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Sunday, May 2, 2021

First Billion COVID Vaccinations Given

 The world has reached the milestone of administering one billion doses of COVID-19 vaccines, just four months after the World Health Organization (WHO) approved the first vaccine for emergency use, and roll-outs began in countries such as the United States and the United Kingdom. The speed at which they have been administered is remarkable, but unequal distribution of the vaccinations highlights global disparities, say researchers.

“It is an unprecedented scientific achievement. Nobody could have imagined that, within 16 months of the identification of a new virus, we would have vaccinated one billion people worldwide with a variety of different vaccines, using different platforms and made in different countries,” says Soumya Swaminathan, the WHO’s chief scientist, based in Geneva, Switzerland.

As of 27 April, 1.06 billion doses had been given to 570 million people, which means that about 7.3% of the world’s population of 7.79 billion have received at least one dose. But scientists say that more than 75% of the world’s population will need to be vaccinated to bring the pandemic under control.

The uneven distribution of vaccinations, both within and between nations, threatens to slow progress towards this goal. “It’s absolutely amazing that in a short time we developed multiple vaccines and gotten a billion doses administered, but the way it’s happened has worsened inequities around the world,” says Krishna Udayakumar, associate director for innovation at the Duke Global Health Institute in Durham, North Carolina.

About three-quarters of all doses have gone to just ten nations (see ‘Divided by doses’). China and the United States alone account for nearly half of all the doses given out, but just 2% have gone to the entire continent of Africa.

Ensuring global vaccine equity is a matter of self-interest for high-income countries in beating the pandemic, says Peter Hotez, a vaccine scientist at Baylor College of Medicine in Houston, Texas. “You can’t do that with under a dozen countries fully vaccinated,” he says. “In terms of saving lives and restoring the global economy, we need places like Myanmar and Papua New Guinea to be successful.”

GLOBAL RESPONSE

Disparities also exist within nations see (‘Racing ahead’). For example, one UK study found that, of 1.1 million people aged over 80 who were treated for health conditions in clinics and hospitals between December and January, 42.5% of white participants had been vaccinated, compared with just 20.5% of Black participants. The same study also found evidence of divides along socio-economic lines.

“Vaccinating only portions of the population is not an effective strategy, and leaves us vulnerable to new variants,” warns Udayakumar. “A global pandemic can only be met with a global response.”

Global vaccine manufacturers are scaling up production to meet demand, but this might take another 6–12 months to achieve, he says. Nevertheless, we are likely to hit the two-billion mark much faster than we hit the first billion, adds Swaminathan.

https://www.scientificamerican.com/article/the-first-billion-covid-vaccinations-have-been-given/

Sanitization drones make debut at Kentucky Derby

 The race was on – safely – for more than 50,000 spectators Saturday at the 147th Kentucky Derby in part thanks to Pittsburgh-based technology company AERAS.

The company, which is the first and only recipient of the Federal Aviation Administration's 137 certification specifically for sanitization purposes, used its patented charged-electrostatic drone technology to sanitize Churchill Downs against COVID-19, returning fans to the oldest sporting event in the United States by using the latest and most innovative technology.

"It's awesome having a hand in bringing back massive in-person sporting events after a year of uncertainty," said Eric Lloyd, CEO and co-founder of AERAS. "Seeing thousands of cheering fans enjoying the Kentucky Derby safely felt like a huge victory over COVID-19."

The Environmental Protection Agency recognizes that electrostatic spray systems create the safest, and best, coverage when applying sanitization solutions. With its AER-Force technology, AERAS patented a way to integrate the EPA's preferred spraying system with high-efficiency drones, thereby creating the only truly charged-electrostatic drone in the world, and the only one specifically approved by the FAA to kill COVID-19 and other viral pathogens.

Powered by its AER-Force technology, AERAS drones release a uniform output of small droplets to create an impenetrable disinfecting barrier along all grounded surfaces. In less than three hours, AERAS can provide massive venues with cost-effective, large-scale sanitization while eliminating all human error.

"Like the rest of America, we're hungry for live concerts and sports," said Jim Abel, global director of business development. "It feels great to see our technology make this type of impact on live events and to be helping to return America back to normalcy."

The 147th Kentucky Derby was one of the largest sporting events to be held since COVID-19 shut the world down in March 2020. With 51,838 fans cheering on the run for the roses in person this year, safety was at the forefront of everyone's minds.

AERAS was ecstatic to work with the Pritchard Sports & Entertainment Group to help bring tens of thousands of ticket holders, staff and media to safely enjoy the Kentucky Derby. In less than 90 minutes, Churchill Downs seating areas were sanitized by AERAS' 107-certified drone operator and AERAS backpack sprayers.

