Tag: Vaccine

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Clergy Preach Religion within the Covid Vaccine to Doubters

Clergy Preach Faith in the Covid Vaccine to Doubters

Black churches have formed national networks to fight pandemics with a sense of purpose that reflects their acceptance of civil rights issues. A working group in Florida led by black churches has linked guns to historically black colleges and universities and offered sanctuaries as vaccination sites. The Black Coalition Against Covid-19 issued guidelines for faith leaders with tips on pandemic and vaccination.

The Rev. Matthew L. Watley of the AME Church of the Kingdom Fellowship in Silver Spring, Md., Who shares vaccine information with communities across the country, bluntly confronts the black community’s deep suspicion of vaccines. He tells skeptics, “The ultimate conspiracy could be simply, ‘Wait until there’s a global pandemic that disproportionately affects African Americans and then convince them not to take the only medical intervention that has been shown to save lives.'”

At Shorter, Rev. Dr. Timothy Tyler spoke about vaccinations on his online services, participated in panels and posted his recordings on Facebook. Now, as UCHealth, the University of Colorado-affiliated health care system, sends the message that it will deliver 500 doses to Shorter on a Sunday, Church members are pressing the phones, persuading senior members, and providing transportation.

One last Sunday, after a tough year outside of church, Dr. Love back in Shorter to get vaccinated. She greeted Pew Mates, whom she had not seen in a long time. She knelt in front of the sanctuary’s altar and wept.

“I prayed for those who did not have the opportunity that I was blessed with and for a healing for our nation,” she said.

Then she went to the Church’s Omar D. Blair Fellowship Hall, named after a Tuskegee Airman who campaigned for civil rights. Here she had led scouting activities. Where the Church celebrated her husband after he died.

Now a new milestone.

She sat at a table to receive the shot, hoping it would free her from the pandemic and restore her to the community life she cherished.

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Can the World Be taught From South Africa’s Vaccine Trials?

Can the World Learn From South Africa’s Vaccine Trials?

In a year that has fluctuated between staggering profits and brutal setbacks at Covid-19, few moments have been as sobering as last month’s discovery that a variant of coronavirus in South Africa was dampening the effects of one of the most effective vaccines in the world.

That finding – from a South African trial with the Oxford-AstraZeneca shot – revealed how quickly the virus had managed to evade human antibodies, ending what some researchers have described as the worldwide honeymoon period with Covid-19 vaccines, and continuing that Hopes return to contain the pandemic.

As countries prepare for this difficult turnaround, the story of how scientists uncovered the dangers of the variant in South Africa has brought focus to the global vaccine trials that were essential in warning the world.

“Historically, people might have thought that a problem in a country like South Africa would remain in South Africa,” said Mark Feinberg, executive director of IAVI, a nonprofit scientific research group. “But we’ve seen how quickly variants pop up all over the world. Even wealthy countries need to pay a lot of attention to the developing landscape around the world. “

After the deliberations in the vaccine race, these global studies saved the world from sleepwalking into the second year of the coronavirus without knowing how the pathogen might weaken the body’s immune response, scientists said. They also provide lessons on how vaccine manufacturers can combat new variants and eliminate long-standing health inequalities this year.

The deck is often stacked against drug trials in poorer countries: drug and vaccine manufacturers attract their largest commercial markets, and often avoid the cost and uncertainty of testing products in the global south. Less than 3 percent of clinical trials are conducted in Africa.

However, the emergence of new varieties in South Africa and Brazil has shown that vaccine manufacturers cannot afford to wait years, as they have often done, before testing that shots work in poorer ones for rich countries.

“If you fail to identify and respond to what is happening on a supposedly distant continent, it has a significant impact on global health,” said Clare Cutland, a vaccine scientist at the Witwatersrand University in Johannesburg who coordinated the Oxford study. “These results have shown the world that there isn’t a single pathogen sitting there doing nothing – it is constantly mutating.”

Although the Oxford vaccine offers minimal protection against mild or moderate cases caused by the variant in South Africa, it will likely prevent these patients from becoming seriously ill, preventing an increase in hospitalizations and deaths. Laboratory studies have produced a mix of hopeful and more worrying results about how much the variant disrupts Pfizer and Moderna’s recordings.

Even so, vaccine manufacturers are trying to test updated booster vaccinations. And countries are trying to isolate cases of the variant that South African studies have shown could potentially re-infect humans as well.

In March of last year, long before scientists became angry about variants, Shabir Madhi, a veteran vaccinologist at the Witwatersrand University, began to persuade vaccine manufacturers to conduct trials.

Dr. Realizing how long Africa often waits for life-saving vaccines as it did with swine flu vaccinations a decade ago, Madhi wanted to quickly examine how Covid-19 vaccines work on the continent, even with people with HIV no excuse for the world the delay in permits or deliveries. Different socio-economic and health conditions can alter the performance of vaccines.

“I’m sure I can get money,” he emailed the Oxford team on March 31 last year, adding that “it would be important to evaluate in relation to HIV.”

Oxford agreed, and the Bill and Melinda Gates Foundation contributed $ 7.3 million, cementing its role as the linchpin of efforts to steer vaccine trials to the global south.

Even so, the process had to contend with difficulties that larger studies with better resources in the US and Europe did not have. On the one hand, Dr. Madhi eliminate several test sites because they did not have sufficiently cold freezers or emergency power generators. This is necessary in a country where frequent power outages can put valuable doses at risk.

Even when the researchers locked down sites and relied on clinics with experience conducting HIV studies, the study was almost rolled back. The test results showed that almost half of the earliest volunteers were already infected with the virus at the time of vaccination, invalidating their results.

Updated

March 13, 2021, 6:24 p.m. ET

“We had a limited amount of funding and a limited number of vaccines,” said Dr. Cutland. “We were very concerned that the process had completely derailed.”

At another test site, all three pharmacists have signed Covid-19 and have withdrawn the only people who are allowed to prepare shots. Nurses in the study lost siblings and parents to the disease. The staff was so overwhelmed that the phones sometimes rang when vaccine managers called from abroad.

The magnitude of the pandemic in South Africa – 51,000 people have died and up to half the population may be infected – nearly overturned the process. But that was also part of what attracted vaccine makers: More cases mean faster results.

