November 27 coronavirus news

Advisers to the Centers for Disease Control and Prevention will vote Tuesday on the very first people to get a coronavirus vaccine once one gets emergency authorization.

The CDC’s Advisory Committee for Immunization Practices has scheduled an emergency meeting for Tuesday to discuss allocation of Covid-19 vaccines, according to a document obtained by CNN.

Members of the committee will discuss who should be in the first group, and clinical considerations for the group. Draft recommendations have suggested that health care workers should be in the 1a vaccine allocation group. Other possible members of the group: people most likely to catch, spread and develop severe disease from the virus such as nursing home residents.

The advisers will also discuss how to monitor safety after allocation of the vaccine, according to the document.

A surge in Thanksgiving demand is taxing Delta’s smaller pandemic-era workforce.  

The issue led Delta to cancel hundreds of flights this week, according to the pilot union and the airline.  

Delta ultimately canceled nearly one in every five flights it was scheduled to operate on Thanksgiving Day, and has dropped in total more than 500 flights this week. The airline said it expects its system to return to normal over the weekend.  

The union representing pilots said staffing reductions due to the coronavirus pandemic and drop-off in travel “have left a smaller pool of pilots qualified and ready to fly in the fleets that are seeing an increased demand over this holiday.”  

Delta said Wednesday that a “number of factors have pressured our ability to timely staff some of our scheduled holiday flights” but did not specify the issues.  

After distributing the November employee schedules last month, Delta added flights to its schedule and asked for volunteers to cover those flights, according to a source familiar with the situation. But when there were not enough employees to cover those legs, the airline was forced to cancel some of those.  

The airline declined to comment on that explanation. The Delta Master Executive Council at the Air Line Pilots Association said its pilots have stepped up to take on extra flights over the holiday period and receive the incentive of premium pay for picking up extra legs.  

But when demand surged this week, the heavy cuts to the aviation system due to the coronavirus began to show.  

Airline passenger traffic is currently only about 40% of what it was last year, according to data from the Transportation Security Administration, and US airlines are running 43% fewer flights.  

Delta and other US airlines responded to the drop in demand by cutting from employee ranks. Work schedules were reduced, 1,800 pilots retired early, and others were placed on inactive status or are in line for training because the model of planes they flew were retired.  

Employee unions and executives at the major US airlines have called for a multi-billion extension of a payroll support program that kept their employees on the job through September. Legislation to do that includes other stimulus and has stalled in Washington.  

The airlines have seen a relative surge in bookings this week as distanced families reunite for Thanksgiving dinner and college students are booted from university housing. More than one million people have crossed through TSA checkpoints only four times since the spring – and three of those days were in the last week.  

Travelers are also booking closer to their departure dates, airlines have said, giving the companies less visibility when arranging schedules more than a month in advance.  

The union, in a statement, said the scheduling issue cannot be attributed to crews calling out sick because of the coronavirus.   

California reported 54 deaths on Friday, pushing the state past a sober benchmark for Covid-related fatalities, which is now a total of 19,033.

California is only the third state to reach this milestone, after New York and Texas. 

The state also added 12,635 Covid-19 cases Friday, bringing the total to 1,171,324. This is down about 2,000 from Thursday's 14,640 cases.

The positivity rate of Covid-19 in California remains at 6.1%, a 1.9% increase from 14 days ago.

According to the state's dashboard, 191 more people were also hospitalized, a 2.6% increase from the previous day. This continues an upward trend since the beginning of November. There are now 1,904 beds remaining in intensive care units across the state, down 23 from yesterday.

The state's case data reporting may be incomplete due to the Thanksgiving holiday.

While modeling studies have suggested that around 60 to 70% of the population would need to be immune to Covid-19 in order to achieve herd immunity, targeted vaccination may be needed to defeat the virus, said Dr. Mike Ryan, executive director of the World Health Organization’s health emergencies program.

Ryan said it may take “some very clever vaccination strategies” that target people in society who are more likely to carry, transmit and spread the virus.

Herd immunity is built around the idea that disease spreads evenly through a community and that everyone’s absolute risk of being infected is about the same, Ryan explained during a news briefing in Geneva on Friday.

But the virus does not spread evenly. 

If there are lots of protected people surrounding those who are unprotected then “effectively, there’s a barrier. There’s a firewall around some who are not vaccinated, a firewall of vaccinated people, and therefore you can achieve control and eradication, sometimes, without vaccinating everyone,” he said.

While an overall number may be important in terms of policy, Ryan said it will be important to be strategic about which groups are targeted for vaccination.

“It may be much more important to target certain sections of the community than it will be to necessarily target some others who may not be participating in transmission as much,” he said.

And the vaccine may not be a miraculous solution to the pandemic, he cautioned. “I don’t think anyone can promise eradication of this virus until we understand much more about the vaccine, and much more about how the vaccines work in the real world and until we understand much more about the details of transmission of this virus.”

Katherine O’Brien, director of Immunization, Vaccines and Biologicals at WHO, added to Ryan’s point with the example of measles. Last year was a terrible year for measles outbreaks globally, she said.

“Many of those outbreaks were happening in countries that had very high measles vaccine coverage,” she said. “But it wasn’t about the whole country’s coverage that was important, it was about the sub communities, the sub national coverage.”

With the right tools, distribution of Pfizer’s coronavirus vaccine – which requires ultra-cold storage – is possible, but people may need to be strategic about where they allocate those resources, a World Health Organization (WHO) official said Friday.

The task does require enormous resources, and people may need to use a targeted distribution approach, O’Brien said during a news briefing in Geneva.

