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Covid-19 Sentry

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Contents

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From Preprints

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From Clinical Trials

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From PubMed

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From Patent Search

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Daily-Dose

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Contents

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From New Yorker

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From Vox

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+There’s strong support for executive actions that preserve DACA and roll back Trump’s environmental regulations. +

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+A majority of Americans are open to President Joe Biden using executive action to advance policy priorities more quickly — but support varies significantly depending on the issue area. +

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+According to a new poll from Vox and Data for Progress, only 18 percent of likely voters think Biden should use executive action whenever he can to implement his policy agenda, while 41 percent would back him using it on a case-by-case basis and 32 percent do not think he should take this route at all. Support also fluctuates by party: Just 10 percent of Democrats don’t think Biden should use executive action at all, while 57 percent of Republicans feel this way. +

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+As the Biden administration has already made clear, there’s a lot that he can do to both reverse Trump-era regulations and advance new ones without congressional approval. Per Vox’s German Lopez, Biden signed 17 executive actions on his first day, addressing a wide range of subjects including a mask mandate on federal property, America’s involvement in the Paris climate agreement, and an extension of federal eviction moratoriums. +

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+The Vox/DFP poll, which was fielded on January 6 and 7, revealed strong support for Biden to use executive action on various fronts, including to enroll more people in the Deferred Action for Childhood Arrivals program, which protects undocumented immigrants who came to the US as children from deportation. Sixty percent of people, including 81 percent of Democrats, 64 percent of independents, and 36 percent of Republicans, support this action. Biden on Wednesday signed a proposal that helps preserve DACA and calls on Congress to approve legislation that would provide a path to citizenship for recipients. +

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+Biden’s use of executive actions is both a way to expedite rollbacks of Trump’s executive initiatives and a necessity to advance some efforts — like a swift vaccine rollout — given the current political reality. As emerging Republican pushback to Biden’s stimulus plan indicates, getting enough GOP support to reach 60 votes in the Senate is poised to be a challenge, and it could take much longer to advance bills with bipartisan backing. Given this dynamic, executive action enables Biden to move far more quickly to address the urgent nature of the ongoing crisis. +

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+The poll surveyed 1,156 likely voters and had a 2.9 percentage point margin of error. +

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+There’s strong support for Biden to use executive action on some areas +

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+Support for Biden’s use of executive action depends on the issue area. This poll, ultimately, wound up covering policies the president has already addressed, as well as several that he hasn’t yet. +

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+Among the subjects that get widespread support in addition to increasing access to DACA: 70 percent of people think he should go it alone in order to increase access to food and housing aid, and 66 percent support his ability to encourage government agencies to use products that are sustainable and made using fair labor practices. +

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+Restoring regulations that protect the environment (51 percent), withdrawing US combat troops from Afghanistan (54 percent), and expanding banking services offered by the US Postal Service (51 percent) all garnered a narrow majority of support as well. +

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+A few other areas, including abolishing the federal death penalty (35 percent) and undoing Trump’s travel ban (39 percent), were more contentious. Both issues broke heavily along party lines: A majority of Democrats would back Biden taking actions on both fronts, while roughly 19 percent of Republicans would. +

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+Biden has already rolled back the travel ban as well as revoked a permit for the Keystone XL pipeline, among his efforts. Additional executive actions could well be on the horizon, depending on what he’s able to tackle in this way — and the type of opposition policies face in Congress. +

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+The vaccine rollout hasn’t gone as smoothly as hoped. Here’s how to fix it. +

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+One of President Joe Biden’s most pressing tasks is speeding up America’s Covid-19 vaccination efforts. +

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+Vaccines are the US’s way out of the pandemic. But the vast majority of Americans — perhaps 70 percent or more, though we don’t know for sure — will have to be inoculated to reach herd immunity or protect at least most of the population. That means vaccinating hundreds of millions of people. +

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+The US isn’t on track to do that quickly. Former President Donald Trump’s administration aimed to vaccinate 20 million Americans by the end of 2020. Three weeks into 2021, slightly more than 15 million have gotten at least one dose. The Trump administration resisted a more hands-on approach that could get the process moving faster, while other countries that acted quickly have been able to surpass or catch up to the US. +

