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October 21, 2020 - Brief Issue 108
The Coronavirus Daily Brief is a daily news and analysis roundup edited by New America’s International Security Program and Arizona State University.
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Top Headlines
United States Has Seen Nearly 300,000 Excess Deaths Since January (Health & Science)
Moderna Expects Interim Covid-19 Vaccine Efficacy Results in November (Health & Science)
Fourteen States Set Hospitalization Records (Health & Science)
Kidney Disease Linked to Worse Covid-19 Outcomes (Health & Science)
Sweden Quietly Shifts Strategy (Around the World)
Spain on Track to Register a Million Infections, Authorities Consider Curfew (Around the World)
Five South Koreans Die After Getting Flu Shots, Eroding Public Trust in Vaccines (Around the World)
Chinese City Offers Experimental Vaccine to Residents (Around the World)
New Zealand Records 25 New Cases for First Time Since April (Around the World)
Senate GOP Voices Opposition to Potential Coronavirus Relief Deal Before Election (U.S. Government & Politics)
Melania Trump Cancels Planned Rally Attendance Citing Covid Recovery (U.S. Government & Politics)
1.5 Million New Yorkers Cannot Afford Food (U.S. Economy)
Small Movie Theaters Struggle Amid Pandemic (U.S. Society)
Turkey Farmers Fear They Have Too Many Birds (U.S. Society)
Health & Science
There have been 8,274,797 coronavirus cases in the United States, and 221,076 people have died (Johns Hopkins). Around 3,295,148 people have recovered, and the United States has conducted 126,940,105 tests. Worldwide, there have been 40,795,980 confirmed cases of coronavirus, with 1,124,952 deaths. At least 27,912,958 people have recovered from the virus.
United States Has Seen Nearly 300,000 Excess Deaths Since January
According to the most recent count by the Centers for Disease Control and Prevention (CDC), 299,000 more people have died in the United States than would be expected in the same time period of a typical year (STAT, WaPo). Of these, only about two-thirds – just over 220,000 – are officially attributed to Covid-19.
Excess deaths, as this number is termed, can help epidemiologists estimate the true toll of a pandemic or other disaster. Generally, official records will undercount the actual mortality, for example due to misdiagnosed illness or if an individual does not seek medical attention.
The report noted that racial and ethnic minorities, particularly Hispanic and Latinx persons, were overrepresented in the excess death count. These disparities are also seen in official Covid-19 death counts. Deaths in white people were only 11.9% higher compared to other years, while deaths among Latinx people were 53.6% higher. Excess deaths were also higher than they were last year among other minority groups, including Asian (36.6%), Black (32.9%) and American Indian and Alaska Native (28.9%) people.
The exact causes of these excess deaths are not completely known. Although many are certainly due to unreported Covid-19 cases, some percentage of the deaths probably had other immediate causes: some people may have put off seeking critical medical care due to the pandemic; others may have lost employment-dependent health insurance coverage; some excess deaths may be attributable to causes not related to the pandemic.
Moderna Expects Interim Covid-19 Vaccine Efficacy Results in November
Stéphane Bancel, Chief Executive Officer of Moderna, said Monday that the drug company expected to have interim Covid-19 vaccine results in hand in November (WSJ). Moderna is one of a handful of frontrunners, including Pfizer, in the race to develop a Covid-19 vaccine. Two other companies, AstraZeneca and Johnson & Johnson, have temporarily paused their late-stage vaccine trials to give researchers time to investigate unexplained illnesses in participants.
The first efficacy analysis will occur when 53 people in the entire study – including those who received a vaccine and the placebo group – show symptoms of Covid-19. The company will also need to monitor its participants for a median period of two months after vaccination to determine whether there are any adverse effects, a threshold which they expect to pass in late November.
If all goes according to plan, Moderna will file with the Food and Drug Administration for emergency use authorization in late November or early December. Like Pfizer, which has a similar timeline, Moderna is already ramping up production of its vaccine and expects to produce 20 million doses by the end of the year.
Fourteen States Set Hospitalization Records
Average new Covid-19 case counts across the United States have been rising steadily for weeks, with an increase of 70% in the seven-day average since September 12 (CNN Health). Hospitalization rates, which lag behind new cases, are also increasing. Fourteen states reported new Covid-19 hospitalization rate records in the past week: Alaska, Arkansas, Iowa, Kansas, Kentucky, Montana, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota, Utah, West Virginia and Wisconsin. Health officials are concerned that numbers will continue to rise over the coming months and urge people to continue wearing masks, maintaining physical distance, and being vigilant about hand washing.
