The Daily - Why Are U.S. Coronavirus Cases Falling? And Will the Trend Last?

Episode Date: January 27, 2021

The number of new coronavirus cases in the United States is falling, but has the country turned a corner in the pandemic? And what kind of threats do the new variants pose to people and to the vaccine rollout?Today, we discuss the latest in the quest to stamp out the pandemic.  Guest: Donald G. McNeil Jr., a science and health reporter for The New York Times. For an exclusive look at how the biggest stories on our show come together, subscribe to our newsletter. You can read the latest edition here.Background reading: New daily cases are starting to slow, in what some health experts see as a turning point. But they warn of a bumpy vaccination rollout amid the emergence of more contagious variants.The C.D.C. has eased coronavirus vaccine rules: The agency now says people can switch authorized vaccines between the first and second doses, and also extend the interval between doses to six weeks.One year, 400,000 coronavirus deaths: a look at how the U.S. set itself up for failure.For more information on today’s episode, visit nytimes.com/thedaily 

From The New York Times, I'm Michael Barbaro. This is The Daily. On yesterday's show, my colleague Donald G. McNeil Jr. spoke with Dr. Anthony Fauci about the Trump era of the coronavirus. Today, with President Biden inaugurated, vaccine distribution well underway, and multiple variants of the virus beginning to spread. An update from Donald on the state of the pandemic. It's Wednesday, January 27th.

So Donald, I want to start by thanking you for interviewing Dr. Fauci. You're not a bad host, I have to say. You're a pretty good host. It's just asking the question and then shutting up. Well, not everyone's capable of that. And I wasn't certain you were capable, but you were. You cut out a lot of my long stories that I would sort of, you know, wind up, you know, after asking the question. So, you know, I appreciate that. You also cut out some of my swearing, so I appreciate that, too. Well, again, we really appreciate that. You also cut out some of my swearing, so I appreciate that too. Well, again, we really appreciate it. Because your conversation with Fauci did such a good

job of establishing where we have been and what it was like to try to fight the virus under the previous administration, I want to talk about where we are right now. So describe this moment in the pandemic for us. What is happening right now? So we're seeing sharp declines in new cases. They're down by about 33% from $260,000 a day in early January to about $170,000 now. That's a big decline. Yeah, yeah, yeah. Decline by a third is a big deal.

We're seeing hospitalizations down by about 10%, and we're seeing deaths down by about 10%. Hmm. How do you explain that? Well, we've seen this before, and we've seen cases rise and then drop. We saw that right over Thanksgiving. We saw it right over Christmas.

And now we're seeing it where it rose until January 9th and then began to drop. Now, those might have been false starts in a way in that Thanksgiving, a lot more people got tested in order to get on airplanes for Thanksgiving travel. And, of course, you pick up some cases that way. Then you saw the same thing at Christmas, Christmas travel again. Then on January 9th, it started going down. And, you know, January, February is not a time when Americans go on holiday travel very much. And so this might be the real thing. You've got a fairly steady level of testing, but the number of positive cases in

that steady level of testing begins to go down and is now going down pretty substantially. And when you say the real thing, Donald, that's a very tantalizing concept. Does that mean that finally we've turned a corner in the pandemic? What do you mean when you say the real thing? I mean, it's not an artifact of testing for holiday travel and then a lag. There really are fewer cases each day in the United States. And we see that state to state to state. Literally every state except Rhode Island is seeing a turning point in the trajectory of the virus that the number of cases has gone up to a peak and look like it's coming down.

We've reached the point now where about a third of the country has been infected. If you look at the total number of cases, 25 million cases. Basically, most epidemiological models now multiply that by about four to get the number of real infections we have in the country. So roughly, we're between 100 million cases and 110 million cases, actual infections, including the asymptomatic ones, which means that about a third of the country has been infected. Wow. And when you reach the point in any herd, in any population, where about a third of the country has been infected. Wow. And when you reach the point in any herd, in any population where about a third of it

is infected, the virus doesn't stop, but the virus begins to slow down. Because in any herd, whether it's a bunch of horses in a corral or it's a bunch of people in a bar, about a third of them are immune to the virus. So the virus can't just ricochet through that crowd as fast as it did months ago when everybody was susceptible to it. So behind this good news decline in the pandemic is the kind of awful reality that the coronavirus has run wild through the United States and infected a third of our population and rendered a third of our population essentially immune. And some of them dead. Right. When people were talking months ago

about reaching herd immunity, that was the argument. Do we hide people away to protect them, or do we reach herd immunity by letting the virus wash through us, just let her rip? Well, it's been let rip, and the consequence is we've got about 400,000 dead. So it's costly. Very costly. So, Dal, this major decline in new cases in the United States, it is coinciding with the emergence of multiple variants of the coronavirus. And I want you to catch us up on those variants. What is the significance of them? How many are they? How meaningfully different are they from each other? And how are they going to interact with this

decline in new infections? Okay. There is a British variant, a South African variant, a Brazilian variant, something called the California variant. And we know different amounts about each one of these. We know the most about the British, a little bit more about the South African, less about the Brazilian, less about the American or Californian one. The British one appears to be about 50% more transmissible than the standard variant in the United States. Right. Meaning one and a half times as likely to infect somebody.

