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January 25, 2021 - Brief Issue 141

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

Overcrowded Conditions in Los Angeles May Contribute to Soaring Covid-19 Cases (Health & Science)

CDC Publishes New Data on Rare Allergic Reactions to Moderna Vaccine (Health & Science)

CDC Report Highlights Need for More Contact Tracing Staff and Increased Community Engagement (Health & Science)

Pfizer to Ship Fewer Covid-19 Vaccine Vials to U.S. After Label Change (Health & Science)

Masks, Physical Distancing Likely Necessary Until At Least Mid Year (Health & Science)

Some Experts Encourage Public Use of N95 Masks (Health & Science)

Mexico’s President Tests Positive for the Coronavirus (Around the World)

EU’s 70% Vaccination Target for Summer Will Be “Difficult,” Says European Council President, Amid AstraZeneca Production Cut (Around the World)

Third French Lockdown Likely, Says Top Medical Advisor (Around the World)

Taiwan Quarantines 5,000 Over Hospital Cluster (Around the World)

New Zealand Investigates “Probable” Coronavirus Community Spread (Around the World)

Israel Halts International Flights (Around the World)

Biden Administration Focuses on Creating Centralized Covid-19 Response (U.S. Government & Politics)

Biden Administration Aims to Deliver 100 Million Shots in 100 Days; Fauci Says Faster Pace is Possible (U.S. Government & Politics)

Birx: Trump Received Parallel Data (U.S. Government & Politics)

Decline in Proportion of Homeowners Delaying Mortgage Bills Stalls (U.S. Economy)

Las Vegas Reopens Schools Amid Surging Suicide Rate (U.S. Society)

Health & Science

There have been 25,128,378 coronavirus cases in the United States, and 419,225 people have died (Johns Hopkins). The United States has conducted 291,979,837 tests and distributed 41,411,550 vaccine doses, with 18,502,131 people initiating vaccination (U.S. CDC). Worldwide, there have been 99,268,840 confirmed cases of coronavirus, with 2,130,995 deaths. At least 54,831,866 people have recovered from the virus.

Overcrowded Conditions in Los Angeles May Contribute to Soaring Covid-19 Cases

In Los Angeles, 11 percent of all homes are overcrowded, higher than any other U.S. metropolitan area. A New York Times report examines the role overcrowded housing may play in Los Angeles’s high case numbers and hospitalizations, as well as the inequalities this pattern exposes. In the lower-income neighborhoods of Los Angeles, where residents often live in small, crowded apartments, the Covid-19 death toll is high and residents describe never-ending ambulance sirens. By contrast, the burden of Covid-19 has been much lighter in wealthy areas, where people are more likely to be able to isolate from family members in a separate bedroom and stay home from work during illnesses. Districts with high rates of overcrowding are disproportionately communities of color.

County and state officials have offered motel rooms to infected individuals who cannot safely isolate at home. However, many are unable to leave their families or choose not to. Los Angeles County officials have started recommending that people living in overcrowded conditions, particularly those who cannot socially distance at work, wear masks even at home.

CDC Publishes New Data on Rare Allergic Reactions to Moderna Vaccine

The U.S. Centers for Disease Control and Prevention has released new data on anaphylactic reactions to the Moderna Covid-19 vaccine (STAT). As with the Pfizer/BioNTech vaccine, anaphylaxis, or severe allergic reactions, are rare among Moderna Covid-19 vaccine recipients. As of January 19, there have been 15 cases of anaphylaxis due to the Moderna vaccine (about 2.1 per million) and 45 cases of anaphylaxis due to the Pfizer/BioNTech vaccine (about 6.2 per million). Those who exhibited severe allergic reactions were treated with epinephrine, and no anaphylaxis-associated deaths have been reported for either vaccine.

