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Health experts issue urgent call for change of course as U.S. economy tanks

Health & BeautyJul 31. 2020Coronavirus cases and deaths Photo by: The Washington Post — The Washington Post

By The Washington Post · Carol Morello · NATIONAL, HEALTH, HEALTH-NEWS 

WASHINGTON – Public health experts called for urgent new measures Thursday to halt the spread of the coronavirus amid warnings that the U.S. economy is in a historic and devastating contraction as covid-19 is killing Americans at the rate of about one every minute.

The stock market took a dive after the Commerce Department reported the economy shrank by 9.5% in the second quarter, the biggest recorded decline since the government began keeping track 70 years ago. The government also reported jobless claims climbing again last week by 1.4 million, another sign the recovery is fizzling. GDP shrank at an annual rate of 32.9%, according to the Bureau of Economic Analysis.

The dismal statistics underscored the fragility of any economic recovery, as many states are reversing their attempts to reopen for business and have imposed new restrictions.

At an evening news briefing, President Donald Trump tried to swat away the raft of bad news about the economy and the disease, which he referred to as the “China virus” and compared to a plague.

“It’s China’s fault,” he said flatly.

Trump noted a resurgence of the disease in states that appeared to have vanquished covid-19 early, largely due to draconian restrictions, and suggested the praise was premature.

“Governors that were extremely popular are not so popular anymore,” he said. “They were held up as models to follow, and then they got it.”

But in deflecting any blame for the spread of the virus he once predicted would miraculously vanish in days and now has killed nearly 150,000 Americans, Trump offered several misrepresentations. 

For example, he said children were “immune” to the disease and should return to school this fall. In fact, immunologists have said that while children under the age of 10 are unlikely to transmit the novel coronavirus, children older than 10 can spread it as easily as adults. 

Trump also predicted a rapid economic recovery from the precipitous drop in employment and consumer spending caused by the pandemic.

“I think next year’s going to be an excellent year, maybe one of our best years ever from an economic standpoint,” Trump said.

Jerome Powell, the chair of the Federal Reserve, said any recovery depends on whether Americans are willing to embrace behavior that can beat back the virus.

“The path of the economy is going to depend, to a very high extent, on the course of the virus and on the measures we take to keep it in check,” he said Wednesday. “Social distancing measures and a fast reopening of the economy actually go together. They’re not in competition with each other.”

Trump also used the coronavirus briefing to attack mail-in voting, hours after his Republican allies joined Democrats to rebuff his suggestion to delay the Nov. 3 election. Trump said he wants the election decided quickly, rather than drag on until millions of mail-in ballots are counted and determined to be legitimate.

“I don’t want to see that take place in a week, after Nov. 3, or a month,” he said. “Or frankly, with litigation and everything else that could happen, it could take years. Years. Or you never even know who won the election.”

Trump sounded more muted than combative as the death toll continued to mount and experts warned of the potential of economic collapse.

Nationwide, 1,400 people infected with the coronavirus died Wednesday, the highest number since May. Several states, including Florida and California, reported record highs for deaths in a single day. More than 4.4 million cases have been reported in the United States, and nearly 150,000 people have died, according to the Washington Post count. 

Among the deaths Thursday was well-known businessman turned politician Herman Cain, who sought the Republican nomination for president in 2012. He had attended a June 20 rally for Trump in Tulsa, Okla., where he was photographed maskless in a crowd of others who were also without masks, but it was not determined whether that is where he contracted the virus.

Optimism is in short supply. Even though new infections have leveled off in some of the hardest hit states in the South, they are creeping up elsewhere, threatening to surge. 

The trends prompted administration insiders and public health experts to urge governments to act more aggressively.

Deborah Birx, the coordinator of the White House coronavirus task force, said states and localities should mandate wearing masks in public.

During an appearance on Fox News, Birx said there remains a “very serious pandemic” in Southern states. Despite signs of improvement, she added, the situation is deteriorating elsewhere.

“So now we see the virus, probably because of vacations and other reasons of travel, moving up into Kentucky, Tennessee, southern Ohio, Missouri, Iowa, Kansas, Nebraska,” she said. “And, of course, we continue to have problems across the coast – Washington, Oregon, California, Idaho and Utah, and now increases in Colorado.”

Birx urged people to follow mandatory measures that Trump and many Americans have resisted and called alarmist or infringements on their liberties.

“We believe if the governors and mayors of every locality right now would mandate masks for their communities and [if] every American would wear a mask and socially distance and not congregate in large settings where you can’t socially distance or wear a mask, that we can really get control of this virus and drive down cases as Arizona has done,” Birx said.

The Association of American Medical Colleges issued an ominous warning, along with a “road map” of actions the country must take to avoid calamity. 

“If the nation does not change its course – and soon – deaths in the United States could be well into the multiple hundreds of thousands,” the organization said. 

The Johns Hopkins Center for Health Security released a report Wednesday with 10 recommendations for action and another stark warning. 

“Unlike many countries in the world, the United States is not currently on course to get control of this epidemic. It’s time to reset,” six scholars wrote.

Despite the concerns over the rising death toll and economic impact, at least 17 of 21 states flagged as coronavirus “red zones” are not following all recommendations by the government’s coronavirus task force.

Rep. James Clyburn, D-S.C., the chairman of the House’s Select Subcommittee on the Coronavirus Crisis, which was formed to assess the Trump administration’s response to the pandemic, wrote governors of several red-zone states urging them to heed experts’ advice.

The recent task force report “recommends far stronger public health measures than the Trump Administration has called for in public – including requiring face masks, closing bars, and strictly limiting gatherings,” Clyburn wrote in a letter to Birx and Vice President Mike Pence. “Yet many states do not appear to be following these unpublished recommendations and are instead pursuing policies more consistent with the administration’s contradictory public statements downplaying the seriousness of the threat.”

Ohio Gov. Mike DeWine, a Republican, on Thursday asked the state’s liquor control commission to cut off alcohol sales at 10 p.m. each night. Any alcohol purchased by that hour would have to be consumed by 11.

Wisconsin Gov. Tony Evers, a Democrat, said his residents now must wear masks inside public buildings and businesses. The order “strongly recommends” face coverings in other settings.

Some Republican lawmakers in the state opposed the order, and court challenges to its constitutionality are expected. Elsewhere, some of the restrictions being imposed by local and state authorities are openly flouted.

Senate candidate Tommy Tuberville, R-Ala., is fundraising and holding in-person meetings in Washington this week, defying orders from D.C. Mayor Muriel Bowser, a Democrat, that visitors from Alabama and other coronavirus hot spots quarantine for 14 days upon arrival.

Tuberville spent at least some of his time at the Trump International Hotel, according to a photo posted to Facebook by Rep. Bruce Westerman, R-Ark., showing the two men in the hotel lobby on Tuesday night. Neither man was masked.

Alabama’s coronavirus cases are surging, with more than 25% of its total cases appearing in the past two weeks, according to state data.

Rep. Louie Gohmert, R-Texas, defiantly walked the halls of Congress maskless and was not practicing social distancing before he was told Wednesday that he could not fly with Trump on Air Force One to Texas because he had tested positive for the virus. 

Even then, he returned to the Capitol, ignoring expert advice on how to avoid spreading covid-19 germs, and filmed a video questioning the effectiveness of masks. He suggested that he may have caught the disease from a mask. 

Gohmert’s mask skepticism spurred House Speaker Nancy Pelosi, D-Calif., to order all lawmakers to wear a mask while appearing on the chamber floor.

And earlier this week, the White House confirmed that national security adviser Robert C. O’Brien had tested positive for the coronavirus and was working from home after experiencing mild symptoms of the disease. In mid-July, O’Brien was in Paris, where he was photographed with his counterparts in meetings in which they sat around a table close to one another without wearing masks. It was not clear when he was first infected.

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Britain signs another deal to secure covid-19 vaccine supplies

Health & BeautyJul 30. 2020A scientist works with stem cells inside a stem cell research laboratory at the GlaxoSmithKline Research and Development Center in Stevenage, U.K., on Tuesday, Nov. 26, 2019. MUST CREDIT: Bloomberg photo by Simon Dawson.

By Syndication Washington Post, Bloomberg · James Paton, Suzi Ring · WORLD, HEALTH, EUROPE 

Britain is snapping up supplies of future coronavirus vaccines, rushing ahead of other countries in a bid to end the pandemic.

The government signed a deal with partners GlaxoSmithKline and Sanofi to secure as many as 60 million doses of their experimental shot. The agreement on Wednesday highlights the aggressive steps the U.K. government is taking to obtain inoculations for its population of 66 million people. Britain has now secured the highest number of doses per capita, putting the country ahead of the U.S., according to London-based analytics firm Airfinity.