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+As part of his $400 billion Covid-19 proposal and national vaccine plan, Biden has promised 100 million shots in 100 days, enough to fully vaccinate 50 million people with the two-shot vaccine. But to achieve — and hopefully exceed, as some experts say is needed — that goal, he’ll have to solve problems with the vaccine distribution chain’s “last mile”: from storage and distribution facilities to actual patients. That requires more federal support and coordination to help state and local governments and health care facilities work through staffing, scheduling, equipment, and other concerns. +

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+In the coming months, as vaccine distribution expands to a wider population, new issues are certain to arise. While not all of these are foreseeable, experts say there are ways to at least plan for addressing them quickly: establishing backup plans, staying in close communication with vaccinators on the ground, constantly surveilling the supply chain’s many moving parts to clear bottlenecks as they come up, and creating a public education campaign to convince more skeptical Americans. +

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+All of this was bound to be difficult from the start. Experts have repeatedly noted that, given both its size and urgency, this will be the biggest vaccination campaign in US history. Some have compared the work it requires to that of the New Deal or World War II. There will be serious challenges and, inevitably, mistakes. +

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+But tens of thousands of lives are at stake. More than 400,000 people have died in the US from Covid-19 — a death rate that, when controlled for population, is more than 2.5 times that of neighboring Canada. With more than 3,000 people on average dying of Covid-19 each day, every day that passes without mass vaccinations means another day on which thousands of lives are likely lost. +

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+Saving those lives begins with Biden embracing his new powers of the presidency. +

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+Biden must fill the void of federal leadership +

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+Trump never offered much leadership on the pandemic, with his administration seemingly opposed to a much larger federal role from the beginning. When asked about a more hands-on federal approach to vaccines, Brett Giroir, Trump’s assistant secretary at HHS, compared the idea to a federal invasion: “The federal government doesn’t invade Texas or Montana and provide shots to people.” +

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+No one is talking about the Army taking over the Texas Capitol to forcibly administer vaccines. What’s needed, experts say, is for the federal government to provide more communication, guidance, coordination, and support, especially when states ask for it. +

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+That begins with the “last mile” of the vaccine supply chain. It’s at this point, as vaccines go from a storage facility to patients, that things appear to have fallen apart in the US. Freezers broke down in California. People in West Virginia mistakenly got an experimental Covid-19 treatment instead of a vaccine. Seniors in Florida waited in long lines to get their shot. Health care workers in New York tried to cheat the system to jump ahead in line. +

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+Across the country, facilities have complained they don’t have the staff to administer the doses they have, as health care workers deal with a surge of Covid-19 patients and workers of all kinds fall sick themselves. Others have said it’s impossible to plan ahead because they often don’t know how many doses or what type of vaccine they’re getting from the feds until the day the shipment arrives. +

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+The Trump administration suggested it wasn’t responsible for fixing these problems: It sent the vaccine doses to states, and it was on the states to distribute those doses from there. +

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+But there are some things the federal government could do, said Nada Sanders, a distinguished professor of supply chain management at Northeastern University. One is called “backward scheduling”: The Biden administration could partner with states to set a goal for how many people to vaccinate and then work backward, going from injecting the vaccine to the factory where the dose was produced in order to figure out what’s needed at every step. This won’t anticipate every single problem, but it will at least give officials a way to prepare. +

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+Bottlenecks “can and will occur,” Sanders told me. “It is just part of managing a supply chain. That is why it must be monitored in real time and bottlenecks addressed as they are forming, well before they become acute.” +

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+As distribution expands, more of these supply bottlenecks will pop up. Already, there have been reports of shortages of dry ice, small glass vials, and materials for vaccine doses. The Trump administration missed its own goal of 40 million doses to states by the end of 2020, and was still millions short three weeks into January. +

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+As we saw with Covid-19 testing, fixing these initial problems won’t solve everything for good. When one part of the supply chain is fixed, growing capacity enables more demand along other parts of the chain, leading to new bottlenecks popping up. +

