‘Learn to live with the pandemic’: Physicians warn a vaccine may not prevent Covid-19 from becoming endemic
Small bottles labeled with a “Vaccine COVID-19” sticker and a medical syringe are seen in this illustration taken taken April 10, 2020.
Dado Ruvic | Reuters
LONDON — The development of a Covid-19 vaccine may not be enough to prevent the coronavirus from becoming endemic, infectious disease experts have warned, suggesting a better way for people to proceed would be to learn to live with the pandemic.
Dozens of candidate vaccines are currently in clinical evaluation, according to the WHO, with drugmakers and research centers scrambling to help bring an end to the coronavirus pandemic.
To date, more than 41 million people have contracted the virus worldwide, with 1.13 million related deaths, according to data compiled by Johns Hopkins University.
Many governments, too, have sought to help the Covid-19 vaccine race by providing funds to allow companies to scale up manufacturing even before drugs have been approved.
Dr. David Heymann, who led the WHO’s infectious disease unit at the time of the SARS epidemic in 2002-2003, believes some governments may be over-reliant on the development of a vaccine at a time when effective communication, diagnostic testing and outbreak containment activities are all critically important tools.
“The difficulty right now is that in many countries, they are looking forward to a vaccine which may or may not come, which may or may not be effective in the short or long term, and they are looking at possible therapeutic (options) which could solve many of the problems,” Heymann said during a webinar for think tank Chatham House on Wednesday.
“But, that’s not a good way to proceed at present … We have to learn to live with the pandemic.”
The U.K.’s chief scientific advisor, Patrick Vallance, told the National Security Strategy Committee in London earlier this week that Covid-19 was likely to become as endemic as the annual flu.
This means the infection rate of the coronavirus, like other coronaviruses, will eventually stabilize at a constant level so that it becomes present in communities at all times.
Vallance also said that creating a vaccine from scratch took 10 years on average. The fastest vaccine ever developed was for mumps, and this took more than four years.
A man plays guitar under a empty Bethesda Terrace in Central Park in New York City on October 19, 2020. New York City is planning to set up mass vaccination sites once Covid-19 vaccines become available vetted by an independent state panel, Governor Andrew Cuomo said on October 18, 2020.
TIMOTHY A. CLARY | AFP via Getty Images
“One of the scenarios for this virus is that it does become endemic and it looks at present like that is going to happen — just like it happened four previous times when there was an emergence of a coronavirus into human populations that became endemic,” Heymann said, referring to the four common human coronaviruses.
“I think the answer is that, yes, this will become endemic,” he continued. “We shouldn’t just be trying to suppress this virus out of existence or trying to suppress it to a level that’s unrealistic. We have to be able to suppress it to a level where it causes minimum damage while at the same time entering a country and becoming endemic.”
When asked how people can learn to live with the pandemic, Heymann replied: “Individuals must know how to do their own risk assessments, as they do for sexually-transmitted infections, as they do for tuberculosis, as they do for other infections.”
“They must do their own risk assessments and understand what measures they can take to prevent themselves from becoming infected and to prevent others from becoming infected,” he said. “It’s all about people understanding that this virus, if it is destined to become endemic, will become endemic no matter what we do. But we can slow that to a certain level that causes less disruption in our societies and lesser death.”
Commuters wearing a face mask or covering due to the COVID-19 pandemic, walk past a London underground tube train at Victoria station, during the evening ‘rus hour’ in central London on September 23, 2020.
TOLGA AKMEN | AFP via Getty Images
To protect yourself, the WHO recommends that people keep a distance of at least 1 meter from others, and disinfect frequently touched surfaces. It also advises cleaning hands thoroughly and often, and for people to avoid touching their eyes, mouth and nose.
“We know now that we are going to have to start living with this virus in a more chronic way — really, in the long term,” Dr. Olivia Tulloch, CEO of Anthrologica, a leading research-based specialist in applied anthropology in global health, said during the same Chatham House webinar.
Tulloch said people across many countries, particularly in the Northern Hemisphere, had been living with strict restrictive measures imposed on their daily lives for several months, with no sign of them ending anytime soon.
