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November 17, 2020 - Brief Issue 120

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

Novel Coronavirus Was Present in Italy Since September 2019, New Study Finds (Health & Science)

Covid-19 Hits Rural Nursing Homes (Health & Science)

Moderna Covid-19 Vaccine Has Storage Advantage Over Pfizer; Pfizer Launches Pilot Delivery Program (Health & Science)

Out-of-Hospital Cardiac Arrest Survival Dropped 17% During Pandemic (Health & Science)

Hungary and Poland Block EU Stimulus Package (Around the World)

Merkel Forced to Postpone Tighter Lockdown Measures (Around the World)

South Korea Warns of New Covid-19 Crisis (Around the World)

China’s Economy On the Rise, Fourth Quarter Expected to Continue Upward Trend (Around the World)

Scott Atlas, Trump Adviser, Calls for Michigan to “Rise Up” Against Coronavirus Restrictions (U.S. Government & Politics)

House of Representatives Launches New Testing Procedures for Members; No Advances on Stimulus as Lame Duck Session Begins (U.S. Government & Politics)

Dow Hits Record High on News of Moderna Vaccine (U.S. Economy)

How the Covid Baby Bust is Disrupting Businesses (U.S. Society)

Health & Science

There have been 11,205,485 coronavirus cases in the United States, and 247,220 people have died (Johns Hopkins). Around 4,244,811 people have recovered, and the United States has conducted 164,366,274 tests. Worldwide, there have been 55,079,810 confirmed cases of coronavirus, with 1,328,167 deaths. At least 35,389,562 people have recovered from the virus.

Novel Coronavirus Was Present in Italy Since September 2019, New Study Finds

According to a study conducted by the National Cancer Institute in Milan, Covid-19 spread in Italy much earlier than previously thought (Reuters). The first Covid-19 patient in Italy was diagnosed February 21st in Lombardy, near Milan. It was previously assumed that the virus began spreading in the region in the early months of 2020. However, a new analysis of blood samples collected from patients enrolled in a lung cancer screening trial between September 2019 and March 2020 showed that some patients had developed Coronavirus antibodies much earlier. In the study, 11.6% of the 959 samples contained antibodies to the virus. Four samples from the first week of October 2019 contained neutralizing antibodies against Coronavirus, indicating that the patients had been infected sometime in September 2019.

Covid-19 Hits Rural Nursing Homes

Nursing home residents are among the most vulnerable to the effects of Covid-19. Since the start of the pandemic, about 40% of Covid-19 deaths have occurred among nursing home residents. Many nursing homes and elder care facilities have enacted strict measures to control the spread of the virus, including no-visitor policies and stringent health and safety protocols. However, as cases have risen around the U.S., including in low-density areas, rural nursing homes have been increasingly hard-hit (WSJ).

“Nursing homes are not isolated from what happens in the community,” said Carrie Henning-Smith, an associate professor at the University of Minnesota School of Public Health. “We’re seeing this run rampant through rural communities.”

Nursing homes in rural counties reported 18% of nursing home Covid-19 deaths during the last week of October, despite caring for only 10% of the nation’s nursing home population. Unfortunately, care facilities in rural areas are often less equipped to handle outbreaks. Some nursing homes report shortages of protective equipment, understaffed facilities, and delays in Covid-19 testing. Despite adherence to public health guidelines, these facilities have found it difficult to control viral spread among their residents. The situation highlights the need for even healthy, less risk-prone individuals to adhere to public health guidelines in order to protect vulnerable populations.

Moderna Covid-19 Vaccine Has Storage Advantage Over Pfizer; Pfizer Launches Pilot Delivery Program

The drug companies Moderna and Pfizer each recently announced better-than-expected interim results for their Covid-19 vaccines (CNN). Pfizer’s vaccine appears to be more than 90% effective, while Moderna reported Monday morning that their vaccine was 94.5% effective. Both results are good news, but the Moderna vaccine has one significant practical advantage over Pfizer’s: storage temperature.

Pfizer’s vaccine must be held at minus 75 degrees Celsius, or about minus 103 degrees Fahrenheit. No other vaccine in the U.S. needs to be stored at such low temperatures, and vaccine storage is a serious logistical concern for officials charged with vaccine distribution. Moderna’s vaccine, on the other hand, can be stored at minus 20 degrees Celsius, the temperature of a standard freezer, making it much easier for doctor’s offices and pharmacies to store the vaccine over time.

