New Coronavirus News from 15 Nov 2020b

Better, smarter, local response systems are the only way to avoid further lockdowns [The Guardian, 15 Nov 2020]

By David Nabarro and John Atkinson

Even with a coming vaccine, we have to radically rethink our approach

Covid-19 is surging back, threatening to overrun hospitals, cause long-term illness and more deaths. The disease will be with us for the foreseeable future. Unless it is contained, there will be more misery and the increased risk of serious social disruption.

In many countries, containment strategies involve restrictions on people’s movements and lockdowns. These have serious economic and social consequences and should be applied sparingly.

But how can we avoid another rise in cases when the current lockdowns end? And how can further lockdowns be avoided next year? Assuming the positive news about vaccine development is sustained, efforts will be made to ensure that those most at risk can access a vaccine in 2021, but it will be some months before vaccination programmes will slow the spread of infection. In the meantime, all nations in western Europe – including the UK – need to be sure that they have better-functioning and resilient localised Covid-19 response systems.

Implementing these systems should reduce the need for a third period of restrictions early in 2021.

Here, we offer a plan that would enable societies to defend themselves, while maintaining public confidence and sustaining economies.

1 Involve people everywhere. It might seem self-evident, but success happens when more people do more of the right things more of the time. In shops, schools, universities and workplaces, millions of people are figuring out how to stay safe. They are creating “Covid-ready” environments. They are ensuring good hygiene, physical distancing, mask-wearing, and self-isolating when sick. They are also paying special attention to those who, because of age, occupation, vulnerabilities or living conditions, are at high risk. This is the heart of the response.

2 Earn people’s trust through honesty, authenticity and consistency. Unambiguous messaging must be delivered to all in meaningful language. Ensure that everyone appreciates the need for all-round compliance and understands what has to be done and when. Respect people and gain their trust. Do not apologise. Be clear on the rationale for restrictions and rules for isolation.

3 Ensure communities are supported through nationwide networks. The ability of societies to keep Covid-19 at bay depends on the quality of connections between people, the extent to which they are supported and local capacity. People at risk of or affected by Covid-19 should know where to go to for assistance. They depend on existing community organisations for support. For such support to be available and meaningful, community organisations need to be linked and the support on offer must be explicit. The honeycomb of links between community groups should be activated everywhere without delay.

4 Develop public health capability to interrupt transmission. Local public health teams are the experts in investigating outbreaks, tracing contacts and interrupting chains of transmission.
Their actions stop spikes, clusters and surges of infection running out of control. Teams need to be led by public health specialists with the full involvement of GPs and pharmacists. They should be adequately funded and regularly updated on evolving knowledge.

5 Suppress outbreaks through integrated incident response teams at local level. As disease outbreaks build up, they must be suppressed rapidly and robustly. Efficient leaders must engage faith groups, businesses, the hospitality sector, public health, schools, colleges, universities, sports clubs, the media, police, hospital services and more.

Each group becomes an integral part of the response team that is activated as needed, meets frequently and agrees on direction and actions. Response team members inform their constituencies and communicate with national agencies. Teams will usually be led from local authorities under chief executive oversight.

6 Ensure the resources and powers of national government are used where most valuable.
Responders are dealing with unprecedented challenges. They need high-quality, up-to-date and immediate information on key events. National resources, eg around testing for Covid-19 and contact-tracing, need to be put in service of the local need. Legislation may be required to support enforcement. Proper funding must be allocated to ensure that those who are sick, shielding or on furlough do not lose out.

7 Connect all the elements and ensure the system works: people, communications, community-based support, professional capability, integrated incident teams and supportive national authorities should not be thought of as separate. Communication, mutual support, finance and regulation are critical to the success of every element. For the response system to function effectively, all of its parts must be connected. Good and trusting relationships between them are key to success. Covid-19 will exploit any gaps or weaknesses in the system.

We all play our part in making all this happen. People’s health and local economies are intimately connected. Covid-19 is not seen as a problem for “someone else”; we recognise that all of us must adapt and evolve. Containing Covid-19 will give us all the confidence to take on other challenges, which will augur well for future generations.

Do it without delay. A further lockdown may be essential when the disease is surging strongly. Without one, it may spiral out of control. But because lockdowns are damaging, Covid-19 must be contained differently. This means setting up strong, community defences and implementing responses rapidly, robustly and with compassion. Well-functioning defences keep case numbers low. That is why it is urgent to establish them everywhere. The time for action is now.

•David Nabarro is a WHO special envoy on Covid, co-director of the Institute for Global Health Innovation at Imperial College London and strategic director of 4SD Systems Leadership Mentoring, Switzerland.