CDC Report Highlights Need for More Contact Tracing Staff and Increased Community Engagement

According to a new analysis by the U.S. Centers for Disease Control and Prevention (CDC), understaffing and a lack of community buy-in may limit the effectiveness of contact tracing efforts (CIDRAP). The study used contact tracing data from 56 U.S. health departments between June 25 and July 24, 2020. Researchers found that investigator caseload was inversely proportional to their ability to interview patients and follow up with contacts, suggesting that areas with higher caseloads could benefit from hiring additional investigators.

The authors of the study also noted that patients identified few contacts, with a median number of contacts elicited per patient prioritized for interview of 1.15. The authors hypothesized that the low number of contacts could be due to high investigator caseloads – investigators may not have had time to ask detailed follow-up questions – or because patients were reluctant to name non-household contacts. The authors suggested that increased community engagement and an emphasis on the importance of contact tracing could be another way to improve the effectiveness of tracing efforts.

Pfizer to Ship Fewer Covid-19 Vaccine Vials to U.S. After Label Change

Earlier this month, Pfizer updated its label to specify that six doses of the vaccine, not five, could be obtained from each vial (CNN, Politico). Now, the drug developer will count the extra dose toward its commitment to distribute 200 million doses to the United States, saying that the contract specified doses rather than vials. However, it is only possible to draw a sixth dose using “low dead volume” syringes, which are not available to all providers. Medical supplies company McKesson has contracted with the federal government to work on distributing compatible syringes. In the meantime, however, some hospitals are being forced to toss the extra dose, and there is concern that fewer people will receive the vaccine in the short term as a result.

Masks, Physical Distancing Likely Necessary Until At Least Mid Year

A model by researchers at Columbia University shows that even once Covid-19 vaccinations are well underway, other mitigation strategies like masking and physical distancing will still be key elements to ending the pandemic in the United States (NYT). The model incorporates estimated speed of vaccine distribution, current mitigation strategies and vaccine efficacy after one and two doses. It assumes that healthcare workers and older adults will be prioritized in vaccine rollout and that vaccine distribution will steadily increase to around 5 million doses per week.

Dr. Jeffrey Shaman, the lead investigator on the project, predicts that 105 million people in the U.S. have already been infected with the coronavirus, well above the officially reported number of approximately 25 million. Even if current restrictions are kept in place until July, the model estimates that around 53 million more infections will be added to that tally before enough people are vaccinated to bring the pandemic to a halt. Lifting restrictions in February or March is likely to result in even more infections. Other experts interviewed by the New York Times agreed with the conclusions of the model, though it has not undergone the rigorous peer review process. Dr. Trevor Bedford, a geneticist at the University of Washington, cautioned that the model did not take into account the possible spread of the more-contagious U.K. coronavirus variant, meaning that a spring surge could be more severe than the model predicts.

Some Experts Encourage Public Use of N95 Masks

Mask wearing has long been considered a key measure for stopping the Covid-19 pandemic. Recently, experts have voiced encouragement for the public to start wearing higher-quality masks. Some, including Dr. Abraar Karan, a physician at Brigham and Women’s Hospital and Harvard Medical School, think it’s time for the public to consider wearing N95 masks, commonly reserved for frontline medical workers. N95s are so named because they block 95 percent of small and large particles, providing strong protection for both the wearer and those nearby.

Throughout much of 2020, supplies of N95s were low, and some hospitals struggled to supply their workers with the critical protective gear. More recently, however, supplies have stabilized. An executive order by President Biden focuses on ramping up supplies like N95 masks even further, and experts hope that they might soon be widely available for public use. Some European countries are already encouraging their citizens to wear N95 masks, and Germany and France have gone as far as to mandate their use in all public areas (CNN).

Coronavirus Variants May Pose Challenges to Pandemic Control

Even as Covid-19 vaccines roll out around the world, scientists and health officials are growing concerned about emerging coronavirus variants that could accelerate the spread of disease and potentially escape vaccine protection.