In an effort to address distribution challenges facing its ultra-cold storage requirements, Pfizer has launched a pilot delivery program for its experimental vaccine in four states: Rhode Island, Texas, New Mexico, and Tennessee. The states were selected for their “differences in size, diversity of populations, immunization infrastructure, and the need to reach individuals in varied urban and rural settings” (Reuters). “We are hopeful that results from this vaccine delivery pilot will serve as the model for other U.S. states and international governments, as they prepare to implement effective COVID-19 vaccine programs,” Pfizer said in a statement on Monday. The four states will not receive vaccine doses earlier than other states just because they participate in the pilot, Pfizer said (Guardian). 

Out-of-Hospital Cardiac Arrest Survival Dropped 17% During Pandemic

A study published in the medical journal JAMA Cardiology found that outcomes for out-of-hospital cardiac arrest were worse during the pandemic than before (CIDRAP). The study examined restoration of heart function as well as survival until hospital release between March 16 and April 30 in both 2019 and 2020. Overall, survival until hospital release fell by 17% in 2020. Rates of restoration of heart function also dropped, from 29.8% to 23.0%. The differences were even greater in counties with high rates of Covid-19 deaths.

The authors of the study said that the proportion of witnessed cardiac arrests, CPR and defibrillator use and median time to call for emergency services was similar in both years. They proposed that the worsened outcomes could be due to decreases in hospitalization for heart conditions and delays in seeking medical attention out of fear of Covid-19 infection. They also suggested that guidelines meant to protect frontline workers, such as limiting the number of personnel present, pausing chest compression during intubation and limiting ventilation if filtration is unavailable, might help explain the reduction in successful heart function restoration. 

Where People Are Catching Coronavirus Still Largely Unknown

As Covid-19 surges in the United States and around Europe, experts advise targeted mitigation, with more restrictions in place for areas with high caseloads and reopening prioritized for areas with lower transmission (WSJ). However, health officials are still not certain exactly where people are getting the virus. In New York City, for instance, senior public health advisor Dr. Jay Varma said that about 10% of the city’s infections are due to travel, 5% to public gatherings, and 5% to institutional settings like nursing homes. The rest are unaccounted for – there is no way to determine their source. This lack of knowledge could be a problem for cities hoping to keep their residents safe while also prioritizing their economies. With more information, more precise strategies could be deployed – for instance, imposing restrictions on only certain neighborhoods, or closing certain businesses known to pose a higher risk. Experts say that the lack of sufficient contact tracing makes it difficult to pinpoint the origins of outbreaks. Improvements in contact tracing, they say, may go a long way toward avoiding indiscriminate lockdowns and helping economies to open safely.

Several States to Independently Vet Any FDA-Approved Vaccine

The Food and Drug Administration (FDA) is expected to review safety and efficacy data for the first Covid-19 vaccine in the U.S. in the coming weeks and, pending that review, approve the vaccine for emergency use (NYT). Several states, mostly Democrat-led, as well as the District of Columbia, have announced plans to conduct their own independent reviews. These independent reviews are intended to reassure a wary public that the vaccine is indeed safe and effective.

Some health officials have criticized the move, however, saying it may just serve to sow more doubt about the vaccine and delay distribution to vulnerable populations. Paul Mango, deputy chief of staff for policy at the U.S. Department of Health and Human Services, called the FDA “the most rigorous organization in the world” and said, “We want shots in arms within 24 hours. Any delay that the state wants to impose will be a delay in getting its most vulnerable citizens vaccines.” States have said that their review processes would not delay vaccine distribution and that they intended to conduct those reviews alongside the FDA. It is likely that vaccines would be available in a given state even if their review process was delayed, as states do not control vaccine distribution during a pandemic.

The FDA intends to offer briefings on its vetting and approval process in order to address state officials’ concerns. Many experts have expressed confidence in the FDA approval process, saying that the FDA has committed to transparency and resisted political pressures to push a vaccine out earlier. Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and now a member of President-elect Biden’s coronavirus task force, said he was “absolutely confident in the FDA process” and thought the state reviews were “absolutely unnecessary.”

