Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
Let’s start by reminding ourselves — and the public that depends on us — that we are a step closer to having a COVID-19 vaccine but that it will not help us get through the weeks ahead as hospitals fill up and morgues soon do, too.
We have to keep reminding the public that hopeful preliminary vaccine news is not a cure and not a reason to let up on prevention.
Let’s also remind the public that once a vaccine is approved it will be months — maybe many months — before most people will be inoculated. An optimistic forecast of when we might “return to pre-pandemic normal” is late 2021.
I bought a new chair for my home office today. We are going to be here for a while.
Get a flu shot. Wear your mask.
Why is the Pfizer announcement such a big deal? What don’t we know?
Pfizer is just one of many drug companies that are working on vaccines. Pfizer’s potential vaccine is in phase 3 testing, which is when a company tries to prove a drug to be both safe and effective. We got a peek Monday at how effective the Pfizer coronavirus vaccine might be. It may be significantly more effective than experts hoped.
Food and Drug Administration guidelines require patients to have been under observation for at least two months after the second dose of the trial vaccine. For Pfizer’s trials, that maps to about the third week of November, or next week.
So there is still a lot we don’t know.
- How will this vaccine protect against the most severe COVID-19 cases?
- How effective is this vaccine for older patients and children?
- Does it provide the same protection for people of all races?
- Will it prevent people from being carriers with no symptoms?
- The study has only been going on for months, so how long would the vaccine last?
- The vaccine does cause some ache and fever side effects. How long do these side effects last and how much of a disincentive would they be to take the shot?
- How big a problem will it be that the Pfizer vaccine needs to be stored at ultracold temperatures while Moderna’s vaccine does not require such cold storage?
The first data comes from a tiny sample. I am not bad-mouthing what seems to be positive vaccine news, but let’s remember Pfizer’s phase 3 study involves 44,000 volunteers. The news we got Monday involves a study of 94 of those patients that Pfizer says represent a diversity of ages (but not children). 94 patients may sound like a tiny number, but it is actually a larger group than Pfizer used to produce its first evidence of efficacy.
As Walid Gellad, director for the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh, said, “Not only is it highly effective based on the press release, but there were 90 cases so we don’t have to deal with the skeptics about interim analyses, and there appeared to be no safety signals.
Pfizer said Monday that it can make 50 million doses by the end of the year — enough to vaccinate 25 million people — and 1.3 billion by the end of 2021. About half of the 25 million people to get the vaccines first will be in the U.S. because Pfizer has agreements to distribute in other countries, too.
It may turn out that there will be more than one vaccine that consumers can choose from if one drug company’s product works better on a segment of the population. And if one of the companies produces a vaccine that only requires one shot, and not two, it might give it a huge advantage, especially in rural or remote areas where access to health care is a challenge.
We should point out that the Pfizer drug began with German company BioNTech, which did the initial research and then partnered with much larger Pfizer. BioNTech has produced other drugs for cancer patients.
Attacking the protein spikes: ‘the right target’
Think of the illustration of the virus that you have seen a zillion times. Those little knobs or spikes on the virus are proteins. The Pfizer vaccine targets them. Those spikes allow a virus to attach to and invade human cells and start the infection.
Researchers are attacking the proteins with biotechnology called mRNA. The “m” stands for “messenger.” Your body naturally creates mRNA to tell cells what to repair and what to rebuild. Think of them as messengers that deliver work orders. Part of your cells read the messages and then string together amino acids that are building blocks to build proteins. During an infection, the messenger instructs cells how to make viral proteins.
The vaccine researchers are trying to build messages (mRNA) that tell cells to build proteins that are found in specific viruses. Remember that there are lots of kinds of viruses, and the one they are targeting now is SARS-CoV-2 — the virus that caused COVID-19.
Once the vaccine enters your body, it triggers cells to produce the proteins that trigger the immune cells that lead to the production of antibodies. Triggering those proteins is the key that makes the lock work. The antibodies help your immune system detect and destroy the virus before you get sick.
Pfizer says in the tests it has conducted so far, 90% of the people who got its vaccine produced antibodies that recognize the proteins in SARS-CoV-2. This summer, the FDA said it hoped a new vaccine would at least be 60% and maybe 70% effective.
