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November 18, 2020 - Brief Issue 121
The Coronavirus Daily Brief is a daily news and analysis roundup edited by New America’s International Security Program and Arizona State University.
The Coronavirus Daily Brief will be on hiatus the week of November 23rd for Thanksgiving. It will return on November 30th.
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Top Headlines
FDA Approves First At-Home Covid-19 Test; Pfizer Could be Days Away from Filing for Emergency Use (Health & Science)
mRNA Vaccines: Breakthrough Technology That Could Make Future Diseases Easier to Cure (Health & Science)
Covid-19 Immunity Could Last Years, New Study Suggests (Health & Science)
Africa’s First Pandemic Default Tests New Framework (Around the World)
Hungary’s Doctors Warn of Soaring Coronavirus Deaths (Around the World)
Amnesty International: Failure to Protect Elderly in Belgium a Human Rights Violation (Around the World)
Dutch PM: Lockdown Will Last Until December (Around the World)
Parisians Petition for an Amazon-Free Christmas (Around the World)
South Australia Orders ‘Circuit Breaker’ Lockdown (Around the World)
People Race to Get Experimental Vaccine in China (Around the World)
Trump Administration Taking Unprecedented Steps to Block Transition, Including on Pandemic Response; Dr. Fauci Emphasizes Importance of Smooth Political Transition and Public Unity to End Pandemic (U.S. Government & Politics)
Senator Chuck Grassley Tests Positive for Coronavirus (U.S. Government & Politics)
Senator Rob Portman Participating in a Covid Vaccine Trial (U.S. Government & Politics)
Retail Sales Continued to Climb But at a Slower Pace in October (U.S. Economy)
Stocks Slip After Moderna News Drove New Dow Jones and S&P Records (U.S. Economy)
How the Pandemic is Reshaping Apartment Hunting (U.S. Society)
Health & Science
There have been 11,359,804 coronavirus cases in the United States, and 248,687 people have died (Johns Hopkins). Around 4,293,640 people have recovered, and the United States has conducted 165,828,419 tests. Worldwide, there have been 55,645,915 confirmed cases of coronavirus, with 1,338,668 deaths. At least 35,798,205 people have recovered from the virus.
FDA Approves First At-Home Covid-19 Test; Pfizer Could be Days Away from Filing for Emergency Use
On Tuesday, the Food and Drug Administration (FDA) granted emergency approval for the first at-home Covid-19 test, made by Lucira Health (NYT, ABC). The test returns results in about 30 minutes, costs $50 or less and is indicated for use by people ages 14 and older. The test will require a prescription for use. Clinicians can also use the test on patients, including children under 14.
Although previous tests have been approved for at-home specimen collection, this is the first test that would not have to be processed in a lab. Jeff Shuren, director of the FDA’s Center for Devices and Radiological Health, called the approval “a significant step toward FDA’s nationwide response to Covid-19,” saying that “more Americans who may have Covid-19 will be able to take immediate action … to protect themselves and those around them.”
The test uses a technology called loop mediated amplification reaction, or LAMP. LAMP copies coronavirus genetic material until it reaches detectable levels, making it possible to detect the virus even if it is present only at low levels. The technology is similar to polymerase chain reaction, or PCR, currently considered to be the laboratory gold standard for detecting coronavirus.
Some experts are concerned about the tradeoff between rapid results and accuracy. According to the company, Lucira’s LAMP test accurately detects 94% of positive Covid-19 cases and correctly identifies 98% of uninfected individuals. This degree of accuracy is slightly lower than that of a lab-based PCR test, but higher than that of a typical rapid antigen test, which is less sensitive and detects only about 80% of positive cases. Dr. Saskia Popescu, an epidemiologist at George Mason University, said that while the at-home test was a notable advance, Covid diagnostics are in need of “more accessible and fast lab-based testing.”
