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What does victory against the COVID-19 pandemic look like? USA TODAY’s vaccine panel weighs in

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For the past year, people have pinned their hopes on vaccines to end the COVID-19 pandemic.

Each month since June, USA TODAY has asked a panel of more than a dozen experts in medicine, virology, immunology and logistics to estimate on an imagined clock when a COVID-19 vaccine would be available to most Americans.

This month, with three authorized vaccines and seemingly enough supply coming, they say it’s only 45 minutes from high noon, when shots will be widely accessible. The momentum follows a sputtering start to the vaccine rollout that stalled the clock at the start of the year. February’s time was 10:45 a.m. 

But the closer we get to the long-awaited goal, the less it seems as if it will mark the end of the pandemic that has disrupted lives and loves for a full year.

So we asked our panelists: When can we declare victory?

Their definitions of an endpoint differed, from a level of outbreak no worse than the flu to no new cases at all.

To Pamela Bjorkman it’s the smallpox scenario – a wiping out of the virus. A structural biologist at the California Institute of Technology, she sees victory as coming when everyone in the world is vaccinated and there are no more cases. 

Others see it more as bringing COVID-19 in line with other diseases humans have learned to coexist with.  

For Dr. Monica Gandhi,an infectious disease expert at the University of California-San Francisco, the pandemic will be over when deaths from COVID-19 falls to levels typically seen with the seasonal flu. 

“There are more than 30,000 deaths a year of influenza in the United States, so bringing COVID-19 mortality down to less than 100 deaths a day would be equivalent to rendering it similar to influenza-related mortality,” she said.

We’re nowhere near that. About 1,900 Americans a day are dying from COVID-19.

It may not be possible to say things have really shifted until next winter, when COVID-19, and all coronaviruses, tend to peak.

“We can declare victory over this pandemic in the U.S. if the virus causes only a negligible bump in cases next winter,” said Dr. Paul Offit, a pediatrician and head of the Vaccine Education Center at Children’s Hospital of Philadelphia.

To get there, Peter Pitts, president and co-founder of the Center for Medicine in the Public Interest, wants Americans to think of being vaccinated as a patriotic duty. To win the war against the virus, the country must get to a national vaccination rate of at least 65% and likely closer to 85%.

“I see herd immunity happening at some point between Memorial Day and the Fourth of July,” Pitts said. “All the more reason to come together as a nation, and roll up our sleeves so we can celebrate with barbecues and fireworks.”

Reaching herd immunity will require kids to be vaccinated, too, noted Vivian Riefberg, professor of practice at the Darden School of Business at the University of Virginia. At this point, with studies still underway, adolescents might be eligible for vaccination sometime in the spring or early summer, and younger children this fall or even later. 

The pandemic’s unofficial end could also come when we’re still having flare-ups of COVID-19 but they’re small enough to handle, said Prakash Nagarkatti, an immunologist and vice president for research at the University of South Carolina in Columbia.

“There will be small fires in the form of sporadic cases of COVID-19 even after administering the vaccine to the majority of the population, but it will be easier to put out such fires,” he said.

There’s also the ravaging of the economy to keep in mind, notes Arti Rai, a health law expert at Duke University Law School.

“One very important indication will be data on job growth,” she said. “Once we reach, or surpass, pre-pandemic levels, we should be able to breathe a sigh of relief.”

We also need manufacturing and distribution readiness to deal with smaller outbreaks, said Prashant Yadav, a medical supply chain expert at the Center for Global Development.

“Having sufficient vaccines and therapeutic supply to meet demand and also a sufficient stockpile of reserves of vaccines and therapeutics” is crucial, he said.

As the country reopens, vigilance will be necessary said Dr. William Schaffner, an infectious disease expert at the Vanderbilt University School of Medicine in Nashville, Tennessee.

“As we gradually open schools, restaurants, sporting events, we will need to be alert to whether these activities result in superspreader events.  If not, that will be very reassuring,” he said.

All of this presumes the Biden administration delivers on its promise last week that there will be enough vaccines to vaccinate every American adult by May.

Overall, the panelists agree that 500 million doses (200 million each of Pfizer and Moderna, 100 million from Johnson & Johnson) will be ready in time. On Wednesday the Biden administration announced the purchase of 100 million more doses of the Johnson & Johnson vaccine, though a date for delivery hasn’t been set.

