities, and most people in those cities use public transportation to get around -- all things that should have made the country more vulnerable to the coronavirus outbreak. Japan also ignored the World Health Organization’s advice to “test, test, test,” and even now, officials have tested only 0.27 percent of the population. The state of emergency has been lifted and the lockdown was not as intense as those in Europe, as the stay-at-home order was voluntary. Theories abound as to why Japan has seemed to escape a major outbreak -- including regional differences in immunity or a previous outbreak that went undetected but provided immunity -- many health experts just attribute the success to the ability to reduce transmission, for example, face masks were a normal part of life even before the pandemic. The government also started an early education campaign to warn people to stay away from enclosed spaces with poor ventilation, crowded places, and close contact settings with face-to-face conversations. 

Middle East 

Iraq Sees Massive Surge in Cases

In recent weeks the number of coronavirus cases in Iraq has increased dramatically, amassing as much as 600 percent in the past month (CNN). Iraq’s largest cemetery is burying 70-80 bodies per day and medical workers report that the virus is spreading among doctors, nurses, and hospital staff due to a lack of personal protective equipment. The country’s healthcare system has been decimated due to years of conflict, and necessary medical supplies, like oxygen, are scarce, making treatment for even mild to moderate cases difficult. Iraq currently has 62,000 confirmed cases, but health experts believe that is a drastic undercounting of the true number, since testing is so limited (Johns Hopkins). 

Israel Reimposes Restrictions to Combat Surge in Cases

On Monday, Israel reimposed a number of restrictions in an attempt to fight a spike in coronavirus infections, including closing bars, gyms, and event halls (Reuters). Restaurants and buses will limit capacity to 20 people at a time and synagogues can only allow 19 worshipers at a time, according to a statement from Prime Minister Benjamin Netanyahu’s office on Monday (Bloomberg). “The pandemic is spreading - that’s as clear as day. It is rising steeply daily and it is dragging with it, contrary to what we had been told, a trail of critically ill patients,” Netanyahu said. The case count has doubled over the past month, totaling more than 30,000 as the country started easing its shutdown in April. 

Europe

European Commission Issues Dismal Economic Outlook

The European Commission said on Tuesday that Europe is facing a deep recession, with the GDP for the 27 economies forecasted to drop by 8.3 percent this year (Guardian). The EU economies are expected to then rebound by 5.8 percent in 2021. The eurozone is forecast to drop by 8.7 percent in 2020 with a 6.1 percent growth in 2021. Both declines and rebounds are worse than had previously been forecast in May. France, Spain, and Italy all face steep falls in output (10.6 percent, 10.9 percent, and 11.2 percent respectively) and the United Kingdom’s economy is expected to shrink by 9.7 percent in 2020. Germany is facing a 6.3 percent fall in GDP and the Netherlands is expected to see a 6.8 percent decrease. Poland is forecast to have the shallowest recession, with only a 4.6 percent decline. 

Italy’s Women Face Challenges with Work after Pandemic

The coronavirus has made working even more difficult for many Italian women, most of whom were already struggling in the Italian work environment that often doesn’t allow for new mothers to return after maternity leave and that doesn’t allow for flexible working hours. Politico reports: “According to new data by the national labor watchdog (INL), some 37,600 women with children submitted voluntary resignations in 2019, compared with just over 13,900 fathers, citing the difficulty of ‘reconciling employment with care needs’ as the main cause for their decision.” The lockdown will have only made things worse, as it has “had very serious consequences on the women who have found themselves managing, often on their own, child care, school, work and the home," said Miriam Tola, a professor and researcher at the University of Lausanne. She believes that the number of women forced to leave the workforce will almost certainly surge this year due to the pandemic. Other countries, including the United States, are facing similar challenges as parents are expected to care for their children while working full-time, sometimes remotely. Bonus Read: “In the Covid-19 Economy, You Can Have a Kid or a Job. You Can’t Have Both,” (NYT). 