On the vaccine front, Pfizer could be just days away from filing for an emergency use authorization for its Covid-19 vaccine, CEO Albert Bourla said on Tuesday (STAT). Under FDA guidelines, manufacturers must follow at least half of the people who received a vaccine in their Phase 3 clinical trial for two months to ensure that there is some safety data before a vaccine can be considered for use. Pfizer’s vaccine is expected to be the first one cleared for use in the United States and vaccinations could begin as soon as December. Experts expect the company to supply the U.S. with enough vaccinations to cover 20 million people in 2020.
mRNA Vaccines: Breakthrough Technology That Could Make Future Diseases Easier to Cure
Part of the reason a vaccine against Covid-19 has been developed so quickly – in addition to enormous amounts of funding that allowed vaccine makers to quickly move into large-scale clinical trials – is the mRNA vaccine revolution. In the body, mRNA translates the DNA code and tells cells which proteins to make in order to carry out the necessary functions of life, from breathing to digestion to building muscle.
The newly-developed Covid-19 vaccines from Moderna and Pfizer each use lab-made mRNA that direct cells to make a coronavirus protein called spike protein. Immune cells within the body recognize this protein as an invader and generate antibodies against it. In the event of a coronavirus infection, the immune system would then quickly recognize the spike protein and deploy defenses to destroy the virus.
The Covid-19 vaccines are the first mRNA vaccines tested and shown to be effective in humans. Traditionally, vaccines use inactivated pathogens or parts of pathogens to stimulate the immune system. Producing these vaccines is time-intensive and expensive, and on average it takes over a decade to take such a vaccine from the first stages of research to the end of clinical trials. In contrast, multiple vaccines against Covid-19 are set to be available for public use just a year after the onset of the pandemic. This was in part due to huge amounts of funding that allowed developers to quickly progress toward large-scale clinical trials, but mRNA vaccines can also be produced more quickly, more cheaply and in smaller facilities.
The Pfizer and Moderna vaccines proved to developers that mRNA vaccines work, and with that knowledge, scientists hope that mRNA technology might be harnessed for future vaccines – against existing viruses, other novel illnesses and even against certain types of cancer (Reuters).
Covid-19 Immunity Could Last Years, New Study Suggests
A new study, published as a pre-print on Monday, suggests that immunity to Covid-19 may last years (NYT). The study has not yet undergone the rigorous peer-review process; nonetheless, it is the most comprehensive and long-range study of Covid-19 immunity yet released. It found that most people still had sufficient immunity eight months after a novel coronavirus infection to fight off another bout of illness. Several other recent studies have found waning levels of antibodies against the virus a few months after infection, sparking concern that immunity against Covid-19 may be short-lived. However, immunologists noted that antibody levels often drop off after an infection and are not the only components of immunity. This new study measured multiple components of long-term immunity, including three types of immune cells which protect the body against subsequent infections.
The study found that all three types of cells persisted in the body, with small declines around six to eight months. The slow rates of decline lead researchers to believe that immunity to Covid-19 may last for years. Exactly how many years is difficult to say – scientists don’t yet know exactly what level of antibodies and immune cells provide protection from Covid-19. So far, re-infections appear to be rare, and this study provides some encouragement that immunity to the virus will last longer than previously thought.
Covid-19 Testing Delayed as U.S. Cases Surge; U.S. Government Supplies 7 Million Abbot BinaxNOW Tests to States
Surging Covid-19 cases, supply shortages and increased demand ahead of the holidays have the potential to cause testing bottlenecks across the United States (Bloomberg). Demand for the tests has increased as cases rise around the nation, according to the American Clinical Laboratory Association, which does approximately half the nation’s testing, and demand is expected to rise further ahead of Thanksgiving. The group cautioned that turnaround times could lengthen as labs become overstretched.
The U.S. government said at a press briefing Monday that it was preparing to send over 7 million BinaxNOW rapid antigen tests from Abbott Laboratories to states and nursing homes (Reuters). The tests do not have to be sent to a laboratory and can return results in as little as 15 minutes. Critics have pointed out that rapid antigen tests are not as accurate as laboratory tests and often fail to identify asymptomatic cases. Others argue that rapid antigen tests can be useful, particularly when laboratories are backlogged.
