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September 29, 2021 - Brief Issue 243

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

Pfizer and BioNTech See Favorable Vaccine Results in Children (Health & Science)

Confusion Over Booster Rollout in the U.S. Contrasts to Swift Rollout in Israel (Health & Science)

Studies May Explain Why Some Develop Diabetes Following Covid Infections (Health & Science)

Romania Coronavirus Cases Hit New Record (Around the World)

Russia Reports Record Daily Covid Deaths (Around the World)

Alberta Hospitals Overwhelmed with Cases (Around the World)

Treasury Secretary Yellen: October 18 is the Key Date for Debt Ceiling (U.S. Government & Politics)

New U.S. Entry Requirements, Generally Looser, But Russia’s Sputnik Vaccine Likely Won’t Count (U.S. Government & Politics)

Federal Judge: All California Prison Staff Must Be Vaccinated (U.S. Government & Politics)

Home Price Grew at Record Pace in July (U.S. Economy)

Health & Science

There have been 43,230,197 coronavirus cases in the United States, and 693,055 people have died (Johns Hopkins). The United States has administered 391,152,574 vaccine doses, with 64.4% of all Americans having received at least one vaccine dose and 55.8% fully vaccinated. Among adults aged 18 or older 77.1% have received at least one dose, and 66.7% are fully vaccinated (U.S. CDC). Worldwide, there have been 232,861,440 confirmed cases of coronavirus, with 4,767,341 deaths.

Pfizer and BioNTech See Favorable Vaccine Results in Children

On Tuesday Pfizer and BioNTech announced that they had submitted data to the U.S. Food and Drug Administration that showed their coronavirus vaccine is safe and effective in children ages 5 to 11 (NYT). They will now submit a formal request to regulators to allow a pediatric vaccine to be administered in the U.S. and also in Europe and other countries. It’s not clear when the vaccine might be cleared for children though, and Pfizer’s chief executive, Dr. Albert Bourla, said, “It’s not appropriate for me to comment how long F.D.A. would take to review the data.” Dr. Bourla said in an appearance at the Atlantic Festival, hosted by The Atlantic magazine that “[the F.D.A.] should take as much time as they think is appropriate for them.” He added that an authorization around Halloween, as some health officials have suggested could be possible, was “one of the options, and it’s up to the F.D.A.” If approved, about 28 million children ages 5 to 11 would be eligible for the vaccine in the United States. 

Confusion Over Booster Rollout in the U.S. Contrasts to Swift Rollout in Israel

States are trying to figure out how to dole out Covid-19 booster shots of the Pfizer and BioNTech vaccine after federal regulators set broad eligibility guidelines. Federal health officials said last week that people over the age of 65 and those over 18 with underlying health conditions or jobs that increase their risk of developing severe Covid-19 are eligible for a third dose. The only real condition is that the booster dose can’t be given any sooner than six months after the second dose. Politico reports, “In West Virginia, where just 40 percent of the population is vaccinated against Covid-19, Gov. Jim Justice — a Republican — is encouraging nearly any adult who has received two doses of the Pfizer vaccine to get in line for a third, citing the growing burden on the state's hospitals. Vermont, which has one of the nation’s highest vaccination rates, is taking a phased approach, starting with people 80 and older last Friday.” That task of sorting out eligibility is complicated by the fact that regulators have so far only approved booster doses for people who received the Pfizer vaccine; the Moderna vaccine and Johnson & Johnson vaccines have not been approved for booster shots yet. Another complication: many people are now beyond the six-month window of when they received their second dose. Molly Howell, the immunization program manager for the North Dakota Department of Health said the biggest booster-related stumbling block so far has been effectively communicating who needs a third shot. “I think the public may be a bit confused,” she said. “It may prevent them from coming in for boosters.” 

Meanwhile, Israel’s booster shot rollout has been swift and sure. Israeli scientists and government health officials decided in late July to administer booster shots as infections from the Delta variant were increasing (WSJ). Within days of the decision, millions of booster shots were administered. According to the Journal, the decision makers relied on two studies in weighing whether or not to move forward with boosters, “One was a Health Ministry analysis of Israeli data that showed those vaccinated in January through March were far more likely to get sick than those inoculated later. The second study to swing the late-night debate behind a shot for over 60s was presented by Dr. Regev-Yochay and her team at Sheba Hospital. It pointed to the sharp rise in infections coming not only from the virulence of the Delta variant, but also from the waning prevalence of antibodies in people who had been vaccinated. Her research showed that resistance to the virus had been falling in test subjects for months.” Since the beginning of the booster campaign, more than three million of Israel’s nine million people have gotten a third shot and now most infections are among those who are unvaccinated. 

