Governments in predominantly wealthy countries are negotiating to buy nearly 8.8bn doses of prospective Covid-19 vaccines in a “frenzy of deals” that could mean many poor countries would not get access to immunisation until at least 2024, a report says.
None of the 320-plus potential vaccines in development have been approved for use, but countries have already struck advance purchasing agreements for 3.73bn doses of the most promising candidates, with negotiations underway for another 5m doses, the study by Duke University’s global health innovation centre calculated.
However, manufacturers will only be able to produce so much of the successful candidates, with researchers estimating it could take three to four years to supply enough vaccine to immunise the global population. That means many wealthy countries may be able to vaccinate their entire populations several times over before most people in low-income countries are immunised, the report said.
“Countries are acting in their own interests, which makes senses,” said Andrea Taylor, an assistant director at the Duke centre. “The problem it leads to is a pattern of behaviour globally where we are limited in the number of doses we can produce in the first year or two … And so many are getting taken off the market and snatched up and reserved for high-income countries, leaving potentially very little for low- and middle-income countries.”
The World Health Organization has overseen the creation of a scheme called Covax in which signatory countries can access an equal share of successful vaccine candidates – first for healthcare and security workers and eventually for a minimum of 20% of their populations.
But many wealthy countries had invested in the Covax facility and struck their own deals directly with pharmaceutical companies, Taylor said, cutting down on the pool of doses that would be equitably distributed. “They’re giving with one hand and taking with the other,” Taylor said.
Ethiopia, for example, will receive enough doses of successful vaccines to cover 20% of its population under Covax, but has not struck any other side deals, meaning most of its citizens could go unvaccinated for years after British residents have been immunised.
Another issue facing poorer countries is that some lack cold-chain supply infrastructure and so will be unable to access vaccine candidates that require storage in freezing temperatures, or others that need to be stored in high heat.
The first hundreds of millions of doses of a Johnson & Johnson candidate that can be stored for several months at normal fridge temperatures – easing its rollout in poorer countries – have already been purchased in large numbers by the US, UK, EU and Canada, the report said.
The study confirmed that Covax has purchased enough vaccine so far to immunise about 250 million people – well short of the 1.14 billion people it has pledged to cover.
The once widely controversial issue of marijuana legalization has been decidedly eclipsed by this year’s divisive presidential race, though voters in five states are being asked to weigh in on legalization. Recreational or medical use, or both, are on the ballot in Arizona, Mississippi, Montana, New Jersey, and South Dakota.
This year’s elections have marijuana legalization likely pushing into additional U.S. states that could grow the industry’s size by $9 billion, according to cannabis market firm New Frontier Data.
Arizona — Proposition 207
Voters who say “yes” to Proposition 207 in Arizona will support legalized recreational marijuana use for those 21 and older, along with a 16% excise tax on the drug. Voters who say “no” to the measure will support keeping the state as one that permits medical use, yet outlaws recreational use and possession.
Mississippi — Ballot Measure 1, Initiative 65 & Initiative 65A
Mississippi voters this election are being asked to weigh in on medical marijuana legalization options. Recreational use remains illegal in the state and is not up for consideration. As a first step, under Ballot Measure 1, voters must decide to either support or outlaw medical use.
Initiative 65 and Initiative 65A are additional issues voters are being asked to weigh in on, should Ballot Measure 1 pass. A “yes” vote for Initiative 65 would limit medical use for treatment of specific medical conditions, as well as cap quantities that patients could possess at 2.5 ounces, whereas 65A would permit broad medical use and possession, without limitations.
Montana — I-190
Adult recreational use is on Montana’s ballot under the Marijuana Legalization Initiative, or I-190. A “yes” vote to the measure would legalize recreational purchase and use for those 21 and older. Possession of the drug would be capped at 1 ounce, or less than 8 grams of concentrate.
New Jersey — Question 1
Adult recreational use is also on the ballot in New Jersey after efforts to legalize recreational use failed in the state legislature. Voters who cast a “yes” vote to Question 1 will support amending the state’s constitution to permit those who are 21 and older to use and possess marijuana, as well as to permit marijuana to be cultivated, processed, and sold in New Jersey.