El Paso Overwhelmed By Coronavirus Cases
El Paso, one of the hardest-hit areas in the country, is quickly becoming overwhelmed by Covid-19 cases (BBC). El Paso County has been averaging 1000 or more new cases per day for nearly a month and currently has an 18.9% testing positivity rate (EPStrong). The city’s convention center has been converted to a makeshift hospital, and some patients are being airlifted to other cities.
El Paso’s morgues have also found themselves unable to handle the excess Covid-19 deaths. Ten refrigerated trailers have been deployed, handling more than 150 bodies last week. Inmates at minimum security prisons have been hired at $2 per hour to move bodies from packed hospitals into the mobile morgues.
Despite the mounting death toll, a stay-at-home order issued by County Judge Ricardo Samaniego was overturned Friday by a state appeals court after local restaurant owners and State Attorney General Ken Paxton sued. Judge Samaniego expressed his disappointment with the ruling in a Tweet, criticizing Mr. Paxton for “find[ing] the opportunity to gloat instead of coming to El Paso to walk along side me by the mobile morgues with 144 El Pasoans; or send his condolences to the families of his 741 constituents who died of COVID-19.”
Loving County: The Last (Technically) Covid-Free County in the U.S.
Just a few hours East of the hard-hit El Paso, the sparsely populated Loving County, Texas, is the last remaining U.S. county with no official confirmed cases of Covid-19 (NYT). Loving County, home to oil fields and ranches, has only 169 full-time residents, but 10 times that number work in the county, hauling equipment and working in the oil fields.
One official positive Covid-19 test was recorded over the summer at the clinic in Mentone, Loving County’s only town. The man was a temporary worker in the town and quickly went home, and the case did not go in Loving County’s record. Steve Simonsen, the county attorney, acknowledged that the idea that Loving County has a perfect record is probably not completely accurate. He said, “it’s a nice little bit of hype, but certainly it’s been here.”
Doctors Better Prepared to Handle Covid-19 Cases
As Covid-19 cases continue to rise in most areas of the country, doctors are turning to lessons they learned earlier in the pandemic (WSJ). As opposed to the early days, physicians now have more data on which treatments work and how to best care for patients. The use of anticoagulants and steroids such as dexamethasone have been found to improve symptoms in some hospitalized patients. A newly-approved antibody treatment from Eli Lilly may help patients with mild and moderate symptoms avoid hospitalization.
Despite doctors and hospitals being better-equipped to handle Covid patients, some health officials are concerned that the sheer number of cases will overwhelm some hospitals, particularly those in more rural areas. There are currently over 73,000 people hospitalized with Covid-19 in the United States. Health officials advise that consistent public health measures are still necessary to prevent the spread of the disease and to avoid overburdening health systems.
Bonus Reads: “South Dakota Nurse Says Many Patients Deny the Coronavirus Exists — Right Up Until Death,” (WaPo); “Does Remdesivir Actually Work Against Covid-19?” (NYT).
Around the World
Africa
Africa’s First Pandemic Default Tests New Framework
Zambia has become the first African nation to default during the coronavirus pandemic and in doing so, will test a new framework developed to resolve debt crises in developing countries by ensuring that Chinese and private creditors share the burden of relief (WSJ). Under a common framework developed by finance ministers from the Group of 20 and announced on Nov. 13, a new process for restructuring the debt of the world’s poorest countries, Chinese lenders will participate in debt restructurings alongside rich, mostly Western nations. Additionally private creditors will be asked to provide relief on similar terms. The Journal writes: “Zambia, which has borrowed heavily from China, missed a $42.5 million interest payment on some of its $3 billion of dollar-denominated bonds, tipping one of Africa’s largest copper producers into default. Zambia says it needs a break on servicing those bonds to allow it to reach a deal with all of its creditors to bring its debts—now above 100% of gross domestic product—to a sustainable level and secure a bailout from the IMF.”
Europe
Bonus Read: “Has Sweden’s Coronavirus Strategy Failed?” (WaPo).