Desperate for a way out of the crisis as the death toll mounts, governments are pursuing vaccines before anyone knows whether they will work. The Glaxo-Sanofi pact follows the U.K. government’s move last week to buy 90 million doses of potential vaccines from a partnership of Pfizer and BioNTech SE as well as from Valneva SE. The University of Oxford’s partner, AstraZeneca, intends to make as many as 30 million doses available to the U.K. by September as part of a pact to deliver 100 million doses.

That amounts to at least 250 million doses of different vaccines. Countries may need large quantities because it’s not clear how many shots under development will get across the line, and some may require repeated jabs to be effective.

“Spreading the risk is a sensible strategy,” said Graham Cookson, chief executive of the Office of Health Economics, a research firm. “However, it’s vital that countries and companies collaborate to ensure global access for all.”

As the U.K., the U.S. and other wealthy nations rush to arrange supply agreements with vaccine makers, health advocates worry that the rest of the world will be left behind. Pfizer and BioNTech last week reached a roughly $2 billion deal to supply their coronavirus vaccine to the U.S.

Sanofi and Glaxo plan to provide a significant portion of worldwide capacity in 2021 and 2022 to a global initiative that’s focused on accelerating development and production and deploying shots equitably.

While some companies have said they plan to profit on their covid-19 vaccines, others such as AstraZeneca and Glaxo have pledged not to during the pandemic. Glaxo CEO Emma Walmsley said the company would rely on the World Health Organization’s guidance on when the pandemic has ended and plans to invest any short-term returns back into planning for future emergencies and donations to developing nations.

“We’ve been very clear we don’t expect to profit from these vaccine partnerships during the pandemic,” Walmsley said on a call with reporters.

The companies are also in talks to sell the vaccine to the U.S., the European Union and global organizations, Sanofi said. Sanofi and Glaxo had been discussing such a deal with the U.K., valued at about $646 million (500 million pounds), a person familiar with the matter said earlier this month.

Sanofi is in late-stage talks with the U.S. and the EU, and announcements could come soon, CEO Paul Hudson told investors.

Glaxo and Sanofi, two of the world’s biggest vaccine makers, are following developers including Oxford, Moderna Inc. and Pfizer in a sprint to deliver a shot to help defeat a pathogen that’s killed more than 650,000 people.

Sanofi, based in Paris, and Glaxo, the British pharma giant, still see an opportunity to make a significant impact. The French company is targeting approval in the first half of 2021.

Sanofi on Wednesday raised its profit outlook for the year as some of its key drugs offset covid-19 disruption, while Glaxo said its 2020 earnings forecast is at risk if routine vaccination rates fail to recover after lockdowns. Sanofi’s stock rose less than 1%, while Glaxo fell 1.6%.

For the U.K., the new agreement gives the country about 3.75 doses per capita, compared with about 1.2 for the U.S., though the figures exclude supplies the U.S. is acquiring from Moderna and are likely to change, according to Airfinity. Coverage per capita would be half that given vaccines may require two doses.

“This diversity of vaccine types is important because we do not yet know which, if any, of the different types of vaccine will prove to generate a safe and protective response to covid-19,” Kate Bingham, chair of the U.K. government’s vaccines taskforce, said in a statement. “Whilst this agreement is very good news, we mustn’t be complacent or over-optimistic.”

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At the heart of dismal U.S. coronavirus response, a fraught relationship with masks

Health & BeautyJul 29. 2020Matt Serenius helps his daughter Sloane Serenius, 2, put on her mask in Washington last week. MUST CREDIT: Photo by Amanda Andrade-Rhoades for The Washington Post.

By The Washington Post · Griff Witte, Ariana Eunjung Cha, Josh Dawsey · NATIONAL, HEALTH 

Mike DeWine had blazed a trail in March with his forceful response to the coronavirus pandemic, rapidly shutting down his state to protect it from the worst ravages of disease.

A month later, Ohio’s governor made what seemed, by comparison, a modest proposal: If businesses wanted to reopen, customers and employees would have to wear masks.

A man wears a mask around his wrist while walking in Washington last week. He said he didn’t like wearing his mask because he recently had open heart surgery and is still experiencing breathing problems. MUST CREDIT: Photo by Amanda Andrade-Rhoades for The Washington Post.

The backlash came instantly. An avalanche of abuse on social media. Calls from anguished citizens. Angry recriminations and threats. 

The next day, a chastened DeWine backed down. Asking people to wear a mask “is offensive to some of our fellow Ohioans,” the Republican declared somberly. “And I understand that.”

It would be three months – plus tens of thousands of cases and thousands of deaths – before the governor would try again.

The mask is the simplest and among the most effective weapons against the coronavirus in the public health arsenal. Yet from the start, America’s relationship with face coverings has been deeply fraught.

Faulty guidance from health authorities, a cultural aversion to masks and a deeply polarized politics have all contributed. So has a president who resisted role modeling the benefits of face coverings, and who belittled those who did.

The result, experts say, is a country that squandered one of its best opportunities to beat back the coronavirus pandemic this spring and summer. In the process, the United States fell far behind other nations that skipped the fuss over masks, costing lives and jeopardizing the recovery heading into the fall.

“Some countries took out their masks as soon as this happened,” said Monica Gandhi, an infectious-disease specialist from the University of California, San Francisco, “and their rates of death are very low.”

In a coronavirus response that has been full of missteps and unforced errors, delayed acceptance of universal masking, Gandhi said, may be the single biggest mistake the United States has made. 

In interviews, elected leaders, health specialists and mask advocates say it did not have to be that way – and very nearly wasn’t. 

The country hit a tipping point on widespread mask use only this month, with a majority of states and the nation’s largest retailers all mandating them. But the science has long been pointing toward the efficacy of masks – even if the guidance from health authorities wasn’t. 

In February – as the virus silently spread in communities from coast to coast – both the World Health Organization and the Centers for Disease Control and Prevention recommended against face coverings for healthy members of the general public. They urged that masks be preserved for front-line health-care workers, especially amid global shortages of personal protective equipment. It was a line repeated by top officials in the Trump administration.

CDC Director Robert Redfield was asked in February whether healthy people should wear masks. His answer to Congress was unambiguous: “No.” 

Anthony Fauci, the nation’s top infectious-disease expert, repeatedly told Americans “there is no reason” for anyone in the United States to wear a mask. U.S. Surgeon General Jerome Adams tweeted on Feb. 29: “Seriously people- STOP BUYING MASKS!”

The health officials had made their recommendations based on the flawed assumption that the bulk of transmission was taking place from people with obvious signs of illness. The thinking was that if people with fevers, coughs and other symptoms were to isolate, case counts would remain under control. 

But it wasn’t long before CDC contact tracers began to find evidence of “silent” spreaders. One report in late March, from a skilled nursing facility in the Seattle area, found 13 asymptomatic or pre-symptomatic patients among 23 residents who tested positive.

Many experts backed the anti-mask guidance, arguing they weren’t sure face coverings would make a significant difference. They were worried masks could make people less disciplined about social distancing.

But some, including George Gao, the director-general of the Chinese Center for Disease Control and Prevention, warned that the United States was making a “big mistake” by not mandating masks. 

Zeynep Tufekci, an information science professor at the University of North Carolina at Chapel Hill, examined the emerging evidence and knew that hand-washing and isolating the obviously sick wouldn’t be enough. If people were spreading the virus before they had any symptoms, “that’s huge. It’s a whole different ballgame.” 

Going against both the CDC and the WHO felt like heresy at a time when few mainstream scientists were. But she decided she had no choice. The case that masks could slow asymptomatic spread was compelling. The arguments against – particularly the idea that people might hoard medical-grade masks, when cloth ones could easily be made at home – would only feed resentment.

“If you’re paternalistic and you don’t treat the public as a partner, what you end up with is mistrust and polarization,” said Tufekci, who laid out her views in a March 17 New York Times op-ed. “That’s not how you do public health.”

Across the country, data scientist Jeremy Howard was reaching a similarly against-the-grain conclusion on masks. A specialist in artificial intelligence at the University of San Francisco, he had no background in public health. But he knew how to interpret numbers.

“I had never personally worn a mask in my life. I thought they were kind of weird,” he said. “But I had vaguely heard they could maybe help a little bit.” 

When he examined the data – particularly from Asia, where masks had become commonplace during the SARS outbreak and were then put to work in the fight against the novel coronavirus – it was overwhelming. In Europe, too, the evidence was persuasive: Masks had become widespread within days in the Czech Republic, thanks to a campaign among cultural influencers. Transmission rates soon fell.

“I was just stunned,” Howard said. “It seemed pretty likely that this was the most effective public health tool that we had.”

