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April 15, 2021 - Brief Issue 183

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

CDC to Gather More Information on J&J Shot and Blood Clots Before Making a Decision (Health & Science)

Rare Cases of Covid-19 Infection Emerge Among Fully Vaccinated Individuals (Health & Science)

According to CDC, Opioid Overdoses Have Spiked During Covid-19 PandemicPfizer and Moderna Start Testing Variant-Specific Booster Shots (Health & Science)

Another Wave of Covid-19 Prompts A Second Mass Exodus in India (Around the World)

Bhutan Vaccinates Almost All Adults in Two Weeks (Around the World)

Shift in E.U.’s Vaccination Campaign Strategy (Around the World)

Pelosi Invites Biden to Address Congress (U.S. Government & Politics)

Powell: Fed Will Reduce Bond Purchases “Well Before” Increasing Interest Rates (U.S. Economy)

Small But Growing Number of Colleges to Require Vaccination (U.S. Society)

Health & Science

There have been 31,422,228 coronavirus cases in the United States, and 563,449 people have died (Johns Hopkins). The United States has conducted 411,687,402 tests and distributed 250,998,265 vaccine doses, with 37.3% of Americans having received their first vaccine dose and 23.1% fully vaccinated (U.S. CDC). Worldwide, there have been 138,340,920 confirmed cases of coronavirus, with 2,974,830 deaths. At least 78,785,642 people have recovered from the virus.

CDC to Gather More Information on J&J Shot and Blood Clots Before Making a Decision

On Wednesday, a day after the Centers for Disease Control and Prevention and the Food and Drug Administration recommended U.S. vaccination sites pause distribution of the Johnson & Johnson vaccines over concerns about rare blood clots, a CDC advisory committee ruled that they need more time to study the risks of the shot (NYT, WaPo). No further recommendations will be made until the Advisory Committee on Immunization Practices reassembles to vote in a week or 10 days. All fifty states, the U.S. military, and several private distributors will continue to suspend use of the J&J shot. 

At the meeting, the panel debated data from six cases of rare blood clots – all in women between 18-48 years old – that have been identified out of the country’s 7.5 million J&J recipients. They also reviewed a seventh case. All the affected women experienced blood clots and low platelet counts; one died, and another is in critical condition. Whether the vaccine was responsible remains unclear, but CDC safety expert Dr. Tom Shimabukuro said blood clotting occurred in women 20-50 years old who received the J&J vaccine roughly three times more often than would otherwise be expected. CDC director Dr. Rochelle Walensky said the government doesn’t know exactly how rare these blood clots are: “Right now, we believe these events to be extremely rare, but we are also not yet certain we have heard about all possible cases, as this syndrome may not be easily recognized as one associated with the vaccine.” Before the panel convenes again, officials hope to collect information on cases that may not have been previously reported, and to disseminate information on how to treat severe blood clots. Aran Maree, a chief medical officer for Janssen – which developed the J&J shot – said the company still maintains that the benefits of the shot outweigh its risks. 

Public health experts fear that federal officials’ recommended pause on the Johnson & Johnson vaccine will fuel mistrust in vaccines and even embolden conspiracy theories, especially among conservatives, who have expressed more hesitancy toward the Covid-19 shot (NYT). “We are concerned about heightened reservations about the J&J vaccine, but in addition to that, those reservations could spill over into public concerns about other vaccines,” said Dr. Paul Simon of the Los Angeles County Department of Public Health. The Kaiser Family Foundation reported in January that 39% of Americans would be less willing to take a Covid-19 shot if they knew others had had severe reactions to it. At a briefing Wednesday, White House Covid-19 response coordinator Jeff Zients said the Biden administration was working to build public confidence in the vaccine, putting $3 billion toward getting “fact-based messaging and resources into the hands of trusted, local messengers” (CNN).

Meanwhile, vaccination sites are canceling and rescheduling J&J vaccination appointments as they try to replace those shots with Pfizer or Moderna (WSJ). The pause on the one-dose J&J vaccine is having an outsize impact on populations that are transient or hard-to-reach (WaPo).

“Women Are Comparing the Potential Risk of Blood Clots From Vaccines to Birth Control. It’s More Complicated Than That, Experts Say,” (The Lily).