Hungary’s Doctors Warn of Soaring Coronavirus Deaths
Doctors in Hungary are saying that a lack of qualified medical staff needed to treat coronavirus patients in intensive care units could soon lead to soaring deaths despite the government’s expensive medical equipment purchases (AP). Last week, Hungarian Prime Minister Viktor Orban put the country’s strict restrictions to date into action in hopes of saving the fragile healthcare system. He predicted that without those measures, the healthcare system had only a “50% chance” of coping with the pandemic. He also ordered hospitals to expand ICUs. Earlier this year, the government purchased 16,000 ventilators, spending 842 million euros, in preparation for this surge in cases. But now, the Hungarian Chamber of Doctors is warning that the number of ICU beds and ventilators aren’t enough to save lives and that qualified doctors and nurses are lacking. According to the AP, “Hungary has 2,000 specialists for ICU wards and a similar number of ICU nurses. But the recent sharp rise in hospitalizations has led to a patient-to-doctor ratio of 20-to-1 in some ICUs.” This leads to a high mortality rate.
Amnesty International: Failure to Protect Elderly in Belgium a Human Rights Violation
A report by the local chapter of Amnesty International says that Belgian authorities violated the human rights of nursing home residents during the beginning of the pandemic by failing to protect them and allowing some to die prematurely. Belgium had one of the world’s highest death rates in the world, driven in large part by those fatalities among nursing home residents (NYT). Between March and October, 61% of deaths in the country were nursing home residents. The report says that one reason for the high mortality rate among nursing home residents was that they were not transferred to hospitals because authorities focused their efforts on protecting the hospitals. In doing so, authorities refused access to treatment and did not provide protective equipment and testing to residents, Amnesty International concluded. The report was based on testimonies by nursing home residents, their families, directors and staff, and civil society organizations.
Dutch PM: Lockdown Will Last Until December
Netherlands Prime Minister Mark Rutte said on Tuesday that the country’s current lockdown measures will remain in place through mid-December, despite a recent decline in the number of new cases. New cases declined 15% in the past week, but Rutte pointed out “if you look around in Europe, the picture is pretty sombre,” and the number of Dutch people with a positive test remained very high (more than 150 infections per 100,000 people across the country) (Reuters). The Netherlands was one of the first European countries to enter a second lockdown in mid-October and the government tightened restrictions further the beginning of November.
Parisians Petition for an Amazon-Free Christmas
More than 4,500 people, including Paris Mayor Anne Hidalgo and several other politicians, have signed a petition for an Amazon-free Christmas. The petition cites concerns that local businesses will suffer if people turn to the online retail giant for their holiday shopping (Politico). France went into a strict lockdown in late October, closing bars, restaurants, and nonessential retailers. The number of new cases has started to decrease but French officials extended the lockdown and have warned that the holiday season will be far from normal this year. France’s culture minister, Roselyn Bachelot, urged residents to avoid purchasing books from retailers like Amazon. The Paris mayor also directly urged Parisians not to buy books from Amazon (WaPo).
Asia and Australia
South Australia Orders ‘Circuit Breaker’ Lockdown
South Australia ordered a strict six-day “circuit breaker” lockdown on Wednesday after discovering a cluster of 22 coronavirus infections (WaPo). Roughly 1.7 million people are being told to stay home except for essential reasons, with only one person from each household allowed to shop for groceries. Schools, stores, and restaurants (even those offering takeout) will be closed by Thursday. “We know that these restrictions are going to be very punishing on the people of South Australia,” South Australian Premier Steven Marshall said Wednesday. “But we also know that we’re doing it for the right reasons to stop a far harsher lockdown which could come if we allow this virus to get away.” Contact tracers are working to identify the source of the outbreak and to notify anyone who may have come into contact with someone who was infected.
People Race to Get Experimental Vaccine in China
China’s vaccine candidates have not been formally proved safe or effective, but officials have been inoculating thousands of people across the country under an emergency-use policy anyway. China has made its unproven candidates available across the country in an effort to demonstrate their safety and effectiveness to the public, many of whom have long been skeptical of vaccines. Top pharmaceutical executives and government officials have publicly said they received a vaccination as part of the campaign. People are rushing to get the emergency use vaccines and supplies quickly run out even though the vaccines are unproven. But as the New York Times writes, “Those users could be taking big risks. People who have taken ineffective vaccines might believe they are safe and engage in risky behavior. They can be barred from taking another, better vaccine because they have already been injected. In a few cases in the past, unproven vaccines have caused health risks.” Some cities are now limiting doses or requiring proof of upcoming travel.
