The Daily - How Close Is the Pandemic’s End?

Episode Date: March 4, 2021

It’s been almost a year since the World Health Organization declared the coronavirus outbreak a pandemic.And the virus is persisting: A downward trend in the U.S. caseload has stalled, and concern about the impact of variants is growing. Yet inoculations are on the rise, and the F.D.A. has approved Johnson & Johnson’s single-dose vaccine, the third to be approved in the U.S.Today, we check in on the latest about the coronavirus. Guest: Carl Zimmer, a science writer and author of the “Matter” column for The New York Times.    Sign up here to get The Daily in your inbox each morning. And for an exclusive look at how the biggest stories on our show come together, subscribe to our newsletter. Background reading: After the Johnson & Johnson vaccine approval, President Biden vowed that there would be enough vaccine doses for “every adult in America” by the end of May.For more information about the emerging mutations, check out The Times’s variant tracker. For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday.

From The New York Times, I'm Michael Barbaro. This is The Daily. Today, we're announcing a major step forward. As President Biden accelerates plans for manufacturing vaccines. We're now on track to have enough vaccine supply for every adult in America by the end of May. And several states race to fully reopen. It is now time to open Texas 100 percent. An update from my colleague, science writer Carl Zimmer, on the state of the pandemic. It's Thursday, March 4th.

Carl, March, this month we have just entered, marks the one-year anniversary of the pandemic for I think a lot of us, especially those of us who live in New York, because that's when life started to change pretty dramatically. And now, a year into this pandemic, it seems like we're in a relatively good place. The daily infection rate has now been falling consistently for weeks and weeks. Americans are being vaccinated in growing numbers, but we're all terrified that variants of the virus will ruin everything. Does that more or less feel like where things are? Kind of.

We all convinced ourselves starting after January 9th or so that we were skiing down a slope that was going to take us all the way straight down to the end of this pandemic. And it is true that we had on average around January 9th, about a quarter of a million new cases every day, which was horrific and the highest we'd ever reached in this pandemic. And we did go down and down and down and down and down. But then actually people may not have noticed, but towards the end of February, like February 20th, 21st, that ski run stopped.

We leveled out at about 67,000 cases on average a day. And that's where we've been ever since. So that long fall for now has stopped. I honestly did not realize that, that this, as you call it, ski slope down of declining infections has basically halted. Just bear in mind that we had a peak in the spring, then we had a higher peak in the summer, then we had a way higher peak in December and January. And now we're just back down to the summer peak. And somehow we've convinced ourselves that that's okay. And if you remember in the summer, we were all freaking out, rightly so, because tens of thousands of people were getting COVID every single day and it was out of control. So we're still out of control. We're

just less out of control than we were in January. Now it's possible that as we move forward, this ski slope will start to go down again and we could pick up speed and have another decline in cases. But for a while now, it's just been flat. So Carl, what explains that? Why have those declines in infections stopped? You know, it's going to take a while to sort this all out, but there are two clear possibilities. One is that people have been looking at these dramatic declines for weeks now and have decided that the pandemic is officially over. The governor of Texas literally just announced that Texas is open for business 100%. Right. And the CDC is actually asking these politicians to just slow the roll a little because we still have these

relatively very high cases. So that may be one reason why we have gone from this really dramatic decline to a flat stretch. In other words, human behavior. People starting to get together more and be less cautious and sharing viruses. Got it. Okay, what is the second possible explanation? The second possible explanation is that we're starting to see the effect of the variants. Scientists have had their eyes on dozens of variants just to see just how dangerous they might be.

And there are definitely three that have really gotten them worried. And they actually give them a name for that. They call them variants of concern. They have incredibly poetic names. There's B.1.1.7, B.1.3.5.1, and P.1. and P1. Okay, well, where should we start? We should start with B.1.1.7 because that's the one that has really been on fire in the United States. B.1.1.7 was first identified in the United Kingdom and it's been here since December, probably in the United States. And it has been doubling maybe every nine or 10 days or so. And now we're up to 25% of all coronaviruses in the United States are estimated to be B.1.1.7. So it has swelled up. In Florida, that may actually be much higher, maybe 36% or so of the variants. This is a very contagious variant. Unfortunately, it may also be a rather lethal variant.