"If sports franchises want to increase the number of people in seats, AERAS is the path," said Jim Christiana, vice president of marketing and corporate communications for AERAS. "We're excited for the opportunity to work with any sports and entertainment facility that wants to provide that peace of mind to fans returning to live entertainment."

Established in Pittsburgh in 2020, AERAS specializes in using a patented charged-electrostatic spraying technology to safely sanitize arenas, stadiums, fields and buildings by dispersing any approved disinfectant as science and best practices dictate to sanitize against COVID-19 and other viral pathogens.

https://www.streetinsider.com/PRNewswire/Pittsburgh-based+AERAS+sanitization+drones+powered+by+AER-Force+make+debut+at+Kentucky+Derby/18347524.html

AstraZeneca Earnings Top Estimates, On Track to Deliver COVID Vax, Analysts Positive on Core Business

 Shares of AstraZeneca (NASDAQ: AZN) traded 3.6% higher today after the European drugmaker posted better-than-expected quarterly results.

The company reported Q1 sales of $7.32 billion to top the $6.94 billion expected from market analysts. AZN said that it benefited from robust sales of its best-selling lung cancer drug Tagrisso, which generated $1.15 billion in sales.

Core earnings per share (EPS) were reported at $1.63 to exceed the consensus of $1.48.

Investors were looking to hear from the drugmaker on vaccine deliveries amid negative PR headlines surrounding the company’s product, as well as accusations from the EU about slow deliveries.

"Shipments (of COVID-19 vaccines) are increasing as manufacturing improves. We never overpromised, we communicated what we thought we would achieve at the time," CEO Pascal Soriot said during a media briefing.

The company made $275 million from selling 68 million doses, which translates into a price of $4 per dose. Soriot added that AZN is on track to deliver 200 million doses each month.

A vast majority of vaccines were delivered to Europe, with almost 20% of the remaining shots delivered to other regions.

"Despite the intense operational and political challenges created by AZN’s COVID-19 vaccine roll out, the core business continues to perform above market expectations in a most challenging quarter, demonstrating strength across therapeutic areas and geographies," Citigroup analysts said in a note following the earnings report.

https://www.streetinsider.com/Analyst+Comments/AstraZeneca+%28AZN%29+Up+as+Earnings+Top+Estimates%2C+On+Track+to+Deliver+COVID-19+Vaccines%2C+Analysts+Positive+on+Core+Business+Performance/18339134.html

Canada’s oil sands region becomes country’s COVID-19 hotspot

 Canada's remote oil sands region in northern Alberta has become a COVID-19 hotspot, disrupting essential annual maintenance work at its massive oil sands plants.

The oil-rich province of Alberta is battling the highest rate of COVID-19 in Canada as the country grapples with a third wave of the pandemic, and on Thursday hit a record for new daily infections, topping 2,000 a day for the first time. The Regional Municipality of Wood Buffalo, home to the oil sands, has the highest rate of active cases per capita in the province.

Maintenance work is critical for production from Canada's oil sands, which hold the world's third-largest crude reserves and produce 3.1 million barrels per day, accounting for roughly three-quarters of the country's total output.

Twelve oil sands plants including Canadian Natural Resources Ltd's (CNQ.TO) Horizon and the Suncor Energy's majority-owned (SU.TO) Syncrude project are tackling outbreaks while in the middle of annual maintenance projects that require flying in extra workers from as far away as Atlantic Canada.

In total, there are 822 active cases at oil sands sites, according to Alberta Health. One worker has died.

Suncor has pushed back the maintenance turnaround on the U2 upgrader at its base plant site by at least a month to see if infections subside, said Terry Parker, executive director of the Building Trades of Alberta, representing 18 local unions.

"It's a very stressful situation right now that they are facing," Parker said, adding some workers were leaving the oil sands because of fears about becoming infected. "The owners are taking the precautions necessary, and we are still contracting this disease."

A Suncor spokeswoman said the company is making minor adjustments to pre-work and day-to-day activities, but it remains on track with its planned maintenance.

Syncrude is reducing the size of the maintenance workforce on its site because of the COVID-19 outbreak, said Brad Corson, chief executive of Imperial Oil (IMO.TO), on an earnings call on Friday. Imperial owns 25% of Syncrude.

The mining and upgrading project, which has 254 active cases, is still aiming to finish the turnaround as scheduled in mid-June, Corson added.

CNRL, Suncor and Syncrude said COVID-19 safety protocols are in place. They have implemented rapid testing and isolation camps in a bid to slow the COVID-19 surge.