Among the most concerning variants are the U.K. strain, commonly known as B117, and the South Africa strain. The B117 strain, which is about 50% more transmissible, has prompted lockdowns across the U.K. and has now made its way into the United States. Although U.S. Covid-19 cases and hospitalizations have been trending downward recently, experts are concerned that the more contagious nature of the variant will cause another surge, mirroring trends in England, Ireland, South Africa and Brazil (NYT). Although more research is necessary, preliminary evidence also suggests that the B117 variant may be slightly more deadly (NYT).

Dr. Vivek Murthy, President Biden’s surgeon general pick, told reporters that “the virus is… going to continue to change and we’ve got to be ready for it” (CNBC). Dr. Murthy called for increased genomic surveillance, which allows officials to detect variants. He also recommended increased testing and contact tracing. The U.K. strain has been detected in numerous U.S. states, but travel into the U.S. from South Africa is being restricted in an effort to contain the spread of that variant (NYT).

Experts are also keeping a close watch on the potential for emerging variants to escape currently authorized vaccines. Although the vaccines are expected to provide some degree of protection against new variants, recent evidence suggests that the vaccines may be somewhat less effective against the South Africa strain (NYT). Although this isn’t an immediate cause for alarm, experts are preparing for the possibility of needing to update existing vaccines. For this reason, they say, a speedy vaccine rollout and a quick end to the pandemic are more imperative than ever. Bonus Read: South African Coronavirus Strain Puts Undertakers on Front Lines,” (WSJ).

Bonus Read: “Travel Bans Should be Based on Evidence, Not Politics or Fear,” (STAT); “Do Curfews Slow the Coronavirus?” (NYT).

Around the World

Americas

Mexico’s President Tests Positive for the Coronavirus 

Mexican President Andres Manuel Lopez Obrador announced Sunday that he has a light case of Covid-19. In a Sunday night tweet, Obrador said that he is currently undergoing treatment for mild symptoms of the virus. “As always, I am optimistic. We will all move forward,” said Obrador, who has maintained a busy travel schedule throughout the country in recent days and has resisted mask-wearing. Mexico, which has the world’s fourth highest death toll, is currently undergoing a surge in infections, with the official death toll expected to surpass 150,000 people on Monday. The government reported 10,872 new cases on Sunday, with hospitals in Mexico City nearing capacity. The full extent of the pandemic is unclear, according to the health ministry, as the Mexican government pursues a strategy of maximizing hospital capacity over test and trace schemes (Reuters).

Europe

EU’s 70% Vaccination Target for Summer Will Be “Difficult,” Says European Council President, Amid AstraZeneca Production Cut

Achieving the goal of a 70% vaccination rate for the European Union is possible but will prove to be “difficult,” European Council President Charles Michel said Sunday. "There are difficulties in the production lines in the coming weeks and that will make the process more complex, but if we manage to mobilize the production lines, we may be able to succeed,” said Michel in a radio interview. "It's going to be difficult," he added. 

The president’s comments come shortly before the EU is expected to approve the Oxford/AstraZeneca vaccine, which could come as early as Monday. AstraZeneca vaccine announced on Friday, however, that supply chain difficulties will result in a lower than expected number of doses in the first round of deliveries. Reuters reported that the cut would amount to a 60% reduction in production. According to a Politico analysis, the 70% vaccination rate will not be reached at the current pace of administration until March 2024. Michel said, however, that he is hopeful that "the implementation of vaccination campaigns will accelerate and become more fluid” in the coming weeks (Politico, Reuters).

Third French Lockdown Likely, Says Top Medical Advisor

A top medical advisor to the French government said on Sunday that a third lockdown will likely be necessary to contain the spread of the coronavirus. Professor Jean-Francois Delfraissy, head of France’s main scientific advisory council on the pandemic, said that the new, more infectious B117 coronavirus strain now accounts for between 7-9% of cases in the country. "If we do not tighten regulations, we will find ourselves in an extremely difficult situation from mid-March,” he said, describing the new variant as the "equivalent of a second pandemic.” France has thus far resisted the introduction of a new lockdown, opting instead for an overnight curfew to reduce transmission. Infections are still rising, however, with the seven-day moving average now at more than 20,000 new cases (BBC).