If the administration can’t meet its goal, it won’t be for lack of trying, Rai said. She cited what she called the administration’s “creative” use of the tools at its disposal to push the technology transfer necessary to scale up production. 

“The latest example is the administration’s use of funding and the Defense Production Act to engineer a partnership between Johnson & Johnson and Merck that will retool Merck’s facilities to help manufacture the J&J vaccine,” she said.

Getting everyone vaccinated may take longer. And convincing those who aren’t certain they want the vaccine is another hurdle. 

“I remain concerned that getting from 50%-60% coverage among adults (those who want the vaccine) to 80%-90% (what we need to control the pandemic) will be very challenging,” said Daniel Salmon, director of the Institute for Vaccine Safety at Johns Hopkins Bloomberg School of Public Health.

Scientists and researchers in the biopharma industry have made incredible progress in delivering the scientific solutions needed to end the pandemic, said Dr. Michelle McMurry-Heath, president and CEO of the Biotechnology Innovation Organization, a trade group.

“However, hurdles still exist, as the president is well aware,” she said. “We must continue to work together, follow the science, and get as many shots in arms as possible.”

How we did it

USA TODAY asked scientists, researchers and other experts how far they believe vaccine development has progressed since Jan. 1, 2020, when the virus was first recognized. Fifteen responded. We aggregated their responses and calculated the median, the midway point among them.

This month’s panelists 

Pamela Bjorkman, structural biologist at the California Institute of Technology

Dr. Monica Gandhi, an infectious disease expert at the University of California-San Francisco

Sam Halabi, professor of law, University of Missouri; scholar at the O’Neill Institute for National and Global Health Law at Georgetown University 

Dr. Michelle McMurry-Heath, president and CEO of Biotechnology Innovation Organization (BIO)

Dr. Kelly Moore, deputy director of the nonprofit Immunization Action Coalition; former member of the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices

Prakash Nagarkatti, immunologist and vice president for research, University of South Carolina 

Dr. Paul Offit, director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia and a professor of Vaccinology at the Perelman School of Medicine at the University of Pennsylvania

Peter Pitts, president and co-founder of the Center for Medicine in the Public Interest, and a former FDA associate commissioner for external relations

Dr. Gregory Poland, director, Mayo Clinic’s Vaccine Research Group, and editor-in-chief, Vaccine

Arti Rai, law professor and health law expert at Duke University Law School

Vivian Riefberg, professor of practice at the Darden School of Business at the University of Virginia and a board member of Johns Hopkins Medicine, PBS, and Signify Health, a health care platform company working to transform how care is paid for and delivered at home. 

Daniel Salmon, director of the Institute for Vaccine Safety at Johns Hopkins Bloomberg School of Public Health.

Dr. William Schaffner, a professor and infectious disease expert at the Vanderbilt University School of Medicine in Nashville, Tennessee.

Prashant Yadav, senior fellow, Center for Global Development, medical supply chain expert

Dr. Otto Yang, professor of medicine and associate chief of infectious disease at the David Geffen School of Medicine at UCLA.

Contact Weintraub at [email protected] and Weise at [email protected]

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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What’s the tallest building in your state? Here’s the list

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No $15 minimum wage, stimulus checks for people making over $80k: What was left out of Joe Biden’s COVID-19 relief bill

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The $1.9 trillion COVID stimulus bill, known as President Joe Biden’s American Rescue Plan, that the House approved Wednesday has been derided by congressional Republicans as a “liberal wish list” that spends money in areas that have no relation to the pandemic.

While Democrats got most of what they wanted, they didn’t get everything.

Several provisions the Democratically controlled House passed last month were dropped from the bill the Senate approved Saturday. That Senate version passed the House Wednesday without further changes and now goes to Biden to sign. 

So what’s not in it that Democrats pushed for?

No $15 minimum wage. Fewer Americans eligible for direct payments. Smaller unemployment benefits. And the elimination of two key transportation projects.