South Dakota — Constitutional Amendment A & Measure 26
Voters in South Dakota will consider both recreational and medical marijuana use. Those who vote in favor of Constitutional Amendment A will support amending the state’s constitution to legalize recreational use, as well as possession and distribution of up to one ounce of the drug, for those 21 years old and older.
The measure, if adopted, would also require the state legislature to draft and pass new laws to establish a state medical marijuana program by no later than April 1, 2022. Measure 26, separately, would require the state to form a medical marijuana program for limited use and possession for people afflicted with a debilitating medical condition.
The American Academy of Pediatrics announced late Monday that the number of children contractinghas soared to unprecedented levels, with nearly 200,000 new cases in the month of October. In just one week late last month, 61,000 new cases were reported in kids – more than any other week during the pandemic.
In terms of overall cases, 18 states have broken daily records for new infections in the past week, and hospitalizations are up in 43 states. Since the start of the pandemic, over 9.2 million cases have been confirmed in the U.S. and more than 231,000 Americans have died due to the virus, according to a tally from Johns Hopkins University.
The pandemic has led to an election season unlike any other before it in the United States. In the lead up to Election Day, record numbers of Americans have cast their ballots early, as the nation continues to.
The CDC says voters who are sick or quarantined can still go to the polls on Election Day, as long as they take proper precautions like wearing a mask.
Contributing: Adriana Diaz and The Associated Press
October was a month of grim records in the Covid-19 pandemic, and as November begins, experts say the US hasn’t seen the worst of it yet.
From Alaska to Maine, at least 31 states across the US reported at least one record-high day of new coronavirus cases in the past month, according to data from Johns Hopkins University. And 15 reported their highest one-day tallies of Covid-19 deaths.
The country’s seven-day average of new daily cases was 78,380 Saturday — a number that has risen 128.2% since a post-summer-surge low on September 12. With any potential vaccine still a ways off from possible distribution, and the colder months threatening to increase spread, experts emphasize more people need to regularly take precautions to stem the rise anytime soon.
“It’s the way we protect our neighbors and our communities. And we need to avoid crowds. We have to socially distance. You can’t go to a mass gathering now. We need to lower our viral footprint,” Dr. Jonathan Reiner, professor of medicine at George Washington University, told CNN on Saturday.
October was unprecedented for several recorded metrics associated with the pandemic.
Of the country’s seven highest daily tallies of new cases, six were in October. The highest — 99,321 recorded on Friday — was the most recorded in one day for any one nation so far.
The number of US Covid-19 patients in hospitals on Saturday, October’s last day, was 47,374 — 65.6% higher than it was on September 20, when it was at a low following the summer surge.
And Reiner said there is no sign that the number of daily cases will drop soon.
“We won’t peak until we change our behaviors. And our behaviors that principally need to change are our lack of masking all over the country,” he said.
The country has recorded more than 9.1 million infections and 230,548 deaths during the pandemic, according to JHU.
A spike in deaths could come, experts say
Hospitals could become overwhelmed as the number of coronavirus cases continues to climb, Dr. Christopher Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation (IHME), told CNN’s Anderson Cooper on Friday.
In El Paso, Texas, where hospitals are struggling to keep up with the number of Covid-19 patients, officials are preparing to add a third mobile morgue unit in anticipation of a spike in deaths.
“If that doesn’t put our situation into perspective I don’t know what will,” County Judge Ricardo Samaniego wrote on Facebook.
The number of hospitalizations is the best measure of how the nation is faring in the coronavirus pandemic, Murray said.
“They are a leading indicator ahead of deaths,” he said.
Murray and his colleagues at IHME
The dreaded fall and winter COVID-19 wave has arrived and with a vengeance. Much of the nation is experiencing a viral load of infections unlike those previously seen since the start of the pandemic.
Any one metric by itself doesn’t fully relay the significance of the threat, but coupling it with multiple metrics, like the number of daily new cases, percent positivity rate, infection rate, hospitalization rate and deaths, provide a more complete burden of the illness.
There are 50 epidemics playing out in the United States, each state with its own trajectory and prognosis. Only two states, Maine and Vermont, are trending in the right direction, having control on their epidemic, the remaining 48 states are all trending in the wrong direction.
