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How the Seek for Covid-19 Therapies Faltered Whereas Vaccines Sped Forward

Fast ein Jahr nach Beginn der Coronavirus-Pandemie, da in den USA täglich Tausende von Patienten sterben und die weit verbreitete Impfung noch Monate entfernt ist, haben Ärzte nur wenige Medikamente zur Bekämpfung des Virus.

Eine Handvoll Therapien – Remdesivir, monoklonale Antikörper und das Steroid Dexamethason – haben die Versorgung von Covid-Patienten verbessert und die Ärzte in eine bessere Position gebracht als zu dem Zeitpunkt, als das Virus im vergangenen Frühjahr anstieg. Aber diese Medikamente sind keine Allheilmittel und nicht jedermanns Sache, und die Bemühungen, andere Medikamente wiederzuverwenden oder neue zu entdecken, waren nicht sehr erfolgreich.

Die Regierung investierte 18,5 Milliarden US-Dollar in Impfstoffe, eine Strategie, die zu mindestens fünf wirksamen Produkten mit Rekordgeschwindigkeit führte. Die Investitionen in Medikamente waren jedoch weitaus geringer, etwa 8,2 Milliarden US-Dollar, von denen die meisten nur an wenige Kandidaten gingen, beispielsweise an monoklonale Antikörper. Studien zu anderen Medikamenten waren schlecht organisiert.

Das Ergebnis war, dass viele vielversprechende Medikamente, die die Krankheit frühzeitig stoppen könnten, sogenannte Virostatika, vernachlässigt wurden. Ihre Studien sind ins Stocken geraten, entweder weil die Forscher nicht genügend Mittel oder Patienten zur Teilnahme gefunden haben.

Gleichzeitig haben einige Medikamente trotz enttäuschender Ergebnisse nachhaltige Investitionen erhalten. Es gibt jetzt eine Fülle von Beweisen dafür, dass die Malariamedikamente Hydroxychloroquin und Chloroquin nicht gegen Covid wirkten. Laut dem Covid Registry of Off-Label & New Agents an der University of Pennsylvania gibt es dennoch 179 klinische Studien mit 169.370 Patienten, in denen zumindest einige die Medikamente erhalten. Und die Bundesregierung hat zig Millionen Dollar in ein erweitertes Zugangsprogramm für Rekonvaleszenzplasma gesteckt, das fast 100.000 Covid-Patienten infundierte, bevor es belastbare Beweise dafür gab, dass es funktionierte. Im Januar haben diese Studien gezeigt, dass dies zumindest bei Krankenhauspatienten nicht der Fall ist.

Das Fehlen einer zentralisierten Koordination führte dazu, dass viele Studien mit Covid-Virostatika von Anfang an zum Scheitern verurteilt waren – zu klein und schlecht konzipiert, um nützliche Daten zu liefern, so Dr. Janet Woodcock, die amtierende Kommissarin der Food and Drug Administration. Wenn die Regierung stattdessen ein organisiertes Netzwerk von Krankenhäusern eingerichtet hätte, um große Studien durchzuführen und Daten schnell auszutauschen, hätten die Forscher jetzt viel mehr Antworten.

“Ich beschuldige mich bis zu einem gewissen Grad”, sagte Dr. Woodcock, der die Bemühungen der Bundesregierung zur Entwicklung von Covid-Medikamenten überwacht hat.

Sie hofft, das Chaos mit neuen Anstrengungen der Biden-Administration zähmen zu können. In den nächsten Monaten, sagte sie, plane die Regierung, große und gut organisierte Studien für bestehende Medikamente zu starten, die zur Bekämpfung von Covid-19 umfunktioniert werden könnten. “Wir arbeiten aktiv daran”, sagte Dr. Woodcock.

Brandneue antivirale Medikamente könnten ebenfalls helfen, aber erst jetzt stellen die National Institutes of Health eine wichtige Initiative zusammen, um sie zu entwickeln, was bedeutet, dass sie nicht rechtzeitig bereit sind, die aktuelle Pandemie zu bekämpfen.

“Es ist unwahrscheinlich, dass diese Bemühungen im Jahr 2021 Therapeutika liefern”, sagte Dr. Francis Collins, der Leiter des NIH, in einer Erklärung. “Wenn ein Covid-24 oder Covid-30 kommt, wollen wir vorbereitet sein.”

Obwohl die Zahl der Fälle und Todesfälle im ganzen Land gestiegen ist, hat sich die Überlebensrate der Infizierten erheblich verbessert. Eine kürzlich durchgeführte Studie ergab, dass die Sterblichkeitsrate der Krankenhausinsassen bis Juni von 17 Prozent zu Beginn der Pandemie auf 9 Prozent gesunken war, ein Trend, der in anderen Studien bestätigt wurde. Forscher sagen, dass die Verbesserung teilweise auf das Steroid Dexamethason zurückzuführen ist, das die Überlebensraten schwerkranker Patienten erhöht, indem es das Immunsystem unterdrückt, anstatt das Virus zu blockieren. Patienten suchen möglicherweise auch früher im Verlauf der Krankheit Pflege. Und Masken und soziale Distanzierung können die Virusexposition verringern.

Als sich das neue Coronavirus Anfang 2020 als globale Bedrohung herausstellte, versuchten die Ärzte verzweifelt, eine Auswahl bestehender Medikamente zu finden. Die einzige Möglichkeit, festzustellen, ob sie tatsächlich arbeiteten, bestand darin, große klinische Studien durchzuführen, in denen einige Personen Placebos erhielten und andere das betreffende Medikament einnahmen.

Hunderte oder Tausende von Menschen in solche Prozesse zu bringen, war eine enorme logistische Herausforderung. Anfang 2020 beschränkte sich das NIH auf einige vielversprechende Medikamente. Diese Unterstützung führte zur raschen Zulassung von Remdesivir- und monoklonalen Antikörpern. Remdesivir, das die Replikation von Viren in Zellen verhindert, kann die Zeit, die Patienten zur Genesung benötigen, geringfügig verkürzen, hat jedoch keinen Einfluss auf die Mortalität. Monoklonale Antikörper, die das Eindringen des Virus in die Zellen verhindern, können sehr wirksam sein, jedoch nur, wenn sie verabreicht werden, bevor Menschen krank genug sind, um ins Krankenhaus eingeliefert zu werden.

Hunderte von Krankenhäusern und Universitäten begannen ihre eigenen Versuche mit bestehenden Medikamenten, die bereits als sicher und weit verbreitet gelten und möglicherweise auch gegen das Coronavirus wirken. Die meisten dieser Studien waren jedoch klein und unorganisiert.

In vielen Fällen waren die Forscher allein, um Studien ohne die Unterstützung der Bundesregierung oder der Pharmaunternehmen durchzuführen. Im April, als New York City von einer Covid-Welle heimgesucht wurde, hörte Charles Mobbs, Neurowissenschaftler an der Icahn School of Medicine am Mount Sinai, von interessanten Arbeiten in Frankreich, die auf die Wirksamkeit eines Antipsychotikums hinweisen.

Ärzte in französischen psychiatrischen Krankenhäusern hatten festgestellt, dass im Vergleich zu den Mitarbeitern, die sich um sie kümmerten, relativ wenige Patienten an Covid-19 erkrankten. Die Forscher spekulierten, dass die Medikamente, die die Patienten einnahmen, sie schützen könnten. In Laborexperimenten wurde gezeigt, dass eines dieser Medikamente, das Antipsychotikum Chlorpromazin, die Vermehrung des Coronavirus verhindert.

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Jan. 30, 2021, 3:17 ET

Die Ärzte versuchten, einen Versuch mit Chlorpromazin zu beginnen, aber die Pandemie ließ in Frankreich – wie sich herausstellte – vorübergehend nach, als sie fertig waren. Dr. Mobbs verbrachte dann Wochen damit, Vorkehrungen für einen eigenen Versuch mit Patienten zu treffen, die am Berg Sinai im Krankenhaus waren, um dann gegen dieselbe Wand zu stoßen. “Wir haben keine Patienten mehr”, sagte er.

Wenn Ärzte wie Dr. Mobbs landesweite Netzwerke von Krankenhäusern nutzen könnten, könnten sie genügend Patienten finden, um ihre Studien schnell durchzuführen. Diese Netzwerke existieren, wurden jedoch nicht für die Wiederverwendung von Drogen geöffnet.

Viele Wissenschaftler vermuten, dass der beste Zeitpunkt zur Bekämpfung des Coronavirus früh in einer Infektion liegt, wenn sich das Virus schnell vermehrt. Es ist jedoch besonders schwierig, freiwillige Probanden zu rekrutieren, die sich nicht in einem Krankenhaus befinden. Forscher müssen Menschen direkt nach dem positiven Test ausfindig machen und einen Weg finden, ihnen die Testmedikamente zu liefern.

An der University of Kentucky begannen Forscher im Mai mit einem solchen Versuch, ein Medikament namens Camostat zu testen, das normalerweise zur Behandlung von Entzündungen der Bauchspeicheldrüse verwendet wird. Die Wissenschaftler dachten, es könnte auch als antivirales Covid-19 wirken, da es ein Protein zerstört, von dem das Virus abhängt, um menschliche Zellen zu infizieren. Da Camostat eher in Pillenform als als Infusion erhältlich ist, wäre es besonders nützlich für Menschen wie die freiwilligen Probanden, von denen viele in abgelegenen ländlichen Gebieten lebten.

Aber die Forscher haben in den letzten acht Monaten versucht, genügend Teilnehmer zu rekrutieren. Sie hatten Probleme, Patienten zu finden, die kürzlich eine Covid-Diagnose erhalten haben, insbesondere mit dem unvorhersehbaren Anstieg und Abfall der Fälle.

“Dies war die Ursache für die Verzögerungen bei im Wesentlichen allen Studien auf der ganzen Welt”, sagte Dr. James Porterfield, ein Kliniker für Infektionskrankheiten am University of Kentucky College of Medicine. Wer leitet den Prozess?

Während Ärzte wie Dr. Porterfield Schwierigkeiten hatten, selbst Studien durchzuführen, sind einige Medikamente zu Sensationen geworden, die trotz fehlender Beweise als Allheilmittel gelobt werden.

Das erste vermeintliche Allheilmittel war Hydroxychloroquin, ein Medikament gegen Malaria. Fernsehexperten behaupteten, es habe Heilkräfte, ebenso wie Präsident Trump. Anstatt eine große, gut konzipierte Studie in vielen Krankenhäusern zu starten, begannen die Ärzte einen Schwarm kleiner Studien.

“Es gab keine Koordination und keine zentralisierte Führung”, sagte Ilan Schwartz, Experte für Infektionskrankheiten an der Universität von Alberta.

Trotzdem erteilte die FDA dem Medikament eine Notfallfreigabe zur Behandlung von Personen, die mit Covid ins Krankenhaus eingeliefert wurden. Als große klinische Studien endlich Ergebnisse lieferten, stellte sich heraus, dass das Medikament keinen Nutzen brachte – und sogar Schaden anrichten könnte. Die Agentur hat ihre Genehmigung im Juni zurückgezogen.

Viele Wissenschaftler waren verbittert und betrachteten all diese Arbeiten als Verschwendung wertvoller Zeit und Ressourcen.

“Die klare, eindeutige und überzeugende Lehre aus der Hydroxychloroquin-Geschichte für die medizinische Gemeinschaft und die Öffentlichkeit ist, dass Wissenschaft und Politik sich nicht vermischen”, schrieb Dr. Michael Saag von der Universität Alabama in Birmingham im November im New England Journal of Medicine.

Jetzt wird ein anderes Medikament populär, bevor es starke Beweise dafür gibt, dass es wirkt: die parasitentötende Verbindung Ivermectin. Senator Ron Johnson, Republikaner von Wisconsin, der im April Hydroxychloroquin pries, hielt im Dezember eine Anhörung ab, bei der Dr. Pierre Kory über Ivermectin aussagte. Dr. Kory, ein Lungen- und Intensivspezialist am Aurora St. Luke’s Medical Center in Milwaukee, nannte es “effektiv ein” Wundermittel “gegen Covid-19”. Es gibt jedoch keine veröffentlichten Ergebnisse aus groß angelegten klinischen Studien, die solche Behauptungen stützen, sondern nur kleine, suggestive.

Selbst wenn die Bundesregierung ein zentrales Versuchsnetzwerk eingerichtet hätte, wie es jetzt versucht wird, wären Wissenschaftler immer noch mit unvermeidlichen Hürden konfrontiert gewesen. Es braucht Zeit, um sorgfältige Experimente durchzuführen, um vielversprechende Medikamente zu entdecken und dann zu bestätigen, dass es sich wirklich lohnt, sie weiter zu untersuchen.

“In der Arzneimittelentwicklung sind wir an Landebahnen mit einer Laufzeit von 10 bis 15 Jahren gewöhnt”, sagte Sumit K. Chanda, Virologe am Sanford Burnham Prebys Medical Discovery Institute in La Jolla, Kalifornien.

