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October 27, 2020 - Brief Issue 111

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

New Record for Seven-Day Average of Covid-19 Cases; Rural Areas Hit Hard (Health & Science)

Hospitals in Utah Prepare to Ration Care (Health & Science)

Study Finds People With Down Syndrome at 10x Greater Risk of Death From Covid-19 (Health & Science)

Pandemic Fatigue Spreading Alongside Virus (Around the World)

Mexico Admits Covid-19 Death Toll is Higher Than Official Figures (Around the World)

Canadian Thanksgiving Could be Responsible for Rise in Cases (Around the World)

Anti-Lockdown Protests Erupt in Italy (Around the World)

President Trump Disputes Chief of Staff’s Comment, Denies Giving Up on Virus (U.S. Government & Politics)

Stocks Slide as Coronavirus Surges and Hopes for Relief Deal Diminish (U.S. Economy)

Time Change May Be Particularly Tough This Year for Those Working From Home (U.S. Society)

Health & Science

There have been 8,704,524 coronavirus cases in the United States, and 225,735 people have died (Johns Hopkins). Around 3,460,455 people have recovered, and the United States has conducted 133,750,060 tests. Worldwide, there have been 43,533,402 confirmed cases of coronavirus, with 1,160,098 deaths. At least 29,216,947 people have recovered from the virus. 

New Record for Seven-Day Average of Covid-19 Cases; Rural Areas Hit Hard

The seven-day average for new Covid-19 cases in the U.S. reached an all-time high of 68,767 on Monday (WSJ). Because the seven-day average smooths out single-day fluctuations – fewer cases are generally reported on Sundays, for instance – health officials often look to this number as a more robust indicator of trends. Although a fall and winter surge has been anticipated by health officials, many did not expect the rise in cases to occur this quickly.

Scott Gottlieb, former Food and Drug Administration commissioner, said he believes the country is now “at the cusp of what is going to be exponential spread in parts of the country” (CNBC). Gottlieb said, “I know people are exhausted [...] but we really have two or three months of the acute phase of this pandemic to get through. This is going to be the hardest phase probably.”

With cases rising quickly, health experts are concerned about the toll on hospitals. Over the past month, hospitalizations have increased by 40%, with over 41,000 patients currently hospitalized with Covid-19 around the country (NYT). Particularly in rural areas, many hospitals are not equipped to deal with high caseloads. And unlike in the early months of the pandemic, the virus is now just as prevalent in low-density areas as in larger cities. Low-density states like Montana and Wyoming have some of the highest per capita caseloads, and many hospitals are already under strain (WaPo). Many of these states do not have mask mandates and are reluctant to implement such policies, but health officials stress that such measures will be critical for containing and managing the virus.

Hospitals in Utah Prepare to Ration Care

In Utah, hospital administrators have prepared a list of criteria for doctors to determine which patients would be allowed to stay in overflowing intensive care units should such difficult decisions need to be made (CNN Health). The criteria include factors such as age, health, and ability to survive. Utah has reported more than 1,000 Covid-19 cases per day for the past 12 days. Greg Bell, president of the Utah Hospital Association, said that if the trend continues, the state could be days away from being forced to ration care. With intensive care at capacity with a large number of Covid-19 patients, government and health officials are urging the public to take the situation seriously and take necessary precautions.

Study Finds People With Down Syndrome at 10x Greater Risk of Death From Covid-19

A research letter published in the Annals of Internal Medicine last week highlights a new group of individuals at high risk for severe Covid-19: people with Down syndrome (CIDRAP). Researchers from the University of Oxford analyzed a database of 8.26 million adults, 4053 of whom had Down syndrome. Within this cohort, 36,391 adults without Down syndrome and 37 adults with Down syndrome tested positive for Covid-19 between January and June of 2020.

The study found that the mortality rate from Covid-19 was much higher among those with Down syndrome than in the general population. After adjusting for age and sex, the hazard ratio (HR) for Down syndrome patients was 24.94, meaning that people with Down syndrome were 24.94 times more likely than the general population to die from Covid-19. After adjusting for a variety of other factors, including residency in a long-term care facility and diagnosis with underlying issues such as dementia and congenital heart disease, the HR for Covid-19-associated death in Down syndrome patients was 10.39.

Down syndrome has not been previously listed as a risk factor for severe Covid-19 symptoms. Although the authors of the study note that additional research is needed on the topic, they believe the study can be used to “inform policy and motivate further investigation.”

Vaccine Development: Moderna Enrolls 30,000 Volunteers; AstraZeneca Vaccine Prompts Immune Response in Older Adults

Moderna, one of the frontrunners in the race to develop a Covid-19 vaccine in the United States, finished enrolling all of its 30,000 clinical trial volunteers on Thursday (CNN Health). According to the company, 20% of the participants are Latino and 10% are Black – higher than the percentages achieved earlier in the trial, but still below the targets recommended by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Moderna’s clinical trial is operating on a similar timeline to Pfizer, which has said it could apply for emergency use authorization of its vaccine as early as the third week in November.