Rare Cases of Covid-19 Infection Emerge Among Fully Vaccinated Individuals

As vaccinations ramp up, with over 74,000 Americans fully vaccinated, a handful of “breakthrough infections” – or, Covid-19 infections in vaccinated people – have been reported across the country (NPR). The exact number of breakthrough infections isn’t clear, though several states have tallies in the hundreds. Health experts say this is to be expected. The coronavirus vaccines authorized for emergency use in the U.S. are at least 80% effective in preventing infection and 94% effective in preventing serious illness or death, but some rare cases of Covid-19 infection post-vaccination will occur. Researcher Dr. Francesca Torriani of the University of California San Diego noted that breakthrough infections are usually not severe, indicating that vaccines prevent Covid-19’s worst outcomes. What makes someone more likely to get infected after receiving a vaccine is still under study, but according to Dr. Anthony Fauci, chief medical advisor to the Biden administration, the small group of patients who have died from Covid-19 after getting vaccinated were mostly older people with comorbidities. Centers for Disease Control and Prevention director Dr. Rochelle Walensky recommended that people keep up masking, personal hygiene, and social distancing measures –  especially in the workplace – even after receiving the vaccine. 

According to CDC, Opioid Overdoses Have Spiked During Covid-19 Pandemic

Preliminary data from the CDC show that more than 87,000 Americans died from opioid overdoses between October 2019 and September 2020, with a 29% rise in deaths over that time compared to the previous 12-month period (NYT). This marks the highest-ever annual death toll from the opioid epidemic. Overdose deaths were on the rise before Covid-19, but experts say the pandemic undoubtedly worsened opioid abuse, as treatment programs closed and stress levels ran high. Fentanyl and other synthetic opioids were the main drugs behind last year’s overdoses, and the largest increase in deaths occurred among Black Americans. Dr. Brendan Saloner of the Johns Hopkins Bloomberg School of Public Health said surveys he and his colleague conducted of drug users in 11 states showed an alarming trend: “The data points corroborate something I believe, which is that people who were already using drugs started using in ways that were higher risk – especially using alone and from a less reliable supply.”

Pfizer and Moderna Start Testing Variant-Specific Booster Shots

A study funded by the National Institutes of Health testing a modified version of the Moderna vaccine – designed to fight off the contagious South African B.1.351 variant – is underway in the U.S., with Pfizer and BioNTech launching a study of their own modified vaccine (MedicalXpress). Researchers are injecting hundreds of already fully-vaccinated subjects with a third “booster” dose, meant to specifically target the variant. Both the Moderna and Pfizer vaccines use mRNA technology that helps the body recognize the virus’ spike protein; substituting one spike protein for another isn’t too high-tech, but the companies will monitor the recipients of these booster doses for side effects. Dr. Paul Offit, a vaccine advisor to the FDA, said if hospitalizations from coronavirus variants start to jump among people who are already vaccinated, the country will need to seriously consider rolling out modified booster shots. "We haven't crossed that line yet, but we might,” Offit said. 

Rare Covid-19 Reaction in Children Appears to Include Neurological Symptoms

A new report suggests that a significant number of kids with Multisystem Inflammatory Syndrome in Children (MIS-C), a rare hyperinflammatory response that shows up weeks after a Covid-19 infection, develop neurological symptoms (NYT). Researchers studied 46 children hospitalized with MIS-C in London, finding that 24 of them experienced symptoms such as hallucination, speech and balance difficulties, and confusion. MISC-C often causes physical symptoms like rash, stomach pain, and heart issues; it is believed to stem from an extreme immune reaction to often mild cases of the virus. Dr. Omar Abdel-Mannan of University College London’s Institute of Neurology said kids with neurological symptoms were about twice as likely to need a ventilator or heart medication than the other MIS-C patients; luckily, none of the children in the London study died and almost all made a “complete functional recovery.” These findings on the neurological complications of MIS-C echo the results of an American study published last month.

Stanford Study Finds Zoom Fatigue Hits Women Hardest

A not-yet-peer-reviewed study from Stanford University published Tuesday found that “Zoom fatigue,” or exhaustion from constantly attending online meetings during the pandemic, affects women more than it does men (NYT). Co-author Jeremy Bailenson explained that Zoom meetings demand high alertness and constant visual engagement, which creates stress: “From an evolutionary standpoint, if somebody was very close to you and staring right at you, this meant you were going to mate or get in a fight.” This phenomenon appears to impact women more acutely than men, with women scoring higher in all five of the researchers’ categories of Zoom fatigue – general, social, emotional, visual, and motivational. The researchers also found that women experience mirror anxiety – where looking at one’s own reflection (or camera) causes anxiety-provoking levels of self-awareness – more acutely. These findings shed light on another aspect of the previously reported stress gap between men and women (NYT). 