Im Februar begannen Dr. Chanda und seine Kollegen eine andere Art der Suche nach einem Covid-19-Antivirusmittel. Sie untersuchten eine Bibliothek mit 13.000 Medikamenten und mischten jedes Medikament mit Zellen und Coronaviren, um festzustellen, ob sie Infektionen gestoppt hatten.

Ein paar Medikamente erwiesen sich als vielversprechend. Die Forscher testeten eine von ihnen – eine billige Lepra-Pille namens Clofazimin – über mehrere Monate und führten Experimente an menschlichem Lungengewebe und Hamstern durch. Clofazimin bekämpfte das Virus bei den Tieren, wenn sie es kurz nach der Infektion erhielten.

Jetzt, fast ein Jahr nach Beginn seiner Forschung, hofft Dr. Chanda, dass er den schwierigsten Teil der Drogentests finanzieren kann: große und randomisierte klinische Studien, die Millionen von Dollar kosten können. Um diese Phase effizient abzuschließen, benötigen Forscher fast immer die Unterstützung eines großen Unternehmens oder der Bundesregierung oder von beidem – wie dies bei den großen klinischen Studien für die neuen Coronavirus-Impfstoffe der Fall war.

Es ist unklar, wie die neuen Drogentestbemühungen der Biden-Regierung entscheiden werden, welche Medikamentenkandidaten unterstützt werden sollen. Wenn die Versuche jedoch in den nächsten Monaten beginnen, könnten sie möglicherweise bis Ende des Jahres nützliche Daten liefern.

Pharmaunternehmen beginnen auch, einige Studien mit wiederverwendeten Arzneimitteln zu finanzieren. Eine in dieser Woche in Science veröffentlichte Studie ergab, dass ein 24 Jahre altes Krebsmedikament namens Plitidepsin 27-mal wirksamer als Remdesivir ist, um das Coronavirus in Laborexperimenten zu stoppen. Im Oktober berichtete ein spanisches Pharmaunternehmen namens PharmaMar über vielversprechende Ergebnisse einer kleinen Sicherheitsstudie mit Plitidepsin. Jetzt bereitet sich das Unternehmen darauf vor, eine Spätstudie in Spanien zu starten, um festzustellen, ob das Medikament im Vergleich zu einem Placebo wirkt.

Der Pharmakonzern Merck führt eine große Studie im Spätstadium mit einer Pille namens Molnupiravir durch, die ursprünglich von Ridgeback Biotherapeutics gegen Influenza entwickelt wurde und nachweislich Frettchen von Covid-19 heilt. Die ersten Ergebnisse der Studie könnten bereits im März vorliegen.

Experten sind besonders gespannt auf diese Daten, da Molnupiravir möglicherweise mehr als nur Covid-19 behandelt. Im April fanden Wissenschaftler heraus, dass das Medikament auch Mäuse behandeln kann, die mit anderen Coronaviren infiziert sind, die SARS und MERS verursachen.

Alle Virostatika, die im Jahr 2021 auftauchen könnten, werden nicht das Leben retten, das Covid-19 bereits verloren hat. Es ist jedoch möglich, dass eines dieser Medikamente gegen künftige Coronavirus-Pandemien wirkt.

Noah Weiland und Katie Thomas haben zur Berichterstattung beigetragen.

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Business

EU locations export controls on coronavirus vaccines

The President of the European Commission, Ursula von der Leyen, speaks to the media in Berlaymont, the seat of the EU Commission.

Thierry Monasse

LONDON – The European Union temporarily controlled the export of block-made coronavirus vaccines on Friday after the UK pharmaceutical company spat at AstraZeneca and other supply issues.

Pfizer recently received two massive blows stating that production should be temporarily reduced while production capacity at the Belgian facility is improved. Last week, AstraZeneca also said it would ship far fewer cans to the EU than originally expected this spring due to production problems at its plants in the Netherlands and Belgium.

After the EU pressured AstraZeneca this week to meet its commitments and then asked the company to move UK-made vaccines to the block, the EU confirmed on Friday that temporary controls will be in place.

“Protecting the health of our citizens remains our top priority and we must take the necessary measures to achieve this,” said European Commission President Ursula von der Leyen on Friday.

“This transparency and approval mechanism is temporary and we will of course continue to honor our commitments to low and middle income countries.”

The controls are expected to last until the end of March. The bloc also triggered Article 16 of its Brexit deal with the UK, which means that exports cannot be sent to Northern Ireland, which could potentially serve as a back door to the rest of the country.

“This time-limited and targeted system only covers those Covid-19 vaccines that have been agreed with the EU under Advanced Purchase Agreements,” said Valdis Dombrovskis, Executive Vice President and Commissioner for Trade of the EU.

“This mechanism includes a wide range of exemptions to fully meet our humanitarian commitments and protect the delivery of vaccines to our neighborhood and to countries in need covered by the COVAX facility.”

EU approves AstraZeneca vaccine

The European Union has been under pressure from what critics are calling the slow adoption of Covid vaccines. The European Commission, the body that runs the sales contracts, has been accused of not securing enough vaccines and the region’s medical agency has been criticized for taking too long to approve vaccinations that have given the go-ahead elsewhere have received.

On Friday, the European Medicines Agency approved the AstraZeneca vaccine for emergency use in the EU, about a month after it first received the green light in the UK, which recently left the block.

Speaking to CNBC on Friday, Irish Prime Minister Micheal Martin denied that this spit between Brussels and a British pharmaceutical company had turned into another “Brexit fight”.

“Overall, I think the European Commission has behaved well and effectively when it comes to vaccine procurement,” he said. “There is a lot of tension out there … a lot of pressure on the Commission from the Member States, from the Prime Ministers. Why? Because the people are under pressure, the people are under pressure.”

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Health

There can be sufficient Covid vaccines for the ‘complete U.S. grownup inhabitants by June,’ physician says

Dr. Johnson & Johnson board member Mark McClellan told CNBC Friday that there could be enough vaccinations for the entire US adult population by the summer.

“Assuming that accurate verification of the J&J data is no longer possible, we will have the capacity between Moderna, Pfizer and J&J to have enough vaccines available for the entire US adult population by June “said McClellan, a former FDA commissioner, said on” The News with Shepard Smith. ”

The US plans to buy 200 million doses of Covid vaccine from Moderna and Pfizer. The Department of Health and Human Services will increase its vaccine supply to states from 8.6 million to at least 10 million doses per week. To date, states have received more than 49 million doses, but only about half of those actually landed in people’s arms, according to the Centers for Disease Control and Prevention. The agency reports that the US fires just over a million shots every day.

McClellan that the US should significantly increase the number of shots given per day and “should bring our ability to vaccinate closer to 3 million doses per day.”

The US has ordered 100 million doses of the J&J vaccine, which the company plans to deliver by June. J&J plans to apply for an emergency permit next week. If J & J’s vaccine is FDA approved, it will be the third emergency approved vaccine in the U.S. Pfizer’s vaccine was approved by the FDA on December 11th, and Moderna’s was approved a week later.

The efficacy numbers for J&J vaccines were lower than for Pfizer and Moderna. Pfizer’s vaccine was found to be 95% effective against Covid-19, while Moderna’s vaccine was about 94% effective. J & J’s vaccine was found to be 66% overall effective in preventing moderate to severe Covid.

Host Shepard Smith asked McClellan about the lower efficacy numbers compared to Pfizer and Moderna, explaining to Smith, “We are fighting a different virus today than three months ago when previous studies were done.”

In addition, J&J conducted its test on three continents, and the level of protection varied depending on the region. The vaccine showed an overall effectiveness of 72% in the US and 66% in Latin America. In South Africa, where the dangerous B.1.351 strain of Covid caused spikes in some cases, the J&J vaccine showed 57% effectiveness.

“Unfortunately, in three months’ time, we’ll likely be fighting another virus. The most important thing to winning this fight is getting as many people as possible vaccinated,” said McClellan. “The faster we shoot in the arms, the more people will be vaccinated here in this country and around the world, the better we can contain this further spread and further damage from Covid.”

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World News

Covid-19 World Reside Updates: AstraZeneca and Johnson & Johnson Vaccines

Here’s what you need to know:

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Fauci Warns New Virus Mutations Are a ‘Wake-Up Call’

On Friday, Dr. Anthony S. Fauci warned that new virus variants, despite the global vaccine distribution, should offer a wake-up call to the continuing dangers of the pandemic.

We’re all aware of the variance that we knew dominated — the U.K. B.1.1.7 , the B.1.351 in South Africa and other variants, such as the P.1. in Brazil. When these variants were first recognized, it became clear that we had to look at, in vitro, in the test tube, whether the antibodies that were induced by the vaccines that we had available would actually neutralize these new mutants. Antigenic variation, i.e. mutations that lead to different lineage do have clinical consequences because as you can see, even though the long-range effect in the sense of severe disease is still handled reasonably well by the vaccines, this is a wake-up call to all of us that we will be dealing as the virus uses its devices to evade pressure, particularly immunological pressure, that we will continue to see the evolution of mutants. So that means that we as a government, the companies, all of us that are in this together, will have to be nimble to be able to just adjust readily to make versions of the vaccine that actually are specifically directed towards whatever mutation is actually prevalent at any given time.

On Friday, Dr. Anthony S. Fauci warned that new virus variants, despite the global vaccine distribution, should offer a wake-up call to the continuing dangers of the pandemic.CreditCredit…Doug Mills/The New York Times

Dr. Anthony S. Fauci warned Friday that new clinical trial results from Johnson & Johnson, showing that its vaccine is less effective against a highly infectious variant of the coronavirus circulating in South Africa, were a “wake up call.” He said the virus will continue to mutate, and vaccine manufacturers will have to be “nimble to be able to adjust readily” to reformulating the vaccines if needed.

Dr. Fauci’s warning, at the White House briefing on the virus, comes amid increasing concern about new and more infectious variants of the virus that are emerging overseas and turning up in the United States. This week, officials in South Carolina reported identifying two cases of the variant circulating in South Africa, and officials in Minnesota announced they had found a case of the variant that was first detected in Brazil.

Dr. Rochelle Walensky, the new director of the Centers for Disease Control and Prevention, who was also at the briefing, said another variant, first identified in Britain, has now been confirmed in 379 cases in 29 states. She said officials remained concerned about the variants and were “rapidly ramping up surveillance and sequencing activities” to closely monitor them. Unlike Britain, the United States has been conducting little of the genomic sequencing necessary to track the spread of the variants.

Dr. Walensky also issued a plea to Americans to continue wearing masks and practice social distancing, and to avoid travel. Earlier this month, the C.D.C. warned that the variant circulating in Britain could become the dominant source of infection in the United States and would likely lead to a surge in cases and deaths that could overwhelm hospitals. And given the speed at which the variant swept through that country, it is conceivable that by April it could make up a large fraction of infections in the United States.

“By the time someone has symptoms, gets a test, has a positive result and we get the sequence, our opportunity for doing real case control and contact tracing is largely gone,” she said. “We should be treating every case as if it’s a variant during this pandemic right now.”

Friday’s briefing, the second in what the Biden White House has promised will be thrice-weekly updates on the pandemic, came just hours after Johnson & Johnson reported that while its vaccine was 72 percent effective in the United States, the efficacy rate was just 57 percent in South Africa, where a variant has been spreading.

Public health officials including Dr. Fauci and Dr. Walensky say the emergence of these variants is heightening the urgency of vaccinations. Dr. Fauci also said Friday that children under 16, who are not currently eligible for the vaccine, will likely start getting vaccinated “by late spring or early summer” if small-scale clinical trials show that it is safe and effective to do so.

He noted that the Johnson & Johnson vaccine is 85 percent effective against severe disease, and called the results “very encouraging,” even though the vaccine is not as effective as those by Pfizer and Moderna, which have emergency approval from the Food and Drug Administration. Johnson & Johnson will now seek its own emergency approval.

“This really tells us that we have now a value-added additional vaccine candidate,” he said.

But Dr. Walensky offered a far more sobering observation. While the daily number of new virus cases has been declining, the figures were still much higher than a period last summer, and deaths currently remain worrisome.

According to data compiled by The New York Times, new virus cases have averaged about 160,000 a day in recent days, compared to about 40,000 new cases a day around early September. As of Thursday, the seven-day average of new deaths was more than 3,200 a day, still near peak levels. The daily death toll has topped 4,000 deaths six times in the United States, including twice this week.

At Wednesday’s briefing by the Biden virus team, Jeffrey D. Zients, Mr. Biden’s coronavirus response coordinator, said the United States is lagging far behind other countries in sequencing the genomes of the new variants — a delay he called “totally unacceptable.” Dr. Walensky said she is working to change that.

“We have scaled up surveillance dramatically just in the last ten days, in fact, but our plans are more than what we’ve done so far,” Dr. Walensky said, adding that the C.D.C. is now asking every state to track for worrisome variants and sequence at least 750 samples from patients per week. In addition, she said, the agency has seven collaborations with universities to scale up surveillance to cover thousands of samples per week.