AstraZeneca, another company with a vaccine in advanced-stage clinical trials, said Monday that their vaccine causes a similar immune response in elderly patients as it does in younger patients (Reuters). This finding is significant because older adults often have weakened immune systems, and vaccines in general are often less effective in the elderly. This issue is of particular concern when it comes to Covid-19, which disproportionately affects older adults.

CDC to Monitor Covid-19 Vaccine Recipients for Health Issues in Smartphone-Based Reporting Program

In order to continue monitoring Covid-19 vaccine safety after it becomes available in the United States, the Centers for Disease Control and Prevention (CDC) is rolling out a smartphone-based surveillance system known as V-SAFE (CNN Health). V-SAFE, which stands for vaccine safety assessment for essential workers, uses email and text messaging to follow up with vaccine recipients for six weeks to monitor for any potential side effects. If a vaccine recipient reports a significant medical event, the event is reported to the Department of Health and Human Services and followed up with a phone call. V-SAFE is not the only way the CDC plans to collect information, but it is hoped that the program will improve the speed with which officials are able to obtain and respond to relevant information. 

Bonus Read: “Hospitals Balance Covid-19 Care With More-Lucrative Services During Latest Virus Surge,” (WSJ).

Around the World

Pandemic Fatigue Spreading Alongside Virus

Governments around the world are battling a second enemy in addition to the coronavirus: the collective exhaustion known as pandemic fatigue. As second and third waves build momentum and authorities enact measures meant to flatten the infection curve, a tired and overwhelmed public is, in some cases, a hindrance to their efforts. As the Wall Street Journal writes, “A tired public tends to let its guard down, triggering more infections and restrictions that in turn compound the fatigue” (WSJ). Pandemic fatigue can be a driver for policy change because anti-coronavirus measures won’t be effective if people won’t adhere to them. Weekly Gallup polls of between 2,714 and 9,353 people in the U.S. found that 91% of respondents said they had worn a mask in the past seven days as of Sept. 27, compared with 80% as of May 10. But problems begin when the rules run up against the need for social connection: Gallup polling over the same May-to-September period showed the number of Americans avoiding small gatherings with family and friends had fallen from 71% to 45%. The problem isn’t unique to Americans; European officials are working to keep restrictions palatable to their residents while also making sure they’re effective. 

Americas 

Mexico Admits Covid-19 Death Toll is Higher Than Official Figures

Mexican authorities admitted on Sunday that the country’s Covid-19 death toll is dramatically higher than the official figure of 88,924 deaths and say they suspect at least 139,153 people have died from the virus (Guardian). The director of Mexico’s National Centre for Preventive Programs and Disease Control, Ruy López Ridaura, told reporters that based on historical averages 524,920 deaths had been anticipated between the start of the year and 26 September, but 718,090 had actually been recorded. Of those 193,170 “excess” deaths, authorities thought nearly 140,000, or 72%, might be attributed to the coronavirus.

Canadian Thanksgiving Could be Responsible for Rise in Cases 

Coronavirus cases continue to climb in much of Canada and officials believe Thanksgiving celebrations could be responsible. Celebrated two weeks ago on the second Monday of October, Canada’s Thanksgiving could serve as a warning to Americans who are gearing up for their own holiday. “Many of the cases that we’re seeing now are the result of spread over Thanksgiving when families gathered together,” Deena Hinshaw, Alberta’s chief medical officer of health, told reporters last week (WaPo). “People did not mean to spread covid,” she said, “but it is a reminder that social gatherings where distancing and masking are not used consistently are a significant risk for spread.” A “cluster” of at least 13 cases in a Toronto suburb has been linked to a Thanksgiving gathering; now ten family members, including three infants, and others from another household have tested positive.

Europe

Anti-Lockdown Protests Erupt in Italy

Violent protests were reported in several cities across Italy on Monday after new restrictions to combat the spread of coronavirus went into effect (BBC). Protestors in Turin threw gas bombs at officers; in Milan, tear gas was used to disperse protestors; and violence was reported in Naples. Protests also took place in a dozen other cities, including Rome, Genoa, Palermo, and Trieste. The government ordered that restaurants, bars, gyms, and cinemas have limited hours or close altogether. Also, many schools will move to online learning.

Belgian Doctors with Coronavirus Asked to Keep Working

In the Belgian city of Liège, doctors who have coronavirus have been asked to continue working because hospitals are so overwhelmed with Covid-19 patients. The head of the Belgian Association of Medical Unions told the BBC that they had no choice if they were to prevent the collapse of the hospital system within days. Schools are also struggling to keep up as many teachers are sick or quarantining; principals are marshaling secretaries and parent volunteers to take over teaching. “We have runaway numbers in terms of contamination and a major issue is the risk of the collapse of the hospital system of our country,” the minister-president of Brussels, Rudi Vervoort, said Saturday as he announced a host of new restrictions (WaPo).

Europe’s Christmas Markets Cancelled

As the holiday season nears, many European cities are announcing that their famed Christmas markets will not be happening this year due to the pandemic (WaPo). Prague, Strasbourg, Nuremberg, Frankfurt, and Berlin have all said their markets are cancelled. The Czech Republic has closed its borders to tourists as it battles the highest infection rate in Europe (AP). 