One contractor at CNRL's Horizon plant, which has 328 active cases, the highest among the oil sands sites, said workers are tested every four days but that seemed to be having little impact on the outbreak.

"You have 8,000 people on site for four weeks, it's going to be a thing," he said, declining to be named because he is not authorised to speak to media.

Indigenous leaders this week called for stricter measures to control the spread of the virus and accused Alberta Premier Jason Kenney of "prioritising profits over lives" by allowing infected workers to come to the region.

Gil McGowan, president of the Alberta Federation of Labour, called on Kenney to shut down work sites with outbreaks across the province, including the oil sands, to get the virus under control.

"This is a recipe for needless infection and needless deaths," McGowan told Reuters.

Alberta has more than 21,000 active COVID-19 cases, including 632 people in hospital.

https://www.reuters.com/business/healthcare-pharmaceuticals/canadas-oil-sands-region-becomes-countrys-covid-19-hotspot-2021-04-30/

Governors Complain That Biden, VP Skip Weekly COVID Calls

 The phone calls come from inside the new administration, but the president is not on the line. In fact, Joe Biden has not dialed in to any of the weekly COVID-19 coordinating calls with the nation’s governors since he came into office, a sharp contrast with his predecessor and a break from last year’s pandemic ritual.

Every Tuesday, usually at 11 a.m. EST, all 50 governors dial in to the same conference call to coordinate federal and state responses to the coronavirus crisis. And until this past January, they heard each time from the vice president. Mike Pence, as head of the White House COVID task force, led those weekly discussions. Donald Trump dropped by from time to time. The calls continue under the current administration but without Biden. “It's been a real frustration, I think it's safe to say, for all 50 governors,” New Hampshire’s Chris Sununu told RealClearPolitics.

Of course, he appreciates hearing from Jeffrey Zients, the new White House COVID response coordinator, and from Dr. Anthony Fauci, the White House chief medical adviser. But Sununu told RCP, “It would go a long way if the president would just get on the phone, or the vice president would get on the phone and take questions. Allow us to ask the folks in charge questions.”

The Trump White House hosted a total of 40 COVID conference calls. Pence led 39 of them, according to that administration’s final COVID report first obtained by RCP. Trump participated in eight. Things are different now, said Pete Ricketts. “President Biden hasn’t been on any of them,” the Nebraska governor told RCP, “and Vice President Harris has only been on one, but that was for about five minutes and she didn’t take any questions.”

Andrew Cuomo now leads the calls as chairman of the National Governors Association. White House Press Secretary Jen Psaki explained that the New York governor was put in charge instead of the vice president because a change was needed. One of the reasons, Psaki told reporters in March, “is that there were operational aspects of the way the last administration approached COVID and approached the distribution of vaccines or approached planning and engagement with governors that wasn’t working.”

The new approach was also required, a White House official told RCP, because the pandemic response has changed dramatically from the early days when little was known about the virus to now, when half of U.S. adults have received at least one dose of the vaccine.

And the COVID calls changed, the official added, only after the White House sought input from the states: “We took the feedback from governors in the prior administration that they wanted to have strong, regular, and coordinated response efforts with the federal government, and we’ve been focused on it.”

The administration works daily with states, the official continued, because its “whole-of-government pandemic response is rooted in effective and consistent communication. … While these calls [with governors] play one role in our relationships, it is not the sole mechanism.”

Another difference between the administrations: the role of the vice presidents. Pence was the leader of the COVID response team. Harris’ responsibilities are elsewhere, including, as Biden has explained, addressing “the root causes” of the southern border migrant crisis. As a result, the medical experts are the ones talking to the governors on the weekly call, not the politicians.

Though Ricketts appreciates “the hard work that all the other officials who are on the phone are doing,” it’s not the same, he explained, as having “high-level access to the decision-makers who can move the bureaucracy.”

“It really is not the type of bipartisan partnership that the president promised when he came into office in his inaugural address. It really is much more of a top-down, we-are-going-to-do-what-we-are-going-to-do thought process.”

The governors who spoke to RCP, on and off the record, expressed frustration with a number of issues, from the lack of guidance on how to spend the money allocated in the American Rescue Plan to the vaccine distribution schedule. Some governors felt particularly blindsided by news that the Food and Drug Administration was putting the Johnson & Johnson vaccine on hold after a small number of recipients experienced blood clots.

“I was listening to the radio one morning when I hear about the pause, and I'm like ‘What's this?’” Ricketts said. He had just held a press conference to tout the J&J vaccine, encouraging Nebraskans to get the shot. “For us to be left in the dark about this,” he said, “is very frustrating.”