South Koreans Investing in U.S. Commercial Real Estate
South Korean investors are aggressively buying U.S. commercial real estate during the pandemic, often targeting warehouses and office buildings with long-term tenants. The current low interest rates are attractive and other foreign investors have withdrawn from the market, meaning there’s less competition. The Wall Street Journal writes: “In the first nine months of the year, Korean investors accounted for 8.6% of all overseas investment in U.S. commercial real estate, up from 3.7% a year earlier, according to Real Capital Analytics. South Korean investment as a share of all overseas investment in U.S. commercial real estate, Q1-Q3. South Koreans invested $1.56 billion, up from $1.24 billion a year earlier, during that time, trailing only Canadian and German investors. A year ago, South Koreans ranked 10th among foreign investors in U.S. real estate, according to Real Capital Analytics.”
U.S. Government & Politics
Trump Administration Taking Unprecedented Steps to Block Transition, Including on Pandemic Response; Dr. Fauci Emphasizes Importance of Smooth Political Transition and Public Unity to End Pandemic
The Trump administration has taken a number of unprecedented steps to block cooperation with President Elect Joe Biden’s transition team including on issues surrounding the virus (Politico). Politico writes, “For the first time in more than half a century, an outgoing administration is stonewalling an incoming one at every level — with no intention of relenting. President Donald Trump hasn’t called President-elect Joe Biden. The Trump campaign hasn’t reached out to the Biden campaign. The White House and federal agencies haven't briefed the Biden transition team. First lady Melania Trump hasn’t invited Jill Biden to the White House for tea.” Among the disruptive aspects of the Trump administration’s refusal to enable a smooth transition is that there have been no briefings on the coronavirus by the current administration for the President Elect and his team. Politico notes, “Even in 2000, when a recount fight in Florida kept the nation in suspense for weeks over who would become president, Card said President Bill Clinton’s staff allowed Bush to have national security briefings. Bush’s challenger, then-Vice President Al Gore, was already receiving them.”
Dr. Anthony Fauci, the nation’s top infectious disease expert, remarked Tuesday on the need for a smooth political transition as President-elect Joe Biden takes office, saying that “transitions are extremely important to the smooth continuity of whatever you’re doing.” Mr. Trump has so far refused to brief Mr. Biden on the pandemic or allow his team access to federal agencies.
When he assumes office, Mr. Biden will take on the challenge of distributing the Covid-19 vaccine, as well as leading public health messaging in a nation for which public health has become a divisive political issue. According to Dr. Fauci, the divisions around mask wearing and vaccine skepticism are hindering the pandemic response. He said that a vaccine will not be effective in slowing the pandemic unless an “overwhelming majority” – 75 to 80 percent – receive the vaccine when it becomes available. If people follow public health recommendations and get vaccinated, he said, the country “could be quite close to some degree of normalcy” by Fall 2021 (NYT).
Senator Chuck Grassley Tests Positive for Coronavirus
On Tuesday, Senator Chuck Grassley (R-IA), the oldest member of the senate at 87, announced that he had tested positive for coronavirus (NYT). Grassley’s diagnosis led him to miss his first vote since 1993 and at least temporarily disrupted the confirmation of Trump’s nominee for the Federal Reserve. Grassley and Senator Rick Scott (R-FL) are both currently in quarantine. Representative Don Young (R-AK), who is also 87, was also hospitalized over the weekend as a result of coronavirus.