“And so, people feel fatigue and confusion and frustration to do with the measures that are being directed at them,” she continued. “We are putting a lot of resource into the science of vaccines but, in terms of social science, we have got a huge amount of work to do.”
It will also be important to understand the mechanisms that would be necessary to address those with a “high degree of hesitancy” if and when a vaccine becomes available, Tulloch said.
A 25-year-old man becomes first in the U.S. to contract coronavirus twice, with second infection ‘more severe’
Dr. Sonia Macieiewski (R) and Dr. Nita Patel, Director of Antibody discovery and Vaccine development, look at a sample of a respiratory virus at Novavax labs in Rockville, Maryland on March 20, 2020, one of the labs developing a vaccine for the coronavirus, COVID-19.
Andrew Caballero-Reynolds | AFP | Getty Images
A 25-year-old man in the U.S. state of Nevada has contracted the coronavirus on two separate occasions, a study in the Lancet Infectious Diseases journal showed, with the patient becoming seriously ill following the second infection.
It is the first confirmed case of a U.S. patient becoming re-infected with Covid-19, and the fifth known case reported worldwide.
The resident of Washoe County, who had no known immune disorders or history of significant underlying conditions, required hospital treatment on testing positive for Covid-19 for the second time.
He has now recovered, though the case raises further questions about the prospect of developing protective immunity against the coronavirus.
To date, more than 37.8 million people have contracted Covid-19 worldwide, with 1.08 million related deaths, according to data compiled by Johns Hopkins University.
The head of emergencies at the WHO said earlier this month that its “best estimates” indicate that roughly 1 in 10 people globally may have been infected by the coronavirus, significantly higher than the number of confirmed cases.
On March 25, the peer-reviewed medical journal said in a study that a 25-year-old man in Nevada’s second-most populous county experienced a wave of symptoms consistent with a viral infection, including sore throat, cough, headache, nausea and diarrhea.
He presented to a community testing event held by Washoe County Health District on April 18 and tested positive for Covid-19 for the first time.
The patient’s initial symptoms fully resolved during isolation on April 27. He continued to feel well thereafter and tested negative for the coronavirus on two separate occasions, on May 9 and on May 26.
The 25-year-old experienced symptoms again from May 28, this time including fever, headache, dizziness, cough, nausea, and diarrhea.
On June 5, 48 days after the initial positive test, the patient contracted the virus for the second time. His condition was found to be symptomatically “more severe” than the first.
He presented to a primary care doctor and required hospital treatment on experiencing shortness of breath. He later recovered and was discharged from the hospital.
COVID-19 Coronavirus molecule, March 24, 2020.
CDC | API | Gamma-Rapho via Getty Images
Scientists said the patient caught the coronavirus on two separate occasions, rather than the original infection bouncing back after becoming dormant. This is because a comparison of the genetic codes showed “significant differences” between each variant associated with each instance of infection.
“These findings suggest that the patient was infected by SARS-CoV-2 on two separate occasions by a genetically distinct virus. Thus, previous exposure to SARS-CoV-2 might not guarantee total immunity in all cases,” the authors of the study said.
“All individuals, whether previously diagnosed with COVID-19 or not, should take identical precautions to avoid infection with SARS-CoV-2,” they added.
To protect yourself, the WHO recommends maintaining a physical distance of at least 1 meter from others, wearing a mask, avoiding crowds, keeping rooms well ventilated and cleaning your hands thoroughly and often.
The Lancet said the patient had provided written consent to publish the report, with ethics approval waived by the University of Nevada, Reno Institutional Review Board.
Secondary coronavirus infections
It had been assumed a second case of the coronavirus would be milder than the first, though it remains unclear why the Nevada patient became more severely ill the second time.
Reports of secondary coronavirus infections in Hong Kong, the Netherlands and Belgium all said they were no more serious than the first.
One in Ecuador, however, mirrored the U.S. case in being more severe, but this case did not require hospital treatment.
The coronavirus has now killed more than 1 million people and upended the global economy in less than nine months
A municipal worker sanitizes a Roman Catholic Church graveyard after the burial of Covid-19 coronavirus infected people in Ranchi on September 6, 2020.
AFP | Getty Images
The coronavirus has killed at least 1 million people across the globe, a nightmarish milestone in the world’s fight against the virus that emerged from Wuhan, China, late last year, according to data compiled by Johns Hopkins University.
