“Way back in May 2020, three researchers at National Institute of Allergy and Infectious Diseases (NIAID) published an op-ed in Nature arguing that with respect to developing universal coronavirus vaccines “the time to start is now.” As it turns out, the time to start for the NIAID was 15 months later when the agency got around to awarding three academic institutions a little over $36 million to research pan-coronavirus vaccines in September 2021.
The Trump administration’s Operation Warp Speed could serve as a much better model for incentivizing pharmaceutical companies to greatly speed up the development and deployment of the candidate pan-coronavirus vaccines on which some are currently working. In a recent op-ed in the Los Angeles Times, two immunologists point out that the global cost of the COVID-19 pandemic is an estimated $16 trillion, compared to the cost of developing a typical vaccine at $1 billion. They note that even a $10 billion vaccine is minuscule compared with the pandemic’s toll.
Among the promising pan-coronavirus candidate vaccines are the Walter Reed Army Institute of Research’s spike ferritin nanoparticle COVID-19 vaccine; Osivax’s nucleocapsid vaccine targeting a protein widely prevalent among coronaviruses that is unlikely to mutate; and Inovio’s DNA vaccine encoding variant sequences of the spike proteins the virus uses to invade cells.”
“Late last year, Laura Wing-Kamoosi visited her 79-year-old father at the hospital in northern Michigan. To her surprise, a worker asked her to remove her N95 and replace it with a surgical mask. She declined, layering the surgical mask atop her N95 instead.
She saw no staff wear N95s, among the best respiratory protection available, while they treated her father for a tear in his aorta and other medical issues, she told POLITICO. One doctor wore his surgical mask under his nose, she said. Her father, who was hospitalized for about a month, contracted Covid-19 during his stay, and while he survived, the virus slowed his recovery.
The hospital, Munson Healthcare, said it requests visitors wear the surgical masks it provides to ensure people are using quality masks and that it allows visitors to layer one over their own. The hospital is following guidance from the Centers for Disease Control and Prevention — and for many public health advocates, that’s exactly the problem.
They fear that surgical masks put the most vulnerable people at higher risk of catching Covid-19. N95s, which seal tighter to the face, offer better protection against the airborne virus, studies show. For more than a year, many have called on the Biden administration to change its guidance to offer more protection inside hospitals, even as mitigation measures have been dialed back and case counts decline.
And yet, patients across the country say they are often told to replace their N95s with surgical masks as they enter hospitals.”
“In two February preprint papers, first reported by the New York Times, researchers traced the spread of the SARS-CoV-2 virus, the pathogen that causes Covid-19, in 2019 in Wuhan. One study looked at initial infections at the Huanan Seafood Wholesale Market, where the first cases were detected. The other examined the genomes of the earliest strains of the virus. Around the same time, researchers from the Chinese Centers for Disease Control and Prevention published their own findings from virus samples they collected from animals and the environment around the market in early 2020.
In addition to seafood, vendors at the market sold live animals, including those collected from remote wilderness areas.
Together, the studies connect the dots of transmission at the epicenter of the pandemic, observing that the virus likely made the leap from animals to humans more than once. “Once you understand that there were infected animals in the market, then multiple spillovers are not just a possibility, they’re what you would expect at that point,” Robert Garry, a virologist at Tulane University and a co-author on both papers, told Vox.
The studies’ conclusions contradict some early reports that the Huanan market was not the original locus of Covid-19. The results also echo how scientists think the first SARS virus spread to humans in 2002. According to Garry, they make the possibility that the outbreak began with a leak from the Wuhan Institute of Virology much less plausible.”
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“while researchers have narrowed down the location in the market where the outbreak likely began and have identified several potential animal hosts, they still haven’t found the specific animals that were infected. And though scientists have found several related viruses in the wild, they haven’t found one yet that they think could have directly spawned SARS-CoV-2.”
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“it may not be possible to find out since the specific infected animals were likely culled. “You’d have to be a time traveler or something like that to go back and see,” Garry said.”