Dr. Madhi’s team weathered the storm, working 12-hour days and adding last-minute swabs to make sure the volunteers weren’t already infected. By May, he had asked Novavax, then a little-known American company with the support of the Trump administration, to conduct a lawsuit there too. Novavax agreed, and the Gates Foundation raised $ 15 million. However, the process was not registered until a few months later.

Novavax said the process took some time. However, the delay also reflected what scientists have called pressure on American-backed vaccine manufacturers to focus their efforts on the United States. Studies there are the best way to unlock coveted approvals from the Food and Drug Administration, the world’s gold standard drug agency.

And vaccine manufacturers tend to know their largest markets best.

“Companies have the greatest experience of clinical trials in parts of the world that represent their commercial markets,” said Dr. Feinberg.

For vaccine manufacturers who have made supplying the world a core part of their strategies, the trials have been a boon. Novavax showed that the effectiveness of the vaccine was only moderately weakened by the variant in South Africa. Johnson & Johnson, who also conducted a South African study, showed that their vaccine was protected from hospitalization and death there.

What you need to know about the vaccine rollout

“You have your fishing line in the water – and by the time we were there the virus developed,” said Dr. Gregory Glenn, President of Research and Development at Novavax. “This is invaluable data for us and the world.”

In a recent laboratory study, the Oxford-AstraZeneca vaccine protected hamsters exposed to the variant from disease, even when the animals’ immune responses were slightly weaker. The human study in South Africa was too small to be able to say definitively whether the vaccine prevents serious diseases. Finding that it offers minimal protection from milder cases was itself daunting, as the shot remains the backbone of the introduction of many poorer countries.

In South Africa, the results failed because of plans to give the Oxford vaccine to health workers. Despite the implementation of trials, the country was unable to use them for early purchase agreements and delayed deliveries. Only a fifth of 1 percent of the people there have been vaccinated, raising fears of another wave of deaths and further mutations.

If HIV research laid the groundwork for vaccine trials in South Africa, some scientists hope that an explosion in global studies on the pandemic will show drug companies that other countries have the infrastructure to conduct larger studies.

To this end, the Gates-supported Coalition for Epidemic Preparedness Innovations offers companies incentives to conduct further Covid-19 vaccine trials in poorer countries.

“People tend to go for what they know,” said Melanie Saville, the coalition’s director of vaccine research and development. “However, in low- and middle-income countries, capacity is increasing and we need to encourage developers to use it.”

Large numbers of South Africans volunteered for the trials. Most mornings, Dr. Anthonet Koen, who operated a location in Johannesburg for the Oxford and Novavax processes, opened their doors at 6 a.m. At this point, the participants had already been outside for two hours.

On December 11th, Dr. Koen that the pandemic was increasing: After weeks without a case, two people in the study tested positive. Then more and more every day. Health officials announced the discovery of the variant a week later. The random placement of the studies gave the scientists what they almost never had: an open-air laboratory where they could watch in real time how a vaccine and a variant stood in front of them.

Since the Oxford results were announced last month, volunteers have tried to comfort them, said Dr. Koen: “I get a lot of condolences and ‘I’m sorry’,” she said.

As long as this vaccine prevents and other serious diseases, the world can live with the virus even in cases of the variant, scientists said. However, the trial in South Africa underscored the need to eradicate the virus before it mutates further. Without them, scientists said, the world could have been blind to what was to come.

“We would assume that these variants are not the end of the story,” said Andrew Pollard, the Oxford scientist responsible for his experiments. “For the virus to survive, it must continue to mutate once the populations have good immunity to the current variants.”

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President Biden Takes 1st Tentative Steps to Deal with International Covid-19 Vaccine Scarcity

Biden Takes First Tentative Steps to Address Global Vaccine Shortage

WASHINGTON – President Biden was under heavy pressure on Friday to donate excess coronavirus vaccines to nations in need to otherwise address global shortages and partnered with Japan, India and Australia to increase global manufacturing capabilities Expand vaccines.

In an agreement announced at the so-called Quad Summit, a virtual meeting of the heads of state and government of the four countries, the Biden government pledged to provide financial support to enable Biological E, a large vaccine manufacturer in India, to manufacture at least 1 Billion doses of coronavirus to help vaccines by the end of 2022.

This would fix acute vaccine shortages in Southeast Asia and beyond without risking the domestic setback of exporting cans in the coming months as Americans demand their shots.

The United States has fallen far behind China, India and Russia in the race to adopt coronavirus vaccines as an instrument of diplomacy. At the same time, Mr Biden is accused of hoarding vaccines from global health lawyers who want his government to route supplies to nations in need desperately seeking access.

The president insisted that Americans come first and has so far refused to make any specific commitments to free US-made vaccines, despite tens of millions of doses of the British-Swedish company AstraZeneca’s vaccine idling in American manufacturing facilities .

“If we have a surplus, we will share it with the rest of the world,” Biden said this week, adding, “We will first make sure that the Americans are taken care of first, but then we will try the rest of the world to help. “

In fact, the president still has a lot of work to do domestically to keep the promises made in the past few days: All states must question all adults for vaccinations by May 1st so that enough vaccine doses are available by the end of May to vaccinate every American adult, and that by July 4th, if Americans continue to follow public health guidelines, life should return to a semblance of normalcy.

Vaccine supplies seem on track to meet these goals, but the president still needs to put in place the infrastructure to manage the doses and overcome reluctance in large parts of the population to take them.

Still, Mr Biden has also made restoring US leadership a core part of his foreign policy agenda after his predecessor’s alliances frayed and relations with allies and global partners strained. His Foreign Secretary, Antony J. Blinken, said in a recent BBC interview that a global vaccination campaign would be part of this effort. Washington is “determined” to be an “international leader” in vaccinations.

Foreign policy experts and global health activists see clear diplomatic, public and humanitarian reasons for this.

“It’s time for US leaders to ask themselves: When this pandemic is over, do we want the world to remember America’s leadership in helping distribute life-saving vaccines, or will we leave that to others?” said Tom Hart, the North American executive director of One Campaign, a nonprofit founded by U2 singer Bono and dedicated to eradicating global poverty.

The federal government has bought 453 million surplus doses of vaccine, the group says. She has asked the Biden administration to share 5 percent of their doses overseas when 20 percent of Americans have been vaccinated, and gradually increase the percentage of divided doses as more Americans receive their vaccines.

According to the Centers for Disease Control and Prevention, 13.5 percent of people in the United States who are 18 years of age or older were fully vaccinated as of Friday.