United States › United StatesOn Jan. 28 14-day change
New cases 165,264 –34%
New deaths 3,868 –2%
World › WorldOn Jan. 28 14-day change
New cases 603,392 –22%
New deaths 16,817 +4%

U.S. vaccinations ›

Where states are reporting vaccines given

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E.U. Plans to Halt Vaccine Exports Until Supply Contracts Are Met

The European Union announced a plan that would effectively stop AstraZeneca from shipping Covid-19 vaccine doses manufactured in the bloc to other countries until its E.U. supply contracts are met.

The commission has adopted a strictly targeted measure that will allow us to gather accurate information about the production of vaccines and where manufacturers intend to ship them. The measure is time-limited and specifically applies to those Covid-19 vaccines that were agreed by advance purchase agreements. The measure is intended to run until the end of March. The aim is to provide us immediately with full transparency, transparency that until now has been lacking, and what Europeans expect. And if needed, it also will provide us with a tool to ensure vaccine deliveries.

Video player loadingThe European Union announced a plan that would effectively stop AstraZeneca from shipping Covid-19 vaccine doses manufactured in the bloc to other countries until its E.U. supply contracts are met.CreditCredit…Dinuka Liyanawatte/Reuters

BRUSSELS — The European Union on Friday announced plans to effectively halt any attempt by AstraZeneca to move vaccine doses manufactured in the bloc to other countries unless it first meets its supply obligations to the bloc’s 27 member states.

The move, the latest escalation in a dispute between the bloc and the pharmaceutical company over reduced supplies, came as the European Union’s drug regulator authorized AstraZeneca’s coronavirus vaccine for use across its member states.

AstraZeneca said this month that it would significantly cut its promised delivery supply of the jab to the European Union as of mid-February. That pitted the bloc against Britain, a former member, which has been receiving a steady flow of vaccine doses from AstraZeneca since approving it well ahead of the E.U., in early December.

The AstraZeneca vaccine was developed in cooperation with Britain’s University of Oxford. The European Union accused the pharmaceutical company of using its promised doses to serve Britain, despite having paid the company about $400 million in October to help it scale up its capabilities and produce doses ahead of authorization.

The policy announced by the European Commission on Friday, presented as a “transparency tool,” will ask all pharmaceutical companies manufacturing coronavirus vaccines in factories within the bloc — currently Pfizer and AstraZeneca — to submit paperwork alerting the European authorities of any intention to move their products to non-E.U. countries. It will be in place until the end of March and will not apply to exports to poorer countries.

The Commission said it reserved the right to block such exports if it determined that the pharmaceutical companies were not meeting their contractual obligations with the E.U. first.

The measure could theoretically also affect Pfizer clients, but the Commission has said it is happy with how that company has handled a supply disruption in its Belgian factory that is setting back deliveries. The company has spread the pain among its clients, which include the E.U., Britain and Canada.

The Commission said that AstraZeneca’s decision to maintain delivery volumes to Britain while slashing its deliveries to the E.U., after a problem arose in a Belgium-based plant, was in bad faith and breach of the company’s contractual obligations.

The company’s chief executive responded that he regretted the situation, but that his company had not committed to a specific schedule, but rather to a vow to make its “best effort.”

The Commission dismissed the claim, and published a heavily redacted version of the contract with AstraZeneca. The contract affords the company many standard protections in case it fails to deliver, but includes some clauses that could be seen as favoring the E.U. interpretation that AstraZeneca is obligated to turn to other factories, including in Britain, to fulfill its delivery promises.

The matter is further complicated by regulation issues: The European drug regulator, the European Medicines Association, received an application for authorization from AstraZeneca on Jan. 12, nearly two weeks after the company received emergency authorization in Britain. The E.U. agency was expected to announce approval of use of the vaccine later on Friday.

The dispute with AstraZeneca is occurring against a backdrop of severe shortages of doses at vaccination centers across Europe. French and German regions have reported that they are nearly running out, and the Madrid region of Spain has suspended its rollout for at least two weeks until fresh deliveries arrive.

The E.U. regulator stopped short of imposing an age cap on the use of the vaccine, despite concerns about a paucity of data on the vaccine’s efficacy in people age 65 and older.

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N.Y.C. Indoor Dining to Reopen on Valentine’s Day

On Friday, Gov. Andrew M. Cuomo announced that indoor dining in New York City could resume at up to 25 percent capacity starting on Valentine’s Day.

New York City restaurants, on our current trajectory, we can reopen indoor dining at 25 percent on Valentine’s Day. The restaurants want a period of time so they can notify workers. They can get up to speed for indoor dining, order supplies, etc. So we’re saying indoor dining. 25 percent on Valentine’s Day. Going forward, we are very excited about the possibility of reopening venues with testing. Restaurants are opened on Valentine’s Day. You could make a reservation now or plan dinner on Valentine’s Day, you propose on Valentine’s Day. And then you can have the wedding ceremony March 15, up to 150 people. People will actually come to your wedding because you can tell them with the testing, it will be safe. Everybody there will be tested, and everybody will be safe.

Video player loadingOn Friday, Gov. Andrew M. Cuomo announced that indoor dining in New York City could resume at up to 25 percent capacity starting on Valentine’s Day.CreditCredit…Clay Williams for The New York Times

Indoor dining will resume with limited capacity in New York City restaurants next month, Gov. Andrew M. Cuomo announced on Friday, more than a month after he had banned it to combat a second wave of the coronavirus.

Starting on Feb. 14, the city’s restaurants can seat customers indoors at 25 percent maximum capacity, he said.

The announcement was a source of hope for the restaurant industry, an important driver of the city’s economic engine, which has been decimated by ever-changing virus-induced restrictions that have forced many restaurants and bars to go out of business and caused thousands of workers to lose their jobs.

After shutting down restaurants in March, Mr. Cuomo allowed the city’s indoor dining to restart in late September. He prohibited it again in mid-December as holiday travel threatened to increase transmission of the virus and overwhelm hospitals.

Restaurants and bars that have stayed afloat have relied on takeout and delivery, as well as outdoor dining, an increasingly untenable option as the frigid winter advances.

Starting March 15, wedding receptions with up to 150 attendees will be allowed in the state, the governor said, as long as the venues are at no more than 50 percent capacity. The gatherings would have to be approved in advance by a local health department, and all attendees will have to be tested.

“We want to use testing as the key to reopening events,” Mr. Cuomo said.

The governor’s decisions come at an incredibly precarious phase in the state’s battle against the virus, which has killed more than 42,500 people in New York State, a one-time center of the pandemic.

Yankee Stadium will open its doors as a mass vaccination site, Mr. Cuomo said, pointing to high positivity rates in the Bronx. He did not specify a time frame.

Participating in a Johnson & Johnson vaccine trial at the Desmond Tutu H.I.V. Foundation Youth Center near Cape Town last month.Credit…Joao Silva/The New York Times

Johnson & Johnson said on Friday that its one-dose coronavirus vaccine provided strong protection against Covid-19, offering the United States a third powerful tool in a race against a worldwide rise in virus mutations.

But the results came with a significant cautionary note: The vaccine’s efficacy rate dropped from 72 percent in the United States to 57 percent in South Africa, where a highly contagious variant is driving most cases. Studies suggest that this variant also blunts the effectiveness of Covid vaccines made by Pfizer-BioNTech, Moderna and Novavax.

The variant has spread to at least 31 countries, including two cases documented in the United States this week.

Johnson & Johnson said it planned to apply for emergency authorization of its vaccine from the Food and Drug Administration as soon as next week, putting it on track to receive clearance later in February.

“This is the pandemic vaccine that can make a difference with a single dose,” said Dr. Paul Stoffels, the company’s chief scientific officer.

The company’s announcement comes as the Biden administration is pushing to immunize Americans faster even as vaccine supplies tighten. White House officials have been counting on Johnson & Johnson’s vaccine to ease the shortfall. But the company may have as few as seven million doses ready when the vaccine is authorized, according to federal health officials familiar with its production, and no more than 32 million doses by early April.

The variant from South Africa, known as B.1.351, could make the vaccine push tougher. Given the speed at which the variant swept through that country, it is conceivable that it could make up a large fraction of infections in the United States by April and therefore undermine the effectiveness of available vaccines.

The two vaccines approved by the U.S. government have been found to be less effective against the B.1.351 variant in clinical trials, a development that has unsettled federal officials and vaccine experts.

Many researchers say it is imperative to vaccinate people as quickly as possible. Lowering the rate of infection could thwart the more contagious variants while they are still rare.

“If ever there was reason to vaccinate as many people as expeditiously as we possibly can with the vaccine that we have right now, now is the time,” said Dr. Anthony S. Fauci, the government’s top infectious disease expert. “Because the less people that get infected, the less chance you’re going to give this particular mutant a chance to become dominant.”

A pregnant woman being vaccinated in Tel Aviv. Credit…Jack Guez/Agence France-Presse — Getty Images

The World Health Organization on Friday changed its guidance for pregnant women considering a Covid-19 vaccine, abandoning opposition to immunization for most expectant mothers unless they were at high risk.

The change followed an outcry to the W.H.O.’s previous stance, which stated that the organization did “not recommend the vaccination of pregnant women” with the vaccines made by Pfizer-BioNTech and Moderna.

Several experts had expressed disappointment on Thursday with the W.H.O.’s earlier position. The experts noted that it was inconsistent with guidance on the same issue from the U.S. Centers for Disease Control and Prevention, and would confuse pregnant women looking for clear advice.

The vaccines made by Pfizer-BioNTech and Moderna, while they have not been tested in pregnant women, have not shown any harmful effects in animal studies. And the technology used in the vaccines is generally known to be safe, experts said.

The W.H.O.’s new phrasing reflects this information:

“Based on what we know about this kind of vaccine, we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women.” The recommendation is now closely aligned with the C.D.C.’s stance.

Experts praised the shift, welcoming agreement between the world’s leading public health organizations on this important issue.

“I was very pleased to see that W.H.O. changed their guidance regarding offering the Covid-19 vaccine to pregnant women,” said Dr. Denise Jamieson, an obstetrician at Emory University and a member of the Covid expert group with the American College of Obstetrics and Gynecology. The association was among the many women’s health organizations that had urged Pfizer and Moderna to speed up vaccine tests in pregnant women.

“The more permissive W.H.O. language provides an important opportunity for pregnant women to get vaccinated and protect themselves from the severe risks of Covid-19,” Dr. Jamieson said. “This impressively rapid revision by W.H.O. is good news for pregnant women and their babies.”

Pregnant women have traditionally been excluded from clinical trials, leaving a dearth of scientific data on the safety of drugs and vaccines in women and their unborn children. Vaccines are generally considered to be safe, and pregnant women have been urged to be immunized for influenza and other diseases since the 1960s, even in the absence of rigorous clinical trials to test them.

Pfizer will test its vaccine in pregnant women over the next few months, according to a spokeswoman for the company. And Moderna plans to establish a registry to observe side effects in women who were immunized with its vaccine.

Border police at the international airport in Frankfurt, Germany.Credit…Thomas Lohnes/Getty Images

Germany on Friday announced its plans to restrict incoming travel from a handful of countries, including Britain and Ireland, in an attempt to curb the spread of infectious coronavirus variants, going beyond the measures recommended by the European Union.

“It’s about stopping the entry of a highly infectious virus,” Horst Seehofer, Germany’s interior minister, said on Thursday, a day before the federal cabinet approved the restrictions.

Under the new travel ban — which also applies to passengers coming from Portugal, Brazil, South Africa, Lesotho and Eswatini (formerly known as Swaziland) — German residents will be able to return home, but non-German residents from the areas in question will be refused entry, even with a negative coronavirus test.

While multiple known infectious variants have been found in Germany, including the B.1.1.7 variant at a hospital in Berlin, which then had to go into lockdown, health authorities believe they can still prevent variants from spreading and driving new infections.

The change will go into effect over the weekend and will be in place until at least Feb. 17. It follows a temporary halt in travel for all passengers coming from the United Kingdom and South Africa, which was lifted a few days after it was enacted. All nonessential travel remains discouraged.

After more than six weeks of a strict lockdown — during which restaurants, bars, nonessential shops and most schools have been shuttered — Germany is starting to show slight improvement in its daily case numbers. On Thursday, health authorities reported 14,022 infections in a 24-hour period, nearly 4,000 less than the amount registered one week earlier.

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Canadian Airlines Suspend Flights to the Caribbean and Mexico

Prime Minister Justin Trudeau of Canada announced on Friday that major airlines have agreed to suspend flights to sunny vacation spots as new coronavirus quarantine measures are put into place.

The government and Canada’s main airlines have agreed to suspend service to some destinations right away. Air Canada, WestJet, Sunwing and Air Transat are canceling air service to all Caribbean destinations and Mexico starting this Sunday up until April 30. Starting next week, all international passenger flights must land only at the following four airports: Vancouver, Calgary, Toronto and Montreal. In addition to the pre-boarding test we already require, as soon as possible in the coming weeks, we will be introducing mandatory P.C.R. testing at the airport for people returning to Canada. Travelers will then have to wait for up to three days at an approved hotel for their test results, at their own expense, which is expected to be more than $2,000. We will also, in the coming weeks, be requiring non-essential travelers to show a negative test before entry at the land border with the U.S. And we’re working to stand up additional testing requirements for land travel.