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“The lab leak hypothesis holds that SARS-CoV-2 escaped from the Wuhan Institute of Virology, a facility roughly eight miles from the Huanan market. Proponents of the theory point to several factors. Researchers there were known to be studying bat coronaviruses. Specifically, they documented a bat coronavirus called RaTG13. Discovered in 2013, it has a genetic sequence with 96 percent overlap with SARS-CoV-2.
Scientists at the Wuhan Institute were also conducting experiments under lower safety conditions than most scientists would recommend for respiratory viruses. Some researchers argue that the types of experiments they were conducting constitute gain of function, where a virus is engineered to become more infectious.
Circumstantially, pathogens have escaped from Chinese laboratories before. And the Chinese government’s actions have added to the suspicions. They may have covered up the extent of the original outbreak, and international investigators have complained that the Chinese government still has not been fully transparent with what happened during the early days of the outbreak.
However, there appears to be no evidence the Wuhan Institute of Virology had an actual isolated sample of SARS-CoV-2, nor did they have any live ancestor to the virus, including RaTG13. They only recorded the genetic sequence.
The latest studies show also that the earliest clusters of the virus were concentrated in a specific area of the Huanan market. If the virus were introduced by a person from outside the market, environmental samples testing positive for SARS-CoV-2 would likely have been spread out more through the building.
In addition, the fact that two distinct lineages emerged in the early outbreak would require that someone from the lab would have had to introduce two different versions of the virus to the lab on two separate occasions.
“The simplest explanation is that infected animals infected people,” Garry said. “You have to go through quite a bit of mental gymnastics to go ‘it came from the lab to the market,’ and you have to believe that happened twice.””
“47 countries still have inoculation rates below 20 percent.
Now, many health organizations involved in the global vaccination effort aim to immunize 90 percent of vulnerable populations in every country — a move that seems to undercut the WHO’s 70 percent target.”
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“Prioritizing vulnerable populations — health care workers, elderly individuals and those with comorbidities — could undermine the global push to prevent variants if it reduces the total number of vaccinated people, some experts said. But facing the reality that the 70-percent-vaccination goal by mid-2022 is virtually doomed, some health groups working on the global vaccination effort are focusing on letting countries set targets according to their abilities and advising them to first target vulnerable populations.”
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““Striving to vaccinate 70 percent of the population of every country remains essential for bringing the pandemic under control — with priority given to health workers, older people and other at-risk groups,” WHO Director-General Tedros Adhanom Ghebreyesus told reporters at a press conference Wednesday.”
“Conflict over President Joe Biden’s immigration policy is complicating passage of a $10 billion coronavirus bill before a two-week congressional recess.
Just a day after Republican Sen. Mitt Romney and Majority Leader Chuck Schumer announced a deal on billions for therapeutics, vaccines and testing, GOP senators threw in a wrench that could mean Congress will break with nothing. Senate Republicans say they want a vote on an amendment that would keep in place the Title 42 border restrictions, which allows limits on immigration due to the pandemic. Without one, they say the bill can’t proceed.
Senate Minority Leader Mitch McConnell told reporters Tuesday that “there’s going to have to be an amendment on Title 42 in order to move the bill.” Without agreement among all 100 senators, the Senate will be unable to take up and quickly move the bill this week.”
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“The impasse could stall for weeks what Biden called much-needed coronavirus aid, unless senators can reach a deal before they plan to leave on Thursday or Friday. Without a breakthrough, the aid won’t be approved until late April or perhaps May. Republicans blocked a vote advance the bill on Tuesday, though Schumer can quickly bring it back up if there’s a deal on amendments.”
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“Democrats already think they’ve conceded plenty to the Republicans after Monday’s bipartisan agreement left out global vaccine funding. So there’s not a ton of enthusiasm for giving Republicans their immigration vote.”
“The roughly $10 billion in pandemic aid the Senate is preparing to vote on after a weekslong impasse will keep the nation’s testing, treatment and vaccination programs afloat for only a couple months, lawmakers, Biden administration officials and public health experts warn.”
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“This round of funding — if it can pass the House and Senate — would help restart key Covid-19 programs that recently ran out of resources, including the development of future variant-specific vaccines and federal government purchases of drugs for people at risk of hospitalization.