•John Atkinson is a specialist in systems change working with the UN and multilateral bodies

Japan’s Economy Surges as Covid-19 Limits Ease [The New York Times、15 Nov 2020]

By Ben Dooley and Hisako Ueno

Activity has jumped as pandemic limits have eased, in a positive sign for global growth, but damage may be deeper than the initial numbers showed.

TOKYO — Japan became the latest major economy to bounce back from the devastation of the coronavirus, as lockdowns eased and pent-up demand led to surging domestic consumption and a rebound in exports.

But the recovery is unlikely to be long-lived, analysts warn, as a surge in new virus cases has led to a second round of lockdowns in the United States and Europe and threatens to dampen sentiment at home.

Japan’s economy, the world’s third largest, surged 5 percent during the July-to-September period, for an annualized growth rate of 21.4 percent, after three straight quarters of contraction. The performance follows spurts of growth in the United States and China, the No. 1 and 2 global economies, after the initial hits caused by the pandemic, in a hopeful sign for global growth prospects.

Japan’s economy had contracted a revised 8.2 percent last quarter as the pandemic kept consumers home and devastated already weak demand for the country’s exports. The collapse in growth was the largest since 1955, when the Japanese government began to use gross domestic product as a measure of its economy, and paralleled similarly disastrous numbers for most of the world’s major economies.

While the country appears to be on the road to recovery, severe economic damage remains, according to Yuichi Kodama, chief economist at the Meiji Yasuda Research Institute.

“The rate of expansion is high, but the real economy is not as good as the numbers. It’s only about halfway recovered from its enormous fall,” he said.

When the pandemic hit in February, Japan’s economy had already begun to shrink because of slumping demand from China, a tax increase on Japan’s consumers and a costly typhoon in October. That underlying weakness made it the first among major economies to fall into recession, defined by two consecutive quarters of contraction.

That same fragility has also made it slower to recover. The size of its rebound has not been as stark as other major economies. The United States economy grew 33 percent, on an annual basis, in the most recent quarter.

Japan declared a national emergency in mid-April, asking people to stay home and businesses to close, but by early summer case numbers had dropped to a few hundred a day nationwide, and life returned to something approaching normal, despite a bump in July.

Large government subsidies kept workers in their jobs and companies in business. To stimulate the service sector, authorities provided discounts for those willing to travel and eat out. Diners returned to restaurants and shoppers returned to malls. By October, moviegoers were flocking to the theaters.

Abroad, pent-up demand from Japan’s major trading partners, especially China — where the virus has been nearly eradicated — drove a recovery in exports. Chinese consumers rushed to buy new cars and factories resumed purchases of electronic components, helping Japanese companies to recover from devastating losses earlier in the year.

Japan’s success in controlling the virus so far — it has recorded around 1,800 deaths since the pandemic began — has made businesses and investors bullish. Economic sentiment in the service sector is at its highest point in six years, according to a monthly government survey. And the country’s main stock exchange, the Nikkei, hit a 29-year high last week.

But it may be difficult to maintain the recovery’s momentum as the virus spreads in the winter months. Although daily case counts in Japan have yet to pass the 2,000 mark, the numbers have grown steadily in recent weeks.

As case counts grow, government efforts to stimulate the economy through discounts on travel and dining out have come under fire, with many questioning the wisdom of encouraging people to move around during the pandemic.

While the government has said it will exercise increased vigilance, Prime Minister Yoshihide Suga has continued to support the program, saying that there is, as of now, no need to consider a new state of emergency.

But “things could change a lot depending on what happens with the coronavirus,” said Yoshiki Shinke, chief economist at the Dai-ichi Life Research Institute. The recovery would most likely stall if the government calls for new restrictions on activities as it seeks to curb new cases, he said, adding “as of right now, all you can say is that there is a lot of uncertainty.”

The bigger immediate threat to growth, however, may be an explosion in virus cases in other countries, said Akane Yamaguchi, an economist at the Daiwa Institute of Research.

The recovery “depends on overseas economies,” she said. “There is downside risk as Europe locks down, and in the United States if the president tightens prevention policies as infections increase.”

Regardless of what happens abroad, Japan’s economy may take a long time to fully recover.
While China’s return to growth will help, “Japan’s economy can’t rely on external demand alone to pull it into economic recovery,” Mr. Kodama of the Meiji Yasuda Research Institute said.

While a vaccine could spur a rapid recovery, he said, without one, “Japan’s economy will continue to be sluggish, tending toward stagnation, through next year.”

WHO reports record high number of Covid-19 cases over weekend [FRANCE 24 English、15 Nov 2020]

The WHO's figures for Saturday showed that 660,905 coronavirus cases were reported to the UN health agency, setting a new high watermark.

That number, and the 645,410 registered on Friday, surpassed the previous daily record high of 614,013 recorded on November 7.

