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October 14, 2020 - Brief Issue 104

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

Johnson & Johnson, Eli Lilly Pause Clinical Trials (Health & Science)

WHO Chief Calls Herd Immunity Approach “Immoral” (Health & Science)

Pfizer Expands Covid-19 Vaccine Clinical Trial to Ages 12 and Up (Health & Science)

Some Countries See Rapid Antigen Tests as Tool to Combat Second Wave (Around the World)

Coronavirus Cases on the Rise in Europe’s Schools (Around the World)

Soccer Star Cristiano Ronaldo Tests Positive for Covid-19 (Around the World)

Mexico Agrees to Buy Potential Vaccines (Around the World)

Coronavirus Turns India Towards Economic Overhaul (Around the World)

McConnell Announces New Senate Push for Coronavirus Relief, Accuses Democrats of Stalling Until After the Election; Democrats Push Own Bill and Negotiate with the White House; Both Democrats and Republicans Reject Latest White House Proposal (U.S. Government & Politics)

JP Morgan Reports 4% Rise in Profits, Showing Resilience Amid Pandemic (U.S. Economy)

AMC Theaters Could Run Out of Money By End of Year (U.S. Society)

Gates Foundation Announces Grant to Support Covid-19 Testing at HBCUs (U.S. Society)

Health & Science

There have been 7,856,714 coronavirus cases in the United States, and 215,902 people have died (Johns Hopkins). Around 3,124,593 people have recovered, and the United States has conducted 117,357,626 tests. Worldwide, there have been 38,130,829 confirmed cases of coronavirus, with 1,086,156 deaths. At least 26,467,823 people have recovered from the virus. 

Johnson & Johnson, Eli Lilly Pause Clinical Trials

Johnson & Johnson, one of the latest companies to enter the final phase of testing for their Covid-19 vaccine, has temporarily paused their clinical trial after a patient fell ill (STAT, NYT, WSJ). The company declined to elaborate, saying only that one of their volunteers had experienced an unexplained illness and that they had paused their trial until a safety board could review the case.

Shortly after Johnson & Johnson paused their vaccine trial, Eli Lilly also paused their final phase clinical trial of an antibody treatment similar to the one President Trump took earlier this month after his Covid-19 diagnosis (NYT, MSNBC). The company said that the independent data safety monitoring board had recommended a temporary pause in enrollment in order to review a “potential safety concern.” The company did not provide details about the safety concern.

Pauses in clinical trials are common, particularly in final phase studies with many participants. A pause allows independent safety boards to determine whether a so-called adverse event – any unexplained illness or other medical event – in a study participant is related to treatment or simply due to chance.

WHO Chief Calls Herd Immunity Approach “Immoral”

Dr. Tedros Ghebreyesus, chief of the World Health Organization, spoke out against the so-called “herd immunity” strategy at a press conference on Monday (BBC, Guardian, CBS). Herd immunity describes a situation in which a community becomes resistant to the spread of an illness after most individuals in that community gain immunity. Herd immunity is generally used to describe the scenario where unvaccinated individuals in a population remain protected from disease as long as a certain percentage of that population is vaccinated against the disease. Recently, however, some have suggested deliberate mass infection with Covid-19 as a means of controlling the virus. Dr. Tedros decried this idea as “scientifically and ethically problematic.” “Herd immunity is achieved by protecting people from a virus, not by exposing them to it,” he said. “Never in the history of public health has herd immunity been used as a strategy for responding to an outbreak, let alone a pandemic.” He went on, “Allowing a dangerous virus that we don’t fully understand to run free is simply unethical. It’s not an option.”

Over 38 million confirmed Covid-19 cases and 1 million deaths have been reported worldwide (Johns Hopkins). Even so, recent studies suggest that only around 10% of people in most countries have antibodies against the virus, theoretically - though not certainly - making them immune to future infection. Herd immunity generally requires 70-95% of individuals to be immune to a given disease. “The vast majority of people in most countries remain susceptible to this virus,” Tedros said. “Letting the virus circulate unchecked therefore means allowing unnecessary infections, suffering and death.”

Pfizer Expands Covid-19 Vaccine Clinical Trial to Ages 12 and Up

The drug company Pfizer announced Monday that it had received FDA approval to enroll children 12 years of age and older in its Covid-19 vaccine trial (NPR). Previously, vaccine trials in the U.S. enrolled only individuals 16 years and older.

Dr. Sara Goza, president of the American Academy of Pediatricians, wrote to top health officials earlier this month encouraging them to approve vaccine studies in children. “Children must be included in vaccine trials to best understand any potential unique immune responses and/or unique safety concerns,” she wrote.