Dutch Police Detain More Than 100 in Anti-Lockdown Riots

Police in Amsterdam arrested more than 100 people on Sunday at an unauthorized protest against nationwide lockdown measures that turned violent. The protest, organized by restaurant owners, came the day after the Netherlands imposed its first nightly curfew since World War II. The demonstrators in Museum Square met police attempting to clear the area by throwing rocks and fireworks, prompting authorities to respond with water cannons, dogs and mounted police.

The Netherlands’ new curfew was narrowly passed in parliament last week amid concerns that the B117 strain first identified in the U.K. would soon cause a new surge in Holland. Schools and non-essential stores have been closed since December, while restaurants and bars have been closed since October (Reuters).

Asia-Pacific

Taiwan Quarantines 5,000 Over Hospital Cluster

Taiwanese authorities will more than double the number of people quarantined over a coronavirus outbreak at a hospital to about 5,000 the health ministry said on Sunday. The government orders follow an outbreak at a hospital first reported on January 12 that has thus far infected 15 people in the city of Taoyuan. There are already about 1,300 people under quarantine owing to the hospital cluster. While the number of people infected is low by global standards, the outbreak represented a rare case of community spread in a country that has largely contained the pandemic. Authorities are particularly nervous about the potential for a new surge as February’s Lunar New Year holiday approaches. Taiwan has reported only 884 cases since the pandemic’s beginning with seven deaths (Reuters).

New Zealand Investigates “Probable” Coronavirus Community Spread 

New Zealand health authorities announced on Sunday that they are investigating the first “probable” case of coronavirus community spread in months. The 56-year-old woman tested positive for the virus days after finishing a mandatory quarantine period in Auckland upon returning from Europe. As she had twice tested negative for the virus before being released to her home in Northland on the North Island, authorities have said they are presuming she caught the virus through community spread. “We are working under the assumptions that this is a positive case and that it is a more transmissible variant, either the one identified first in South Africa or the UK, or potentially Brazil - or another transmissible variant,” said Director-General of Health Ashley Bloomfield at a press conference. New Zealand has had only 1,927 confirmed coronavirus cases since the pandemic’s beginning, garnering praise for its public health campaign to combat the pandemic (Reuters, BBC).

Middle East

Israel Halts International Flights

Israeli authorities will halt international flights from Monday night onward for one week amid fears of new, highly contagious strains of the coronavirus. “Other than rare exceptions, we are closing the sky hermetically to prevent the entry of the virus variants and also to ensure that we progress quickly with our vaccination campaign,” Prime Minister Benjamin Netanyahu said in public remarks at the start of a cabinet meeting on Sunday. The announcement came amid clashes in Israel between police and ultra-Orthodox Jewish anti-lockdown protesters in the city of Bnei Brak. Members of such religious communities have drawn the public’s ire throughout the pandemic for often ignoring lockdown restrictions at schools and seminaries on spiritual grounds. One officer fired his gun into the air in an attempt to disperse the crowd. 

While public health restrictions in Israel remain in place, including school closures, Israel currently leads the world in vaccination rates. More than 25% of the population has received an initial dose of the Pfizer vaccine, according to the health ministry. The vaccine is currently available for all over the age of 40, as well as for 16-18 year-olds with parental permission (Reuters). 

Egypt Begins Vaccination Drive 

Egypt has begun vaccinating frontline medical workers on Sunday with the Chinese Sinopharm vaccine. It will be provided free of charge and eventually be made available to all Egyptians in a phased rollout. But Health Minister Hala Zayed declined on Sunday to commit to a timeframe for the vaccination of Egypt’s 100 million people. “As soon as each citizen registers, they will take their turn. But you cannot set a timeframe for when this will be, and even the countries that have set a timeframe have not been able to fulfill it, not because they have a problem, but because of the global production issue,” said Zayed. Egypt has recorded 161,143 coronavirus cases since the pandemic’s beginning, including 8,902 deaths. Health officials, however, have pointed out that the number is likely an underestimate given testing capacity issues (Reuters).