Howard put his argument for members of the public to wear do-it-yourself or other store-bought cloth masks into a March 28 piece for The Washington Post. Senators were calling the next day, asking for private briefings. One of them, Sen. Patrick Toomey, R-Pa., was so impressed he vowed to make the case to the president. 

The White House was receptive, but only to a point.

Inside the administration, there had already been weeks of debate on masks at the coronavirus task force level without a decision on what to recommend to the public. 

In the last week of March – as the official case count was approaching 100,000 – the CDC presented what was then considered a radical proposal to the White House, recommending routine masking by the public. Senior administration officials, particularly members of the vice president’s office on the coronavirus task force, pushed back, arguing it was unnecessary. 

The new guidance was somewhat of a compromise. It encouraged – but did not require – people to cover their faces in “public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission.” 

On April 3, President Donald Trump stood at the White House podium and issued the recommendation. “It may be good” advice, he offered. But he immediately undercut the guidance by announcing he would not be wearing a mask himself. 

“Somehow sitting in the Oval Office, behind that beautiful Resolute Desk” as he met with “presidents, prime ministers, dictators, kings, queens,” Trump said, “I don’t know, somehow I don’t see it for myself.”

Initially, some Trump aides said they did not like the idea of him wearing a mask publicly because they believed it would be bad politically and make the president look weak. They thought it might lead others to panic or think the pandemic was worse than it was. There were also fears among some in the president’s circle that his supporters would rebel against anything that smacked of a government directive.

Among some of Trump’s most ardent fans, anti-mask insurrections were already brewing. In dark corners of the internet, mask conspiracy theories took shape. On the steps of state capitol buildings, activists shouted their objections to a masked attack on “liberty.”

Some of the president’s advisers, including chief of staff Mark Meadows, expressed repeated skepticism of masks and whether they made a difference, campaign and White House officials said. Trump campaign masks were produced and presented to the president but never sold. Some aides were fearful of selling merchandise he did not wear and appearing to profit off a pandemic, officials said. 

“The President’s position has been consistent on this,” White House spokeswoman Sarah Matthews said in a statement. “In late March, before there was even a recommended but not required guidance given by the CDC on mask-wearing, he supported facial coverings.”

With little hope for progress at the White House, Howard had begun to make his data-based case for masks to the governors, focusing especially on Republicans who had shown a willingness to embrace a scientific approach to attacking the coronavirus. DeWine was at the top of his list. 

The 73-year-old Ohioan had won plaudits from public health experts for the speed with which he shut down gatherings, businesses and schools in March when the coronavirus began to spread in the state. Cases stayed low, even as the economic damage rippled.

As pressure intensified on DeWine to reopen the state in late April, the governor seized on a mask requirement in stores and other businesses as a way to do so safely. 

Masks would not be “forever,” the governor announced April 27, “but if we want to get back to work, we have to protect our employees.” 

Within hours, as protests over the governor’s assault on “freedom” poured in, DeWine knew it had been a mistake that would need to be reversed. 

“After 40 years of representing Ohioans in many different jobs, I’ve got a pretty good ability to gauge these things,” he said in an interview. “And with the pushback we got, my instinct was that this was too far.” 

Unlike closing schools – which could happen with the stroke of a pen – requiring masks would involve getting “millions of Ohioans making individual decisions dozens of times a day.” 

And unlike in Asia – where DeWine had traveled pre-pandemic and seen the widespread use of face coverings to ward off disease – there was no culture of mask-wearing for public health benefits in the United States. 

The president’s unwillingness to set an example by wearing a mask didn’t help. 

“I would have liked to have seen the president do that,” DeWine said.

Also unhelpful, the governor said, was guidance from some public health authorities that continued to be contradictory, even as the science behind masks became increasingly clear.

Studies suggesting masks could be effective in curbing the risk of transmission continued to accumulate. But the WHO – which has been criticized throughout the pandemic for being slow to respond to emerging data – took until June 5 to issue a mask recommendation for the general public. Even then, it was tepid and full of asterisks, with the global health body insisting the change was consistent with its original guidance.

U.S. officials have been more forthright in acknowledging their advice has shifted, arguing it was in response to shifting data. 

“If you acted on the best information you had at the time and then later you get new evidence that points in a different direction, does that mean what you did three months ago was wrong? Well, existentially, yes it was. But it was based on the evidence we had at the time,” Fauci said in an interview Friday.

Once policy did shift, Fauci said, medical officials were united in getting behind the new recommendation. But other senior administration officials weren’t on board.

“That was a problem,” he said. 

Trump was foremost among those who weren’t interested in promoting masks.

When, in late May, he toured a Ford plant in Michigan where masks were required, he refused to put one on in front of the cameras. “I didn’t want to give the press the pleasure of seeing it,” he said. 

Over Memorial Day weekend, he retweeted a mocking criticism of his election opponent, former vice president Joe Biden, for wearing a mask.

Videos began going viral as Americans squared off on what to do about customers in stores who refused to mask up. Social media groups devoted to casting doubt on their efficacy proliferated. Face coverings had become debate points in the U.S. presidential campaign and potent symbols in the culture war.

Public health specialists could only shake their heads.

The debate radiated through big cities and small ones as the coronavirus began a resurgence in June, with many areas that had dodged the first round of infection getting hammered this time. 

Joplin had no active cases at the start of June. Weeks later, the city of 50,000 in southwest Missouri had one of the nation’s fastest rising infection rates.

For five hours in late June, the city council debated whether to mandate masks, only to defeat the motion by a single vote. 

Two weeks later, with hospitals hitting their capacities, the council voted again. This time, the mask mandate passed 6-3.

Mayor Ryan Stanley was among those who changed his mind. He had initially thought that a mandate was unenforceable and that, in a deeply conservative, pro-Trump region, it would only encourage defiance. But when he visited local businesses the weekend after the requirement kicked in, he was astonished by what he saw. 

“We were getting 15% adoption before. I was crossing my fingers and hoping for 50 to 60%,” he said. “But now it’s at 90 to 95%. It’s certainly doing its job.”

Stanley said mask opponents had been loud – staging noisy demonstrations and dominating the debate. But they hadn’t actually been that numerous.

Public opinion polls bear that out, with large majorities of the population, across both major parties, favoring mandates. 

Policies have begun to match those attitudes. A cascade of states – including Ohio – have instituted requirements in recent weeks, with DeWine identifying compliance as critical to the state’s hopes of bringing down infection rates and opening schools. 

Major retailers such as Walmart have as well, making shopping trips difficult without a mask.

Evidence shows the mandates are working.

“There were seat belts in cars for decades. There were lots of public service announcements, people saying, ‘Wear seat belts’ ” said David Keating, who worked with Howard to found the nonprofit advocacy group #Masks4All. “But it’s when the law started requiring it that seat belt usage soared.”

Even the president has joined in – though still somewhat tepidly. On a visit to Walter Reed National Military Medical Center earlier this month, he wore a mask in public for the first time. Last Tuesday, he tweeted a photo of himself in a mask with the explanation that “many people say that it is Patriotic to wear a face mask when you can’t socially distance.” 

Trump wore a mask again on Monday while touring a biotechnology plant. But as recently as last week, he was barefaced while in public at his hotel in D.C., despite local rules that require a face covering.

Political advisers and campaign officials say there has been a concerted effort around Trump – from aides to family members to advisers to lawmakers – to show that wearing a mask is the right thing to do. Aides have encouraged people to praise the president for wearing a mask, hoping that he will continue to embrace it, officials said. 

It had been clear for months – as America’s coronavirus case count has climbed above 4 million and the death toll closes in on 150,000 – that masks are a public health imperative. But with grim polls showing Trump trailing in almost every key state, they have now become a political one, too.

“He was basically on an island even among his own supporters,” said Brendan Buck, a longtime Republican operative who last worked for then-Speaker Paul Ryan. “It doesn’t take a genius to understand that this pandemic is why he’s losing so badly.”

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Google employees will work from home until at least summer 2021

Health & BeautyJul 27. 2020

By The Washington Post · Hannah Denham · BUSINESS, TECHNOLOGY, HEALTH, US-GLOBAL-MARKETS, CAREER-WORKPLACE 

Google won’t bring its 200,000 employees back to the office until July 2021, pushing past its January timeline as U.S. coronavirus cases surge and a vaccine remains months away.

That makes parent company, Alphabet, the first major U.S. company to push its comeback into the second half of next year. Google spokesman Jason Post confirmed the decision, first reported by the Wall Street Journal, on Monday.

Chief executive Sundar Pichai announced the new timetable in a companywide email, to “give employees the ability to plan ahead.” 

Pichai made the decision last week. He was partly influenced by the differing approaches to school reopening across the country, the Journal reported. The work-from-home option applies to employees at the company’s headquarters in Mountain View, Calif., as well as in other parts of the United States, the United Kingdom and India.