Within Saturday's new case numbers, the WHO's Americas region registered a one-day record high of 269,225 new confirmed cases.

Within each week, the pattern of cases being reported to the WHO tends to peak towards Friday, Saturday and Sunday, and dip around Tuesday and Wednesday.

According to the WHO's figures, there have been more than 53.7 million confirmed cases of the disease in total since the start of the pandemic, while over 1.3 million people have lost their lives.

WHO director-general Tedros Adhanom Ghebreyesus warned Friday that there was "a long way to go" in getting the virus under control globally.

France sees slight fall in new case rate

France meanwhile registered 27,228 new confirmed cases of Covid-19 and a further 302 deaths from the disease in the last 24 hours, health ministry data showed on Sunday, although there were signs of a fall in the rate of new cases.

France has now recorded 1,981,827 confirmed COVID-19 cases in all, while 44,548 people have died from the virus - the seventh-highest death toll in the world.

Nevertheless, the data marked a slight decrease compared with the previous day's Covid-19 figures in terms of new confirmed cases and deaths.

France is in the middle of its second, national lockdown aimed at curbing the spread of the virus, following its March-May shutdown.

President Emmanuel Macron's government has set a December 1 deadline for this lockdown, although the government has said it could extend it beyond that if it feels the numbers are not falling fast enough.

The government is coming under pressure from shops and businesses to loosen restrictions in time for the Christmas shopping period.

Coronavirus emerged in Italy earlier than thought, study shows [CNBC、15 Nov 2020]

The new coronavirus was circulating in Italy since September 2019, a study by the National Cancer Institute (INT) of the Italian city of Milan shows, signaling that Covid-19 might have spread beyond China earlier than previously thought.

The World Health Organization has said the new coronavirus and Covid-19, the respiratory disease it causes, were unknown before the outbreak was first reported in Wuhan, in central China, in December.

Italy’s first Covid-19 patient was detected on Feb. 21 in a little town near Milan, in the northern region of Lombardy.

But the Italian researchers’ findings, published by the INT’s scientific magazine Tumori Journal, show that 11.6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020, had developed coronavirus antibodies well before February.

A further specific SARS-CoV-2 antibodies test was carried out by the University of Siena for the same research titled “Unexpected detection of SARS-CoV-2 antibodies in the pre-pandemic period in Italy”.

It showed that four cases dated back to the first week of October were also positive for antibodies neutralizing the virus, meaning they had got infected in September, Giovanni Apolone, a co-author of the study, told Reuters.

“This is the main finding: people with no symptoms not only were positive after the serological tests but had also antibodies able to kill the virus,” Apolone said.

“It means that the new coronavirus can circulate among the population for long and with a low rate of lethality not because it is disappearing but only to surge again,” he added.

Italian researchers told Reuters in March that they reported a higher than usual number of cases of severe pneumonia and flu in Lombardy in the last quarter of 2019 in a sign that the new coronavirus might have circulated earlier than previously thought.

Coronavirus digest: German leaders warn lockdown measures to last months [DW (English)、15 Nov 2020]

Several German leaders have spoken out against relaxing coronavirus restrictions too early. The Economy Minister warned Germany could face another four to five months of partial lockdown. Follow DW for the latest.

German Economy Minister Peter Altmaier told German newspaper Bild am Sonntag that the partial lockdown measures would likely last many more months and warned against easing coronavirus restrictions too early.

"The infection figures are still too high. Much higher than two weeks ago…despite all efforts, a change for the better has not yet been achieved," Altmaier told the paper, adding that he sees "little leeway" for re-opening restaurants and movie theaters.

"We cannot afford a yo-yo shutdown with constant opening and closing of the economy," he said, adding that Germans might have to continue living under coronavirus restrictions beyond December.

"We will have to live with considerable precautions and restrictions for at least the next four to five months."

Altmaier's comments come ahead of a meeting on Monday between Chancellor Angela Merkel, her ministers and state leaders to assess the effectiveness of the country's partial shutdown, which began on November 2.

Two state leaders also expressed their doubts about easing the curbs, including Bavaria's state premier Markus Söder, who told Bild am Sonntag: "There is absolutely no room for relaxing of restrictions. Easing too early risks Christmas. We have to consider whether the measures taken so far are sufficient."

Saxony's state premier Michael Kretschmer told the newspaper: "In my view, there is no basis for relaxation due to the high infection rates."

Europe
In Germany, the number of confirmed coronavirus cases increased by 16,947 to 790,503, data from the Robert Koch Institute for infectious diseases showed. The recorded death toll rose by 107 to 12,485.

German authorities are planning to set up hundreds of vaccination centers across the country from December in order to begin the coronavirus inoculation program, according to a report in the newspaper Welt am Sonntag.

