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October 20, 2021 - Brief Issue 253

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

U.S. Pediatricians and Psychiatrists Declare National Emergency in Youth Mental Health (Health & Science)

Reinfection Will Become Common, Especially Among Unvaccinated, Says Study (Health & Science)

 FDA to Allow Mix-and-Match Approach to Boosters (Health & Science)

Pfizer-BioNTech Highly Effective Against Hospitalization in 12-18 Age Group (Health & Science)

Report: Pfizer Contracts Place Company’s Interest Over Public Interest Globally (Around the World)

South Africa Regulator Rejects Sputnik V (Around the World)

Ireland Pauses Reopening Due to Increase in Cases (Around the World)

Dutch Cases Jump 44% in One Week (Around the World)

Italy’s Chinese Community Feels Targeted by Green Pass Rules (Around the World)

Anger Over Covid Drives San Francisco Recall Effort and a Larger Wave of Recall Attempts (U.S. Government & Politics)

Large Companies Use Their Size to Lessen Impact of Supply Chain Disruptions (U.S. Economy)

Vaccine Maker J&J Sees Sales Climb Across Divisions (U.S. Economy)

Health & Science

There have been 45,140,220 coronavirus cases in the United States, and 728,313 people have died (Johns Hopkins). The United States has administered 409,438,987 vaccine doses, with 66% of all Americans having received at least one vaccine dose and 57.1% fully vaccinated. Among adults aged 18 or older 79% have received at least one dose, and 68.6% are fully vaccinated (U.S. CDC). 5.8% of fully vaccinated Americans have received a booster shot. Worldwide, there have been 241,686,570 confirmed cases of coronavirus, with 4,915,999 deaths.

U.S. Pediatricians and Psychiatrists Declare National Emergency in Youth Mental Health

In a joint statement issued on Tuesday, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association said children and teens are facing a mental health crisis that has been exacerbated by the pandemic. “This worsening crisis in child and adolescent mental health is inextricably tied to the stress brought on by Covid-19 and the ongoing struggle for racial justice, and represents an acceleration of trends observed prior to 2020,” the statement said. More than 140,000 children in the United States have lost at least one caregiver since the start of the pandemic; youth of color have been disproportionately affected. The New York Times reports, “According to the Centers for Disease Control and Prevention, between March and October 2020, emergency department visits for children with mental health emergencies rose by 24 percent for those between ages 5 and 11, and 31 percent for children 12 to 17. Among girls ages 12 to 17, E.R. visits identified as potentially the result of a suicide attempt were up more than 50 percent in early 2021 compared with the same period in 2019, according to the C.D.C.” (NYT). The organizations urged policymakers to increase federal funding for families to access mental health services and to integrate mental health care into pediatric care and schools. 

Reinfection Will Become Common, Especially Among Unvaccinated, Says Study

Last fall, many scientists and health officials believed that reinfection with Covid-19 was relatively rare as only two dozen or so such cases had been recorded worldwide. But now researchers have found that natural immunity to the coronavirus dwindles over time and reinfections are more and more common. Prof. Jeffrey Townsend and colleagues at Yale University School of Medicine analyzed known reinfection and immunological data from other coronaviruses, including those that cause Sars, MERS, and common colds (Guardian). By combining this with antibody and other immunological data from people who had recovered from Sars-CoV-2, they were able to model the risk of Covid-19 reinfection over time. Their research, published in The Lancet Microbe, suggests that reinfections will become increasingly common. “If we had no infection controls, no one was masking or social distancing, there were no vaccines, we should expect reinfection on a three-month to five-year timescale – meaning that the average person should expect to get Covid every three months to five years,” Townsend said. Townsend highlighted the implications of the study by saying “if you haven’t been vaccinated, you should get vaccinated, and if you’ve been infected, you should go ahead and get vaccinated anyway, because that will extend the duration of your protection.”

FDA to Allow Mix-and-Match Approach to Boosters

The U.S. Food and Drug Administration is expected to approve coronavirus vaccine booster shots that are different from initial doses, according to federal officials who spoke to the media (WaPo, NYT). The announcement is expected to come today, Wednesday, as part of the agency’s authorization of boosters for the Moderna and Johnson & Johnson vaccines. It’s possible that the FDA will encourage people to get the same booster shot as their initial vaccine if possible, however. So far, the science behind the mix-and-match approach is promising. 