Roughly half of the world’s total Covid-19 fatalities have been reported in only four countries — the United States, Brazil, India and Mexico, according to Hopkins data.
The U.S. reached a death toll above 200,000 people last week, more than any other country on the planet. Declared a pandemic over six months ago, the coronavirus has swept through nearly every nation and has infected more than 33 million people along the way, according to Johns Hopkins. It’s shuttered businesses and schools, wreaking havoc on global economies and leaving millions unemployed.
“One million is a terrible number, and I think we need to reflect on that before we start considering a second million,” Dr. Mike Ryan, executive director of the World Health Organization’s health emergencies program, told reporters on Friday.
CNBC has compiled a package of stories that will run Monday and Tuesday looking back at how the coronavirus pandemic has changed health care, the economy and society itself since its discovery less than nine months ago.
Please check back here for links to these coming stories and more as they are published:
From a wet market in Wuhan, China, the coronavirus infiltrated Asia within weeks of its discovery before traveling to Europe, hitting the U.S. in January in Washington state and New York City. It’s since spread throughout Latin America and now Africa.
A historical look at how the Covid-19 outbreak compares with the 1918 flu pandemic — from the diseases themselves to resistance to wearing masks during both outbreaks. There was even a 1918 epidemiologist who withstood criticism for his public health recommendations, similar to Dr. Anthony Fauci today.
From Bangalore, India, to Sao Paulo, doctors and health workers share personal stories about the coronavirus outbreak from across the world.
Milan is out and the Rocky Mountains are in. The pandemic is turning airlines’ most price-sensitive customers, leisure travelers, into a prize. Carriers are adding more vacation destinations and trying to create softer, gentler policies for a group that has long taken a back seat.
While the U.S. health response to the coronavirus pandemic has faced criticism, the economic response has been among the best in the world. In the throes of the pandemic, the Federal Reserve and U.S. lawmakers moved swiftly to implement unprecedented stimulus aimed at supporting the largest economy in the world during a global halt to economic activity.
Emergency Medical Technicians (EMT) arrive with a patient while a funeral car begins to depart at North Shore Medical Center where the coronavirus disease (COVID-19) patients are treated, in Miami, Florida, July 14, 2020.
Maria Alejandra Cardona | Reuters
Florida reported 276 new deaths caused by the coronavirus on Tuesday, marking the highest number of deaths reported in a single day by the state since the pandemic began.
That brings the total number of Covid-19 deaths in Florida to 8,553, according to the state’s department of health. Florida also reported 5,886 new cases of the virus, bringing the cumulative total to 542,792 confirmed cases across the state since the outbreak began.
The Florida Department of Health didn’t immediately provide a comment for this article.
The state previously reported a single-day high of 257 Covid-19 deaths on July 31, according to data compiled by Johns Hopkins University. The seven-day average of new Covid-19 deaths in Florida hit a high of 185 average deaths per day on Aug. 5, according to a CNBC analysis of Hopkins data.
The percentage of tests that came back positive on Monday also increased to 10.3%, up from about 8.6% on Sunday. That statistic is a closely watched data point that could indicate whether the outbreak is expanding and whether the state is conducting enough testing.
Florida is one of the hardest-hit states in the country by the coronavirus, but daily new cases have appeared to decline in recent days. Epidemiologists, however, warn that it’s too soon to establish any kind of strong trend and say that testing has fallen even faster.
The seven-day average of daily new cases has dropped by 38% compared with two weeks ago, according to CNBC’s analysis of data compiled by Hopkins, but testing has declined as well. The state was running roughly 54,000 tests per day two weeks ago, but that has dropped by about 46% to just over 37,000 as of Aug. 10, based on data compiled by the Covid Tracking Project, a volunteer project founded by journalists at The Atlantic magazine.
“I’m always cautious. It does seem like we’re on a downward trend maybe,” Cindy Prins, an epidemiologist at the University of Florida, told CNBC on Tuesday, saying the state’s positivity rate, or percent of positive Covid-19 tests, has fallen from its recent peak at 12.3%, according to the state’s health department. She added that the state ought to conduct more testing to better understand the outbreak.
