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"COVID-19 Lockdown Exit Analysis" 9th Mar 2021

Five Minute Briefing

The long road ahead for COVID-19 vaccine distribution

Richard Hatchett, CEO of the Coalition for Epidemic Preparedness Innovations (CEPI) told STAT the group will launch its strategy for its next set of goals this week. It is aiming to find ways to unblock vaccine production bottlenecks without harming non-COVID vaccine production.

He said CEPI is poised between thinking about how to end the COVID pandemic and looking at the institutions that have been set up and how they might be improved for future pandemic preparedness. We started out considering next-generation vaccines as just offering attributes for the long-term: low cost, single dose, thermal-stable products. However, the introduction of the COVID variants forces CEPI to think about multivalent vaccines that protect against several strains of the virus, or vaccines that can be easily turned from one strain to another.

He went on, CEPI will soon put out a call for proposals for fully protective betacoronavirus vaccines. There are at least 20 groups around the world moving in that direction and the plan is to put out a major initiative - hopefully by the end of the month.

However, the main types of vaccine depend on a relatively narrowly defined set of critical inputs, whether these are consumables or raw materials that each vaccine depends on. The bags, the stoppers, the tubing - all chemical raw materials, but CEPI is getting signals from individual vaccine manufacturers that they are on relatively thin ice in terms of supplies to continue their manufacturing. Upstream providers of these critical supplies are talking about lengthening back-order times and they are seeing larger orders because they are concerned they might need to stockpile.

Pre-COVID the estimated global aggregate production of vaccines was in the range of 3.5 billion to 5.5 billion doses. Now CEPI is being told they are aspiring to produce 10 billion to 12 or 14 billion doses of COVID vaccines along in 2021. These are huge numbers in terms of the consumption of resources to produce these vaccines which could have an impact on the production of non-COVID vaccines.

