Tracking Variants, New Hot Spots, and More Coronavirus News

Researchers trace new variants in Africa, cases surge in India, and US vaccine rollout progresses even with snags. Here’s what you should know:

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Scientists in Africa race to find new variants in areas where testing lags

This week, a coalition of scientists and labs across Africa published a preprint on a novel variant first detected in travelers entering Angola. The research is part of a new effort to identify and sequence samples in the region, and hopefully strengthen scientists’ understanding of how the virus is moving across the continent. This can be difficult in areas where testing lags, but it’s an international imperative. Vaccine distribution efforts in Africa are slow-going as wealthy nations have hoarded initial shots, which means the virus could continue to spread and mutate for a long time.

Meanwhile, in Europe and the US, several more contagious variants—notably B.1.1.7, which was first seen in Britain—are thought to be behind a rising share of new cases. This week, the CDC said that this variant is now the dominant source of new infections in the US.

India struggles to keep up vaccinations as cases skyrocket

India is quickly emerging as a new global hotspot. New infections have topped previous records multiple times this week and the death toll is climbing higher than it’s been since November. To date, 90 million shots have been administered in the country, most of which are the first of two doses, meaning that only a small share of the country’s 1.3 billion people are even partially protected.

What’s more, vaccines in India are now reportedly in critically short supply. Mumbai’s mayor said Friday that without additional supplies the city will run out of shots on Saturday. The Serum Institute of India, which is the world’s largest vaccine maker, already halted exports earlier this month, citing the need to fight mounting infections at home. The drugmaker’s chief executive said exports could restart by June but this may still have a significant bearing on global supply.

Vaccine rollout continues to move quickly in the US, but not without stumbling blocks

Vaccinations continue apace in the US. Earlier this week, President Biden announced that 150 million shots had been administered, putting the country on target to meet his goal of 200 million doses by his hundredth day in office. Biden also moved up the deadline for making all adults eligible for vaccination to April 19, though many states have already done so. Around 20 percent of the country is now fully vaccinated. However, some officials predict that next week could complicate mass vaccination plans, as Johnson & Johnson deliveries are expected to drop by more than 80 percent in the wake of manufacturing struggles.

There have been other hitches in the country’s vaccine rollout as well. On Thursday, two mass vaccination sites closed temporarily after several people had adverse reactions. Medical experts say there’s no reason to believe anything is wrong with the vaccines. Elsewhere, mounting numbers of unclaimed appointments in states like Mississippi show that there are still many people who are hesitant to get vaccinated.

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One Question

How is the pandemic impacting cities?

Urbanists have heralded the pandemic as a potential opportunity to remake cities for the better, prioritizing the experience of pedestrians and bikers over cars and figuring out ways to make buildings breathe better. Other researchers have noticed that the ways urban crime dropped in 2020 provide important information that could help cities increase safety, and do so more equitably, even after the pandemic. Still, there’s no doubt that the pandemic has taken a toll on urban life. One example: Mass transit, the lifeblood of cities like New York, is in serious jeopardy.


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New Travel Guidelines, Real-World Vaccine Efficacy, and More

The efficacy of vaccines in the real world, updated travel guidelines for the inoculated, and yet another rise in cases worldwide. Here’s what you should know:

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A real-world study finds that approved vaccines are highly effective as drugmakers work to expand access

Earlier this week, the Centers for Disease Control published results from a study that found that the Pfizer-BioNTech and Moderna vaccines appear 90 percent effective at protecting against Covid-19 in the real world. The data is yet another promising indicator that these vaccines work really well, but, importantly, this doesn’t mean that they offer complete protection—masking and distancing in public are important even if you’ve received both shots. As the last year has made eminently clear, our understanding of this disease, and how to fend it off, is constantly evolving, so it’s important for everyone to continue taking all the precautions that we know to be effective.

Meanwhile, the drug companies are working to expand approval and distribution. Pfizer announced this week that its vaccine appears to be safe and effective in teens as young as 12, while Johnson & Johnson kicked off its own trial for people ages 12 to 17. And on Thursday, the Food and Drug Administration announced that it will let Moderna put up to 50 percent more doses in each vial in an amendment to its emergency use authorization. The change is expected to speed up distribution.