Asia 

Pandemic Hinders China’s Aim to End Extreme Poverty

In China, the pandemic has added conditions that keep people in extreme poverty, hurting leader Xi Jinping’s vow to “leave no one behind” (NYT). Xi Jinping is expected to declare victory in the Communist Party’s campaign to eliminate extreme poverty in China; it focused on the 5 million people who earned less than 92 cents a day. While that number is down from nearly 56 million people just five years ago, the pandemic has exposed the campaign’s shortcomings and gaps that have excluded China’s most vulnerable citizens in rural areas. Experts warn that the government’s response to the crisis, which favored infrastructure spending and tax breaks for companies instead of direct aid for individuals or families, could widen the gap between rich and poor. The central government has ignored rural workers during the pandemic, many of whom were stranded hundreds of miles away from factories where they work and were unemployed for months. Now, those farmers and rural workers say that the campaign to end poverty is more of a publicity stunt than actual aid, as many people with low income say they are arbitrarily excluded from government assistance despite qualifying for it on paper. 

U.S. Government & Politics

President Trump Disputes Chief of Staff’s Comment, Denies Giving Up on Virus

On Monday, Trump denied that his administration was giving up on controlling the virus, contradicting comments his Chief of Staff Mark Meadows made on Sunday, and which we covered in yesterday’s brief (Politico). Trump told reporters regarding Meadows’ comments, “No, not at all. In fact, the opposite. Absolutely the opposite. We’ve done an incredible job.” He added that the U.S. is “absolutely rounding the corner” despite the U.S. posting new record daily case numbers as the pandemic accelerates again. Meadows, who told CNN on Sunday that the U.S. was “not going to control the pandemic” but instead “control the fact that we get vaccines, therapeutics and other mitigation areas,” contended that his comments were being taken out of context. He stated, “I mean, when we look at this, we’re going to defeat the virus. We’re not going to control it. We will try to contain it as best we can” while speaking maskless at the White House and emphasizing a timeline of weeks for vaccines to arrive that public health experts are skeptical of. Meadows’ comments drew criticism from Democratic Presidential Nominee Joe Biden, who stated, “This wasn’t a slip by Meadows,” adding, “It was a candid acknowledgment of what President Trump’s strategy has clearly been from the beginning of this crisis: to wave the white flag of defeat and hope that by ignoring it, the virus would simply go away. It hasn’t, and it won’t.” Meadows’ comments follow reports that White House officials have flirted with a strategy of achieving herd immunity by not containing the virus (NYT). Bonus Read: “As Covid Threat Surges, Trump and Pence Try 2 Acts to Save GOP Ticket,” (Politico).

U.S. Economy

Stocks Slide as Coronavirus Surges and Hopes for Relief Deal Diminish

On Monday, the stock market slid amid news of surging coronavirus cases in the U.S. and Europe and diminishing hopes that a coronavirus relief bill will pass before the election (WSJ). The Wall Street Journal reported, “Major indexes opened lower, and the declines accelerated into the afternoon. All 30 components of the Dow Jones Industrial Average were lower, as were all 11 sectors of the S&P 500. The Dow industrials fell 760 points, or 2.7%, putting the blue chips on track for their worst day since Sept. 3. The S&P 500 dropped 2.1%, and the Nasdaq Composite fell 2%.” Steven Wieting, chief strategist at Citi Private Bank, told the Journal, “The ability to fight the virus further right now is very much in question, and it’s a political question.”

U.S. Society

Time Change May Be Particularly Tough This Year for Those Working From Home

As November 1 with its turning back of clocks by one hour for daylight savings time approaches, many Americans may find the time change particularly tough this year due to the effects of working from home (WSJ). The Wall Street Journal writes, “The first clock shift since the pandemic’s arrival in earnest in the U.S. is coming at 2 a.m. Nov. 1—and for those no longer working in offices, the effects could be more intense than usual. For some people, the switch can upend a hard-won rhythm of working from home, focusing and staying emotionally balanced—but the shift also can make for a powerful tool for getting through the dark days of winter if handled correctly, scientists say.” According to a Danish study, even under normal conditions, the time shift can increase depression by 8%. However, according to Michael J. McCarthy, an associate professor of psychiatry at University of California San Diego, without the interactions that come from working in an office and commuting, the effects of the shift may be magnified as people focus with fewer distractions on the reduced daylight. Erik Herzog a professor at Washington University in St. Louis also told the Journal, “The lights that we have in our house are much dimmer than anything you experience, even on a cloudy day, outside.” The Journal notes some ways to minimize the impact, writing, “Experts in this field recommend going outside in the early morning for about 30 minutes if possible, whether it’s on a stoop or front yard. Also, run errands earlier.”

Analysis & Arguments

Margaret Renkl writes on fighting Covid with Dolly Parton and the Rock (NYT).

Amanda Mull looks at the difference between feeling safe and being safe in the pandemic (Atlantic).

Robinson Meyer examines the latest U.S. surge in coronavirus cases, a surge that lacks an epicenter (Atlantic).

Michael Brendan Dougherty argues that neither party truly has a plan for responding to the pandemic (National Review).

 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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