U.S. Government & Politics

Bipartisan Group of 57 Government Scientists and Health Officials Criticize Trump’s Virus Response

On Monday, a bipartisan group of 57 former government public health officials and scientists released a statement criticizing the Trump administration’s handling of the coronavirus pandemic (WaPo). The statement, which included signatories from the Trump, Obama, and George W. Bush administrations, read in part: “At great cost to our country, science and expertise have been marginalized in our government’s response to the pandemic thus far.” The statement continued, “The federal pandemic response has muzzled key public health experts within the government and pushed them aside in decision-making processes. In short, the independence of our public health institutions has been compromised. If we continue to cast aside the scientific advice of our own experts, the consequences for the nation will be dire. Indeed, sidelining science has already cost lives, imperiled the safety of our loved ones, compromised our ability to safely re-open our businesses, schools, and places of worship, and endangered the health of our democracy itself.” The Washington Post writes, “The statement’s signatories include Luciana Borio, acting chief scientist under Obama and Trump who left the administration in 2019; Kathleen Sebelius, secretary of the Department of Health and Human Services in the Obama administration; Julie Gerberding, director of the Centers for Disease Control and Prevention under Bush; Peter Lurie, associate commissioner of the Food and Drug Administration under Obama and Trump; and Christine Todd Whitman, Environmental Protection Agency administrator under Bush.”

ICE Issues Guidance for Foreign Students; Forbids Student Visas for Online Only Classes 

On Monday, Immigration and Customs Enforcement (ICE) announced that foreign students enrolled at U.S. universities will not be allowed to stay in the country if their classes are taught fully online and will either have to transfer to a different school or leave the country. Students will be allowed to remain in the United States if their classes involve an in-person or hybrid model. The policy will have a major impact on foreign students who face obstacles including differing timezones, long visa processing times, and international travel restrictions (WSJ, Forbes, CNN). 

Federal Workers Return to the Office 

On Monday, the New York Times reported that federal workers have begun returning to their Washington, D.C. offices, and many will continue to do so as agencies follow the guidance of the Trump administration. According to the report, the Department of Energy has authorized 20 percent of its workers to return, while the Department of Defense authorized 80 percent of its workforce to return (as many as 18,000 people) to the Pentagon. Some agencies, including the Department of Homeland Security, have extended work from home orders, as have many private companies in Washington, D.C. and surrounding areas. Washington, D.C. Mayor Muriel Bowser urged the Trump administration to continue encouraging telework in April, and D.C.’s health strategy suggests that offices remain at 25 percent or lower capacity. Everett Kelley, President of the American Federation of Government Employees, the largest union representing federal workers, said that reopening offices “so the administration can say they reopened the government is irresponsible” (NYT). 

D.C.: No Virus Spike Linked to Protests

On Monday, Washington, D.C.’s Health Director Dr. LaQuandra Nesbitt stated that the city has so far not seen any spike in the number of coronavirus cases tied to the protests that followed the death of George Floyd while he was in the custody of the Minneapolis Police Department (DCist). Nesbitt commented during a press conference, “We have not seen or heard our new cases report their exposure being associated with mass gatherings,” but cautioned, “That being said … we continue to have mass gatherings so that doesn’t allow us to exclude mass gatherings as a … potential source for exposure.”

Atlanta Mayor Tests Positive for Coronavirus

On Monday, Atlanta Mayor Keisha Lance Bottoms announced that she had tested positive for coronavirus (Politico). Bottoms tweeted, “COVID-19 has literally hit home. I have had NO symptoms and have tested positive.” According to Politico, she is among those being closely considered by Joe Biden for the Democratic Vice Presidential spot.

U.S. Economy

Goldman Sachs Lowers Third Quarter U.S. Economic Outlook

On Monday, Goldman Sachs lowered its economic outlook for the United States amid surging coronavirus cases (CNBC). The bank estimated that the third quarter GDP would rise by 25 percent on an annualized basis, a decline from an earlier estimate of a 33 percent increase. Jan Hatzius, Goldman’s chief economist, commented, “The sharp increase in confirmed coronavirus infections in the US has raised fears that the recovery might soon stall.” GDP fell 5 percent in the first quarter, the worst fall since the 2008 recession, but even with the new estimate, the annual increase is still expected to mark a robust recovery with the biggest quarterly rebound since 1947.

Uber Purchases Postmates for $2.65 Billion 

On Monday, Uber Technologies announced its $2.65 billion purchase of Postmates, a rival food delivery app to Uber Eats. Uber representatives said they were interested in Postmates for its large presence in the South and West, and for the opportunity to increase customer loyalty to the Uber ride-share app. The purchase makes Uber the second-largest restaurant delivery service in the U.S., behind DoorDash. Earlier this year, Uber unsuccessfully sought to purchase Grubhub, the third-largest delivery app in the nation. Food delivery services have grown considerably since the beginning of the pandemic, with Postmates reporting a 50 percent increase in orders in the second quarter. The purchase is set to close at the beginning of 2021 (WSJ). 