The CDC says that fully vaccinated people can travel if they take other pandemic precautions

This morning the CDC issued new travel guidelines for people who have been fully vaccinated, saying that it’s low-risk for them to travel domestically and internationally, though they should continue to take other precautions like wearing a mask and abiding by social distancing guidelines. The potential return to activities like air travel has sparked questions about how people will prove they’ve been vaccinated. There’s been talk of “vaccine passports,” and many plans to create them are underway, but doing so in a way that’s ethical and equitable, and protects people’s privacy, may be a challenge.

This latest update from the CDC comes just a few days after its director warned Americans not to ease Covid-19 restrictions just yet. Many Americans are giddy at the thought of a semi “normal” summer, but until vaccines are widespread, this virus will continue to evolve and spread.

Cases rise worldwide, with some countries instituting new lockdowns while others resist taking precautions

In recent days, countries around the world including Turkey and Bangladesh have logged their highest daily case counts yet. The situation in Brazil continues to be particularly dire. São Paolo, its largest city, recorded record daily burials this week, with cemeteries staying open until 10 pm and gravediggers exhuming old graves to make room for new deaths from Covid-19. Even so, President Jair Bolsonaro still refuses to impose a lockdown or any other stringent measures that could curb the virus’ spread.

Cases also continue to rise in Europe, a situation for which the World Health Organization says the region’s “unacceptably slow” vaccination efforts are to blame. Right now 27 European countries are in partial or full lockdown, including France, which will extend its measures to encompass the whole country for four weeks starting on Saturday.

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A New Vaccine Goal, a Hasty Return to ‘Normal,’ and More News

President Biden sets a new vaccination goal, Europe curbs its vaccine exports, and experts caution against a hasty return to “normal.” Here’s what you should know:

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Biden sets a new goal of administering 200 million vaccines by April 30

On Thursday, less than a week after the US doled out its 100 millionth vaccine, the president announced that his administration has a new goal: distributing 200 million shots by his hundredth day in office, April 30. If the country maintains its current average vaccination rate, we’ll hit that goal ahead of schedule. In an effort to accelerate further, more states have announced plans to make vaccines available to all adults in the coming month, including Florida and California.

After a rocky start, vaccine manufacturing is also increasing rapidly: The US monthly output for its three authorized vaccines is expected to be 132 million doses in March, up from 48 million in February. Morgan Stanley has estimated that three-quarters of Americans over 12 should be vaccinated by the middle of the summer. Still, it’s hard not to be impatient: The vaccine FOMO is real. So much so that the dark web is teeming with vaccine listings in an attempt to capitalize on some people’s eagerness to skip the line.

Europe limits vaccine exports as cases surge and partial lockdowns go back into place

On Wednesday, the European Commission laid out a plan to curb vaccine exports for six weeks as rollout in the region continues to stall. The EU has said pharmaceutical companies, particularly AstraZeneca, are largely to blame; the drugmaker has struggled so far to deliver the doses it promised to the EU. These new rules are likely to affect Britain, which has thus far been the biggest beneficiary of vaccines manufactured in the EU. The Commission said it will take reciprocity, a country’s epidemiological situation, and its vaccination rate into account when making decisions about exports.

Right now, the situation in Europe is growing increasingly dire. Beyond supply issues, bureaucratic inaction and other logistical problems have slowed vaccinations as well. Countries including Italy and France have implemented partial lockdowns. Experts have said that Americans should heed the surge in Europe as a reminder to stay vigilant.

A return to “normal” seems closer, but the US isn’t there yet

As vaccinations continue, there has been more and more talk of the end of the pandemic, and a return to “normal” in the US. But after a year of living in lockdown and constant fear, readjusting won’t happen overnight, even when it does seem definitively safe. And at the moment, experts say, it would be a mistake to move too quickly toward a full reopening. Americans still need to be cautious when calculating risk.

Earlier this week, CDC director Rochelle Walensky said that she’s concerned eased restrictions and a recent uptick in spring break travel could spell trouble. And in a press conference today, she reinforced this, pointing to this week’s rise in average new cases nationwide and slight increase in hospitalizations. The end may be closer, but it’s not here yet.