But the package was whittled down from more than $30 billion federal officials originally argued was needed to $22.5 billion the White House pitched to Capitol Hill last month to $15.6 billion congressional leaders tried to attach to the 2022 spending bill.
Now, $10 billion is on the table and the money for the global vaccination effort and for testing, treating and vaccinating the uninsured was dropped, all but guaranteeing the Biden administration will shortly need Congress to do this all over again.”
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“Public health leaders warn that these short-term bursts of cash are creating gaps in preparedness, leaving millions vulnerable to a new Covid surge.”
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“with no global money in the current deal, policymakers fear the disruption to the U.S.’ pandemic work overseas will continue indefinitely.
“Doing nothing to slow the global spread of COVID-19 is foolhardy,” Senate Appropriations Chair Patrick Leahy (D-Vt.) warned Monday. “As the virus continues to mutate and wreak havoc overseas, more Americans will become sick and die.”
For months, officials at the U.S. Agency for International Development have warned lawmakers that they would soon run out of money to help facilitate vaccinations in low- and middle-income countries, and advocated for at least $19 billion for the global Covid fight.”
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“On the domestic front, the funding delays have forced the federal government to halt purchases of enough additional booster doses for all Americans and slash the purchase and distribution of monoclonal antibody treatments and antiviral pills for high-risk Covid patients. It has also disrupted research into new treatments and cut off reimbursements to doctors around the country for testing, treating, and — as of Tuesday — vaccinating the uninsured. Even if Congress manages to approve the funding this week, public health experts say, there’s a good chance all of these threats will reemerge in just a few months, damaging the stability and continuity of their fight against the virus.”
“Laboratory studies indicate that masks, especially N95 respirators, can help reduce virus transmission. But as Flam notes, “the benefits of universal masking have been difficult to quantify” in the real world, where cloth models predominate and masks may not be clean, well-fitted, or worn properly.
The strongest real-world evidence in favor of general masking comes from a randomized trial in Bangladesh, which found that the use of surgical masks reduced symptomatic infections by 11 percent. That’s not nothing, but it’s a pretty modest effect, and it was achieved with surgical masks worn by adults in conditions that encouraged proper and consistent use. The same study found that cloth masks did not have a statistically significant effect.”
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“Given the situation during the omicron surge, there are additional reasons to doubt that mask mandates, even with perfect compliance, had much of an impact. While mandates required shoppers to don masks before entering supermarkets, for example, the risk of transmission in such settings is low, given the amount of time customers usually spend in them, the size of the air space, and typically wide distances between patrons. Conditions in bars and restaurants are more conducive to virus transmission, since customers spend more time there in closer proximity to each other, often while talking. But since people were allowed to remove their masks while eating and drinking, requiring them to cover their faces upon entry was more a symbolic gesture than a serious safeguard.
Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. Even if masking works, that does not necessarily mean mandates do.
An Annals of Epidemiology study published last May found that mask mandates in the United States were associated with lower transmission rates from June through September 2020. “The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening,” the researchers reported. But the study did not take into account other policies or voluntary safeguards that may have differed between jurisdictions with and without mask mandates. Nor did it look at actual mask wearing, as opposed to legal requirements.
Based on data from various countries and U.S. states from May to September 2020, a preprint study published last June found that general mask wearing was associated with a reduction in virus transmission. But the researchers found no clear relationship between mask mandates and mask use. “We do not find evidence that mandating mask-wearing reduces transmission,” the authors reported. “Our results suggest that mask-wearing is strongly affected by factors other than mandates.”
An August 2021 systematic review of 21 observational studies found that all of them “reported SARS-CoV-2 benefits” from mask mandates “in terms of reductions in either the incidence, hospitalization, or mortality, or a combination of these outcomes.” But “few studies assessed compliance to mask wearing policies or controlled for the possible influence of other preventive measures such as hand hygiene and physical distancing.”
Like the debate about lockdowns, the debate about mask mandates will continue. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. But it seems clear that anyone who takes it for granted that mask mandates have played a crucial role in controlling the spread of COVID-19 is making a series of assumptions that are not justified by the evidence.”