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+The idea is to be ready for these problems and to use federal tools — such as the Defense Production Act, which can be used to boost production of needed materials — to smooth out issues as they arise. It also means working with flexibility and adaptability, given that unexpected problems can come up at any time. +

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+In some cases, the feds will need to provide direct resources to local and state governments. This is another area in which the Trump administration fell short: State groups spent months lobbying for $8 billion to build out vaccine infrastructure, but the administration gave them only $340 million. It wasn’t until late December, when Congress and Trump passed a second stimulus package, that the federal government finally allocated the billions states had asked for. +

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+Even that came too late. States really needed the money to plan for vaccination efforts before they were underway, and some state officials say they need even more now that they’re actually dealing with a messy rollout. +

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+The Biden administration will also eventually have to convince people to get vaccinated, including some of the roughly quarter of Americans who are hesitant. That will require a large public education and awareness campaign, and probably some creativity and help from others — for instance, maybe having Taylor Swift or LeBron James get vaccinated on camera. Trump doing the same could help persuade his supporters, many of whom tend to be more skeptical about needing a vaccine. The US won’t be able to convince everyone to get a shot, but 100 percent compliance isn’t needed for herd immunity and sufficient protection. +

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+Biden has already promised much of this in his Covid-19 proposal and vaccine plan, which include more support to states and proposals for mass vaccination centers and mobile units. The question now is how and whether these things are actually implemented. +

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+This isn’t going to be easy, but it’s possible +

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+The current mishaps with the vaccine rollout are particularly concerning because this was supposed to be the easier part. The first groups getting vaccinated were relatively easy to target — officials should know where health care workers and nursing home residents are and have medical staff nearby. With vaccine allowances now expanding to more individuals in further-flung places, vaccination campaigns stand to get much harder. +

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+“I thought the first month would go smoothly, and then we’d hit the big crash as the decisions became more complex,” Julie Swann, a vaccine distribution expert at North Carolina State University, told me. +

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+Experts have warned all along that the later parts of the US’s Covid-19 vaccine campaign would be an especially massive, complicated undertaking. We don’t yet know all of the problems that will arise in the coming months as more and more vaccines are distributed. “Ultimately, it is difficult to give [vaccines] out and prioritize it for a population,” Swann said. +

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+But other countries have shown it can be done better. Israel is vaccinating people at seven times the rate of the US, and the United Arab Emirates, Bahrain, and United Kingdom are also ahead of the US. Countries that got a later start than America on vaccines, like Denmark and Ireland, are rapidly catching up. +

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    <img alt="A chart of vaccination rates in different countries." src="https://cdn.vox-cdn.com/thumbor/Qc1AJis-jyDyy8pvftft2pCX2Qw=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22250872/covid_vaccination_doses_per_capita.png" />
+  <cite><a class="ql-link" href="https://ourworldindata.org/grapher/covid-vaccination-doses-per-capita?tab=chart&amp;stackMode=absolute&amp;time=latest&amp;region=World" target="_blank">Our World in Data</a></cite>
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+Mathematically, the current campaign simply isn’t quick enough. At the current rate of 900,000 vaccinations per day, it would take more than 250 days — into the fall — to reach what experts believe could be herd immunity for Covid-19. Many experts have called for finishing the vaccine campaign this summer, before the next school year, a possible fall surge, and another dangerous mutation of the virus. A months-longer undertaking could result in tens of thousands more deaths. +

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+There’s no reason the US, as the wealthiest country in the world, should uniquely struggle so much with this. The country has done big vaccination campaigns before — every year with flu shots, in fact — and it’s how America eradicated diseases such as smallpox, polio, and measles within its borders. It’s not easy, but it’s absolutely possible. +

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+The key, though, is to leverage the powers of the federal government. Throughout the pandemic, America’s biggest failures have occurred when the federal government was slow to act or didn’t act at all. That was true with personal protective equipment for health care workers, as the Trump administration refused to make greater use of tools like the Defense Production Act. It was true for testing, as the administration described itself as a “supplier of last resort” and left state, local, and private actors to handle the bulk of the work. And it’s now true for vaccines, as Trump’s White House refused to get more involved. +