Google’s move could motivate other corporations to reevaluate their timelines, especially as the number of confirmed covid-19 cases, hospitalizations and deaths continue to rise in the United States. At least 4.2 million cases have been reported in the U.S. and at least 144,000 deaths.

Silicon Valley has taken varying approaches to mitigate safety risks for its workforce. Remote working was widely adopted in March, and many companies have signaled plans to reopen offices in January.

Facebook’s current plan is keep its 48,000 workers at home through the end of the year, though CEO Mark Zuckerberg said in May that he expects as much as half of them to transition to remote work in the next decade. Amazon’s corporate employees also are expected to telecommute through 2020. (Amazon founder Jeff Bezos owns The Washington Post.) Snap recently extended its timeline from September to January.

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Astra to pay Daiichi up to $6 billion for new cancer drug

Health & BeautyJul 27. 2020A sign featuring the AstraZeneca at the company’s DaVinci building at the Melbourn Science Park in Cambridge, England, on June 8, 2020. MUST CREDIT: Bloomberg photo by Jason Alden.

By Syndication Washington Post, Bloomberg · Marthe Fourcade, Suzi Ring, Rachel Chang · BUSINESS, HEALTH, SCIENCE-ENVIRONMENT, US-GLOBAL-MARKETS 

AstraZeneca agreed to pay as much as $6 billion to buy into Daiichi Sankyo Co.’s promising medicine for lung and breast cancer, the drugmakers’ second potential blockbuster oncology deal in two years.

The U.K. drugmaker will pay Japan’s Daiichi $1 billion upfront to jointly develop and bring to market a cancer therapy in early clinical tests called DS-1062, the companies said Monday. As much as $5 billion in additional payments could follow, subject to regulatory and sales milestones.

AstraZeneca is forging ahead to become a global oncology powerhouse, even as it works on a vaccine for the coronavirus pandemic. Last year, the company committed to pay Daiichi as much as $6.9 billion for another cancer medicine, which marked its biggest deal in more than a decade. For the Japanese company, the deal is the latest in what has turned into a transformative partnership. Besides the cancer deals, Daiichi is in talks to make Astra’s Covid-19 vaccine in Japan.

The Daiichi treatment, an antibody-drug conjugate that targets tumors that express a protein known as TROP2, is “extraordinary,” José Baselga, Astra’s head of cancer research, said in an interview. He described it as an “agent that could transform and will transform the therapy landscape.”

AstraZeneca shares were little changed in London, trading at 8,617 pence. Daiichi shares rose 3% to 8,666 yen in Tokyo before the announcement.

The Japanese drugmaker pivoted to oncology treatments only a decade ago, after being mired for years in litigation over data fabrication at its Indian subsidiary. A key turning point came when the Tokyo-based company hired Antoine Yver, who ran the oncology unit at AstraZeneca, in 2016, paving the way for the British giant to take notice of Daiichi’s groundbreaking work in cancer.

“We had a number of potential collaborators who met with us,” about the therapy, Yver said in an interview. Astra was picked because “of their experience, because of their strength in oncology, because of our past collaboration.”

Since the first Astra deal last March, Daiichi’s stock has soared 70% and it’s now the second-biggest pharmaceutical company in Japan by market capitalization, edging past Takeda Pharmaceutical Co.

AstraZeneca will pay cash for the latest deal in three stages: $350 million this month when the deal closes, $325 million after 12 months and again a year later. Daiichi will manufacture and supply the cancer drug, and keep exclusive rights to the medicine in Japan.

Data from early trials points to strong activity in lung cancer, but also high toxicity with two deaths, said Sam Fazeli, an analyst at Bloomberg Intelligence.

Baselga said the drugmakers are working to mitigate the toxicity and the patients had received the highest doses of the drug, which are unlikely to be those retained for broad use.

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Virus infections top 16 million globally

Health & BeautyJul 27. 2020

By The Washington Post · Meryl Kornfield, Marisa Iati · NATIONAL, WORLD, HEALTH 

The United States tallied just shy of 1,000 coronavirus-related daily deaths on Saturday after a four-day streak of four-digit death tolls, the biggest such accounting of human loss from the virus since late May.

The country reported 59,737 new infections and 566 additional deaths as of Sunday evening, resulting in a seven-day average of infections that was slightly lower than Saturday’s and an average of deaths that was a little bit higher.The world surpassed 16 million confirmed cases over the weekend and reached at least 641,000 coronavirus-related deaths. The United States accounts for about one-fourth of the reported infections and one-fifth of the death toll.

As of Sunday evening, the seven-day averages for new cases hit fresh highs in several states, including Alaska, Colorado, Hawaii, Louisiana, Minnesota, Mississippi, Missouri, Montana, New Mexico, North Dakota, Oklahoma, Wisconsin and Wyoming.

Nevada, Texas and South Carolina set records for their seven-day averages of daily deaths, and Mississippi and North Carolina tied their previous highs.

In Texas, the seven-day average for cases was 8,302 on Saturday as Hurricane Hanna roared ashore. Winds, torrential rain and storm surges left a path of destruction in an area already ravaged by coronavirus infections. The seven counties from Corpus Christi south to Brownsville and inland along the border with Mexico, predicted to face Hanna’s strongest winds and heaviest rains, have diagnosed 18,420 active covid-19 cases, many in the past few weeks, according to the Texas Health and Human Services Commission.

Elsewhere in the state, bar owners reopened Saturday night, defying a June 26 order by Republican Gov. Greg Abbott to shut down. Fort Worth bar owner and “Freedom Fest” protest organizer Chris Polone said in a video posted on Facebook that of the about 800 bar owners who participated, not one was penalized by authorities.

The county that Fort Worth is in has reported 24,562 coronavirus cases, 3,367 more since last week.

The surge in cases comes as states wrestle with reopening their economies or imposing greater public health restrictions to slow the spread of the coronavirus.

In Florida, Halsey Beshears, the secretary of the state’s Department of Business and Professional Regulation, signaled that he planned to start talking with bars and breweries about how they can return to business. His announcement came as Florida’s average number of deaths rose for the third straight day.

The state surpassed New York in total confirmed cases; Florida hit 414,511 on Saturday, with its health department reporting 12,180 new infections. Only California, with double the population of the Sunshine State, has more cases than Florida.

Despite the recent surge in cases and deaths, White House senior staff members painted a rosy picture of the country rebounding from the crisis.

“I don’t deny that some of these hot-spot states are going to moderate that recovery, but, on the whole, the picture is very positive, and I still think the V-shaped recovery is in place,” White House chief economic adviser Larry Kudlow told CNN host Jake Tapper on “State of the Union” on Sunday, referring to how a quick rebound would look on a bar chart.

Kudlow and other administration officials denied intraparty conflict was at play as lawmakers rush to pass legislation before the enhanced jobless aid expires. Hinting at developments, Kudlow said that the federal government would extend a four-month moratorium on evictions that ended Friday, and that $1,200 direct-impact payments will be part of the negotiated stimulus package.

Treasury Secretary Steven Mnuchin told Fox News’s Chris Wallace on Sunday that the White House and GOP lawmakers were “on the same page” and would present a stimulus package Monday, straying from what White House Chief of Staff Mark Meadows and Senate Majority Leader Mitch McConnell, R-Ky., previously suggested. McConnell on Friday announced that an agreement could take a “few weeks,” potentially leaving millions of Americans in limbo when benefits are cut off.

Meadows also suggested progress Sunday, saying new therapies for treating the coronavirus could be announced this week. Speaking on ABC News’s “This Week,” he provided no details on what the therapies might involve or who was developing them. But he maintained that the key to defeating the virus would ultimately come down to “American ingenuity” more than mandates requiring people to wear masks, maintaining social distancing or keeping businesses closed.

Negotiations with Democrats will hinge in part on temporary unemployment benefits that are set to expire at the end of this week. Republicans aim to reduce the $600 weekly payments.

House Speaker Nancy Pelosi, D-Calif., said Sunday that the Trump administration is effectively trying to take away employees’ freedom to not go to work if they don’t feel safe. On CBS News’s “Face the Nation,” Pelosi said President Donald Trump’s aim to pull unemployment benefits back from people with job options is unsafe.

“I have a new name for him, Mr. Make Matters Worse,” Pelosi told Margaret Brennan. “He has made matters worse from the start. Delay, denial, ‘it’s a hoax,’ ‘it will go away magically,’ ‘it’s a miracle’ and the rest.”

The White House’s coronavirus testing coordinator conceded Sunday that turnaround times for diagnostic testing should improve, promising better times this week.

In an interview Sunday on “State of the Union,” Adm. Brett Giroir blamed “large commercial labs that perform about half the testing in our country.”

