A record week of no records
When the “third surge” began in the fall of 2020, the most notable thing was just how universal it seemed. The first wave of COVID-19 cases was overwhelmingly located in the Northeast. When the second surge came in the summer, it was mainly concentrated in southern states like Texas, Florida, and Arizona. The third surge hit hardest in the upper Midwest, but it spread coast to coast. Cases in Southern California exploded. States that had taken blows in previous rounds, including both Texas and New York, saw another rise. And then Thanksgiving travel gave the nation a boost. And then Christmas. And then New Years.
For some months, it seemed like cases across the nation would just keep skyrocketing. The widespread nature of the outbreak meant that changes in regulations in any one area made little impact on the overall numbers. Without a national policy in place, there seemed to be little way to address the virus until everyone was either sick, or vaccinated.
But after the post-holiday values peaked in the second week of January, the nation began a cooling trend. Enough states, counties, and cities had imposed new restrictions that it had a real impact, and the end of the holiday travel season removed fresh fuel from the fire. On a 7-day moving average, every day since Jan. 12 has seen a lower number of new cases than the day before. Just as the third surge was nationwide, so is that cooling trend. For the first time since that surge began, not a single state hit a new record for daily cases in the last week.
This doesn’t by any means imply that things are good. A map of the nation shows that coronavirus infections are still bright red in almost every single county, but if the nation is a hot skillet for the moment the burner appears to have been turned down. That’s good news … so long as this doesn’t become the starting point for surge number four, which is very well could, if people give in to pandemic fatigue and false assumptions about vaccines. Speaking of which …
more vaccines, more better
Starting this week, shipments of the Pfizer and Moderna vaccines to states have been increased to 10 million doses a week. This week also saw the first consecutive 7-day streak of over 1 million people a day being vaccinated. It’s far from enough (unless getting everyone vaccinated by 2022 is the goal), but it’s an improvement.
In addition to increased shipments of existing vaccines, Phase 3 data from two more candidates reached the public. Novavax—the vaccine that got the most support from the fund formerly known as “Operation Warp Speed”—released results of trials in the U.K. and South Africa. Johnson & Johnson followed just one day later with preliminary results of trials in the U.S., South Africa, and Latin America.
Novavax is unlikely to talk to the FDA about an Emergency Use Authorization until it finishes additional trials in the U.S. and South America. However, it’s U.K. numbers—95.6% efficacy against the original COVID-19 strain and 85.6% against the fast-spready U.K. variant—look good. This trial was the first time any of the manufacturers has provided real numbers for how their vaccines stacked up against some of the new COVID-19 variants. While it seemed like Novavax barely lost a step in dealing with the U.K. version, it was slowed considerably when coming up against the South African variant. In the South African trial, the vaccine was only 49.4% effective (60% if the high number of HIV-positive patients in the trial are excluded).
Johnson & Johnson reported their toplines as 72% effective in the United States, 66% in Latin America, and 57% in South Africa. However, those numbers are both worse and better than they seem. They’re worse, because J & J decided to report only how well their vaccine stopped moderate and severe cases of COVID-19, meaning that some of those in the 72% of U.S. patients still caught moderate “flu like” cases of the disease. They’re better because the single-dose vaccine seems to become more effective over time. The numbers reported represent a time slice 29 days in, but after that the vaccine seems to become even more effective. As the numbers in Latin America and South Africa indicate, the variants also gave this vaccine issues. However, efficacy seemed to improve—even against the variants—over the next twenty days.
Johnson & Johnson’s final numbers are going to take some heavy-duty statistical processing because of some of the choices they’ve made. However, they’re likely to put a fat stack of papers in front of the FDA’s expert panel some time in mid-February. That could mean that this single-shot, easily transported, easily-stored vaccine starts to become available by March.
Side note: All the manufacturers are now working to update their vaccines to reflect the changes in the spike protein seen in the latest variants. For vaccines based on the mRNA process, like Pfizer and Moderna, this can be done rapidly. Both companies could be turning out updated vaccines in a matter of weeks, except that how to test or regulate a vaccine “update” will probably take longer to figure out than actually making the changes.
Joe Frickin’ Biden
But the best new on COVID-19 this week may be the best news on everything else. While he was doing a few things like creating a Civilian Climate Corps, telling the Department of Justice to stop using private prisons, and reinstating a ban on selling G** D*** tanks to police departments, Biden also still found time to deal with COVID-19.
After giving a sober and direct address to the nation last week, Biden signed a whole stack of executive orders to both expand and streamline handling of the coronavirus crisis. This was immediately followed by a return of daily press briefings from Biden’s coronavirus team, including an Anthony Fauci obviously ecstatic at being able to speak the truth. At every point, Biden and his team made it clear that heaven and earth would not be obstacles to their efforts to accelerate rollout of vaccine and protect the nation.
On Tuesday, Biden announced that he had purchased 200 million additional doses of the Pfizer and Moderna vaccines and ordered his team to put in place logistics to vaccinate every adult in America by summer. At the end of the week, Biden made clear that while it would be nice to pass his COVID-19 relief plan with bipartisan assistance, the important thing is to pass the plan. It was was not just forceful, it was masterful.
When he became the nominee, Joe Biden may have seemed like a compromise. So far he is turning out to be the most aggressive Democratic president in decades, and the perfect president for this moment.