The country is s eeking to buy 100 million doses of a vaccine being developed by German pharmaceutical company BioNTech and US partner Pfizer. Researchers say the drug has 90% efficacy.

Germans should put Christmas travel and party plans on hold to help fight against coronavirus, one of the country's top disease expert warned on Sunday.

Bernd Salzberger, the chairman of the German Society for Infectiology, said next month's holiday period could be a "kick-starter" that would see the virus spread in the same way flu has in previous years.

"People travel all over the country, mingling everywhere. They go to the pub to meet their old classmates," the University of Regensburg professor said.

But he warned Germans that they will "not have a normal life in December."

"This cannot and would not be sensible," Salzberger said in an interview.

More than one in five German police officers have had to go into quarantine since the beginning of the pandemic, a total of 11,890 out of around 51,000.

There are currently 1,857 police officers in quarantine, whether due to professional or private contacts.

British Prime Minister Boris Johnson has been told to self-isolate after he came into contact with someone who tested positive for COVID-19.

"He will carry on working from Downing Street, including on leading the government’s response to the coronavirus pandemic," said a spokesman for Johnson, who was hospitalized with COVID-19 earlier this year.

The spokesman added that the prime minister was well and had no symptoms of COVID-19.
Some 10 COVID-19 patients have died in Romania after a fire broke out in an intensive care ward in the northern city of Piatra Neamt.

Romania has reported 8,813 coronavirus-related deaths since the beginning of the pandemic.

In Italy, almost half of the population will be in partial confinement on Sunday after the regions of Campania and Tuscany became classified as "red zones."

The Austrian government announced the closure of schools and non-essential stores until December 6 after two weeks of partial lockdown measures failed to slow down the spread of the coronavirus.

Portugal has implemented a curfew in more than a hundred municipalities, where about 70% of its population of 10 million resides. The curfew begins at 11 p.m. on weekdays and from 1 p.m. on Saturdays and Sundays. Nearly 500 people protested against the curfew measures on Saturday in central Lisbon.

French Prime Minister Jean Castex warned the country would "live with the virus for a long time," and added that he is considering new rules until a vaccine arrives. "Festive, family gatherings in party halls will not be able to resume for a long time. Similarly, bars and restaurants, also high-risk transmission areas, will not be able to re-open from December 1," he said.

In more positive news, the number of coronavirus patients in hospital, and in intensive care, in France has dropped for the first time since September. The country has been under a nationwide lockdown for two weeks.

COVID-19 patients still occupy 96% of France's intensive care beds. France has reported more coronavirus infections than any other European country.

Greece has shutdown elementary schools, kindergartens and nurseries until the end of the month. Colleges and high schools have already been closed since Monday. A stay-at-home order was re-introduced on November 7.

The European Medicines Agency (EMA) said that an effective vaccine could be available within the next two months. EMA Director Guido Rasi said the EU body would be able to give the green light to the first vaccine by the end of the year and start distribution from January.

Middle East

Lebanon has begun a new "total" home confinement measure which is set to last two weeks.
The government imposed the stay-at-home order in a bid to fight soaring levels of coronavirus infections that have overburdened the country's hospitals.

Iran has reached another record high of new daily cases, reporting 12,543 infections in the past 24 hours. The country has seen cases soar with a total of 762,068 officially recognized infections since the outbreak began.

The Health Ministry also reported on Sunday that 459 people had died.

Americas

Mexico has surpassed 1 million coronavirus infections and registered 98,259 test-confirmed deaths. Health officials have previously said the real number of cases is likely significantly higher than the reported figures.

Brazil has recorded 921 coronavirus deaths in the last 24 hours, bringing the national death toll to 165,658. Brazil now has more than 5.8 million infections, according to the Health Ministry.

Coronavirus Updates: Dr. Fauci Concerned By Trump's Opposition To Biden Transition [Gothamist、15 Nov 2020]

BY SYDNEY PEREIRA

New York City is in Phase 4 of reopening now, which includes zoos, botanical gardens, museums, and gyms, as well as 25% indoor dining. Certain parts of Brooklyn and Staten Island under a zoned shutdown. Get answers to questions you may have with our "Ask An Epidemiologist" series, or learn more about NYC COVID-19 testing options with our explainer. Here are some local and state hotlines for more information: NYC: 311; NY State Hotline: [phone]; NJ State Hotline: [phone].