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One day, 10-year-old Timothy was excited about chess practice and Mandarin class. The next, he was obsessive and suicidal. All of his doctors agreed that something was wrong, but they couldn’t agree on what. The boy and his family had stumbled into a hotly contested corner of pediatric medicine.

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One Question

Could humans give SARS-CoV-2 to other animals?

It’s likely that the novel coronavirus spilled over into humans from bats, though no one knows exactly where or how. Now, a small group of scientists is studying the possibility that the virus could jump from humans back to other animal species. This is called “spillback,” and there are already signs it’s happening (like the mink outbreak in Europe last winter). Experts say that creating a better system for surveilling how SARS-CoV-2 moves between animals will be key to preventing further viral mutation and spread in the long term.


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A Boy, His Brain, and a Decades-Long Medical Controversy

In 2014, a story about one of Frankovich’s patients made the pages of a local newspaper. Other doctors had diagnosed the little girl with bipolar disorder, but the Stanford team treated her for PANS, and she’d made a dramatic recovery. The article, Frankovich says, marked “a very low point in my career and life.” It brought on a renewed wave of criticism, which was bad enough. Even worse, Frankovich says, it gave hope to vastly more patients and families than she and her colleagues would ever be able to treat. “We got absolutely crushed with phone calls and emails and people just showing up,” she recalls. “It was a nightmare.” But the article was also a turning point: Frankovich soon got an offer of support from the hospital’s chief operational officer. She requested a clinic room and a half-time coordinator.

As the calls and emails kept coming, Frankovich’s team would sift through thousands of medical records, looking for patients with the clearest-cut cases of PANS. She estimates they were able to treat one in 10 patients who applied, if that. They met families who had sold their cars and refinanced their homes to pay for their children’s medical care. Many said, like Rita, that Frankovich’s clinic was the first place they felt hope.

Doctors have been proving other doctors wrong for millennia. Established credo has been overturned many times, only to be replaced with new information and new beliefs about science and medicine. In the 19th century, perhaps one in five British men who were admitted to a mental hospital suffered what was then called general paresis of the insane, a crippling condition that ended in delusions of grandeur, paralysis, and death. As the poet Kelley Swain writes in The Lancet, the Victorians considered it “a disease of dissolution and disrepute,” more moral than biological. We have a different name for the disease now, neurosyphilis, and a treatment, penicillin. But in the decades it took for medical science to cross that threshold, people were left to suffer in shame without proper treatment.

Many PANS patients and their families feel stuck on the wrong side of the threshold. “The system is not there for them in the same way it is for other illnesses,” Frankovich says. She points out that a child undergoing treatment for a brain tumor gets access to a specialized ward and a team of medical professionals and social workers. “But when a kid comes in with a mental health deterioration and their brain MRI is normal,” she says, the support network “walks away from them.” The families become so desperate for treatment, Frankovich adds, that “they can appear very dysfunctional and disorganized, and they can be very aggressive with trying to get their child help.” (Several PANDAS skeptics declined to be interviewed for this story, saying they feared online harassment.)

Jonathan Mink, a pediatric neurologist at the University of Rochester Medical Center, attributes the heightened emotions to a mismatch between what families want—an answer, a treatment—and what medical science is equipped to provide: “Some people come up to me and say, ‘I know you’re not a believer in PANDAS, and I say, ‘It’s not about believing in PANDAS. I believe in the data, and right now the data on PANS and PANDAS is inconclusive.’ ” He adds, “The underlying hypothesis is reasonable, but the data is very mixed. So how do we approach things when we physicians are uncertain?”

Stanford Shulman, the early PANDAS critic, also stressed the need for better data. “Should all older adults take an aspirin once a day? Because that was dogma for a long, long time,” he says. “But then studies came along in the New England Journal of Medicine, very large studies demonstrating no benefit and potential side effects, so we do have to change our mind.” He adds, “If we’re proven wrong, and really proven wrong, then we have to change our opinions, and that’s true for all medicine.”