The authoritarian governments of China and Russia, less affected by national public opinion, are already using vaccines to expand their sphere of influence. As the Biden government plans its strategy to counter China’s growing global clout, Beijing is polishing its image by shipping vaccines to dozens of countries on multiple continents, including Africa, Latin America, and the Southeast Asian backyard in particular.

Russia has been providing vaccines to Eastern European countries like Hungary, the Czech Republic and Slovakia at a time when Biden officials want to unify the European Union against Russian influence on the continent.

“We may be outdone by others who are more willing to share, even if they do so for cynical reasons,” said Ivo H. Daalder, former NATO ambassador and president of the Chicago Council on Global Affairs. “I think countries will remember who was there for us when we needed them.”

Updated

March 13, 2021, 3:49 p.m. ET

In the face of worrying and highly contagious new varieties in the US and around the world, public health experts say vaccinating people overseas is necessary to protect Americans too.

“It has to be sold to Americans to keep Americans safe over the long term, and it has to be sold to a highly divided, toxic America,” said J. Stephen Morrison, a global health expert with Centers for Strategic and International Studies. “I don’t think that’s impossible. I think Americans are beginning to understand that in a world of variation, anything that happens outside of our borders increases the urgency to act really quickly. “

Mr Blinken also said this to the BBC: “Until everyone in the world is vaccinated, nobody is really completely safe.”

The quad vaccine partnership announced at the summit on Friday includes different commitments from each of the nations, according to the White House.

In addition to supporting the Indian vaccine maker, the US has pledged at least $ 100 million to bolster vaccination capacity overseas and support public health efforts. Japan is “in discussion” to provide loans to the Indian government to expand the production of vaccines for export and will support vaccination programs for developing countries. Australia will allocate $ 77 million for vaccine provision and delivery assistance with a focus on Southeast Asia.

The four countries will also form one  Quad Vaccine Experts Group by  Top scientists and government officials who will work to overcome production hurdles and funding plans.

Mr Morrison said the government deserves “some credit” for the effort, adding, “It shows diplomatic ingenuity and speed.” However, a spokesman for One Campaign, which focuses on extreme poverty, said his group would still see a plan for the United States’ vaccine supply, noting that Africa had given far fewer doses per capita than Asia.

Mr Biden’s efforts to ramp up vaccine production helped the United States produce up to a billion doses by the end of the year – far more than needed to vaccinate the roughly 260 million adults in the United States.

What you need to know about the vaccine rollout

A government-brokered deal to see drug company Merck manufacture Johnson & Johnson’s single-dose vaccine, which the president celebrated in the White House on Wednesday, will help achieve that goal. Also on Wednesday, Mr Biden directed federal health officials to source an additional 100 million doses of the vaccine from Johnson & Johnson.

The government has stated that these efforts are aimed at having enough vaccines for children, booster doses, to face new varieties and unforeseen events. Jeffrey D. Zients, Mr Biden’s coronavirus response coordinator, told reporters Friday that the Johnson & Johnson-Merck deal would also “expand capacity and ultimately benefit the world”.

Not only did Mr Biden resist the urge to dump excess doses, but he also criticized the Liberal Democrats for blocking a motion by India and South Africa for a temporary waiver of an international intellectual property agreement that would make it easier for poorer countries to access generic versions of Coronavirus vaccines and treatments.

“I understand why we should prioritize our supply to Americans – it was paid for by American taxpayers, President Biden is President of America,” said Representative Ro Khanna, a Liberal Democrat from California. “But there is no reason to prioritize the profits of pharmaceutical companies over the dignity of other countries.”

Mr Biden recently announced a $ 4 billion donation to Covax, the international vaccine initiative supported by the World Health Organization. David Bryden, director of the Frontline Health Workers Coalition, a nonprofit that supports health workers in low- and middle-income countries, said money was also urgently needed to train and pay these workers to administer vaccines overseas.

However, that donation and the Quad’s announcement of financial support for vaccine production on Friday fell short of the urgent demands of public health advocates for the United States to provide ready-to-use doses that can be quickly injected.

However, the quad’s focus on Southeast Asia most likely reflects an awareness of China’s gratitude in the region for Beijing’s focus in its vaccine distribution efforts.

If Mr Biden is widely viewed as helping the world recover from the coronavirus pandemic, that could become part of his legacy when President George W. Bush made a huge investment in public health funding in the 2000s the AIDS crisis in Africa responded. More than a decade later, Bush and the United States continue to be revered across much of the continent for the President’s Emergency Plan for AIDS Relief (Pepfar), which the government said has spent $ 85 billion and saved 20 million lives.

Michael Gerson, a former Bush White House speechwriter and policy advisor who helped shape the Pepfar program, said its impact has been both moral and strategic and that the program has been “an enormous amount of money to the United States.” goodwill “in Africa.

“I think the principle here should be that the people who need it most should get it, no matter where they live,” he said. “There is little moral sense in giving the vaccine to a healthy American 24-year-old in front of a front-line worker in Liberia.”

But he added, “It’s very difficult for an American politician to explain.”

Ana Swanson contributed to the coverage

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Business

U.S. tops 100 million Covid vaccine doses given, 13% of adults absolutely vaccinated

U.S. tops 100 million Covid vaccine doses given, 13% of adults fully vaccinated

Residents wait in line to be vaccinated on March 10, 2021 in Chicago, Illinois at a COVID-19 mass vaccination center set up in a parking lot outside the United Center, home of the Chicago Bulls and Blackhawks.

Scott Olson | Getty Images

The U.S. exceeded 100 million Covid-19 vaccine doses administered on Friday, according to the Centers for Disease Control and Prevention.

About 35 million people have been fully vaccinated, which is 13.5% of the adult US population, according to the CDC. About 65.9 million people have received at least one intake of two-dose therapy, the CDC said.

The milestone includes the 16.5 million vaccines administered under the Trump administration, but brings President Joe Biden closer to his goal of getting 100 million shots in his arms in his first 100 days in office.

Of those 65 and older, more than 32% are fully vaccinated and over 61% have received at least one dose, according to the CDC. This is noteworthy in that roughly 80% of the deaths caused by Covid-19 in the United States were in people aged 65 and over.

The government has gradually accelerated the pace of vaccinations since Biden took office. The White House originally attempted to administer 1 million shots a day, which some public health specialists criticized as a low target. The US hit a record 2.9 million shots on Friday, according to the CDC.