Because it's got a mutation on the spike protein and in the receptor binding domain of the spike protein that makes it better able to attach to cells. That same mutation is in the South African variant and in the Brazilian variant, but they have additional mutations. And those additional mutations make it look as though they might partially escape the vaccines and might partially escape the body's immune response, which would mean you might, in theory, get infected with them again, even if you've already had the virus before. That sounds scary.

It absolutely sounds scary. It's not total. I mean, something can have a weaker response to a vaccine or a weaker response to the body, but not be totally negated. And so people shouldn't panic. I mean, we think of the spike protein as looking like a

spike or the tip of a spear because that's the way it's drawn when you see it. But really, it's not. It's this long string of 1,300 amino acids that then folds and balls itself up into this giant wad of what looks like a bundle of telephone wire and things like that. And when antibodies attack, they kind of work their way through this tangle of telephone wire and glom onto bits of the protein. And if you change the shape of the protein, some of the antibodies may not be able to make their way through this jumble of telephone wire and attach where they normally attach, so you get a weaker antibody response. Doesn't mean your response is totally wiped out. It's as if you had, you know, no armor, and now you've got armor with a bunch of holes in it. Well, some arrows can get in and some arrows can't. You can still be killed,

but it may be harder. Hmm. So just to summarize, the mutations in the Brazilian and South African variant, they have created a shape of spike that just makes it harder for these antibodies to find their way to where they're supposed to go to damage that spike and make it harder for the virus to infect us. Yes, that is the prevailing theory as to what these mutations are doing, that they are changing the way the protein folds, which changes the ultimate shape of the protein once it's all balled up. Now, we know that all three of these variants are more contagious. The question is, are they more lethal? There was a controversial statement made

by Prime Minister Boris Johnson in England the other day saying that the British variant might be a third more lethal. But that's based on very preliminary evidence. And his own scientists said, hey, let's not say that clearly. That's spreading panic. The other two variants, Clearly, that's spreading panic. The other two variants, if they are better able to escape vaccines or better able to escape the counterattack from our immune systems, might indeed be more lethal, somewhat more lethal. But we don't know that yet. It's an assumption you'd make, but we don't have that yet. It's an assumption you'd make,

but we don't have the data to prove it. And remember, we're talking about sort of fractionally more lethal. We're not talking about COVID-19 becoming the Black Death. We're talking about a slightly more dangerous virus. And of course, treatments are getting better and hospitalization getting better, and hospitalization, you know, getting better. So hopefully we can overcome that.

So before we get to how these variants are going to complicate the question of treatment and vaccination in the U.S., I just want to return to these declines in new infections, because it would seem like these more contagious variants will be jeopardizing those significant declines that you just described. That seems almost inevitable. It is inevitable. It is what scientists are afraid of. They are afraid that if we don't vaccinate people fast enough, that the British variant will spread and become the dominant variant. The CDC has already predicted that that will happen by March. And that means new infections will speed up. And it's now becoming a race between vaccinating people and the spread of the variant. And the fear is that if the variant spreads faster than the

vaccine can, you'll see cases begin to go up again towards another peak. We'll be right back. So Donald, before the break, you were describing the threat that these coronavirus variants pose to the decline in new infections and the threat that they pose to the vaccines we have developed for an earlier version of the coronavirus. Just how much less effective do we expect a Pfizer or a Moderna vaccine to be against the Brazilian or the South African variants? I don't think we know yet just exactly how less effective. just exactly how less effective. There was a scientist yesterday who said, look, these vaccines induce a super awesome amount of antibodies in you, and now they are reduced

to merely an awesome level of antibodies. So we still think these vaccines will probably work. And remember, it's not just antibodies that the vaccines inspire to work in your body. They also trigger the B cells and the T cells, which are part of the immune system. And there are other things, macrophages that come in and gobble up viruses, all sorts of things. There's a complex response in your immune system. But the easiest thing to measure is antibodies, so that's what we look at. Scientists assume, based on what they know, that the vaccines will