“I started out by saying that we are never going to be happy with testing until we get turnaround times within 24 hours, and I would be happy with point-of-care testing everywhere,” Giroir said, referring to when sample collection and testing occurs in the same place. “We are not there yet. We are doing everything we can to do that.”

Giroir defended testing capacity, saying “no one is trying to stop testing in this country,” when Tapper asked about Trump’s remarks that he had instructed officials to slow testing out of concern that it would highlight the spread of the virus in the country.

As many of the largest school districts have already announced that students won’t immediately return to in-person instruction in the fall, Health and Human Services Secretary Alex Azar said Sunday that the administration does not believe there should be uniform thresholds to meet for schools to reopen.

“Each community is going to have to make the determination about the circumstances for reopening and what steps they take for reopening, but the presumption should be we get our kids back to school,” Azar told CBS News’s Brennan.

Schools that reopen may not be able to stay open if cases surge again in those communities, former Centers for Disease Control and Prevention director Tom Frieden warned.

“The hard part is opening them and keeping them open,” Frieden told Wallace on “Fox News Sunday.”

Scott Gottlieb, a former commissioner of the Food and Drug Administration, said a slow testing process or high rate of positive tests in a community should trigger a review of whether schools there should remain in session.

“I think somewhere in 5 to 10%, it’s starting to get iffy,” Gottlieb said on “Face the Nation,” speaking about positivity rates. “Above 10%, I think that’s a threshold where you really want to think carefully about closing the school districts, because that is a sign that there is an epidemic underway inside that community.”

Outside the United States, North Korea declared a “maximum” national emergency and locked down the city of Kaesong near the border with South Korea after what could be the north’s first coronavirus case, the state-run Korean Central News Agency reported Sunday. North Korea alleged that the patient illegally crossed the border from South Korea last week and said virus screening results are “uncertain.”

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Coronavirus ravaged Florida, as Ron DeSantis sidelined scientists and followed Trump

Health & BeautyJul 26. 2020President Trump/File photo

By The Washington Post · Cleve R. Wootson Jr., Isaac Stanley-Becker, Lori Rozsa, Josh Dawsey · NATIONAL, HEALTH, POLITICS, SCIENCE-ENVIRONMENT 

ST. PETERSBURG, Fla. – As Florida became a global epicenter of the coronavirus, Gov. Ron DeSantis held one meeting this month with his top public health official, Scott Rivkees, according to the governor’s schedule. His health department has sidelined scientists, halting briefings last month with disease specialists and telling the experts there was not sufficient personnel from the state to continue participating. 

“I never received information about what happened with my ideas or results,” said Thomas Hladish, a University of Florida research scientist whose regular calls with the health department ended June 29. “But I did hear the governor say the models were wrong about everything.” 

DeSantis, a Republican, this month traveled to Miami to hold a roundtable with South Florida mayors, whose region had emerged as a novel coronavirus hot spot. But the Republican mayor of Hialeah was shut out, weeks after saying the governor “hasn’t done much” for a city disproportionately affected by the virus. 

As the virus spread out of control in Florida, decision-making became increasingly shaped by politics and divorced from scientific evidence according to interviews with 64 current and former state and administration officials, health administrators, epidemiologists, political operatives and hospital executives. The crisis in Florida, these observers say, has revealed the shortcomings of a response built on shifting metrics, influenced by a small group of advisers and tethered at every stage to the Trump administration, which has no unified plan for addressing the national health emergency but has pushed for states to reopen.

DeSantis relies primarily on the advice of his wife, Casey, a former television reporter and host, and his chief of staff, Shane Strum, a former hospital executive, according to multiple Republican political operatives, including a former member of his administration. 

“It’s a universe of three – Shane and Casey,” said one Republican consultant close to DeSantis’s team who spoke on the condition of anonymity to offer a candid assessment.

The response – which DeSantis boasted weeks ago was among the best in the nation – has quickly sunk Florida into a deadly morass. Nearly 5,800 Floridians have now died of covid-19, the disease caused by the virus – more deaths than were suffered in combat by Americans in Afghanistan and Iraq since 2001. One out of every 52 Floridians has been infected with the virus. The state’s intensive care units are being pushed to the brink, with some over capacity. Florida’s unemployment system is overwhelmed and its tourism industry is in shambles. 

DeSantis began the year as a popular governor, well-positioned to help his close ally President Donald Trump win this crucial state in November’s election. DeSantis is now suffering from sagging approval ratings. Trump has fallen behind Democrat Joe Biden in recent polls of Florida voters. And both men, after weeks of pushing for a splashy Republican convention in Jacksonville, succumbed to the reality of the public health risks Thursday when Trump called off the event.

Trump asked DeSantis in a phone call in May if he would require masks for the convention and whether the virus would be a problem, according to a person with knowledge of the conversation. DeSantis said he would not require masks and the virus would not be a major problem in August in Florida.

“You were elected to be the governor of our state and make decisions about what is best for us in Florida,” Hialeah Mayor Carlos Hernández said of DeSantis. “If he was more concerned with what the president thought of him, the outcomes are here.” 

DeSantis’s office did not respond to interview requests or to a set of detailed questions sent by The Washington Post. In response to questions, a spokesman for the health department said the governor and Rivkees, the surgeon general, “are continuing to remind all Floridians to protect the vulnerable by avoiding the Three Cs: Closed Spaces, Crowded Places and Close-Contact Settings and by wearing a mask in public.” 

The spokesman, Alberto Moscoso, did not explain why the department had ended its work with the university modeling team or why Rivkees appears only once this month on the governor’s schedules, which have been released through July 23. 

During the same period, DeSantis spoke regularly to members of the Trump administration. He appeared twice on Fox News and called in to Rush Limbaugh’s radio show.

“Ron DeSantis is doing a great job and will go down in history as a great governor of Florida,” the president told The Washington Post through a spokeswoman. 

Those who defend the governor’s approach point to his early efforts to protect nursing homes. They also dispute claims that he has been inflexible, emphasizing his decision to re-close bars and clubslast monthafter a spike in infections. The governor’s allies have also commended him for securing more remdesivir, an antiviral drug used to treat the most severe coronavirus patients, which is in short supply across the country. 

Rep. Matt Gaetz, R-Fla., said the governor’s relationships in Washington have benefited Florida. In the spring, the state emerged on top “in terms of supplies and resources,” because, in the telling of Trump, “we’re really good at asking for stuff,” Gaetz said.

Jared Moskowitz, a former Democratic state legislator who now heads the Florida Department of Emergency Management, said DeSantis has been “completely accessible” and “open-minded in our conversations.” 

He continued: “Anything that I have needed or asked for, dollars that are going to be required to respond appropriately have always been available.” 

The department’s command center was temporarily shuttered this month after a series of infections among staff working there.

Some of Florida’s woes are shared by other states, especially in the Sun Belt: Economies powered by tourism and hospitality whose leaders sought reasons to invite people back to their states; skeletal public health systems that could not adequately respond with contact tracing and other interventions; and holiday celebrations that caused residents, particularly young people, to flout guidelines.

But the crisis in Florida has been particularly acute, infectious-disease specialists say, because politics have dictated the response at crucial junctures – never more so than with the state’s reopening, which was cast by the governor as a return to normal rather than as a new and even more precarious phase of the pandemic.

Trump told aides that Florida’s early success gave other states a justification to reopen, according to three administration officials. Meanwhile, DeSantis quickly turned presidential rhetoric into gubernatorial orders, all while rejecting measures, including a statewide mask mandate and an extended stay-at-home order, that helped other states contain their outbreaks.

Officials involved in the local health and emergency response say DeSantis has selectively highlighted favorable metrics, such as a decline in the median age of people who are testing positive, rather than developing more serious mitigation strategies. 

“I think we’re on the right course,” he said as cases surpassed 400,000 and he continued to push for schools to open for in-person classes in a few weeks.

Some on the front lines are drawing different conclusions. 

“The numbers are up, my man,” said Frank Rollason, the emergency management director in hard-hit Miami-Dade County. “They speak for themselves.” 

– – –

The governor’s small inner circle stands in contrast to the number of people tapped for his reopening task force in April. The group included more than 100 participants but only five doctors, who were placed on a working group alongside representatives from the elder-care industry and farming leaders. 

The working group met twice for 2.5 hours, said one member, dentist Rudy Liddell, and did not develop written recommendations or provide continued input once the report of the executive committee was released at the end of the month. 

The guidelines that emerged from the executive committee closely mirrored the reopening recommendations issued by the White House. There were few specific benchmarks following the first phase of a statewide reopening on May 18 – after about six weeks of sweeping restrictions – with movement into new phases premised instead on “adequate health care capacity” and the absence of a resurgence of the virus. In early June, DeSantis announced that much of the state could move into the second phase, lifting restrictions on bars and movie theaters, on the same day the state recorded 1,317 new cases, the largest surge in six weeks.