There are now three Covid-19 vaccines that have received emergency approval from the Food and Drug Administration. Moderna and Pfizer’s two-dose emergency vaccines were approved in December, and Johnson & Johnson’s single vaccine was approved last month.

The White House has worked with manufacturers to speed up production and increase the overall supply of shots for the U.S. On Wednesday, Biden announced that the government plans to source an additional 100 million doses of the J&J vaccine.

J&J currently has a contract with the U.S. government to provide 100 million cans by the end of June, though White House officials said this week the company can deliver those cans by the end of May. This is thanks to a deal where J&J rival Merck will help make vaccine doses, Jeff Zients, the White House’s Covid-19 responses coordinator, told a news conference Friday.

Zients added that Moderna and Pfizer are expected to each deliver 200 million doses of their vaccines by the end of May.

“That’s more than enough vaccine to keep all adult Americans vaccinated by the end of May,” Zients said. “Now we need to increase the number of vaccines we’ve talked about and the number of places that Americans can be vaccinated.”

Biden used his first prime-time address to the nation on Thursday to urge states to question all adults for the Covid vaccines by May 1’s final decision. Alaska began opening the permission before Biden’s speech.

Some public health professionals fear that while the demand for vaccines was high when it was first introduced, the available demand may decline.

In his address on Thursday evening, Biden urged Americans to continue to follow public health measures and get vaccinated when it is their turn. He also aims to allow Americans to meet up in small groups in person with their friends and loved ones to celebrate July Fourth in case the pandemic in the US continues to decline

“If we all do our part, this country will soon be vaccinated, our economy will improve, our children will be back in school and we will prove once again that this country can do everything,” said Biden. But “if we don’t stay vigilant and conditions change, we may have to reintroduce the restrictions to get back on track.”

Correction: This article has been updated to reflect that President Joe Biden has not yet achieved his goal of 100 million vaccine doses in his first 100 days.

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Covid vaccine skepticism will stop U.S. from normalcy

J&J's one-shot Covid vaccine approved by Europe

A new poll found that 49% of Republican men said they would not be vaccinated against Covid-19, and Dr. Vin Gupta said that “the course of this pandemic is being determined to the detriment of all Americans”.

“All predictions right now are that we will overcome the worst with normalcy by the end of June, early July. However, that depends on people actually receiving the vaccine on the order of 75% to 80% of eligible adults until that period, “said Gupta, who works in an intensive care unit. “If that is not the case – if the skepticism or hesitation is so high – we will not get there.”

Gupta, a pulmonologist and medical assistant for NBC, pointed to models from the Institute of Health Metrics and Assessment (IHME) at the University of Washington, which suggest that if the US were still there, 100,000 cases and at least 1,000 deaths a day could still occur Rate of eligible adults vaccinated increases were below projections.

Joe Biden made a swift return to normal during his first prime-time address as president on Thursday evening.

“After this long, tough year, this Independence Day is going to be very special as we not only mark our independence as a nation, but also our independence from this virus,” he said.

Gupta, an associate assistant professor at IHME at the University of Washington, told CNBC’s “The News with Shepard Smith” that Covid will be something Americans live with and that it is more likely to become an endemic virus, which means that it will regularly be found among the population.

“There will still be transmission of the virus, but people don’t get sick and end up in the hospital,” Gupta said. “That’s the hope that only a small part of society will remain vulnerable, and we can do it. This is what normalcy will be like; management, not total extermination.”

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Biden Takes First Tentative Steps to Handle International Vaccine Scarcity

Biden Takes First Tentative Steps to Address Global Vaccine Shortage

WASHINGTON – President Biden was under heavy pressure on Friday to donate excess coronavirus vaccines to nations in need to otherwise address global shortages and partnered with Japan, India and Australia to increase global manufacturing capabilities Expand vaccines.

In an agreement announced at the so-called Quad Summit, a virtual meeting of the heads of state and government of the four countries, the Biden government pledged to provide financial support to enable Biological E, a large vaccine manufacturer in India, to manufacture at least 1 Billion doses of coronavirus to help vaccines by the end of 2022.

This would fix acute vaccine shortages in Southeast Asia and beyond without risking the domestic setback of exporting cans in the months ahead as Americans demand their shots.

The United States has fallen far behind China, India and Russia in the race to adopt coronavirus vaccines as an instrument of diplomacy. At the same time, Mr Biden is accused of hoarding vaccines from global health lawyers who want his government to route supplies to nations in need desperately seeking access.

The president insisted that Americans come first and has so far refused to make any specific commitments to free US-made vaccines, despite tens of millions of doses of the British-Swedish company AstraZeneca’s vaccine idling in American manufacturing facilities .

“If we have a surplus, we will share it with the rest of the world,” Biden said this week, adding, “We will first make sure that the Americans are taken care of first, but then we will try the rest of the world to help. “

In fact, the president still has a lot of work to do domestically to keep the promises made in the past few days: All states must question all adults for vaccinations by May 1st so that enough vaccine doses are available by the end of May to vaccinate every American adult, and that by July 4th, if Americans continue to follow public health guidelines, life should return to a semblance of normalcy.

Vaccine supplies seem on track to meet these goals, but the president still needs to put in place the infrastructure to manage the doses and overcome reluctance in large parts of the population to take them.

Still, Mr Biden has also made restoring US leadership a core part of his foreign policy agenda after his predecessor’s alliances frayed and relations with allies and global partners strained. His Foreign Secretary, Antony J. Blinken, said in a recent BBC interview that a global vaccination campaign would be part of this effort. Washington is “determined” to be an “international leader” in vaccinations.

Foreign policy experts and global health activists see clear diplomatic, public and humanitarian reasons for this.

“It’s time for US leaders to ask themselves: When this pandemic is over, do we want the world to remember America’s leadership in helping distribute life-saving vaccines, or will we leave that to others?” said Tom Hart, the North American executive director of One Campaign, a nonprofit founded by U2 singer Bono and dedicated to eradicating global poverty.

The federal government has bought 453 million surplus doses of vaccine, the group says. She has asked the Biden administration to share 5 percent of their doses overseas when 20 percent of Americans have been vaccinated, and gradually increase the percentage of divided doses as more Americans receive their vaccines.

According to the Centers for Disease Control and Prevention, 13.5 percent of people in the United States who are 18 years of age or older were fully vaccinated as of Friday.

