Dr. Osterholm: Americans will be living with the coronavirus for decades

 

 

Osterholm’s viewpoint is sobering. The 67-year-old expects the novel coronavirus to be present for the rest of his life. He doesn’t believe the wave theory (a first wave, a lull, followed by other waves) will apply to this pandemic. “That’s not what’s happening here,” he told MarketWatch in an interview.

MarketWatch: One of the things I’m pretty interested in is the talk and the hope around a vaccine. Do you think we have misconceptions about what it means when we have a vaccine?

Michael Osterholm: Everyone is looking at the vaccine as being a light switch: on or off. And I look at it as a rheostat, that’s going to take a long time, from turning it on from its darkest position to a lightest position. If you’re anticipating a light switch, you’re going to be concerned, confused, and in some cases very disappointed in what it might look like in those first days to months with a vaccine.

MarketWatch: I saw a piece in The Atlantic this week and I thought they positioned it well. They described it as the beginning of the end.

Osterholm: It won’t be. We will be dealing with this virus forever. Effective and safe vaccines and hopefully ones with some durability will be very important, even critical tools, in fighting it. But the whole world is going to be experiencing COVID-19 ‘til the end of time. We’re not going to be vaccinating our way out of this to eight-plus billion people in the world right now. And if we don’t get durable immunity, we’re potentially looking at revaccination on a routine basis, if we can do that. We’ve really got to come to grips with actually living with this virus, for at least my lifetime, and at the same time, it doesn’t mean we can’t do a lot about it.

MarketWatch: Do you think we’re going to see some of these vaccines fail in clinical studies?

Osterholm: One of the challenges we have is: what do we mean by fail? What’s the definition? Some people right now have a view that any vaccine that isn’t like the measles vaccine is going to be a challenge, meaning they’ve got to work 93% to 98% of the time. I don’t think there’s any sense that that’s going to happen with this vaccine. That doesn’t mean that there isn’t going to be an effective vaccine at 50%, 60% or 70%.

We have to keep watching for safety signals. We have to make sure that over time we can assure the public with open and transparent data that: This is what you can expect in terms of reactions, this is what might have any long-term complications.

MarketWatch: When it comes to how medical information is being disseminated, there have been a lot of changes. You’ve done some peer review and work with journals. Do you think some of these preliminary scientific writings are being shared with the public too soon?

Osterholm: Oh, absolutely. We’re drinking from a fire hose right now in terms of new information. You can make the case that’s important because we’re in a position to learn things that could have a very real impact on patient outcome and therefore getting the data out are critical. But then there’s a downside to that, too, because with that comes an increasing amount of marginal if not potentially erroneous information.

MarketWatch: Do you think we’re going to see distinct waves of outbreaks in the U.S.?

Continue reading “Dr. Osterholm: Americans will be living with the coronavirus for decades”

NYC health commissioner quits over de Blasio’s COVID-19 response

New York City’s top public health official resigned Tuesday, accusing Mayor Bill de Blasio (D) of sidelining medical experts in the midst of a pandemic that has hit America’s largest city especially hard. In an emailed resignation letter, Health Commissioner Oxiris Barbot said she quit with “deep disappointment that during the most critical public health crisis in our lifetime, that the Health Department’s incomparable disease control expertise was not used to the degree it could have been.” “Our experts are world renowned for their epidemiology, surveillance and response work. The city would be well served by having them at the strategic center of the response not in the background,” Barbot wrote in an email first reported by The New York Times.

In an email to staffers, Barbot praised the agency as the gold standard in public health. “As I shared with the Mayor, your world class skills are what make this agency so respected around the globe,” Barbot told her colleagues. “Your experience and guidance have been the beacon leading this city through this historic pandemic and that to successfully brace against the inevitable second wave, your talents must be better leveraged alongside that of our sister agencies.”

Barbot has repeatedly clashed with de Blasio since the beginning of the pandemic. In May, the mayor stripped the health department of its authority over a massive contact tracing program, teams the department had led in past crises.

Nearly a quarter-million New York City residents have tested positive for the coronavirus, which began spreading widely through the city in March. At its peak in early April, more than 6,000 people were testing positive every day. Almost 19,000 have died, a steeper toll than any single state in the nation. The number of new cases has plummeted in recent weeks. On July 31, the last day for which data is available, just 82 New Yorkers tested positive. De Blasio on Tuesday appointed Dave Chokshi, a population health and medicine expert at NYU’s School of Medicine, to replace Barbot. Chokshi has been aiding the city’s response to the coronavirus outbreak.

“Dr. Chokshi has spent his career fighting for those too often left behind,” de Blasio said in a statement after Barbot’s resignation. “Never has that been more true than during the Covid-19 pandemic, where he has helped lead our City’s public health system under unprecedented challenges. I know he’s ready to lead the charge forward in our fight for a fairer and healthier city for all.”

