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October 22, 2020 - Brief Issue 109

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

U.S. Approaches Rapid Acceleration of Cases (Health & Science)

AstraZeneca Covid-19 Vaccine Trial Participant Dies in Brazil; Trials to Resume in U.S. (Health & Science)

CDC Revises Definition of ‘Close Contact’ After Study Shows Cumulative Contact May Cause Spread (Health & Science)

Seven Countries Report More Than 100,000 Cases Each (Around the World)

European Hospitals are Preparing for Winter (Around the World)

Italy Records 15,000 Cases in a Day; France’s Cases Increase, Hit One Million, as Effect of Curfew Still to be Seen; Czech Republic Reenters Lockdown Despite Promises From Prime Minister (Around the World)

White House Looks at Cutting Covid Funds, Other Funding in Supposed “Anarchist Jurisdictions” (U.S. Government & Politics)

Senate Dems Block Vote on Senate GOP Relief Bill; Pelosi Cautions on Hopes for Pre-Election Relief Deal as Negotiations with the White House Continue (U.S. Government & Politics)

Pandemic Threatens Urban Renewal (U.S. Economy)

The Viral Danger of Sports: Dinner Not Play? (U.S. Society)

Health & Science

There have been 8,338,091 coronavirus cases in the United States, and 222,210 people have died (Johns Hopkins). Around 3,323,354 people have recovered, and the United States has conducted 127,825,177 tests. Worldwide, there have been 41,261,631 confirmed cases of coronavirus, with 1,131,863 deaths. At least 28,136,723 people have recovered from the virus. 

U.S. Approaches Rapid Acceleration of Cases

Dr. Scott Gottlieb, former commissioner of the U.S. Food and Drug Administration (FDA), is warning that the United States is approaching a rapid acceleration in Covid-19 cases (CNBC, CNN Health). “I think we’re about two or three weeks behind Europe,” Gottlieb said, “so we’re about a week away from starting to enter a period where we’re going to see a rapid acceleration in cases.”

In comparison to Europe, however, the United States started with a much higher baseline of cases, meaning the U.S. surge could soon be much worse. The national seven-day average of daily new Covid-19 cases reached 59,500 on Tuesday, the highest since the first week of August. Dr. Peter Hotez, infectious disease expert at Baylor College of Medicine, expects the U.S. to record up to 70,000 new cases per day next week or the week after (CNN Health). 

AstraZeneca Covid-19 Vaccine Trial Participant Dies in Brazil; Trials to Resume in U.S.

A volunteer who participated in a trial of the Covid-19 vaccine developed by AstraZeneca and Oxford University has died in Brazil, authorities report (Reuters). Oxford University confirmed that the trial will continue to move forward, saying that a careful review found no safety concerns related to the vaccine. Authorities declined to provide additional details, citing medical confidentiality. The Brazilian newspaper O Globo reported that the volunteer had been in the placebo group and had not received the vaccine. In a large-scale clinical trial, a variety of medical outcomes are expected, many unrelated to the trial itself.

The AstraZeneca trial is still on a temporary hold in the United States while the Food and Drug Administration (FDA) completes a review of an unexplained illness in a volunteer in the United Kingdom. However, the trial could resume in the U.S. later this week (Reuters, Politico). A letter to U.K. trial participants from the Oxford Covid-19 Vaccine Team stated, “The FDA has also now completed their analysis of the information relating to the participants concerned and has come to the same conclusion as the other drug regulators including the MHRA. Vaccination will therefore shortly resume in the USA.” Ann Falsey, an infectious disease expert at the University of Rochester School of Medicine, also reported that the FDA was discussing the resumption of the trial. The AstraZeneca trial was temporarily paused worldwide following the report of unexplained illness, and has since resumed in the U.K., Brazil, India and South Africa. Bonus Read: “Oxford Developed Covid Vaccine, Then Scholars Clashed Over Money,” (WSJ).

CDC Revises Definition of ‘Close Contact’ After Study Shows Cumulative Contact May Cause Spread

A case study from the Centers for Disease Control and Prevention (CDC) published Wednesday suggests that multiple brief encounters with individuals infected with Covid-19 may be just as risky as a longer interaction (STAT, WaPo). The study examined the case of a male correctional officer who interacted briefly with six infected individuals who were awaiting diagnostic SARS-CoV-2 (Covid-19) tests. Although contact tracing and video surveillance determined that the officer had not met the CDC definition of ‘close contact’ – being within 6 feet of infected individuals for at least 15 consecutive minutes – the officer experienced Covid-19 symptoms approximately 1 week later and was soon confirmed to have contracted the virus.

Video surveillance revealed that the officer had been briefly within 6 feet of infected individuals approximately 22 times throughout his 8-hour shift. The encounters lasted only about a minute each, but cumulatively totaled about 17 minutes. The officer had no other known exposures in the 2 weeks preceding symptom onset.