Kidney Disease Linked to Worse Covid-19 Outcomes
A study published in the medical journal Anaesthesia last week uncovered a link between Covid-19 disease severity and the presence of kidney disease or injury (CIDRAP). The study examined 372 adult Covid-19 patients admitted to ICUs in the United Kingdom between March and July. Fifty-eight percent of these patients had kidney dysfunction, of which 22% was chronic kidney disease (CKD) existing before the Covid-19 diagnosis and 78% of which was developed as a complication during hospitalization.
The study found that those with CKD and Covid-19-related kidney injury were much more likely to die than patients with healthy kidneys. Whereas 21% of ICU patients with healthy kidneys died, 48% of patients with new kidney injury and 50% of patients with CKD died. Surprisingly, severity of CKD did not impact mortality: across various CKD stages, including 19 patients with end-stage renal failure, mortality rates remained approximately the same.
The reason for increased mortality among patients with kidney dysfunction is unknown, but the authors of the study raise several possibilities: viral infection may cause inflammation of blood vessels in the kidneys, similar to effects seen in the lungs; cytokines and other inflammatory factors triggered in the lungs may travel to the kidneys and cause injury; or severe Covid-19 infection may cause multiorgan failure, affecting kidney function. The authors write, “Further urgent mechanistic work is required to greater understand the pathophysiology of kidney injury and failure in patients with Covid-19.”
United Kingdom Prepares for Controversial Human Challenge Vaccine Trials
Researchers at Imperial College London are preparing to deliberately infect volunteers with Coronavirus in order to test the efficacy of various vaccines (STAT, NPR, NYT). These so-called “human challenge trials” are not unheard of in the vaccine world, but they are controversial, particularly in the case of Covid-19. Most other human challenge trials have involved diseases such as typhoid and malaria, for which reliable therapies already existed. In the case of Covid-19, scientists and ethicists worry that volunteers could experience severe illness, unknown long-term effects, and even death.
Nonetheless, others see a challenge trial as a potentially life-saving measure which could help speed vaccine development. Chris Chiu, lead researcher on the project, said, “The UK’s experience and expertise in human challenge trials as well as in wider Covid-19 science will help us tackle the pandemic, benefiting people in the UK and worldwide.”
The study plans to enroll only healthy people ages 18-30, a lower risk group, who have no history of Covid-19 symptoms nor any known risk factors for the disease. In the first part of the study, researchers will determine the lowest possible viral dose that reliably causes Covid-19. Next, volunteers will be inoculated with one of several candidate vaccines and exposed to the virus. Volunteers will be quarantined in a biosecure unit at London’s Royal Free Hospital for several weeks and monitored for at least a year afterward.
Though it is still awaiting final approval, the UK government has slated $43.4 million (33.6 million pounds) for the study. The study would be the first of its kind and, pending final approval, would begin in January, with initial results expected in May.
One in Four New York City Transit Workers May Have Contracted Covid-19
A recent survey published by the NYU School of Global Public Health suggests that nearly 25% of New York City transit workers have been infected with Covid-19 (WSJ, Business Insider). Survey participants were asked whether they had been told by their doctor that they had a Covid-19 infection, had a positive Covid-19 diagnostic test, had a positive Covid-19 antibody test, or had been hospitalized for Covid-19. Of 645 participants, 24% responded “yes” to at least one of those questions.
The self-reported infection rates are much higher than previous statistics have reported. In May, Governor Cuomo released data from antibody tests which indicated that 14.2% of transit workers had contracted Covid-19 at some point. New York Metro Transit Authority’s chief communications officer, Abbey Collins, pushed back on the survey data, saying that it encompassed “only a fraction of the NYC Transit workforce, and captured only those who were most motivated to participate.”
Around the World
Bonus Read: “Covid-19’s Global Divide: As West Reels, Asia Keeps Virus at Bay” (WSJ)
Europe
Sweden Quietly Shifts Strategy
After taking a different approach throughout the coronavirus pandemic and avoiding lockdown measures, Sweden is now shifting strategies and could be adopting restrictive measures similar to those of its neighbors. Anders Tegnell, Sweden's state epidemiologist, is set to meet with local health officials over the next week to discuss new measures that could be introduced in response to outbreaks in Stockholm and the nearby city of Uppsala, according to the Telegraph. During the first wave, the Swedish government allowed shops, bars, restaurants, and schools to remain open while most of Europe and it’s Nordic neighbors entered lockdowns. As a result, Sweden has recorded a much higher per capita death rate, with 5,918 deaths as of Sunday, compared with 278 in Norway and 346 in Finland. The government is now looking to give local authorities power to strongly recommend that people avoid busy public places and public transport as well as to discontinue contact with those considered most vulnerable to infection. “It’s more of a lockdown situation—but a local lockdown,” Dr. Johan Nojd, who leads the infectious diseases department in the city of Uppsala, told The Telegraph. In a statement provided to TIME, however, a spokesperson for the Public Health Agency of Sweden rejected that characterization. “It is not a lockdown but some extra recommendations that could be communicated locally when a need from the regional authorities is communicated and the Public Health Agency so decides,” the spokesperson said. Still, it is a significant shift in the way the government is approaching the pandemic.