To curb the spread of COVID-19, these are five measures that must be taken to prevent further amplification of cases, illnesses, hospitalizations and death.
1. Mandate face masks
The verdict is in, masks work. In a study published in Health Affairs, mask mandates in 15 states and the District of Columbia led to a slower daily COVID-19 growth rate that was seen over time.
Currently across the nation, 49% of Americans wear a mask in public, with only some states mandating wearing a face covering. If we increase this to 95%, we could save 129,000 lives, the study said.
2. Better risk communication on preventative measures
Communication can make or break any medical response. Countries, like those in Asia, that have been able to curtail the spread of COVID-19 have showcased effective risk communication with the general public — that is — telling the public in layman’s terms the good, the bad, the ugly and what we don’t know yet.
MORE: Massachusetts’ COVID-19 response was science-based, so why are cases rising?
Even more important is saying it with one voice, not mixed messages that erodes trust. During a time when many Americans are experiencing pandemic fatigue, are confused about the evolving science of COVID-19 and want to resume pre-pandemic activities, providing coherent, consistent and reliable guidance has never been more important.
Reliable guidance includes communicating what constitutes low-risk activities (outdoor events) versus high-risk activities (indoors, confined space and poor ventilation), as well as reminding people to stay home when sick, and continue physical distancing and hand-washing.
3. Surveillance at the local level
Early in this pandemic, the nation was blinded by the number of COVID-19 cases that were brewing in our communities. Fast forward 10 months, and we’ve learned a lot about this disease and the various indicators that can help track and trace where the virus is spreading.
As the number of daily new coronavirus cases in the U.S. reached a record high of 91,295 on Thursday, a handful of states have each reported a decline in new infections over the latest two-week period.
The five states listed below have each seen a decrease in the average number of daily new cases over a 14-day period from October 16 to 29, according to data compiled by Johns Hopkins University (JHU).
Daily case counts below reflect a seven-day moving average of daily new infections reported from October 16 to 29.
- Day 1 (October 16): 2,040.34
- Day 14 (October 29): 1,477.75
- Highest daily case count in 14-day period: 2,213 on October 17
- Lowest daily case count in 14-day period: 1,477.75 on October 29
While the average daily case tally in Missouri statistically dropped in the recent two-week period, the figure has been increasing throughout the outbreak since mid-March, according to JHU.
- Day 1 (October 16): 1,127
- Day 14 (October 29): 864.25
- Highest daily case count in 14-day period: 1,348 on October 22
- Lowest daily case count in 14-day period: 864.25 on October 29
While the average number of daily new cases in Oklahoma statistically declined in the latest two-week period, the average count has been rising sharply since early June, after flattening out from mid-March, according to JHU.
- Day 1 (October 16): 551.86
- Day 14 (October 29): 498.75
- Highest daily case count in 14-day period: 615.71 on October 24
- Lowest daily case count in 14-day period: 494.50 on October 27
The average number of daily new cases in Louisiana statistically declined in the latest two-week period. However, the count has been flattening out from late August, after decreasing since late July, when it peaked at 2,267 on July 23, according to JHU.
- Day 1 (October 16): 79.14
- Day 14 (October 29): 59.75
- Highest daily case count in 14-day period: 91.57 on October 22 and 23
- Lowest daily case count in 14-day period: 59.75 on October 29
The average number of daily new cases in Hawaii were reported to be on a downward trend in the latest 14-day period. The average count has been decreasing since late August when it peaked at 255 on August 26. The figure remained flat from mid-March to mid-July, before it rose sharply, according to JHU.
- Day 1 (October 16): 129.57
- Day 14 (October 29): 148
- Highest daily case count in 14-day period: 148 on October 29
- Lowest daily case count in 14-day period: 124 on October 22
The average daily case tally in Delaware reported a statistical decline in the latest 14-day period. However, average daily new cases
Pressure to create a coronavirus vaccine is increasing by the day, but for a safe vaccine to enter the market, it takes time.
At least five states – California, Nevada, New York, Oregon and Washington – and a Black medical group say they’ll conduct independent verification of any COVID-19 vaccines approved by Food and Drug Administration.