Just how much more lethal? The current estimates are maybe 30% more lethal, maybe even more. That's a serious escalation. percent more lethal, maybe even more. That's a serious escalation. Yes, it is. It is. Just the fact that it is more contagious is dangerous because that can eventually lead to just more cases overall. And more cases mean more people going to the hospital and more people dying. Right. Now, if you add on top of that, that it's more lethal, it's really something that you want to crush. And what's our understanding of how this variant is responding to the currently available vaccines? It's responding to the vaccines just like all the other coronaviruses. In Israel, for example, they've been rolling out

vaccines at an incredible pace, and they can actually see the decline in hospitalizations and other effects of COVID-19. They've got lots of B.1.1.7 there and that does not seem to be affecting the vaccines, which is great news. And we also have to remember that things like masks and social distancing and good ventilation, they work against B.1.1.7 too. It's just that we have to be really diligent with all those measures to really bring B.1.1.7 down. Conditions like a lockdown that might really help to crush an outbreak of some other variants just aren't going to be good enough for B.1.1.7. But if you are really diligent about controlling the transmission of this variant, you can make a difference. And that's great for the vaccines because vaccines work best

when the cases are low. Okay. On to the second variant of concern. Second variant of concern is called B.1.3.5.1. That was first identified in South Africa. It's in the United States. The Centers for Disease Control has recorded so far 53 cases in 16 different states. And what kind of risk does it pose? So the big risk that people are worried about is that it seems like this virus is good at evading defenses. So for example, if you got COVID-19 from another variant and developed immunity through antibodies, B.1.3.5.1 might be able to get past those antibodies and get into your cells anyway. So it could reinfect you. It could reinfect you. That is an especially unwelcome development. It is unwelcome. Now, this is something that happens with viruses all the time. So,

for example, with influenza, you know, influenza evolves and then immunity you might have had by having the flu before doesn't prevent you from getting the flu again. So, you know, it's not shocking, but it is disappointing. And what about this variant's response to vaccines? This variant's response to vaccines has really brought up a lot of people in the vaccine business short. It has really worried them. It just so happened that where this variant took off, South Africa, was also the place where a number of vaccine companies were running trials. So they could actually see how well their vaccines worked against B.1.3.5.1, and then they could

compare it to other countries where the variant was not yet common. And you can see that there are vaccines that work pretty well or very well in other countries, and in South Africa they didn't work well at all. So that tells you that the antibodies that we're producing when we get vaccinated with the first generation of vaccines may not work as well against B.1.3.5.1. They'll still give some protection, but not as much protection as we had hoped from the initial results of vaccines. So given all of that, what is the lethality of this variant? I'm guessing it's pretty high. There's actually no evidence that it's more lethal than other variants. So,

you know, at least we don't have to worry about that. And what about the third variant? The third variant is P1. P1 was first identified in Brazil. It, too, is in the United States. There are only, so far, 10 cases that have been identified in five states. So this one seems to be the rarest of all, as far as we can tell. But, you know, when I talk to experts and say, okay, all these variants, you know, which one really worries you? Some of them say P1. P1 is the one that keeps them up at night. And why do they fear it the most of these three variants of concern? They fear it because P1 has a pretty extraordinary origin story. It arose in a city called Manaus, which is a city of a bit over 2 million people in the Amazon.

Now, in the spring last year, Manaus went through a terrible time with COVID-19. The city was ravaged, the cemeteries were overflowing. And then later, scientists estimated that maybe as many as 75% of people got infected. Wow. It's a huge amount. Now, the true amount might be somewhat lower, but in any case, a lot of people got infected. And so some people were saying,

well, maybe Manaus has herd immunity now. Maybe they don't have to get worried about huge surges in the future because they've been through this and they have immunity. That turned out to be wrong because in December, they started going through an even bigger spike. And so scientists were saying, well, what is going on? And as they investigated this new second outbreak, they discovered that a new variant had arisen and was probably driving the outbreak called P1.