Video player loadingPrime Minister Justin Trudeau of Canada announced on Friday that major airlines have agreed to suspend flights to sunny vacation spots as new coronavirus quarantine measures are put into place.CreditCredit…Blair Gable/Reuters

Prime Minister Justin Trudeau of Canada announced Friday that flights between the country and several sunny vacation spots will be suspended, as new testing and quarantining measures are put in place for most air travelers entering Canada.

After previously requiring that air travelers coming to Canada for nonessential purposes show evidence of a negative coronavirus test result from within 72 hours before being allowed on planes, Mr. Trudeau said that they will now also be tested when they land upon their return to Canada. Travelers will have to wait for the results of that second test for three days in a government hotel at their own expense under the new measures.

“Now is just not the time to be flying,” Mr. Trudeau said at an outdoor news conference. “By putting in place these tough measures now, we can look forward to a better time when we can all plan those vacations.”

During most of the pandemic, international flights leaving and entering Canada have been limited to four airports. The flights that are canceled under the new order mainly service resort areas in Mexico and the Caribbean. Airlines are making arrangements to return Canadians who are already in those areas, Mr. Trudeau said.

In December, Canada temporarily stopped air travel to and from the United Kingdom following the appearance there of a new variant of the coronavirus.

Mr. Trudeau estimated that the mandatory three-day stay would cost travelers about 2,000 Canadian dollars, or about $1,570. Travelers with a negative test result will then need to quarantine for 11 more days at their homes. Those with positive test results will be sent to government facilities.

Travelers entering Canada on nonessential trips at land border crossings will also soon be tested, Mr. Trudeau said. They have long been required to quarantine for two weeks.

The premiers of Ontario and Quebec, the country’s two most populous provinces, have been pressuring Mr. Trudeau to introduce testing upon arrival at airports and introduce further flight restrictions. Several Canadian politicians and officials have also come under severe criticism and, in some cases, resigned their positions for traveling outside of the country for vacation.

Mr. Trudeau acknowledged that the percentage of Covid-19 cases in Canada linked to foreign travel is “extremely low.” But he said that the new restrictions should limit the risk posed by new variants of the virus.

“These variations represent a very real challenge,” Mr. Trudeau said.

Columbia University has mostly offered online instruction during the pandemic, and allowed only a sliver of students to live on campus or attend in-person classes. Credit…Mark Lennihan/Associated Press

Over 1,100 undergraduate and graduate students at Columbia University have pledged to withhold their tuition for the spring semester to demand a discount for what they see as a lost spring term.

While some universities have brought students back to campus, Columbia has mostly offered online instruction for students and allowed only a sliver of them to live on campus or attend in-person classes.

In response, students are asking the university to reduce their total costs — including tuition, fees, and room and board — by at least 10 percent, following suit of several schools including Georgetown University, Princeton University and Williams College. Columbia College, the university’s undergraduate school, can cost more than $80,000 a year for students not receiving financial aid.

Strike organizers said that both graduate and undergraduate students were participating; the university has more than 31,000 students.

“It’s a reasonable demand,” said Matthew Gamero, 19, a sophomore who is one of the strike organizers. “This is about the university providing an education of its worth, and to have it online is certainly not what we’re paying for.”

“This is a moment when an active reappraisal of the status quo is understandable, and we expect nothing less from our students,” the university said in a statement. “Their voices are heard by Columbia’s leadership, and their views on strengthening the University are welcomed.”

A tuition discount is only one of a series of demands made by strikers. They have also called on the university to reduce funding for campus policing, improve working conditions for graduate students and provide aid for the surrounding West Harlem community.

The tuition strike was officially kicked off after the spring term bill was due last Friday. For undergraduates, the university could impose a $150 late fee and prevent them from registering for summer or fall classes. The university could also penalize seniors by withholding their diplomas until their balance is paid.

People walk near the Eiffel Tower in Paris the day after Christmas. France will shut its borders to nonessential travel from countries outside the European Union on Sunday.  Credit…Michel Euler/Associated Press

France said on Friday that it would close its borders to non-European Union countries as cases rise and the government struggles to avoid a new lockdown.

Jean Castex, the French prime minister, said that all travel between France and nations outside of the E.U. would be banned starting on Sunday, with exceptions made only for urgent matters. All travelers from E.U. countries, except for cross-border workers, will have to present a negative coronavirus test to enter the country, Mr. Castex added.

Speculation about new restrictions had been growing in France over the past week, with a flurry of conflicting and often confusing information from officials, and many were expecting President Emmanuel Macron to replace the current 6 p.m. to 6 a.m. curfew with a new lockdown.

Speaking after a special cabinet meeting in Paris, Mr. Castex acknowledged France faced a “strong risk of acceleration of the epidemic” because of the more contagious British and South African variants of the virus, and said debates over a new nationwide lockdown were “legitimate.”

“But we all know the very heavy toll it has on the French, on all counts,” he said of a lockdown. “This evening, we consider that in view of the numbers over the past few days, we can still give ourselves a chance to avoid one.”

The variants that emerged in Britain and South Africa have both been detected in France, and the country’s vaccination campaign has slowed amid disruptions in the E.U. supply chain. The number of new cases has continued to rise in France over the past few weeks, with nearly 23,000 new cases reported on Friday, though they have not skyrocketed like they have for some of France’s neighbors.

Britain, which has faced record numbers of cases and deaths, tightened its travel restrictions on Wednesday, requiring British citizens arriving from 22 high-risk countries to quarantine in hotels for 10 days at their own expense. England entered its latest lockdown at the start of January.

The European Commission, the executive arm of the European Union, recommended on Monday restricting nonessential travel in a bid to prevent blanket border closures, which can obstruct trade and the movement of cross-border workers.

“We need to keep safe and discourage nonessential travel,” Ursula von der Leyen, the president of the commission, wrote on Twitter, citing the danger of new variants circulating.

Mr. Castex also announced the closure of the country’s largest malls that do not sell groceries, starting on Sunday, and increased police checks on curfew violations and establishments like restaurants that open illegally. Companies will be further encouraged to have their employees work from home, he said.

“Our goal is to do everything to avoid a new lockdown, and the next few days will be decisive,” Mr. Castex said.

A woman walks past a sorority house on the University of Michigan campus, where more than a dozen cases of a coronavirus variant were found.Credit…Shannon Stapleton/Reuters

Fourteen students at the University of Michigan have contracted a highly contagious variant of the coronavirus, leading health authorities to issue a stay-at-home recommendation for students living on and off campus.

Students were advised to not leave their residences until Feb. 7, except to attend classes, seek medical treatment or run essential errands.

The outbreak of the variant, first detected in Britain and known as B.1.1.7, appears to have started with a student who traveled to the United Kingdom over the winter break, according to Susan Ringler-Cerniglia, a spokeswoman for the Washtenaw County Department of Health.

The first case on the university’s campus was identified on Jan. 16 after the student tested positive and notified officials that he or she had traveled to an area where the variant was prevalent. That prompted additional sequencing that identified the student was infected with the variant, Ms. Ringler-Cerniglia said.

Since then an additional 13 students who are positive with the same variant have been identified. One of them had visited a local indoor mall and a grocery store before testing positive, leading authorities to issue a public notice to people who had visited those locations, asking them to seek testing.

Rick Fitzgerald, a spokesman for the university, said that all the infected students were in isolation with mild symptoms.

The stay-at-home recommendation announced by the Washtenaw County Health Department this week applies to the Ann Arbor campus but not to the broader community.

“More stringent, mandatory actions may be imposed if this outbreak continues to grow and additional variant clusters are identified,” the health department said in a memo to university officials on Wednesday.

Michigan athletics also imposed a two-week pause in competitions and practice, citing the emergence of the variant as the reason. Five of the cases involved individuals connected to the athletic program.

The variant is regarded as 50 percent more transmissible than the standard form of the virus but it isn’t more dangerous, and the vaccines that are currently on the market appear to be effective against it.

Since Michigan’s winter session began Jan. 19, the university has identified a total of 175 coronavirus cases, including the 14 cases of the variant.

Cardinal Timothy Dolan blessed the crowds from the steps of St. Patrick’s Cathedral in Manhattan after Easter Mass in 2016.Credit…Kathy Willens/Associated Press

Cardinal Timothy M. Dolan, the leader of the Roman Catholic Archdiocese of New York, was in quarantine on Friday after he interacted last week with a person who later tested positive for the coronavirus, according to a spokesman.

In a statement, the archdiocese said the cardinal “has not tested positive, feels fine, and has no symptoms.” Joseph Zwilling, a spokesman for the archdiocese, said the cardinal is tested regularly, had tested negative since the interaction, and would be tested again “in a few days.” He did not specify what kind of tests were used nor the timing of when he cardinal was tested after the interaction.

Tests taken too soon after exposure may return false negative results, because the virus has not yet had time to build up to detectable levels. People are thought to carry the largest quantity of virus around the time their symptoms appear, if they experience symptoms at all.

The cardinal’s quarantine had not previously been announced by the archdiocese. Mr. Zwilling said the cardinal had been in quarantine since Wednesday but that no announcement had been made because the infected individual had not received the results of their coronavirus test until Thursday.

“He did not have any public events, and all of his meetings were via Zoom, etc.,” Mr. Zwilling said in an email, referring to the cardinal. “We are announcing today because the exposure was confirmed, and the first public events — Mass tomorrow evening and Sunday morning — were coming up, and he will obviously not be present for those events.”

The cardinal will “continue to follow health and safety protocols as instructed by medical professionals, as will others on his staff who also had close contact with this individual,” the statement said.

Cardinal Dolan is one of the most influential figures in American Catholicism, and the Archdiocese of New York is the second-most populous in the United States, with more than 2.8 adherents living in a territory that stretches from Staten Island into the Hudson Valley.

He had celebrated Mass last Sunday at Saint Patrick’s Cathedral and interacted with other priests and parish personnel, all wearing masks, at that time, according to online video of the service.

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W.H.O. Delivers Update on China Visit

On Friday, the World Health Organization reviewed the details of its investigation into the origin of the coronavirus in China, and what it hopes to learn from the visit.

There is a very long list of site visits planned and face-to-face meetings continue. The — the visits will include the Wuhan Institute of Virology, other labs, the Wuhan markets, early responders, hospitals in which the first clusters of cases occurred. We continue to be hopeful that all of the data and all of the meetings that they need will be had. And and just to reconfirm that all hypotheses are on the table, and we’re looking forward, hopefully, to a successful conclusion of the mission. Success in the case of animal human interface investigations is not measured necessarily in absolutely finding a source on the first mission. This is a complicated business, what we need to do is gather all of the data, all of the information, summarize all of these discussions and come to an assessment as to how much more we know about the origins of the disease, and what further studies may be needed for the release of.

Video player loadingOn Friday, the World Health Organization reviewed the details of its investigation into the origin of the coronavirus in China, and what it hopes to learn from the visit.CreditCredit…Hector Retamal/Agence France-Presse — Getty Images

After months of delays, a team of World Health Organization scientists tracing the pandemic’s origin began its field work on Friday in Wuhan, the Chinese city where the coronavirus was first detected.

The W.H.O. said its team of 15 experts planned to visit hospitals, laboratories and a live animal market over the next several weeks in Wuhan, a city of 11 million, where the virus was detected in late 2019.

“As members start their field visits on Friday, they should receive the support, access and the data they need,” the W.H.O. said on Twitter. “All hypotheses are on the table as the team follows the science in their work to understand the origins of the #COVID19 virus.”

The Chinese government had repeatedly sought to delay the inquiry, apparently out of concern that the experts would draw attention to the government’s early missteps in handling the outbreak. But it relented under mounting global pressure.

The W.H.O. experts were first asked to undergo 14 days of quarantine in Wuhan, which ended on Thursday.

They plan to speak with some of the first patients to show symptoms of Covid-19, as well as with medical workers and Chinese scientists, according to the W.H.O. Their fieldwork will include a visit the Huanan Seafood Wholesale Market, where some of the first cases were detected.

They will also visit the Wuhan Institute of Virology and a laboratory operated by Chinese Center for Disease Control and Prevention.

The question of the pandemic’s origin has caused friction between China and the United States, with officials in each country at times blaming the other for unleashing the virus on the world.

Jen Psaki, the White House press secretary, said on Wednesday that the United States hoped for a “robust and clear” international investigation.

Chinese officials, in response, defended the country’s handling of the inquiry.

“We hope the U.S. side will work with China, take on a responsible attitude and respect facts, science and the diligent work of W.H.O. experts,” Zhao Lijian, a spokesman for the Chinese foreign ministry, said at a news conference in Beijing on Thursday.

  • Chinese officials said on Friday that several passengers traveling to China from the United States had falsified coronavirus test results so they could gain entry to the country. The Chinese consulate in San Francisco said the passengers had “changed their test results from positive to negative” and that other travelers had lied about test results. The consulate did not provide details about the passengers or the punishments they might face. China maintains strict border control rules, including a requirement that travelers present results from antibody and nucleic acid tests before they fly. The consulate said the passengers had violated public health laws. “The way they put others at risk is odious,” the statement said.