“It was outcome-determinative – they knew what they wanted to do,” said Sen. Gary Farmer, the incoming Senate minority leader. “It was a joke. . . . It was, ‘Here’s the plan. Here’s the chance to rubber stamp it.’ ” 

As the state shifted into reopening, the Republican National Committee announced plans for its convention. The National Basketball Association opted to finish its season in Orlando. Disney World reopened July 11.

Compliance in April with the sweeping stay-at-home order brought the state’s numbers down to a point that reopening looked feasible, said Cindy Prins, an epidemiologist at the University of Florida. The problem, she said, was the speed with which the state moved through the subsequent phases of its economic restart. 

“There was hardly enough time for the new infections even to show up,” she said.

The governor’s quest to put the pandemic behind him undermined the very message – that the virus was still a deadly threat – that could have made his reopening a success, said Glenn Morris, director of the University of Florida’s Emerging Pathogens Institute.

“One of the areas where we failed in Florida was in convincing people that as things began to open up, that we still had a serious situation, that the virus was still present in the community and that there remained a critical need to maintain the basic practices recommended by the [Centers for Disease Control and Prevention],” he said.

Critical mitigation strategies remain inadequate, according to lawmakers and experts, owing to years of disinvestment in the state’s public health infrastructure. One estimate, by a researcher at Florida International University, found that the state had slashed public health spending 35 percent between 2009 and 2015.

The health department’s 2017 budget request warned of “insufficient individuals at the local level who have the skills to perform epidemiological analyses” and manage outbreaks.

Contact tracing, which has been central to controlling outbreaks in other settings, has been highly limited in Florida. State Rep. Rene Plasencia, a Republican representing parts of Orange County and Brevard County, said not a single family member or friend sickened by the virus has been contacted by the health department. 

With the virus tearing through urban centers, “we’re at a point where I don’t even know how you would do contact tracing anymore,” Plasencia said.

The lesson of the pandemic for Florida, said Charles Lockwood, dean of the University of South Florida’s College of Medicine, was, “Never declare victory until the referee blows the whistle.” When the wave of cases predicted this spring did not initially crash down on the state, Tampa General Hospital and the University of South Florida used the time to order ventilators and stockpile personal protective equipment, Lockwood said. 

Meanwhile, steps he suggested to health officials in his county were not acted upon, including a recommendation to use cellphone technology to track at-risk patients and encouragement to stand up a more robust system of contact tracing. In both instances, he said, local health officials indicated they were constrained because these were functions controlled in Tallahassee, the state capital. The health administrator in Hillsborough County, Douglas Holt, declined to be interviewed. 

Efforts to offer advice on contact tracing at the state level were rebuffed as well, according to experts involved in the response. Hladish, the infectious-disease researcher, said he and other specialists had tried to raise the subject during one of their calls with department staff but were told contact tracing was handled by a different team. 

“We were told that they were too busy to talk,” he said. 

Even health department staff were constrained in the nature of the advice they could offer, according to multiple state health officials stationed in counties, who spoke on the condition of anonymity because they were not authorized to discuss the ongoing response. They said conversations with stateofficials have recently included reminders that they were not authorized to advise school districts about whether to reopen, but simply to “provide them with information,” as one official put it. 

These officials said calls that once occurred daily with Rivkees, the surgeon general, have been scaled back to three times a week. Rivkees, a pediatrician whose specialty is not epidemiology or disease surveillance, was escorted out of a news conference in April after saying Floridians may have to practice social distancing and wear masks for up to a year, a prediction at odds with statements from DeSantis and Trump. 

Some of his top staff have left the department mid-pandemic.

The administrator of the department’s surveillance section left in March for a job at Pfizer. Rebekah Jones, who had been managing the department’s public-facing data portal, was dismissed in May after a dispute over changes to the dashboard, which she said were designed to hide relevant information. State officials, who accused Jones of “insubordination,” said the changes were aimed at increased accuracy. Scott Pritchard, who headed the department’s investigations unit, left last month. He informed his team he was leaving on the day DeSantis announced plans to reopen schools at “full capacity,” according to people familiar with the matter. 

Pritchard, who did not respond to a request for comment, then left the state altogether. 

– – –

DeSantis has left Florida for the White House numerous times during the pandemic. 

At an April briefing in the Oval Office, Trump offered to hold the governor’s foam display boards as DeSantis detailed how Florida had corralled the coronavirus better than almost any other state. 

“Everyone in the media was saying Florida was going to be like New York or Italy, and that has not happened,” DeSantis said.

The number of confirmed coronavirus cases in Florida now eclipses New York’s caseload by more than 3,300. Florida has at least 168,000 more cases than Italy, a country with about three times the state’s population. 

DeSantis joined Trump for a White House event on drug pricing Friday, when the state recorded 12,444 new cases of the virus and 136 deaths. 

DeSantis was a little-known congressman in the first half of the Trump administration who made a name for himself with appearances on Fox News denouncing the investigation into Russian interference in the 2016 election. 

He netted the president’s endorsement in the 2018 Republican gubernatorial primary, riding it all the way to the governor’s office. 

“What’s the old phrase – dance with the one who brought you,” said Gary Farmer, the incoming Florida Senate minority leader. “That’s what he’s doing. His political fortune in becoming governor was not just closely tied, but almost exclusively tied, to the Donald Trump train.” 

Trump feels bonhomie with DeSantis, likes having him in the Oval Office and regularly speaks with him on the phone, even though many around the president do not trust the governor, people familiar with the matter say. DeSantis also regularly consults with Brad Parscale, the president’s recently deposed campaign manager.

Florida’s intimal ability to skirt the worst effects of the virus was a boon for DeSantis and for Trump: The governor’s aggressive efforts to jump-start his economy were right out of Trump’s playbook, perceived at the time as a benefit in the battleground state. Administration officials regularly sent reports and others clips of DeSantis bragging about Florida not having cases early in the outbreak, to argue that many states were overreacting, and at times, that seasonal heat could cure the virus.

Now, with the virus spreading uncontrolled in Florida, former health officials think DeSantis has joined the president in seeking to manage expectations about its consequences rather than formulate a plan to bring it under control. 

“They keep hoping it’s going to go away by itself,” said Richard Hopkins, an epidemiologist who spent 19 years at the Florida Department of Health. “I don’t know what’s going on – whether they’re afraid that they will get primaried by someone to their right if they take appropriate public health action.”

Approval of DeSantis’s handling of the pandemic has fallen by double digits since April, when 50 percent of registered voters in Florida backed the governor’s approach. Now, 38 percent of residents approve of his response, while 57 percent disapprove, according to a Quinnipiac University poll released Thursday.

The return this summer to crisis conditions has felt like whiplash for front-line workers.

In June, employees at the six-hospital Memorial health care System based in Hollywood, Fla., thought they had dodged a wave of coronavirus patients that threatened to overwhelm their hospitals.

Exhaling workers began to dismantle surge areas from auditoriums and classrooms that had been converted into treatment areas. But it was premature. By the end of the month, covid-related hospitalizations had begun to soar, said the system’s chief medical officer, Stanley Marks.

“We converted them back,” Marks said. “By early July we again were in full emergency mode.”

Darlene Dempsey, a nurse at the good Samaritan Medical Center in West Palm Beach and a lifelong Republican, said she could no longer support Trump or DeSantis, both of whom had chosen to “gaslight nurses” instead of using the time in March and April to ramp up production of medical equipment and develop a testing plan. 

“The fairy tales about all being under control are nonsense,” she said. “Our government has failed us.” 

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Pfizer vaccine deal at $20 a dose sets ceiling for rivals

Health & BeautyJul 23. 2020The Pfizer logo on the lab coat of an employee. MUST CREDIT: Bloomberg photo by Scott Eisen

By Syndication Washington Post, Bloomberg · James Paton, Riley Griffin, Robert Langreth · BUSINESS, HEALTH, US-GLOBAL-MARKETS 

In signing a $2 billion deal to supply their experimental coronavirus vaccine to the U.S., Pfizer and BioNTech are setting a price ceiling of less than $20 a dose that will affect how much other companies can charge to protect people from covid-19.

Pfizer’s $19.50 price point takes into account the “public health requirements during the pandemic,” said Sally Beatty, a Pfizer spokeswoman. The companies are pursuing a two-dose regimen of one of its vaccine candidates, and the roughly $40 course, Beatty said, is “almost 30% less than what others charge for a seasonal flu vaccine.”

Governments worldwide are seeking to blunt a pandemic that’s killed more than 600,000 people, and dozens of companies are wrestling with how to price future vaccines. Rival drugmakers are unlikely to exceed the $20 price tag unless they can deliver a product that’s more effective, has fewer side effects or doesn’t need as many doses, particularly those developing candidates based on so-called messenger RNA technology, such as Moderna.