For the past several years, Frankovich has been trying to raise money and recruit patients for a comprehensive, long-term study of PANS, which would follow 600 children for as long as 12 years. “We need proper funds to provide the kind of robust evidence that could end the controversy,” she says. “My colleagues have applied for NIH grants to study PANS and PANDAS, and despite their proven accomplishments they failed to get government funding. So how do we provide the evidence that this is real?”

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Even Mild Brain Injuries Raise the Risk of Dementia Years Later

You don’t have to be a professional football player to get a solid conk on the head. By one estimate from medical researchers, over 27 million people around the world sustain a traumatic brain injury every year. Some are from car accidents, others are from falls, or taking a header on the soccer field. But a growing body of evidence shows that even mild hits to the head can cause long-term damage and heighten the risk of neurological disease.

The brain is soft and usually cushioned from our skulls by cerebrospinal fluid. But when something hits the head hard enough, our brains get jostled and can smash into that hard bone, causing swelling or bleeding. That can lead to concussion symptoms like short-term memory loss or confusion. (Not every concussion causes people to black out or feel nauseous or dizzy.)

A new study published this month in the journal Alzheimer’s & Dementia draws from a large data pool tracking Americans whose health outcomes have been tallied for the last 25 years. The authors find that head injuries, even mild ones, are associated with a long-term increase in risk of dementia. The study also found that the more head injuries people sustain, the greater the risk of developing dementia.

Dementia is a general term for memory and cognitive losses caused by changes in the brain. The most common type is Alzheimer’s disease, a progressive and irreversible disorder in which tangles of proteins interrupt how neurons communicate with each other. But there are other types of dementia, including vascular dementia, which occurs when there isn’t enough blood flow supplying oxygen to the brain, and frontotemporal dementia, which is caused by a loss of cells in the front and side regions of the brain that can drastically alter personality and behavior.

The researchers hope that this new information will add to growing awareness about the implications of head injuries and the importance of preventing them. “That’s really one of the most important take-home messages from this study, because head injuries are something that are preventable to some degree,” says Andrea Schneider, a neurologist at the University of Pennsylvania and the lead author of the paper. “You can do practical things like wearing bike helmets or wearing your seatbelt.”

Previous studies have demonstrated a similar relationship between head injuries and dementia, but most focused on specialized populations like military veterans. Schneider says this study is one of the first to look at the relationship in a general, community-based population, which might be more representative of the average person.

Schneider and her colleagues at the University of Pennsylvania analysed data from over 14,000 participants in the Atherosclerosis in Communities study, an ongoing effort which has followed people between the ages of 45 and 65 in Minnesota, Maryland, North Carolina, and Mississippi since 1987. The study was meant to track the environmental and genetic conditions that might contribute to heart disease, but the researchers also collected medical records and asked participants to self-report any head injuries.

When the University of Pennsylvania researchers analyzed the data on traumatic brain injuries, they found that people who sustained one head injury were 25 percent more likely to develop dementia than those who did not. That risk doubled for those who had sustained two or more head injuries.

There are other health factors that could play a role, too. Genetics make some people more prone to dementia; some forms are heritable or accompany other progressive disorders like Parkinson’s and Huntington’s disease. Other risks include vascular problems like diabetes and high blood pressure, environmental influences like pollution, and lifestyle choices like smoking. But Schneider says head injury is a significant factor. “We were able to say that about 9.5 percent of all cases of dementia in our study were attributable to head injury,” she says.

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100 Million Vaccines, New School Guidelines, and More News

Biden meets his vaccination target, the CDC says students can be 3 feet apart, and cases surge in Europe. Here’s what you should know:

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Biden meets target of 100 million vaccinations 58 days into his term

President Biden announced that today, 58 days into his presidency, his administration will meet its goal of doling out 100 million coronavirus vaccines within its first 100 days. Yesterday the White House also announced that it plans to “loan” a combined 4 million doses of the AstraZeneca vaccine to Mexico and Canada. The vaccine has been authorized for use by the WHO but not yet by regulators in the States, and the US has stockpiled tens of millions of doses while awaiting emergency use authorization.