U.S. Government & Politics

Biden Administration Focuses on Creating Centralized Covid-19 Response

In the days since he took office, President Joe Biden has signed a flurry of executive orders and directives aimed at controlling the Covid-19 pandemic (NYT). In contrast to his predecessor, Biden’s plan is more focused on creating a centralized response system. Among Biden’s orders is a call to invoke the Defense Production Act to speed manufacturing of protective gear and testing equipment. Previously, the Trump administration invoked the act to manufacture syringes for vaccines. Mr. Biden also signed orders requiring masks during interstate traveling, calling for a re-evaluation of Covid-19 data gathering systems, establishing a task force to address health inequities, and issue guidance for school and workplace reopenings. The Biden team has also asked the National Institutes of Health to draft a plan for drug development during public health crises, particularly focusing on randomized clinical trials. Bonus Read: “Unpacking the Biden Administration's Coronavirus Strategy,” (NPR).

Biden Administration Aims to Deliver 100 Million Shots in 100 Days; Fauci Says Faster Pace is Possible

A key goal for the Biden administration is to administer 100 million Covid-19 vaccine doses in 100 days, approximately 1 million doses per day. Critics have suggested that this goal is not high enough, especially given that the U.S. is already approaching the 1 million per day target. On Friday, for instance, the U.S. administered nearly 1.6 million doses (CNN). Dr. Anthony Fauci, the nation’s foremost infectious disease expert, said that he believes the U.S. can achieve a faster immunization rate. According to Dr. Fauci, it is possible to vaccinate 70-85 percent of U.S. adults by the end of summer. At a rate of 1 million immunizations per day, that benchmark would take until the end of the year, assuming a two-dose vaccine. A single-shot vaccine such as the Johnson & Johnson candidate could speed the process. So far, the U.S. has administered the most total doses of any country, though countries such as Israel, the U.A.E. and Britain have administered more doses per capita (WaPo). Bonus Read: “How the U.S. Could Double Vaccination Pace With Existing Supply,” (NYT).

Birx: Trump Received Parallel Data 

On Sunday, former White House coronavirus coordinator Deborah Birx told CBS’ “Face the Nation” that Trump had received parallel data on the pandemic from outside advisers (Politico). Birx commented, “I saw the president presenting graphs that I never made,” adding, “So, I know that someone — or someone out there or someone inside was creating a parallel set of data and graphics that were shown to the president.” While Birx said she did not know who provided the data, she suggested that it might have been provided by Dr. Scott Atlas, a controversial adviser to Trump who eventually resigned and who lacked a background in infectious diseases or epidemiology. Birx, who has herself been the subject of criticism for her role in the Trump administration’s pandemic response, plans to retire after assisting with the Biden transition.

U.S. Economy

Bonus Read: “Bullish Stock Bets Explode as Major Indexes Repeatedly Set Records,” (WSJ).

Decline in Proportion of Homeowners Delaying Mortgage Bills Stalls

In a sign of the continued economic impact of coronavirus, the decline in the number of homeowners who are delaying their mortgage payments has stalled, according to a report in the Wall Street Journal on Sunday (WSJ). The Journal reports, “A promising sign of a bounce back in the pandemic-ravaged economy has stalled: Fewer borrowers are resuming mortgage payments. The proportion of homeowners postponing mortgage payments had been falling steadily from June to November, an indication that people were returning to work and the economy was beginning to recover. But the decrease has largely flattened since November, when the current wave of coronavirus cases surged in communities across the country.” The Journal notes that the stalled decline comes amid a range of other worrisome signs, writing, “Other data indicate a slowing U.S. economy this winter, and greater pressure on household finances. Employers cut jobs last month for the first time since the spring. The number of job openings has declined, and claims for unemployment insurance remain elevated. Retail sales have fallen for three consecutive months.”