The pause was abrupt and left states scrambling to find alternatives even though fewer than one in a million recipients of the J&J shot reported experiencing the complication.

“They didn’t even pick up the phone, and say, ‘Hey, by the way, you might see this in the news. We'll explain it on the call,’” Sununu said. “Nothing.”

White House officials insist that they heard about the pause through media reports, just like the rest of the country. “We were notified last night that there would be an announcement this morning,” Zients told reporters after the news broke. The FDA made the call, he added, and “there was no heads-up here.”

Still, some governors have concerns. “Communication is not the administration’s strong point, but it's still important. Transparency is the foundation of public trust, especially during a crisis,” Sununu said.

“One of the ways they can do better is by … treating us like valued partners,” Ricketts added in a separate interview.

Biden has urged Americans to remain cautious even as the rising number of vaccinations signals the beginning of the end of the pandemic. During remarks to herald having administered 200 million vaccine doses, the president warned that “if we let up now and stop being vigilant, this virus will erase the progress we’ve already achieved, the sacrifices we’ve made, the lives that have been put on hold, the loved ones who’ve been taken from us, the time we’re never going to get back.”

Would it help to get a president back on the phone then? “Not really,” answered one governor who spoke to RCP on condition of anonymity. “We know everything there is to know about this thing now. We know how to deal with it.”

https://www.realclearpolitics.com/articles/2021/04/26/governors_complain_that_biden_vp_skip_weekly_covid_calls_145651.html

Prospect Medical pulls application for ownership change at Roger Williams, Fatima hospitals

 Rhode Island Attorney General Peter Neronha said the owners of Roger Williams Medical Center and Fatima Hospital care more about "lining their own pockets" than patients after the company withdrew an application for an ownership change Friday.

Prospect Medical Holdings had asked Neronha and the state Department of Health to sign off on majority owner Leonard Green, a private equity firm, leaving the company.

But on Friday morning, hours before Neronha was set to release his decision, the California-based hospital chain pulled its application and asked a Superior Court judge to block Neronha from making his decision public.

In a lengthy midday news release, Neronha blasted the private equity firm, which he said wants to "walk away with $12 million more in its pockets and absolved of billions of dollars in debt."

"Our robust review of the proposed transaction revealed a national company whose principals and investors extracted hundreds of millions of dollars from the hospitals and services they own," Neronha wrote. "As a result, the company now faces risks to its financial viability, which is required to respond to challenges that may arise in a volatile healthcare market, potentially putting every hospital in its system – including our Rhode Island hospitals – at risk of a reduction in services, sale or closure."

Conflict between Prospect and Neronha flared on Thursday when the hospital chain threatened to close the hospitals, and take legal action, if the state imposed significant new conditions to approve the ownership change. In particular, the company expected that it would be ordered to place up to $150 million in escrow if the sale was to go though.

"The imposition of such an escrow is unreasonable, unacceptable and unprecedented," Prospect spokesman Bill Fischer said in a statement Thursday that noted four other states have approved the transaction.

But Prospect's ownership and financial condition have become a source of controversy in Rhode Island, with union leaders and politicians objecting to what they see as insufficient investment in the hospitals.

Senate President Dominick Ruggerio, whose district includes Fatima, called the two hospitals "essential to the health and well-being of our communities."

Sen. Louis DiPalma, D-Middletown, said testimony in the Senate Oversight Committee, which he chairs, "raised several red flags with regard to the financial viability of Prospect’s hospital systems, and we are grateful that Attorney General Neronha has conducted a thorough review as part of the regulatory process."

Prospect bought Roger Williams and Fatima in 2014. The hospitals employ 2,800 people and provide essential safety-net services.

In a request for a temporary restraining order filed Friday morning in Superior Court, Prospect said Neronha's decision, which was shared with the company, "contains confidential information and numerous factual inaccuracies that — if publicly disclosed — would cause irreparable harm to the hospitals, their employees, their healthcare providers, and their patients."

But Neronha said the public deserves to know more about what's happening behind the scenes at the hospitals.

"Under the proposed transaction, majority owner Leonard Green, having made its money at the expense of the financial health of the hospitals, now wants out," Neronha wrote. "You chose to get into healthcare.  Act like you believe in it."

https://www.providencejournal.com/story/news/politics/2021/04/30/prospect-medical-holdings-withdraws-request-under-pressure-ri-ag/7409161002/

U.K. Covid-19 Variant's Hold in U.S. Has Silver Lining: Vaccines Counter It

 The highly contagious U.K. variant of the Covid-19 virus, now the dominant virus strain in the U.S., is making the pandemic harder to control. But it also comes with a silver lining: The authorized vaccines work well against it.

