As Vaccines Near Approval, Distribution Headaches Loom
It’s been a good month for vaccine news. Results from three COVID-19 vaccine candidates suggest they all confer a surprisingly high degree of protection from serious disease. But soon comes the hard part: distributing the shots across the United States.
In her new article, my colleague Alice Park lays out Operation Warp Speed's vaccine rollout plan—and found plenty of potential pain points. Following approval by the Food and Drug Administration (FDA), which could happen in early December, the first batch of 6.4 million doses will be immediately available to transport to states. But who will get those shots, and how?
“I think the rollout of the vaccines will be complicated,” Alice says. That’s because the leading candidate, made by Pfizer, is likely to gain approval first, but it also requires the most sensitive handling. It must be kept extremely cold during transport and storage, and relatively few facilities are equipped to manage it at the moment, although Pfizer is shipping its doses in special thermal containers to maintain the necessary cold chain. Furthermore, the company has already put workers through practice runs so they are more comfortable with transporting and managing the vaccine, but anything could happen during the real distribution process.
Another quandary is that vaccines will be distributed based on priority, not a first-come, first-serve basis, Alice says. Health care workers, first responders and other essential workers will have priority, followed by the elderly and people with chronic health conditions. Getting limited doses to targeted groups of people requires coordination and planning—especially since overburdened health care workers, already juggling so many responsibilities and demanding schedules, are first on the list.
“I think the trickiest part will be for states to determine how to distribute the first doses among people in high-priority groups,” Alice says. “Then there are the practical issues around making sure that once a box of doses is opened, that enough people are ready to get vaccinated so those doses don't go to waste, since they can't be refrozen.”
COVID-19 vaccines likely won’t be widely available to most Americans until the spring or summer, Alice reports, but that may give people in the distribution chain enough time to fine-tune the rollout. “We should expect hiccups in the process that hopefully will be smoothed out as more vaccines become available,” Alice says.
Editor's note: The Coronavirus Brief will be off for the Thanksgiving break, resuming Monday, Nov. 30. In the meantime, keep up with TIME's COVID-19 coverage at TIME.com/health. Thank you for reading, and have a safe holiday.
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TODAY'S CORONAVIRUS OUTLOOK
The Global Situation
More than 59.7 million people around the world had been diagnosed with COVID-19 as of 1 a.m. E.T. today, and more than 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. 24, there were 588,416 new cases and 12,785 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:
France is easing coronavirus restrictions following a decline in the number of daily new cases there, French President Emmanuel Macron announced yesterday. Most of France's lockdown will lift on Dec. 15, but bars and restaurants will remain closed through Christmas, and restaurants won't reopen until Jan. 20 at the earliest, Euronews reports. But other rules will be relaxed sooner: beginning Nov. 28, people can leave their homes for longer periods of time, and shops can reopen with certain hygiene restrictions.
A major COVID-19 outbreak has sidelined workers at 28 mask and glove factories in Malaysia, the New York Timesreports. More than 2,400 workers at the personal protective equipment (PPE) company, Top Glove, have been infected this month. Top Glove, which is now under investigation over what one Malaysian government official called “terrible” working conditions, temporarily shuttered 16 factories and reduced production at the others.
Health officials in Hong Kong announced new restrictions yesterday ahead of a potential new coronavirus surge, CNN reports. Starting tomorrow, all bars, karaoke spots, bathhouses, night clubs and party rooms will close for a week, said Food and Health Secretary Sophia Chan at a press conference. Hong Kong reported 85 new cases yesterday; most were traced back to an outbreak at a dance studio.
Also in Hong Kong: a poodle there has tested positive for COVID-19, officials said today. The dog, which is showing no symptoms, was tested after its owner was in close contact with an infected person, CNN reports. So far, there is "no evidence to show that pets are playing a role in the spread of infection with the COVID-19 virus among humans," Hong Kong officials said, but they're continuing to test animals and monitor potential spread regardless. In the meantime, officials advise people to avoid kissing their pets.
The Situation in the U.S.
The U.S. had recorded more than 12.5 million coronavirus cases as of 1 a.m. E.T. today. More than 259,000 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. 24, there were 172,935 new cases and 2,146 new deaths confirmed in the U.S. Here's how the country as a whole is currently trending:
There's just one day left to change your Thanksgiving plans, and Dr. Anthony Fauci is making a final plea to Americans to keep indoor festivities as small as possible. “We all know how difficult that is, because this is such a beautiful, traditional holiday, but by making that sacrifice, you're going to prevent people from getting infected,” Fauci said this morning on Good Morning America, echoing recommendations from the U.S. Centers for Disease Control and Prevention (CDC) to celebrate indoors only with your immediate household. “A sacrifice now could save lives and illness and make the future much brighter as we get through this.” If Americans don’t take these precautions, another surge is likely to hit about three weeks from now. “Vaccines are right on the horizon, if we can just hang in there a bit longer,” Fauci added.
A vaccine candidate co-developed by Oxford University researchers and AstraZeneca was celebrated this week when the drugmaker announced it was 90% effective. But a mistake is largely responsible for that high efficacy: instead of giving trial participants in the U.K. two full doses as planned, "we went back and checked ... and we found out that they had under-predicted the dose of the vaccine by half," AstraZeneca executive Mene Pangalos told Reuters. That initial half-dose proved 90% effective, while two full doses proved about 62% effective. “Yes, it was a mistake,” Pangalos said.
Filipino nurses make up just 4% of registered nurses working in the U.S., but they account for nearly a third of nurses here who have died of COVID-19. One possible reason: Filipino nurses are more likely to work in emergency rooms, nursing homes and ICUs compared to white nurses, CNN reports, increasing their exposure. "It wasn't because they weren't wearing a mask, it wasn't because they decided to eat at a restaurant," said Jollene Levid, who’s been tracking these deaths. "They were literally trying to keep someone alive and they caught it," she says.
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of Nov. 25, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
The Double-Edged Sword of Living in Hawaii During a Pandemic
Hawaii has a low per-capita coronavirus case count compared to the rest of the U.S., and geography deserves a lot of the credit. But Hawaii’s isolation also means that health care resources are comparatively few, so any new case is a threat, my colleague Alejandro de la Garza reports. Read more here.
Remembering a College Freshman Who Died of COVID-19
Michael Lang, an 18-year-old University of Dayton freshman, had just started college in August, but by the next month, he developed symptoms of COVID-19. He died in October after falling into a coma. “He was really just a loving kid that just got shortchanged,” Lang’s mother told TIME. Read more here.
What a Year of Stress and Isolation Does to Kids
Weathering 2020 hasn't been easy for people of any age. But for children, the damage of isolation and quarantine may last far longer than the pandemic itself. New York magazine explores what happens to babies, children and teens during times of toxic stress, fear and separation—like the one we find ourselves in right now. Read more here.
COVID-19 Is Ravaging Nursing Homes More Than Ever
The number of nursing homes with at least three COVID-19 cases hit a record high—more than 1,300—in November, NBC News reports. Many care facilities still don't have enough masks, protective equipment or testing, and providers expect the shortage to worsen as cases continue to rise. Read more here.
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Today's newsletter was written by Mandy Oaklander and edited by Alex Fitzpatrick.
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