  • Vietnam recorded nine more coronavirus cases on Friday, including one in the capital, Hanoi, as a new outbreak spread beyond the two northern provinces where infections had first been detected a day earlier. Officials put the number of cases from the latest outbreak at 93 as of Friday afternoon but said that it could reach 30,000, nearly 20 times the number of cases that Vietnam detected during the entire first year of the pandemic. Vietnam has been among the most successful countries in containing the virus, with strict border controls, mask-wearing, contact tracing and isolation of infected people. The latest outbreak comes as officials from the governing Communist Party meet to select the country’s new leaders, an event held once every five years.

  • Hungary’s medicine authority has approved the coronavirus vaccine developed by the Chinese company Sinopharm. “This means that in addition to Pfizer, Moderna, Sputnik and AstraZeneca, we can also count on Sinopharm,” said Dr. Cecilia Muller, the country’s chief medical officer. “We trust that these vaccines will be readily available in large quantities and the immunization process will be completed in larger numbers in less time.” The country’s foreign minister later announced that it had purchased five million doses of the vaccine. Regarding the options, Prime Minister Viktor Orban expressed enthusiasm for the Chinese vaccine on Friday. “I will wait for the Chinese vaccine,” he said. “I trust that one the most.”

  • Spain’s first case of the South African variant of Covid-19 was detected in the port city of Vigo, in the northwestern region of Galicia. Health authorities in Galicia said a 30-year old man who works in the shipping industry returned from a recent work trip to South Africa and tested positive for the variant earlier this month. He had light symptoms and was not hospitalized, they said.

Registered nurses demonstrated against unsafe staffing practices at Good Samaritan Hospital in San Jose, Calif., in December. Credit…Sarahbeth Maney for The New York Times

The unions representing the nation’s health care workers have emerged as increasingly powerful voices during the still-raging pandemic.

With more than 100,000 Americans hospitalized and many among their ranks infected, nurses and other health workers remain in a precarious frontline against the coronavirus and have turned again and again to unions for help.

Nurses across the country from various unions are participating in dozens of strikes and protests. National Nurses United, the country’s largest union of registered nurses, held a “day of action” on Wednesday with demonstrations in more than a dozen states and Washington, D.C., as it starts negotiations at hospitals owned by big systems like HCA, Sutter Health and CommonSpirit Health.

“It’s so overwhelming. It’s unlike anything I’ve ever seen before,” said Erin McIntosh, a nurse at Riverside Community Hospital in Southern California, a part of the country that has been among the hardest hit by a surge in cases. “Every day I’m waist-deep in death and dying.”

Hospitals said the unions are playing politics during a public health emergency and say they have no choice but to ask more of their workers.

But health care workers say they have been bitterly disappointed by their employers’ and government agencies’ response to the pandemic. Dire staff shortages, inadequate and persistent supplies of protective equipment, limited testing for the virus and pressure to work even if they might be sick have left many workers turning to the unions as their only ally. The virus has claimed the lives of more than 3,300 health care workers nationwide, according to one count.

Credit…Joshua Lott/Reuters

“We wouldn’t be alive today if we didn’t have the union,” said Elizabeth Lalasz, a Chicago public hospital nurse and steward for National Nurses United.

Despite the decades-long decline in the labor movement and the small numbers of unionized nurses, labor officials have seized on the pandemic fallout to organize new chapters and pursue contract talks for better conditions and benefits. National Nurses organized seven new bargaining units last year, compared to four in 2019. The Service Employees International Union, which represents Mrs. McIntosh, also says it has seen an uptick in interest.

Tyler Perry in 2019.Credit…Frederic J. Brown/Agence France-Presse — Getty Images

With the pandemic exposing racial disparities in the United States — Black people have died of Covid-19 at nearly three times the rate of white people, according to the Centers for Disease Control and Prevention — health officials have been working to promote vaccinations in Black communities, and to combat doubt.

So doctors in Atlanta turned to Tyler Perry — a popular and prolific actor, director and studio head — to spread the word to Black audiences that the vaccine was harmless. He agreed to interview the experts, turning it into a TV special that aired Thursday night on BET. On the show, he peppered doctors from Grady Health System with questions about the safety of the vaccine, how it was developed, how it was tested and how it works.

At the end of the interview, with his sleeve pulled up, Perry got the jab as cameras rolled.

Perry is one of the most powerful people in the entertainment industry. He built his fortune portraying the character of Madea, a tart-tongued and irreverent matriarch, onstage and onscreen, before retiring her in 2019 to concentrate on other projects, which include running his 330-acre studios in Georgia.

Skepticism about the Covid-19 vaccine among Black people has been deeply concerning to health officials. A recent study by the Kaiser Family Foundation found that one in three Black people was hesitant about vaccine. A recent CNN analysis found that Black and Latino Americans were getting the vaccine at significantly lower rates than white people — rates attributed to, among other factors, lack of access to health care for many Black people, but also to an entrenched mistrust about the medical establishment.

On the BET special, Perry spoke of episodes in history that have led to a lack of faith in the medical establishment and the government, among them the Tuskegee Syphilis Study, in which doctors allowed syphilis to progress in Black men by withholding treatment from them, and the case of Henrietta Lacks, a Black woman who died of cervical cancer in 1951, whose cells were used in research without her knowledge or consent.

“We as Black people have healthy hesitation when it comes to vaccinations and so on and so forth, and even disease,” he said.

Perry said he didn’t want people getting vaccinated just because he had. “What I want to do is give you the information, the facts,” he said. “There’s a lot of misinformation out there.”

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New York City Sets ‘Aggressive Goal’ of 5 Million Vaccinations by June

Mayor Bill de Blasio said the city is aiming to vaccinate 5 million New Yorkers against Covid-19 by June. He also announced plans to bring city workers back to offices in May and reopen schools for all students in September.

We’re going for an aggressive goal, five million New Yorkers vaccinated by June. I am absolutely certain we can do it so long as we have the vaccine. And I am more and more confident because the actions the Biden administration, because the Johnson Johnson vaccine is coming, more and more confident that we will have what we need. I’m going to push hard on the federal government to get every pharmaceutical company in America into this work because they’re not right now. The federal government needs to ensure that they are required to produce vaccine, whether they’re the originator of the vaccine or not. So long as we have the supply, we can reach five million new Yorkers in June, get to a point of community immunity. And we’re going to bring back our city workforce in May and after, because obviously so many are on the job right now. But the folks who work in our offices and do so much important work, we want them back. We want to send a signal to this whole city. We’re moving forward. We want to see the private sector bring workforces back. We are going to have an entirely different situation as we proceed into the spring. By the end of the spring, I think you’re going to see something very different. And we’re going to a great group of folks out there, our vaccine for all core leading the way. Now, a lot of different pieces matter, and one of the most crucial ones that matters to us for today, for our parents, for our families, for our future, tomorrow — our schools, one of the things that says most clearly, we are back is our schools. And so in September, our schools come back fully. We focus on helping kids overcome that Covid achievement gap. Our 2021 student achievement plan focuses on the academic side, but also the emotional side, the mental health needs of our kids after everything they’ve been through.

Video player loadingMayor Bill de Blasio said the city is aiming to vaccinate 5 million New Yorkers against Covid-19 by June. He also announced plans to bring city workers back to offices in May and reopen schools for all students in September.CreditCredit…James Estrin/The New York Times

In his final State of the City address, Mayor Bill de Blasio offered a sprawling vision of New York City’s recovery from a pandemic that has taken tens of thousands of lives and destroyed the city’s economy.

The mayor committed to accelerating the city’s vaccination efforts and set a goal of inoculating five million New Yorkers by June.

“We’re going for an aggressive goal,” Mr. de Blasio said at a news conference on Friday morning, adding that “I am absolutely certain we can do it, so long as we have the vaccine.”

On Friday, Mr. de Blasio said that, given an adequate supply of the vaccine, the city could vaccinate half a million people per week, and that he planned to reopen vaccination sites that had closed as more vaccine became available.

Johnson & Johnson announced on Friday that their vaccine was very effective at preventing the virus, but that its efficacy dropped steeply against a more contagious variant in South Africa. White House officials have been counting on Johnson & Johnson’s vaccine, to ease the shortfall of vaccine supply. Unlike the federally authorized vaccines made by Pfizer and Moderna, Johnson & Johnson’s vaccine is effective after only one dose. But the company may only have about seven million doses ready when the F.D.A. decides whether to authorize it, according to federal health officials familiar with its production, and about 30 million doses by early April.

Mr. de Blasio also noted on Friday that the citywide seven-day average rate of positive test results was 8.63 percent, and city data show that in more than 30 city ZIP codes the rate is above 10 percent.

During the State of the City address, the mayor also said he would begin in May to bring back to offices the thousands of city employees who have been working remotely, and would safely reopen schools for all students in September.

“New York City’s vaccination effort is the foundation of a recovery for all of us,” the mayor’s 18-page recovery plan says. “With every vaccine shot, New York City moves closer and closer to fully reopening our economy, restoring the jobs we lost and ensuring equality in our comeback.”

If the federal government provides enough stimulus dollars to the city, Mr. de Blasio said, he will create a City Cleanup Corps of 10,000 temporary workers to focus on beautifying the city — an idea he compared to President Franklin D. Roosevelt’s Works Progress Administration during the Great Depression.

Mr. de Blasio also proposed two plans to help small businesses: a $50 million “recovery tax credit” program for businesses that have faced hardships from the pandemic, and a $100 million “recovery loan” program to help shops stay open. The city will provide low-interest loans of up to $100,000 to roughly 2,000 small businesses, according to the mayor’s plan.

But Mr. de Blasio has also warned that the city is facing major budget cuts and layoffs. He recently announced that the city’s property tax revenues are projected to decline by $2.5 billion next year, driven by a drop in the value of office buildings and hotel properties that have emptied out during the pandemic.

Gov. Andrew M. Cuomo announced on Friday that restaurants in New York City, major drivers of its economy that have struggled under pandemic restrictions, could reopen for indoor dining at 25 percent capacity starting on Feb. 14. Mr. Cuomo closed them last month as virus numbers ticked up.

Mr. de Blasio and Mr. Cuomo have expressed optimism that President Biden, along with a Democratic-led Congress, will bring substantial assistance to the city. Mr. de Blasio also called for higher taxes on wealthy New Yorkers in his speech — a policy he has pushed for years, but that Mr. Cuomo has opposed.

Mr. de Blasio noted that more than 100 billionaires in the state increased their net worth by billions of dollars during the pandemic and called again for a redistribution of wealth.

“There is clearly enough money in New York to invest in a fair and fast recovery — it’s just in the wrong hands,” he said.

A protest outside the Denver office of the Occupational Safety and Health Administration last year after hundreds of workers at a Colorado meatpacking plant developed Covid-19, six fatally.Credit…David Zalubowski/Associated Press

The federal occupational safety agency on Friday posted new guidance for employers on reducing the spread of Covid-19 in the workplace, just over one week after President Biden signed an executive order directing it to do so.

The move by the Occupational Safety and Health Administration, part of the Labor Department, includes only recommendations, not requirements. But the agency said it was exploring a rule mandating certain protective measures.

The agency declined to issue such a rule, known as an emergency temporary standard, during the Trump administration. But Mr. Biden indicated support for a standard during the campaign.

The new guidance makes fewer distinctions than the Trump administration’s version based on the exposure risk of different workers. “Everyone should be protected, not some more protected than others,” Ann Rosenthal, a senior adviser to the agency, said on a video call with reporters.

The document issued on Friday also uses less equivocal language than the agency did under President Donald J. Trump. For example, it says the most effective prevention programs “ensure that absence policies are nonpunitive.” During the Trump administration, the agency advised employers to “ensure that sick leave policies are flexible and consistent with public health guidance.”

Meatpacking and meat processing have been a particular source of concern, accounting for an outsized portion of Covid-19 infections nationally.

In late December, a state judge in California issued a temporary restraining order in a lawsuit involving workers at a local poultry plant, requiring a variety of safety protocols such as providing masks and requiring workers to wear them, as well as face shields, where social distancing isn’t possible.

The court announced Friday that it would issue a preliminary injunction to the same effect, giving workers an ongoing ability to force compliance if the company backs off the protocols. It cited evidence submitted by the plaintiffs that “regulatory agencies are overwhelmed by the issues raised by the Covid-19 pandemic and are unable to inspect with the same regularity as was the practice prior to the pandemic.”

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Business

EU piles stress on AstraZeneca over delayed vaccines, reveals particulars of contract

The President of the European Commission, Ursula von der Leyen, will give a lecture at the end of a video conference of the members of the European Council that dealt with the Covid 19 pandemic in Brussels on January 21, 2021.

OLIVIER HOSLET | AFP | Getty Images

LONDON – The European Union released an edited version of the contract it signed with AstraZeneca on Friday as the bloc put pressure on the drug maker to deliver the promised Covid vaccine shipments.

The EU, which has been criticized for its slow adoption of vaccinations, was hit with a blow by AstraZeneca last week when the company said it could only deliver a fraction of the shots it agreed to for the first quarter.