Here's the latest:
• NYC Reports 2.6% Virus Positivity, Schools Will Stay Open Monday
• Cuomo Urges De Blasio To Reconsider Public School Shutdown Plan
• COVID-19 Positivity Rate In NYC Falls To 2.5%, Averting Public School Shutdown For Now
• Illegal Parties In Manhattan And Brooklyn Broken Up In Overnight Raids, NYC Sheriff Says
2:37 p.m.: President Donald Trump's ongoing opposition to any transition of power to President-elect Joe Biden will have an impact on the federal government's response to the ongoing public health crisis, Dr. Anthony Fauci said Sunday morning in an interview on CNN.

"It's almost like passing a baton in a race. You don't wanna stop and then give it to somebody. You wanna just essentially keep going," Fauci, the director of the National Institute of Allergy and Infectious Diseases, told CNN's Jake Tapper in response to a question on how the transition process impacts public health.

"Of course it would be better if we could start working with them," Fauci said, referring to the incoming Biden-Harris administration. Fauci also said Trump had not met with the White House coronavirus task force in several months.

CNN reports the transition process—in which the incoming president-elect receives briefings on federal agencies—hasn't moved forward, while staffers below the political appointees are quietly preparing documents in some agencies.

Trump has refused to concede in the weeks following the election. On Sunday, he admitted in a tweet that Biden had won, but soon after clarified he has not conceded and blamed his loss on false information about a "rigged" election. (Twitter has marked the posts for disputed information.)

Fauci told CNN he's served six presidents across 36 years, and noted the transition process "is really important in a smooth handing over of the information."

"It certainly would make things more smoothly if we could do that," Fauci said.

Meanwhile, in the final months of Trump's presidency, the future vaccination phase of the pandemic continues to be a source of conflict between Trump and Governor Andrew Cuomo. Last week, Trump claimed he wouldn't send vaccine doses to New York until Cuomo approves it.

On Sunday, Cuomo threatened to sue the Trump administration over his vaccine plan, which the governor has said would increase racial disparities.

"I tell you today if the Trump Administration does not change this plan and does not provide an equitable vaccine process, we will enforce our legal rights, we will bring legal action to protect New Yorkers," Cuomo said in remarks at a Manhattan church on Sunday.
Cuomo added that enough "injustice has been done during COVID. It stops now. It stops with this vaccine."

No vaccine has been officially approved, and the process for distribution and administration would result in new challenges for the country and local governments.

NY is still fighting back a second wave of the virus.

The statewide positive testing rate was 2.74% on Saturday, Cuomo announced. The seven-day rolling average was at 2.86%. Cluster zones across the state had a 4.05% positivity rate, which is factored into the statewide rates.

Thirty New Yorkers died of coronavirus on Saturday, according to the governor's office. The official death toll across the state reached 26,133—a tally that does not include probable coronavirus deaths.

As nation awaits transition of power, Fauci issues timely warning to his fellow scientists [MarketWatch、15 Nov 2020]

By Quentin Fottrell

In a conversation with the American Medical Association, the director of National Institute of Allergy and Infectious Diseases spoke about politics, science and vaccines

On Friday, President Donald Trump said that “time will tell’ if he stays in power, despite his Democratic rival Joe Biden winning both the popular and electoral vote in the U.S. presidential election. The president threatened to withhold a coronavirus vaccine, if/when it becomes available, from New York. Meanwhile, the U.S. racked up over 1 million new coronavirus infections in the last 10 days, and reached another grim milestone in cases on Friday.

“Whatever happens in the future, who knows which administration it will be — I guess time will tell, but I can tell you this administration will not go to a lockdown,” Trump said at the White House’s Rose Garden, speaking about the “Operation Warp Speed” public-private partnership that aims to accelerate development of a COVID-19 vaccine. He didn’t respond to reporters’ shouted questions about conceding the election.

Dr. Anthony Fauci, meanwhile, has a word for his industry colleagues. In a conversation with the American Medical Association, Fauci, 79, director of National Institute of Allergy and Infectious Diseases, said physicians need to be careful about their public statements. “Stay completely apolitical,” he said this month. “Don’t get involved in any of the political aspects, and just focus on what your job is as a scientist and a physician. You do that, you’ll be fine.”

‘Don’t get involved in any of the political aspects, and just focus on what your job is as a scientist and a physician. You do that, you’ll be fine.’

— Anthony Fauci, director of National Institute of Allergy and Infectious Diseases
On Monday, Pfizer PFE, +2.85% and BioNTech BNTX, +4.30% said their vaccine candidate BNT162b2 is 90% effective in first interim analysis of Phase 3 study in participants without previous evidence of SARS-CoV-2 infection. Speaking before Pfizer and BioNTech released their vaccine news, Fauci said a vaccine with an efficacy of 70% to 75% would be going in the right direction.

While the U.S. makes up 4% of the world’s population, it has had 20% of all COVID-19 cases. As of Sunday, the U.S. had reported 10.9 million coronavirus cases and 245,933 COVID-related deaths, just ahead of India (8.8 million cases to date), according to Johns Hopkins University. To put that in context: The U.S. has a population of 328 million people versus 1.35 billion in India.