The authoritarian governments of China and Russia, less affected by national public opinion, are already using vaccines to expand their sphere of influence. As the Biden government plans its strategy to counter China’s growing global clout, Beijing is polishing its image by shipping vaccines to dozens of countries on multiple continents, including Africa, Latin America, and the Southeast Asian backyard in particular.

Russia has been providing vaccines to Eastern European countries like Hungary, the Czech Republic and Slovakia at a time when Biden officials want to unify the European Union against Russian influence on the continent.

“We may be outdone by others who are more willing to share, even if they do so for cynical reasons,” said Ivo H. Daalder, former NATO ambassador and president of the Chicago Council on Global Affairs. “I think countries will remember who was there for us when we needed them.”

Updated

March 12, 2021, 5:39 p.m. ET

In the face of worrying and highly contagious new varieties in the US and around the world, public health experts say vaccinating people overseas is necessary to protect Americans too.

“It has to be sold to Americans to keep Americans safe over the long term, and it has to be sold to a highly divided, toxic America,” said J. Stephen Morrison, a global health expert with Centers for Strategic and International Studies. “I don’t think that’s impossible. I think Americans are beginning to understand that in a world of variation, anything that happens outside of our borders increases the urgency to act really quickly. “

Mr Blinken also said this to the BBC: “Until everyone in the world is vaccinated, nobody is really completely safe.”

The quad vaccine partnership announced at the summit on Friday includes different commitments from each of the nations, according to the White House.

In addition to supporting the Indian vaccine maker, the US has pledged at least $ 100 million to bolster vaccination capacity overseas and support public health efforts. Japan is “in discussion” to provide loans to the Indian government to expand the production of vaccines for export and will support vaccination programs for developing countries. Australia will allocate $ 77 million for vaccine provision and delivery assistance with a focus on Southeast Asia.

The four countries will also form one  Quad Vaccine Experts Group by  Top scientists and government officials who will work to overcome production hurdles and funding plans.

Mr Morrison said the government deserves “some credit” for the effort, adding, “It shows diplomatic ingenuity and speed.” However, a spokesman for One Campaign, which focuses on extreme poverty, said his group would still see a plan for the United States’ vaccine supply, noting that Africa had given far fewer doses per capita than Asia.

Mr Biden’s efforts to ramp up vaccine production helped the United States produce up to a billion doses by the end of the year – far more than needed to vaccinate the roughly 260 million adults in the United States.

What you need to know about the vaccine rollout

A government-brokered deal to see drug company Merck manufacture Johnson & Johnson’s single-dose vaccine, which the president celebrated in the White House on Wednesday, will help achieve that goal. Also on Wednesday, Mr Biden directed federal health officials to source an additional 100 million doses of the vaccine from Johnson & Johnson.

The government has stated that these efforts are aimed at having enough vaccines for children, booster doses, to face new varieties and unforeseen events. Jeffrey D. Zients, Mr Biden’s coronavirus response coordinator, told reporters Friday that the Johnson & Johnson-Merck deal would also “expand capacity and ultimately benefit the world”.

Not only did Mr Biden resist the urge to dump excess doses, but he also criticized the Liberal Democrats for blocking a motion by India and South Africa for a temporary waiver of an international intellectual property agreement that would make it easier for poorer countries to access generic versions of Coronavirus vaccines and treatments.

“I understand why we should prioritize our supply to Americans – it was paid for by American taxpayers, President Biden is President of America,” said Representative Ro Khanna, a Liberal Democrat from California. “But there is no reason to prioritize the profits of pharmaceutical companies over the dignity of other countries.”

Mr Biden recently announced a $ 4 billion donation to Covax, the international vaccine initiative supported by the World Health Organization. David Bryden, director of the Frontline Health Workers Coalition, a nonprofit that supports health workers in low- and middle-income countries, said money was also urgently needed to train and pay these workers to administer vaccines overseas.

However, that donation and the Quad’s announcement of financial support for vaccine production on Friday fell short of the urgent demands of public health advocates for the United States to provide ready-to-use doses that can be quickly injected.

However, the quad’s focus on Southeast Asia most likely reflects an awareness of China’s gratitude in the region for Beijing’s focus in its vaccine distribution efforts.

If Mr Biden is widely viewed as helping the world recover from the coronavirus pandemic, that could become part of his legacy when President George W. Bush made a huge investment in public health funding in the 2000s the AIDS crisis in Africa responded. More than a decade later, Bush and the United States continue to be revered across much of the continent for the President’s Emergency Plan for AIDS Relief (Pepfar), which the government said has spent $ 85 billion and saved 20 million lives.

Michael Gerson, a former Bush White House speechwriter and policy advisor who helped shape the Pepfar program, said its impact has been both moral and strategic and that the program has been “an enormous amount of money to the United States.” goodwill “in Africa.

“I think the principle here should be that the people who need it most should get it, no matter where they live,” he said. “There is little moral sense in giving the vaccine to a healthy American 24-year-old in front of a front-line worker in Liberia.”

But he added, “It’s very difficult for an American politician to explain.”

Ana Swanson contributed to the coverage

Categories
Health

AstraZeneca Covid vaccine suspended in some international locations over blood clot fears

AstraZeneca Covid vaccine suspended in some countries over blood clot fears

A health worker holds a box of the AstraZeneneca vaccine at the Bamrasnaradura Institute for Infectious Diseases in Nonthaburi Province on the outskirts of Bangkok.

Chaiwat subprasome | SOPA pictures | LightRocket via Getty Images

LONDON – The coronavirus vaccine developed by AstraZeneca and Oxford University has been exposed in a number of countries in Europe and Asia after reports of blood clots in some vaccinated people.

However, many other nations have defended their use of the shot and announced that they will continue their respective vaccination campaigns.

Thailand became the first Asian country to stop using the sting on Friday due to safety concerns, shortly after Denmark announced a two-week hiatus from its nationwide rollout after reports of blood clots and a death.

In a setback to the battered vaccination campaign in Europe, seven other countries have also suspended the use of the Oxford-AstraZeneca shot: Norway, Iceland, Bulgaria, Luxembourg, Estonia, Lithuania and Latvia.

Austria and Italy have since announced that they will no longer use certain batches of the vaccine as a precaution.

The European Medicines Agency, the European Medicines Agency, stressed Thursday that there was no evidence that the shot was causing blood clots, adding that the vaccine’s benefits “continue to outweigh the risks”.

The EMA acknowledged that some member states had stopped using the Oxford-AstraZeneca shot, but said vaccinations may continue to be given while a clot investigation is ongoing.