In June, the National Institutes of Health conducted a trial to see what happened when fully vaccinated people used a different vaccine for a booster. Researchers found that switching boosters raised the level of coronavirus antibodies, no matter what combination people got. The Times writes, “The results for people who initially received a Johnson & Johnson vaccine were particularly striking. Those receiving a Johnson & Johnson booster saw antibodies go up just fourfold. Switching to a Pfizer-BioNTech booster raised antibody levels by a factor of 35. A Moderna booster raised them 76-fold.” It’s still unclear if a single booster shot will be sufficient to provide long-lasting immunity or if Covid-19 shots will become a yearly ritual, like the flu shot. Bonus Read: “Covid-19 booster shots: What you need to know,” (Politico)

Pfizer-BioNTech Highly Effective Against Hospitalization in 12-18 Age Group

The U.S. Centers for Disease Control and Prevention reported on Tuesday that the Pfizer-BioNTech vaccine was 93% effective against hospitalization in 12- to 18-year-olds. The CDC studied hospitalizations at 19 pediatric hospitals across 16 states from June through September. The New York Times writes: “Among the 179 patients in the study who had Covid, three percent were vaccinated and 97 percent were unvaccinated. Twenty-nine of the young Covid patients needed life support, and two died; all of those patients were unvaccinated, the agency said. Vaccinated children with Covid also tended to have shorter hospital stays than unvaccinated children.”

The study offers strong evidence for federal regulators, who are currently considering authorizing the vaccine for children ages 5 to 11 and shows that vaccines not only add to immunity for the general population, but also protect children from the rare cases where they become severely ill. “This evaluation demonstrated that two doses of Pfizer-BioNTech vaccine are highly effective at preventing Covid-19 hospitalization among persons aged 12–18 years,” the agency’s scientists wrote, “and reinforces the importance of vaccination to protect U.S. youths against severe Covid-19.”

Around the World

Bonus Read: “'Brown recovery' wipes out hopes that pandemic stimulus would drive climate spending,” (Politico).

Report: Pfizer Contracts Place Company’s Interest Over Public Interest Globally

On Tuesday, the consumer advocacy group Public Citizen released a report examining secret, unredacted contracts between Pfizer, maker of one of the widely used Covid vaccines, and governments around the world (WaPo). Citing “examples from around the world,” the report states, “Public Citizen has identified several unredacted Pfizer contracts that describe the outcome of these negotiations. The contracts offer a rare glimpse into the power one pharmaceutical corporation has gained to silence governments, throttle supply, shift risk and maximize profits in the worst public health crisis in a century.” Zain Rizvi, the report’s author, told the Washington Post, that the “contracts consistently place Pfizer’s interests before public health imperatives.” Examples of patterns in the contracts that Public Citizen criticized included general secrecy, prohibitions on donations of vaccine doses, and the use of secret arbitration courts that grant substantial power to Pfizer to change conditions of the license in the case of disputes. A spokesperson for Pfizer contended that the confidentiality language was “standard in commercial contracts,” and argued that it was “intended to help build trust between the parties, as well as protect the confidential commercial information exchanged during negotiations and included in final contracts.” The Washington Post writes, “Experts who reviewed the terms of contracts with foreign governments suggested that some demands were extreme. In contracts reached with Brazil, Chile, Colombia and the Dominican Republic, those states forfeited ‘immunity against precautionary seizure of any of [their] assets.’” Lawrence Gostin, a professor of public health law at Georgetown University, told the Post, “It’s almost as if the company would ask the United States to put Grand Canyon as collateral.”

South Africa Regulator Rejects Sputnik V 

The South African Health Products Regulatory Authority, or SAHPRA, said in a statement Tuesday that the Russian Sputnik V vaccine could “not be approved at this time” and cited safety concerns that the manufacturer wasn’t able to answer (AP). The regulatory agency cited two failed research studies that tested an HIV vaccine that used the same technology as that used in the Sputnik V vaccine that found men who were vaccinated had a higher risk of being infected with HIV. The Russian makers of Sputnik V were “not able to adequately address (their) request” for data proving the vaccine’s safety in a country with high rates of HIV. Dr. Julian Tang, a virologist at Britain’s University of Leicester, was perplexed by the decision. “It’s a strange connection to make,” he said, explaining that while past concerns have been raised about using the particular virus vector in Sputnik V, much remains uncertain. “It’s not the vector that caused HIV so you can’t just blame it on that,” Tang said.

Ireland Pauses Reopening Due to Increase in Cases

Ireland had planned to end the use of Covid certificates for indoor dining and to reopen nightclubs and allow large outdoor events without restrictions starting on Friday, Oct. 22. But Cabinet ministers have decided to prolong the use of Covid certificates following a rise in hospitalizations due to Covid-19. On Monday, there were 1,578 new cases and 484 Covid-19 hospitalizations in Ireland (BBC). Prime Minister Micheál Martin said that beginning Friday, there would be no restrictions on the number of people attending weddings and funerals nor on outdoor events and that the phased return to work would continue. He said the changes to the reopening plans were made to “ensure that the next steps we take are safe and sustainable."

Dutch Cases Jump 44% in One Week

New coronavirus infections rose 44% in one week in the Netherlands, straining several hospitals and forcing them to cancel non-emergency procedures. Infections were at their highest level since the end of July and were rising for the third consecutive week following the easing of many social distancing measures across the country last month (Reuters). "Most of those in hospital with COVID-19 have not been vaccinated," the Dutch Institute for Public Health said on Tuesday. "At intensive care units this is the case for 4 out 5 patients." According to government data, 83% of the Dutch adult population has been fully vaccinated.