New Treatment May Help Covid-19 Patients Recover Faster

The results from a clinical trial published in the medical journal The Lancet Respiratory Medicine show that a new inhaled medication may reduce the chance that hospitalized Covid-19 patients will become severely ill or die (CIDRAP). The medication is an immune response protein called interferon beta-1a, which is essential for fighting off new diseases. SARS-CoV-2 is known to suppress interferon beta-1a, and as we reported yesterday, a recent study shows that the interferon response is lower in individuals with more severe disease.

The trial, which involved 98 patients at nine hospitals in the U.K., found that patients who received the treatment were twice as likely to improve clinically at 15 or 16 days after start of treatment than those who received placebo (21 of 48 compared to 11 of 50). None of the patients in the treatment group died, while three patients in the placebo group died. At the 28-day follow-up, those in the treatment group were three times more likely to be able to resume normal activity compared to those given the placebo.

Some outside experts believe that, while promising, the results should be interpreted cautiously. In a commentary in the same journal, two infectious disease experts noted that another recent study on interferon beta-1a found no benefits to treatment. However, they said that the lack of efficacy could have been because the treatment in that study was delivered by injection rather than by inhalation, which targets the lungs directly. They also noted that interferon beta-1a might trigger a dangerous inflammatory response in critically ill Covid-19 patients. They recommended a larger clinical trial in order to confirm the results of the study and track any long-term effects of treatment.

California Becomes the Latest State to Enact More Pandemic Restrictions

California Governor Gavin Newsom announced Monday that 41 of the state’s 58 counties will be put under the state’s most restrictive response tier due to uncontrolled coronavirus transmission (The Hill, Newsweek). More than 94% of the state’s residents live within these counties. Under the new restrictions, no indoor dining will be allowed, and gyms, theaters and places of worship will be closed. Covid-19 cases have doubled in California over the last 10 days, and last week the state was the second to record 1 million total cases.

“We are sounding the alarm,” Newsom said. “California is experiencing the fastest increase in cases we have seen yet. The spread of Covid-19, if left unchecked, could quickly overwhelm our health care system and lead to catastrophic outcomes.”

Bonus Read: “Rapid Testing Is Less Accurate Than the Government Wants to Admit,” (ProPublica).

Around the World

Europe

Bonus Read: “Europe Got Covid Largely Under Control in the Summer. What Went Wrong?” (WSJ)

Hungary and Poland Block EU Stimulus Package

On Monday Hungary and Poland blocked the landmark stimulus package that was meant to rescue the bloc’s economies from the effects of the coronavirus along with the broader budget because the funding was conditioned on upholding rule-of-law standards (NYT). The two countries are vetoing the spending bill because they have worn down the separation of powers at home and don’t want the requirement to adhere to democratic principles, like an independent judiciary and free media, attached to the stimulus (Reuters). The 1.8 trillion euro ($2.1 trillion) multiyear budget contains at least 750 billion euros earmarked to help members’ economies out of the recession caused by the pandemic. The spending bill was a bold move by EU leaders that demonstrated a level of collaboration and unity that was unprecedented in the history of the bloc and was the first time the EU had agreed to jointly issue debt. Now, as second and third waves continue to ravage the continent and many countries are in some sort of lockdown that is further endangering economic recovery, EU leaders must work to break the stalemate at a teleconference scheduled for Thursday. A delay in the bill after November would push the deployment of funds into 2021 and would hurt economies of member states. 

Merkel Forced to Postpone Tighter Lockdown Measures

German Chancellor Angela Merkel said she does not have the backing of state leaders for new restrictions to take Germany’s current “lockdown lite” to a full-blown lockdown after meeting with state officials on Monday (Guardian). She has postponed any decision until the next meeting with the 16 state premiers, which is scheduled for next week. The chancellor was in favor of limiting social interactions in private to only two households and banning parties or gatherings until Christmas Eve, according to a draft proposal cited by Der Spiegel. “I could have imagined imposing further contact restrictions today, but there was no majority for that,” Merkel said after Monday’s meeting. She added there was a need for greater social distancing. Germany entered a lockdown on Nov. 2, with restaurants forced to offer delivery or takeout only, retail stores to limit customer capacity, beauty salons closed, and limitations on private gatherings put in place. Some schools are also doing remote-based learning. 