By Wednesday, around 5 million people in Europe had received the Oxford-AstraZeneca vaccine. Of this number, 30 cases of so-called “thromboembolic events” were reported. These cases relate to blood clots that form in the blood vessels and block blood flow.

AstraZeneca said the vaccine has been extensively studied in Phase 3 trials and peer-reviewed data confirms the shot is “generally well tolerated.”

Why do countries pause vaccination campaigns?

The Thai Ministry of Health announced on Friday that it would temporarily postpone the use of the Oxford-AstraZeneca vaccine. The shot is reportedly labeled a “good vaccine” but is said to be suspended for safety investigation.

Kiattiphum Wongjit, permanent secretary of the health ministry, said the Southeast Asian country may suspend its vaccination campaign as it has largely controlled a second wave of Covid cases through quarantines and border controls, according to Reuters.

A press conference will be held on March 12, 2021 in Bangkok, Thailand, to temporarily suspend the introduction of vaccination against AstraZeneca Covid-19 in Thailand.

Xinhua | Rachen Sageamsak via Getty Images

The country of nearly 70 million people has so far recorded around 26,600 cases and 85 deaths, according to Johns Hopkins University.

The decision of Thailand to suspend the planned launch of the Oxford-AstraZeneca vaccine, which was due to start on Friday, was made following the decision of the Danish health authority.

“It is important to emphasize that we have not decided against the AstraZeneca vaccine, but are putting it on hold,” said Soren Brostrom, director of the National Health Agency in Denmark, on Thursday.

“There is good evidence that the vaccine is both safe and effective. However, we and the Danish Medicines Agency need to respond to reports of possible serious side effects from both Denmark and other European countries.”

Many high-income countries have chosen to continue rolling out the Oxford-AstraZeneca vaccine for safety reasons.

The UK, France, Australia, Canada and Mexico are among the nations that have tried to reassure citizens about the vaccine’s benefits and have announced that they will continue their respective vaccination campaigns.

“An analysis of our safety data of more than 10 million records has shown no evidence of an increased risk of pulmonary embolism or deep vein thrombosis in any particular age group, gender, batch or country with AstraZeneca COVID-19 vaccine.” said an AstraZeneca spokesman.

“In fact, the number of these types of events observed is significantly lower in vaccinated people than would be expected in the general population.”

What do the experts say?

The EMA’s safety committee is investigating the problem, but has determined that there is currently no evidence that the vaccination caused blood clots. It should be noted that these are not listed as side effects of this vaccine.

The European Medicines Agency also noted that the data available so far showed that the number of blood clots in vaccinated people is no higher than in the general population.

“Reports of previously received blood clots are no greater than the numbers that would have occurred naturally in the vaccinated population,” said Dr. Phil Bryan, Vaccine Safety Director for the UK Medicines and Health Products Agency.

“Public safety will always come first. We will continue to examine this issue carefully, but the evidence available does not confirm the vaccine is the cause. People should still get their COVID-19 vaccine when prompted become.” Said Bryan.

Peter Brownsea, a Southampton resident, receives the Oxford / AstraZeneca Covid-19 vaccine from a member of the Hampshire Fire and Rescue Service at a temporary vaccination center at the Basingstoke Fire Station in Hampshire, southern England, while crews continue to answer 999 emergency calls.

Andrew Matthews | AFP | Getty Images

Stephen Evans, Professor of Pharmacoepidemiology at the London School of Hygiene & Tropical Medicine, said: “The problem with spontaneous reports of suspected vaccine side effects is the tremendous difficulty in distinguishing a causal effect from a coincidence.”

“This is especially true when we know that Covid-19 disease is very closely related to blood clotting and that there have been hundreds, if not many thousands of deaths caused by blood clotting as a result of Covid-19 disease. That first thing to do is to be absolutely sure that the clots were not caused by any other cause, including Covid-19, “added Evans.

How does the vaccine work?

The Oxford AstraZeneca vaccine is designed to prevent coronavirus in people aged 18 and over. It’s made up of an adenovirus that has been modified to contain the gene to make a protein from SARS-CoV-2, the virus that causes Covid-19.

The most common side effects of the shot, which does not contain the virus and cannot cause Covid, are typically mild or moderate and improve within a few days after vaccination.

In late clinical studies, the AstraZeneca-Oxford shot was found to have an average of 70% effectiveness in protecting against the virus.

A recent study by Oxford researchers found that the Covid vaccine was 76% effective at preventing symptomatic infection for three months after a single dose and that the effectiveness rate actually increased with a longer interval between the first and second dose.

– CNBC’s Holly Ellyatt contributed to this report.

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World News

Treasury yields increased following stimulus, vaccine information

Dow rises 80 points as market tries to build on February's rally

Traders on the floor of the New York Stock Exchange

Source: The New York Stock Exchange

The yield on 10-year government bonds reached its highest level in over a year on Friday. This is a sign of optimism on an economic comeback, but it also reflects heightened fears of inflation after the $ 1.9 trillion stimulus package came into effect.

The yield on the 10-year benchmark Treasury note rose 9 basis points to 1.619% at 9:40 am CET and briefly reached 1.642%, its highest level since February 2020. The yield on the 30-year treasury bond rose 10 basis points to 2.382%. The returns move inversely to the prices and 1 basis point equals 0.01%.

“The bearish of bonds was compounded by Biden’s return to normal time update. The president has outlined a path out of the pandemic that would bring the US back to some semblance of normality by July 4th,” said Ian Lyngen, rate strategist at BMO Capital Markets, wrote in an email on Friday.

“While last week the Friday afternoon bear pattern has been a significant challenge that has been felt for much of this year, when we think about the information on offer, there is little else we can do to prevent the higher variance in returns the remaining price movements in other markets. “

The yield curve between the 2-year rate of return and the 10-year rate of return reached 1.486%, the highest spread since September 2015.

The yield curve for government bonds is the interest rate difference between different maturities of bonds. When it gets steeper it is considered a positive sign for the economy. Meanwhile, a flattening curve is seen as a warning of economic weakness.

The volatility in returns weighed on US stocks, with the S&P 500 falling 0.3%. The tech-heavy Nasdaq Composite lost more than 1% on concerns about rising interest rates.

Government bond yields rose after Biden signed the $ 1.9 trillion coronavirus relief package Thursday afternoon.

