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February 23, 2021 - Brief Issue 156

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

Two Additional Studies Corroborate Earlier Evidence That Recovered Coronavirus Patients Likely Need Only One Vaccine Dose (Health & Science)

Thirteen U.S. Experts Press the Biden Administration to Implement Regulation on Air Quality Requirements for Work Environments to Stop the Spread of the Coronavirus (Health & Science)

FDA Announces Guidance for Testing Vaccine Boosters (Health & Science)

U.S. Prisons’ Use of Solitary Confinement for Coronavirus-Infected Inmates Is Not Dramatically Reducing Viral Spread inside Facilities (Health & Science)

Germany Reworks Vaccination Plan, Prioritizes Teachers (Around the World)

First South Korea Panel Approves Covid-19 Vaccine (Around the World)

Cases Spike in Some Parts of India, Raising Fears of New Variants (Around the World)

Democrats Prepare to Pass Covid Relief on Party Line Vote (U.S. Government & Politics)

Biden’s Priorities of Fast and Equitable Vaccine Distribution May be in Tension (U.S. Government & Politics)

Hospitality Workers Seek New Jobs (U.S. Economy)

Health & Science

There have been 28,190,409 coronavirus cases in the United States, and 500,310 people have died (Johns Hopkins). The United States has conducted 341,874,832 tests and distributed 75,205,940 vaccine doses, with 64,177,474 doses administered (U.S. CDC). Worldwide, there have been 111,773,496 confirmed cases of coronavirus, with 2,475,744 deaths. At least 63,065,754 people have recovered from the virus.

Two Additional Studies Corroborate Earlier Evidence That Recovered Coronavirus Patients Likely Need Only One Vaccine Dose

Two recently released studies show that those who recovered from a coronavirus infection may only need a single dose of the Covid-19 vaccine (NYT). The Times reports that these newer studies corroborate evidence from earlier published studies that had similar findings. Though immune responses vary from person to person, having a vaccine boosts the body’s response to produce more antibodies. University of Toronto immunologist Jennifer Gommerman says of the research findings, “I think it’s a really strong rationale for why people who were previously infected with Covid should be getting the vaccine,” adding that taking a vaccine will “even the playing field.” One of the new studies was posted as a preprint manuscript on medRxiv, with research by Washington State’s Cancer Research Center, Vaccine and Infectious Disease Division, the University of Washington, Centre de Recherche du CHUM in Canada, Université de Montréal, and McGill University. Researchers analyzed the effectiveness of antibody responses to coronavirus strains Wuhan-Hu-1 and variant B.1.351 from South Africa with antibodies from convalescent donors both before and after their vaccination with either the Moderna or Pfizer/BioNTech vaccine. Prior to inoculation, the antibodies were able to neutralize the original strain and sometimes neutralize the variant. However, after vaccination, there was a “1,000-fold increase in neutralizing antibody titers against both [coronavirus] strains and [even] SARS-CoV-1.”

The second study, also posted as a pre-print manuscript on medRxiv with research by New York University Langone Vaccine Center and New York University School of Medicine, found that a second vaccine dose did not significantly alter the immune response by those who already had Covid-19 (NYT). After the first dose of the vaccine, participants in the study had antibody responses that increased “by a hundredfold to a thousandfold,” reports the Times. After the second dose, levels did not increase. According to the lead author of the study and Director of the NYU Langone Vaccine Center Mark J. Mulligan, “It’s a real testament to the strength of the immunologic memory that they get a single dose and have a huge increase.” The other earlier studies came from research out of the Icahn School of Medicine at Mount Sinai in New York, and the University of Maryland School of Medicine with the Baltimore VA Medical Center and Global Virus Network in Baltimore. Bonus Reads: “Covid Vaccines - 'Spectacular' Impact on Serious Illness,” (BBC), and “False Claims Tying Coronavirus Vaccines to Infertility Drive Doubts Among Women of Childbearing Age,” (WaPo).

Thirteen U.S. Experts Press the Biden Administration to Implement Regulation on Air Quality Requirements for Work Environments to Stop the Spread of the Coronavirus

Thirteen experts submitted a letter to the Biden administration via Covid-19 response coordinator Jeffrey D. Zients, U.S. Centers for Disease Control and Prevention (CDC) director Rochelle Walensky, and National Institute of Allergy and Infectious Disease director Anthony Fauci, calling for regulation to be implemented as it relates to air ventilation and masking in work places. According to a report by the New York Times, “The letter urged the C.D.C. to recommend the use of high-quality masks, such as N95 respirators, to protect workers at high risk of infection.” According to a report by CNBC, the letter’s authors stated, “The failure to address inhalation exposure to SARS-CoV-2 continues to put workers and the public at serious risk of infection,” adding, “People of color, many of whom work on the front lines in essential jobs, have suffered — and continue to suffer — the greatest impacts of the COVID-19 pandemic.” This is not the first time a letter written and endorsed by researchers help to adjust recommendations by a public health agency. In July 2020, our daily brief noted that the World Health Organization (WHO) adjusted its policy on aerosolized spread of the virus and recognized “evidence emerging” that the coronavirus can be transmitted by airborne aerosolized particles (Reuters, NYT). An open letter by 239 scientists from 32 countries published in Clinical Infectious Diseases stated that the WHO should acknowledge “the role of airborne spread of Covid-19 and the need for governments to implement control measures,” reported the Guardian.

