U.S. Could Soon Have a Glut of Vaccine Doses
Officials expect the supply to outstrip demand by mid-May, and are grappling with what to do with looming surpluses. Here’s the latest on Covid-19.,
The Biden administration’s relatively smooth coronavirus vaccine distribution effort is about to hit a snag.
Vaccine manufacturers have been steadily increasing their output, and states have snapped up new doses as quickly as the government could deliver them. But officials expect the supply of vaccines to outstrip U.S. demand by mid-May, if not sooner, and are grappling with what to do with looming surpluses when scarcity turns to glut.
President Biden has promised enough doses by the end of May to immunize all of the nation’s roughly 260 million adults. But between then and the end of July, the government has locked in commitments from manufacturers for enough vaccine to cover 400 million people — about 70 million more than the nation’s entire population.
Whether to keep, modify or redirect those orders is a question with significant implications, not just for the nation’s efforts to contain the virus, but also for how soon the pandemic can be brought to an end. Of the vaccine doses given globally, about three-quarters have gone to only 10 countries. At least 30 countries have not yet injected a single person.
And global scarcity threatens to grow more acute as nations and regions clamp down on vaccine exports. With infections soaring, India’s government is holding back nearly all of the 2.4 million daily doses manufactured by the Serum Institute of India, the private company that is one of the world’s largest producers of the AstraZeneca vaccine. That action follows the European Union’s decision this week to move emergency legislation that would curb vaccine exports for the next six weeks.
Biden administration officials who are inclined to hold on to the coming U.S. surplus point to unmet need and rising uncertainty: Children and adolescents are still unvaccinated, and no one is certain whether or when immunity could wear off, which could require scores of millions of booster shots.
Vaccine manufacturers and some top federal officials say decisions about what to do with extra vaccine orders must be made within weeks, or the uncertainty could slow production lines.
The manufacturing process can take up to 10 weeks, so changes for a foreign market need time. The regulatory rules that govern vaccine shipments present another hurdle, as does the limited storage life of the drug substances that make the vaccine.
Senior officials say the administration is leaning toward keeping the doses it has ordered, and at some point directing the excess to other nations in one-off deals or giving it to Covax, an international nonprofit backed by the World Health Organization that is trying to coordinate equitable vaccine distribution. The Biden administration has already donated $4 billion to that international effort.
States are racing to vaccinate as many people as possible as the United States’ coronavirus infection curve continues its plateau for a third week at more than 55,000 new cases per day, a level that health experts warn could rapidly escalate into a new wave.
Kansas, Minnesota and South Carolina announced on Friday that they would open vaccine eligibility to residents 16 years and older next week. But Minnesota’s health department said there would not be enough vaccines on Tuesday to meet the immediate demand. The state is expecting more doses delivered in the coming weeks.
New Jersey, which has seen a 25 percent increase in new cases, compared with the average two weeks earlier, also announced vaccine eligibility would expand beginning on April 5 for residents 55 and older. At that time, New Jersey also plans to open eligibility for those 16 years and older with developmental disabilities and residents who work in the higher education sector.
And Oregon announced plans to expand eligibility for certain residents, including front-line workers, beginning April 5. Gov. Kate Brown said April 5 is two weeks ahead of what the state had planned for this group of residents. She said this was possible “thanks to increasing supplies.”
State officials are able to broaden their eligible pools thanks to a steady increase in vaccine shipments. Federal officials say that Pfizer and Moderna, whose vaccines require two doses, are now together supplying about 24 million doses a week.
Jeffrey D. Zients, the White House’s chief pandemic adviser, told reporters during a White House virus briefing on Friday that he is expecting an end-of-the-month burst of supply from Johnson & Johnson, whose vaccine requires only one shot. The company has supplied a very limited number of doses so far but will deliver at least 11 million doses next week, he said.
Some 25 states are reporting persistently high case numbers, according to a New York Times database, and state officials have been easing restrictions.
The number of deaths continue to trend downward, averaging about 1,000 a day, down from more than 2,000 each day a month ago. But eight states are seeing rising deaths: Kentucky, Maryland, Montana, Nebraska, New Hampshire, Ohio, Utah and West Virginia.
“It’s clear, there is a case for optimism, but there is not a case for relaxation,” Mr. Zients said.