Asia

South Korea Warns of New Covid-19 Crisis

South Korea will impose stricter social distancing rules for the greater Seoul area, officials said on Tuesday, warning that an even bigger crisis is looming if these measures fail to control the new spike in cases (Reuters). Public gatherings of 100 people or more will be banned, religious services and sporting events will limit capacity to 30%, and clubs and karaoke bars will have to increase the distance between guests starting on Thursday. South Korea undertook aggressive tracing and testing in response to the initial outbreak but has been battling a persistent rise in infections recently; the daily case count has been around 200 new cases per day for four consecutive days and health officials say the daily count could increase to 400 in the coming weeks (AP). Tuesday’s case count was 230, the highest since September; the country’s total number of infections is 28,998, with 494 deaths.

China’s Economy On the Rise, Fourth Quarter Expected to Continue Upward Trend

China’s economic activity made a recovery in October and experts expect an even faster economic rebound in the final quarter of 2020. Investment and consumer spending grew at faster year-over-year rates in October compared to September and industrial production remained “solid” (WSJ). Retail sales rose 4.3% in October compared to last year, up from 3.3% in September, though still lower than the 4.6% increase expected by economists. “According to the Journal: “Industrial output, which has led the nation’s economic recovery in recent months, rose 6.9% in October from a year earlier, on par with September’s pace and higher than market expectations for a 6.5% increase, according to data released Monday by the National Bureau of Statistics. Fixed-asset investment rose 1.8% in the January-October period, accelerating from 0.8% growth in the first three quarters of the year and coming in higher than the 1.6% increase expected by economists polled by the Wall Street Journal.” Economic growth in the fourth quarter is expected to be even faster than that of the third quarter,” Fu Linghui, a spokesman for the statistics bureau, said in a briefing Monday. He also said that China’s imports and exports will outpace that of the world as a whole, even as the pandemic continues to make the rest of the world’s activity unpredictable. 

Walmart Sells Japanese Operations, Retreats from Global Market

After 18 years, Walmart has sold most of its stake in a Japanese supermarket chain as it continues its retreat from global markets in favor of e-commerce (WSJ). It’s the third longtime overseas holding to be sold in less than seven weeks: in October, Walmart agreed to sell U.K. grocery store chain Asda Group; in November, Walmart said it was selling its retail operations in Argentina at an after-tax loss of about $1 billion. Executives said in early 2018 that the company would move away from international operations in favor of higher-growth e-commerce opportunities and it seems as though the shift in shopping habits amid the pandemic has accelerated that plan. 

U.S. Government & Politics

Scott Atlas, Trump Adviser, Calls for Michigan to “Rise Up” Against Coronavirus Restrictions

On Sunday night in a tweet, Dr. Scott Atlas, an advisor to Donald Trump on coronavirus who does not have a background in epidemiology or infectious diseases, called for Michiganders to “rise up” against the state’s coronavirus restrictions (WaPo, Politico). Atlas quote tweeted a tweet about new measures promulgated by Michigan Governor Gretchen Whitmer, adding, “The only way this stops is if people rise up. You get what you accept. #FreedomMatters #StepUp.” Earlier on Sunday, Michigan’s Governor Gretchen Whitmer announced a “pause to save lives” consisting of three weeks of updated restrictions. Atlas’s tweet quickly drew criticism and reminded many of Trump’s earlier calls to “LIBERATE MICHIGAN!.” Whitmer, who was allegedly the target of a militia kidnapping plot motivated in part by backlash to her prior measures to respond to the coronavirus pandemic, commented that Atlas’ tweet “actually took my breath away, to tell you the truth.” Atlas later tweeted, “Hey I NEVER was talking at all about violence. People vote, people peacefully protest. NEVER would I endorse or incite violence. NEVER!!.”

House of Representatives Launches New Testing Procedures for Members; No Advances on Stimulus as Lame Duck Session Begins

The House of Representatives returned on Monday for the lame duck session between the election and the swearing in of the new Congress, and it has instituted a new system for coronavirus testing of members (NPR). The new plan to conduct widespread testing is the first such plan for either legislative chamber. NPR writes, “after pressure from members and facing increasing caseloads across the country, a new testing regime is being implemented as members return after being away for the election. Pelosi, in conjunction with Dr. Brian Monahan, the Capitol attending physician, recently announced the addition of up to 2,000 weekly coronavirus tests for current members and staff.” At least 25 congressional representatives have tested positive for the virus, according to NPR’s count. 