Based on this study, the CDC updated its definition of ‘close contact’ as being within 6 feet of infected individuals for a time totaling 15 minutes or more over a 24-hour period. Experts have long been aware that the 15-minute guideline is not a hard-and-fast rule but rather a functional guideline used for contact tracing. The CDC noted in their report that additional factors may also be considered, including “proximity, the duration of exposure, whether the infected person has symptoms, whether the infected person was likely to generate respiratory aerosols, and environmental factors such as adequacy of ventilation and crowding.”

Covid-19 Vaccine Unlikely to Completely Stop Viral Spread, According to U.K. Chief Scientific Officer

According to Patrick Vallance, the U.K.’s chief scientific advisor, Covid-19 is unlikely to be completely eradicated by a vaccine and will likely continue to circulate (CNBC). Vallance noted that, with improved treatments and with vaccination, the chances of infection and the severity of the disease would go down. “We can’t be certain,” said Vallance, “but I think it’s unlikely we will end up with a truly sterilizing vaccine, something that completely stops infection, and it’s likely this disease will circulate and be endemic.”

A paper published in the journal Science last week explored this possibility, investigating several possible transmission patterns. There is much that is still unknown about the virus, including how long people stay immune and how quickly the virus mutates, but based on similar viruses, the authors raise the possibility of yearly outbreaks of Covid-19, or possibly resurgence every few years. 

Mixed Results for Tocilizumab as Covid-19 Treatment

Three studies examining the effects of the immunosuppressant tocilizumab on Covid-19 patients were published Wednesday in the medical journal JAMA Internal Medicine. Each study examined the results of the drug in treating patients hospitalized with Covid-19 (CIDRAP).

A study of 3,924 Covid-19 patients in the U.S. found moderate reductions in mortality in patients treated with tocilizumab (28.9% of patients in this group died, compared with 40.6% in the control group). The authors noted potentially severe side effects to treatment, including liver toxicity.

The second study, conducted in Italy, involved 123 adult Covid-19 patients hospitalized with severe symptoms. The study found no significant differences in clinical deterioration between the treatment and control groups at 14 days. After an interim analysis found no benefits to treatment, the study was terminated.

A third study, conducted in France, observed 130 patients hospitalized with moderate to severe pneumonia. After 14 days of treatment with tocilizumab, 24% of patients required ventilation. By contrast, 36% of patients in the control group required ventilation. The authors noted that their results needed to be “confirmed with a larger randomized clinical trial with longer follow-up.”

Dr. Jonathan Parr of the University of North Carolina at Chapel Hill wrote a detailed commentary on the articles in which he cautioned that the results were far from conclusive. He said, “[The] findings do not support the routine use of tocilizumab for COVID-19 in most settings,” and asserted that only double-blind, placebo-controlled randomized clinical trials would provide conclusive evidence to support or reject the routine use of tocilizumab in clinical settings.

Covid-19 Supply Chains Guard Against Potential Thefts

In addition to ensuring sufficient supplies and adequate cold storage space for Covid-19 vaccines, manufacturers and health officials are taking steps to prevent thefts (WSJ). Although production is ramping up as several vaccine candidates near completion of clinical trials, there will be shortages at first, with initial doses likely going to vulnerable medical professionals and individuals with significant risk factors.

In order to thwart potential thieves, suppliers are equipping shipments with GPS tracking software, adding blacklight verification to vials, and even sending out fake shipments. Paul Mango, deputy chief of staff for policy at the U.S. Department of Health and Human Services, commented, “We are appropriately paranoid about anything that has to do with either cybersecurity or physical security and we are taking great precaution to ensure that these are safeguarded.”

Bonus Reads: “States Prepare for Their Own Vaccine Safety Reviews Amid Worries About Trump’s Influence on the FDA,” (Politico); “Public Health Experts Push Vaccine Makers, HHS to Release Covid-19 Trial Protocols,” (STAT).

Around the World

Seven Countries Report More Than 100,000 Cases Each 

In the past seven days, seven countries — Argentina, Brazil, the United Kingdom, France, India, Russia and the United States — have reported at least 100,000 new coronavirus cases, says the New York Times. In the U.S., there have been 421,114 new cases in the past week. India reported 411,718 new cases over the past seven days. Even though the country reported the lowest number of new cases since July on Monday, experts question the new testing methods used by the government and the accuracy of the case count. France added 174,273 cases in the past week with 2,000 patients in intensive care, a number that hospitals haven’t seen since May. Brazil reported 160,326 cases in the past seven days but is also among the countries with the lowest testing rate. Daily infections in the United Kingdom have nearly tripled since the start of October, with 127,622 cases reported over the past week. Argentina reported 101,964 cases in the past week and was also the fifth country to surpass one million total cases. In Russia, where authorities have avoided implementing even local lockdowns, there were 103,822 new cases in the past week (WaPo). 