Italy’s Chinese Community Feels Targeted by Green Pass Rules

The Chinese community in the city of Prato in Tuscany feels penalized by Italy’s Covid Green Pass and has reached out to government authorities to try to resolve the issue (Reuters). The Green Pass shows proof of immunity to Covid-19 through vaccination, previous infection, or a recent negative test. But the government only recognizes the Pfizer, Moderna, Johnson & Johnson, and AstraZeneca vaccines and most Chinese residents in Prato have been inoculated with the Chinese-made Sinovac. The community of 25,000 residents is one of the largest Chinese communities in Italy and many of them have been prevented from working since Oct. 15, when the vaccine mandate came into effect. 

The head of Prato's Chinese community, Luca Zhou Long, wrote to Tuscany's President Eugenio Giani asking him to resolve "the bureaucratic hurdle" preventing many Chinese from going to work. "It is clear that this situation involves considerable difficulties for production, not due to a lack of vaccination but due to the impossibility to obtain the certificate," Long wrote in the letter made public on Tuesday. Italian Prime Minister Mario Drahi has expressed skepticism about the efficacy of the Sinovac vaccine. In June, he said it “has shown itself not to be adequate.” 

U.S. Government & Politics

Anger Over Covid Drives San Francisco Recall Effort and a Larger Wave of Recall Attempts

On Monday, San Francisco’s Department of Elections certified a February 15th recall election for three board of education officials (Politico). The three officials are President Gabriela López, Vice President Faauuga Moliga, and Commissioner Alison Collins, and to get certification, the recall effort obtained 80,000 signatures (the recall law requires 50,000). The recall effort is driven in large part by anger over the impact of the pandemic and how the board handled it. Katie Merrill, a Democratic strategist supportive but not officially tied to the recall effort, told Politico, “Recall fever is alive and well in San Francisco and voters are all in for this,” adding, “They were mad, they were frustrated at the school board that shirked its responsibility during the pandemic — which is trying to get to get kids back at school.” Politico writes, “Joshua Spivak, one of the nation’s foremost recall experts, said Monday that the San Francisco movement reflects how school board members in particular have been targeted by recall ire across the country this year, in some areas due to Covid-19 policies and others because of fears that schools are teaching ‘critical race theory.’” San Francisco’s recall effort is part of a larger wave of more than 200 attempts to recall school board officials in California, according to Spivak. According to Spivak, such efforts rarely succeed in getting certification but tend to succeed when they do.

U.S. Economy

Large Companies Use Their Size to Lessen Impact of Supply Chain Disruptions

The Wall Street Journal reports that large companies, including Procter & Gamble, are using their large size to help lessen the impact of pandemic-related supply chain disruptions (WSJ). The Journal writes, “P&G executives said the company’s scale, ability to spend on supply-chain fixes and its flexible operations are enabling it to keep products in stock even as consumers increasingly encounter sparse shelves at stores. In China, for instance, P&G moved production to other factories when some provinces limited plants’ power usage in recent weeks as part of a national effort to limit energy consumption.” However, even with this ability, P&G is still raising prices. On Tuesday, the company said it will be “charging more for razors and certain beauty and oral care products, price increases that come in addition to earlier moves to start charging more for staples from diapers to toilet paper.” In another example of the role of size in dampening the impact of supply chain disruptions for large companies, the Journal reports that IKEA has pointed to its large selection of items as helping it please customers as stocks of particular items fall short. Grocer Albertsons Cos, the United States’ second largest grocery store company, has adopted a similar strategy.

Vaccine Maker J&J Sees Sales Climb Across Divisions

Johnson & Johnson, the company behind one of the vaccines in use in the United States, saw its sales increase eleven percent last quarter compared to its sales a year ago (WSJ). The increase represents the “return of more doctor’s visits and medical procedures after the pandemic disrupted the industry,” according to the Wall Street Journal. The increase is also apparent across the company’s divisions. The Journal reports, “Medical-device sales grew 7.6% amid a higher level of surgical procedures. Pharmaceutical sales were up 14%, the result of more prescriptions of drugs for multiple myeloma, inflammatory diseases and other conditions. Johnson & Johnson’s sales of consumer products such as Tylenol, Motrin and skin-care lines rose 5.7%. Those sales trends exclude acquisitions and divestitures.”

Bonus Read: “The Economic Rebound Is Still Waiting for Workers,” (NYT).

Analysis & Arguments

Linsey Marr writes on the lessons of Covid that may help contain the transmission of other respiratory diseases (NYT).

Paul Krugman argues that vaccine mandates are needed to clear the supply chain disruptions (NYT).

Jonathan Chait looks at what he describes as the “creepy” increase in conservatives portraying Covid as a positive good (NYMag).

 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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