AstraZeneca has denied it failed to deliver on its commitments, stating that shipments to the 27-nation bloc were targets rather than promises. The company also cited production problems at its European plants for the delays.

The European Commission, the EU executive, welcomed AstraZeneca’s commitment to greater transparency after the company agreed to publish details of the agreement. AstraZeneca was not immediately available to leave comments when CNBC contacted them.

The contract, which was signed on August 27, provides for AstraZeneca to undertake to the best of its ability to build capacity to produce 300 million doses of vaccine, with the Commission having the option to order an additional 100 million doses.

In the case of AstraZeneca, the agreement defines “best effort” as the activities a company with similar resources would undertake in the development and manufacture of its vaccine.

This includes “bearing in mind the urgent need for a vaccine to end a global pandemic that is creating serious public health problems, restrictions on personal freedoms and economic impacts around the world, but considering its effectiveness and safety”.

The contract states that AstraZeneca will use its “best possible efforts” to manufacture the vaccine at manufacturing facilities in the EU. The deal also provides for this to include plants based in the UK, although the country left the bloc last year.

AstraZeneca has been told to send some of the UK-made cans to the block, but the company said a separate deal with the UK prevented that.

The European Medicines Agency is expected to make a decision on Friday on whether the AstraZeneca vaccine will actually be approved for use.

International Competition Concerns

The President of the European Commission, Ursula von der Leyen, said on Friday morning on German radio: “There are binding orders and the contract is crystal clear.”

“AstraZeneca also explicitly assured us in this contract that no other obligations would prevent the fulfillment of the contract,” she said, according to Reuters.

Von der Leyen of the EU claimed the deal included clear delivery amounts for December and the first three quarters of 2021.

Earlier this week, Pascal Soriot, CEO of AstraZeneca, said the EU contract was based on what is known as a “best effort” clause and did not officially oblige the drug maker to a specific delivery schedule.

The EU von der Leyen rejected this proposal on Friday, adding that the clause would only apply if it was unclear whether AstraZeneca could develop a safe and effective vaccine. She also claimed that the contract specifically mentioned four manufacturing facilities that would supply the vaccine to Europe, two of which are in the UK.

A look at the headquarters of the British-Swedish multinational pharmaceutical and biopharmaceutical company AstraZeneca as a Covid-19 vaccine developed by AstraZeneca and inspected in Brussels, Belgium on January 28, 2021.

Dursun Aydemir | Anadolu Agency | Getty Images

EU officials have indicated that deliveries from the UK to Europe could be rerouted if delays in European production persist.

UK Prime Minister Boris Johnson said he remained “confident” of delivering the AstraZeneca vaccine developed in partnership with Oxford University. Johnson added that he was “very pleased” that the country was among the fastest in Europe to introduce the vaccine.

The UK has the second highest number of confirmed Covid cases in Europe after Russia, recording the highest number of coronavirus-related deaths of any European nation and the fifth highest worldwide.

The EU of around 450 million people is struggling to get its vaccinations up and running as it is insufficiently supplied and is currently lagging far behind countries like Israel and the UK in delivering vaccines to its citizens.

Vaccine maker Pfizer-BioNTech initially delivered a blow, announcing it would temporarily cut production to improve its production capacity in Belgium. This was followed by AstraZeneca last Friday, which reduced its delivery estimates for the region.

An unnamed senior EU official told Reuters that the bloc expected about 80 million doses by March but had been told it would only receive 31 million doses instead. The company has not confirmed the quantities concerned.

A deepening dispute between the EU and AstraZeneca has raised concerns about international competition for limited vaccine supplies. Hopefully the vaccinations can help end the coronavirus pandemic.

– CNBC’s Holly Ellyatt contributed to this report.

Categories
Health

Pregnant Girls Get Conflicting Recommendation on Covid-19 Vaccines

Schwangere, die nach Leitlinien für Covid-19-Impfstoffe suchen, sind mit der Art von Verwirrung konfrontiert, die die Pandemie von Anfang an verfolgt hat: Die weltweit führenden Organisationen für öffentliche Gesundheit – die US-amerikanischen Zentren für die Kontrolle und Prävention von Krankheiten und die Weltgesundheitsorganisation – bieten widersprüchliche Angebote Rat.

Keine der Organisationen verbietet oder fördert ausdrücklich die Immunisierung schwangerer Frauen. Sie wägen jedoch dieselben begrenzten Studien ab und geben unterschiedliche Empfehlungen.

Das Beratungsgremium der CDC forderte schwangere Frauen auf, sich vor dem Hochkrempeln mit ihren Ärzten zu beraten – eine Entscheidung, die von mehreren Frauengesundheitsorganisationen begrüßt wurde, da die Entscheidungsfindung weiterhin in den Händen der werdenden Mütter lag.

Die WHO empfahl schwangeren Frauen, den Impfstoff nicht zu erhalten, es sei denn, sie hatten aufgrund von Arbeitsexpositionen oder chronischen Erkrankungen ein hohes Risiko für Covid. Am Dienstag gab es Leitlinien zum Moderna-Impfstoff heraus, die bei Frauen und Ärzten in den sozialen Medien für Unsicherheit sorgten. (Anfang dieses Monats wurden ähnliche Leitlinien zum Pfizer-BioNTech-Impfstoff veröffentlicht.)

Mehrere Experten äußerten sich bestürzt über die Haltung der WHO und sagten, die Risiken für schwangere Frauen aus Covid seien weitaus größer als jeder theoretische Schaden durch die Impfstoffe.

“Es gibt keine dokumentierten Risiken für den Fötus, es gibt keine theoretischen Risiken, es gibt kein Risiko in Tierstudien”, sagte Dr. Anne Lyerly, Bioethikerin an der Universität von North Carolina, Chapel Hill. “Je mehr ich darüber nachdenke, desto enttäuschter und trauriger fühle ich mich darüber.”

Die Meinungsverschiedenheit zwischen der CDC und der WHO beruht nicht auf wissenschaftlichen Erkenntnissen, sondern auf deren Fehlen: Schwangeren wurde die Teilnahme an klinischen Studien mit den Impfstoffen verwehrt, eine Entscheidung, die einer langen Tradition des Ausschlusses schwangerer Frauen entspricht biomedizinische Forschung, aber eine, die jetzt in Frage gestellt wird.

Während das Ziel angeblich darin besteht, Frauen und ihre ungeborenen Kinder zu schützen, drängt das Ausschließen schwangerer Frauen von Studien das Risiko aus dem sorgfältig kontrollierten Umfeld einer klinischen Studie in die reale Welt. Die Praxis hat Patienten und Anbieter gezwungen, sensible, besorgniserregende Probleme mit wenig harten Daten über Sicherheit oder Wirksamkeit abzuwägen.

Impfstoffe gelten im Allgemeinen als sicher, und schwangere Frauen werden seit den 1960er Jahren aufgefordert, sich gegen Influenza und andere Krankheiten immunisieren zu lassen, auch wenn keine strengen klinischen Studien durchgeführt wurden, um sie zu testen.

“Als Geburtshelfer stehen wir häufig vor schwierigen Entscheidungen über die Verwendung von Interventionen in der Schwangerschaft, die in der Schwangerschaft nicht ordnungsgemäß getestet wurden”, sagte Dr. Denise Jamieson, Geburtshelferin an der Emory University in Atlanta und Mitglied der Covid-Expertengruppe am American College für Geburtshilfe und Gynäkologen. Das College befürwortete nachdrücklich die Einbeziehung schwangerer und stillender Frauen in die Impfstoffstudien.

“Was viele Menschen vermissen, ist, dass es Risiken gibt, nichts zu tun”, sagte Dr. Jamieson. “Es ist keine kluge Strategie, schwangeren Frauen die Möglichkeit zu bieten, sich impfen zu lassen und sich selbst zu schützen, wenn bekannte und schwerwiegende Risiken für Covid durch die Schwangerschaft bestehen.”

Die Unsicherheit ist nicht auf Covid-Impfstoffe beschränkt: Viele, wenn nicht die meisten Medikamente, einschließlich weit verbreiteter Medikamente, wurden noch nie bei schwangeren Frauen getestet. Es kann Jahre oder Jahrzehnte dauern, bis unerwünschte Nebenwirkungen auftreten, wenn keine Studie mit einer Kontrollgruppe zum Vergleich vorliegt.

“Dies ist keine Geschichte über die WHO oder andere Personen, die von einer Impfung in der Schwangerschaft abraten”, sagte Carleigh Krubiner, Policy Fellow am Center for Global Development und Hauptforscher für das Projekt “Schwangerschaftsforschungsethik für Impfstoffe, Epidemien und neue Technologien” (VERHINDERN). “Es ist eine Geschichte über das Versäumnis, schwangere Frauen rechtzeitig und angemessen in Impfstudien einzubeziehen.”

Dr. Krubiner erklärte, sie verstehe die Verpflichtung der WHO und anderer Beratungsgremien, sich auf wissenschaftliche Studien zu stützen, und fügte hinzu: „Die Realität ist, dass wir noch keine Daten zu diesen Impfungen in der Schwangerschaft haben und es ohne diese Daten sehr schwierig ist Komm raus und gib eine umfassende Empfehlung zur Unterstützung ab. “

Die CDC und die WHO haben im Verlauf der Pandemie viele Male dissonante Ratschläge gegeben – insbesondere zur Nützlichkeit von Masken und zur Möglichkeit, dass das Virus in Innenräumen mit dem Flugzeug fliegt.

In einer Erklärung sagte die CDC am Donnerstag, dass aufgrund der Wirkungsweise der Impfstoffe Pfizer-BioNTech und Moderna „es unwahrscheinlich ist, dass sie ein spezifisches Risiko für schwangere Frauen darstellen“.

Die Empfehlung der CDC könnte für die USA sinnvoll sein, wo Frauen möglicherweise leicht ihre Gesundheitsdienstleister konsultieren können, sagte Joachim Hombach, ein Gesundheitsberater der WHO zu Impfungen. Die WHO berät jedoch viele Länder mit niedrigem und mittlerem Einkommen, in denen Frauen keinen Zugang zu Ärzten oder Krankenschwestern haben.

Die Empfehlung der WHO wurde auch “im Zusammenhang mit der begrenzten Versorgung” der Impfstoffe abgegeben, sagte Dr. Hombach. “Ich denke nicht, dass die Sprache entmutigend ist, aber die Sprache gibt die Fakten an.”

Pfizer bezog schwangere Frauen nicht in seine ersten klinischen Studien ein, da es die von der Food and Drug Administration festgelegten Richtlinien befolgte, um zunächst Studien zur Entwicklungstoxizität und Reproduktionstoxizität durchzuführen, sagte Jerica Pitts, eine Sprecherin des Unternehmens. Pfizer und Moderna übermittelten der FDA im Dezember Ergebnisse aus Toxizitätsstudien an trächtigen Ratten.

Pfizer plant, im ersten Halbjahr 2021 eine klinische Studie an schwangeren Frauen zu beginnen, sagte Frau Pitts. Laut Colleen Hussey, einer Sprecherin des Unternehmens, richtet Moderna ein Register ein, um die Ergebnisse schwangerer Frauen zu erfassen, die den Impfstoff erhalten.

Kritiker der Entscheidung der Unternehmen, schwangere Frauen von Studien auszuschließen, sagen, dass die Studien zur Reproduktionstoxizität viel früher hätten durchgeführt werden können – sobald vielversprechende Impfstoffkandidaten identifiziert wurden. Die Unternehmen hätten ein Protokoll zur Registrierung schwangerer Frauen hinzufügen sollen, sobald klar war, dass die Vorteile der Impfstoffe den potenziellen Schaden überwogen, sagte Dr. Krubiner.

“Es ist schwer zu verstehen, warum diese Verzögerung auftritt und warum sie nicht früher eingeleitet wurde”, sagte sie. “Das größere Problem ist, dass wir Monate verloren haben, wenn sie anfangen.”

Akiko Iwasaki, ein Immunologe an der Yale University, der Impfungen für schwangere Frauen befürwortet hat, stellte das zugrunde liegende Problem in Frage, das zur Entscheidung der WHO führte.

“Was auch immer es ist, ich wünschte, die WHO wäre transparenter in ihren Gründen für diese Empfehlung”, sagte sie. “Das Leben von Frauen hängt davon ab.”

Covid19 Impfungen >

Antworten auf Ihre Impfstofffragen

Bin ich in meinem Bundesstaat für den Covid-Impfstoff berechtigt?