Other pediatric disease experts also welcomed the change in policy. While it is common for initial safety studies to be done in adults first, many pediatric experts agree that enrolling children in these rapidly-progressing studies is vital for a full understanding of how a vaccine might affect this population.

Covid-19 Patients May Face Unexpected Medical Bills

A recent analysis by the New York Times explores the unexpected medical costs coronavirus patients may incur after a hospital stay. Surprise hospital bills have long been an issue in American healthcare. Patients who do not realize that an out-of-network provider or medical laboratory has been added to their care are often stuck with large bills their insurance will not cover. Last year, Congress was on the verge of passing a bipartisan plan outlawing such charges, but the plan was derailed after private equity firms lobbied heavily against it. At the start of the pandemic, Congress sent a $175 billion relief package to healthcare providers with the stipulation that patients could not be sent surprise medical bills for treatment related to Covid-19.

However, as the New York Times details, these protections do not cover all aspects of medical care – most notably, medical laboratories and ambulance or airlift services, which did not receive relief funds and are not bound by rules around surprise billing. According to the report, a life-saving air ambulance ride carries a median charge of $38,000, of which an average patient can expect to be billed $21,000. This cost has risen about 15% each year since 2015.

Dr. Karan Chhabra, lead author of a study exploring the prevalence of unexpected, out-of-network bills, argues that these kinds of bills undermine public trust at a critical time. “The government is telling people if you have coronavirus, you cannot get surprise-billed,” she said. “It’s incredibly counterproductive if people cannot trust the policies meant to protect them when they’re getting care for this illness.”

Around the World

Some Countries See Rapid Antigen Tests as Tool to Combat Second Wave

Some countries that are working to contain a second wave of coronavirus are using faster and cheaper tests that are also less accurate. These so-called antigen tests deliver results in minutes and cost just under $6.00 each, which would allow for more widespread testing while also avoiding the delays and shortages that have so far hindered efforts to diagnose and trace those infected (Reuters). Germany has ordered 9 million antigen tests per month, which, in theory, covers 10% of the population. The United States and Canada are also buying millions of the tests, as is Italy, whose recent tender for 5 million tests received offers from 35 companies. Germany’s health authority, the Robert Koch Institute, recommends the antigen tests as a complement to molecular PCR tests, which have become the standard for identifying active infections. However, the PCR tests’ accuracy, and therefore popularity, have led to shortages as demand has outstripped the capacity for supply. PCR tests detect genetic material in the virus while antigen tests detect proteins on the virus’s surface, both through nasal swabs. Some health authorities see the antigen tests as a way for low-priority patients, i.e. those without symptoms, to receive initial screening that would allow the more accurate PCR tests for those with symptoms. 

Europe

Coronavirus Cases on the Rise in Europe’s Schools

Schools in coronavirus hotspots across Europe are reporting thousands of cases of coronavirus among students and staff (WSJ). In the U.K., over one-third of the 1,700 coronavirus outbreaks -meaning the appearance of more than two cases - in the four weeks through Sept. 27 originated in an education setting. In France, 35% of the 1,070 outbreaks currently under investigation have been in schools or universities. And in Spain, 4.5% of all schools have reported COVID-19 cases. In Italy, there were 2,438 cases among elementary, junior-high, and high-school students as of Oct. 3, compared to 809 cases just two weeks previous. Germany has not made national data in regards to coronavirus in its school systems public, but authorities have said that it hasn’t had an impact yet. In each country, health and government authorities are grappling with how to keep schools open in spite of the rise in infections, citing the social and economic costs of closing classrooms once again. In some countries, preventative measures like masks and distancing have been ramped up, while in others, partial class closures and quarantines have resulted from the outbreaks. “The best thing we can do for children during times like this is to send them to school,” France’s education minister, Jean-Michel Blanquer, said in an interview.

Europe Tries to Take Unified Approach to Fight New Waves of Coronavirus without Re-entering Lockdown; The Netherlands Returns to Partial Lockdown, Italy Imposes Additional Restrictions; French President Expected to Announce More Restrictions; Northern Ireland Enters Lockdown

On Tuesday the European Union adopted new guidelines in an effort to coordinate members’ varying travel restrictions, turning to a single map with color-coded system that shows the scale of the outbreaks. The bloc will unify quarantine procedures and testing to smooth out travel between member states while also providing ample warning when national travel advisories are changing so that travelers aren’t stranded (NYT). While the new measures aren’t mandatory and individual member states can still take unilateral action, they are a step in the right direction in alleviating some of the confusion that has come about as many states announced new restrictions and advisories to residents. Many government officials have admitted that they are trying to avoid another national lockdown by taking a targeted approach, but the patchwork quilt of restrictions has caused chaos among travelers during the fall school holidays as each country’s rules and restrictions are different and can change overnight.