At least 34 states have pledged to make vaccines universally available to their adult populations by mid-April, and at least 14 more have announced plans to expand eligibility on or before May 1, a goal set by Mr. Biden. Alaska, Mississippi, Utah and West Virginia have already made all adults eligible to receive shots, and some local jurisdictions have also begun vaccinating all adults.
California will open up vaccine eligibility on Thursday to any resident 50 or older and will expand that to residents 16 or older on April 15, state officials said. Florida said that any state resident 40 or older would be eligible starting on Monday, and that the minimum age would drop to 18 on April 5.
Kentucky plans to open vaccinations to those 40 and older starting on Monday.
Mr. Biden, who initially promised to have “100 million shots in the arms” of Americans by his 100th day in office, said on Thursday that he was doubling the target. As of Friday, more than 120 million shots have been administered since Jan. 20. And with an average of 2.6 million shots administered per day, and more supply increases expected next month, the White House is fully expected to meet the new target, Mr. Zients said on Friday.
Vaccine hesitancy could slow progress, cautioned Francis Collins, the director of the National Institutes of Health. The goal of reaching a point in the country when enough people have had the virus or have been vaccinated could be jeopardized by people who “will basically say, ‘No, not for me,'” he said Thursday on Fox News.
“That could basically cause this pandemic to go on much longer than it needs to,” he said.
Can people immunized against the coronavirus still spread it to others? A new study will attempt to answer the question by tracking infections in vaccinated college students and their close contacts, researchers announced on Friday.
The results are likely to be of intense interest, because they may help determine how careful vaccinated people need to be — whether they can throw away their masks, for example, or must continue to wear them to protect unvaccinated people.
More than 87 million have received at least one dose of a coronavirus vaccine, according to a New York Times database. The Centers for Disease Control and Prevention has advised that fully vaccinated Americans may gather indoors in small groups without precautions, including masks, but should still wear masks in public.
The reason is that it’s not yet certain that vaccinated people cannot briefly be infected and transmit the virus. Clinical trials of the vaccines were designed only to assess whether the vaccines prevent serious illness and death. The manufacturers are now collecting information on whether the vaccines can also thwart infections, swabbing volunteers‘ noses every two weeks.
But that method falls short, because the testing is too infrequent to catch all infections and will not track the spread of the virus to the participants’ contacts, said Dr. Larry Corey, an expert in vaccine development at the Fred Hutchinson Cancer Research Center in Seattle and a leader of the new study.
“The only way you do that is by very frequent sampling, and we’re covering our bases by doing it every day,” Dr. Corey said. “It’s going to be the most thorough look at the issue.”
The new study will include more than 12,000 college students immunized with the Moderna vaccine at more than 20 universities across the United States. Half of the students will be randomly selected to receive the vaccine right after they are enrolled, while the other half will get the vaccine four months later.
All of the participants will swab their noses daily to check for the virus, provide periodic blood samples to screen for antibodies, and answer questions through an app. Scientists will follow the students for five months.
By monitoring the students so closely, the scientists expect to be able to track infections in the first 24 or 48 hours, and determine how long an infected person may transmit the virus to others, Dr. Corey said. Over time, the scientists expect to ask about 25,500 close contacts of the participants to swab their noses daily for two weeks, provide two blood samples and answer weekly questionnaires.
College students are an ideal population in which to study transmission after vaccination. They have among the highest rates of coronavirus infection, in large part because they live in tightly packed dormitories and have more social contacts than older adults do, while fortunately, hospitalizations and deaths are comparatively low. American colleges and universities have reported more than 530,000 cases since the beginning of the pandemic.
The former director of the Centers for Disease Control and Prevention said in a CNN clip on Friday that he favored a theory, decried by many scientists and rejected as “extremely unlikely” by at least one World Health Organization international expert, that the coronavirus escaped from a lab in Wuhan. The former official, Dr. Robert Redfield, offered no evidence and emphasized that it was his opinion.
“I am of the point of view that I still think the most likely etiology of this pathogen in Wuhan was from a laboratory, escaped. The other people don’t believe that. That’s fine. Science will eventually figure it out,” Dr. Redfield told Dr. Sanjay Gupta in the video clip, referring to the origin of the virus. A formal report from the W.H.O. team and the Chinese scientists it worked with, on the origins of the pandemic and on the coronavirus in humans, is expected next week.