Derzeit können mehr als 150 Millionen Menschen – fast die Hälfte der Bevölkerung – geimpft werden. Aber jeder Staat trifft die endgültige Entscheidung darüber, wer zuerst geht. Die 21 Millionen Beschäftigten im Gesundheitswesen des Landes und drei Millionen Einwohner von Langzeitpflegeeinrichtungen waren die ersten, die sich qualifizierten. Mitte Januar forderten Bundesbeamte alle Bundesstaaten auf, die Berechtigung für alle über 65-Jährigen und für Erwachsene jeden Alters mit Erkrankungen zu öffnen, bei denen ein hohes Risiko besteht, dass sie schwer krank werden oder an Covid-19 sterben. Erwachsene in der Allgemeinbevölkerung stehen am Ende der Reihe. Wenn Gesundheitsbehörden von Bund und Ländern Engpässe bei der Verteilung von Impfstoffen beseitigen können, sind alle ab 16 Jahren bereits im Frühjahr oder Frühsommer förderfähig. Der Impfstoff wurde bei Kindern nicht zugelassen, obwohl derzeit Studien durchgeführt werden. Es kann Monate dauern, bis ein Impfstoff für Personen unter 16 Jahren verfügbar ist. Aktuelle Informationen zu den Impfrichtlinien in Ihrer Region finden Sie auf Ihrer staatlichen Gesundheitswebsite

Ist der Impfstoff frei?

Sie sollten nichts aus eigener Tasche bezahlen müssen, um den Impfstoff zu erhalten, obwohl Sie nach Versicherungsinformationen gefragt werden. Wenn Sie nicht versichert sind, sollten Sie den Impfstoff trotzdem kostenlos erhalten. Der Kongress hat in diesem Frühjahr ein Gesetz verabschiedet, das es Versicherern verbietet, eine Kostenteilung wie eine Zuzahlung oder einen Selbstbehalt anzuwenden. Es bestand aus zusätzlichen Schutzmaßnahmen, die es Apotheken, Ärzten und Krankenhäusern untersagten, Patienten, einschließlich nicht versicherter Patienten, in Rechnung zu stellen. Trotzdem befürchten Gesundheitsexperten, dass Patienten in Schlupflöcher geraten, die sie für Überraschungsrechnungen anfällig machen. Dies kann bei Personen der Fall sein, denen zusammen mit ihrem Impfstoff eine Arztbesuchsgebühr berechnet wird, oder bei Amerikanern, die bestimmte Arten der Krankenversicherung haben, die nicht unter die neuen Vorschriften fallen. Wenn Sie Ihren Impfstoff von einer Arztpraxis oder einer Notfallklinik erhalten, sprechen Sie mit ihnen über mögliche versteckte Kosten. Um sicherzugehen, dass Sie keine Überraschungsrechnung erhalten, ist es am besten, wenn Sie Ihren Impfstoff an einer Impfstelle des Gesundheitsministeriums oder in einer örtlichen Apotheke erhalten, sobald die Aufnahmen breiter verfügbar sind.

Kann ich wählen, welchen Impfstoff ich bekomme?Wie lange hält der Impfstoff? Brauche ich nächstes Jahr noch einen?

Das ist zu bestimmen. Es ist möglich, dass Covid-19-Impfungen genau wie die Grippeimpfung zu einem jährlichen Ereignis werden. Oder es kann sein, dass der Nutzen des Impfstoffs länger als ein Jahr anhält. Wir müssen abwarten, wie dauerhaft der Schutz vor den Impfstoffen ist. Um dies festzustellen, werden Forscher geimpfte Menschen aufspüren, um nach „Durchbruchsfällen“ zu suchen – jenen Menschen, die trotz Impfung an Covid-19 erkranken. Dies ist ein Zeichen für eine Schwächung des Schutzes und gibt Forschern Hinweise darauf, wie lange der Impfstoff hält. Sie werden auch die Spiegel von Antikörpern und T-Zellen im Blut geimpfter Personen überwachen, um festzustellen, ob und wann ein Auffrischungsschuss erforderlich sein könnte. Es ist denkbar, dass Menschen alle paar Monate, einmal im Jahr oder nur alle paar Jahre Booster benötigen. Es geht nur darum, auf die Daten zu warten.

Benötigt mein Arbeitgeber Impfungen?Wo kann ich mehr erfahren?

Die von Pfizer und Moderna im Dezember veröffentlichten Toxizitätsdaten ergaben keine schädlichen Auswirkungen der Impfstoffe auf trächtige Ratten – Beweise, die von der WHO in ihren Leitlinien angeführt wurden.

Eine extreme Folge eines konservativen Ansatzes für Impfstoffe während der Ebola-Epidemie in der Demokratischen Republik Kongo, als Gesundheitspersonal allen Mitarbeitern an vorderster Front einen Impfstoff gegen die Krankheit anbot und Kontakte von Personen bestätigten, dass sie diese hatten – außer wenn sie schwanger waren oder Stillen. Ohne den Impfstoff starben 98 Prozent der schwangeren Frauen, die mit dem Ebola-Virus infiziert waren.

Die Regeln wurden nach einem öffentlichen Aufschrei geändert, aber bis dahin waren viele schwangere Frauen gestorben, sagte Dr. Lyerly.

Covid-19 hat sich auch für schwangere Frauen als gefährlich erwiesen. Eine große CDC-Studie, die im November veröffentlicht wurde, ergab, dass schwangere Frauen mit Covid, die symptomatisch waren, signifikant häufiger ins Krankenhaus eingeliefert wurden oder starben als nicht schwangere Frauen, die ebenfalls Covid-Symptome hatten.

Die Beweise veranlassten Beamte der Behörde, eine Schwangerschaft in die Liste der Erkrankungen aufzunehmen, die das Risiko schwerer Krankheiten und des Todes durch Covid erhöhen.

Die CDC hat eine Smartphone-Anwendung namens v-safe eingerichtet, um Berichte über Nebenwirkungen von immunisierten Personen zu erhalten. Bislang haben sich rund 15.000 schwangere Frauen in das Register eingetragen, berichtete das Impfkomitee der Agentur am Mittwoch.

“Ich denke, das ist unsere beste Chance, schnell Sicherheitsdaten zu erhalten”, sagte Dr. Jamieson.

Großbritannien empfahl zunächst dringend, Covid-Impfstoffe für schwangere Frauen zu verwenden, hat jedoch seitdem seine Leitlinien überarbeitet, um die Impfung schwangerer Frauen zuzulassen, die an vorderster Front arbeiten oder anderweitig einem hohen Risiko ausgesetzt sind. “Ich hoffe, die WHO wird es auch noch einmal überdenken”, sagte Dr. Jamieson.

Einige Experten sagten, die Empfehlungen seien nicht so unterschiedlich, wie sie auf den ersten Blick erscheinen könnten. “Die CDC ist eher geneigt zu sagen, dass schwangere Frauen Zugang zum Impfstoff haben sollten, aber ihre Umstände mit ihren Anbietern besprechen sollten”, sagte Dr. Ana Langer, eine Expertin für reproduktive Gesundheit, die die Frauen- und Gesundheitsinitiative an der TH Chan School in Harvard leitet der öffentlichen Gesundheit. „Die vorläufige Empfehlung der WHO besagt, dass Frauen, bei denen ein besonders hohes Risiko besteht, exponiert zu werden oder Covid zu bekommen, den Impfstoff erhalten sollten. Wo ist hier der große Unterschied? “

Denise Grady trug zur Berichterstattung bei.

Categories
Health

EU suggests AstraZeneca diverts Covid-19 vaccines from UK

An AstraZeneca vaccine production line.

Bloomberg | Bloomberg | Getty Images

LONDON – The European Union has proposed that drug maker AstraZeneca reroute supplies of its coronavirus vaccine from the UK to mainland Europe as the battle over production delays and supplies continues.

It comes after AstraZeneca told the EU last week that it would initially deliver far fewer doses of its Covid vaccine to the block of 27 than initially thought.

The European Medicines Agency is expected to make a decision on Friday on whether the AstraZeneca vaccine will actually be approved for use.

In Germany, doubts have been expressed about the effectiveness of the vaccine in those over 65 years of age. On Thursday, the German vaccine committee recommended that the AstraZeneca vaccine only be offered to people between the ages of 18 and 64.

This is due to the fact that there is insufficient data to assess the effectiveness in people over 65 years of age.

Older study participants were later admitted to Phase 3 clinical trials of the AstraZeneca vaccine, which took place in the UK and Brazil, and earlier in South Africa. Therefore, there is less data on the effectiveness of the shot in those over 65.

Germany’s position casts doubt on the approval of the AstraZeneca vaccine at a time when a violent turmoil has broken out between the drug manufacturer and the EU over the delivery of the sting. The EU on Wednesday called for the pharmaceutical company to deliver on its agreement to supply millions of coronavirus vaccines by whatever means necessary.

“Constructive” discussions

Health Commissioner Stella Kyriakides said talks with the company, which continued on Wednesday, were “constructive”. But she also tweeted that “contractual obligations must be met, vaccines must be delivered to EU citizens”.

She said in a statement that the EU rejected the “first come, first served” logic after AstraZeneca’s CEO attributed delays in delivery to teething troubles at European manufacturing sites and ironing out similar issues in the UK. because they had ordered his vaccine dose three months earlier than the EU.

In a press conference, Kyriakides said there was “no hierarchy” in the manufacturing facilities identified in his pre-purchase agreement with AstraZeneca and no provision as to which EU would or would not supply.

“There are four factories in the contract, but there is no distinction between the UK and Europe. The UK factories are part of our pre-purchase agreement so they must deliver,” she said. There was no clause in the contract stating that the drug manufacturer would give priority to the UK, she added.

Slaughter brows

It is the latest development in the very public confrontation between the EU and AstraZeneca, as the latter is facing problems in two of their European plants.

The British-Swedish company’s CEO, Pascal Soriot, further fueled tensions on Tuesday when he said in an interview with the Italian newspaper La Repubblica that the deal with the EU was a “best possible” rather than a “contractual obligation”.

The EU hit back and asked the drug manufacturer to provide detailed plans for its delivery schedule. An official urged AstraZeneca to redirect cans made in the UK to the EU, despite the company’s failure to respond to the problem, according to a Reuters report.

In an interview on Tuesday, Soriot said: “The UK government said that delivery from the UK supply chain would go to the UK first. Basically it is. The EU agreement mentions that UK production facilities were an option for Europe, but later. “

UK Prime Minister Boris Johnson did not comment directly on the matter on Wednesday but said: “We are very confident in our deliveries, we are very confident in our contracts and we are proceeding on that basis.”

Vaccination drives

So far, the UK has vaccinated over 7.1 million people with a first dose of vaccine and nearly half a million received their second dose, which means more vaccinations have been received than Germany, France, Italy and Spain combined data numbers, according to Our World In.

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China Needed to Present Off Its Vaccines. It’s Backfiring.

China’s coronavirus vaccines were supposed to deliver a geopolitical win that showcased the country’s scientific prowess and generosity. Instead, in some places, they have set off a backlash.

Officials in Brazil and Turkey have complained that Chinese companies have been slow to ship the doses and ingredients. Disclosures about the Chinese vaccines has been slow and spotty. The few announcements that have trickled out suggest that China’s vaccines, while considered effective, cannot stop the virus as well as those developed by Pfizer and Moderna, the American drugmakers.

In the Philippines, some lawmakers have criticized the government’s decision to purchase a vaccine made by a Chinese company called Sinovac. Officials in Malaysia and Singapore, which both ordered doses from Sinovac, have had to reassure their citizens that they would approve a vaccine only if it has been proven safe and effective.

“Right now, I would not take any Chinese vaccine because there’s insufficient data,” said Bilahari Kausikan, an influential former official at Singapore’s Ministry of Foreign Affairs. He added that he would consider it only with “a proper report.”

At least 24 countries, most of them low and middle income, signed deals with the Chinese vaccine companies because they offered access at a time when richer nations had claimed most of the doses made by Pfizer and Moderna. But the delays in getting the Chinese vaccines and the fact that the vaccines are less effective mean that those countries may take longer to vanquish the virus.

Beijing officials who had hoped the vaccines would burnish China’s global reputation are now on the defensive. State media, meanwhile, has started a misinformation campaign against the American vaccines, questioning the safety of the Pfizer and Moderna shots and promoting the Chinese vaccines as a better alternative. They have also distributed online videos that have been shared by the anti-vaccine movement in the United States.

Liu Xin, an anchor with CGTN, the state broadcaster, asked on Twitter why the foreign media has failed to “follow up” on the deaths of people in Germany who have taken one vaccine — though scientists have said the people were already seriously ill. Ms. Liu’s tweet was shared by Zhao Lijian, a top spokesman at China’s foreign ministry.

George Gao, the head of the Chinese Center for Disease Control and Prevention, has questioned the safety of the American vaccines because their developers used new techniques rather than the traditional method embraced by Chinese makers.

China had hoped its vaccines would prove it had become a scientific and diplomatic powerhouse. It remains on par with the United States in the number of vaccines approved for emergency use or in late stage trials. Sinopharm, a state-owned vaccine maker, and Sinovac have said they can produce up to a combined two billion doses this year, making them essential to the global fight against the coronavirus.

Unlike the Pfizer and Moderna vaccines, their doses can be kept at refrigerated temperatures and are more easily transported, making them appealing to the developing world. They have been doled out as aid to countries like Pakistan and the Philippines.

China’s campaign has been plagued with doubts, however. Many people have memories of the country’s vaccine scandals. Several governments remain angry about Beijing’s lack of openness about the virus in the early days of the pandemic. Its efforts at the start of last year to distribute masks and protective equipment to the West came under fire amid reports of shoddy quality and the demands by Chinese officials for public thanks.