Spain on Track to Register a Million Infections, Authorities Consider Curfew
Spain is nearing a total of a million infections since the beginning of the pandemic, with 988,322 registered so far (Johns Hopkins). It would be the first European country to reach the one million mark and the sixth country globally (Guardian). The death toll is at more than 34,000. Health Minister Salvador Illa said on Tuesday that the government is considering instituting new restrictions, including curfews in Madrid and elsewhere to try to slow the second wave. “We have very tough weeks ahead, winter is coming,” Illa told reporters. “The second wave is no longer a threat, it is a reality in all of Europe” (Reuters). However, imposing a curfew in Madrid, which is one of the biggest virus hotspots in Europe, would require invoking a state of emergency and would prove challenging in Spain’s polarized parliament.
Asia/Pacific
Five South Koreans Die After Getting Flu Shots, Eroding Public Trust in Vaccines
Five people have died after getting flu shots in South Korea over the past week, authorities said, sparking fear over the vaccine’s safety just as the seasonal vaccine push is expanded amid the pandemic (Reuters). Even though authorities said there was no reason to believe the deaths were related to the vaccine, an investigation is underway. The deaths come just weeks after the national program was suspended due to safety concerns as some 5 million doses, which needed to be refrigerated, were left to warm to room temperature during transport. Authorities planned for around 19 million people to receive the vaccine for free in an effort to stem potential complications related to Covid-19 combining with the flu season. Public trust in the vaccine is now at risk in South Korea, and indeed, people around the world are skeptical of vaccines in general as countries rush to approve experimental Covid-19 vaccines without completing full safety studies.
Chinese City Offers Experimental Vaccine to Residents
The city of Shaoxing in China’s Zhejiang province will begin offering an experimental coronavirus vaccine to residents (Reuters). Residents between the ages of 18 and 59 can apply online for the inoculation, the city announced on Tuesday on its WeChat account. It did not name the vaccine or say how many doses would be offered. In July, China launched an emergency use program aimed at inoculating emergency personnel, essential workers, and other groups at higher risk of infection. Hundreds of thousands of people have already been given experimental vaccines even though the use of shots that are still being studied has raised safety concerns among health experts.
New Zealand Records 25 New Cases for First Time Since April
New Zealand reported two new community transmissions of Covid-19 and 23 imported cases on Wednesday, with most of the cases being linked to a group of Russian and Ukranian fisherman (Reuters). The fishermen were staying at a managed isolation facility in Christchurch, according to the Director General of health, Ashley Bloomfield. It is the first time since April that the country recorded 25 new cases in a day, with Bloomfield saying the cases were “a record” as the country hasn’t “had that number for a while” (Stuff).
U.S. Government & Politics
Senate GOP Voices Opposition to Potential Coronavirus Relief Deal Before Election
On Tuesday, Senate Majority Leader Mitch McConnell (R-KY) told his Senate Republican colleagues that he had communicated a warning to the White House regarding his opposition to its negotiations with House Democrats over a potential coronavirus relief bill (WaPo). Two sources familiar with the meeting told the Washington Post that McConnell argued that House Majority Leader Nancy Pelosi was not negotiating with Treasury Secretary Steven Mnuchin in good faith. McConnell’s opposition to the negotiations over a potential $2 trillion package and support for a smaller bill pushed by the Senate GOP could mean no relief will pass before the election. On Tuesday, McConnell told reporters that if a deal was negotiated, he would put it on the Senate floor “at some point” but would not say it would be before the election. Meanwhile, Trump suggested on “Fox and Friends” that he’d support a bill larger than the $2.2 trillion supported by House Democratic leadership despite having pushed for a lower amount in negotiations. He commented, “It’s very simple: I want to do it even bigger than the Democrats. Not every Republican agrees with me, but they will.” Most GOP Senators remain opposed to such a large package (Politico).