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+This is a national crisis. Every state has far too many Covid-19 cases, based on Vox’s tracker of state epidemics. Every state is failing to vaccinate its people quickly enough — few have administered more than 70 percent of their dose supply. We need national solutions for this. +

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+As Ashish Jha, dean of the Brown University School of Public Health, wrote in the Washington Post, “For all this pandemic has taught us and cost us, it has demonstrated again that we are the United States and, especially in crisis, an effective federal government is essential.” +

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+This is Biden’s promise, both on the campaign trail and in his Covid-19 plan: He’ll push a bigger role for the federal government. He now has a chance to show the idea can work. Lives depend on it. +

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+Sign up for the Weeds newsletter. Every Friday, you’ll get an explainer of a big policy story from the week, a look at important research that recently came out, and answers to reader questions — to guide you through the first 100 days of President Joe Biden’s administration. +

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+The variant carries mutations that may weaken the effect of vaccines. +

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+On January 15, US public health officials warned that a more contagious variant of the coronavirus that causes Covid-19 could dominate infections in the United States by March. That grim warning referred to B.1.1.7, a variant that was first identified in the United Kingdom. +

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+But now, one week later, scientists are increasingly concerned about another variant that emerged in South Africa. +

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+There’s evidence from several small, and not-yet-peer-reviewed, studies that mutations in the South Africa variant — known as 501Y.V2 and already present in at least 23 countries — may have a higher risk of Covid-19 reinfection in people who’ve already been sick and still should have some immunity to the disease. +

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+Scientists haven’t confirmed that this variant is more contagious, though evidence is pointing in this direction. They’re also concerned that 501Y.V2 could have implications for treatments for Covid-19. Regeneron, a company that has developed a cocktail of two monoclonal antibodies as a therapy for patients with the illness, reported that 501Y.V2 may be able to evade one of the antibodies in its mix. The drug is still effective, but subsequent mutations could render it less so. +

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+But perhaps most alarming is the prospect that the mutations in the variant could limit the effectiveness of existing vaccines, one of the best tools we have for controlling the pandemic. +

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+The results of these recent studies are “a serious indication we have to look hard at how well vaccines might work,” Penny Moore, a virologist at the National Institute for Communicable Diseases in South Africa, told Vox. Taken together, they highlight the dangers of letting Covid-19 spread unchecked and also portend the challenges that lie ahead as the virus continues to evolve. +

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+What the 501Y.V2 coronavirus variant might mean for Covid-19 vaccines +

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+Moore is the lead author of a new study on 501Y.V2, out Tuesday as a preprint on BioRxiv. She and her team in South Africa took blood plasma samples from 44 people who had been infected with the coronavirus during the country’s first wave of infections last summer and then checked how their existing antibodies responded to 501Y.V2 as well as older variants. +

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+The researchers sorted the plasma samples into categories — high and low antibody concentrations. Though antibodies can wane after infection, that doesn’t necessarily mean that protection fades completely. Another recent study showed that immunity stemming from infection lasts at least five months in most people, so the antibodies in those who’ve had the virus should still shield against earlier versions of the virus if someone is infected again. +

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+In 21 cases — nearly half — the existing antibodies were powerless against the new variant when exposed in test tubes. This was especially true for plasma from people who had a mild previous infection, and lower levels of antibodies, to begin with. +

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+The findings suggest immunity from previous versions of the virus might not help individuals fend off the new variant if they’re exposed, particularly if their prior case was mild or symptom-free. +

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+For Fred Hutch Cancer Research Center scientist Trevor Bedford, who was not involved in the research, the study also came as a possible warning sign about the vaccines. As early as autumn this year, manufacturers may need to begin reformulating their shots to respond to the changes in the virus’s genetic code, he wrote on Twitter: +

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+501Y.V2 is still largely restricted to South Africa, but it (or other antigenically drifted variants) may spread more widely in the coming months. I would be planning this potential "strain" update for fall 2021. 9/10 +