Dutch Prime Minister Mark Rutte announced on Tuesday that the Netherlands must return to a “partial lockdown” that includes the closure of bars and restaurants (Reuters). Masks will be required in all indoor spaces, public transit use limited to essential travel only, and alcohol sales were also banned for the evening hours. Rutte said the new measures take effect on Wednesday and will last for two weeks. The number of cases in the country of 17 million surged to a daily record of almost 7,400 on Tuesday, making it one of the highest per capita infection rates in the world. In Italy, Prime Minister Giuseppe Conte imposed tougher restrictions for the second time in a week by limiting gatherings, restaurants, and sports and school activities (Guardian). The newest restrictions ban parties in restaurants, clubs, or outside and discourages people from hosting more than six guests in their home at a time. 

French President Emmanuel Macron is scheduled to give a televised national address on Wednesday to announce additional lockdown measures (Guardian). New Covid-19 infections spiked in the country recently and France’s five largest cities – Paris, Marseille, Lyon, Toulouse and Lille – are already at the maximum alert level with bars and gyms closed and restaurants operating in a limited capacity. French health authorities reported 12,993 new Covid-19 infections over the past 24 hours, up on Monday’s 8,505, but down from Saturday’s record of 26,896 and Sunday’s 16,101.

On Wednesday, Northern Ireland announced a four-week lockdown, with schools closing for two weeks in a renewed effort to eradicate the coronavirus. Cases have surged to their highest level yet and Arlene Foster, Northern Ireland’s first minister, attributed the measures to a “very worrying increase” in the number of new cases (NYT). The lockdown is not as strict as the previous one in the spring, as retail shops are allowed to remain open and restaurants can operate with delivery or take out services. 

Soccer Star Cristiano Ronaldo Tests Positive for Covid-19

Cristiano Ronaldo, one of the world’s most famous athletes and international soccer star, has tested positive for coronavirus. Portugal’s soccer federation announced his diagnosis on Tuesday, saying that he was not displaying any symptoms but he had entered isolation. Ronaldo, who plays for the Italian club Juventus, is playing for Portugal’s national team in the Nations Cup. He will sit out Wednesday’s game against Sweden.

Americas

Mexico Agrees to Buy Potential Vaccines

On Tuesday the Mexican government signed agreements with three different companies that are working to develop a vaccine for COVID-19 in hopes of securing vaccinations for more than 100 million people through 2021 (WSJ). According to the Wall Street Journal, “Mexico will buy eventual vaccines for 39 million people from AstraZeneca PLC of the U.K., as many as 17 million from Pfizer Inc. and 35 million from China’s CanSino Biologics Inc.” Mexico is also participating in the international vaccine alliance Covax and expects to obtain about 26 million doses through that partnership. According to Mexcian Finance Minister Arturo Herrera, Mexico has paid $159 million up front and will bring that total to $321 million by the end of 2020. The total cost of the vaccines is estimated at $1.7 billion. 

Asia 

Coronavirus Turns India Towards Economic Overhaul

India’s economy contracted by almost one-quarter in the months following the initial outbreak of the pandemic, the sharpest blow suffered by any of the world’s largest economies. Now, Prime Minister Narendra Modi is hoping that deregulation will boost the economy back to pre-pandemic levels. The reforms pushed through by the prime minister’s Bharatiya Janata Party (BJP) affect a wide array of economic activity, with changes in the agricultural realm already being implemented. For example, one of the changes that went into effect immediately was the dismantling of a regulatory system that forced farmers to sell the majority of their crops to government-approved wholesale markets (WSJ). Now, they can sell directly to consumers or food processors, which the BJP government hopes will improve farmers’ prospects by widening their customer base. Other “new labor measures that increased the number of companies that can fire workers without government permission, raised the barriers for workers to unionize, relaxed rules preventing women from working night shifts and restricted unions’ ability to organize strikes. At the same time, it expanded the country’s social security program to include many contract workers,” says the Wall Street Journal.

U.S. Government & Politics

McConnell Announces New Senate Push for Coronavirus Relief, Accuses Democrats of Stalling Until After the Election; Democrats Push Own Bill and Negotiate with the White House; Both Democrats and Republicans Reject Latest White House Proposal

On Tuesday Senate Majority Leader Mitch McConnel (R-KY) announced that the Senate would make another push to pass a coronavirus relief bill while also accusing Democrats of delaying the passage of a bill until after the presidential election (Politico). McConnell commented, “Republicans do not agree that nothing is better than something for working families. The American people need Democrats to stop blocking bipartisan funding and let us replenish the PPP before more Americans lose their jobs needlessly.” House Democrats have pushed for a $2 trillion relief bill, more than Republicans in the Senate have so far been willing to accept. The Democrats have had their own negotiations with the White House, which recently offered a $1.8 trillion package. Many Senate Republicans voiced criticism of that offer. Democrats rejected the offer, and according to Politico, citing three sources, House Speaker Nancy Pelosi told a Democratic conference call, “We need an agreement, but we cannot get an agreement just by folding. Our leverage has never been greater.” However, Pelosi has seen some pressure from Democrats to accept the latest offer.