The long road ahead for COVID-19 vaccine distribution
A pandemic expert weighs in on the long road ahead for Covid-19 vaccine distribution
STAT spoke recently to Richard Hatchett, CEO of CEPI. Hatchett told us the group will later this week launch the strategy for its next set of goals and take part in an important discussion at the London think tank Chatham House aimed at finding ways to unblock the vaccine production bottlenecks without harming non-Covid vaccine production.
Japan COVID-19 inoculations off to snail pace start due to vaccine, syringe shortages
Japan’s COVID-19 inoculation campaign is moving at a glacial pace, hampered by a lack of supply and a shortage of specialty syringes that underscore the enormous challenge it faces in its aim to vaccinate every adult by the year’s end. Since the campaign began three weeks ago, just under 46,500 doses had been administered to frontline medical workers as of Friday. At the current rate, it would take 126 years to vaccinate Japan’s population of 126 million. Supplies are, however, expected to increase in the coming months. By contrast, South Korea, which began its vaccinations a week later than Japan, had administered nearly seven times more shots as of Sunday. Unlike many other countries, Japan requires clinical trials for new medicines, including vaccines, to be conducted with Japanese patients, slowing down the approval process.
U.S. CDC advice for fully vaccinated people
Fully vaccinated people can gather without masks indoors, should still avoid travel: U.S. says
People who have been fully vaccinated against COVID-19 can meet without masks indoors in small groups with others who have been inoculated but should avoid non-essential travel and continue to wear face-coverings in public, the Biden administration said on Monday. In a long-awaited update of its guidance for behaviors to prevent the spread of the coronavirus, the U.S. Centers for Disease Control and Prevention (CDC) said fully vaccinated people could also meet in small groups with unvaccinated individuals deemed at low-risk for severe COVID-19 from one other household without masks. The slight lifting of restrictions represented a still cautious approach to public health guidance despite the quickly growing number of vaccinated people. President Joe Biden has urged Americans to remain vigilant and continue to follow CDC guidelines to prevent another surge of cases.
CDC says fully vaccinated Americans can spend time together indoors and unmasked
People who have been fully vaccinated against Covid-19 can now spend time together indoors and unmasked, according to new Biden administration guidance. Fully immunized Americans can also visit with low-risk individuals from other households even if they haven’t yet received a vaccine. And if vaccinated individuals are exposed to Covid-19, there’s no need to either quarantine or get tested for the disease, according to new recommendations released Monday from the Centers for Disease Control and Prevention. “We know that people want to get vaccinated so they can get back to doing the things they enjoy with the people they love,” Rochelle Walensky, the CDC director, said in prepared remarks. “There are some activities that fully vaccinated people can begin to resume now in the privacy of their own homes. Everyone — even those who are vaccinated — should continue with all mitigation strategies when in public settings.”
Fully vaccinated Americans can gather without masks, say health officials
Fully vaccinated Americans can gather with other vaccinated people indoors without wearing a mask or social distancing, according to long-awaited guidance from federal health officials. The recommendations also say vaccinated people can come together in the same way — in a single household — with people considered at low risk for severe disease, such as in the case of vaccinated grandparents visiting healthy children and grandchildren. The Centres for Disease Control and Prevention announced the guidance on Monday. The guidance is designed to address a growing demand, as more adults have been getting vaccinated and wondering if it gives them greater freedom to visit family members, travel, or do other things like they did before the Covid-19 pandemic swept the world.
Fauci says plateau of COVID-19 cases in US is unacceptable and warns against an 'on and off' reopening strategy
Fauci says the plateau of COVID-19 cases in the US is unacceptable and warns against an 'on and off' reopening strategy
The US COVID-19 case count is plateauing at "not an acceptable level," Dr. Anthony Fauci told CBS' "Face the Nation" on Sunday, warning against public-health measures being turned "on and off." Fauci, the White House chief medical advisor, told CBS' Margaret Brennan that having another surge when cases were already at "quite a high level" would be "risky." The US Centers for Disease Control and Prevention's director warned last week that a fourth surge of cases could be coming in the US
Vaccine doses and delivery
Brazil to get extra 5 million COVID-19 doses from Pfizer: economy minister
Brazil’s Economy Minister Paulo Guedes said on Monday that Pfizer Inc will deliver an additional 5 million COVID-19 vaccination doses, which would increase the number of shots expected from the drugmaker by the end of June to 14 million. Speaking in Brasilia, Guedes said President Jair Bolsonaro had spoken with the global head of Pfizer and was scheduled to speak with the head of Janssen, the pharmaceutical subsidiary of Johnson & Johnson. The government last week said it intended to buy 100 million doses from Pfizer and 38 million from Janssen through the end of December.
NZ will have enough Pfizer vaccine doses for entire population
New Zealand will buy additional COVID-19 vaccines, developed by Pfizer and Germany’s BioNTech, which will be enough to vaccinate the whole country, Prime Minister Jacinda Ardern said on Monday. The government has signed an agreement to buy an extra 8.5 million doses, enough to vaccinate more than 4 million people, Ardern said, adding the vaccines were expected to reach the country in the second half of the year. “This brings our total Pfizer order to 10 million doses or enough for 5 million people to get the two shots needed to be fully vaccinated against COVID-19,” Ardern said in a statement.
One in six doctors report COVID-19 vaccine sites disrupted by delivery failures