Research Points to Ancient Coronavirus Epidemic Among East Asians’ Ancestors

At this year’s meeting of the American Association of Physical Anthropologists, evolutionary geneticist David Enard of the University of Arizona in Tucson reported that an ancient coronavirus, or something similar to it, may have caused an epidemic 25,000 years ago in Asia (Science News). Enard’s team analyzed the genomes of 2,504 people from 26 ethnic groups across the globe, looking at the genetic code for 420 proteins known to interact with coronaviruses, 332 with SARS-CoV-2 specifically. Only people of East Asian descent showed increased production of the coronavirus-related proteins, indicating that the ancestors to this population may have lived through a coronavirus epidemic. Further analyzing these people’s genetic material, the researchers estimated that 42 of the coronavirus-related proteins started to be produced more frequently 25,000 years ago, placing a timestamp on a possible epidemic caused by a coronavirus (or coronavirus-like pathogen). Whether these genetic differences have contributed to lower death rates among East Asian countries isn’t clear, but investigating genes that help the body respond to a coronavirus infection could offer insight for developing new treatments. 

Bonus Read: “‘Long Covid’ Mystery Sparks a Research Revolution,” (Politico).

Around the World

Bonus Read: “Johnson & Johnson Halt Isn’t Just a U.S. Problem,” (NPR).

Another Wave of Covid-19 Prompts A Second Mass Exodus in India

Low-paid migrant workers are fleeing the cities en masse in India, just as they did a year ago when the pandemic began and the country first went into lockdown. The city of Mumbai and the state it's in, Maharashtra, are at the center of what is now the fastest-growing outbreak in the world with more than 150,000 new cases a day across India. The state has imposed curfews and shut down malls, restaurants and places of worship and a complete lockdown could be coming soon, according to Rajesh Tope, the state’s health minister (WSJ). Trains going to Bihar and Uttar Pradesh, the two states where many migrant workers are from, have been packed full as they leave Mumbai as many of the laborers are trying to avoid being stranded. In 2020, thousands of migrant workers were forced to make their way home by walking hundreds of miles after all trains and buses were stopped due to the pandemic. That mass migration played a significant role in spreading the virus and officials fear that will be the case again as most villages are unprepared to test or treat sick workers when they return (NYT). 

Bhutan Vaccinates Almost All Adults in Two Weeks

The Himalalyan kingdom of Bhutan vaccinated almost all of its eligible population in less than two weeks. The country’s vaccination campaign began on March 27 and by April 8, 93% of eligible adults had received a first dose (NPR). In a statement, Health Minister Dasho Dechen Wangmo described the campaign as a "sense of purpose that each of us is embracing to protect our country and the people we love." She urged individuals to get vaccinated to protect themselves and their communities — as well as King Jigme Khesar Namgyel Wangchuck. "His Majesty the King has shared thoughts about taking the vaccine only after every eligible person in the country received their shots safely," she said. "All of us must come forward, so that we make way for His Majesty to receive the vaccine as soon as possible."

Shift in E.U.’s Vaccination Campaign Strategy

Ursula von der Leyen, the president of the European Commission, announced on Wednesday that the E.U. will receive an extra 50 million doses this month of the vaccine developed by Pfizer as the bloc pivots to mRNA vaccines like Pfizer’s (NYT). The move is part of efforts to speed up the vaccination campaign amid difficulties with the vaccines developed by AstraZeneca and Johnson & Johnson. Johnson & Johnson suspended the rollout of its vaccine in the E.U. on Tuesday following reports of extremely rare but serious potential side effects, similar to those reported with the AstraZeneca vaccine. The European Union has not canceled its existing orders of the AstraZeneca and Johnson & Johnson vaccines, but signaled it was not going to be placing more. 

Denmark Halts AstraZeneca Rollout Completely

On Wednesday Denmark became the first country to plan a permanent stop to using the AstraZeneca vaccine a month after it temporarily suspended its use following reports of a small number of recipients developing rare but serious blood-clotting disorders (NYT, BBC). Soeren Brostroem, the director general of the country’s health authority, said Denmark could rely on two other vaccines from Pfizer and Moderna and that the country had the pandemic under control. The European Union’s drug regulator, the European Medicines Agency, recommended that countries keep using the vaccine because its benefits far outweigh any potential risks for most people. 