Got it. The one that some scientists now fear above all else in a place like the United States. Yeah, well, they're taking a look at it more closely since its discovery, And they're finding that not only does it spread quickly, but appears to be able to evade antibodies, maybe antibodies that people develop from a previous infection. So maybe some people are getting reinfected in Manaus. And, you know, it also raises concerns about vaccines, for example. How well will vaccines work against P1? And the reason that they fear it is that P1 has left Manaus. It is found throughout Brazil. It's in many other countries,

including the United States. And now we have to wait and see, is P1 going to behave in these new homes as it did in Manaus? Right, which would include reinfecting people who had previously gotten coronavirus, potentially on a mass scale. It could just take off and infect people who have never had COVID before, maybe infect people who have had COVID before. It might even infect people who've gotten vaccinated. Okay, well, what do we know about how vaccines will or won't protect against this variant?

We know very little about how vaccines will or won't work against P1. There's been no vaccine trial in a place where there was lots of P1. That would be the best way to learn about it. Scientists have done experiments where they put the P1 virus in a test tube with cells and watch them infect the cells and then throw in antibodies produced from vaccines. And it looks at least in a test tube like P1 is able to get away from some of those antibodies and get into the cells. But, you know, we're not test tubes. So the fact that

antibodies are less effective against P1 than other kinds of coronaviruses doesn't really tell us exactly how much vaccines will be harmed in their effectiveness. So one of the reasons scientists are freaked out by this variant is because they don't know how it will respond to vaccines. Correct. It's kind of a wild card. If it took off, you know, more people might be getting infected even though they're vaccinated. We just don't know. We don't know. And, you know, we would like to have more certainty as we're trying to bring this pandemic to an end. And we have this variant that popped out of Manaus and is now moving around the world. We still don't know a lot about it. Carl, when we talk about variants, it had been our assumption

that we had reached a point in the pandemic where there just weren't that many people left to infect, right? Through a combination of previous infections and vaccinations, the number of folks who remained vulnerable was supposed to have shrunk. And the idea was that the virus would slowly run out of potential hosts. But the variants that you are discussing here and their features, including their ability to dodge antibodies and reinfect people and potentially outwit vaccines, that would seem to change that calculation about fewer hosts being available. Yes. When you're talking about so-called herd immunity, you're sort of assuming that that immunity applies to all the coronaviruses that are out there. So if you've got a P1 or a B1 351 floating around that can evade some of those antibodies, the vaccines are less effective

against it, then that herd immunity isn't quite what you had hoped. But, you know, that is something that science can deal with. We know how to deal with new variants. I mean, no variant is going to be a match against a really great vaccination campaign. If we get a lot of people vaccinated as fast as possible, it's just going to make it really hard for all these different variants to get from person to person. And the faster we do it, the better shape we're going to be in. We'll be right back. So, Carl, on the subject of vaccinations, we now have a new one from Johnson & Johnson, which is the third to be authorized for use in the U.S. What exactly do we need to know about it and how it fits into everything

that we've been talking about? Well, this is the first vaccine that's been authorized as just a single shot. So it is effective at preventing COVID-19 with just one dose. It appears to have milder, less common side effects when you get vaccinated, you know, so in terms of the achiness or the fever, it seems like there's a bit less of that. And also it can be kept in a refrigerator for three months and stay just fine, as opposed to Pfizer and Moderna's vaccines, which have to be kept frozen. So it's a lot easier in a lot of different ways. And how is it possible that a single dose can accomplish in this vaccine what two doses is required to accomplish with the other vaccines we have so far from Moderna and Pfizer? Well, when Johnson & Johnson was testing out the vaccine initially in mice

