July 21, 2020

Good morning.

Join Axios co-founder Mike Allen and me tomorrow at 12:30pm ET with Rep. Ann Kuster (D-N.H.), Boston University School of Medicine chief of rheumatology and professor of medicine Tuhina Neogi, and American Autoimmune Related Diseases Association CEO and president Randall Rutta for a conversation on how the pandemic is changing health care access for those dealing with chronic pain.

Today's word count is 1,093, or a 4-minute read.

1 big thing: We're still in the early stages of the vaccine race

Illustration: Aïda Amer/Axios

New clinical trial data from two experimental coronavirus vaccines — one from Oxford University and AstraZeneca in the U.K., and the other from CanSino Biologics in China — are providing cautious optimism in the race to combat the pandemic, Axios' Bob Herman reports.

The big picture: Science has never moved this fast to develop a vaccine. And researchers are still several months away from a clearer idea of whether the leading candidates help people generate robust immune responses to this virus.

Driving the news: The Oxford and CanSino vaccines didn't lead to any severe adverse reactions or hospitalizations, according to the results released yesterday.

  • Safety — not efficacy — was the main thing these studies were supposed to be testing. And they performed well enough to move on to further trials.
  • Competing candidates from Moderna and Pfizer/BioNTech have also performed well in safety trials.

Yes, but: Future trials will be the ones that tell us whether any of these potential vaccines actually trigger patients' immune systems to respond to the virus.

  • In the results released yesterday, Oxford researchers gave their vaccine to 543 people but only tested 35 for "neutralizing antibodies." A separate, nonrandomized group of 10 people got a booster dose of the Oxford vaccine a month after the initial dose.
  • Preliminary antibody responses from CanSino's vaccine were "disappointing" to several experts.

The bottom line: There are 23 coronavirus vaccines in clinical testing right now, according to the World Health Organization.

  • We now have data on the first four, but the studies mostly are confirming that the vaccines aren't severely harmful and that large-scale studies are warranted — not that they definitely work yet.
  • "It is good and hopeful news indeed, but we'll only know when the large trials are done," tweeted Robert Califf, a former FDA commissioner under President Obama.

2. The vaccine race is global

Illustration: Annelise Capossela/Axios

Vaccines from the U.K., U.S. and China are sprinting ahead in a global race that involves at least 197 vaccine candidates and is producing geopolitical clashes even as it promises a possible pandemic escape route, Axios' Dave Lawler writes.

What they're saying: Experts are increasingly confident that it's no longer a question of if but when vaccines will be available.

  • "Absolutely, for sure, we will get more than one vaccine," Barry Bloom, a professor of public health at Harvard, told reporters yesterday.

But, but, but: The challenges of producing, distributing and delivering a vaccine (particularly in two doses, as the Oxford vaccine requires) around the entire world are hard to even fathom.

  • Even distributing a vaccine in one country will require an unprecedented buildup of facilities, materials (like glass vials), personnel and protocols, assuming enough people are even willing to take it.

The global picture is even murkier. Several countries and pharmaceutical companies have committed to "fair and equitable" distribution.

  • In principle, that would suggest a vulnerable front-line worker in Uganda, say, should get the vaccine before a young, healthy person in the United States.
  • In practice, well ... no one really knows.
  • For now, governments are prioritizing their own populations.

What to watch: Managing the largest vaccination project in history will clearly require global collaboration — but it's also becoming a competition between rival powers.

Go deeper.

3. The latest in the U.S.

Data: The COVID Tracking Project; Map: Andrew Witherspoon/Axios

A judge in Hidalgo County, Texas, ordered all county residents on Monday to shelter at home from Wednesday until midnight on Aug. 5 due to rising coronavirus cases in the state.

Florida is shaping up as America's bellwether on reopening schools, with teachers unions suing the state on Monday, Axios' Justin Green and Orion Rummler report.

President Trump posted a photo of himself wearing a face mask on Monday and tweeted that "many people say that it is Patriotic to wear a face mask when you can’t socially distance."

Trump told reporters at the White House Monday that he plans to resume his daily coronavirus press briefings sometime this week, "probably starting" Tuesday.

The parent company of Southern supermarket chain Winn-Dixie will not require face masks to be worn in its roughly 500 stores, saying it doesn't want to "put [its] associates in a position to navigate interpersonal conflict," reports the Washington Post.

The American Federation of Teachers on Monday warned Congress that 1.3 million public education jobs could be at risk if it doesn't move to prioritize funding for state and local governments in its next coronavirus stimulus package.

4. Hotspots see more COVID cases in nursing homes

Coronavirus hotspots have seen a surge of new infections in nursing homes and other long-term care facilities, the Kaiser Family Foundation's Drew Altman writes in today's column.

Why it matters: Older and sicker people are at much higher risk for serious illness and death, and are at risk from these growing outbreaks despite efforts to protect elder-care facilities.

The big picture: One of the dominant narratives about the Sunbelt surge in new cases is that the infected population is younger, and therefore at less risk. But that's not the whole story.

By the numbers: Over a 14 day-period ending July 10, new cases in long-term care facilities rose by 18% across the 23 hotspot states for which data are available.

  • Florida led the way with a 51% increase, and Texas saw a 47% increase within long-term care facilities. California's long-term care facilities experienced a 23% increase in new infections.
  • Arizona did not report this data.

These spikes almost certainly reflect significant community spread, as well as shortages of protective equipment within the facilities.

The bottom line: The lesson for long-term care facilities may be the same as the lesson for schools: There is no way to get a handle on coronavirus in one setting without first controlling community spread overall.

  • The data suggest that when the virus is spreading widely among younger people in fitness centers, or bars, or house parties, it's going to find its way to older and more vulnerable people.

5. The skeptics are growing

Data: Axios/Ipsos polls. May 1-4, 1,012 U.S. adults. July 17-20, 1,037 U.S. adults; Chart: Danielle Alberti/Axios

A rising number of Americans — now nearly one in three — don't believe the virus' death toll is as high as the official count, despite surging new infections and hospitalizations, per this week's installment of the Axios-Ipsos Coronavirus Index.

Between the lines: Republicans, Fox News watchers and people who say they have no main source of news are driving this trend, Axios' Margaret Talev reports.

Why it matters: It shows President Trump's enduring influence on his base, even as Americans overall say they are increasingly dissatisfied with his handling of the virus and political support is shifting toward Joe Biden.

By the numbers: Overall, 31% of Americans say they believe the number of Americans dying is lower than the number reported, up sizably from 23% when we asked the same question in May.

The big picture: The survey shows most Americans are digging in for a long fight against the virus, even if they have conflicting views about what to believe.

  • 72% say they're prepared to maintain social distancing or self-quarantining for as long as it takes — up from 49% in May — as people realize the end is more than a couple of months off.

This survey finds the highest overall use of face masks since the pandemic began — with 99% of Democrats and 75% of Republicans now saying they're wearing a mask sometimes or all of the time when they go out.

Go deeper.