“This definitely sets a base, I think you can even call it a ceiling, for mRNA vaccine pricing,” Brad Loncar, chief executive officer of Loncar Investments, said in an interview. “This price comes right down the middle in what investors think is fair. It will definitely support a profit, and will incentivize companies to continue to innovate further.”

New York-based Pfizer, which is evaluating at least four experimental vaccines with Germany’s BioNTech, reported positive preliminary data from one of its candidates this week. Beatty said Pfizer “will not rely on taxpayer dollars in the development or manufacture of the vaccine candidate,” and thus is shouldering all of the risk in bringing a shot to market.

– – –

In the Pfizer deal, the U.S. agreed to secure 100 million doses of its vaccine candidate. The payment depends on approval from the U.S. Food and Drug Administration and the ability to successfully manufacture it, Pfizer’s Beatty said. The timeline for supply is not yet known.

The U.S. can acquire as many as 500 million additional doses, though Pfizer “will need to separately negotiate the terms for the remaining doses if the U.S. orders more,” according to Beatty.

Pfizer shares rose 4.1%, to $38.20, in afternoon trading in New York on Wednesday, while BioNTech’s U.S. depositary receipts jumped 8.3%, to $99.

The U.S. has ordered experimental shots, including one co-developed by the University of Oxford and AstraZeneca, which fell as much as 2.7% in the wake of the Pfizer agreement.

– — 

Even with Pfizer setting a moderate price for a shot, the drug giant and its partner stand to profit from their effort.

“If this vaccine prevents disease after one use, we calculate a windfall of more than $15 billion revenue for Pfizer,” Sam Fazeli, a Bloomberg Intelligence analyst, said in a note. “We believe this sets the top price for a vaccine, with lower prices elsewhere. Need for repeated use would be the game changer.”

The agreement has implications for companies such as Moderna, whose investors see a significant financial opportunity. The U.S. biotech’s vaccine could generate sales of more than $5 billion a year, according to Jefferies. Shares of Moderna, Inovio Pharmaceuticals and Novavax have risen sharply this year.

Earlier this week, Tazeen Ahmad, an analyst with BofA Securities, estimated that BioNTech’s vaccine program is worth about $11.7 billion. That’s based on an estimated $36 net price per dose in the U.S., $30 per dose in the European Union and $12 per dose in the rest of the world.

Pricing a covid-19 vaccine is far different than other products because of the potential demand and value, Pfizer chief executive Albert Bourla said in June at a conference.

“If we try to calculate the value of the vaccine for the pricing like any other vaccine,” through common market principles, Bourla said, “it would be unethical.”

– – –

The U.S. deals have stoked concerns that other countries, especially poorer regions of the world, will be left behind. Other rich countries, such as the U.K. and those in Europe, have also secured deals.

On Monday, Pfizer and BioNTech announced a plan to supply 30 million doses of one of their vaccine candidates to the U.K. this year and next, though they did not disclose what they stood to gain from the agreement. Pfizer’s Beatty said on Wednesday that the companies have also engaged the Covax program, a group established by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations and World Health Organization to launch supply discussions.

The U.S. typically pays “the high-water-mark price” when it comes to pharmaceuticals, according to Loncar. It’s likely that the U.K and other countries are able to secure the still-experimental vaccine for lesser sums, he said.

The U.S. in May pledged as much as $1.2 billion to AstraZeneca to help make Oxford’s vaccine, and the government has backed projects underway at Johnson & Johnson, Moderna and other companies.

The Pfizer vaccine would be free to the American people, according to the government. The U.S moves are part of a larger initiative to secure coronavirus vaccines for the U.S., officially dubbed “Operation Warp Speed.”

“Expanding Operation Warp Speed’s diverse portfolio by adding a vaccine from Pfizer and BioNTech increases the odds that we will have a safe, effective vaccine as soon as the end of this year,” Health and Human Services Secretary Alex Azar said in the statement.

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Pandemic likely to ‘get worse before it gets better,’ Trump says in somber return to coronavirus briefing

Health & BeautyJul 22. 2020President Donald Trump speaks during a coronavirus briefing at the White House on Tuesday, July 21, 2020. CREDIT: Washington Post photo by Jabin Botsford

By The Washington Post · Toluse Olorunnipa · NATIONAL, HEALTH, POLITICS 

WASHINGTON – President Donald Trump walked to the lectern in the White House briefing room alone Tuesday, attempting to single-handedly hit the reset button on the public blame he is facing for not controlling the novel coronavirus pandemic.

Three months after he abandoned the daily virus briefings and attempted to turn the country’s attention to what he described as the “great American comeback,” Trump’s low-key reappearance before reporters seemed to be a tacit admission that his previous strategy had not worked. 

Six months after the first coronavirus case was confirmed in the United States – and with almost 4 million confirmed infections – Trump’s attempt to re-engage with the crisis and embrace public health guidelines marked a notable departure from his recent approach to the pandemic.

“We are in the process of developing a strategy that’s going to be very, very powerful,” Trump said Tuesday, reading from prepared remarks that did not include details of what the strategy would entail.

While Trump continued to showcase his trademark boosterism with repeated praise of his administration, he also appeared to acknowledge that the virus he once said would soon disappear continues to pose a serious threat to the country, as well as to his reelection chances.

“It will probably, unfortunately, get worse before it gets better,” he said during the 30-minute briefing in which he spoke in subdued tones. “Something I don’t like saying about things, but that’s the way it is.”

That somber approach harked back to late March, when Trump warned of a “great national trial unlike any it has ever faced before” and predicted a “very painful two weeks” for the country. 

That soberness did not last long; Trump spent much of April and May attacking governors who did not reopen their economies and resisting calls for the federal government to play a more central role in managing the crisis. 

Public health experts blame much of the country’s current predicament on that lack of leadership in those months – specifically pointing to Trump’s unwillingness to push face coverings and social distancing as he traveled the country holding rallies and mocking people who wore masks. Trump’s approval among the general public has also plummeted in recent months, with Americans giving him low marks for his leadership in crisis.

On the same day that his Democratic rival Joe Biden slammed him by saying “he’s quit on this country,” Trump attempted to use the revived daily briefing to prove otherwise.

Trump used part of his time in the briefing room to push a public health message that many lawmakers and medical experts have been requesting for months. He praised health-care workers for saving lives, largely avoided attacks on Democrats, and urged Americans to wear masks and stay away from crowded bars.

While he avoided some of the gaffes from his previous briefings and spent less time airing personal grievances, Trump still used the televised platform to break away from White House talking points and stir controversy. He contradicted press secretary Kayleigh McEnany’s claims that he gets tested multiple times a day for the virus, and he sent well wishes to a woman who has been accused of grooming Jeffrey Epstein’s underage victims and recruiting them to be sexually abused over several years.

“I just wish her well,” Trump said when asked about Ghislaine Maxwell, Epstein’s longtime companion who prosecutors say was an accomplice in his predation.

Trump’s decision to appear at the briefing without members of the coronavirus task force was itself a matter of controversy in the hours before the event. Fearing that the president might become distracted and unfocused without public health officials in the room, several Republicans – and some White House officials – have called for the briefings to feature less Trump and more doctors. 

But several top health officials in the administration did not know as of Tuesday morning whether they would be participating in the briefing alongside the president. 

Appearing Tuesday on CBS News’s “This Morning,” U.S. Surgeon General Jerome Adams did not directly answer a question about whether high-profile members of the coronavirus task force would appear.

Asked by co-host Gayle King whether he, White House coronavirus response coordinator Deborah Birx or National Institute of Allergy and Infectious Diseases Director Anthony Fauci would be in attendance, Adams said: “They’re still figuring that out.”

Shortly before the briefing, Fauci told CNN that he had not been invited.

During the briefings Trump headlined in March and April, the president regularly undercut or muddled the messaging from public health officials. Trump, who rarely attended the coronavirus task force meetings, would often show up for the televised briefings with a different set of talking points.

The president regularly pitched the anti-malarial drug hydroxychloroquine as a “game changer” even as Fauci and others cautioned that it was untested and might not serve as an effective treatment. The Food and Drug Administration has since pulled its emergency use authorization for the drug after some studies showed that it could lead to a higher risk of death.

Trump also used previous briefings to contradict health experts on face coverings, telling reporters in April that he did not plan to use one. Several administration officials, including Fauci, Birx and Adams, have pleaded with Americans to use masks when in public – a message ensnared in partisan politics as Trump has vacillated on whether face coverings are a vital public health measure or a political statement.

The president appeared to reverse course on his mask skepticism on Monday, tweeting a picture of himself wearing a mask and writing that “many people say that it is Patriotic” to use a face covering when social distancing is not possible. 