These review panels, which began popping up last month, are meant to instill public confidence and counter the political pall cast over COVID-19 vaccine development and approval. In recent weeks, faith has improved in the FDA’s commitment to base COVID-19 vaccines decisions in science, but the growing number of oversight groups seek to add another layer of trust.
And while some worry the independent review boards may hurt the effort, all agree establishing that trust is vitally important. A survey this month found only 58% of Americans said they would get vaccinated as soon as a vaccine became available.
“We would like to give Washingtonians the highest confidence that when a COVID-19 vaccine is available that it’s safe and works,” Washington Gov. Jay Inslee said of the pact.
The first push for oversight outside the FDA came Sept. 21, when the National Medical Association announced it would create an expert task force to review any decisions about COVID-19 vaccines and treatments. The association of Black physicians was founded in 1895 at a time when racism in medical groups excluded Black doctors.
“Questions of political influence on scientific process because of Operation Warp Speed (OWS), have threatened the public trust in the FDA that will adversely affect participation in clinical trials, especially in the African-American community,” the association said in its announcement.
The first state to launch an oversight group was New York, on Sept. 24. At the time there was significant concern in the scientific community the FDA was being pressured by the Trump Administration to approve a vaccine quickly in order to have it available by the presidential election.
It was an expectation President Trump has expressed in tweets, news conferences and during campaign rallies.
“The White House’s dispute with the FDA raises serious questions about whether or not the vaccine has become politicized,” New York Gov. Andrew Cuomo said on Sept. 24.
“Frankly, I’m not going to trust the federal government’s opinion and I wouldn’t recommend to New Yorkers based on the federal government’s opinion. We’re going to put together our own review committee headed by the Department of Health to review the vaccine.”
The climate around vaccines began to shift on Sept. 8, when vaccine developers issued a public letter vowing to keep politics out of science. Soon after, and defying White House pressure, the FDA stood firm in requiring at least two months of safety data before a vaccine could be considered for release.
Still, last week, California Gov. Gavin Newsom announced the state would create an independent 11-member Scientific Safety Review Workgroup to study the safety of COVID-19 vaccines as an added safeguard to any efforts
States say they lack federal funds to distribute coronavirus vaccines as CDC tells them to be ready by Nov. 15
State officials have been planning in earnest in recent weeks to get shots into arms even though no one knows which vaccine will be authorized by the Food and Drug Administration, what special storage and handling may be required and how many doses each state will receive.
Despite those uncertainties, the Centers for Disease Control and Prevention is asking states to be prepared to “preposition” doses in key locations throughout the country. Officials want to move quickly once the FDA authorizes a vaccine and a CDC advisory panel issues recommendations on which populations should be vaccinated, according to a letter the CDC sent Monday to state preparedness and immunization officials.
As part of that effort, the CDC is asking states to provide by Tuesday critical information, including a list of each jurisdiction’s top five sites capable of receiving and administering a vaccine that must be stored at ultracold temperatures of minus-70 Celsius (minus-94 Fahrenheit). The letter refers to the vaccine only as Vaccine A, but industry and health officials have identified it as Pfizer’s candidate.
Pfizer chief executive Albert Bourla said Tuesday that “hundreds of thousands” of doses had already been produced and that a first look at the data would occur soon. Pfizer will not apply for any authorization of its vaccine sooner than the third week of November, when it will have sufficient safety data.
“We acknowledge that you are being asked to do unprecedented work,” wrote Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, which is leading the CDC’s role in vaccine distribution. She added: “This is a new planning ask.”
State officials say they have been trying to raise the issue with federal officials but have received little response.
“It is absolutely ridiculous that the administration, after spending $10 billion for a Warp Speed effort to develop a vaccine, has no interest in a similar investment in a Warp Speed campaign to get the vaccine to every American as quickly as possible after it is approved,” said Michael Fraser, executive director of the Association of State and Territorial Health Officials.
Operation Warp Speed is the federal initiative, funded by more than $10 billion of taxpayer money, to fast-track development of coronavirus countermeasures.
“The now accelerated timeline underscores the need to address the issue of funding for state and territorial health agencies to make this all work,” Fraser said. “There are many other costs that have no clear way to be paid for at this point.”