Senator Rob Portman Participating in a Covid Vaccine Trial
Senator Rob Portman (R-OH) is participating in a Covid vaccine trial, Politico reported on Tuesday (Politico). Portman revealed his participation in an interview. Politico writes, “Portman, who has broken with many of his fellow Republicans on issues like mask wearing, joined a large, late-stage trial of Johnson & Johnson’s vaccine candidate almost two weeks ago. He said polls showing skepticism about an eventual Covid-19 shot convinced him that public figures need to demonstrate confidence in a vaccine.” Portman is the only senator who is known to and made public their participation in a vaccine trial.
Federal Officials Urge Health Departments to Pay Attention to Lessons From 2009 H1N1 Outbreaks
As the U.S. prepares to plan and implement vaccine programs around the country, federal officials are looking to lessons learned from the 2009 H1N1 pandemic (WaPo). One frequently cited lesson is that of avoiding overly ambitious government messaging, particularly about vaccine supply projections. In 2009, vaccine production was delayed, and by mid-October, only a quarter of the projected vaccines had been distributed. Public health departments cancelled vaccination clinics, and even when vaccines did become available, most people did not get them.
Public health experts caution that messaging that indicates that a vaccine will end the Covid-19 pandemic quickly could similarly undermine public confidence. In reality, a vaccine will be rolled out over a period of months and will be effective in halting the pandemic only when 75-80% of the population has received it.
Kelly Moore, associate director of the Immunization Action Coalition, said one of the biggest challenges from 2009 is still ongoing: the lack of a broad immunization network. Currently, there is no framework for coordinating state and federal efforts, including recruiting the thousands of clinicians needed to provide immunizations. Moore hopes that the lessons learned from the coronavirus pandemic will help health officials respond to pandemics better in the future. “My hope is we will leverage this opportunity in a way we didn’t leverage 2009,” she said. “Episodic investment is no way to do public health.”
U.S. Economy
Retail Sales Continued to Climb But at a Slower Pace in October
U.S. retail sales continued to grow for the sixth straight month in October, but the rate of growth slowed substantially (WSJ). The Wall Street Journal writes, “American shoppers boosted their buying more slowly in October, another sign the U.S. economic recovery is losing steam as coronavirus cases increase across the country.” Sales grew a seasonally adjusted .3 percent; a decline from September’s 1.6 percent growth. The Journal warns that data on retail sales can often be adjusted over time and may not fully reflect at its release the actual state of the market.
Stocks Slip After Moderna News Drove New Dow Jones and S&P Records
On Tuesday, the stock market fell slightly after both the Dow Jones and the S&P hit record highs on Monday in large part due to the news of Moderna’s vaccine trial results (WSJ). The Wall Street Journal writes, “The Dow Jones Industrial Average fell as many as 430 points Tuesday morning after setting a record on Monday and closing just short of the 30000-point milestone level. Most recently, it was down about 100 points, or 0.3%. The S&P 500 slipped 0.1%, while the Nasdaq Composite was up about 0.2%.”
Bonus Read: “Hundreds of Companies That Got Stimulus Aid Have Failed,” (WSJ).
U.S. Society
How the Pandemic is Reshaping Apartment Hunting
With the pandemic surging and people still trying to socially distance, the process of apartment hunting has become more complex often involving virtual tours (WSJ). In a report on Tuesday, the Wall Street Journal examined some of the dynamics of the new situation. Casey Cuccio, who was looking for an apartment in Hartford, Connecticut, recounted her experience of finding a place that looked perfect during a virtual tour only to drive 2.5 hours to do a walk through tour to find that the tour did not show the whole situation. Cuccio, told the Journal, that there was a strong mildew smell and “It reminded me of the smell of my college dorm basement laundry room.” The Journal writes, “Demand for virtual tours began to skyrocket in spring, said Michael Lane, president of ShowingTime, a Chicago-based company that provides a real-estate-showing management platform. The company has managed nearly 150,000 virtual tours since April, including spikes of more than 30,000 in both May and July.” However, among the people the Journal spoke with, Cuccio’s experience is not unique, and many emphasized the importance in their searches of physically visiting the final possibilities.
Bonus Reads: “Recession With a Difference: Women Face Special Burden,” (NYT); “All Those Used Delivery Boxes Are a Hot Commodity,” (WSJ).
Analysis & Arguments
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