Chokshi served as a White House fellow during the Obama administration and as a top health adviser to the secretary of Veterans Affairs.

New York City’s Department of Health and Mental Hygiene is one of the most prominent and practiced health departments in the world. Two former commissioners, David Sencer and Tom Frieden, went on to run the Centers for Disease Control and Prevention.

U.S. job growth slows sharply in July

 

WASHINGTON (Reuters) – U.S. employment growth slowed considerably in July amid a resurgence in new COVID-19 infections, offering the clearest evidence yet that the economy’s recovery from the recession caused by the pandemic was faltering. Nonfarm payrolls increased by 1.763 million jobs last month after a record 4.791 million in June, the Labor Department said on Friday. Economists polled by Reuters had forecast 1.6 million jobs were added in July. The unemployment rate fell to 10.2% from 11.1% in June, but it has been biased downward by people misclassifying themselves as being “employed but absent from work.” At least 31.3 million people were receiving unemployment checks in mid-July.

“The steam has gone out of the engine and the economy is beginning to slow,” said Sung Won Sohn, a finance and economics professor at Loyola Marymount University in Los Angeles. “The loss of momentum will continue and my concern is that the combination of the virus resurgence and lack of action by Congress could really push employment into negative territory.”

The labor market step-back is more bad news for President Donald Trump, who is lagging in opinion polls behind former Vice President Joe Biden, the presumptive Democratic Party nominee for the Nov. 3 election. It also piles up pressure on the White House and Congress to speed up negotiations on a second aid package, which have been dragging over differences on major issues including the size of a government benefit for tens of millions of unemployed workers. A $600 weekly unemployment benefit supplement expired last Friday, while thousands of businesses have burned through loans offered by the government to help with wages. The economy, which entered into recession in February, suffered its biggest blow since the Great Depression in the second quarter, with gross domestic product dropping at its steepest pace in at least 73 years. Infections of the respiratory illness soared across the country last month, forcing authorities in some of the worst affected areas in the West and South to either shut down businesses again or pause reopenings, sending workers back home. Demand for goods and services has suffered. The slowdown in hiring challenges the U.S. stock market’s expectation of a V-shaped recovery. The S&P 500 index .SPX is up nearly 50% from its March trough. As COVID-19 cases spiral, and Republicans and Democrats bicker over another stimulus package, economists see a W-shaped recovery. Economists estimate the Paycheck Protection Program that gave businesses loans that can be partially forgiven if used for employee pay saved around 1.3 million jobs at its peak. The extra $600 weekly unemployment checks made up 20% of personal income and helped to boost consumer spending in May and June.

US Tops 2,000 Deaths In 24 Hours: Johns Hopkins

https://youtu.be/O3b3LtPt4N8

The United States has recorded more than 2,000 coronavirus deaths in 24 hours, the highest number of daily fatalities in three months, Johns Hopkins University’s real-time tally showed Thursday.

The country, which has seen a major resurgence in coronavirus since the end of June, added 2,060 deaths in one day as well as more than 58,000 new cases, the Baltimore-based university showed at 8:30 pm (0030 GMT Friday).

The last time the US recorded more than 2,000 deaths in 24 hours was on May 7.

Trump promises to defeat ‘China virus’ And have the vaccine by Election DAY

United States President Donald Trump proclaimed on Thursday his country would “defeat the China virus” as he touted the latest progress made in developing a treatment for the disease. “We have made tremendous strides and have a bounty of…

President Trump says he’s “optimistic” that a vaccine will be ready around Election Day, and it “wouldn’t hurt” his chances against former Vice President Joe Biden. But having a vaccine available for widespread public use before 2021 is unrealistic, according to public health experts, including the Coronavirus Task Force’s Dr. Anthony Fauci. Mr. Trump told Geraldo Rivera’s radio program “Geraldo in Cleveland,” on WTAM, Thursday that a vaccine could “in some cases” be ready sooner than November 3, but “right around that time.” Asked about this on the White House South Lawn a couple hours later, the president said he’s “optimistic” about a vaccine being ready around that date. “I’m optimistic that it’ll be probably around that date. I believe we’ll have the vaccine before the end of the year, certainly, but around that date, yes, I think so,” Mr. Trump sad.

Goldman Says Covid-19 Vaccine Approval Could Upend Markets

(Bloomberg) — Investors should consider the risk of a successful coronavirus vaccine unsettling markets by sparking a sell-off in bonds and rotation out of technology into cyclical stocks, according to Goldman Sachs Group Inc.

The increased probability of an approved vaccine by the end of November is underpriced by equity markets, wrote strategists including Kamakshya Trivedi in a note Wednesday. Over the next few months, the ramifications of the U.S. election and the evolution of the virus — in part as schools reopen — are also likely to be key drivers of the market, they said.