Supply Disruptions as Manufacturing Rebounds

As the manufacturing industry rebounds from the impact of coronavirus, suppliers of key materials are struggling to keep up with rising demand (WSJ). The Wall Street Journal reports, “A quicker-than-expected recovery in U.S. manufacturing is resulting in supply disruptions and higher costs for materials used in everything from kitchen cabinets to washing machines to automobiles.” Mark Verhein, president of Church Metal Spinning Co., told the Journal “The lack of availability is what kills you.” Brad Serlin, president of United Scrap Metal Inc., told the Journal, “We can sell everything we have,” adding, “Steel mills that were out of the market all of a sudden are doing big orders.” The Journal reports that such supply disruptions have turned orders that used to take a week to fill into six to eight week jobs.

U.S. Society

Las Vegas Reopens Schools Amid Surging Suicide Rate

Clark County, Nevada, home to Las Vegas, has reopened its schools in part as a response to evidence of surging teen suicide rates (NYT). The New York Times reports, “The reminders of pandemic-driven suffering among students in Clark County, Nev., have come in droves. Since schools shut their doors in March, an early-warning system that monitors students’ mental health episodes has sent more than 3,100 alerts to district officials, raising alarms about suicidal thoughts, possible self-harm or cries for care. By December, 18 students had taken their own lives.” According to the Times, “The spate of student suicides in and around Las Vegas has pushed the Clark County district, the nation’s fifth largest, toward bringing students back as quickly as possible. This month, the school board gave the green light to phase in the return of some elementary school grades and groups of struggling students even as greater Las Vegas continues to post huge numbers of coronavirus cases and deaths.” Other school districts, including one in Arizona, have also cited concerns about growing suicide rates and mental health struggles in discussions of reopening schools. Jesus Jara, superintendent of Clark County, commented, “when we started to see the uptick in children taking their lives, we knew it wasn’t just the Covid numbers we need to look at anymore.” Even so, the Times notes, “Adolescent suicide during the pandemic cannot conclusively be linked to school closures; national data on suicides in 2020 have yet to be compiled.”

Pandemic Driven Shifts in Living and Work Trends Disrupt Mass Transit

According to Politico, shifts in where Americans are living and trends towards remote work are posing challenges for mass transit (Politico). Politico writes, “Mass transit might eventually rebound from the worst economic trauma of the coronavirus pandemic. But it still may never be the same, due to the vast changes the outbreak is triggering in the way Americans live and work.” It notes that ridership was already declining pre-pandemic, adding, “it's likely that the virus will only accelerate some of the trends behind that decline. Those include hastening the migration of jobs and people away from dense cities, where transit works best, as well as a newfound enthusiasm for letting employees work from home.” Jim Derwinski, CEO of Chicago's Metra system and chair of the Commuter Rail Coalition, told Politico, “Many of these big urban areas have seen a complete shift of where people are living right now.” According to Politico, changes in office use may reduce traffic and parking congestion, an important incentive for the use of mass transit. At the same time, Politico notes, “home sales in suburbs and small towns have risen to 85 percent of total sales, up from 80 percent before the outbreak. That's accelerating an overall shift away from the hub-and-spoke model that transit systems were built on, after years in which suburban office parks have pulled rush hour traffic away from urban cores.” Scott Bogren, the executive director of the Community Transportation Association of America, told Politico, “Even a 5 percent decrease in commuters in a major metropolitan area is going to have massive impact.”

Analysis & Arguments

Read the Biden administration’s new national Coronavirus strategy (White House).

Sarah Zhang writes on why vaccinating children may be the key to achieving herd immunity (Atlantic).

Dan Solomon writes that Texas’ Covid case count is a massive undercount (Texas Monthly).

 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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