When the history of the plague year is finally written, the Trump Administration's Operation Warp Speed (OWS) will likely be seen as an almost unalloyed success. The Pfizer-BioNTech vaccine has received emergency use authorization (EUA) and is already being rolled out and administered. The U.S. Food and Drug Administration is expected to issue an EUA for a second vaccine, produced by Moderna, later this week, and other vaccines from Johnson & Johnson, AstraZeneca, Sanofi and GlaxoSmithKline are in the pipeline. OWS has been on top of vaccine development and financing from the beginning, inking a total of $12 billion R&D and supply-purchase deals with the companies—a bet that's paying off spectacularly now.
But as my colleague Emily Barone reports, just behind the happy headlines are some harder—less cheery—truths.
For starters, there's the number of vaccines that are actually rolling out and getting into Americans' arms. In July, the U.S. signed a $1.95 billion deal with Pfizer to finance production and delivery of 100 million doses of its then-in-development vaccine. That's a big number as far as it goes—but it doesn't go very far. The vaccine requires two doses, meaning the deal was sufficient for just 50 million out of 328 million Americans—or barely 15% of the population, assuming a flawless delivery.
Making the government’s judgment look worse, the U.S. reportedly declined Pfizer’s offer to sell it more doses. By contrast, the European Union, with an overall population of 447 million, signed a deal with Pfizer to purchase 200 million doses—covering about a quarter of its population.
U.S. officials argue that the OWS strategy was always to spread America's vaccine bets, dividing the total $12 billion among several vaccine makers so it would be ready to take advantage of whatever was actually approved. In some respects, that bet is paying off. As the New York Timesreports this morning, the U.S. worked more closely with Moderna than with Pfizer, signing a $2.5 billion, 100-million dose deal last summer that helped the company buy raw materials and expand production capacity. Last week the government added an additional 100 million doses to the order. With 300 million doses between both Moderna and Pfizer, close to half of the U.S. population could be inoculated.
But other OWS-backed vaccine candidates are coming along more slowly. AstraZeneca’s vaccine showed very different efficacy at different dosing levels, slowing its approval, while Sanofi and GlaxoSmithKline are not expecting to roll out their vaccines until next year.
What's more, as Emily reports, the $12 billion total is not terribly much compared to other major federal efforts. Social Security, for example, cost $1.1 trillion in 2019, and Medicare $750 billion in 2018.
(To see a larger version of these charts, click here.)
The OWS spending compares more closely to 2018's $11 billion farmer relief package meant to offset losses from the U.S. trade war with China. A Bloomberg analysis of 80 agreements between vaccine manufacturers and governments found that the U.S. ranked 32nd in per-capita vaccine vaccine reservations. (Canada, the U.K. and Australia are at the top of the list, followed by 27 European Union countries and Chile.)
It’s churlish, perhaps, to find fault at the same time American TV screens are filled with images of vaccines being packed and shipped and the first recipients rolling up their sleeves to be injected. But if there are epidemiological lessons scientists will learn from the plague year of 2020, there are tactical and economic ones policymakers should learn too. All of it should make us better prepared the next time a virus emerges from the wild.
Yesterday's rollout of the Pfizer vaccine had something of the feel of an election night, with news coverage pouring in from precincts around the country. As my colleagues Alice Park, Jamie Ducharme and W.J. Hennigan report, it was especially fitting that the first person to receive the vaccine was a health care worker in New York, since the city was an early hot spot for the pandemic.
Two hundred miles south, 975 vials arrived at the University of Maryland Medical System, which purchased six ultra-cold freezers and rented space in more to store the incoming supply. Similar scenes played out at Sanford Health in North Dakota, where Jesse Breidenbach, senior executive director of pharmacy, got a text informing him that vaccines were coming their way on a truck from Fargo, N.D. Within 10 minutes, a colleague called to tell him nearly 3,000 doses had arrived. At Lifespan Health System in Rhode Island, 2,000 doses rolled in with another 1,000 expected today, and the University of Pittsburgh Medical Center got its first 975 doses at 9:15 a.m. ET. By 11:00, five health workers had been inoculated during a livesteamed news event.
While these scenes play out across the U.S.—as well as in the U.K. and Canada—European Union residents are beginning to clamor for faster approval of the Pfizer-BioNTech vaccine, the Associated Press reports. The European Medicines Agency was not planning to gather to review vaccine data until Dec. 29, but the meeting has now been moved up to Dec. 21. "Our goal is approval before Christmas," said German Health Minister Jens Spahn.
The FDA today released the data it will use to determine whether to issue emergency use authorization for the Moderna vaccine, as Reuters and others report—and the numbers are promising. In Moderna's study of 30,000 subjects, the vaccine proved 94.1% effective with minimal side effects, including fever, fatigue and headaches. Like the Pfizer vaccine, it is a two-dose treatment; efficacy was shown to be only 80.2% among people who received just a single dose. An independent panel will meet Thursday to review the Moderna data before passing its findings to the FDA, which is expected to follow its recommendation on whether to issue an EUA.
Despite global concerns about the efficacy and safety of Russia’s Sputnik V vaccine, the developer now claims an effectiveness rate of 91.4%—and 100% against severe cases—according to the Irish Examiner. The sample group is said to have been made up of 22,714 volunteers who showed robust antibody reactions 21 days after receiving one dose of the vaccine. The Moscow Times reports that foreign nationals with valid passports, certificates of employment and public health insurance will be eligible to receive the vaccine along with Russian citizens. One celebrated foreigner who took advantage of the offer: director Oliver Stone, who has been touring Russian nuclear power plants in preparation for a climate change documentary.