Europe

European Hospitals are Preparing for Winter 

Europe’s second wave of coronavirus cases is already putting hospitals under pressure in the hardest-hit cities, and healthcare systems around the continent are putting lessons learned in the spring to use in building contingency plans for the winter (WSJ). In Paris, hospitals are stockpiling drugs and protective equipment in hopes of avoiding shortages as they did in the spring. In Spain, hospitals have outlined “elasticity plans” that would increase the number of beds for Covid-19 patients. In the Lombardy region of Italy, where the European outbreak began, hospitals are preparing to move patients to places where space is available in an attempt to prevent intensive care units from becoming overwhelmed. While the outbreak is different this time around -- those falling ill are younger on average, people are seeking treatment earlier, and hospitals now know how best to treat patients -- those mitigating factors aren’t enough as case counts increase out of control. Doctors worry that even though they understand the virus better now, they will still lack the resources and staff to properly treat patients. Bonus Read: “Covid-19’s Wintry mix: As We Move Indoors, Dry Air Will Help the Coronavirus Spread,” (STAT).

Italy Records 15,000 Cases in a Day; France’s Cases Increase, Hit One Million, as Effect of Curfew Still to be Seen; Czech Republic Reenters Lockdown Despite Promises From Prime Minister

Italy registered 15,199 new coronavirus cases in the past 24 hours, the highest daily tally since the beginning of the country’s outbreak (Reuters). Italy was the first country in Europe to face the pandemic, but infections declined over the summer. Now, cases are surging again and this time they are more widely distributed; during the first wave the Lombardy region around Milan was the hardest-hit. Prime Minister Giuseppe Conte has said he is determined to avoid another national lockdown and is instead delegating responsibility to local authorities to determine measures that are appropriate for their regions. 

France’s new cases rose by at least 25,000 for the sixth time in 12 days on Wednesday, suggesting that the curfews put in place in Paris and other large cities have yet to take effect (Reuters). Health experts have said that it generally takes two weeks for such measures to have any impact on the spread of the virus. Early Thursday morning France surpassed one million coronavirus cases since the start of the pandemic (WaPo). Spain was the first Western European nation to report more than one million cases, also reaching the grim milestone this week. 

As cases continue to surge in the Czech Republic, the government is placing the same restrictions on citizens as they did in the spring, even though Prime Minister Andrej Babis repeatedly said those measures would never return (AP). Babis apologized for the forthcoming social and economic impact the restrictions would have, but said “we have no time to wait” and explained that “the surge is enormous” and that the health system was in danger of collapse as early as November 7. Initially, the Czech Republic implemented a fast and decisive response to the pandemic, but was also one of the first countries to ease restrictions and almost abandoned them altogether over the summer. Now, cases are climbing fast, with a record of almost 15,000 new cases on Wednesday. 

EU Cuts Canada from Safe Traveler List, Adds Singapore

The European Union is set to cut Canada, Georgia, and Tunisia from its “white list” of countries from which travelers can visit the bloc without any Covid restrictions like quarantining or showing negative test results (Reuters). However, the ambassadors from the 27 EU nations agreed to add Singapore to the list. The new measures will be formalized by the end of this week as long as none of the EU member countries object. After the changes, the list will include only nine countries: Australia, China, Japan, New Zealand, Rwanda, Singapore, South Korea, Thailand and Uruguay.

German Health Minister Tests Positive, ‘Hamsterkauf’ on the Rise

German Health Minister Jens Spahn has tested positive for the coronavirus, the health ministry said on Wednesday (DW, Reuters). Spahn immediately went into isolation and is experiencing “cold-like symptoms.” Spahn is one of Germany’s most high-profile political figures to contract coronavirus and the country is facing a surge in cases with a record number of new cases this past week. Authorities have imposed tougher restrictions on public life, like requiring masks outdoors in crowded areas. The country logged more than 11,200 new cases in the past 24 hours, the first time the daily tally has risen above 10,000. ‘Hamsterkauf’ -- the German term for “panic buying” that loosely translates to “hamster purchases” -- is also on the rise again as sales for toilet paper were up nearly 90% last week compared to pre-pandemic levels.

U.S. Government & Politics

White House Looks at Cutting Covid Funds, Other Funding in Supposed “Anarchist Jurisdictions”

The White House is considering cutting funding for coronavirus relief and a variety of other services in cities it designates as “Anarchist Jurisdictions” (Politico). Politico writes, “The White House is considering slashing millions of dollars for coronavirus relief, HIV treatment, screenings for newborns, and other programs in Democratic-led cities that President Donald Trump has deemed ‘anarchist jurisdictions,’ according to documents obtained by POLITICO.” The administration’s references to supposed anarchist jurisdictions could mean loss of funding for Portland, Oregon, New York City, Washington, D.C., and Seattle, essentially mobilizing relief funds as a tool in Trump’s disputes with liberal cities. The discussions are part of an effort to follow through on Trump’s September 2 order regarding such jurisdictions. Politico notes, “at least one department has already moved to implement Trump’s directive for new funding. The Department of Transportation earlier this month said Trump’s ‘anarchy’ memo would factor into the department’s review of applications for a new $10 million grant program supporting Covid-19 safety measures.”

