Health care workers? Check. Residents of nursing homes and long-term care facilities? Check. People over 65? Check.
COVID-19 vaccine prioritization rules vary across the country, but most states have already made these groups eligible for the shot. Doing so was fairly uncontroversial; people in these categories are all undeniably vulnerable to the virus and in urgent need of protection. But now that the rollout is widening even further, who should go next is a logistical and ethical minefield.
On deck in many places: people with underlying health conditions that make them susceptible to COVID-19. This makes sense, but up to 60% of Americans have such health issues, according to the U.S. Centers for Disease Control and Prevention (CDC). Supply already lags behind demand in many places, and further expanding eligibility will result in millions of Americans competing for appointments, writes my colleague Alice Park. Health officials will soon have to make tough decisions about who to prioritize, "with a potential nightmare scenario of cancer patients fighting with heart patients for scarce vaccines," Alice writes.
No one wants to judge who is most at risk among this huge group, especially not state health departments. It's a thankless task with certain criticism, not to mention a waste of time and energy that could be spent vaccinating people.
Within the broad rules that states set, hospitals and doctors are having to self-select who to prioritize among the overall newly eligible group. Some institutions are simply sorting people by age, Alice writes. If age isn't enough to make a determination, whoever is available to get the shot first will often win the appointment. But that risks skipping over people who don't have easy access to health care, which would further widen the gap between low-income populations and those with more resources.
"This next priority group highlights the need to better match the supply of vaccines with demand, since having limited doses will force some places to have to make hard decisions about who is more or less at risk," Alice says. "There are no right answers, but the more state and local health departments, doctors and pharmacists start thinking about this, the more likely they will be to come up with an acceptable solution to a really difficult problem."
43.4 million doses of the COVID-19 vaccine have been shipped to various U.S. states as of this morning, while about 32.9 million doses have been administered thus far, according to TIME's vaccine tracker—representing 9.9% of the overall U.S. population who have received at least one dose.
New World Health Organization guidance recommends the use of the Oxford-AstraZeneca coronavirus vaccine for all adults, a move that could bolster public confidence in the shot after a small but widely-reported study showed it was less effective against a strain spreading in South Africa. The vaccine, which is more affordable and easier to ship and store than many other coronavirus shots, is 63% effective against symptomatic COVID-19 infection, the WHO concluded, and shots should be spaced 8 to 12 weeks apart for the most protection.
Johnson & Johnson CEO Alex Gorsky said yesterday that people may need an annual COVID-19 vaccine for the next few years—like a flu shot—to be protected against mutations, CNBC reports. Last week, Johnson & Johnson applied for emergency use authorization from the U.S. Food and Drug Administration for its single-dose vaccine; an FDA panel will meet Feb. 26 to debate the data.
Japan will end up throwing away one in six doses of the Pfizer-BioNTech vaccine supply it has received because it does not have enough specialized syringes to extract the final dose from each vial, Kyodo News reports. Japan has procured enough doses to vaccinate 72 million people, but without the necessary syringes, the supply will only cover 60 million. The government is urging medical supplies manufacturers to increase production of the syringes.
TODAY'S CORONAVIRUS OUTLOOK
The Global Situation
More than 106.9 million people around the world had been diagnosed with COVID-19 as of 1 a.m. E.T. today, and more than 2.3 million people have died. On Feb. 9, there were 424,861 new cases and 15,492 new deaths confirmed globally.
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 1.5 million confirmed cases:
People in the U.K. may not be able to travel abroad until all adults in the country have been vaccinated, British Transportation Secretary Grant Shapps said today, the New York Timesreports. The hope is to stop people from vacationing abroad, getting sick and bringing the virus back with them while part of the adult population is still vulnerable. According to the Times, the U.K. has so far vaccinated about 19% of its 66 million-person population—one of the highest rates globally.
WHO and UNICEF officials said today that nearly 130 countries have yet to administer a single dose of any vaccine, leaving 2.5 billion people indefinitely vulnerable. Of all the doses given, "more than three quarters of those vaccinations are in just 10 countries that account for 60% of global GDP," said UNICEF Executive Director Henrietta Fore and WHO Director-General Dr. Tedros Adhanom Ghebreyesus in a joint statement. The inequitable supply of vaccines could prolong both the global economic downturn and the pandemic itself.
The Situation in the U.S.
The U.S. recorded more than 27.1 million coronavirus cases as of 1 a.m. E.T. today. More than 468,000 people have died. On Feb. 9, there were 92,666 new cases and 3,031 new deaths confirmed in the U.S.
Here's how the country 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:
After a long stretch of record-setting numbers for COVID-19 cases and deaths in the U.S., daily case numbers have fallen significantly, my colleague Jamie Ducharme reports. Yesterday was the third consecutive day in which the number of new cases fell below 100,000, and death counts and hospitalizations are also falling. The drop probably isn't because of vaccines (yet); more likely, it's just a return to the kinds of numbers the U.S. was experiencing before a spike over the winter holidays. Experts are worried that Americans and elected officials will see these numbers as permission to loosen precautions—a risky move as new variants spread across the country.
If people who are interacting either wear a cloth mask on top of a surgical mask or knot together the ear loops of a surgical mask to make it fit more tightly, coronavirus transmission can be reduced by up to 96%, according to new CDC research. Though the experiments were done in laboratories and may not perfectly translate to real-world experiences, the results point to the importance of a good, tight fit to block viral particles.
Recent data show "no red flags" among 20,000 pregnant women who received a COVID-19 vaccination since the rollout began in the U.S., Dr. Anthony Fauci said today during a White House COVID-19 briefing. Clinical trials looking into vaccination and pregnancy are still underway, but these new data may help pregnant people navigate the vexing question of whether to get a shot.
A new COVID-19 therapy made by Eli Lily received emergency use authorization from the FDA yesterday, the New York Timesreports. The treatment is a combination of two monoclonal antibody drugs and is designed for high-risk COVID-19 patients who aren't sick enough to be hospitalized. Early data suggest that the therapy may be better able to fight illness caused by new coronavirus variants than currently available options.
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of Feb. 10, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
Surviving COVID-19 as a Centenarian
A 116-year-old nun in France thought to be the world's second-oldest person has survived COVID-19, the Associated Press reports. "I didn’t even realize I had it," Sister André told a French newspaper. She turns 117 tomorrow. Read more here.
COVID-19 Is Causing a Spike in Alcohol-Related Diseases
Thousands of recovering alcoholics have relapsed during the pandemic, and hospitals are reporting huge increases in patients who have alcoholic hepatitis and liver failure as a result, Kaiser Health News reports. Health experts believe that isolation, unemployment and hopelessness caused by the pandemic are at the root of the rise. Read more here.
The Promises and Pitfalls of Rapid Testing
Cheap, rapid COVID-19 tests have long been touted as crucial to curbing the pandemic, yet they're still controversial among scientists. The tests miss many people with lower levels of the virus, so some experts believe they promote a false sense of security, but others argue that they serve an important role by catching the most infectious people, Giorgia Guglielmi explains in Nature. 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 Mandy Oaklander and edited by Alex Fitzpatrick.
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