Despite Dr. Redfield’s comments, officials briefed on the intelligence say there is no new evidence that would cause American spy agencies to reassess their views. There is no new information that bolsters the so-called lab theory, according to officials briefed on the intelligence.
During the Trump administration, then-Secretary of State Mike Pompeo, and to a lesser extent the president himself, pushed the theory that the coronavirus had escaped from a lab.
Mr. Pompeo pressed the spy agencies to investigate the lab theory and Richard Grenell, then the acting director of national intelligence, convened a review of what was known about the origin of the novel coronavirus.
Some in the Trump administration shared Mr. Pompeo’s suspicions that an accident had occurred, and coronavirus samples being researched had inadvertently infected workers who then spread it in Wuhan. These officials pointed to some scientific reports that they said bolstered their feelings.
The claims that the virus was created or modified intentionally in a lab were dismissed by scientists and U.S. intelligence officials. The Office of the Director of National Intelligence in the Trump administration concurred “with the wide scientific consensus that the Covid-19 virus was not man-made or genetically modified.”
Although that statement was diplomatically worded, the message from the intelligence agencies was clear that, despite pressure from the Trump administration, they had no evidence that the coronavirus had escaped from the lab. And many intelligence officials remained far more skeptical than Mr. Pompeo, telling colleagues there was simply not enough information to say where the coronavirus came from, and certainly not enough to challenge the scientific consensus that was skeptical of the lab theory.
The C.I.A. and other intelligence agencies have been skeptical that China was sharing all that it knew about the virus, although that was at least in part because of local officials withholding critical information from Beijing at key moments at the beginning of the outbreak.
A group of scientists who remain convinced of the possibility of a lab leak wrote an open letter in early March when the W.H.O. team report was first anticipated demanding a thorough investigation of Chinese labs. Virologists who have studied the evolution of coronaviruses and the way they have jumped to humans in the past causing SARS and MERS continue to argue that the evidence for a natural origin apart from a lab leak is overwhelming.
The Chinese government, prominent Chinese scientists and many virologists, who study the evolution of viruses and the appearance of infectious diseases, have said the lab leak theory was very unlikely, citing genetic evidence and the many opportunities for natural infection in human interactions with animals like bats, where the virus is believed to have originated.
When Dr. Anthony S. Fauci, the United States’ top infectious disease expert, was asked at a White House news conference on the pandemic on Friday about Dr. Redfield’s comments, he noted that the remarks were only an opinion. Dr. Fauci said that there are different ways viruses could become adapted to humans.
“You know one of them is in the lab and one of them, which is the more likely, which most public health officials agree with, is that it likely was below the radar screen, spreading in the community in China for several weeks if not a month or more, which allowed it, when it first got recognized clinically to be pretty well adapted,” Dr. Fauci said.
At the same news conference on Friday, Dr. Rochelle Walensky, the current director of the C.D.C., said she was looking forward to reviewing the upcoming joint report from the W.H.O. experts and Chinese scientists.
“I don’t have any indication for or against either of the hypotheses that Dr. Fauci just outlined,” she said.
Zachary Montague and Isabella Grullon Paz contributed reporting.
Kenya imposed stringent new restrictions in the capital, Nairobi, and in four other counties, fighting a deadly third wave of Covid-19 infections that has placed its fragile health system under devastating pressure.
In a televised address on Friday, President Uhuru Kenyatta said that a tenfold increase in infection rates since January, coupled with a 52 percent increase in hospital admissions this month, called for “drastic measures.”
“Kenya is now squarely in the grip of a third wave of this pandemic,” he said.
Several variants have been identified in Kenya, but some were found among travelers, and there is little data to suggest how prevalent they may be or what role they might be playing in the East African nation’s surge. They include B.1.1.7, the more transmissible and possibly more lethal variant first identified in Britain; B.1.351, a variant first found in South Africa that may bypass the protection afforded by current vaccines; and A.23.1, a variant that is now dominant in Kenya’s neighbor Uganda and nearby Rwanda.
As of midnight, Mr. Kenyatta said, all gatherings are banned in Nairobi and four adjoining counties, which make up a single infection zone. Travel is prohibited in and out of the restricted area, where bars, restaurants and places of worship will close, and a nightly 10 p.m. curfew moves to 8 p.m. However, Nairobi’s international airport will remain open.