Individual states have also made good progress. After President Biden announced last week that he aims to make vaccines available to all adults by May 1, at least 17 states have moved even more quickly. In Mississippi and Alaska, appointments are already open to anyone age 16 and older. In Ohio, all adults will be able to sign up for shots starting March 29, and a number of other states have outlined plans for expanding eligibility in April. However, there is concern about who an age-based system leaves behind. Disability rights advocates have expressed anger at the way vulnerable populations are being forgotten. And in some places, vaccinating incarcerated people continues to be a struggle.

CDC amends school guidelines, paving the way for more classrooms to reopen

On Friday morning the CDC updated its guidelines for schools, saying that with universal masking, students should stay 3 feet apart from one another, rather than 6. This change is expected to allow many more schools to resume in-person classes. Earlier this week, the Biden administration also said it would put $10 billion toward screening students and teachers so that more schools can reopen.

Outside of the classroom, many states have inched closer to reopening this week: New Jersey is increasing indoor capacity for gyms and restaurants, and New York announced that Yankees and Mets games will be open to fans this season. Still, experts warn that accelerating reopening now would be a mistake. While the national daily case average continues to fall, as do hospitalization rates nationwide, the average number of cases has gone up at least 10 percent in 15 states. And worryingly, Michigan in particular is seeing a dramatic increase in hospitalizations.

Cases surge in Europe as regulators affirm AstraZeneca’s safety

The European Medicines Agency asserted that the AstraZeneca vaccine is safe after more than a dozen countries paused their rollout of the shot amid concerns that it could cause blood clots. The EMA did add that a new warning label will be appended to the vaccine so professionals are on guard for a potential rare complication that could lead to blood clots and bleeding in the brain; however, experts remain staunch in their insistence that the science proves the vaccine is safe. Overall, they say, the shot will prevent much more illness and death than it could cause.

Following the announcement, countries including France and Germany said they would resume administering the AstraZeneca vaccine immediately, and leaders including Boris Johnson said they would receive the shot in order to encourage the public to do the same. Building vaccine trust and expediting rollout are imperative in Europe as the region faces yet another uptick in cases: Parts of Italy and France went back into lockdown this week, and German leaders are mulling extending the current lockdown to curb the virus’s rapid spread.

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How has Covid-19 gummed up the court system?

The pandemic has complicated courts’ attempts to uphold the rights to public access and to fair and open trials, which was often a struggle even before much of the country went remote. With in-person proceedings limited at best, officials have turned to video and phone conferences, which can be unpredictable and glitchy. Virtual proceedings make it harder for lawyers and clients to communicate with each other during hearings. And while remote proceedings eliminate courthouses’ accessibility issues, there are other barriers to access, particularly for people with disabilities. Going virtual can also pose issues for people without reliable internet at home, particularly among historically marginalized communities.


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The Pandemic Turns One, Vaccine Trials Adapt, and More News

The pandemic has raged for a year, vaccine trials contend with approved shots, and Biden signs a $1.9 trillion relief bill. Here’s what you should know:

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The Covid-19 pandemic turns one year old

This week marked one year since the WHO declared Covid-19 a pandemic and the seriousness of the situation seemed to crystallize in the national consciousness. In a televised anniversary address on Thursday night, President Biden offered heartening news: His administration is on track to distribute 100 million vaccine shots in his first 60 days, and expects to give out 2 million a day going forward. What’s more, he said he will direct states to make all adults eligible to be vaccinated no later than May 1.

All of this means that if we’re diligent about abiding by public health guidelines like mask-wearing and social distancing even after we’ve been vaccinated, the end of this pandemic, at least as we know it, may be imminent. But what exactly does it mean to return to “normal”? Psychologically, experts say recovering from the trauma and uncertainty of the past year won’t happen overnight. As we emerge from survival mode, we’ll have to renegotiate how and whom we live with and love. Relationships with friends and family may have been tested during this time, and many of us have lost loved ones.