Italy’s Covid-19 Vaccinations Skipped the Elderly, Deaths Increase 

Italy has had one of the highest numbers and per-capita death rates in the West, with thousands dying each week of Covid-19. Italy’s government says one factor contributing to the high death rate is its slow vaccine rollout to the elderly population (WSJ). Across the country, regional authorities gave vaccines to younger workers instead of the elderly and those in care homes alongside frontline workers, per the national guidelines. Prime Minister Mario Draghi criticized regions for “neglecting the old” in favor of professional groups, who he said have bargaining power. The regions reacted defensively, blaming the central government’s unclear guidelines and a shortage of vaccine doses. On Friday, Mr. Draghi’s government ordered regions to vaccinate strictly by age group, beginning with older Italians. “If we had vaccinated those aged above 70 or 75 from the beginning, we would have avoided so many deaths,” said Antonella Viola, a virologist at the University of Padua. Only 17% of Italian residents ages 70-79 have had one or more doses of a Covid-19 vaccine, the lowest level in the EU apart from Bulgaria.

U.S. Government & Politics

Bonus Read: “The End of the Imperial Governorship,” (Politico).

Pelosi Invites Biden to Address Congress

On Tuesday, Speaker of the House Nancy Pelosi formally invited President Biden to address a joint session of Congress on April 28 (Politico). The joint session - functionally the State of the Union but not called that in the first year of a presidency, comes later than usual. Politico writes, “Pelosi had previously cited the need to wait for decisions from the Office of the Attending Physician and the House Sergeant at Arms on capacity amid the Covid-19 pandemic. Former Presidents Donald Trump and Barack Obama both gave their first addresses in February of their first years in office.”

States Sue Over Restrictions on Using Covid Relief to Cut Taxes

The $1.9 trillion stimulus and relief package that passed last month included a provision prohibiting states from using the funds allocated to support state and local governments for the purpose of cutting taxes. Several states are now suing over the restriction (WSJ). The Wall Street Journal reports, “Republican lawmakers and attorneys general argued the provision, which would apply for three years, is overly vague, unconstitutional and would unfairly penalize states in good fiscal health. Five states have filed lawsuits seeking an injunction against the provision—the first hearing is scheduled for the end of the month—and Republicans in Congress have introduced legislation to repeal it.”

Bonus Read: “Biden Officials Bracing for Possibility of Weekslong Disruption to J&J Vaccine Supply,” (Politico).

U.S. Economy

Powell: Fed Will Reduce Bond Purchases “Well Before” Increasing Interest Rates

On Wednesday, Federal Reserve Chairman Jerome Powell stated that the Federal Reserve would reduce its pace of bond purchases “well before” increasing interest rates (WSJ). Powell said, “We will taper asset purchases when we’ve made substantial further progress toward our goals, from last December when we announced that guidance,” adding, “That would in all likelihood be before—well before—the time we consider raising interest rates.” The Wall Street Journal writes, “Since last June, the Fed has been purchasing at least $120 billion a month of Treasury debt and mortgage-backed securities to hold down long-term borrowing costs. Since December, the central bank has said the economy must make ‘substantial further progress’ toward its goals of maximum employment and 2% inflation before scaling back that policy.”

U.S. Society

Small But Growing Number of Colleges to Require Vaccination

The number of colleges planning to require that students be vaccinated for Covid-19 remains small but is growing, the Wall Street Journal reports (WSJ). The Journal writes, “Duke University in North Carolina, Brown University in Rhode Island and Syracuse University in New York said last week that students must be vaccinated to be allowed on campus in the fall. They join a handful of other colleges that include Rutgers University in New Jersey and Cornell University in Ithaca, N.Y., that have recently said students must be vaccinated to matriculate for in-person classes.” Antonio Calcado, Rutgers executive vice president and chief operating officer, told the Journal, “I think there’s a lot of common sense here. The science says that the vaccine is safe, it’s got a phenomenal efficacy rate.” However, as the Journal notes, such plans place colleges at the center of a raging debate over proper practices regarding mandating vaccination and requiring proof of vaccination for participation in a range of activities.

American Airlines to Expand Summer Flight Schedule

American Airlines announced on Wednesday that it plans to expand summer schedule of available flights to close to the pre-pandemic normal state of affairs (WSJ). The Wall Street Journal reports, “American said it would fly 150 new routes this summer, and now expects to offer more than 90% of its pre-pandemic seating capacity within the U.S., and 80% of its international capacity.”

Bonus Read: “Las Vegas is Set to Come Out of Covid-19 Better Than Ever,” (CNN). 

Analysis & Arguments

Reggie Nadelson writes on the long-awaited return of New York restaurants (NYT).

Ezekiel J. Emmanuel, Aaron Glickman, and Amaya Diana make the case for mandating vaccinations for health workers and students (NYT).

Jennifer Piscopo critiques claims that women leaders have been particularly successful in confronting the pandemic (ReVista).

Sarah Zhang writes on the growing importance of the mRNA vaccines (Atlantic).

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

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

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