Bonus Read: “You’re going to be asked to prove your vaccination status. Here’s how to do it.” (WaPo).

Studies May Explain Why Some Develop Diabetes Following Covid Infections

Covid-19 can infect cells in the pancreas that make insulin and change the way they work, which could potentially explain why some previously healthy people develop diabetes following Covid-19 infection (Guardian). Doctors have been concerned about the number of patients who have developed diabetes either while infected with coronavirus or shortly after recovering from it. Professor Shuibing Chen at Weill Cornell Medicine in New York screened various ells and organoids to try to identify which ones could be infected with the virus. He found that lung, colon, heart, liver, and pancreatic organoids could all be infected. Further, he found that insulin-producing beta cells within the pancreas were also susceptible and if infected, these cells produce less insulin. “We call it transdifferentiation,” said Chen, who presented the results at the annual meeting of the European Association for the Study of Diabetes on Wednesday. “They are basically changing their cellular fate, so instead of being hardcore beta cells which secrete a lot of insulin, they start to mix different hormones. It could provide further insight into the pathological mechanisms of Covid-19.” 

Separate research by Prof. Francesco Dotta at the University fo Siena in Italy confirmed that Covid-19 attacks pancreatic cells. Specifically. Dotta and his colleagues found that the virus targets the angiotensin-converting enzyme 2 (ACE2) protein on their surface. Insulin-producing beta cells express particularly high levels of this protein. The Guardian writes, “They also demonstrated that ACE2 levels were increased under inflammatory conditions, which is important because people with existing type 2 diabetes may already have some inflammation within their pancreas.” Dotta explained, “This means that these insulin-producing beta cells could be even more susceptible to viral infection when inflamed.” 

While these studies seem to support the theory that Covid-19 could increase the risk of developing diabetes in some people, it’s unclear whether the changes Covid-19 causes to the cells are long-lasting.

Around the World

Romania Coronavirus Cases Hit New Record

The number of new coronavirus infections in Romania rose to 11,049 in the past 24 hours -- a new record (Reuters). The country has the second-lowest vaccination rate in the European Union, with only a little over a third of its adult population vaccinated. About 40% of medical staff were not vaccinated. The government said on Tuesday that only 26 intensive care beds remained available and that additional beds could not be added because of staff shortages.

Russia Reports Record Daily Covid Deaths

Health authorities in Russia registered 852 deaths on Tuesday, the highest single-day death toll since the pandemic began (Al Jazeera). The country is currently seeing a rise in cases due to the highly infectious Delta variant and a slow-down in the mass vaccinations drive. Health experts worry that a fourth wave of infections is beginning after millions of Russian students returned to schools and colleges. In Moscow, officials have tightened mask wearing requirements and Deputy Mayor Anastasia Rakova said that the Delta variant now accounts for all cases in the city. Only 28% of the country’s 146-million population is fully vaccinated and only  32% is fully vaccinated.

Alberta Hospitals Overwhelmed with Cases 

The fourth wave of coronavirus in Alberta, Canada is overwhelming its hospitals and leaving the healthcare system on the brink of collapse. Intensive care units in Alberta are 84% full, even with nearly 200 “surge” beds added. If they reach 90% capacity, critical care triage protocols will apply, meaning doctors would be forced to ration care and prioritize those with the best chance of survival (Reuters). "Our job is to save lives, not choose who gets to live and die," said Shazma Mithani, an emergency doctor at Edmonton's Royal Alexandra Hospital and the Stollery Children's Hospital. "We are in the absolute worst situation we have ever been in, and it was entirely preventable, all of it." A lot of anger over the situation is being directed to Premier Jason Kenney, who apologized on Sept. 15 for mishandling the pandemic and imposed a requirement for proof of vaccination to enter certain businesses. On a radio show on Sunday, Kenny said, “We have been hit hard with this fourth wave primarily because we went into this with the lowest vaccination rate in Canada” but also rejected calls for a “hard lockdown” to stop the rise in cases.