The plan calls for direct payments of up to $ 1,400 to most Americans. Direct deposits will come into Americans’ bank accounts as early as this weekend, White House press secretary Jen Psaki said Thursday.

In addition to announcing his plan to make Covid vaccines available to all adults ages 18 and older, Biden said in his first prime-time address Thursday night that hopefully Americans should be able to gather in small groups around the to celebrate the fourth of July.

Yields were also higher after the number of weekly new jobless claims fell lower than expected on Thursday, reaching 712,000 for the week ended March 6, down from the estimate of 725,000.

The 10-year yield has been rising rapidly lately, increasing from 1% since late January amid concerns about rising inflation. These concerns were compounded by fears that the US government’s tax relief package, in addition to reopening the economy, could stimulate it too quickly and cause prices to rise.

Investors will watch out for the Federal Reserve’s decision on interest rates over the next week and for comments on the central bank’s stance on rising bond yields.

“If the bond sell-off intensifies ahead of the March 17th FOMC decision, the Fed may have to finally take action against the movement in government bond yields,” Edward Moya, senior market analyst at OANDA, told clients. “The Fed has clearly been sticking to the script that tighter financial conditions or disorderly markets would warrant action. If yields stay at a rapid rate, they will get clamor.”

There are no auctions on Friday.

– with reports from Jesse Pound, Yun Li and Tom Franck of CNBC.

Categories
Health

‘Fraught With Points’: Defective Software program Snarls Vaccine Signal-Ups

‘Fraught With Issues’: Faulty Software Snarls Vaccine Sign-Ups

When coronavirus vaccines first became available, Virginia health officials turned to software recommended by the Centers for Disease Control and Prevention to schedule appointments. However, people complained that the software called VAMS was too confusing for older adults.

So the state switched to a different system, PrepMod – but that had problems too. Links sent to seniors for their appointments were reusable and found their way to Facebook, resulting in a vaccination event in Richmond with dozens of overbookings. Some of these people threatened health care workers when they were turned away.

“It was a nightmare scenario,” said Ruth Morrison, the political director of Richmond and Henrico County’s Health District. “People who show up confused and angry thinking they have an appointment.”

State and local health departments across the country continue to face delays in delivering shots, partly because appointment software tools such as those used in Richmond remain flawed. The problems threaten to slow the adoption of vaccines, even if shipments and distribution increase rapidly across the country.

Large software systems have often been problematic for companies and governments. HealthCare.gov, a website released after the Affordable Care Act, crashed early. However, the problems with the vaccination sites have an added sense of urgency as health officials try to vaccinate as many people as possible as soon as possible.

On Thursday, President Biden said his government would send technical teams to help states improve their websites. He also said that by May 1, the federal government would open a website that Americans could use to find out where the vaccine can be obtained.

Many state officials have switched software providers just to see little or no improvement. In California, technical glitches have allowed unauthorized individuals to make appointments. Massachusetts residents were hampered by website crashes. Some North Carolina residents eschew online registrations altogether and instead participate in a vaccine that’s free for everyone.

PrepMod is used by 28 states and municipalities after many states eschewed the $ 44 million VAMS tool developed by Deloitte. Salesforce and Microsoft have also developed vaccination software, and their customers are similarly frustrated. Smaller tech companies have also developed their own planning tools.

“It’s like a patchwork quilt,” said Ms. Morrison, who after the Failed PrepMod process decided her county would try something different. “Some of these systems have strengths, but all of them also have weaknesses.”

Other health officials have defended the appointment systems, and the developers behind the software said the complaints about their products were exaggerated.

Tiffany Tate, the creator of PrepMod and executive director of the Maryland Partnership for Prevention, said criticism of their system was largely due to healthcare providers’ lack of knowledge of how to use it or to the ever-changing needs of states.

“The pandemic is moving forward and we need to be able to keep up,” she said. “We just have to be a very flexible platform.”

Deloitte, whose software is used by nine states, said VAMS was originally intended for smaller groups in the early stages of vaccine adoption in the states. As a result, the company “responded quickly to changing requirements” and updated the system to handle a greater load.

Health experts say several factors made software rollout difficult. In some cases, developers condensed work that typically took years to weeks, resulting in glitches. In addition, the different approaches to determining eligibility in dozens of locations using the software made it difficult to develop a unified approach.

Some states use more than half a dozen scheduling systems, from tools used by federal, state, and local government agencies to software used by private hospitals and pharmacies to rudimentary solutions like SignUpGenius. Some websites do not support scheduling at all, but do allow users to search databases to find available vaccines or get on waiting lists. Often the systems cannot communicate with each other.

“You basically build and test data systems on the fly as millions of people try to find vaccines,” said Claire Hannan, executive director of the Association of Immunization Managers, which works for government health departments.

Updated

March 12, 2021, 5:29 p.m. ET

Microsoft, which has sold vaccination software to multiple states and Washington, DC, frustrated New Jersey with its system, and in late February, after days of website crashes in the country’s capital, the company admitted it “fell short “was.

Microsoft said in a statement that it was “designed to help governments manage their Covid-19 vaccination programs as quickly, safely and efficiently as possible”.

PrepMod’s problems have resulted in delays in vaccine rollouts in countries like Washington State and Pennsylvania. When the Massachusetts vaccine appointments website went down for a few hours after a surge in demand, PrepMod took responsibility and apologized.

Andrew Therriault, a Boston-based data scientist, said he was “amazed” at the extent of PrepMod’s shortcomings. One problem he found was that the system didn’t reserve an appointment slot as people filled out their information so that they could be booted anytime someone else hit them on that particular slot.

“I’m trying to imagine someone doing this who isn’t that tech-savvy – it basically means they don’t have an opportunity to compete,” Therriault said.

Some of the login software have also caused a huge headache by not allowing unique registration links that expire after a single use.

The reusable connections have hampered vaccination efforts in places like California, where health departments use both PrepMod and a Salesforce-based system, MyTurn.

What you need to know about the vaccine rollout

In some cases, health officials who wanted to reach black and Latin American communities with low vaccination rates issued MyTurn nomination codes for those groups that ended up being widespread, including among more affluent white communities. Because the codes did not expire after a single use, these people could use them to get vaccinated before their turn.

Ms. Tate of PrepMod said health care workers and others who improperly shared the links were to blame.

“It’s not a problem with our system. That’s a problem with people who should be responsible, ”she said. The company added an option for unique links.