still be pretty good. Nonetheless, as we do with flu every year, they are tweaking the vaccine to make it a little more perfectly targeted. Pfizer and Moderna have announced that they can do that, to come up with sort of a booster shot that could be added to the two shots you get of each of those vaccines. Huh, that would mean a third shot for a person who is vaccinated, and it would be specially reformulated

to address one of these variants or multiple variants? Well, yeah, that's what it would mean. But that's in a perfect world where everybody's had their two shots already. You'd have the third one. We haven't. We're not close to the perfect world yet. So it's good that they're doing that work, but it's also going to take some weeks to actually make that vaccine. Then they have to brew it up and distribute it.

So the foot race that's going on right now between the vaccines and the variants is going to be played out well before that third booster shot comes along. The battle is on right now. Okay, so in this foot race between the variant and the vaccine, how do we stop the spread of the variants? The United States has not been very good at stopping the spread of any variations of the coronavirus. Yeah. It's too late to stop the spread of the British variant. It's in multiple states, more than 20. It's imperative to stop the spread of the South African and Brazilian variants.

And the way you do that is to block travel from those countries. And the Biden administration has picked up and strengthened some of the stuff the Trump administration was doing. There is a, is or will be soon, a ban on travel from Britain or South Africa or Brazil. But they're also making an incorrect assumption that the Trump administration did repeatedly, which is that only banning citizens of those countries will stop the virus, when in fact the virus doesn't care what passport you carry and is perfectly happy to come here in an American nose, as in a foreign nose, if you like. And so you have to do something also to stop the Americans from carrying that virus into the country. And, you know, the answer that many countries would have, everybody from

China to Singapore to New Zealand would be quarantine those people. Maybe not for 14 whole days, but, you know, long enough to give them maybe a couple of different kinds of tests to make sure they're actually negative. Right. So what you're saying is right now we're letting Americans travel from Brazil and South Africa back to the United States, potentially carrying the virus with them, and we're not carefully monitoring their quarantine the way countries like China have. In other words, these travel bans are very porous and, in a sense, kind of useless. Yeah. And this has happened before. I mean, you know, in 2009, when the H1N1 swine flu from Mexico was a threat, there were some cases in Southern California and Texas where everybody thought, oh, it's coming over the border.

But it landed in New York City in 27 students from St. Francis High School in Queens who had all gone to Cancun on their spring break. And that's how the disease came to New York City. So, I mean, it's common. It's just as common for a disease to come back in returning Americans as it is in foreigners. So we should assume that the South African and Brazilian variants will be with us if they already aren't with us. We should assume that if we're not careful, they will definitely be here and begin to spread.

There's still time to contain this, we think, but we have to move fast and we have to move aggressively. I just want to say, for the record, this conversation started with good news. It did. Yeah. We're all of us caught in this bind, aren't we? So you started to hint at what President Biden is up to. And now that you have laid out the pretty challenging landscape that he is inheriting when it comes to the pandemic, help me understand what his approach is so far. I know it's just been a few days. And how much it's differing from the Trump administration? Well, he's got scientists in charge of the response whom he is allowing to speak, or he has said that it will be that way, that Tony Fauci will now be allowed to say what's going on rather than having the president say what's going on and then Tony Fauci being forced to contradict him and being caught in an awkward bind. You have Rochelle Walensky, who's an expert on infectious diseases, running the CDC. And rather than being silent, she says there will be regular briefings from her or from her experts.

You know, all these are incredibly good signs. This is the way we used to be here. I mean, during previous epidemics, you know, the president would occasionally say things, but mostly the head of the CDC, sometimes the Surgeon General, sometimes Tony Fauci would, you know, get up there and tell the truth about what was happening. You know, in the past, there would be, you know, a television appearance by somebody, you know, maybe once every couple of weeks, but there would be three or four telephone briefings a week for reporters with a lot of time to ask questions and a lot of experts being encouraged, Dan, why don't you take that one because that's your area of expertise. The person to be in charge of vaccination would be there on the phone call. You listen to the experts and that's what I hope is going to happen this time. I mean, we'll have a science-based response,

which we did not have before. We had a panic-based response and a let's not scare the stock market-based response that it's all going to go away response and stuff. So we, hopefully this will be taken seriously. Well, handing press conferences to scientists is one thing. I think the thing most Americans want to get a handle on is how much more efficiently will vaccines be distributed and administered under this new presidency? That feels like where the rubber's going to meet the road. And so far, President Biden has articulated a set of goals not all that different in ambition from the Trump administration in terms of about a million vaccinations a day. What do you make of that? Well, we have reached about one million doses in arms per day, and they now hope to ramp that up.

