Jun 12, 2020

Axios Vitals

By Caitlin Owens
Caitlin Owens

Good morning.

Today's word count is 1,243, or a 5-minute read.

1 big thing: The limits of making a coronavirus vaccine

Illustration: Sarah Grillo/Axios

Moderna said Thursday that starting in 2021, it could manufacture "possibly up to 1 billion doses per year" of its experimental coronavirus vaccine with the help of a contract manufacturer, Axios' Bob Herman reports.

Yes, but: 1 billion vaccine doses may sound like a lot, but government and public health leaders would inevitably still have to make hard choices about who should get the vaccine first.

By the numbers: 500 million people could get vaccinated from 1 billion vaccine doses, based on Moderna's tests of one person getting two 100-microgram shots.

  • There are 7.8 billion people on Earth, meaning Moderna's vaccine could initially cover 6% of the global population.

The burning questions: That production level not only falls short of immediate need, but all 1 billion doses also will not come out at the same time. It's leading ethicists to consider the following:

  • Which clinics, hospitals and other facilities will get it?
  • Will health care workers, older people in places like nursing homes and others with compromised immune systems be prioritized? If so, who comes after?
  • If there are new coronavirus outbreaks, should those locales get an influx of the vaccine?
  • What if the vaccine costs a couple of hundred dollars, like other vaccines? Will everyone be able to get it regardless of insurance coverage or ability to pay?
  • As Moderna is based in the U.S., will the U.S. prioritize itself over other countries, and will it cut deals with other countries?

The bottom line: Even with other coronavirus vaccines rapidly moving through clinical trials, billions of people simply won't have access to a vaccine by 2021.

  • And if history is any indication, the poor and minorities will be at the back of the line unless equitable national and global policies are put into place.

Go deeper: How the U.S. might distribute a coronavirus vaccine

2. Nursing homes running out of protective gear

Nursing homes around the country are short on personal protective equipment like masks, eyewear and gowns, despite promises by the federal government to help, Kaiser Health News reports.

Why it matters: Nursing homes are extremely vulnerable to coronavirus outbreaks, and 43,000 residents have died over the last few months.

  • Personal protective gear is vital in ensuring the virus doesn't spread from one patient to another.

Between the lines: FEMA announced in May that it would be sending a 14-day supply of protective supplies to nearly 15,000 nursing homes around the nation, but some have yet to receive the first batch.

  • Some have received cloth masks instead of medical-grade ones, even though HHS says these masks aren't meant for caring for contagious patients.
  • FEMA officials told KHN that, as of June 4, packages had been shipped to 11,287 nursing homes.

By the numbers: During the last two weeks of May, 3,213 of the more than 15,000 nursing homes in the country reported that they had less than a week's supply of masks, gowns, gloves, eye protectors or hand sanitizer.

  • Of these facilities, 946 reported at least one confirmed coronavirus case since the pandemic started.
  • 653 skilled nursing facilities told the government that they had run out of at least one type of protective supply during this time period.

Go deeper: Controlling the coronavirus in nursing homes won't be easy

3. The latest in the U.S.
Expand chart
Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios. This graphic includes "probable deaths" that New York City began reporting on April 14.

Novel coronavirus transmission in Houston, Texas is uncontrolled and poses a significant threat to the community, Harris County Judge Lina Hidalgo said in a Thursday press conference. Residents in the city — the epicenter of the pandemic in Texas — are advised to social distance, wear face coverings and avoid crowds.

Former Vice President Joe Biden released a plan on Thursday for how he believes the federal government should set the foundation for reopening the country and jump-starting the economy during the coronavirus pandemic.

Treasury Secretary Steve Mnuchin told CNBC Thursday that shutting down the economy again to stop the spread of the coronavirus is not an option.

Regeneron Pharmaceuticals is testing a new coronavirus antibody drug in humans as part of a federally funded, wide-ranging, placebo-controlled clinical trial.

Another 1.5 million Americans filed jobless claims last week, according to data released by the Labor Department on Thursday.

4. Vietnam could be a rare pandemic winner
Expand chart
Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Axios Visuals

It’s hard to say which is more remarkable, Axios' Dave Lawler writes: that Vietnam has recorded zero COVID-19 deaths despite a population of 96 million, or that the communist government expects the economy to grow by 5% this year during a massive global recession.

Why it matters: Both numbers deserve some scrutiny, but there’s no evidence a major outbreak is being covered up, and the bullishness about Vietnam’s economy is shared by the IMF and World Bank (though their growth estimates are lower).

How it happened: Vietnam shares a border and deep economic links with China, and recorded its first case on Jan. 23.

  • It quarantined an affected region near Hanoi in mid-February, and quickly scaled up an impressive contact tracing regime, knowing it lacked the resources to conduct mass testing.
  • The government distributed information about the outbreak via text message and told Vietnamese it was their patriotic duty to wash their hands and self-isolate.
  • “The steps are easy to describe but difficult to implement, yet they’ve been very successful at implementing them over and over again,” Matthew Moore, a CDC official based in Hanoi, told Reuters.

Go deeper.

5. Damage to public’s trust in COVID-19 science

Illustration: Eniola Odetunde/Axios

A recent spate of problems with some coronavirus studies combined with top-level miscommunication about the virus is raising concern that people's trust in scientific data and scientists may falter, my colleague Eileen Drage O'Reilly reports.

Why it matters: Without trust in science, people can't make informed decisions about the risk of getting COVID-19, the treatments for it and any potential future vaccines, public health experts warn.

What's happening: Researchers retracted two recent studies about the effectiveness of hydroxychloroquine in treating COVID-19, the World Health Organization has had a pattern of mistakes and miscommunication, and there's a lack of a strong scientific voice from the federal government.

  1. The push for fast research is a double-edged sword. A majority of registered clinical trials for COVID-19 treatments from early to late March had "many, many shortcomings" of various degrees of seriousness, says Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness.
  2. Recent events like the two studies that had to be retracted due to questionable patient data collected by Surgisphere "could potentially erode the trust that we have in science in general," Dominique Brossard, professor and chair of the Department of Life Sciences Communication at UW Madison, tells Axios.
  3. Mixed messages from government and public health officials are eroding trust in science and scientists, several experts said.

The bottom line: Public trust in science data and top-down communication must be retained for this pandemic to be eradicated.

Go deeper.

6. Coronavirus and local commerce
Adapted from JPMorgan Chase; Chart: Axios Visuals

The sudden economic shock from coronavirus stay-at-home orders caused a stunning drop in local commerce in cities across the country, with San Francisco seeing the heaviest decline, followed by Chicago, New York and Detroit.

How it works: The JPMorgan Chase Institute analyzed a subset of credit card transactions typical of everyday goods and services bought and sold at the local level to create a "local commerce" economic view, Axios' Kim Hart writes.

What they found: Local commerce spend declines were fairly uniform across neighborhoods with a wide variation of household median income. The only two categories that showed growth overall were grocery stores and pharmacies, with online spend on groceries nearly doubling.

But in low-income neighborhoods, local commerce spend plummeted much further into negative territory.

  • Lower-income neighborhoods saw a disproportionate share of severe spending declines over 15%, with 11.5% of neighborhoods in the lowest-income bracket experiencing severe spending declines.
  • Consumers in low-income neighborhoods were less likely to order groceries online and more likely to travel farther to reach grocery stores, increasing time away from home and the risk of getting sick.

The bottom line: The data points to what we already know — that the pandemic and its economic shocks disproportionately hurt those who could least afford it.

Go deeper: Coronavirus is bringing economic suffering across the U.S.

Caitlin Owens