Meanwhile, the top agenda item for the lame duck session will be the passage of a further round of coronavirus stimulus and relief. However, Speaker of the House Nancy Pelosi signaled there has been no progress since the House adjourned, commenting, “We're in that same place, even more so.” Senate Majority Leader Mitch McConnell similarly suggested there has been little movement, saying of the House Democrats’ proposed bill, “That's not a place I think we're willing to go.” Even so, both have expressed optimism that something will pass.

Businesses Prepare to Battle New Coronavirus Restrictions Amid Surging Cases

Even as coronavirus cases surge across the country, businesses are preparing to battle new restrictions likely to be and already being imposed by public health authorities (WaPo). The Washington Post reports, “Movie theaters in New York City are demanding the right to reopen. Restaurateurs in Massachusetts are trying to serve more customers at night. And top retailers are targeting store limits across the country, hoping to boost shopping — and profits — as the holidays approach.” Facing pressure from the Global Cinema Federation trade association, New York Governor Andrew Cuomo allowed theaters outside of New York City to open at diminished capacity, but the National Association of Theatre Owners is pushing for openings to be allowed in the city. In Pennsylvania, hospitality industry groups are trying to overcome the state’s Democratic Governor’s veto of a bill to loosen restrictions. In Massachusetts, the state’s Republican Governor faces growing opposition to his curfew order. Many businesses perceive the restrictions as a threat to their economic sustainability after hopes rose with the loosening of some restrictions prior to the most recent surge in cases.

U.S. Economy

Dow Hits Record High on News of Moderna Vaccine 

The Dow Jones Industrial Average hit an all time record high on Monday on news that Moderna’s vaccine was effective in almost 95% of cases according to early data from its trial (WSJ). The Wall Street Journal reports, “The index of blue-chip companies rose about 390 points, or 1.3%, to 29869 in recent trading, leaving it within striking distance of the yet-to-be-reached 30000 mark. Earlier in the day, it hit a new intraday record of 29942.88. The S&P 500 rose 0.9% after settling Friday at a new record high. Monday’s rally was broad, with shares of megacap technology companies rallying alongside banks, retailers and travel stocks. The Nasdaq Composite rose 0.5%, pausing a trend from last week during which investors sold shares of companies that benefited from consumers staying home and favored those that would benefit from the reopening of the economy.”

Bonus Read: “‘Predatory and Opportunistic’: Southwest Airlines Seizes the Moment as Rivals Struggle,” (WSJ).

U.S. Society

How the Covid Baby Bust is Disrupting Businesses

As a result of the pandemic, birth rates are projected to fall in the U.S., and with those falling birthrates comes disruption to several businesses that serve new parents and their children, according to a report in the Wall Street Journal on Monday (WSJ). The Journal reports, “Makers of infant formula and diapers are girding for another possible Covid-19 challenge: fewer babies. Birthrates have been declining for years in the U.S. and China, and new projections suggest that the coronavirus pandemic could lead to hundreds of thousands of fewer births in the coming months. A drop in new arrivals could spell trouble for makers of infant products, who have been developing new lines and shifting their focus to other products, analysts and executives say.” The impact would not only be on the U.S. but other countries as well including China. However, official data is not yet available and some industry figures remain unsure about whether and to what extent there will be an impact.

Bonus Read: “To Survive the Pandemic, Savile Row Cuts a Bespoke Strategy,” (NYT).

Analysis & Arguments

Brown University Professor of economics and bestselling author Emily Oster is keeping parents informed about rates of coronavirus in schools and how to make data-driven decisions about in-person or remote-based learning (Covid-19 School Response Dashboard). 

In an interview with Jeffrey Goldberg, Obama discusses the pandemic, his fear for American democracy, and other issues (Atlantic).

Zeynep Turfecki writes that it is time to hunker down as the pandemic surges (Atlantic).

Nicholas Christakis looks at the long-term effects of the pandemic across the globe, from wages to health care to global supply chains to pollution (WSJ).

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

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

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