Maybe we can reach one and a half million a day pretty soon. That means assuring and keeping track of a steady supply of vaccines coming out of the factories and getting to the states. The states and cities will still be in charge of just sticking the vaccines into the arms, but you can help them do that a lot. You can give them money to train vaccinators and set up vaccination centers. You can optimize the supply to those places and set up a database where everything can be reported so that we have a very clear idea at the end of

each day how many vaccines are on hand and where they are. In other words, this can be more centralized. The Biden administration can do that. Yeah. Well, given these variants and their spread, given the pretty messy situation with vaccine administration so far. How optimistic are you that the timelines that have been pretty firmly planted in people's heads in this country about when normalcy will return are actually plausible? We have mentioned them on the show in the past. The notion was that by the end of the summer, things might look a lot like they used to look. And I'm starting to have my doubts about that timeline.

How about you? Well, I don't subscribe to by the end of the summer exactly. I have tried to resist predicting the future all along. I'm ultimately optimistic that sometime this year, things will be back to normal, but I can't say when. And every time I said that, I always said, you know, if things roll out exactly as hoped, if multiple vaccines are approved, if nothing goes wrong in the production process, if, you know, assuming people are going to accept

the vaccines more than we thought last year, it's going to happen sometime, but I don't want to say, you know, June 15th or whatever. It's up in the air. If we speed up, it'll come, the vaccination, it'll come sooner. If the virus changes radically, we'll have new problems. And it's, like I said, it's going to be a battle. Speed up the vaccination, try to stop the variants, the bad variants from spreading in this country, do as much as we can to outrace the British variant, which is already in the country, and hope that no new, truly dangerous American variants spring up. There's always that possibility too. So I have to ask, have you gotten your vaccine? No. No. And I'm trying. I didn't try as hard in the beginning as I should have.

And I sort of missed the boat. I have called some of the hotlines multiple times. I've even had a call back. And after giving all the information was told, oh, I'm sorry, there's no more appointments. And I'm like, seriously, am I back to square one? I'm sorry, sir. You know, I'd like to see my granddaughter. I'd like to be vaccinated.

Mm-hmm. you know, I'd like to see my granddaughter. I'd like to be vaccinated. Now, my herd is currently 37.5% immune. And I can explain how I got there. So I'm with my girlfriend. She works, volunteers part-time in a hospital, sometimes seeing patients. So she got vaccinated.

One does. We hang out in our pod with a couple. We'll call them Fred and Ethel. Fred is having cancer treatment. And so his oncologist got him a job and Ethel was able to get through the hotline of the Javits Center. So they've all had one of two shots. So that's 75% of our pod is half vaccinated. So that's 37.5% protection. I'm the zero inside the herd. I'm the goat in the buffalo herd, if you like. But, you know, I'm getting closer. And, you know, once I can find the vaccine and I get to and I wait a couple of weeks

till the antibodies kick in, then I'll be able to see my granddaughter. But for now, you're the skunk at the picnic. Yeah, fine. Skunk at the picnic, the goat in the buffalo herd, whatever. Well, I wish you the best of luck as you work the phones and navigate. Pretty tricky system. Well, thanks. I'll let you know how it goes.

Please do. Well, thank you, Donald. We appreciate it. Okay. Take care, Michael. The first confirmed U.S. case of the Brazilian variant has been detected in Minnesota. Local health officials said that the case involved a U.S. resident who had recently traveled to Brazil, the kind of traveler whose movements would not be impacted by current U.S. travel rules.

We'll be right back. Here's what else you need to know today. Here's what else you need to know today. On Tuesday, the acting chief of the Capitol Police apologized to Congress for failing to secure the Capitol on January 6th when pro-Trump rioters stormed the building. In closed-door testimony before the House, the chief, Yogananda Pittman, said that the Capitol Police understood that there was, quote, strong potential for violence, but had failed to take the necessary steps to prepare for it. And a majority of Senate Republicans voted against holding an impeachment trial of former President Trump, suggesting that the Senate does not have enough votes to convict him.

Just five Republicans joined 50 Democrats in voting to move ahead with the trial. 17 Republicans would need to cross party lines in order to convict Trump during next month's trial. in order to convict Trump during next month's trial. Today's episode was produced by Alexandra Li-Yang and Michael Simon-Johnson. It was edited by M.J. Davis-Lynn and engineered by Chris Wood. That's it for The Daily. I'm Michael Barbaro. See you tomorrow.