TODAY'S CORONAVIRUS OUTLOOK
The Global Situation
More than 72.8 million people around the world had been diagnosed with COVID-19 as of 1 a.m. E.T. today, and more than 1.6 million people have died. On Dec. 14, there were 524,320 new cases and 8,792 new deaths confirmed globally.
Editor's note: On Nov. 25, Turkey changed its policy to include asymptomatic cases in its daily numbers. On Dec. 10, the country provided a large case dump to bring the total historical reporting in line with this new standard. However, the data are not yet available to accurately distribute this increase retroactively. The result is a significant anomaly that impacts the charts and maps both for Turkey, and, due to the country’s large case numbers, the world.
Here's how the world as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
And here is every country with over 1 million confirmed cases:
More than 1,100 people in Southern England have been infected with what appears to be a new variant of SARS-CoV-2, the virus that causes COVID-19, according to Reuters. The mutation involves changes to one of the virus's spike proteins, and investigators are trying to determine if that makes the virus more easily transmissible from person to person. Mutations are common among viruses, with SARS-CoV-2 averaging one or two per month. So far, none of the mutations appears to cause more severe cases of the disease, and there is no indication that they would render the new vaccines less effective.
South Africa is steeling itself for a second wave of coronavirus infections, The Guardianreports, with officials blaming the spike on students' end-of-semester parties in recent weeks. One weeklong event from Nov. 27 to Dec. 4 in the southeastern coastal town of Ballito attracted more than 1,500 people, about two-thirds of whom have since tested positive. Cape Town, where similar gatherings have been held, is experiencing its own spike. Researchers report that most of the newly infected people are between 15 and 19 years old.
The Situation in the U.S.
The U.S. had recorded more than 16.5 million coronavirus cases as of 1 a.m. E.T. today. More than 300,000 people have died. On Dec. 14, there were 193,454 new cases and 1,311 new deaths confirmed in the U.S. Here's how the country is currently trending:
Yesterday's vaccine rollout gave the nation good reason to celebrate, but, as CNN reports, health experts continue to warn that things will get worse before they get better, with the upcoming winter likely to be the darkest passage in the pandemic. In the past week alone, the U.S. has averaged 215,000 new cases daily, with more than 110,000 people hospitalized nationwide and deaths exceeding 2,300 per day. The vaccine will put an end to that—but only eventually. "It's not going to be like turning a light switch on and off," Dr. Anthony Fauci said during a Center for Strategic and International Studies event on Monday. "I don't believe we're going to be able to throw the masks away and forget about physical separation in congregate settings for a while, probably likely until we get into the late fall or early next winter."
As vaccine rollouts begin across the U.S., public acceptance of the shots is increasing, according to the health policy analysis group KFF. Currently, 71% of Americans say they would definitely or probably get a vaccine if it is proven safe, up from 63% in September. Among the groups least likely to say they would get a vaccine are Republicans (42%), people in the 30 to 49 age group (36%) and rural residents (35%). Worries about side effects, lack of trust in government and concerns that the vaccine was rushed are the most frequently cited reservations among holdouts.
Dr. Fauci is urging President-elect Joe Biden and Vice President-elect Kamala Harris to receive the new COVID-19 vaccine as soon as possible, according to Politico and others. Fauci cites national security, and the calendar gives his argument more force. Recipients need to wait three weeks before getting their second dose, so if Biden and Harris received their shots today, they would complete their regimen just a few days before they are sworn in on Jan. 20. "For security reasons, I really feel strongly that we should get them vaccinated as soon as we possibly can," Fauci said today on Good Morning America. Biden today declined Fauci's suggestion, saying he did not want to jump the queue, but rather wants to wait his turn. Fauci is also urging current President Donald Trump and Vice President Mike Pence to be vaccinated as soon as possible; White House Press Secretary Kayleigh McEnany today declined to say when the President will receive the vaccine.
New York's already subdued Christmas could be followed by a decidedly bleak New Year, as both New York City mayor Bill de Blasio and state governor Andrew Cuomo eye a full citywide shutdown beginning in the last week of December if COVID-19 positivity rates don't decline. Indoor dining has already been banned, and more drastic steps could follow, reports local affiliate ABC7. Cuomo is considering similar measures for the rest of the state as well.
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of Dec. 15, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
How to Get Vaccinated Early if You're High Risk
The short answer is that there's no short answer. For months we've been hearing that seniors and people with underlying conditions will be high on the vaccine priority list, but where you go to get the shot or how you claim your place in line is uncertain. TIME's Jamie Ducharme does have some answers, the most important of which is: "self-advocacy." Read more here.
When the Cure for Loneliness Is a 95-Year Old Man
The pandemic has driven many families apart—but in a few cases it has brought them together, too. In the Globe and Mail, columnist Eric Bombicino writes touchingly about how he and his widowed grandfather became closer than they’d ever been during a recent week when Bombicino came to visit (after testing negative first, of course). "It may sound a little off for a thirtysomething to say," he writes, "but this 95-year-old man is my best friend." Read more here.
Meet the Pandemic's Most Celebrated Photographer
The impossibly poignant image of a health worker embracing an elderly COVID-19 patient over Thanksgiving at the United Memorial Medical Center in Houston may be the signature image of the pandemic. Everyone knows the picture; fewer the photographer. He is Go Nakamura and BuzzFeed News has a Q&A with the talented—and soon-to-be much less anonymous—artist. 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. If you have specific questions you'd like us to answer, please send them to covidquestions@time.com.
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Today's newsletter was written by Jeffrey Kluger and edited by Alex Fitzpatrick.
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