and in monkeys, they were really struck by the fact that even after one dose, these animals were getting really strong production of antibodies. And when I gave them a dose of the coronavirus, this vaccine did a really good job with just one dose of fighting it off. So they said, hey, let's go for one dose. Interesting. Because we're in a pandemic. And, you know, if we can use a million doses to vaccinate a million people instead of half a million people, we're going to go a long way to helping to stop this pandemic. So that was the choice that they made. And now we know that one dose of Johnson & Johnson vaccine is effective at preventing COVID-19. So if this is not too delicate or complicated a question, how does the Johnson & Johnson vaccine as a single dose stack up against

the two-dose Moderna and Pfizer vaccines in terms of effectiveness? So Moderna and Pfizer have an efficacy of 95%. So that's a measure of how much they reduce your risk of getting sick. Johnson & Johnson's, they've found an efficacy in the United States of 72%. But you have to be careful with those kinds of comparisons because Johnson & Johnson was carrying out their trial at a different time than Pfizer and Moderna did. Pfizer and Moderna started their trial in late July. Johnson & Johnson didn't start for a couple months after that. So by the time that Johnson & Johnson had a lot of recruits getting vaccinated, we were in the middle of a really intense surge of COVID, much bigger than what we had dealt with before.

And what vaccine developers have found is that if you run a trial when rates are really high, you might end up with an efficacy estimate that ends up being low. And that's just because your volunteers are getting exposed to the virus more. They have more of a chance of getting infected. If rates are low, people just might not have the opportunity

to get sick in the first place. And you don't really put your vaccine to as much of a test. That's fascinating. You're saying people in clinical trials might catch the coronavirus at higher rates at a more serious time of the pandemic, which could make Johnson & Johnson's vaccine seem less effective than perhaps it really is. That's correct. There are ways that you can test two vaccines head-to-head under exactly identical

conditions, and those are really important. But in the middle of a pandemic, we're not able to do that. So we have these independent trials. And the key thing is that they all work well. And not only that, but Johnson & Johnson's vaccine actually has a very high efficacy for keeping you from getting severe COVID. That's going to send you to the hospital and put you at risk of death. After about 28 days after vaccination, nobody went to the hospital. Wow. From the vaccinated groups with Johnson & Johnson's vaccine. So that gives you a sense that this thing is going to protect you. And so we now have three good options for getting vaccinated

and being protected from this disease. Right. I recall a colleague of ours telling us early on in the pandemic that any vaccine that is 50% or more effective is spectacular. And all three of these vaccines are well beyond that level of effectiveness. Yeah, they all go way beyond the threshold that the FDA set last year for a coronavirus vaccine. And the fact is that when scientists take a look at how much benefit there will be at waiting to use a really effective vaccine versus pushing out a less effective vaccine very quickly, it turns out that waiting is just a mistake. You're giving the virus more time

to spread and to sicken people and to kill people. So the faster that we can get all of these vaccines out, the more effective we're going to be at driving down the pandemic and getting ahead of the variants. So I don't want to put words in your mouth, but tell me if I'm right here. To those who are listening and thinking to themselves, well, if I had a choice, I think I would like X vaccine over Y vaccine. It sounds like the reality is you would be very lucky to have any of these three vaccines, no matter which one. You just get the first vaccine that you can get. You should not be waiting around, waiting for your favorite bespoke vaccine to become available.

In that time, you could get COVID. Right. So get the first authorized vaccine that you can. It is going to reduce your risk of getting COVID-19. And it's also going to reduce your risk of passing on the virus to other people. We're starting to see that there's evidence that these vaccines, including Johnson & Johnson's, reduce transmission. And that's really important because that is going to bring down the overall burden of the epidemic

across the whole country. Carl, you said that variants are no match for a good vaccination campaign, which makes me wonder where exactly we are in the U.S. vaccination campaign at this moment and how Johnson & Johnson's vaccine might change that, if at all. We're doing pretty well, I would say. Over 50 million people have received at least one dose of a vaccine. We're getting towards 2 million people a day getting vaccinated, We're getting towards 2 million people a day getting vaccinated, and that is going to increase. So we can imagine 3 million people getting vaccinated a day, maybe 4 million. Johnson & Johnson is going to help this increase in a big way, starting with 4 million doses that they're going to be able to supply immediately now that they're authorized. And Johnson & Johnson and Merck, which is a very