GPonline reported in January that GPs were experiencing problems with deliveries as orders were pushed back multiple times or cancelled at late notice - forcing surgeries to reschedule or cancel appointments. The BMA survey reveals that 16% of doctors reported local sites had been forced to rearrange vaccination sessions because of disruption to deliveries of COVID-19 vaccine. Meanwhile, more than a quarter of doctors said local vaccination sites could have delivered more jabs if supply had been increased.
Will the U.S. have Covid vaccine doses for everyone by the end of May? Probably
President Biden confidently declared last week that there would be enough Covid-19 vaccine delivered to the U.S. government by the end of May to vaccinate every American. But predictions about vaccine availability have repeatedly been proven wrong. How confident should Americans be this time? The short answer: somewhat. There is no doubt that the U.S. is moving from a time of vaccine scarcity, when there is not enough vaccine to go around, to one of vaccine surplus, when it will be far easier for people who want a Covid vaccine to receive one. By early summer, barring a manufacturing catastrophe, there should be enough vaccine for every American.
Children back at school
English children head back to school after two months of home learning
Millions of English children and teenagers headed back to school on Monday for the first time in two months, having endured their second extended stretch of home learning because of a strict national lockdown to slow the spread of COVID-19. The reopening of English schools to all pupils is the first step in a four-stage government plan to ease the lockdown while trying to prevent a new surge in infections after a devastating winter wave that severely strained hospitals. Since the start of the pandemic, Britain has recorded 124,500 deaths within 28 days of a positive COVID-19 test, the fifth highest official death toll in the world and the worst in Europe.
England: Children step back into the classroom as lockdown eases
Millions of children stepped back into their schools in England on Monday for the first time in two months, ending a second extended stretch of home learning enforced as part of a lockdown to slow the spread of COVID-19. The resumption of classroom teaching marks the first move of the United Kingdom government’s four-stage plan to ease the national lockdown, which officials aim to lift entirely by late June.
Covid-19: School rapid test cannot be overruled, says minister
The government is sticking to the rule that a positive rapid Covid test done in secondary schools in England cannot be overruled by the gold-standard tests processed by labs. Concerns have been raised by testing experts that significant numbers could be incorrectly told they are infected. They have called for all positives from the rapid testing done in schools to be confirmed by the standard PCR test.
Ramping up vaccinations
Local pharmacists step up in COVID-19 vaccination effort
In the U.S., local pharmacy owners are filling in the gaps as federal, state and county authorities across the country struggle to ramp up vaccinations vital to crushing the COVID-19 pandemic. In some small towns across the U.S., an independent pharmacy is the only local place where residents can get a COVID-19 vaccination. President Joe Biden recently celebrated the injection of the 50 millionth dose of COVID-19 vaccine since his inauguration. But the huge undertaking has been hampered by vaccine shortages and concerns whether marginalized communities are getting access to shots. The hope is that local pharmacies will now play a key role in getting more Americans inoculated
Covid-19: Vaccine offers for all those aged 56 or over
People aged 56 to 59 in England are being invited to book their coronavirus vaccine from this week. Letters for people in the age group, offering them the vaccine, started being delivered to homes on Saturday. It comes after eight in 10 people aged 65 to 69 have taken up the offer of a jab, NHS England said. But the Office for National Statistics (ONS ) has warned the UK is "not out of the woods yet". More than 18 million people in England have already had one dose of the vaccine - over a third of the entire adult population.
Israel starts vaccinating Palestinian workers after delays
Israel, which has faced criticism for excluding Palestinians from its vaccination campaign, started to inoculate Palestinians working in the country and in settlments in the occupied West Bank, more than two months after launching an immunisation blitz of its own population. Palestinian labourers who crossed into Israel at several occupied West Bank checkpoints received their first doses of the Moderna vaccine on Monday. Some 100,000 Palestinian labourers from the West Bank work in Israel and its settlements, which are considered illegal under international law.
All sorts of vaccine hesitancy
Russia’s Covid-19 Vaccine Is Embraced Abroad, Snubbed at Home
Last summer, Russia was the first nation to announce its approval of a Covid-19 vaccine. Dozens of countries from Mexico to Iran have since ordered millions of doses of the shot, known as Sputnik V. But at home, Russia’s vaccination campaign has sputtered in the midst of one of the world’s highest levels of vaccine hesitancy. While the vaccine is free and widely available, only 3.5% of Russians have received at least one shot, compared with 17.1% in the U.S. and 32.1% in the U.K. Recent surveys show that less than a third of Russians are willing to get the Sputnik V vaccine. Behind the skepticism are lingering doubts about Sputnik V’s rapid development and an ingrained distrust of authorities stemming from the country’s Soviet past.
COVID-19: Jair Bolsonaro tells Brazil to 'stop whining' about virus despite world's second highest death toll
President Jair Bolsonaro has told Brazil to stop "whining" about coronavirus and move on from the disease. Brazil currently has the second highest COVID-19 death toll in the world after the US, with more than 261,000 fatalities. On Thursday, it recorded 75,102 new coronavirus cases in a day - the biggest daily rise since July and the second highest on record. But speaking to crowds in Rio de Janeiro on Thursday, Mr Bolsonaro said: "Enough fussing and whining. How much longer will the crying go on?
Covid-19 Vaccine Hesitancy Is Worse In E.U. Than U.S.