In the rest of Kenya, sporting activities are suspended, and schools and universities will close until further notice.
The curbs came a week before the Easter holiday when many Kenyans pile into crowded buses to return to their family homes in rural areas.
A vaccination program that started in March raised hopes for an end of the pandemic, which has devastated the country’s tourism-dependent economy. One small bright spot in the tourism downturn has been an influx of wealthy Europeans hoping to ride out the pandemic in upmarket resorts along Kenya’s coast.
But the soaring rate of infections and deaths has forced the country into a painful new lockdown, Mr. Kenyatta said. As of Thursday, Kenya reported a total of 126,170 cases and 2,092 deaths. The positive test rate hit 22 percent this week, compared with 2 percent in January, he said.
Just over a hundred days into New York City’s vaccination campaign, 30 percent of adults and half of those 65 and older have received at least one dose of a Covid-19 vaccine. Millions more remain left to be vaccinated, and the city will have to overcome already significant disparities in vaccination rates across neighborhoods and demographic groups.
White and Asian New Yorkers have been vaccinated at higher rates than Black and Latino residents, who have been more likely to die from or be hospitalized with Covid-19 both in New York City and nationwide.
Some of the highest vaccination rates are in the city’s wealthiest neighborhoods — places where residents were most likely to leave the city at the start of the pandemic. In parts of the Upper West Side and Upper East Side, about half of adults have received at least one shot. In Corona, Queens, where the virus was far deadlier, only 19 percent have.
Neighborhoods with mostly white residents, like the Upper East and Upper West Side, Riverdale in the Bronx, Breezy Point in Queens, mid-island and the south shore of Staten Island, are outpacing city averages.
The majority Black and Latino neighborhoods in large swaths of Queens, Brooklyn, Upper Manhattan and the southern Bronx are in some cases 20 to 30 percentage points behind neighborhoods at the top of the list.
Reasons for the disparities vary, and they will not all be clear from simply looking at a map. Many seniors are homebound or have had trouble navigating complex and confusing websites to sign up for the vaccine (obstacles not just for seniors, really).
For Black and Latino New Yorkers, some surveys have shown higher rates of hesitancy toward a vaccine, though barriers to access are an equal if not greater challenge.
For non-English speakers, language barriers can create fear and confusion. For poorer residents, it’s simply more difficult (and more expensive) to take a few hours or a day or two off work to get a shot.
The city is averaging 60,000 to 70,000 shots per day. At that rate, it will take months to reach the remaining seven million New Yorkers, including children, who are not yet eligible for any vaccine.
A recent surge of Covid-19 cases in Ethiopia has left medical workers at the country’s biggest treatment center scrambling to find enough oxygen for patients in critical condition.
Ethiopia has recorded a 24 percent increase in Covid-19 cases, to 194,524 in the past month, and deaths rose 17 percent, health ministry data show. Ethiopia, with a population of 117 million, has recorded 2,741 deaths since its first case was announced in March of last year.
Abel Mujera, the clinical director at the Millennium Hall Covid-19 treatment center in Addis Ababa, said demand for oxygen had more than doubled in two months — from 200 cylinders per day in January to 450 now.
“Sometimes that’s barely enough to support the needs of our patients,” he said. “For the past few weeks, we had a surge in Covid-19 cases, and most of the patients we admit have a higher demand for oxygen and they need admission to critical care.”
Mr. Abel, 29, spends most mornings calling the loved ones of deceased Covid-19 patients at Millennium Hall, which the government set up shortly after Ethiopia’s first coronavirus case was confirmed.
“It’s so hard,” he said.
A Covid-19 report released last week by the Ethiopian Public Health Institute said a spike in cases had been recorded in Addis Ababa, the capital, because of “decreased adherence to the public health and social measures” as well as a “high risk” that dangerous virus variants had entered the country.
Mr. Abel’s facility is treating 213 patients, of which 80 percent need oxygen — up from an average of 60 patients in January and February.
Complicating the situation is that the oxygen arriving in the city each day comes from distant places like Awassa, a drive of roughly 170 miles away, and Bishoftu, a drive of about 40 miles, where power cuts can sometimes limit the supply.