The U.S. daily tally of coronavirus infections topped 160,500 on Saturday after hitting a daily record of 184,000 on Friday. Hospitals in the Midwest and southern states including Texas and Florida continued to feel the strain. Hospitalizations are at their highest level since the pandemic began, up 30% since Nov. 1, according to the Covid Tracking Project.

Fauci has walked a fine line between educating the public about coronavirus and President Trump. Last month, Trump took aim at Fauci on a campaign call and on Twitter TWTR, +1.56%, calling him a “disaster” in a campaign call and bemoaning his media appearances, but the veteran immunologist told Americans to follow the scientific data, and to stay out of the political fray.

On Twitter, the president, 74, also criticized Fauci’s media appearances urging people to wear masks and socially distance, and appeared to be rankled by the doctor’s media exposure: “Dr.Tony Fauci says we don’t allow him to do television, and yet I saw him last night on @60Minutes, and he seems to get more airtime than anybody since the late, great, Bob Hope.”

Fauci, meanwhile, has given the American public the same advice he gave fellow scientists over the weekend. “My advice to young people is — unless you want to be a politician — stay away from the politics and let science and good data guide your policy.” Fauci added, “We’re going through a time that’s disturbingly anti-science in certain segments of our society.”

On Monday, Fauci appeared on CNN and said that a vaccine could be administered by the end of this year. He called the announcement by Pfizer and BioNTech “good news” and “a really big deal.” He told CNN’s Wolf Blitzer, “We may have doses that we are able to give to people by the end of November, the beginning of December, probably well into December.”

Speaking to AMA Executive Vice President and CEO James Madara last weekend, Fauci also said there have been significant improvements in treatment regarding when it’s best to put people on ventilators and how much oxygen to administer during intubation. “We just get better at treating the disease. We know what works, what doesn’t work,” he said.

“We know that dexamethasone clearly diminishes the death rate in people requiring mechanical ventilation and/or people who require high-flow oxygen,” Fauci said during the interview on Saturday. “We have remdesivir for hospitalized patients who have lung involvement.” Using anticoagulants for some patients is also increasingly common for COVID-19 treatment, he said.

Fauci Says Pfizer Vaccine’s Trial Success May Boost Acceptance [Bloomberg、15 Nov 2020]

By Jason Gale

The success of Pfizer Inc.’s Covid-19 vaccine trial may help persuade more people to get inoculated amid a surge in new coronavirus cases, according to Anthony Fauci, the top U.S. infectious-disease doctor.

Pfizer’s vaccine, developed in collaboration with Germany’s BioNTech SE, has “an extraordinarily high degree of efficacy -- more than 90%, close to 95%,” Fauci said in an interview. That could be a key factor in overcoming reluctance to take pandemic vaccines that have been developed at top speed.

“What I would hope is that even though there’s a degree of skepticism about vaccines in general, that when the general public sees how effective this vaccine is,” said Fauci, director of the National Institute of Allergy and Infectious Diseases, “we might see a turnaround of the attitude toward vaccination.”

The U.S. may begin offering the vaccine to priority groups at the end of December, Fauci said. It’s hoped to blunt spiking infections that reached a record 190,000 new daily cases this week.
The Trump administration has both purchased and funded development of doses from Pfizer and other drugmakers with a goal of making enough supplies for most Americans by year-end.

Read more: Trump’s ‘Operation Warp Speed’ Aims to Rush Coronavirus Vaccine
The name of the administration’s effort, Operation Warp Speed, may have created an impression that corners are being cut to create a vaccine, undermining public confidence, researchers including Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, have said.

Just over half of U.S. adults said in September they would definitely or probably take a vaccine to prevent Covid-19 if it were available, down from 72% in May, a national survey by the Washington-based Pew Research Center showed. A survey in June of people in 19 countries published last month in the journal Science found 71.5% of participants would probably take a Covid-19 vaccine, with acceptance ranging from almost 90% in China to less than 55% in Russia.

Results of a late-stage trial of a vaccine candidate from Moderna Inc. that uses the same messenger RNA technology as the Pfizer shot are likely to be available within a week, Fauci said. “And if that is really comparable to what we saw with the Pfizer trial, we’ll now have two highly effective vaccines,” he said.

“We’ve got to convince people to take the vaccine, because if you have a highly effective vaccine and only 50% of the people take it, you’re not going to have the impact that you’d need to essentially bring a pandemic down to such a low level that it’s no longer threatening society,” Fauci said. “And that’s the goal of a vaccine.”