A YouGov survey this month of roughly 19,000 people in 17 countries and regions showed that most were distrustful of a Covid-19 vaccine made in China. The misinformation campaign surrounding Western vaccines could further undermine its image.

The delays in shipments to places like Brazil and Turkey have been the latest hitch.

In Turkey, the government initially promised that 10 million doses of the Sinovac vaccine would arrive in December. Only three million did in early January, according to Fahrettin Koca, Turkey’s health minister. He did not explain the reason for the shortfall, which has been criticized by opposition politicians. The remaining doses finally arrived on Monday, according to Anadolu, Turkey’s state-run news agency.

Covid-19 Vaccines ›

Answers to Your Vaccine Questions

If I live in the U.S., when can I get the vaccine?

While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.

When can I return to normal life after being vaccinated?

Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.

If I’ve been vaccinated, do I still need to wear a mask?

Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.

Will it hurt? What are the side effects?

The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.

Will mRNA vaccines change my genes?

No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.

In a statement, China’s foreign ministry cited its needs at home, where the coronavirus has re-emerged.

“Currently, China’s domestic vaccine demand is huge,” it said. “While meeting domestic demand, we are overcoming difficulties, thinking and trying ways to develop international vaccine cooperation with other countries, especially developing countries in different ways, and providing support and assistance according to their needs and within our capacity.”

The sporadic outbreaks could also hinder production. Sinovac, which declined to comment, said on Friday online that it was looking for workers for a Beijing-area facility where an outbreak had frightened off potential employees.

Countries like Turkey and Brazil are rolling out their immunization programs with a Sinovac vaccine because Western companies cannot deliver as quickly. But Brazil’s efforts have been delayed as well. Eduardo Pazuello, the country’s health minister, said China is not acting fast enough with the documents needed to export raw materials to Brazil.

“We are making strong moves at the diplomatic level to find where that resistance is and solve the problem,” Mr. Pazuello told a news conference last Sunday.

On Wednesday, Rodrigo Maia, Brazil’s speaker of the house, told reporters that he had met the Chinese ambassador to Brazil, who “made it clear that there is no political obstacle, that it was a technical process that was delayed a little.”

Other vaccines are beginning to fill the gap. Brazil’s health ministry announced on Thursday that a previously delayed shipment of two million doses of the Oxford-AstraZeneca vaccine would be arriving the next day from India.

The world was also caught off guard by the disclosure that the Sinovac vaccine may not be as effective as previously thought. Earlier, officials in Turkey said trials there showed the vaccine has a 91 percent efficacy rate. In Indonesia, it was 68 percent. In Brazil, researchers initially said its efficacy was 78 percent.

Then, on Jan. 12, scientists said it had an efficacy rate of just over 50 percent, once people who experienced mild symptoms were included. That level is a hair above the threshold set by the World Health Organization to consider a vaccine effective. In a news conference last week, Sinovac’s chief executive officer, Yin Weidong, reiterated that the vaccine is 100 percent effective in preventing severe cases. He said the lower efficacy rate was because the trial was focused on health care workers, who had a higher propensity of contracting Covid-19 than the general population.

Jair Bolsonaro, Brazil’s president and a critic of both China and its Covid-19 vaccines, pounced on the data. On Jan. 13, he mocked the vaccine’s efficacy rate, asking a supporter: “Is that 50 percent good?”

To be sure, the Chinese vaccines have a big appeal to many countries. More than 40 countries have expressed an interest in importing Chinese vaccines, according to China’s foreign ministry. Several world leaders, including President Reccep Tayyip Erdogan of Turkey and President Joko Widodo of Indonesia, have gotten a Sinovac vaccine.

But the spotty and inconsistent disclosures about the vaccines remain a problem. In the case of Sinopharm, the company said a vaccine candidate made by its Beijing Institute of Biological Products arm had an efficacy rate of 79 percent, but it did not disclose crucial details. Sinopharm didn’t respond to a request for comment.

In Hong Kong, a special administration region of China that has ordered 7.5 million doses of the Sinovac vaccine, officials have not received an application for emergency distribution nor any data from the Chinese company.

“Whether it is because they are not making enough or if they have no plans to send the vaccines to Hong Kong yet, I don’t know,” said Dr. Lau Chak Sing, who heads a Hong Kong government advisory panel on Covid-19 vaccines.

Data disclosure has also been an issue in the Philippines, which has secured 25 million Sinovac vaccine doses. Risa Hontiveros, an opposition lawmaker, said President Rodrigo Duterte’s administration “continues to cram their preference for Chinese-made vaccines down the public’s throat, without emergency use approval and with inconsistent data.”

Leila de Lima, a senator and opposition leader who is in prison, expressed anger that the government is paying $61 a dose, more than double what Sinovac’s partner in Indonesia is paying. The presidential palace said that price was overstated but it couldn’t divulge the real ones because of a confidentiality agreement.

Despite the uncertainty, many people may have little choice.

“I’ll have my jab,” said Kayihan Pala, a member of the Turkey Medical Association’s Covid-19 monitoring board. “I am waiting my turn, because there is no other option.”

Letícia Casado, Tiffany May, Elsie Chen and Jason Gutierrez contributed reporting.

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To Promote Vaccines, New Orleans Dances With Its Sleeves Rolled Up

Public health officials and politicians have repeatedly called for national vaccination campaigns since the summer. However, in the absence of a meaningful federal campaign, concerned local officials have started developing their own publicity.

New Orleans is possibly best positioned to be at the top. The city is regularly hit by hurricanes and has an emergency management office that works in the field of public messaging.

Covid19 vaccinations>

Answers to your vaccine questions

If I live in the US, when can I get the vaccine?

While the exact order of vaccine recipients may vary from state to state, most doctors and residents of long-term care facilities will come first. If you want to understand how this decision is made, this article will help.

When can I get back to normal life after the vaccination?

Life will only get back to normal once society as a whole receives adequate protection against the coronavirus. Once countries have approved a vaccine, they can only vaccinate a few percent of their citizens in the first few months. The unvaccinated majority remain susceptible to infection. A growing number of coronavirus vaccines show robust protection against disease. However, it is also possible that people spread the virus without knowing they are infected because they have mild or no symptoms. Scientists don’t yet know whether the vaccines will also block the transmission of the coronavirus. Even vaccinated people have to wear masks for the time being, avoid the crowds indoors and so on. Once enough people are vaccinated, it becomes very difficult for the coronavirus to find people at risk to become infected. Depending on how quickly we as a society achieve this goal, life could approach a normal state in autumn 2021.

Do I still have to wear a mask after the vaccination?

Yeah, but not forever. The two vaccines that may be approved this month clearly protect people from contracting Covid-19. However, the clinical trials that produced these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected with the coronavirus can spread it without experiencing a cough or other symptoms. Researchers will study this question intensively when the vaccines are introduced. In the meantime, self-vaccinated people need to think of themselves as potential spreaders.

Will it hurt What are the side effects?

The vaccine against Pfizer and BioNTech, like other typical vaccines, is delivered as a shot in the arm. The injection is no different from the ones you received before. Tens of thousands of people have already received the vaccines, and none of them have reported serious health problems. However, some of them have experienced short-lived symptoms, including pain and flu-like symptoms that usually last a day. It is possible that people will have to plan to take a day off or go to school after the second shot. While these experiences are not pleasant, they are a good sign: they are the result of your own immune system’s encounter with the vaccine and a strong response that ensures lasting immunity.

Will mRNA vaccines change my genes?

No. Moderna and Pfizer vaccines use a genetic molecule to boost the immune system. This molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slide inside. The cell uses the mRNA to make proteins from the coronavirus that can stimulate the immune system. At any given point in time, each of our cells can contain hundreds of thousands of mRNA molecules that they produce to make their own proteins. As soon as these proteins are made, our cells use special enzymes to break down the mRNA. The mRNA molecules that our cells make can only survive a few minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a little longer, so the cells can make extra viral proteins and trigger a stronger immune response. However, the mRNA can last a few days at most before it is destroyed.

At the beginning of the pandemic, a “Masks Up, NOLA!” Slogan. As the virus raced through the neighborhoods, Laura A. Mellem, the city’s public engagement manager for its NOLA Ready program, was well aware that black New Orleans were being hit in disproportionate numbers. Blacks make up about 60 percent of the city’s population, but nearly 74 percent of Covid-19 deaths.

“But the communities hardest hit by the virus are probably the most reluctant to get the vaccine because they have long been abused in the name of science,” Ms. Mellem said.

How can you convince them to get the shot?

In November, the city assembled the Vaccine Equity and Communications Working Group, a coalition of high-profile public health doctors, religious leaders, leaders from Black, Latin American, and Vietnamese communities, and leaders of the city’s major social clubs. The group completed surveys and identified cultural icons that would appeal to residents.

Instead of focusing the news on the misery caused by the pandemic, Ms. Mellem decided to emphasize an ambitious and welcoming tone, a central finding from behavior change research and thought leaders in cities like San Francisco. As Edward Maibach, Professor of Public Health Messaging at George Mason University writes, the most effective communication makes “the behavior we encourage simple, fun and popular.”

“I get my shot so I can visit my 92-year-old mother and eat in our favorite restaurants,” says Julie Nalibov of the Krewe of Red Beans, who helps the city’s ailing cultural artists, many of whom are over 70.

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United Airways CEO needs to make Covid vaccines necessary for workers

A health care professional wears personal protective equipment (PPE) during a United Airlines Covid-19 test pilot program at Newark Liberty International Airport in Newark, New Jersey, the United States, on Monday, November 16, 2020.

Angus Mordant | Bloomberg | Getty Images

United Airlines CEO wants Covid-19 vaccines to be mandatory for employees and encourages other companies to do the same.

This attitude is different from other airlines and companies in other sectors such as retail and auto manufacturing.

“The worst thing I think I’ll ever do in my career are the letters I wrote to the surviving family members of employees we lost to the coronavirus,” CEO Scott Kirby said Thursday in an employee’s town hall, a transcript of which has been verified by CNBC. “Because I have confidence in the safety of the vaccine – and I recognize this is controversial – I think it is right for United Airlines and other companies to require the vaccines and make them mandatory.”

United had more than 60,000 active U.S. employees as of late 2020 and has sent recall notifications to around 17,000 other workers whose jobs were cut last year.

Kirby acknowledged the logistical challenges of vaccinating staff.

Airline employees are considered important workers and will likely receive the vaccine in front of many people. But the rollout so far has been slow and chaotic as the nation ran after the goals.

Airline executives have said widespread vaccination will help revive demand for air travel as airlines grapple with losses running into billions.

“I don’t think United can get away with it and realistically be the only company that needs vaccines and makes them mandatory,” he said. “We need some others. We need some others to show leadership. Especially in the healthcare industry.”

The staff note said it is working with government officials and health care providers to set up vaccine distribution centers at some of its major hubs.

Some employees have been reluctant to take vaccines.

“It’s certainly a touchy subject,” said Michael Klemm, president of the International Association of Engineers and Aerospace Workers, District 141, who represents United’s fleet and passenger services staff, in an email. “We have received some frustrations from members who do not want to take the vaccine and concerns from members who do not want to work with someone who is not taking it.”

Klemm said the union members could file a complaint about disciplinary measures resulting from their refusal to be vaccinated. If they refuse to be vaccinated because of a religious belief or disability, they can file complaints with the Federal Equal Employment Opportunity Commission.

United Flight Attendants’ union, the Association of Flight Attendants, said its focus is on ensuring vaccine access for crew members.

“Right now, flight attendants are at different levels of access in each state,” AFA spokeswoman Taylor Garland said in a statement. “We need a federal approach that prioritizes flight attendants as the essential workforce that facilitates international trade.”

Other airlines have not announced plans to prescribe vaccines.

Southwest Airlines said last week that it “currently” does not require employees to receive Covid-19 vaccines, but has strongly encouraged employees to do so.

American Airlines is taking a similar approach, and announced to staff last week, “We do not plan to require our team members to receive the vaccine unless vaccinations are ultimately required to travel to specific destinations.”

Meanwhile, Delta Air Lines said it is “working actively with all states to understand how Delta employees are prioritized in the initial distribution of vaccines.”

The Atlanta-based airline has encouraged employees to get vaccinated. On Wednesday, the company told flight attendants that their pay would be protected if they responded to a vaccine that prevented them from working and that they would receive an additional six hours of pay after receiving the second dose of the vaccine as seen by CNBC.

United in a staff note this week urged employees to get vaccinated as soon as possible and not wait for guidance from the airline.

Some companies are trying to convince workers to get the vaccine by offering additional wages. Yogurt and food company Chobani said it will give employees in its manufacturing facilities and offices up to six hours of paid time to get the two vaccinations.

So far, some retailers like Aldi, Lidl and Dollar General have announced similar plans to offer additional payment. Aldi said it would also like to open on-site vaccination clinics in its warehouses and offices to make it easier for workers to get the shots and remove the barriers to childcare or finding transportation.