+— Trevor Bedford (@trvrb) January 20, 2021 +
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+The specific mutation scientists are most worried about +

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+The 501Y.V2 variant carries one mutation of particular concern, known as E484K. This change appears in the part of the virus, the spike protein, that fits into the receptor in human cells. The spike protein is also the major target for the currently available mRNA vaccines, from Pfizer/BioNTech and Moderna. +

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+“This mutation sits right in the middle of a hotspot in the spike,” Moore said. And it’s become notorious among virologists for its ability to elude coronavirus antibodies. +

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+Scientists have demonstrated how this might happen in other cell culture experiments. A new study, also in preprint form from South African researchers, look a similar approach to Moore’s — testing how antibodies from six convalescent plasma donors react to 501Y.V2. But this time they used live virus, considered “the gold standard for these experiments,” said study co-author Richard Lessells, a University of KwaZulu-Natal infectious disease specialist. And their findings pointed in the same direction: 501Y.V2 can — at least in the lab — escape the antibody response elicited from a prior infection, and the E484K mutation “has the clearest association with immune escape.” +

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+In another recently published BioRxiv preprint, researchers in Washington state tracked how mutations altered the effectiveness of the antibody response in convalescent plasma of 11 people — and also found E484K had particularly potent antibody evasion capabilities. +

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+Other variants of concern also carry the E484K mutation, including one first identified in Manaus, Brazil, known as P.1. And one case study suggests reinfection in some people might be possible when they’re exposed to the new variant. +

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+In a preprint, researchers in Brazil documented the case of a 45-year-old Covid-19 patient with no co-morbidities, who months after her first bout with the illness, was reinfected with the new variant. The patient experienced more severe illness the second time around. While it’s limited evidence, it “might have major implications for public health policies, surveillance and immunization strategies,” the authors wrote. +

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+The study’s broader context is also concerning: After more than three-quarters of the population in Manaus were estimated to be infected with the virus during a spring surge, cases are piling up again and hospitals are filling up. Researchers suspect reinfections with the new variant could be the driver. +

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+“The news is not all grim” +

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+But “the news is not all grim,” said University of Utah evolutionary virologist Stephen Goldstein. A preprint, led by Rockefeller University scientists, suggested antibodies from the vaccine may be more potent than antibodies from a previous infection. Researchers tested blood samples from 14 people who had received the Moderna vaccine and six who were immunized with the Pfizer/BioNTech vaccine. The E484K mutation, and two others found in the South Africa variant, were associated with a “small but significant” drop in antibody activity, the researchers found. +

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+Still, said Goldstein, the antibodies induced by the vaccine “are so high to start with that the serum was still extremely potent against the mutant.” +

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+To fully understand the threat the mutations pose to vaccines, we’ll need clinical trials involving vaccinated people, Moore said. “These studies flag a problem,” she added, “but how that translates to real life, we can’t tell.” +

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+There’s also huge variation in immune responses among people, Goldstein said. In the Washington paper, the researchers found “extensive person-to-person variation” in how the mutations affected an individual’s antibody response. +

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+“The bottom line there is some reason for concern about reduced efficacy but efficacy will not fall off a cliff,” Goldstein said. “The vaccines are incredibly potent. ... If [they go] from 95% [efficacy] to 85% or even a little lower, we are still in great shape.” That’s why researchers and public health officials are heavily advocating for everyone to be vaccinated as quickly as possible. +

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+Even so, Moore cautioned: “From an immune escape point of view, the variants first detected in Brazil and South Africa are more of a concern but this is just the beginning. It’s our first indication that this virus can and does change.” +

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+It’s possible that as we learn more, even the E484K mutation won’t turn out to undermine the vaccines. But there may be other changes to the virus lurking out there or evolving that will escape even vaccine-induced antibodies. “So many people now are infected that this is an arm’s race — the virus is now given every opportunity to mutate,” Moore said, “so it can take those steps on the pathway to immune escape more easily.” +

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From The Hindu: Sports

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From The Hindu: National News

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From BBC: Europe

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From Ars Technica

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From Jokes Subreddit

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