Here’s a closer look at some of the changes to the American Rescue Plan:

The minimum wage will not increase to $15

Liberals in Congress have sought for years to raise the federal hourly minimum wage from $7.25 to $15. President Joe Biden’s American Rescue Plan was seen as the best chance to include a $15 hike because the $1.9 trillion COVID relief package was being considered under Senate rules that bypass the filibuster and, therefore, do not require any Republican support.

They’ll have to wait longer.

The Senate Parliamentarian determined the wage hike did not qualify under those rules to be included in the package so it was taken out. Sen. Bernie Sanders, I-Vt., has vowed to introduce the $15 measure as a stand-alone bill but it’s very unlikely to pass because it would need 60 votes – which would mean getting the support of at least 10 Republicans – in the Senate to overcome an expected GOP filibuster.

Not everyone who received a stimulus check last time will get one

The earlier two rounds of direct payments went to Americans whose income was as high as $99,000. Not this time.

Individuals who make up to $75,000 still will get the maximum payment – in this case, $1,400. But the phase-out ends at $80,000 leaving millions who got some money twice before without any this time. Same joint filers will still get $2,800 if their combined income is $150,000 or less but not if it’s between $160,000 and the previous ceiling of $198,000.

The change was pushed by moderates and agreed to by Biden as a way of limiting the cost of the overall bill.

Enhanced unemployment benefits not as generous as House had wanted

The bill the House initially passed in February called for $400 in weekly employment benefits above what states already offer. But the Senate, following lengthy negotiations, settled on a $300-per week figure Democrats in the House agreed to accept.

One minor concession: the benefit will last through Sept. 6, compared to the House version that would have expired at the end of August.

Some high-profile projects won’t be getting money

Few provisions of the relief package drew as much scorn from Republicans than two transportation projects in the bill – one each from the home states of the Democratic leaders in both chambers.

The bill included $141 million to fund expansion of the BART, a subway system serving the San Francisco Bay Area, where House Speaker Nancy Pelosi serves. Another $1.5 million for a bridge between part of upstate New York and Canada was also scrapped. New York is the home state of Senate Majority Leader Chuck Schumer.

Both projects were removed following an outcry from Republicans who used the two projects to paint the bill as a “liberal wish list” that they say has little bearing on helping the country climb out of the pandemic.

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All of the COVID-19 stimulus bills, visualized

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President Joe Biden is expected to sign into law on Friday the $1.9 trillion COVID-19 relief package aimed at sending relief to Americans hurting form the year-long coronavirus pandemic. 

Congress has passed about $4 trillion in spending over the last year to respond to the pandemic and its economic effects. Most of the bills passed with bipartisan support, but Biden’s plan passed along mostly party lines because Republicans opposed the large price tag of the package and provisions they say weren’t related to COVID-19. 

Here’s how to visualize the enormous figures for the different bills to help with the consequences of the pandemic.

Let’s start with $1 million: If we imagine a block of 10,000 $100 bills fits in a large suitcase, then 1,000 of these blocks would give us a billion dollars, the size of a small pool.

Now we can start visualizing the relief bills. The first one rolled out almost one year ago:

Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020

Became law March 6, 2020.

Provided $8.3 billion to fight the spread of COVID-19 in the United States by funding vaccine and testing development.

Families First Coronavirus Response Act

Became law March 18, 2020.

The $225 billion legislation provided COVID-19 testing funds, paid sick leave, and food assistance funding.

CARES Act

Became law March 27, 2020.

The $2.2 trillion bill included $1,200 stimulus checks, enhanced unemployment benefits, created the Paycheck Protection Program small business forgiveness loan program, aid for state and local governments, and aid for corporations.

Paycheck Protection Program and Health Care Enhancement Act

Became law April 24, 2020

At $483 billion, the measure authorized more funding for the Paycheck Protection Program and funding for COVID-19 testing.

Consolidated Appropriations Act, 2021

Signed into law on Dec. 28, 2020.

The $920 billion in total spending (attached to a larger government funding bill) included $600 stimulus checks, renewed the Paycheck Protection Program, provided billions for vaccines, and a renewal of a federal boost to unemployment benefits at $300 per week. 

American Rescue Plan, 2021

The first relief bill from the Biden presidency includes $1.9 trillion in total spending. The package has $1,400 stimulus checks, money for schools to reopen, and billions for vaccine distribution and development. 

The bill will be the second largest COVID-19 package after the CARES Act.

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