This success is not just about Pfizer’s drug. It means many of the vaccines under development seem to be on the right track because all of the major trials underway target those protein spikes. That drug companies have put “all eggs in one basket” has been one of the biggest concerns in recent months because if trials showed this was the wrong approach, it would have set a vaccine back a long time. So, we seem to be on the right trail.
“There was always a discussion: Is the spike protein the right target? Well, now we know it’s the right target,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told StatNews on Monday. “So, it’s not only immediate good news, it really is optimistic about what’s going to roll out in the next several months with the other vaccines.”
We may look back on Nov. 9, 2020, as a day when we learned about a great advancement in science and pharmacology. If these researchers have discovered a way to make mRNA vaccines that work effectively, then it opens the way for a new rapid response to the next virus pandemic. And there will be others. For all we know, this virus will be recurring as it evolves.
As an illustration of how much companies were betting on mRNA research, Moderna, one of the other leading researchers chasing a vaccine, chose “MRNA” for the company’s stock ticker name.
Right after Pfizer made its Monday announcement, Ivanka Trump, the president’s daughter and top adviser, praised “the tireless work of Operation Warp Speed,” referring to the Trump administration’s coronavirus response effort. But Kathrin Jansen, Pfizer’s vice president for vaccine research, told The New York Times, “We were never part of the Warp Speed. We have never taken any money from the U.S. government, or from anyone.”
Pfizer estimates it is spending about $2 billion of its own money developing its drug.
Was it just by chance that Pfizer announced the uplifting news a couple of days after the winner of the presidential election became clear? Pfizer’s CEO told Axios that he would have delivered the news earlier if the data was available.
FDA’s emergency approval for a Lilly antibody therapy
Late Monday, the FDA approved the emergency use of a coronavirus treatment produced by Eli Lilly. The treatment is aimed at mild to moderate infections in both adults and children. This drug also works by targeting those protein spikes. Once again, it is all about trying to get the immune system to kickstart itself.
The FDA said, “Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful antigens such as viruses. Bamlanivimab is a monoclonal antibody that is specifically directed against the spike protein of SARS-CoV-2, designed to block the virus’ attachment and entry into human cells.”
Early tests showed people who got the medicine were significantly less likely to require hospitalization than others, although keep in mind the rate of hospitalizations of people with moderate symptoms is about 6%.
Why did the stock market and oil futures go up and gold drop?
Gold futures dropped for their biggest losses in seven years Monday, partly on the news of a promising vaccine. The stock markets mostly rose sharply while oil futures also rose. It all appears to be a reflection of a dose of optimism that we have better days ahead — when people will travel, work and spend and not need a gold safety net.
The vaccine delivery systems being set up
All of the drug companies are having to design ways to deliver their products if and when they prove to be safe and effective. Pfizer says it designed suitcase-sized shipping containers that will keep its doses at ultracold temperatures for up to 10 days. The Wall Street Journal reports that each container holds between 1,000 and 5,000 doses and that Pfizer would buy space on 20 FedEx, UPS and DHL International transport planes to send the drug to distribution centers. The shipping companies would truck the supplies from there.
Pfizer has designed a special box to transport its hoped-for vaccine. The boxes, roughly the size of a large cooler, will hold a couple of hundred glass vials, each containing 10 to 20 doses of vaccine. The boxes are equipped with GPS-enabled thermal sensors, allowing Pfizer to know where the boxes are and how cold they are. (If they get too warm, workers can add dry ice.)
One big problem: a global shortage of dry ice
To ship billions of doses of vaccines, we will need a lot, and I mean a lot of dry ice. Which brings up this one big problem. The New York Times reports:
As if the challenge weren’t sufficiently daunting, the world is facing a looming shortage of dry ice — an unexpected side effect of the pandemic.
Dry ice, the stuff that exudes chilly smoke and enthralls school-age scientists, is made from carbon dioxide, which is most commonly created as a byproduct during the production of ethanol.
But ethanol production ebbs and flows based on the demand for gasoline. This spring, as stay-at-home orders went into effect, people began driving less. As a result, ethanol production slumped, and so did the supply of carbon dioxide.
In April, Richard Gottwald, chief executive of the Compressed Gas Association, sent a letter to Vice President Mike Pence warning of “a significant risk of a shortage in carbon dioxide.”