Local officials still need to recruit thousands of people to staff vaccine clinics and enroll and train providers. They also have to ramp up information technology and data systems to track vaccine inventory and ordering to ensure people get the correct doses at the right times — most vaccines will require two shots — and to monitor for adverse events. They will need to develop locally tailored vaccination communications campaigns, too.
“States have received some funding, but it’s not nearly enough” to support the scale, scope and
Nearly 44.5 million coronavirus cases have been reported world-wide, and the global death toll is approaching 1.2 million.
India: Total coronavirus cases in India surpassed eight million as the country reported 49,881 new cases. India has the second highest number of infections in the world behind the U.S., according to data compiled by Johns Hopkins University. The country’s death toll rose by 517 to 120,527.
China: Health authorities on Thursday reported 23 locally transmitted cases for the previous day, all in Kashgar, a city in the far-western Xinjiang region. Since last Sunday, the Kashgar government has tested 4.7 million of its residents and reported more than 100 local cases, most of which are tied to a local garment factory, according to local officials.
Australia: A day after lifting its strict lockdown, Australia’s Victoria state recorded three new coronavirus cases. New South Wales, home to Sydney, added four new locally acquired cases and a school closed after a student tested positive. New South Wales Premier Gladys Berejiklian said she wanted to see the southern state’s contact-tracing system tested before she would consider reopening the state border. She said she received economic advice that it would be more prudent to reopen to all of Australia, New Zealand and possibly other overseas places than Victoria until the risk of another outbreak there was proven to be low.
Guam: The U.S. territory reported 48 new cases, bringing the total to 4,466. The number of hospitalized patients rose to 88, as the hospitals on the island start to reach capacity. Guam’s governor on Wednesday extended a public health emergency until Nov. 29 and a partial lockdown remains in place.
Japan: New cases topped 700 for the third time in the past seven days, as Japan reported 731 new infections. The country’s death toll stands at 1,733, including three fatalities logged Thursday.
South Korea: South Korea added 125 more cases, with many linked to clusters at nursing homes and other medical facilities. Health officials have shut down Seoul night clubs for the Halloween weekend and warned there could be more upticks as South Koreans travel during the fall.
Coronavirus US: More than 40 states are reporting an increase in Covid-19 cases and many in the Midwest are seeing record hospitalizations
When it comes to the climbing metric, the US is “not in a good place,” director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci said during a virtual Q&A on Wednesday. Health experts have pushed measures against the virus to bring the baseline of infections down before colder months drove them back up. But rising records of cases and hospitalizations are making up “a bad recipe for a tough time ahead,” Fauci said.
In the Midwest, residents are being impacted by the rising cases with spiking rates of hospitalizations.
Indiana and Wisconsin reported their peak levels of coronavirus hospitalizations. And Kansas saw the most ICU hospitalizations of the virus in one day, the same day the state surpassed 1,000 deaths since the pandemic began.
“Each one of these Kansans was someone’s child, parent, or grandparent,” Gov. Laura Kelly said in a release. “They were part of a community.”
Mask mandates lower hospitalizations, study says
Mask mandates may be a key strategy to lowering rates of hospitalization, according to the findings of a study from Vanderbilt School of Medicine.
In hospitals where more than 75% of the patients came from counties that required masks, rates of hospitalizations did not rise between July and October, while hospitals with fewer than 25% of patients from those counties saw an increase over 200%.
Other mitigation factors likely came into play, as areas with mask requirements are more likely to have residents who follow other mitigation strategies, the authors wrote.
“The good news is that we have learned a great deal since the beginning of the pandemic,” they said. “An important takeaway from this analysis is that areas with virus mitigation strategies … have seen lower growth in hospitalizations since the summer months; hospitals in these areas are in a much better position to serve the entire spectrum of community health needs, not just COVID-19 patients.”
As the weather continues to grow colder, Fauci said in an interview with CNBC Wednesday that he supports a national mask mandate.
“We’re going to have many more hospitalizations and that will inevitably lead to more deaths. So, this is an untenable situation. That’s the reason why I say we have got to do these things,” Fauci said.
While he is in support of a mask mandate, Fauci said he doesn’t think it will happen nationally “because it might not come from the White House to do it.”
States concerned over alarming hospitalization rates
Many state leaders are putting measures