experienced vaccine manufacturer, have entered into a partnership brokered through the Biden administration to ramp up their supply even more. Pfizer and Moderna have also entered into agreements to be supplying hundreds of millions of more doses as well. And just on Tuesday, President Biden made a big announcement. He said that there will be enough doses of the coronavirus vaccine available for the entire adult population of the U.S. by the end of May. Which is kind of a shockingly new and early deadline that really changes people's expectations. It really is, because before, Biden was shooting for the end of July. So he has just brought his schedule up by two months. three of these vaccines and the ramping up of production, the country's clearly just starting to hit its stride and is essentially going to be able to get vaccines to adults in the country

faster than we thought. Well, certainly the vaccine companies are going to get us those vaccines. The question is, are we going to be able to get those vaccines to people quickly? And that is going to come down to really good distribution systems across all the states. But right now it's a real patchwork. And that is a legacy of our, you know, state-based healthcare system where each state is left to its own devices. some of them are doing well and some of them are definitely not. We've got a lot of vaccines coming. And so we really need to be efficient in getting as many people vaccinated as quickly as we can. And I guess, Carl, then the question becomes, how does everything we're talking about interact and on what schedule, right? Vaccine distribution,

schedule, right? Vaccine distribution, variants blossoming and spreading, and reopenings, like the one we just learned about in Texas, back 100% when we know not everyone in Texas has been vaccinated and the variants are spreading. It's going to be a very complicated spring and summer. You know, we could see a huge fourth surge. I really hope we don't. But if we aren't careful, we could let the variants take off and explode before enough people are vaccinated. But if we vaccinate quickly while we're keeping on our masks and being careful and make sure that all the states are doing as good a job as they can to get vaccines to everybody, we can really get this pandemic behind us in a way that saves a lot of lives. I have to ask this, asking everyone on our show, have you gotten your vaccine yet?

I've not gotten my vaccine yet, but I am really stoked in the state of Connecticut. They are going to open up my age group in March 22nd. And I have to say, you know, having been reporting on vaccines for about a year now, you know, when I started reporting on these things, I didn't know if these vaccines would exist. Right. And now one of them is about to go into my arm, and I'm really looking forward to it. Whichever one it is. Right.

Well, all we ask is that you record the experience. Absolutely. There will be selfies. Thanks, Carl. Thanks a lot. On Wednesday, during an event at the White House, President Biden was asked by reporters about the decision by Texas, and later Mississippi, to end their mask requirements.

I hope everybody's realized by now, these masks make a difference. We are on the cusp of being able to fundamentally change the nature of this disease because of the way in which we're able to get vaccines in people's arms. Biden called it a mistake. And the last thing, the last thing we need is the Neanderthal thinking that in the meantime, everything's fine. Take off your mask. Forget it. It still matters. Forget it. It still matters. We'll be right back. Here's what else you need to know today. The Times reports that the Capitol Police Force is preparing for another possible assault on the Capitol building after obtaining intelligence of a potential plot by a militia group to attack the building today.

In response to that intelligence, the House of Representatives canceled plans for a legislative session on Thursday to avoid having lawmakers in the building. The plot appeared to be inspired by supporters of QAnon, the pro-Trump conspiracy theory. And... I want to address the recent allegations that have been made against me. During a news conference on Wednesday, New York Governor Andrew Cuomo apologized to the women who have accused him of sexual harassment, but said that he did not plan to resign because of them. I now understand that I acted in a way that made people feel uncomfortable.

in a way that made people feel uncomfortable. It was unintentional, and I truly and deeply apologize for it. I feel awful about it, and frankly, I am embarrassed by it. And that's not easy to say. But that's the truth. The women have accused Cuomo of inappropriate comments and conduct,

including unsolicited kissing. But during his news conference, Cuomo insisted that he had never inappropriately touched anyone. Today's episode was produced by Rachel Quester and Nina Potok. It was edited by Dave Shaw and M.J. Davis-Lynn and engineered by Corey Schreppel. that's it for the daily i'm michael barbara see you tomorrow