Salesforce declined to comment, but Darrel Ng, a California Department of Health spokesman, said MyTurn added unique links as well.

UC San Diego Health, which operates a drive-through bulk injection facility, is using its existing software in place of MyTurn because the two systems are incompatible, said Dr. Christopher Longhurst, UC San Diego Health’s chief information officer. Otherwise, those arriving in the hospital system for a second dose would have to be separated from those scheduled in MyTurn, he said.

“We’d have to use all of our second doses in some lanes while using new software in other lanes,” he said. It would be “incredibly inefficient”.

This week, the MyTurn system offered more appointments than a Scripps Health-operated vaccination site in San Diego had, causing the site to close for several days because doses were running low.

“There are problems with the MyTurn system,” said Dr. Ghazala Sharieff, Scripps Chief Medical Officer. “These challenges add another layer of unnecessary stress to our team.”

Health officials said reliance on the imperfect tools of outside companies underscores the need to invest in technology for public health departments, many of which still use paper and fax machines to keep records.

According to Mary Beth Kurilo, senior director at the American Immunization Registry Association, state registers that track residents’ vaccination history – called vaccination information systems – could be adjusted to schedule appointments. But the federal government never asked them, she said, and they needed more money and time to prepare.

Some regions have chosen to avoid technology entirely.

In Johnston County, NC, southeast of Raleigh, the Department of Health decided it would have been too taxing for staff to manage appointments online.

The policy has been efficient, said Health Department spokeswoman Lu Hickey, but it does mean the county – which also doesn’t require personal identification – doesn’t know if people are vaccinated in the correct order and are relying on the honor must be system.

In Richmond, Ms. Morrison said officials were looking for solutions and even considered trying VAMS again.

“We cobbled it together at the local level through a lot of manual work and workarounds that we put in place to set up band aids,” she said.

Categories
Health

Coronavirus anniversary: Europe’s gradual vaccine rollout

Coronavirus anniversary: Europe's slow vaccine rollout

On Tuesday, January 12, 2021, a health care worker will take care of a Covid 19 patient in the intensive care unit of the Robert Bosch Hospital in Stuttgart. Chancellor Angela Merkel warned that Germany would face tough lockdown measures until the end of March if the authorities do not contain a rapidly spreading variant of the coronavirus.

Bloomberg | Bloomberg | Getty Images

It’s been a year since the World Health Organization declared the coronavirus outbreak a pandemic, and as the UK and US progress with their vaccination rollouts, the EU is still in the depths of crisis.

The block is currently in a lethargic vaccination program and there are fears of another wave of infections from Paris to Prague.

On the first anniversary of the public health crisis, Europe doesn’t have much time to ponder the losses of the past year – when over 547,000 people in the region died from the virus and thousands lost their livelihoods.

There are more and more cases in parts of the bloc, mainly caused by the spread of more infectious virus variants, from western EU country France to Central Europe to Hungary in the east.

France reported 30,303 new coronavirus infections in the past 24 hours on Wednesday, with the number of new cases rising above 30,000 for the first time in two weeks. Health experts say the hospital system in the greater Paris area is on the verge of rupture, Reuters reported.

Meanwhile, Hungary, the Czech Republic and Poland have seen large increases in cases, which has led Eastern European governments to increase vaccination rates. So much so that several countries have resorted to a break with the EU with the approval of the Russian coronavirus vaccine Sputnik V, which has not yet been approved by the EU drug regulator.

Bulgaria and Serbia, as well as Sweden and Italy, are also among the countries where there has been an increase in cases.

The coronavirus, which first appeared in Wuhan in December 2019, was declared a pandemic a year ago, on March 11, 2020.

At this point it had already formed in northern Italy, which became the epicenter of Europe’s first eruption. The timing of the spread coincided with the peak of the ski season, allowing the virus to spread to the UK, France and Germany.

The EU’s Covid Experience

National responses to the pandemic have varied, but the EU tried to coordinate its response, closing external borders for all but non-essential travel, and coordinating purchases of personal protective equipment and medical supplies such as ventilators.

However, the state and structure of health services in different parts of the EU, as well as the tracking and tracing systems in place, played a role in determining the spread and damage caused by the virus.

Germany, for example, has been praised for its initial response to the virus, in which the infected and their contacts were tracked down and isolated. Modern hospital infrastructure has also helped limit the number of deaths compared to other countries. Germany (with around 83 million inhabitants) has so far reported 2.5 million cases and 72,858 deaths compared to Italy (a country of 60.3 million people), 3.1 million cases and 100,811 deaths, according to data from Johns Hopkins University.

In total, according to the European Center for Disease Control and Prevention in the EU and in the entire European Economic Area (essentially in the EU plus Iceland, Liechtenstein and Norway), over 22.5 million cases have been reported so far.

The extent to which countries blocked their economies and public life during the pandemic also had an impact on infection rates.

Most of the countries in the EU chose to close all shops but the main ones, to close gyms, restaurants, theaters and bars, and to close the region’s cultural and social life and economy. Although some, like Sweden, were notable for their decision not to lock, they sparked controversy and criticism from other EU countries, especially their neighbors.

However, it has gradually moved away from that position, especially in the face of a third wave of infections, and stricter restrictions on shops, gyms, swimming pools and sports facilities went into effect on March 6.

Economic damage

Economies across the bloc are hoping to open up as soon as possible, but the emergence of new, more virulent strains of the virus has ruined Christmas, ski season, and hopes that life could return to normal by Easter.

At the same time, vaccination adoption across the bloc remains painfully slow compared to the UK and US

The latest data from France shows that by March 9, 4.1 million people had received an initial coronavirus vaccine. In contrast, the UK had given over 22.8 million first doses at the same time.

The UK ordered, approved and administered vaccines faster than the EU, which placed orders in blocks rather than following individual guidelines. This was seen as an obstacle to the dynamics of the rollout.

The economic damage from the pandemic cannot be counted yet, but repeated lockdowns over the past year have taken their toll. A feared new wave could also delay a long-awaited reopening.

Data shows the damage the pandemic has already done to the region’s economy and citizens. Preliminary data from Eurostat, the EU data agency published in February, estimate that GDP (gross domestic product) fell by 6.8% in 2020 in the euro area and by 6.4% in the EU.

Eurostat estimates that 15.6 million men and women were unemployed in the EU in January 2021. Compared to January 2020, unemployment rose by 1.465 million in the EU and 1.010 million in the euro area.