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Solving COVID: April 28, 2021


1. Where things stand The United States has vaccinated nearly 142 million people — roughly 53 percent of the population over age 16. Encouragingly, the so-called "fourth wave" that began in early April seems to be subsiding, with average new daily cases falling more than 20 percent over the last two weeks. The pace of vaccinations has slowed, however, from a high of more than 4 million doses administered per day in early April to just 1.6 million doses administered on April 27. Some mass vaccination sites are closing up shop as vaccine supply outstrips demand and the national focus turns to encouraging more hesitant Americans to get the jab. According to The New York Times, "White House and health officials are comparing the next phase of the vaccination campaign to a get-out-the-vote effort." Some states are getting creative: West Virginia, for example, will give young people a $100 savings bond if they get vaccinated. Global cases remain high, and this week Dr. Anthony Fauci called for a more global response, saying "a global response means equity throughout the world." [The Washington Post, The New York Times]

2. CDC says fully vaccinated people generally don't need masks outdoors The Centers for Disease Control and Prevention updated its guidelines on Tuesday to say that it's generally safe for those who have been fully vaccinated against COVID-19 to go maskless outdoors when not in crowded settings. A CDC graphic outlined various situations in which fully vaccinated people don't need to wear a mask, including walking, running, or biking outdoors with members of their household or attending small outdoor gatherings. Fully vaccinated people can also safely dine outdoors with friends from multiple households without a mask. The guidance said unvaccinated people also don't need to wear a mask while walking, running, or biking outdoors with household members and while attending small, outdoor gatherings with fully vaccinated family and friends. But it still recommended unvaccinated people wear a mask at outdoor gatherings with other unvaccinated people.

3. Biden administration sharing AstraZeneca coronavirus vaccine abroad The United States will send other countries its supply of the COVID-19 vaccine developed by AstraZeneca and the University of Oxford, the White House said Monday. The Oxford-AstraZeneca vaccine has not been granted emergency use authorization by the Food and Drug Administration yet, and White House COVID-19 coordinator Jeff Zients said the country doesn't need the supply given "the strong portfolio of vaccines" already available in the U.S. The Biden administration previously shared about 4 million doses of the Oxford-AstraZeneca vaccine with neighboring Canada and Mexico. Now the Biden administration plans to send doses to other countries desperate to step up their vaccination campaigns. About 10 million doses have been produced and await FDA quality inspection. Another 50 million doses should be ready by June. [The Associated Press, The Washington Post]

4. Israel recorded zero COVID-19 deaths in a day for the first time in 10 months Israel recorded no new daily COVID-19 deaths on Friday for the first time in 10 months. At that point, the country had enacted strict lockdown measures to curb the spread of the coronavirus, but that's not the case now. Cases are plummeting even as Israel has gradually been lifting restrictions, including an outdoor mask mandate. So far, the evidence strongly suggests that the decline is largely thanks to a swift and successful vaccine rollout. Israel has the highest vaccination rate in the world: About 56 percent of the population has received two doses, which is required for the Pfizer-BioNTech vaccine that's been in use in Israel. [BBC]

5. Pfizer CEO says oral COVID-19 drug could be ready by end of year Pfizer CEO Albert Bourla said Tuesday that the company's experimental oral medicine for COVID-19 could be available by the end of 2021. "If all goes well, and we implement the same speed that we are, and if regulators do the same, and they are, I hope that by the end of the year," Bourla told CNBC's Squawk Box. The company began early-stage clinical trials for its new antiviral coronavirus therapy in March. The drug is a protease inhibitor designed to target an enzyme the virus uses to replicate in human cells. Pfizer partnered with German drugmaker BioNTech to make the first coronavirus vaccine to be approved for emergency use in the United States. It also has requested FDA approval to authorize use of its vaccine on adolescents ages 12 to 15, and it is testing the vaccine on children 6 months to 11 years old. [CNBC]


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While global COVID-19 vaccination progresses, India is in a state of calamity with daily infections exceeding 350,000 and over two and a half thousand deaths. But these are only deaths or infections reported in hospital meaning that the figures are likely to be much much worse. The world is combining its efforts to supply oxygen and ventilators to a health system which is nearing collapse due to the overwhelming numbers of Covid patients that frontline healthcare workers are having to deal with.

By contrast, The Week article reports the USA has vaccinated 142 million people (or approximately 53% of the population over age 16). The 4th wave which has occurred in the USA, started in April 2021 and is showing dramatic signs of subsiding as a direct result of the vaccination program. However, the main issue now is the vaccine hesitant and those individuals who have only had one dose of either the Pfizer BioNTech or the Moderna vaccines. Going forward, this lack of urgency to have the second vaccination, affecting a significant number of people thus far, may play better to the strengths of the one dose Johnson and Johnson vaccine.

The CDC has re emphasized what I've reported in previous commentaries that once vaccination has occurred, the risk of person to person transmission is significantly reduced. The CDC is now advocating that there is no need for vaccinated individuals to wear masks outdoors.

As the USA has an adequate supply of domestic vaccines, it will distribute its own stock of purchased Oxford AstraZeneca vaccine to other countries in desperate need of vaccines, having already done so for both Canada and Mexico.

In a landmark sea change in the epidemiology of COVID-19 disease, Israel has reported that there have been no new covid related deaths in a single day for the first time in ten months.

And for those unfortunate individuals who have caught COVID-19, there is also hopeful news on horizon. Pfizer have developed an oral drug which prevents replication of the coronavirus inside the cell and therefore fights the infection directly.


- Doctor Donald Greig