On January 21, 2021, the White House released an executive order focused on protecting worker health and safety, which mandated the Occupational Safety and Health Administration (OSHA) to “issue emergency temporary standards for Covid-19…by March 15.” However, the Times reports, OSHA will likely only implement changes that are aligned with CDC guidance. According to Bellevue Hospital Center infectious disease specialist Céline Gounder, “The C.D.C. has not emphasized the risk of aerosol transmission enough,” adding, “Unfortunately, concerns about supply continue to muddy the discussion.” As we’ve noted in several previous briefs, aerosolized transmission of the coronavirus is a key way the virus spreads, and poor ventilation and a lack of effective masks has contributed to superspreader events in work places such as meatpacking plants and other food processing centers.

FDA Announces Guidance for Testing Vaccine Boosters

On Monday, the U.S. Food and Drug Administration (FDA) announced that vaccine adjustments/boosters for new coronavirus variants would not require “lengthy randomized controlled trials,” reports the New York Times. The FDA suggests smaller trials, which are akin to what an annual influenza trial would entail. Vaccine producers are already planning to make adjustments to their current vaccines in order to protect against newer variants (Science Magazine). Representatives of the Moderna and Pfizer/BioNTech vaccines believe changes could be made to their pre-existing vaccines within six weeks, making them more effective for new strains, though that timeline does not include the trial process and production. According to a press release by Moderna, the company is already developing a booster for the South African variant known as B.1.351. According to the Times, current vaccines available “still offer protection and appear to greatly reduce the severity of the disease, preventing hospitalizations and death,” even though they are not as effective at preventing illness from the newer coronavirus strains. The FDA noted that animal studies could be included to test the efficacy of the booster vaccines. Bonus Read: “Some Covid-19 Tests Can Help Flag U.K. Variant,” (WSJ).

U.S. Prisons’ Use of Solitary Confinement for Coronavirus-Infected Inmates Is Not Dramatically Reducing Viral Spread inside Facilities

As we’ve noted in several previous briefs, prisons across the United States have become, at various times, coronavirus superspreader locations, resulting in vast numbers of infected staff and inmates. Without an easy way to contain the virus in communal living settings, correctional facilities have turned to solitary confinement as a quarantine method, reports Popular Science. In a report published in June by a campaign called Unlock the Box, in April 2020 across the United States there was an “estimated 500 percent increase in the use of solitary confinement as a result of the COVID-19 pandemic… 300,000 people in April, as compared to an estimated 60,000 people held in solitary confinement each day prior to the outbreak.” Executive Director of Prisoners’ Legal Services of Massachusetts Elizabeth Matos explains, “None of these facilities are built to actually allow for social distancing" (Popular Science). The United States has the largest prison population in the world, and because of overcrowded facilities with tight quarters, prison management have taken drastic measures to isolate their coronavirus-infected inmates. However, medical isolation is different from solitary confinement; the former includes the ability to live with other inmates, use of tablets and televisions, and ways to connect with loved ones outside the facility, notes Popular Science. According to an April report by The Marshall Project, some inmates from medium- and maximum-security prisons “are locked in their cells at least 22 hours per day.” What’s more, in an attempt to avoid this isolation, prisoners may opt to keep symptoms to themselves, inadvertently increasing the spread of the virus. According to a report by the University of California San Francisco, “Many advocates fear that use of isolation to curb transmission of COVID-19 in correctional facilities will complicate the emerging crisis, as incarcerated people become reluctant to report symptoms for fear of being moved to solitary confinement, those who do report symptoms will be forced to endure an experience known to cause psychological and physical harm, and system-wide unrest will be triggered in institutions where fears about being placed in medical isolation could run rampant.” According to a research letter published in JAMA over the summer, “the adjusted [Covid-19] death rate in the prison population was 3.0 times higher than would be expected if the age and sex distributions of the US and prison populations were equal.”