Trump Administration Says PPP Loans Supported 50 Million Jobs; Releases Recipient Data 

The Trump administration released data on Monday that the Paycheck Protection Program (PPP) loans supported 50 million jobs throughout the U.S., according to self-reported figures by businesses (WaPo). The data, including the names of organizations that took loans under the program, was released after oversight groups pressured the administration for increased transparency about the loan program. The figures released represent loans over $150,000, accounting for only 13.5 percent of all PPP loans distributed. Top recipients of PPP funding in this group include restaurants, medical offices, and car dealerships (NYT). Disclosure: New America received a loan as part of the Paycheck Protection Program.

U.S. Society

Harvard to Conduct All Fall Semester Classes Online

Harvard University announced on Monday that all of its fall classes would be conducted online, with only 40 percent of undergraduate students allowed to return to campus. The university will offer all first year students the opportunity to live in single dorms on campus, as well as students who do not have access to the technology needed to complete their courses. Students on campus will be required to wear masks, maintain social distancing, and will be tested every three days. A Harvard spokesperson said that virtual platforms “should be the first option for social contact” during the semester. Despite the changes, Harvard will not lower its tuition. Princeton announced similar protocols for the upcoming semester, including virtual learning for all classes (Forbes, NYT).

Crowded Private Parties in Miami Despite Ongoing State Surge

Health experts and legal authorities in Miami are struggling to control large, crowded house parties thought to be coronavirus hotspots. As Florida cases continue to rise at alarming rates, young people have turned to hosting parties at private residences where social distancing is ignored and few wear masks. Health officials have been unable to track the location and attendance of these parties, as attendees often withhold information about the social gatherings. “There’s very much a sense of, ‘That’s none of your business,’” said Dr. J. Glenn Morris, Jr. from the University of Florida in Gainesville. Counties in New York recently issued subpoenas to local partygoers who refused to comply with contract tracers, enforced with $2,000 daily fines. However, contact tracing in Florida is already stretched thin, with only 2,200 of the 6,400 people recommended by the National Association of County and City Health Officials to curb community spread (NYT). 

New York Buses Surpass Subway Ridership

In April and May, at the height of the pandemic, New York City's bus system surpassed subway ridership for the first time since the transit system began collecting data 50 years ago. The city’s buses were considerably more full over the past three months, while the subway saw a 93 percent drop in riders since the start of the pandemic. After years of declining bus use in New York and across the country, transportation experts attribute the spike in ridership to bus reliability, efficiency, and flexibility. Joseph P. Schwieterman, a professor at DePaul University, said that “buses are versatile in a time of crisis. They serve a wider range of riders than trains. As transit agencies pinch pennies to stop the flow of red ink, the bus may take center stage” (NYT). 

Analysis & Arguments

Former Treasury Secretary Robert Rubin and former British Foreign Secretary David Miliband argue that more stringent border enforcement won’t provide protection from coronavirus (NYT).

J.C. Pan argues the politicized debate over masks is the result of conservative austerity and its prevention of broader societal responses to the pandemic, causing a focus on individual behavior (New Republic).

Tess Wilkinson-Ryan writes on her research into the psychological challenges that will come with efforts to reopen (Atlantic).

Dissent provides a special section on the pandemic and its societal impact with a range of essays (Dissent).

Yunghi Kim examines the impact of hunger during the pandemic (NYT).

Kimberly Garrison warns of the health risks at gyms both as a result of the pandemic and the issues that predated it (NBC).

In Lighter News

New Restaurant Initiative Helps Keep Restaurants Open While Feeding Frontline Healthcare Workers

A volunteer initiative called Feed Your Hospital has donated more than 13,000 meals to frontline healthcare workers from Asian restaurants hard-hit by the pandemic. Over $200,000 has been raised by generous donations to support the initiative. Currently, over 100 hospitals in 13 cities across the United States are served by Feed Your Hospital’s 34 partner restaurants (Good Morning America).

 Readers can send in tips, critiques, questions, and suggestions to coronavirusbrief@newamerica.org.

The Brief is edited by Melissa Salyk-Virk and David Sterman and co-edited by Emily Schneider and Narisara Murray, with Brianna Kablack and Senior Editor Peter Bergen.

Read previous briefs here and stream and subscribe to our weekly podcast here.

About New America

New America is dedicated to renewing the promise of America by continuing the quest to realize our nation's highest ideals. Read the rest of our story, or see what we've been doing recently in our latest Annual Report. 

Help us to continue advancing policy solutions and journalism by making a donation to New America.