Read More: Covid Vaccines Face a Volatile World When It Comes to Trust
The vaccines developed by Pfizer/BioNTech SE and Moderna are given in a two-shot regimen. The duration of their protection, or that of any Covid-19 vaccine, isn’t yet known, Fauci said.
Coronaviruses generally don’t generate an immune response with decades-long durability, and people are infected with one or more of the four coronaviruses that cause the common cold year after year, he said.

If the vaccine’s effect has “one to two years of durability, to me that’s fine, because we just go back and boost people and get the immunity up,” Fauci said.

More than 20 Covid vaccines have entered the final stage of patient studies that new pharmaceutical products are usually required to undergo for regulatory approval. Even though the late-stage trials may take only a few months, participants and others who receive experimental vaccines will be followed for as long as two years as part of safety monitoring and surveillance, Fauci said.

“You always want to be very careful when it comes to safety when you’re dealing with vaccines that you’re going to be giving to hundreds of millions, if not billions of people,” he said. “And that is something that is on everybody’s front burner. Safety is paramount.”

Fauci reiterates 'cautious optimism' regarding COVID vaccine [Healio、15 Nov 2020]

Speaking at The Liver Meeting Digital Experience, Anthony S. Fauci, MD, restated actions needed to control the current resurgence of COVID-19, recommended treatments and his “cautious optimism” about recently released vaccine study data.

“Here we are now with a global pandemic of historic proportions, the likes of which we have not seen in the last 102 years,” Fauci, director of the National Institutes of Allergy and Infectious Disease said. “In the United States, we have been hit the hardest of any other country with close to 10 million cases and over 230,000 deaths. ... On November 4, we hit 100,000 cases in a single day.”

Anthony S. Fauci

“We have had experience with coronaviruses now for decades and decades,” Fauci said, referring to the varieties that make up a third of the common cold. With this knowledge, science showed five fundamental actions that could contribute to prevention of acquisition and transmission of SARS-CoV-2: universal wearing of masks, 6 feet of physician distance, avoiding crowds, staying outdoors vs. indoors and frequent handwashing.

“If those five public health measures were adhered to universally and consistently over the country, it is clear from our previous experience with other nations and even regions in our own country, we would not have the degree of surging of cases we are currently seeing,” he said.

Fauci reviewed the facts we know about COVID-19.
• There is a spectrum of disease with 81% of people with confirmed virus showing just mild or moderate symptoms while 14% have severe symptoms and 5% are critical.
• Older age is a “striking” predictor of hospitalization.
• Comorbidities increase risk for severe COVID-19 illness. “Paramount among this is obesity and chronic obstructive pulmonary disease,” he said.
• Racial and ethnic disparities are “quite serious” with Hispanic, Native American and Black populations being infected and hospitalized at much higher rates than white people.
• Post-COVID-19 syndrome is becoming more apparent. “Variable percentages ... of people who have symptomatic disease – be it symptoms that don’t necessarily require hospitalization – ... when they recover virologically, a certain percentage, sometimes as high as one-third experience lingering symptoms for weeks to months,” Fauci said.

Though the NIH has a living document with treatments guidelines, only two – remdesivir (Gilead Sciences) and dexamethasone – are currently recommended for hospitalized patients. Fauci said others are still under investigation, including monoclonal antibodies, which he said are “being very actively pursued.”

Currently, many have their eyes on the six companies in the running for the COVID-19 vaccine.
Fauci described a “strategic approach” to developing a COVID-19 vaccine in which the government worked to “harmonize” protocols for these six companies so they adopted a common safety and data monitoring board and common primary and secondary endpoints and common immunological parameters for easier comparison.

Fauci recounted the “very exciting” recently reported data from Pfizer on its vaccine candidate and said Moderna is also close to reporting their outcomes.

“We now look at this with cautious optimism that by the end of this calendar year and well into 2021, we will be administering doses first to the highest priority and then ultimately to virtually everyone in the United States,” Fauci said.

Health officials sound alarm over impact of Trump’s transition blockade [POLITICO、15 Nov 2020]

By ELEANOR MUELLER

As coronavirus cases spike, those on both sides of the aisle say the president’s refusal to concede the election could cripple the nation’s ability to control the pandemic.

Public health officials, members of Joe Biden’s transition team, and elected Democrats and Republicans urged President Donald Trump on Sunday to begin the transfer of power to President-elect Joe Biden, warning that continuing to waylay the process amid a spiking pandemic could endanger American lives.

“Of course it would be better” if public health officials could begin working with Biden’s transition team right now, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on CNN’s “State of the Union.” “That is obvious.”

Trump’s administration has been stonewalling the transition process since Biden’s victory, with the General Services Administration — responsible for coordinating presidential transitions under the Presidential Transition Act of 1963 — so far not recognizing Biden as president-elect and thus blocking him from contacting agencies and accessing resources within the federal government. Trump, who has yet to concede the election, continues to maintain that it was “rigged.”