“Part of the approach that many countries may take is to choose to use vaccines that require an ultra-cold chain for only certain portions of the population that need to be vaccinated,” she added.

O’Brien said some may choose to use the vaccine among health care workers, in facilities where installing an ultra-cold freezer may be more simple than in other settings.

“Every country is going to have to work very hard and is going to have to innovate around systems to actually deliver vaccines that do have an ultra-cold chain,” O’Brien added, citing solutions like portable freezers and dry ice.

O’Brien noted that Pfizer has developed special thermal shippers to transport the vaccines, which can maintain the temperature of the vaccines for about 10 to 15 days.

“The intention is certainly to be able to use it, along with other vaccines because no one vaccine is going to have adequate supply, nor will any one vaccine necessarily have suitable operational characteristics to meet all of the needs,” she said.

Remember: Pfizer and BioNTech submitted on Nov. 20 to the US Food and Drug Administration for emergency use authorization for their coronavirus vaccine candidate.

Emergency use authorization, or EUA, from the FDA is not the same as full approval. An EUA allows products to be used under particular circumstances before all the evidence is available for approval. 

The FDA intends to make a decision about authorizing Pfizer and BioNTech’s coronavirus vaccine within a few weeks of a key meeting scheduled for Dec. 10, according to an agency official.

The number of coronavirus patients hospitalized and in intensive care units in France has continued to decline since Nov. 17, according to figures released by the French Health Agency on Friday. 

There are currently 28,620 Covid-19 patients in France’s hospitals, a decrease of 662 from Thursday.

In addition, the number of patients in intensive care units is down by 695 from last Friday’s figures. There are now 3,871 Covid-19 patients in intensive care units.

Data released also shows the positivity rate of people tested for Covid-19 over the past seven days keeps decreasing with 11.7% on Friday, compared to almost 18% two weeks ago.

France registered 12,459 new coronavirus cases Friday, bringing the total to 2,196,119.

Brazilian President Jair Bolsonaro said Thursday that while his government will distribute the approved coronavirus vaccines free of charge to the population, he personally will not take one.

Bolsonaro has repeatedly downplayed the severity of Covid-19, even after contracting the virus in July, and has raised doubts about future vaccines.

During his weekly broadcast streamed live on social media Thursday night, Bolsonaro said the federal government would purchase vaccines approved by the regulatory commission Anvisa, and "place them at the disposal of the population for free and on a voluntary basis.”

He also said that Congress is unlikely to make the vaccine mandatory.

Brazil has the second-highest number of Covid-19-related deaths worldwide and the third-highest number of total cases.

A committee that advises the US Centers for Disease Control and Prevention about vaccines has scheduled an emergency meeting for Tuesday.

The Advisory Committee on Immunization Practices posted the meeting announcement on its website with little explanation.

While it does not say explicitly that the meeting is to discuss coronavirus vaccine distribution, there’s no other likely reason for such a meeting to be called.

A CDC spokesperson later confirmed the meeting was called to discuss coronavirus vaccines but could not provide more details.

ACIP met on Monday to discuss whether to recommend any coronavirus vaccine that might get emergency use authorization (EUA) from the US Food and Drug Administration and to talk about who should be first in line to get one.

While the FDA approves or authorizes a vaccine, it’s the CDC, based on ACIP’s advice, that decides who should get vaccines and when.

ACIP usually meets regularly three times a year but the approval of a pandemic vaccine is an unusual circumstance.

The CDC did not immediately answer requests for explanation about the meeting.

So far, Pfizer is the only company to apply for an EUA from the FDA. The submission to the FDA was based on results from the Phase 3 clinical trial of Pfizer's vaccine, which began in the United States on July 27 and enrolled more than 43,000 volunteers.

More information and research is needed to understand the difference in efficacies of AstraZeneca vaccine dose schedules and whether a new trial is needed to check the efficacy of the lower dosage, World Health Organization officials said during a news briefing in Geneva on Friday.

There is only so much that can be included in a release, she said, and it needs to be reviewed in terms of the data and questions asked about the data that may come up during the review.

“It’s difficult to weigh in on this,” O’Brien said. “I think what we can emphasize, though, is that from what we understand about the press release, there is certainly something interesting that has been observed, but there are many reasons that could underlie the differences that were observed.”

More information, including evaluations of the immune response in the trial, is needed, she said.

Dr. Soumya Swaminathan, WHO’s chief scientist, agreed with O’Brien, saying that everything that is known is from the news release, and it appears that less than 3,000 people were given the half dose, then full dose of the vaccine.

It is also understood that no one over the age of 55 was in that group. The group given two full doses were larger numbers and had different age groups.

“It’s very hard to compare these two groups and that I would say the numbers are still small to really come to any definitive conclusions,” she said.

“Now, of course, the advantage of using a smaller dose, particularly if you’re getting higher efficacy, is great and you can save on the vaccine and at the same time you are benefitting from higher efficacy, but I think it would be speculation at this point,” she said.

Swaminathan said that they have heard that AstraZeneca would like to do a full trial of the half dose full dose schedule, “if we are to explore this hypothesis of having perhaps a better efficacy with a lower dose, then it would need a trial.”

Remember: The US Food and Drug Administration requires a threshold of at least 50% efficacy. It is not clear if the FDA will authorize emergency use however.

AstraZeneca has not yet tested its half-strength dose in the US either. But on Thursday, a spokesperson for the company told CNN their aim was to include the half-strength dose regimen into their US trials, which currently has around 10,000 participants.