Throughout the Covid-19 pandemic, the U.S. has been somewhat of an outlier. With merely 4% of the world’s population, the U.S. accounts for more than 20% of globally reported deaths and nearly 25% of confirmed cases. But in the vaccination race the U.S. is proving to be a formidable competitor, having administered 30% of the world’s vaccine doses; approximately 26.3 doses per 100 people. Among Western industrialized nations only the U.K. has a better vaccination rate. Of those in the U.S. in the 65 and above age group, 59% have received at least one dose, and 69% of those over 75 have gotten at least one dose.
Nearly a third of all Republicans say they ‘definitely won’t’ get vaccinated, citing Trump’s Covid falsities
Nearly one-third of all Republicans are opposed to receiving coronavirus vaccinations, according to a growing number of polls, as reports indicate many Americans rejecting the jab have cited former President Donald Trump’s misinformation about Covid-19. Those who have said they were “definitely not” planning on getting a coronavirus vaccine suggested the global pandemic had been overblown by the media and the Democratic Party in interviews with the Washington Post for a report published on Monday. The comments largely reflected the former president’s misleading statements and outright falsities about the novel virus as it swept through the United States last year, at a time when Mr Trump was claiming the virus would disappear and was not a threat to the nation. More than 500,000 Americans have since died as a result of the pandemic.
US officials believe Russia launched a disinformation campaign against the Pfizer COVID-19 vaccine to boost the status of its own: Report
Russian intelligence is sowing disinformation about the Pfizer coronavirus vaccine, the WSJ reported. Four foreign-owned outlets are disseminating info that questions the Pfizer vaccine's efficacy and safety. US intelligence believes this effort to undermine Pfizer is a way to bolster Russia's vaccine.
Science says it's safe, but some in France don't trust AstraZeneca vaccine
According to the most recent data made available by the French health ministry, for the end of February, France was using 24% of its AstraZeneca doses, compared with 82% for vaccines made by Pfizer/BioNTech and 37% for the Moderna shot. That is partly due to logistical bottlenecks, but also because some French people don’t trust the AstraZeneca shot - despite multiple scientific studies that indicate it is safe and effective - according to interviews Reuters conducted with eight people involved in France’s vaccine rollout. They said some of those offered the vaccine were worried about side-effects, sceptical it was effective against new variants of COVID-19, and confused by shifting evidence on how well it works for older people.
New vaccine studies
Intellectual disability, obesity tied to COVID-19 hospitalization, death
The first study, led by researchers from Jefferson Health in Philadelphia and published late last week as a commentary in the New England Journal of Medicine Catalyst, involved analyzing the medical records of 558,672 US COVID-19 patients from January 2019 to November 2020. Patients with intellectual disabilities had higher rates of coronavirus infection than those without those limitations (3.1% vs 0.9%). In unadjusted analysis, compared with the 431,669 patients without intellectual disabilities, the 127,003 patients with intellectual disabilities were more susceptible to hospitalization (63.1% vs. 29.1%), intensive care unit (ICU) admission (14.5% vs. 6.3%), and death (8.2% vs. 3.8%).
COVID SCIENCE-Vaccine response may be weaker in elderly; ...
The COVID-19 vaccine from Pfizer Inc and German partner BioNTech SE induces weaker immune responses in elderly people compared to younger and middle-aged adults, new data suggest. Researchers studied 91 vaccine recipients under the age of 60 and 85 recipients over age 80. Seventeen days after the second of two doses, nearly one-third (31%) of the elderly recipients did not have any antibodies capable of neutralizing the virus. This was true for only 2% of the younger group, the researchers reported on Friday on medRxiv ahead of peer review. Even among those under age 60, only 16% had neutralizing antibodies after the first dose, the researchers found. "But that doesn't mean that the elderly should expect severe complications if they get infected," said coauthor Ortwin Adams of University Hospital Dusseldorf in Germany.
Pfizer/BioNTech COVID-19 vaccine neutralizes Brazil variant in lab study
The COVID-19 vaccine from Pfizer Inc and BioNTech SE was able to neutralize a new variant of the coronavirus spreading rapidly in Brazil, according to a laboratory study published in the New England Journal of Medicine on Monday. Blood taken from people who had been given the vaccine neutralized an engineered version of the virus that contained the same mutations carried on the spike portion of the highly contagious P.1 variant first identified in Brazil, the study conducted by scientists from the companies and the University of Texas Medical Branch found
EU regulator urges caution on Sputnik COVID-19 vaccine
A senior European Medicines Agency (EMA) official urged European Union members on Sunday to refrain from granting national approvals for Russian COVID-19 vaccine Sputnik V while the agency reviews its safety and effectiveness. "We need documents that we can review. We also don't at the moment have data...about vaccinated people. It is unknown. That's why I would urgently advise against giving a national emergency authorisation," EMA managing board head Christa Wirthumer-Hoche told a talk show on Austrian broadcaster ORF. "We can have Sputnik V on the market here in future when the appropriate data have been reviewed. The rolling review has begun now at EMA," she added after the agency said last week it had launched such a review.
New lockdown
East Timor imposes first coronavirus lockdown over outbreak fears
The tiny Southeast Asian nation of East Timor will put its capital city on a coronavirus lockdown for the first time, its government said on Monday, amid fears it could be facing its first local outbreak. A "sanitary fence and mandatory confinement" will be imposed in Dili for seven days from midnight Monday with residents asked to stay home unless necessary to leave, the country's council of ministers said in statement. It said the measure was because of a "high probability of community transmission", but did not elaborate. "It is forbidden to travel, by land, sea or air, out of this municipality, except in duly justified cases for reasons of safety, public health, humanitarian or other that are necessary for the accomplishment of the public interest," it said.