With coronavirus infections repeatedly setting daily records in the U.S., the delay could have outsize consequences: There are now almost 11 million diagnosed cases in the U.S., and more than 245,000 Americans have died.

“We are in a very dangerous period, the most dangerous public health period since 1918,” Dr. Michael Osterholm, one of Biden’s advisers, said Sunday on NBC’s “Meet the Press,” referring to the Spanish flu pandemic of that era.

Shutting Biden and his team out at this point in the pandemic could endanger public health by risking a delay in a vaccine roll-out, a national strategy for testing and the distribution of crucial supplies, experts say.

“It’s almost like passing a baton in a race,” Fauci said on Sunday. “You don’t want to stop and then give it to somebody. You want to just essentially keep going — and that is what transition is, so it certainly would make things [go] more smoothly if we could do that.”

Former Surgeon General Vivek Murthy, now co-chair of Biden’s coronavirus advisory board, indicated on Sunday that the transition team had yet to see the Trump administration’s Covid-19 data or plans.

“There are thousands and thousands of career civil servants and political appointees who have been working very hard on this pandemic for many months now,” Murthy told Chris Wallace on “Fox News Sunday.” “They have plans that are in process. They have data they have collected that the public doesn’t always have access to — and to be able to see that data, see those plans, is what’s going to help us put together the best possible product in the end.”

“So those dialogues are critical,” he went on. “We are going to need that as soon as possible to make this all work well.”

Biden’s chief of staff, Ron Klain, also called on the Trump administration to open the door to the transition team.

“Joe Biden’s going to become president of the United States in the midst of an ongoing crisis,” Klain said on NBC’s “Meet the Press.” “That has to be a seamless transition.”

“We now have the possibility ... of a vaccine,” he went on. “There are people at HHS making plans to implement that vaccine. Our experts need to talk to those people as soon as possible so nothing drops in this change of power we’re going to have on January 20th.”

Biden’s transition hopes the GSA recognizes Biden as president-elect this week, Klain said, “so we can start to ... meet with these vaccine officials.”

Asked on ABC’s “This Week” whether the Biden transition team should be allowed contact with health officials, the Trump administration’s coronavirus testing czar, Brett Giroir, replied: “This is an issue of public health and saving American lives. There’s nothing more important than that.”
The transition team is “ready to go,” Atul Gawande, a member of Biden’s coronavirus advisory board, replied on the show. “It is in the nation’s interests that the transition team get the threat assessments that the team knows about, understand the vaccine distribution plans.”

“We need to know where the stockpiles are, what the status is of masks and gloves,” he went on. “There’s a lot of information that needs to be transmitted. You can hear in Admiral Giroir’s voice: The doctors and scientists want to give us that information. It is vital.”

Gov. Mike DeWine of Ohio, a Republican, said on Sunday that while “the president has every right to go into court” to contend election results, “we also need to begin that process” of handing over power.

DeWine’s remarks reflected the tightrope many Republicans have been walking, acknowledging to varying degrees that Biden is the winner but declining to condemn Trump’s increasingly futile efforts to prove he will come out on top.

Trump has “every right to bring any kind of evidence that he has,” DeWine said on CNN’s “State of the Union.” “And no one should begrudge him that or say that there is anything irregular about that.”

“On the other hand, it’s clear that, certainly based on what we know now, that Joe Biden is the president-elect,” he went on. “And that transition, for the country’s sake, it’s important for a normal transition to start through.”

Arkansas’ Republican governor, Asa Hutchinson, echoed DeWine, saying on NBC’s “Meet the Press” that he expected Biden “to be the next president” and calling one of Trump’s tweets on Sunday “the start of an acknowledgment.”

“During times of transition, our enemies have an opportunity to try to take advantage of us,” Hutchinson said, “and we want to make sure that there is a smooth transition, particularly when it comes to the vaccine distribution, the coronavirus, that everybody understands what we’re doing there and what the plan is for the future.”

Sen. Bernie Sanders (I-Vt.), who is considered a candidate for Biden’s Cabinet, called the fact that Trump refuses to concede “absolutely disgraceful.”

“Trump will have the distinction of doing more than any person in the history of this country in undermining American democracy,” Sanders said on CNN. “The fact that he is not even cooperating in the transition, the fact that he continues to deny reality and continue to suggest that Biden has illegally won the election, is beyond belief in terms of behavior for an American president.”

The last time Trump attended a meeting of the White House’s coronavirus task force was “several months ago,” Fauci said on Sunday. Speaking on ABC’s “This Week,” Giroir confirmed that Trump had not attended a meeting in at least five months.