— The New York Times
If the so-called Stop the Steal movement appeared to be chasing a lost cause once President Biden was inaugurated, extremist organizations are now adopting a new agenda from the anti-vaccination campaign to try to undermine the government.
The safety and efficacy of coronavirus vaccines is being bashed in chat rooms frequented by all manner of right-wing groups, among them the Proud Boys; the Boogaloo movement, a loose affiliation known for wanting to set off a second Civil War; and various paramilitary organizations.
Although negative reactions to the vaccines have been relatively rare, many extremist groups are using the isolated cases to try to bolster false and alarmist disinformation in articles and videos with labels like “Covid-19 Vaccines Are Weapons of Mass Destruction — and Could Wipe out the Human Race” and “Doctors and Nurses Giving the Covid-19 Vaccine Will be Tried as War Criminals.”
The groups tend to portray vaccines as a symbol of excessive government control.
“If less people get vaccinated then the system will have to use more aggressive force on the rest of us to make us get the shot,” read a recent post on the Telegram social media platform, in a channel linked to members of the Proud Boys charged in the storming of the Capitol.
The focus on vaccines is particularly striking on discussion channels populated by followers of QAnon, the group that prophesied that Donald J. Trump would continue as president while his political opponents were marched off to jail.
“They rode the shift in the national conversation away from Trump to what was happening with the massive ramp-up in vaccines,” said Devin Burghart, the head of the Seattle-based Institute for Research and Education on Human Rights, which monitors far-right movements. “It allowed them to pivot away from the failure of their previous prophecy to focus on something else.”
The number of American adults reporting recent bouts of anxiety or depression rose significantly between August and February, increasing to more than two in five adults in late January, federal health researchers said on Friday.
The largest increases were among young adults and those who never finished high school, but every demographic group — including all racial and ethnic groups, genders and ages — experienced some increase in symptoms, said Anjel Vahratian, an associate director at the National Center for Health Statistics and the report’s lead author.
Among adults aged 18 to 29, the percentage who reported having anxiety or depressive symptoms in the previous week increased to 57 percent in late January, up from 49 percent in August 2020. About half of respondents without a high school diploma reported symptoms recently, up from 41.8 percent in August. Overall, 41.4 percent of all adults reported symptoms in late January and early February, up from 36.4 percent in August.
Men and women reported more symptoms, as did adults in their 30s and adults in their 60s, who saw statistically significant increases.
Dr. Vahratian said she was surprised by the magnitude of the increases. Though the study does not prove the problems were caused by the pandemic, previous studies have shown a link between large disease outbreaks and mental health, she noted.
“You have extended social restrictions, limits on businesses, isolation and issues with employment — these have all been associated with increases in mental health problems,” Dr. Vahratian said. “We can’t speak to the direct causes because the survey didn’t ask about the cause of the symptoms. But it suggests that a variety of things going on during the pandemic are involved.”
The data, reported by the Centers for Disease Control and Prevention, are based on an ongoing survey called the Household Pulse Survey, which polls tens of thousands of Americans. The sample is nationally representative, but the researchers noted that people without internet access could not participate in the online format.
The number of Americans seeking mental health treatment increased during the pandemic, with 24.8 percent of adults saying they were receiving treatment in February, up from 22.4 percent in August. But the number of respondents who said they needed counseling and did not receive it also increased, to 11.7 percent from 9.2 percent.
The latest data, however, may suggest that Americans are feeling a bit better, Dr. Vahratian said. New numbers from the survey, which is ongoing, point to a slight decrease in symptoms of anxiety and depression in March, she added.
New Zealand has said it will require people returning from overseas to remain in the country for six months, twice as long as the previous requirement, and to pay for hotel quarantine if they don’t.
The new rules, which took effect on Wednesday, add to the anxiety of New Zealand residents abroad who have been waiting to book spots in a quarantine system that the government introduced in October. There is a waiting list of around four months, and new slots often disappear within minutes.
Under the new system, returnees who plan to stay less than six months must pay 3,100 New Zealand dollars, or around $2,150, for the two-week hotel quarantine they are required to undergo upon arrival. They were previously required to pay the fee for stays of less than three months.
The changes were a response to anecdotal evidence that New Zealanders were entering the country for a three-month “holiday” to avoid paying the fee, said Chris Hipkins, the minister for Covid-19 response.