Approval of a vaccine could “challenge market assumptions both about cyclicality and about eternally negative real rates,” the team wrote, adding such a scenario may support steeper yield curves, traditional cyclicals and banks, while challenging the leadership of technology stocks. If this happened along with a change in the U.S. administration, emerging market equities could benefit “if trade policy risks diminish while U.S. tax risks rise,” according to the note.

They see a potential downside target of 2,200 in the S&P500 should there be a significant reversal of activity from a second wave of the virus, the strategists added. The U.S. benchmark closed just under 3,328 on Wednesday.

Why scientists are worried about a ‘Warp Speed’ COVID-19 vaccine

As the race for a COVID-19 vaccine heads into the stretch run, scientists are tempering their enthusiasm with caution. The biotechnology company Moderna and the National Institutes of Health have begun Phase III efficacy trials for their vaccine. The University of Oxford and Pfizer are running combined Phase II and III testing for their respective drugs. All together, drugmakers have 27 vaccines in trials. The goal of Operation Warp Speed, the U.S. vaccine initiative, is 300 million doses of a safe, effective vaccine by January, and if realized, it would be one of the greatest scientific achievements of all time. On Tuesday, Goldman Sach predicted the Food and Drug Administration would approve at least one vaccine before the end of the year. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said last month he was hopeful a vaccine would be available by late fall or early winter.

Here’s what worries scientists:

—FDA regulators will likely face enormous political pressure to approve a vaccine, even one that’s not proven safe and effective.

—A vaccine that’s less effective than billed could cause wider spread of the pandemic, Michael S. Kinch, director of the Centers for Research Innovation in Biotechnology and Drug Discovery at Washington University in St. Louis, writes in Stat News.

“A merely short-term effect could encourage vaccinated individuals to resume risky behaviors, which would all but guarantee that the epidemic endures,” argues Kinch, who is also a professor of biochemistry and molecular biophysics.

—A vaccine would likely erode compliance of social distancing and mask wearing, measures that are proven effective against spread of the virus.

“They automatically are going to say, ‘Oh great, I’m just going to get my little vaccine, and I can go back and do exactly the things I was doing last year’. That is absolutely not true,” Maria Elena Bottazzi, associate dean of the National School of Tropical Medicine at Baylor College of Medicine, told Business Insider in an interview.

—We don’t have enough data.

“What we have right now is a collection of animal data, immune response data and safety data based on early trials and from similar vaccines for other diseases,” writes Natalie Dean, assistant professor of biostatistics at the University of Florida, in the New York Times.

“The evidence that would convince me to get a COVID-19 vaccine, or to recommend that my loved ones get vaccinated, does not yet exist,” she says.

—If a substandard vaccine is green-lighted without adequate testing or trials, unforeseen harmful side effects could emerge. A weak initial vaccine and/or one with dangerous side effects would likely cause confidence in all vaccines to plummet and strengthen anti-vaccine sentiments. If a safer, more effective vaccine were subsequently developed, the residual mistrust could result in fewer people getting vaccinated.

—Epidemiologists estimate that to tame the pandemic, at least 70 percent of the population may need to develop immunity, either by vaccine or getting infected. Millions of Americans refusing to get inoculated by a vaccine that’s at least 50 percent effective (the minimum level according to the World Health Organization) could thwart that goal.

—A vaccine might only provide short-term immunity because of the nature of coronaviruses. Back in April, Dr. David States, professor of human genetics and director of bioinformatics at the University of Michigan, tweeted:

“If you’re hoping a vaccine is going to be a knight in shining armor saving the day, you may be in for a disappointment. SARS COV2 is a highly contagious virus. A vaccine will need to induce durable high level immunity, but coronaviruses often don’t induce that kind of immunity.”

Trump is not considering nationwide lockdown

President Trump Is Not Considering A National Coronavirus Lockdown, McEnany Confirms

(Screenshot/YouTube/White House)

President Donald Trump is not considering a national lockdown to stop the spread of coronavirus, White House Press Secretary Kayleigh McEnany confirmed Tuesday. Trump and Republicans have long pushed back on the idea of a mandatory national quarantine, citing the federal government’s lack of authority to do so under the Constitution. Trump called on state governors to institute distancing measures tailored to their own states this spring, resulting in widespread protests against governors who took a more severe route.

Some experts say the lifting of current distancing measures across the country relies largely on the production of a successful coronavirus vaccine. White House Coronavirus Task Force member Dr. Anthony Fauci has said he is optimistic that a vaccine will be developed before 2021. The Trump administration’s ‘Operation Warp Speed’ project is aimed at partnering the public and private sectors to develop a vaccine or therapeutics to combat COVID-19.

Dr. Amesh Adalja of the Johns Hopkins University Center for Health Security told the Daily Caller it may be more than a year before life returns to what Americans thought of as normal in 2019, however.

Adalja said the development of a vaccine is one part of the solution, but that vaccine must then be mass-produced, a process which he says could take until 2022.