Five months later, “the ethanol industry still has not bounced back,” Mr. Gottwald said in an interview. “We are seeing a shortage.” And that is making dry ice hard to come by.
You can track the shortage on industry websites like gasworld.com.
FedEx has its own machines to produce dry ice and UPS says it may install them.
One other thing: Glass, as in the glass that vaccines come in, cracks when it gets really cold. But Corning says it has a special pharmaceutical glass that can handle the cold temperatures and the government’s Operation Warp Speed program awarded it a contract worth more than $200 million to get production rolling. The “Valor Glass” vials will be produced in U.S. facilities in Big Flats, New York; Durham, North Carolina; and Vineland, New Jersey.
What is this ‘COVID fee?’
People are starting to notice little (and sometimes not so little) “COVID fees” on their bills. Dentists and nursing homes and who knows who else are tacking these fees onto bills because they have to pay for protective gear and more cleaning and so on.
The New York Times found one person who got stuck with a $40 COVID fee on her dentist bill for routine teeth cleaning. Barbershops, pedicure places and restaurants have added COVID-19 surcharges to bills, too. Have you noticed them?
A few examples:
- Dentists: Kaiser Family Health reported on dentists charging $10 to $20 per visit to offset the significant costs caused by COVID-19. For example, one dental office said it used to pay $6 for a box of face masks that, this summer, were going for $6 for a single mask. Add to that new air filtration systems, face shields and a lower number of patients allowed in the office at a time.
- Salons: A Texas hair salon is adding a $3 “sanitation charge” to each receipt.
- Restaurants: A Missouri restaurant implemented a 5% surcharge to cover rising food prices. In New York City, restaurants may charge up to 10% in a COVID surcharge but it has to be clearly labeled on the bill and it cannot apply to takeaway orders. And restaurant chains that have more than 15 locations may not use the surcharge.
Have you ever noticed that these surcharges never seem to go away? My lawn mowing service added a “fuel surcharge” years ago when gasoline prices got jacked up by something I do not recall. I never got a notice that prices were coming down when fuel prices dropped below $2 a gallon. (I am not complaining about my yard guy. He works hard and is worth every penny.)
In Wilmington, North Carolina, one local restaurant added a 12% COVID surcharge this summer but dropped it to 8% recently. The restaurant said the price of gloves and even ketchup packets skyrocketed during the pandemic, and the business added new air filtration and touchless checkout systems. But the business said it chose not to permanently levy the surcharge and will keep it just to make up for the unexpected expenses.
A Biden election is not good news for private prison companies
Companies linked to private prisons saw their stock prices plunge as fast as Joe Biden piled up votes. CoreCivic, a real estate investment trust formerly known as Corrections Corporation of America, saw its biggest stock price drop since summer. Look at CoreCivic and GEO, another private prison company compared, to the S&P 500:
As Quartz points out, the private prison industry would not have a friend in Biden:
The Biden campaign has said it will change the US’s policies on immigration and asylum, “end prolonged detention, and reinvest in a case management program.” Private prison stocks were under pressure even before the election. CoreCivic, whose biggest customer is US Immigration and Customs Enforcement (ICE), was downgraded in April by credit-rating company Fitch, citing reduced access to institutional finance. JPMorgan, Bank of America, SunTrust Bank, and PNC Bank have said they will stop providing services and lending to the private-prison industry, and some investors have become wary of the sector.
Biden’s campaign website laid out a plan for the end of private federal prisons:
Biden will end the federal government’s use of private prisons, building off an Obama-Biden Administration’s policy rescinded by the Trump Administration. And, he will make clear that the federal government should not use private facilities for any detention, including detention of undocumented immigrants. Biden will also make eliminating private prisons and all other methods of profiteering off of incarceration — including diversion programs, commercial bail, and electronic monitoring — a requirement for his new state and local prevention grant program. Finally, Biden will support the passage of legislation to crack down on the practice of private companies charging incarcerated individuals and their families outrageously high fees to make calls.
The way we work now
If you miss your colleagues and the sound of your office, you can go here and turn up the sounds of people working. I turned up the sound of the “office dog” and it makes my dog nuts.
Find your fun where you can these days, friends.
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