U.S. Government & Politics

Treasury Secretary Yellen: October 18 is the Key Date for Debt Ceiling

On Tuesday, in a letter to Congress, Treasury Secretary Janet Yellen identified October 18, as the key date at which point the United States will not be certain of its ability to pay its bills in the absence of government action to raise the debt ceiling (WSJ, WaPo, NYT, Politico). Yellen wrote, “At that point, we expect Treasury would be left with very limited resources that would be depleted quickly.” She added, “It is uncertain whether we could continue to meet all the nation’s commitments after that date.” As we covered in a prior brief, the Treasury Department previously warned that the pandemic would make it difficult to determine an exact date at which point the U.S. would no longer be able to pay its bills absent action. Yellen also warned that the U.S. “would likely face a financial crisis and economic recession” if the Treasury department cannot repay its debtors. Meanwhile, Congress remains split on raising the ceiling. The Wall Street Journal writes, “Senate Republicans have lined up against the debt-limit increase, saying that Democrats, as the party in power, should raise the ceiling themselves. Democrats have emphasized that lifting the debt limit is a shared responsibility of both parties, and said votes to lift the debt ceiling during the Trump administration were bipartisan.” 

New U.S. Entry Requirements, Generally Looser, But Russia’s Sputnik Vaccine Likely Won’t Count

As we covered in the brief last week, the United States has loosened its travel restrictions on people entering the U.S. from multiple countries provided that they are fully vaccinated and have no symptoms. However, the new rules will likely not allow those who are vaccinated with Russia’s Sputnik vaccine to enter (WaPo). The Washington Post reports, “the new rules, set to take effect in November, appear to also shut out many people who consider themselves to be fully immunized — including millions who have received two doses of Russia’s Sputnik V vaccine. Hundreds of thousands of Russians could be directly affected. Despite frosty diplomatic relations and limited demand for international travel, roughly 300,000 Russians visited the United States in 2019, the last year for which figures are available, according to the U.S. Travel Association.” This is because the rules only allow entry to those “vaccinated with shots approved for emergency use either by the U.S. Food and Drug Administration or the World Health Organization. That includes vaccines made by Pfizer and Moderna, as well as shots developed by Chinese firms such as Sinopharm and Sinovac.” Russia’s Sputnik vaccine does not currently meet the criteria. Russia’s sovereign wealth fund, the Russian Direct Investment Fund, which backed the vaccine, criticized the exclusion, stating, “been approved in 70 countries where over 4 billion people, or over half of the world’s population, live, but its efficacy and safety have been confirmed both during clinical trials and over the course of real-world use in a number of countries.” The Sputnik vaccine was being considered for approval by the WHO, but the agency suspended its review citing concerns about manufacturing processes. Notably Russia was not the subject of prior travel restrictions, but with the new vaccine requirements, for many Russians their ability to enter the U.S. will come to an end “just as doors open to millions of travelers from Europe and elsewhere” as the Post notes.

Federal Judge: All California Prison Staff Must Be Vaccinated

On Monday, a federal judge ruled that all prison staff in California must be vaccianted (KTLA, AP, Sacramento Bee). The judge wrote, “Once the virus enters a facility, it is very difficult to contain, and the dominant route by which it enters a prison is through infected staff” in his decision siding with a court appointed receiver overseeing medical care and rejecting the arguments of California’s Democratic Governor Gavin Newsom. A spokesman for the Corrections Department stated that they are “evaluating the court’s order at this time to determine next steps,” adding, “We respectfully disagree with the finding of deliberate indifference, as the department has long embraced (voluntary) vaccinations.” The guards union has also suggested it may appeal.

U.S. Economy

Home Price Grew at Record Pace in July

According to the S&P CoreLogic Case-Shiller National Home Price Index, home prices grew at a record pace in July (WSJ). The Wall Street Journal writes that the index, “which measures average home prices in major metropolitan areas across the nation, rose 19.7% in the year that ended in July, up from an 18.7% annual rate the prior month. July marked the highest annual rate of price growth since the index began in 1987.” Craig Lazzara, managing director and global head of index investment strategy at S&P Dow Jones Indices, told the Journal, “The last several months have been extraordinary not only in the level of price gains but in the consistency of gains across the country.” July was the fourth month in a row of record increases. As we have covered in prior briefs, the housing market has boomed during the pandemic. However, rising prices have recently shown signs that they may be beginning to drive down demand. 

Bonus Read: “Big Tech Companies Amass Property Holdings During Covid-19 Pandemic,” (WSJ).

Analysis & Arguments

Senator Tom Cotton (R-AR) argues against Covid-based clemency (National Review).

Emily Cohen Ibañez and Alissa Quart present a video examining Covid’s impact on women of color (Intercept).

Helen Rosner conducts a Q and A with epidemiologist Céline Gounder on the topic of booster shots (New Yorker).

 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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