“The researchers surveyed more than 6,000 people in the United States, United Kingdom, European Union, Australia, and New Zealand. They contacted them first in December 2020, to assess their intentions before the vaccines were widely available, and asked them to pick a number between 0 and 10 to represent their likelihood of getting vaccinated. Then they followed up in summer of 2021 to see how people actually behaved.
To me, their most interesting findings concerned the most ardent vaccine refusers. Six months later, one-third of the people who had rated themselves 0 in December had gotten vaccinated.
So what happened? What convinced them?
Some of it was circumstances. Among those who had put themselves between 0 and 3 on getting vaccinated, those who were older (and therefore at higher risk of serious illness) and concerned with their health risks were more likely to get vaccinated in spite of their skepticism. So did the people who anticipated indirect exposure to Covid-19 through their friends or relatives. People who consumed more traditional media and who had more trust in scientists were also more likely to come around.
Vaccine mandates were not in effect at the time of these surveys, but the study generally found a mixed response to compulsory vaccinations among the respondents.”
“combined with previous coronavirus response bills and spending packages, the federal government has now spent almost $5 trillion addressing the pandemic”
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“It’s not clear yet where all this money will go — states have an enormous amount of leeway as to how they’ll spend it and until 2026 to do so. (In total, $155 billion went out to states in 2021, with the rest due to be distributed later this year.) Most states have used the windfall of cash to address the budget problems caused by the economic downturn following the pandemic and to address the inequities thrown into sharp relief during the past two years. But while there are broad commonalities in how states have spent the money, it’s also true that how relief from the pandemic is defined varies widely — not necessarily across partisan lines but in ways that are still shaped by local conditions and ideology.”
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“Almost every state that has allocated money so far has spent some on broadband, water and sewer infrastructure”
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“Infrastructure has also been a big priority for states like Florida, which is spending money on highways and other transportation projects that had been long-planned but unfinished. Lazere said some of the need for infrastructure goes all the way back to the Great Recession, which began in 2007, and the long, slow recovery that followed. “These were areas of need that had not been addressed, [for which] there hadn’t been a dedicated state or federal funding source, so the rescue plan gave them the opportunity to tackle these problems that had been around for a long time,” he said.
Additionally, because the funds are a large, one-time payment, with no expectation that they’ll continue into the future, it encourages spending on infrastructure.
“It really starts with states doing that analysis, to be able to know what’s affordable over the long-term and what’s not,” said Josh Goodman, who is part of The Pew Charitable Trusts’s state fiscal health project.”
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“In Alabama, $400 million will be used for building two new prisons.”
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“the state has been under a court order to improve mental health care in its prisons since 2017, and advocates of the new law say using the recovery funds to build a new prison will address those problems, as well as overcrowding and inadequate staffing. They also say the new facilities will improve the overall health care and mental health care available to incarcerated individuals.”
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“In more liberal states and localities, lawmakers are pursuing new financial assistance programs for local families. One idea that has picked up steam is funding guaranteed income pilot programs, with eligible residents receiving between $500 and $1,000 in cash assistance monthly. Support for these programs has been growing across the ideological spectrum, especially in the last few years.”
“A recent study of the program’s effects from the National Bureau of Economic Research (NBER) finds that the majority of the funds spent by the program went to business owners and shareholders rather than to workers themselves. Ultimately, “only 23 to 34 percent of the program’s funds went directly to workers who would have otherwise lost their jobs.” The jobs it did keep in place were preserved at very high cost—somewhere between $170,000 and $257,000 a year, far more than the typical earnings of affected workers, which are closer to $58,000 per year.
While the PPP was able to save some jobs, albeit, at a very high cost, the overall result of the program was precisely the opposite of what was intended. The purpose of the program was to preserve the jobs of wage workers, not to funnel money to business owners. As David Autor, a Massachusetts Institute of Technology economist and the lead researcher behind the paper, told The New York Times recently, “it turns out [the money] didn’t primarily go to workers who would have lost jobs. It went to business owners and their shareholders and their creditors.” The program, he added, was “highly regressive.””