The flurry of comments comes following statements, covered in previous briefs, by Pelosi that Tuesday was the deadline to agree on a deal that would pass before the election. But on Tuesday evening, Pelosi said in a letter to House Democrats following a 45-minute conversation with Mnuchin that their “conversation provided more clarity and common ground as we move closer to an agreement,” signaling that the Tuesday deadline she set had “enabled us to see that decisions could be reached and language could be exchanged, demonstrating that both sides are serious about finding a compromise” (WSJ). Now, it seems that that deadline has shifted to the weekend, with White House chief of staff Mark Meadows saying on CNBC that Pelosi and the administration were trying to secure “some kind of agreement before the weekend.” Yet even if Pelosi and Mnuchin do manage to reach a deal, a vote in the Senate would probably wait until after the election, at least according to McConnell’s warning to the White House.
Melania Trump Cancels Planned Rally Attendance Citing Covid Recovery
On Tuesday, First Lady Melania Trump cancelled plans to join Donald Trump at a campaign rally in Pennsylvania that evening, citing her continued recovery from Covid-19 (CNN). The rally would have been the first she attended in more than a year aside from the convention, according to CNN. The First Lady’s Chief of Staff stated, “Mrs. Trump continues to feel better every day following her recovery from Covid-19, but with a lingering cough, and out of an abundance of caution, she will not be traveling today.”
U.S. Economy
1.5 Million New Yorkers Cannot Afford Food
One and a half million New Yorkers cannot afford food and tens of thousands have found themselves lining up for food pantries, according to a Tuesday report in the New York Times (NYT). City Harvest, one of New York’s largest distributors of emergency food, reported 12 million visits to its pantries between March and August, an increase of about three million from 2019. Another group, BronxWorks, saw the number of people and families it serves increase eight times as a result of the pandemic. Accompanied by photos, the Times’ report profiles some of those relying on food pantries, many of whom are using them for the first time.
Federal Reserve Official: Covid Reveals System’s Fragility
On Tuesday, Federal Reserve Vice Chairman for Supervision Randal Quarles said that the coronavirus pandemic has revealed the fragility of the banking system (WSJ). In the text of remarks to be presented Tuesday, Quarles stated, “The Covid event revealed a banking system that withstood this shock quite well with limited official sector support, and a nonbank system that was significantly more fragile.” He also commented, “We know already that work needs to be done to improve the resiliency of money market funds before the vulnerabilities in these funds amplify another shock.”
U.S. Society
Small Movie Theaters Struggle Amid Pandemic
While the pandemic and the governmental and societal response have hit the movie theater industry hard in general, small movie theaters have been particularly challenged (WSJ). The Wall Street Journal writes, “Although national cinema chains have been hit, too, for small family-owned operators, the problems are particularly acute and personal. They don’t have large financial cushions, making them especially vulnerable to downturns that can wipe out family livelihoods.” Some theaters have adopted new approaches to try and make up for the revenue shortfall. Lynn Kinsella, the owner of New York theater told the Journal that while she had started selling curbside popcorn, “It doesn’t make up for the 90% of revenue that we’ve lost.” Theaters made approximately $8 billion in box office sales in 2019, but so far in 2020, they have only made $2.08 billion.
Turkey Farmers Fear They Have Too Many Birds
Turkey farmers fear that they have bred too many turkeys for this Thanksgiving season, as the pandemic reshapes people’s expected holiday plans (WaPo). The Washington Post writes, “The coronavirus pandemic will interrupt 50 years of steadily increasing turkey consumption, threatening to change holiday traditions forever. Social distancing and travel challenges will mean more, smaller holiday gatherings this November — thus smaller home-cooked turkeys on the table, fewer holiday restaurant reservations and, in an increasing number of households, no turkey at all.” Meanwhile, processing plants are trying to prevent coronavirus outbreaks in their slaughterhouses and packaging facilities, and retailers are increasingly aiming to sell turkey by the pound or in ready made form. Drew Bowman, who raises about 70,000 turkeys a year, told the Post, “We always get anxious before the holidays. It’s our busiest time of the year by far, with more work to be done, longer hours, and there are always things that can go wrong,” adding, “But just like any other person, this has been a year with a lot of emotions, with so much uncertainty, and as a small-business owner, it keeps you up at night worrying about the ramifications. There are a lot of unknowns for us right now.” Bowman’s turkey sales had already dropped as the pandemic closed the fairs and parks that buy his product while diminishing demand from colleges.
Analysis & Arguments
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