New Report Finds Increased Screen Time May Be Contributing to Nearsightedness in Young Children

A new report from China published in JAMA Ophthalmology found that “myopia increased up to three times in children aged 6 to 8 in 2020 compared to the previous five years,” reports STAT. The research looked at 194,904 photoscreening tests for 123,535 children and found that “Home confinement due to coronavirus disease 2019 appeared to be associated with a substantial myopic shift in children [ages six to eight years]” (JAMA). STAT notes that it may be too early to tell how prevalent this myopia shift may be for children worldwide, but the change in children’s screen time are “increasingly impacting eyesight.” According to research published in Acta Ophthalmologica, nearsightedness can be decreased the more time children spend outdoors, in addition to treatments that include medical eye drops or contact lenses, notes STAT. The research found that “when outdoor time was used as an intervention, there was a reduced myopic shift of -0.30 D compared with the control group after 3 years of follow-up… Increased time outdoors is effective in preventing the onset of myopia as well as in slowing the myopic shift in refractive error. But paradoxically, outdoor time was not effective in slowing progression in eyes that were already myopic.”

Baltimore Residents Missing from the Supply Chain of Coronavirus Vaccines Made in Their City

According to a report by the Washington Post, Baltimore, a city that has become the engine of regional vaccine production for Emergent BioSolutions (manufacturing Johnson & Johnson and AstraZeneca’s vaccines), may never see the bulk of these vaccines used for its residents. According to the Post, the vaccine’s ingredients produced in the manufacturing plant will be shipped to other locations across the United States and even across the world. Of the 7,700 Covid-19-related deaths, about 900 have been in Baltimore. Baltimore Mayor Brandon M. Scott wrote a letter to Johnson & Johnson requesting that the company “sell 300,000 of its vaccine doses directly to the city, bypassing the federal allocation system to ‘create a national model for equitable vaccine distribution’ and enabling city officials to speed the delivery of shots to residents of color, in particular,” noted the Post. However, the company is unlikely to bend due to production agreements with the U.S. federal government. The Johnson & Johnson vaccine is currently being evaluated by the Food and Drug Administration for emergency use authorization, while AstraZeneca is working through the final stages of its U.S. clinical trials. Thirty-five-year-old Baltimore resident Micah Dowtin told the Post, “I don’t understand why they would be producing it here and then shipping it out to other places when there are people here who don’t have any,” adding, “You’re supposed to take care of home first, right?”

Bonus Read: “The Pandemic Is Receding in the Worst Hotspots. Will It Last?” (NYT).

Around the World

Europe

Germany Reworks Vaccination Plan, Prioritizes Teachers

The German government has reworked its vaccination strategy after it faltered due to lack of supply and public resistance to the shot developed by AstraZeneca. As schools and kindergartens are expected to reopen from the lockdown imposed in November soon, federal and state health ministers on Monday reworked the vaccination rules so that teachers and daycare workers will now get priority access to the AstraZeneca vaccine (Reuters). Health Minister Jens Spahn has also requested that the AstraZeneca shot be given to the police force and army, after some health and other frontline workers baulked at receiving it. The AstraZeneca vaccine has been met with resistance in Germany and other European countries after trials showed it to be less effective than the vaccines developed by Pfizer and Moderna. Germany’s top vaccines agency, the Paul Ehrlich Institute, found that the AstraZeneca vaccine causes stronger side effects; in nearly a quarter of people receiving it experience flu-like symptoms and around 15% experienced shivers or fever. The Paul Ehrlich Institute noted that the side effects are short lived and said the vaccine is highly effective. Germany has launched a public relations campaign in hopes of reassuring the public; “The vaccine from AstraZeneca is both safe and highly effective,” Steffen Seibert, Chancellor Angela Merkel’s chief spokesman, tweeted on Monday. “The vaccine can save lives.” Germany has administered 5 million vaccine doses so far, or around six for every 100 residents, putting it well behind countries like Israel, Britain, or the United States that have more aggressive campaigns.

Asia

First South Korea Panel Approves Covid-19 Vaccine

The first of three expert panels in South Korea that are reviewing the Pfizer/BioNTech Covid-19 vaccine recommended that the government approve the vaccine on Tuesday (Reuters). The second panel, the national pharmaceutical panel, is planning to make its recommendation on Friday but the government will wait for a third panel before deciding whether to grant approval. South Korea will kick off its inoculation campaign on Friday using the vaccine developed by AstraZeneca and Oxford University to vaccinate high-risk individuals. It is planning to use 117,000 doses of the Pfizer/BioNTech vaccine that were supplied through COVAX, the international vaccine sharing program, that bypasses the need for the government’s final approval. Around 55,000 healthcare workers will receive the first doses of the Pfizer vaccine on Saturday. 

Cases Spike in Some Parts of India, Raising Fears of New Variants

Although India has seen an overall decline in the number of coronavirus cases since September, some parts of the country are now experiencing a spike in new cases, prompting officials to impose lockdowns and other restrictions (ABC). Experts have warned that the reasons for India’s declining case count isn’t fully understood and public health officials are now investigating potential mutations in the virus that could be making it more contagious. The spike in new cases is most pronounced in the western state of Maharashtra, as we covered in yesterday’s brief. There, almost 7,000 new cases were detected in the past 24 hours. The southern state of Kerala is also seeing more cases than the rest of the country, with numbers hovering between 4,000 to 5,000 over the past month. Government-funded research has suggested that a more contagious variant of the virus could be spreading in Kerala.   

