Aug 24, 2020

Axios Vitals

Good morning ... Caitlin is off this week, so you're stuck with me for a while.

  • Join Axios politics and White House editor Margaret Talev and Cities author Kim Hart tomorrow at 12:30pm ET for a live, virtual event on North Carolina's economic recovery from COVID-19. Register here.

Today's word count: 945, or a 3.6-minute read.

1 big thing: How Americans want to handle a vaccine
Data: The Harris Poll; Chart: Andrew Witherspoon/Axios

Whenever the first coronavirus vaccine makes it across the finish line, there won't be enough to go around.

  • So experts say two rounds of rationing will be necessary — one to divvy up the available doses around the world, and then another to decide who gets first crack at the U.S.' limited supply.

Most Americans are OK with a domestic priority system but don't think the U.S. should share a vaccine internationally if it's the first country to develop one, according to a new Harris poll shared exclusively with Axios.

By the numbers: 69% of respondents in the Harris survey said they’d support a priority system for distributing a vaccine within the U.S., while just 31% said they’d prefer a first-come, first-served approach.

  • 66% said that if the U.S. develops a vaccine, it should only be made available abroad after all U.S. orders have been filled; just 34% said it should be made available overseas immediately.

Why it matters: Distributing limited supplies of a new vaccine, to address a global pandemic, will be incredibly difficult to do well.

  • The instinct to vaccinate your own country first is understandable enough, but Americans would of course be very upset if, say, China were to refuse to make a vaccine available to the U.S.
  • The public's openness to a risk-based allocation domestically, on the other hand, is a more encouraging sign. That would be a whole lot different from the system most Americans are used to.

Between the lines: Based on the drumbeat of encouraging news in the vaccine race, and the enormous international demand, it's not too early to be thinking about distribution.

  • But it's also important not to get ahead of ourselves. Remember: The first vaccine probably won't be the knockout blow you may be hoping for.
2. The FDA's controversial move on blood plasma

FDA Commissioner Stephen Hahn watches as President Trump speaks during the announcement of FDA authorization for the use of blood plasma to treat COVID-19. Photo: Pete Marovich/Getty Images

The Food and Drug Administration's decision to authorize the emergency use of blood plasma as a coronavirus treatment is one of its most controversial decisions of the pandemic.

How it works: Convalescent plasma has been used before, with other infections. And it has worked.

  • Blood is drawn from people who have recovered from an infection — and who therefore have antibodies to fight that infection — and is then given to sick people.

Yes, but: The evidence that this approach will help with the coronavirus is limited.

  • Some of the country's top medical scientists, including Anthony Fauci and NIH Director Francis Collins, have previously said they didn't think the data from the leading study of plasma for COVID-19, led by the Mayo Clinic, was strong enough to support an emergency authorization, according to the New York Times.

White House officials have leaned on the FDA to move faster. Economic adviser Peter Navarro told FDA officials last week, "You are all Deep State and you need to get on Trump Time," Axios' Jonathan Swan reports.

  • Trump himself followed up over the weekend, also accusing "the deep state, or whoever" within the FDA of trying to delay therapeutics until after the election.

Between the lines: The closest parallel here would be hydroxychloroquine, which was granted an emergency use authorization early in the outbreak, only to have it revoked as more evidence piled up showing that the drug probably doesn't help, and may even be harmful.

  • The concerns over plasma focus on the strength of the evidence that it works. Critics haven't suggested that it's unsafe.

The bottom line: It's clear what the White House wants from the FDA, and any apparent shortcut around the FDA's usual, rigorous standards will raise questions about the possibility of more harmful shortcuts in the future.

3. A test run for concerts

Photo: Sean Gallup/Getty Images

Remember live music? Researchers in Germany staged a tightly controlled concert on Saturday to see whether there's a way to bring them back safely, even in a pandemic.

  • Roughly 1,500 people filed into an arena in Leipzig — all after testing negative for coronavirus infections and while wearing masks — for the simulation.

Details, per the AP:

  • Participants wore bracelets that tracked their movements throughout the arena — which even featured a real pop act, to get the most real-life crowd response possible — so that researchers could track the aerosols they emitted and the surfaces they touched.
  • Researchers tested three scenarios, all designed to mimic the beginning of a pandemic, with three levels of social distancing.
  • Results are expected within four to six weeks.

My thought bubble: Germany has recorded roughly 9,300 deaths and is averaging under 2,000 new cases per day. The U.S. is at roughly 170,000 deaths and just under 50,000 daily cases.

  • The fastest way to safely get back to doing fun things in the presence of other people is to get the virus under control.
4. The long-term dividends of better testing

Illustration: Eniola Odetunde/Axios

The race to improve testing for COVID-19 is leading to the development of new, rapid testing technology with potential benefits well beyond this pandemic, my colleague Bryan Walsh reported over the weekend.

Where it stands: We're seeing a spate of new, quick-turnaround tests for the coronavirus.

  • The FDA has granted an emergency use authorization to a test developed at the University of Illinois, as well as one developed by Yale researchers, with help from the NBA (it was tested on NBA players).
  • Mammoth Biosciences last month received backing from the National Institutes of Health to scale up its CRISPR-based diagnostic.
  • And a Princeton spinout called NeuTigers has developed an AI-powered diagnostic that identifies COVID-19 infections using health data from wearable devices like smartwatches.

Why it matters: The burst of innovation around disease diagnostics — as well as the growth of at-home health tracking devices — could lay the groundwork for a range of tests that rapidly detect infections of all kind, says Jack Regan, the CEO of the molecular diagnostics company LexaGene.

5. Catch up quick
Expand chart
Data: The COVID Tracking Project; Note: Does not include probable deaths from New York City; Map: Andrew Witherspoon/Axios
  • Tropical storms looming off the Gulf Coast are only going to make coronavirus response harder (Washington Post).
  • The Republican convention this week will lean into an explicit contrast with Democrats over willingness to shut down some parts of the economy (Wall Street Journal).
  • Health care workers are beginning to crack under the strain of the pandemic (NPR).
  • Aides to President Trump told members of Congress that a vaccine would be approved before the election (NYT).
  • European vacationers are scrambling as some countries reimpose travel restrictions (CNN).