Ongoing vaccine trials must adapt to contend with approved shots

As the vaccine rollout accelerates, drugmakers are facing a new dilemma: getting people to sign up for trials for new shots, where they might get a placebo instead of the real thing. In response, some are investigating new ways to run trials, like comparing their vaccine against one that’s already been authorized. Nevertheless, new shots are getting closer to being approved. Novavax, for one, released encouraging efficacy data from its UK trial on Thursday, and it expects initial results from a 30,000-person trial in the US and Mexico in early April.

The EU’s vaccine rollout made progress this week, even as it also faced setbacks. On Thursday, Johnson and Johnson’s shot became the region’s fourth approved option. But a number of countries have paused their use of AstraZeneca’s shot over concerns that it could cause blood clots. Nonetheless, Europe’s drug regulator urged countries to press ahead, saying there’s no evidence yet that the AstraZeneca vaccine is to blame and that the benefits of the shot still outweigh the risks. 

Biden signs $1.9 trillion relief bill as the US prepares to rebuild

On Thursday, President Biden signed the US’ $1.9 trillion coronavirus relief bill into law. The aid package will allocate more than $6 billion to food-security programs, extend already expanded unemployment assistance, and send $1,400 checks to many Americans as soon as this weekend. Democrats and progressive policy advocates are heralding it as a much-needed, permanent expansion of the social safety net, while Republicans questioned the need for the bill when many states seem to be moving toward reopening on their own.

This bill is just one of the many ways that this pandemic, and our post-pandemic recovery, have the potential to fundamentally reshape society. Covid-19 has pushed many American cities to rethink how they use space, reducing the area set aside for parking to make way for bikers and pedestrians. And many parents are coming away from a challenging year of largely remote learning with a keen sense of the structural changes our education system needs

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Why do we need Covid-19 data that accounts for sexual orientation and gender identity?

Many officials are hesitant to collect medical data that asks people for information about their sexual orientation and gender identity. But according to a new study from the CDC, sexual minority Americans have significantly higher rates of a number of chronic medical conditions that often correlate with more severe cases of Covid-19. Having more information about this would make it easier to gauge the toll of this pandemic on LGBTQ+ communities and tailor public health responses accordingly. Even including an option field on intake forms, surveys, and more could help us better understand the specific risks and needs of a vulnerable community.


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The Pandemic Can’t End While Wealthy Nations Hoard Shots

Those two organizations have aimed to right the imbalance by sponsoring an organization called Covax, a partnership of the WHO and UNICEF with two nonprofits, the Coalition for Epidemic Preparedness Innovations and Gavi, the Vaccine Alliance. Covax, which launched last June, bundles donor money from high-income nations with purchase commitments from low-income countries to guarantee those countries will receive vaccines. (The Trump administration refused to join Covax; President Joe Biden reversed that decision on his first day in office and last month committed $4 billion.)

On February 24, Ghana became the first country to receive vaccines from the Covax scheme, 600,000 doses of the Oxford-AstraZeneca single-dose formula; that was followed a few days later by doses arriving in Côte d’Ivoire. By last week, the cooperative had sent vaccines to 14 countries in sub-Saharan Africa, southeast Asia, and the Pacific Rim, and predicted it will be able to distribute 237 million doses worldwide by the end of May.

Still, the amount of vaccine that Covax can command is a fraction of what rich countries have agreed to purchase directly. As of March 1, according to the Launch and Scale Speedometer at the Duke Global Health Innovation Center, the high- and upper-middle-income countries of the world—including the US, Canada, the United Kingdom, the European Union, and Japan—have collectively booked 5.8 billion doses. Covax has secured contracts for 1.1 billion.

This is “an abject moral failure,” says Ruth R. Faden, a Johns Hopkins professor and founder of its Berman Institute for Bioethics, who serves on a WHO working group on Covid-19 vaccines. “It’s as if the wealthy countries of the world have gone shopping and cleared the shelves before the other countries of the world could even get inside.”