Senate Dems Block Vote on Senate GOP Relief Bill; Pelosi Cautions on Hopes for Pre-Election Relief Deal as Negotiations with the White House Continue

On Wednesday, Senate Democrats blocked a vote on the Senate GOP’s proposed coronavirus relief bill (WaPo, Politico). The vote to advance the bill failed 51-44, requiring 60 votes to move forward. An almost identical bill failed along the same vote lines in August. Meanwhile House Speaker Nancy Pelosi suggested that negotiations with the White House on a larger bill are continuing but that it is unclear if a deal will pass before the election, specifically pointing to the question of whether the Senate Republicans would support a deal. Pelosi commented, “We obviously want to have a deal by Nov. 3rd. That really is going to be up to whether the president can convince Mitch McConnell to do so.”

Pew Research: Just 24% of Trump Supporters Say Covid Very Important Issue for Their Vote

New research from the Pew Research Center found that only 24% of Trump supporters describe Covid-19 as a very important issue for their vote (Pew). In contrast, 82% of those who either plan or lean towards voting for Biden say it is “very important.” The Pew survey was conducted between October 6 and 12 with 10,059 adults of whom 8,972 were registered voters. The survey also found that the percentage of Trump supporters who described the issue as “very important” had declined 15 points since Pew’s last survey in August.

New Jersey Governor had Close Contact with Person Who Tested Positive

On Wednesday, New Jersey Governor Phil Murphy left a press conference after learning that he had had close contact with someone who tested positive for Covid (Politico). Politico described his departure from the event in Blackwood, Camden County as “abrupt.” Murphy, who had previously criticized Trump for attending a fundraiser at his Bedminster golf course after testing positive, said he had tested negative on Monday and stated, “I will now, unfortunately, have to take myself off the field,” adding, “I can’t ask President Trump not to come to Bedminster and do a fundraiser and have me sit here.” The contact was reportedly with a senior staffer, and the governor and his wife are quarantining (WaPo).

Bonus Read: “Actually, Americans Do Want to Wear Masks to Vote,” (Politico).

U.S. Economy

Pandemic Threatens Urban Renewal

Cities that have been built around office buildings that used to bring in thousands of workers every day are struggling amid the pandemic, but cities like Detroit, Cleveland, and Oakland, California are especially vulnerable to economic distress. Experts believe that cities that have faced years of decay will have a difficult time recovering from the pandemic as they haven’t had time to build established bases of office tenants (AP). And even though downtown populations in Cleveland and Detroit are growing, the overall populations are still declining. Without daytime traffic from offices and suburban commuters who stayed in cities for evening outings, downtown areas have turned to ghost towns and once bustling lunch spots and coffee joints are losing revenue. As the pandemic continues, many businesses will be forced to close, causing damage that could ripple through downtowns and further hurt remaining businesses.

U.S. Society

Bonus Read: “To Survive, Restaurants Are Taking Takeout to the Next Level,” (WSJ).

The Viral Danger of Sports: Dinner Not Play?

As the NFL struggles with coronavirus outbreaks amid its season, evidence so far suggests that the virus is not spreading from team to team on the field of play but during team dinners and other social activities off the field, according to the Wall Street Journal (WSJ). The Journal writes, “Breaking bread—as a team or in small gatherings—played a starring role in team outbreaks at Notre Dame and on both the Tennessee Titans and New England Patriots, for example. But those teams’ subsequent football games didn’t create additional problems: their opponents tested negative.” Dr. Allen Sills, the NFL’s chief medical officer, states, “We still see no evidence of on-field transmission from football-related activities.”

Analysis & Arguments

Lars Calmfors, a member of the Royal Swedish Academy of Sciences warns other countries against pursuing Sweden’s model despite its economic success (WaPo).

Ashley Fetters writes on what is lost when office conversations disappear (NYT).

Elisabeth Rosenthal writes on how to enable bars to survive the winter amid pandemic restrictions (NYT).

Brendan Borrell explores the importance of one tree species to vaccine efforts (Atlantic).

Bryce Covert writes on how the pandemic has impacted people’s health coverage (Nation).

The Wall Street Journal explores how SNL is produced during the pandemic (WSJ).

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

The Brief is edited by David Sterman and Emily Schneider with Jessica Scott and Senior Editor Peter Bergen.

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