The latest good vaccine news comes from AstraZeneca, which reported yesterday that its COVID-19 vaccine—made from a disabled cold virus, modified to deliver genetic material from the coronavirus—was up to 90% effective. Unless of course it was 62% effective. Or 70%. All three numbers caused some public confusion, but as my colleague Alice Park explains, it all makes immunological sense.
Among people who received a half dose of the AstraZeneca vaccine, and then a full dose about a month later, about 90% were protected from symptomatic COVID-19 illness. Among those getting two full doses of vaccine a month apart, 62% were protected from getting sick. The 70% is where the average fell.
The full set of data has not yet been published, leaving vaccine experts at least partly in the dark. “The different levels of efficacy with two different dosing regimens is scientifically intriguing,” Dr. Jessica Justman, associate professor of medicine in epidemiology at Columbia Mailman School of Public Health, told Alice.
As Alice writes, one possible explanation could be that recipients' immune systems may be mounting a response to the cold virus rather than the coronavirus. Halving the first dose may help dampen this immune response to the cold virus, possibly increasing the response to the coronavirus. It’s also possible that the difference could be due to the way the trials were structured; additional upcoming results may shed some light on the matter.
The AstraZeneca results were preliminary, and leave a lot of unanswered questions—for the public, scientists and, crucially, regulators. But if the half-dose-plus-full-dose regimen proves more effective, there could be a silver lining there: we’d need less vaccine material to inoculate the same number of people. “It’s a win-win,” Justman told Alice. “You get better protection and provide it to more people.”
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TODAY'S CORONAVIRUS OUTLOOK
The Global Situation
More than 59.1 million people around the world had been diagnosed with COVID-19 as of 1 a.m. E.T. today, and nearly 1.4 million people have died. Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
On Nov. 23, there were 519,437 new cases and 8,291 new deaths confirmed globally. Here's how the world as a whole is currently trending:
Here is every country with over 800,000 confirmed cases:
As a spike in U.S. air travel over Thanksgiving threatens to act as a hot-house for the coronavirus, there are moves overseas to make flying much safer. In a CNN interview, Alan Joyce, CEO of Australia’s Qantas airlines, said that his carrier would be the first to require international passengers to show proof of a COVID-19 vaccination before flying—once the vaccines become available, of course. It is unclear whether other airlines will follow suit.
While Australia tightens travel restrictions, the U.K. is loosening them, allowing international travelers—including Britons returning home from viral hot spots—to quarantine for just five days instead of the customary 14 if they receive a negative COVID-19 test upon return, Reuters reports. But immediate testing can be unreliable, since it may not detect an infection in someone who was exposed to the virus in just the previous few days. The U.K. was addressing not just public health issues but economic ones, however, as the nation’s airlines, suffering heavy losses due to travel restrictions, pleaded for relief.
The pandemic has given rise to a whole new form of international relations that the Washington Post is dubbing "vaccine diplomacy," with China and Russia taking the lead. In the U.S., the government is focusing on stockpiling supplies of new vaccines for domestic use; the European Union and other Western democracies are taking a similar approach—though they are also cooperating in a World Health Organization plan to distribute surplus vaccines to needier nations. China and Russia, by contrast, see sharing vaccines widely as a form of soft power.
The Situation in the U.S.
The U.S. had recorded more than 12.4 million coronavirus cases as of 1 a.m. E.T. today. More than 257,000 people have died. Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
On Nov. 23, there were 169,190 new cases and 889 new deaths confirmed in the U.S. Here's how the country as a whole is currently trending:
As officials prepare to deploy multiple effective coronavirus vaccines in the coming weeks and months, Americans are clamoring to know when they can get the shots. To ensure that the process unfolds as smoothly and peaceably as possible, the U.S. Centers for Disease Control and Prevention has released four ethical guidelines governing distribution. The first is maximizing benefits, with shots going initially to people in greatest need. Then comes justice—ensuring equal access regardless of economic or social status. Relatedly, the CDC will seek to mitigate health inequities, ensuring that communities of color, which have been especially hard hit by the disease, are treated fairly. Finally, the CDC pledges transparency, with the public being told how all distribution decisions are made.
Children represent little more than 3% of all U.S. COVID-19 hospitalizations, but the overall number of pediatric cases is soaring, according to a new report from the American Academy of Pediatrics (AAP). In the week ending Nov. 19, a record 144,145 new cases were reported in the 17 and below age group—part of an overall 28% increase in juvenile cases over the past two weeks. Children now make up 11% of total confirmed cases in the U.S. The AAP warns that the numbers could be higher since not all states report their data the same way, and some could be less accurate than others.
The Thanksgiving holiday may have finally caught a break—in the form of good weather. One recommendation for people who still plan on having a comparatively large gathering (which health experts strongly advise against) is to hold it outdoors. Balmy temperatures and clear skies forecast across much of the U.S. make that prospect a lot more practical. It’s only along the east coast that the outlook is less sunny, with rain forecast in many major cities. Still, even an outdoor feast should be kept short, with as few people as possible and mask and distancing rules observed.
With the General Services Administration at last allowing the presidential transition process to formally begin, the incoming Biden administration is working to get up to speed fast on the state of the pandemic. As the New York Timesreports, so-called “landing teams” from the transition will be arriving at the Department of Health and Human Services, the CDC and the Food and Drug Administration, beginning formal briefings with current personnel. The most pressing work will be done at the FDA, where plans for vaccine approval and rollouts are being formulated, and the CDC, where officials are developing a public relations and information campaign to persuade Americans to trust—and take—the vaccines.
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of Nov. 24, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
How U.S. Medical Schools Are Training Doctors for a Post-Pandemic World
Being a med student is never easy—and things get even tougher in the teeth of a pandemic. But medical schools have been nimble, in part by switching to online learning—which has included virtual patient exams, diagnoses and even online cadaver dissection. Moreover, the new curriculum is prepping young doctors for a world in which they will be practicing more telemedicine, addressing systemic health inequities, and even having to cope with future pandemics. Read more here.
Grim Life in the Morgues of Spain
With Spain’s second COVID-19 wave bringing the country to a total of 1.5 million cases and 43,000 deaths, among the least appreciated but most overworked members of its medical community are mortuary workers, the Associated Press reports. As deaths rise, morgue teams must contend with collecting up to 200 bodies a day; seeing their families only virtually lest they infect them; and such sensitive issues as how to remove a deceased nursing home resident while a living roommate looks on. Read more here.
The Crisis in the Heartland
Last spring it was in big U.S. cities—especially New York—that COVID-19 patients stretched hospitals beyond their capacity. Now it’s in the Midwest, and as Reuters explains, that spells trouble. In many smaller communities, the best hospitals can offer is emergency care—enough to stabilize patients but not help them long-term. Read more here.
Vaccine Hesitancy in Communities of Color
Racial inequality in health care and the long history of racial exploitation in the U.S. has left communities of color especially mistrustful of COVID-19 vaccines—a new study shows that only 14% of Black Americans believe a vaccine will be safe and only 18% believe it will be effective, the Washington Post reports. Among Latinos the numbers are a bit better but still discouraging 34% and 40%, respectively. Fewer than half of Blacks and only two-thirds of Latinos said they would definitely or probably accept a vaccine—making herd immunity harder to achieve. Read more here.
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com.
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Today's newsletter was written by Jeffrey Kluger and edited by Alex Fitzpatrick.
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