Given Trump’s long history of criticizing mask use – he told The Wall Street Journal in June that some Americans wore masks as a protest of him personally – some medical experts said they wished the president would model good public health by walking into the briefing room with his face covered.

“I genuinely hope the President wears a mask to the press briefing as a signal to the several million people watching on TV that wearing a mask is simple and important,” tweeted Rob Davidson, an emergency physician and executive director of the Committee to Protect Medicare, a national network of doctors that has lobbied against Trump. “At a minimum I hope he encourages all Americans to #maskup. A national mandate would be better.”

Trump did not wear a mask to the briefing, but he pulled one out of his pocket and – in a rare departure – did not equivocate as he called on Americans to use them. 

“We’re asking everybody that when you are not able to socially distance, wear a mask, get a mask,” Trump said. “Whether you like the mask or not, they have an impact.”

Trump has long viewed the briefings as an opportunity to tout his handling of the pandemic and put a positive spin on the virus’s devastating toll. Even as daily deaths were spiking in March and April, Trump told reporters that his actions had actually saved millions of lives. He repeated the claim Tuesday.

Trump favorably compared the United States to other countries during the briefing, saying “we’ve done much better than most.”

In reality, the United States has performed far worse than most of the industrialized world in containing the spread of the virus. Cases in the United States have continued to spike in recent weeks, reaching records even as countries in Europe and elsewhere began to bring their outbreaks under control.

While Americans make up less than 5% of the global population, the United States accounts for almost a quarter of all deaths from the coronavirus.

Before the news conference, several previous White House press secretaries gave Trump public advice about how he should approach the briefing room.

Trump “should come out and present the update on what the government is doing in terms of fighting #COVID19 and getting economy open then walk off and allow other officials to provide additional updates and answer questions,” Sean Spicer, the first press secretary in the Trump White House, wrote Tuesday on Twitter. 

He quoted a post from Ari Fleischer, press secretary in the George W. Bush White House, which called the briefings a “mistake” before going on to offer guidance.

“Be specific about what the Fed government is doing” and “Get out of the room within 30 minutes,” he wrote.

Sarah Sanders, who succeeded Spicer, told Fox News on Monday that Trump should remind people that he is doing everything he can to protect them from the virus. 

“Do it in a way that’s compassionate – talk about how he cares about the people and remind them of that being the core of who he is,” she said. 

Trump did take a brief moment during his prepared remarks to acknowledge the more than 139,000 Americans who have died from the virus – though he stopped short of taking any responsibility for their deaths.

“We mourn every precious life that’s been lost,” Trump said. “I pledge in their honor that we will develop a vaccine.”

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Oxford coronavirus vaccine safe and promising according to Phase 1 results published in the Lancet

Health & BeautyJul 21. 2020Photo credit:freepik

By Washington Post · William Booth, Carolyn Y. Johnson · NATIONAL, WORLD, HEALTH 

LONDON — An Oxford University group and the British-Swedish pharmaceutical company AstraZeneca reported Monday that their coronavirus vaccine candidate, on which the U.S. and European governments have placed substantial bets, was shown in early-stage human trials to be safe and to stimulate an immune response. 

The study, published in the British medical journal the Lancet and involving 1,077 volunteers, was described as promising. A second report in the same medical journal on a Chinese vaccine showed what researchers not involved in the study described as modest, positive results.

The two vaccines are among 23 candidates now being tested in human trials, according to a running tally kept by the World Health Organization. More than 130 others are in preclinical trials. None has yet proven itself to protect people from infection or illness. Scientists caution that no one yet knows what level of immune response will be protective against the virus in the real world through a cross section of humanity – young to old, healthy to those with preexisting conditions. 

But with hopes soaring that a number of vaccines will soon emerge to quiet the global pandemic, governments are making massive investments and pharmaceutical companies are readying production.

The U.S. government has pledged up to $1.2 billion toward the Oxford effort and secured a promise of 300 million doses by October. A European alliance has claimed another 400 million doses, while the British government has dibs on 100 million doses, alongside another possible candidate being developed by Imperial College London. 

China approved the use of its vaccine within its military in late June. 

British Prime Minister Boris Johnson was enthusiastic about the Oxford early-stage results.

“This is very positive news. A huge well done to our brilliant, world-leading scientists and researchers,” Johnson tweeted Monday. “There are no guarantees, we’re not there yet & further trials will be necessary – but this is an important step in the right direction.”

The record-breaking pace of vaccine developers has heartened many who want to see the virus tamed in the new year and life return to normal.

But much about the virus remains unknown. Just last week, British researchers reported that people infected with the virus may see defensive antibodies against it quickly fade, within months, raising the possibility that long-term protection may be elusive. 

Still, researchers at Oxford and elsewhere are optimistic they can stimulate a permanent praetorian guard against infection.

“We hope this means the immune system will remember the virus, so that our vaccine will protect people for an extended period,” Andrew Pollard, one of the leaders of the Oxford study, said in a statement. “However, we need more research before we can confirm the vaccine effectively protects against SARS-CoV-2 infection, and for how long any protection lasts.” 

Large-scale, real-world trials of the Oxford vaccine are underway in Britain, Brazil and South Africa. The United States plans to test it later this summer, along with a handful of other candidates, in clinical trials each with about 30,000 volunteers. 

The Oxford vaccine is named ChAdOx1 nCoV-19 and was made from a weakened and nonreplicating version of a common cold virus, an adenovirus. The vaccine has been engineered to express a bit of the coronavirus that produces the spike protein that the virus uses to enter and infect human cells.

Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia said it’s still unclear how protective the immune memory in T cells will be against coronavirus, in part because immune memory is typically more valuable against pathogens that have a longer incubation period than the coronavirus. 

His biggest concern about the Oxford study was that while the vaccine triggered the immune system best when given with a second shot, that two-dose regimen was only tested in 10 patients.

“I’d want to see in a phase two trial: two doses consistently inducing a neutralizing antibody response – and that it’s relatively long lived, not months, not a few weeks,” Offit said.

Infectious-disease experts caution that vaccines must be widely administered to protect the general population, and in an era of widespread skepticism, and even overt hostility toward research and scientists, any vaccine that underperforms or causes serious side effects will set back the effort. 

An editorial in the Lancet warned, “The race for a vaccine moves fast, as the need for a solution is evident, but we cannot forget that safety is of the highest importance.”

In a reflection of how widely anticipated even very early vaccine results have become during the pandemic, results from the Oxford trial were leaked to news outlets in the days before publication, and the hype continued to build over the weekend.

“To me, the message is: it looks like it warrants further study. There’s no showstopper here,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine. “The bottom line is there’s maybe some promise, but definitely you cannot declare victory by any means on these two vaccines. There’s nothing here that would cause me to say we can now release this to the public.”

The Chinese candidate was tested in 500 people and shown to be relatively safe, causing side effects such as pain at the injection site, fevers and headache. It induced an immune response in most participants. However, the vaccine’s early performance has been disappointing to some scientists, and there have been worries that there may already be a reason it won’t work on many people. There is substantial immunity in the human population to the technology at the core of the vaccine – a harmless virus that is used to ferry in a gene that triggers the immune response to the coronavirus.

The vaccine triggered the production of neutralizing antibodies that can block the virus in only about half the test subjects – 59% of those given a high dose and 47% given a lower dose. Older people tended to respond less favorably.

The ultimate proof of whether any vaccine works will be large-scale clinical trials that use a flip of the coin to randomly decide whether thousands of people receive the experimental vaccine or a placebo shot – and then wait to see if the vaccinated group is protected against infection or severe disease.

The immune system uses a multipronged approach to defeat any pathogen, and it’s not yet known exactly what protects against a coronavirus infection.

Much public attention has focused on antibodies that block and neutralize the virus. Other experimental coronavirus vaccines from biotechnology company Moderna and pharma giant Pfizer have been shown to trigger antibodies at similar or greater levels than people who are naturally recovering from coronavirus infections, a benchmark that many scientists consider a hopeful sign.

But there are other forms of immune memory, including T cells, that are an area of increasing interest as evidence accumulates that antibody levels can drop off quickly in people naturally recovering from an infection. The Oxford study, like studies from Moderna and Pfizer, measured some T cell responses. 

One type of T cell, helper T cells, can be compared to “the football coach, where the coach calls the play,” said Angela Rasmussen, a virologist at Columbia University. “They’re coordinating the immune response of all the other cells in the immune system – those are really important.” The helper T cells can instruct the immune system to produce virus-fighting antibodies.

There are also “killer,” or cytotoxic, T cells, which are capable of destroying infected cells.

“It is unclear the role that cytotoxic T cells play in amelioration of covid-19 disease,” Offit said in an email. “It is, in a sense, a second line of defense.”