The variant, called B.1.1.7, is better able to exploit lapses in mask wearing and social distancing, and requires more people to develop an immune response to slow it down. Yet vaccines from Pfizer Inc. and its partner BioNTech SE, Moderna Inc., and Johnson & Johnson, along with safety precautions, still remain effective, and health authorities say the shots are starting to slow down Covid-19 cases in the U.S.

"If we did not have this background of vaccination, we would be completely overwhelmed right now," said Joshua Schiffer, an associate professor in the Vaccine and Infectious Disease Division at the Fred Hutchinson Cancer Research Center. The virus's increased contagiousness "makes it much, much harder to contain," he said.

The B.1.1.7 variant first appeared in the U.K. late last year, spurring a deadly new surge in cases and another round of strict lockdowns. It jumped to several other countries, including the U.S., where it rapidly became the most common viral variant. Nearly 60% of Covid-19 cases in the U.S. could be attributed to the variant by early April, according to data from the Centers for Disease Control and Prevention.

A study published in March in the journal Science suggested that B.1.1.7 was within a range of 43% to 90% more infectious than pre-existing variants. With a more infectious variant, each person, on average, can transmit the virus to more people, exacerbating the virus's spread.

B.1.1.7's heightened contagiousness is one reason health authorities continue to urge people to keep up with precautions such as mask wearing, social distancing or sticking with outdoor activities until more people are fully vaccinated and cases drop. About 39% of U.S. adults are fully vaccinated, the CDC says.

"With an older variant, you might've been in that transmission chain and transmitted to one other person. Now you might be transmitting to 1.5 or 1.7 other people, and so if you can cut that transmission chain, you'll have an even bigger effect," said Emma Hodcroft, a molecular epidemiologist at the University of Bern in Switzerland. "The role of being that broken link who stops that transmission chain is even more important."

The proportion of people who need to have an immune response from vaccination or past infection to slow down the spread of the virus also increases when a virus is more contagious, infectious-disease experts say.

The variant has several mutations that distinguish it from earlier versions of the virus, including some that impact its spike protein -- a structure that sits on the surface of the virus and helps it attach to human cells. All of the authorized vaccines in the U.S. target the spike protein and are designed to mount defenses against it, and are all still effective against the B.1.1.7 variant despite its mutations. At least one lab-based study found the variant also doesn't increase the risk for re-infection.

"The good news is that the vaccines are effective against B.1.1.7," said Mary Jo Trepka, an infectious-disease epidemiologist at Florida International University. "It's all the more reason that we want to get people vaccinated and want them to get vaccinated now."

Last week the CDC further eased its guidelines for fully vaccinated people, saying they don't need to wear masks in certain situations. The current seven-day average of cases is just over 52,500, a decrease of about 16% from the previous seven days, and hospitalizations have declined nearly 10%, CDC Director Rochelle Walensky said Friday.

"With 100 million Americans fully vaccinated as of today, we continue to move ahead in our progress to end this pandemic," said Dr. Walensky.

Other coronavirus variants that scientists have flagged as a concern have also been identified in the U.S., including those that first emerged in Brazil and South Africa, as well as variants that originated in the U.S.

The variants from Brazil and South Africa, called P.1. and B.1.351, respectively, so far haven't gained a strong foothold in the U.S. and some infectious-disease experts say that the dominance of B.1.1.7 might make it more challenging for these variants to spread.

It is likely that B.1.1.7 arrived in the U.S. before those other variants of concern, and early super-spreader events might have helped it spread and out-compete them, Dr. Schiffer said. The new variant proportions vary by state, however. For example, the P.1. variant makes up 14.3% of cases in Illinois.

Scientists say that public-health authorities need to pay attention to emerging variants. If a population has partial immunity but doesn't drive cases down, variants that can better evade immune defenses, such as B.1.351, might gain an edge, virologists say.

Additional variants of concern will also likely emerge as Covid-19 cases increase globally. Researchers are gathering data on whether the vaccines are effective against the variant that recently emerged in India. But one lab-based study, not yet peer-reviewed, suggests that India's Covaxin vaccine is able to neutralize the variant.

Some drugmakers are working on vaccine updates targeted at some of the newer variants, however, and scientists say that variants can also be brought under control with the now-familiar public-health measures.

"They haven't developed superpowers. They aren't clawing their way through anyone's mask," said Dr. Hodcroft, referring to viral variants. "A lot of the things that we have in place right now that we followed, those can be effective."

https://www.marketscreener.com/quote/stock/MODERNA-INC-47437573/news/U-K-Covid-19-Variant-s-Hold-in-U-S-Has-Silver-Lining-Vaccines-Counter-It-33135259/