“Ultimately, our managed isolation facilities are designed to ensure that New Zealanders who need to return home are able to,” he told reporters on Wednesday.
New Zealand is one of the few places in the world that are limiting the number of residents who can return home during the pandemic. Tens of thousands of Australian citizens have also been stranded abroad in recent months because of restrictions that limit number of people allowed on flights into the country.
The charges in New Zealand are expected to affect approximately 3 percent of those returning, according to the Ministry of Business Innovation and Employment.
As of February, New Zealand’s quarantine system was free to most residents and had collected $4.7 million in fees since its introduction last spring. The system has cost taxpayers about $1.7 million a day, according to figures provided to Radio New Zealand last year.
New Zealand has all but eliminated local transmission of the coronavirus, reporting a total of 2,476 cases and 26 deaths as of Friday, according to a New York Times database. It has vaccinated 41,500 people, most of them workers at the country’s border or immigration facilities.
In Australia, hospitals, prisons and nursing homes in Brisbane went into lockdown on Friday after a 26-year-old man tested positive for Covid-19. It was the first local transmission detected in Queensland State in two weeks. The health authorities said that the man had been infectious since last Friday and that they were still trying to determine how he had contracted the virus.
Norway on Friday extended its suspension of the AstraZeneca vaccine for another three weeks as the country assesses the vaccine, which the European Medicines Agency, the continent’s top drug regulator, has called “safe and effective.” At least four people who received the vaccine in Norway have since died. On Thursday, Denmark said that it, too, would extend its suspension of the vaccine, until April 15, while Sweden said it would resume its use for people over 65.
A top health official in Germany warned that the country could see 100,000 new cases a day amid a new wave of infection that he said was likely to be worse than either of the first two. The official, Lothar Wieler, is the head of the Robert Koch Institute, Germany’s primary disease control agency. “We have to be prepared for the fact that more people will become seriously ill again, that hospitals will be overloaded and also that many people will die,” he said at a news conference on Friday. After a sharp increase in its virus caseload this month, Germany has recorded about 17,000 new cases a day over the past week.
Argentina is delaying applying the second dose of Covid-19 vaccines for three months to prioritize giving people at least one dose amid a sluggish vaccination drive. Argentina has been using Russia’s Sputnik V, China’s Sinopharm and Covishield, the Indian version of the AstraZeneca vaccine. Argentina, a country of 45 million people, has given out a total of 3.55 million doses, including over 658,000 who have received the two doses.
For generations, medical students were initiated to their training by a ritual as gory as it was awe-inducing: the cadaver dissection. But amid the pandemic, the cadaver dissection — like many hands-on aspects of the medical curriculum — turned virtual, using a three-dimensional simulation software.
Of the country’s 155 medical schools, a majority transitioned at least part of their first- and second-year curriculums to remote learning during the pandemic. Nearly three-quarters offered lectures virtually, according to a survey by the Association of American Medical Colleges, and 40 percent used virtual platforms to teach students how to interview patients about their symptoms and take their medical histories.
Though the cadaver dissection posed a trickier challenge, nearly 30 percent of medical schools used online platforms to teach anatomy.
Medical students in many states have been eligible for and able to receive the vaccines, but some have not yet fully shifted back to in-person learning, with school administrators saying they preferred to wait until Covid-19 case rates decline further. Some in-person training, like practicing clinical skills, has largely resumed.
Medical schools adapted in the past year with inventive approaches to clinical training. Case Western Reserve University School of Medicine and Stanford used virtual reality technology to teach anatomy. The Vagelos College of Physicians and Surgeons at Columbia University offered students the opportunity to shadow doctors virtually, sitting in on telemedicine appointments.
The Keck School of Medicine, at the University of Southern California, opted to have faculty members dissect cadavers while wearing body cameras so students could watch remotely. The cadavers were also imaged using three-dimensional scanners, so students could practice manipulating the sorts of images produced by magnetic resonance imaging and CT scans.
Educators are aware that for all the promise of new technologies, there’s a sense of loss for students who aren’t able to be in hospitals, classrooms and dissection laboratories in person.
Some students, though, pointed to a silver lining in their virtual medical training: They’ve become adept at speaking with patients about sensitive issues over video, a lesson very likely to prove essential as the field of telemedicine expands.