Bonus Read: “Trump Attacks Fauci Amid Campaign Ad Feud,” (Politico). 

U.S. Economy

JP Morgan Reports 4% Rise in Profits, Showing Resilience Amid Pandemic

On Tuesday, JP Morgan Chase announced that its third quarter profits rose 4%, showcasing the company’s resilience amid the pandemic (WSJ). The Wall Street Journal writes, “The bank set aside just $611 million for potential future loan losses, far less than expected and the $10.47 billion it booked in the second quarter. Profit doubled from the second quarter.The bank’s profit rose to $9.44 billion, or $2.92 a share, from $9.08 billion, or $2.68 a share, a year earlier. Analysts had expected $2.23 a share, according to FactSet. The smaller reserve build signals the bank believes it is prepared for the losses that will come.” However, the bank’s CEO James Dimon cautioned that the gains might be temporary and told reporters, “A good, well-designed stimulus package will simply increase the chance we get better outcomes, but there is so much uncertainty we’re not saying that that’s definitive.”

U.S. Society

AMC Theaters Could Run Out of Money By End of Year 

The AMC movie theater chain could run out of money by the end of 2020, according to a report Tuesday in the Wall Street Journal (WSJ). The Journal writes, “The movie-theater operator has reopened 494 of its 598 U.S. theaters, but attendance is down about 85% on a same-theater basis from the equivalent period last year since reopening began, AMC said Tuesday. At the company’s current cash-burn rate, reserves would be depleted by the end of this year or early next year, Kansas-based AMC said.” AMC’s announcement regarding its troubles came as the company’s stock fell 8% on Tuesday morning, and shares are down 48% over the year. Movie theater companies like AMC have struggled as restrictions aimed at stopping the spread of coronavirus have closed or limited attendance at theaters, as the pandemic impacts the development and release schedules of movies, and as companies increasingly release their movies straight to streaming while streaming services continue to show growth.

Gates Foundation Announces Grant to Support Covid-19 Testing at HBCUs

On Tuesday, the Bill and Melinda Gates Foundation announced a $15 million grant to support Covid-19 testing on Historically Black College and University (HBCU) campuses (WSJ). As part of the grant, Florida A&M University, Hampton University, Howard University, Meharry Medical College, Morehouse School of Medicine, and Xavier University will each receive $1.5 million. The Journal notes, “These schools will act as hubs for other historically Black colleges in their regions, and will process Covid-19 tests administered on those campuses. Forty-six schools have currently signed on to participate in the project, a Thermo Fisher spokeswoman said.” The grant supports efforts by the Thermo Fisher Foundation's Just Project, which has already been providing materials to HBCUs across the country.

Bonus Read: “Fewer Fistfights, Less Sex—TV Production Gets a Covid Makeover,” (WSJ).

Analysis & Arguments

Watch New America’s Future Security Forum discussion on the implications of the coronavirus pandemic with Michael T. Osterholm, Director, Center for Infectious Disease Research and Policy; Daniel Lamas, New America National Fellow and Pulmonary and Critical Care Doctor, Brigham & Women's Hospital; George Poste, Chief Scientist, Complex Adaptive Systems Initiative and Regents’ Professor and Del E. Webb Chair in Health Innovation, Arizona State University; Helene Gayle, President & CEO, Chicago Community Trust, Chair of New America, and Co-Chair of the Committee on Equitable Allocation of Vaccine for the Novel Coronavirus; moderated by brief senior editor Peter Bergen (New America).

New America International Security Program Fellow J. Peter Scoblic and Philip Tetlock write on how to think better about the future in light of the coronavirus pandemic (Foreign Affairs).

Ruchir Sharma writes on Vietnam’s apparent successes in combating coronavirus and more (NYT).

Annabelle Williams reports on how college students have adjusted to dating in the era of pandemic (WaPo).

Ross Ramsey reports on a new poll regarding how Texans view a possible vaccine (Texas Tribune).

Joe Pinsker writes on the dangers that come with the temptation to travel home over the holiday season (Atlantic).

The New York Times Editorial Board argues that Iran’s rising death toll from Covid-19 shouldn’t be ignored by the Trump administration (NYT).

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

The Brief is edited by David Sterman and Narisara Murray and co-edited by Emily Schneider with Senior Editor Peter Bergen.

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

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