The problem isn’t only that manufacturers’ shelves are bare (and, to extend the metaphor, that rich countries’ panic pantries are full). By pulling multiple countries into a buying collective, Covax was supposed to gain the ability to negotiate lower prices that poor nations could afford. Rich countries’ cutting their own deals undermines that. And in a further twist, some of those countries are using their vaccine commitments as levers for diplomacy. Both Russia and China have encouraged their manufacturers, which are state-affiliated, to cut deals with Asian and Latin American nations, a subtle way of gaming political influence. (Vaccine nationalism cuts both ways, though. Last Thursday, invoking a European Union compact, the Italian government refused to let AstraZeneca sell vaccines made in the EU to Australia, contending that Italy needs them more.)

Multiple proposals are circulating to solve the international imbalance, by imposing a universal ethical framework for distribution, prioritizing by each country’s population or number of health care workers, or sharing technology and loosening countries’ hold on vaccine IP. Yamey has suggested rich countries be required to tithe their purchases, redirecting one dose to Covax out of every 10 purchased. Norway’s government already has done a form of this, pledging to donate doses at the same rate that it uses them at home, and UK officials have proposed donating extra doses once their domestic vaccine campaign ends. “If there was political will, or if there was a greater urgency or a willingness to step away from vaccine apartheid,” Yamey says, “we would all be better off.”

Meanwhile, globally and within the US, a second ethical question is rising. It has always been understood that delivering doses to some of the most difficult places to reach would be much easier with a vaccine that can be transported at room or refrigerator temperature, instead of the home-freezer temperatures required by the Moderna formula and the ultra-cold lab-freezer levels needed to preserve the Pfizer-BioNTech one. Ideally, a vaccine for the most difficult-to-reach last miles would also deliver protection in a single dose, to solve the problem of having to track people down a second time or require them to walk long distances or travel over rough terrain.

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The US Has a Covid ‘Scariants’ Problem. Here’s How to Fix It

This sequencing boost is helping scientists map in finer detail the mutational landscape of the coronaviruses circulating around the country. So it’s not surprising that they’re starting to turn up more surprises. But as the pace of generating genomic data has accelerated, there has not yet been a similar, concerted push forward in what’s called “variant characterization.”

Sequencing can help you identify mutations that might be problematic. But it can’t tell you if those mutations make that version of the virus behave differently than others. For that, you need to conduct studies with antibodies, living human cells, and animal models. Each type of experiment or analysis requires a unique set of skills, and there are many different methods for measuring the same things. You need immunologists, structural biologists, virologists, and a whole bunch of other -ologists, too. And, ideally, you’d want them to all adhere to the same scientific standards so you can compare one variant to the next and determine if a new strain is concerning from a public health standpoint or merely interesting

In the US, the CDC is the primary body with authority to designate any emerging strains as either of “variants of interest” or “variants of concern.” Crossing that threshold requires strong evidence that a particular constellation of mutations confers the ability to do any one of four things: spread faster and more easily, inflict more severe disease, weaken the effectiveness of Covid-19 treatments, or elude antibodies produced either from vaccination or during prior infection with an older version of the virus.

So far, the agency has only elevated three new versions of SARS-CoV-2 to the most concerning category: B.1.1.7, which was first detected in the UK, B.1.351 from South Africa, and P.1 from Brazil. (Though there’s an ongoing fight over which code-naming system to use, most scientists have agreed to steer clear of the “insert-place-name-here” nomenclature for its imprecision and stigmatizing effect. For simplicity’s sake, we’ll refer to B.1.1.7, B.1.351, and P.1 from here on out as the Big Three.)

But the agency is currently tracking additional variants of interest—including B.1.256 out of New York and B.1427/429 in California—and keeping tabs on ongoing studies to assess these strains’ ability to evade immune responses and erode the protections afforded by existing vaccines. As new data becomes available, the agency may bump up any particularly worrying variants to this top tier. “The threshold for designating a variant of interest should be relatively low in order to monitor potentially important variants,” a CDC spokesperson told WIRED via email. “However, the threshold for designating a variant of concern should be high in order to focus resources on the variants with the highest public health implications.”

The spokesperson did not provide details on what the agency considers “strong evidence,” but said the CDC has been involved with international partners including the World Health Organization in discussing criteria for variant designation.