Bonus Read: “As Pandemic Took Hold, Suicide Rose Among Japanese Women,” (NYT).

U.S. Government & Politics

Democrats Prepare to Pass Covid Relief on Party Line Vote 

Democrats are preparing to pass a Covid relief and stimulus package that looks like it will be passed on a party-line vote, Politico reports (Politico). House Democrats expect to pass a $1.9 trillion bill by the end of the week. Politico writes, “The House Budget Committee will meet Monday afternoon to tee up the legislation for floor passage on Friday or Saturday, with Senate action as soon as the following week.” The expectation that the bill will not receive Republican support means that for the bill to clear the Senate, where under current rules the package could be blocked by a filibuster requiring a likely unachievable 60-votes to proceed, Democrats will likely have to use the reconciliation process, which allows circumvention of a filibuster without changing the existing parliamentary rules.

Biden’s Priorities of Fast and Equitable Vaccine Distribution May be in Tension

As the United States seeks to roll out vaccines, the Biden administration is finding itself confronted by possible tensions between its commitment to a fast distribution of the vaccine and an equitable distribution of the vaccine (Politico). Politico writes, “Though the Biden administration has prioritized equitable vaccine distribution, putting that goal into practice is difficult. Local public health officials are under pressure to quickly distribute their limited supplies and reach high-risk groups first in line. So far, limited data continues to show that people in hard-hit minority communities are getting vaccinated at a much slower pace than people in wealthier white ones.” Shereef Elnahal, a former New Jersey health commissioner who currently heads Newark’s University Hospital, told Politico, “We could see the inequities get worse before they get better” while noting that tensions exist between efforts to impose accountability on equitable distribution and efforts to use all vaccines quickly. As we have covered in prior briefs, disparities in vaccine distribution are apparent. Politico writes, “the share of first doses going to white Americans has increased slightly since the first month of inoculations, from 60.4 percent to 63.7 percent, according to the most recent federal data. The share of doses to Black Americans has also risen slightly, from 5.4 percent to 6.3 percent, while it fell for Latinos from 11.5 percent to 8.8 percent. In one hopeful sign, 34 states are now reporting race and ethnicity data, double the 17 from a month ago, according to the Kaiser Family Foundation.”

Biden Announces Changes to Paycheck Protection Program to Aid Small and Minority Owned Businesses

On Monday, President Biden announced changes to the Paycheck Protection Program, which helps provide Covid relief to businesses, that aim to increase access to the program by very small and minority owned businesses (WSJ). The Wall Street Journal writes, “As part of the changes, the Small Business Administration will accept applications for the Paycheck Protection Program exclusively from companies with fewer than 20 employees for 14 days starting Wednesday, Mr. Biden said.” Biden stated that the changes, “will make sure we look out for the mom-and-pop businesses even more than we already have.” The program as a whole is slated to end on March 31.

U.S. Economy

Hospitality Workers Seek New Jobs

The pandemic has resulted in around four million hospitality workers losing their jobs, leading many to seek new careers in an effort to adapt to the uncertain environment (WSJ). The four million lost jobs account for about a quarter of the sector’s employment and the Wall Street Journal writes, “As of January 2021, 15.9% of the industry’s workers remained unemployed; more than any other industry, according to the Bureau of Labor Statistics.” The Journal profiled a few of those shifting careers as a result. Among them is Ellen White who was head trainer at Public Kitchen on Manhattan’s Lower East Side before being furloughed, who told the Journal that she uses the same skills as a customer service representative for a home Covid test company. She told the Journal, “It’s easy for me to quell someone’s nerves or to calm someone down,” adding, “I’m so used to being face to face with an angry person about cold salmon.” Jaclyn Garcia, a 32-year-old who lost a position with Loews Hotels & Co. told the Journal, “It was seven months of just feeling like you’re not good enough, after being at the top of your company and your career.” After seeking skills training, she found a position as an account manager at ProEst, a construction-estimate software company.

Analysis & Arguments

Veteran AIDS Activist Peter Staley talks with Sam Adler-Bell and Matthew Sitman about his interactions with Dr. Fauci in the 1980s and Fauci’s record on the Covid response (KYE).

Michael S. Rosenwald examines history’s deadliest pandemics (WaPo).

Dr. Wayne A.I. Frederick writes on the impact of people missing preventive check ups during the pandemic (NYT).

Scientific American interviews several experts to discuss answers to pressing Covid-19 vaccine questions.

 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.

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

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