In other words, it’s not just a matter of finding new variants, it’s a matter of characterizing their biological behavior—what does it mean for someone to get infected with one versus another? “Getting sequences is just the beginning of the story,” says Topol. “There’s much more science that has to happen to know if a mutation is meaningful. And right now, lots of labs that are publishing on this are just looking at one part of the story, because that’s the quick thing to do. But what’s quick can also be misleading.”

For example, a number of studies in recent weeks have shown that antibodies trained to attack older versions of the virus have a much harder time recognizing the B.1.351 and P.1 variants. That’s raised alarms about vaccine effectiveness. But just because antibodies don’t fight these new mutants as well in a test tube doesn’t mean your immune system will have the same problems in a real-world Final Boss Fight. The immune system is more than antibodies, and far fewer labs have the expertise necessary to conduct tests with live T cells, the other major player in developing Covid-19 immunity. These cells, which clear the virus by culling herds of infected cells, are finicky to grow outside the human body. So it’s taken a little while longer to understand how they respond to the variants. But new data suggests they respond just fine.

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J&J Shots Administered, States Reopen Too Soon, and More News

The first Johnson & Johnson shots are administered, some states begin opening prematurely, and new variants demand vigilance. Here’s what you should know:

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Headlines

US vaccinations increase as the first Johnson & Johnson shots are administered

It was a good week in vaccine news. Johnson & Johnson’s Covid-19 vaccine was approved for use, and the first doses were administered shortly thereafter. Johnson & Johnson has had some difficulty ramping up manufacturing, but on Tuesday, President Biden announced that a competing drugmaker, Merck, would help manufacture the shots at its factories. With this boost, the White House projects that there will be enough vaccines for every American adult by the end of May.

Because the Johnson & Johnson shot requires just one dose and can be stored at regular refrigerator temperatures, some have touted it as a good option to send to harder-to-reach, more rural communities. While the vaccine has proven highly effective, some lawmakers have expressed concern that this could create the feeling that there’s a two-tiered distribution system. That said, so far ruralness has actually proven to be a vaccine distribution asset in states like North Dakota, which has administered more than 90 percent of its doses week after week.

States try to navigate the many unknowns of reopening

As of Thursday, more than 20 percent of American adults have received at least one dose of a coronavirus vaccine. As increasing numbers of people are inoculated, the country is entering a strange gray zone, where individuals and states are disputing how much, if at all, it’s OK to return to pre-pandemic living. It seems pretty clear that all of the approved vaccines stop some infection and transmission, but we don’t know exactly how much. Regardless, experts agree: It’s too soon to declare victory.

Even so, this week saw several states rolling back key pandemic restrictions. In Texas and Mississippi, governors Abbott and Reeves rescinded key provisions, including their statewide mask mandates, decisions that President Biden blasted as “Neanderthal thinking.” Alabama’s governor announced Thursday that her state will follow suit and lift its mask mandate in early April. And Connecticut will do away with many of its Covid-19 restrictions later this month, though mask wearing will still be mandatory.

Experts call for vigilance as we work to understand new virus variants

To fully end this pandemic, we’ll need to understand how this virus changes and evolves within and among people. Recent months have thrown this into relief, as more variants or Sars-CoV-2 have been identified and made headlines. Many of these aren’t necessarily cause for alarm. In a recent interview with WIRED, for example, Anthony Fauci said that a new variant first identified in New York City is unlikely to cause major issues.

But that’s not to say that we shouldn’t be watching some of these mutations closely. Brazil, where a new variant appears to be spreading rapidly, recorded its highest single-day death toll on Tuesday. Experts have affirmed that this is all the more reason to stay vigilant, even post-vaccination. “Please hear me clearly,” CDC director Rochelle Walensky said earlier this week, “At this level of cases with variants spreading, we stand to completely lose the hard-earned ground we have gained.”

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One Question

How can teachers tap into students’ strengths during remote learning?

There are a few key things teachers can do to help older students in particular press ahead with remote learning. First, it’s important to understand, acknowledge, and connect with the collective and individual traumas we’ve all experienced this year. This can help students see school as an escape from the real world, and boost their engagement. Thoroughly planning virtual classes and making sure they’re very interactive is also key. And, as always, flexible thinking creates the space for students to each participate in their own way, which makes a world of difference.


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