“You want to hit that point where you’ve got enough testing going on that you’re really identifying the majority of the people who are positive, because that allows for the disease control effort,” she said. “Then you’ll see not only the percent positivity get lower, but your cases as well will start to decrease, and I think that’s the spot we want to be in.”
She added that Hurricane Isaias, which hit Florida and other states on the East Coast earlier this month, may have disrupted some of the state’s Covid-19 response efforts. For example, she said, testing declined due to the storm, which may have made it seem as though cases were decreasing as well.
Deaths — which lag behind daily new cases as people get infected, become sick and eventually die — are seen as a more stable indicator of an outbreak, because they are less dependent on available testing capacity.
U.S. coronavirus deaths top 1,000 for four straight days as California, Florida and Texas report record averages
Medical personnel move a deceased patient to a refrigerated truck serving as make shift morgues at Brooklyn Hospital Center on April 09, 2020 in New York City.
Angela Weiss | AFP | Getty Images
The U.S. reported more than 1,100 coronavirus deaths on Friday, marking the first time since May the morbid daily death toll rose above 1,000 for four consecutive days, according to Johns Hopkins University data.
There were 10 states across the U.S. that reported record daily coronavirus deaths based on a seven-day moving average, according to a CNBC analysis of data compiled by Johns Hopkins. CNBC uses a seven-day trailing average to smooth out spikes in data reporting to identify where cases and deaths are rising and falling.
Covid-19 cases across the country remained steady, however, with the nation’s seven-day average growing by less than 1% compared with a week ago, according to Hopkins data. Deaths and hospitalizations typically lag behind an increase in cases because it can take a while after someone is diagnosed to become seriously ill and potentially die, epidemiologists say.
Some states that have reported climbing cases for weeks, including California, Texas and Florida, are now seeing record daily coronavirus deaths based on a seven-day moving average.
Texas had an average of 138 new deaths on Friday, which is more than 29% higher compared with a week ago, according to a CNBC analysis of Johns Hopkins data. California had an average of 104 new deaths, which is more than 13% higher compared with a week ago. Florida reported an average of 121 daily deaths, a near 21% increase compared with a week ago.
On Thursday, Adm. Brett Giroir, an assistant secretary for health at the U.S. Department of Health and Human Services, said that the rate of deaths from the coronavirus in the United States should begin to fall in the “next couple of weeks.”
The seven-day rolling average of coronavirus infections is beginning to drop, and U.S. health officials predict hospitalizations will go down next week and mortality rates will follow in about two weeks, he said during a press briefing with reporters.
Giroir’s prediction differs from forecasts at the Centers for Disease Control and Prevention. National and state-level forecasts suggest that the number of new deaths in the U.S. over the next four weeks will likely exceed the number reported over the previous four weeks, according to the CDC.
“Nobody’s letting up their foot from the gas,” he added. “If we throw caution to the wind, go back to the bars, this will all go into reverse.”
Texas Gov. Greg Abbott told CNBC Friday that the state has not yet “conquered” the coronavirus and it’s “going to take a little while” to eliminate, although the state has made some strides. State officials and funeral home directors are ordering extra body bags and refrigerated trucks as they prepare for an increase in deaths from Covid-19, which has already killed at least 4,717 people in the state.
“I feel like we have reached a plateau where we’ve contained the exponential growth of Covid at this particular time, but we have a lot more work to do in the coming weeks,” Abbott said. “We don’t have Covid conquered right now.”
Zoe looks for a little handout from diners on Grant Street in a makeshift outdoor dining area bounded by steel barricades in San Francisco, Calif., on Tuesday, June 16, 2020.
Carlos Avila Gonzalez | The San Francisco Chronicle via Getty Images
San Francisco Mayor London Breed announced Friday that the city will pause its reopening plan “indefinitely” and will close indoor malls and non-essential offices as the coronavirus continues to spread throughout the state.
Breed said that San Francisco County has been added to California’s “monitoring list,” which may add additional state-mandated restrictions and closures if the county stays on the list for three consecutive days.
On Monday, Gov. Gavin Newsom ordered counties on the list, which represented 80% of the state’s population, to close indoor operations for fitness centers, worship services, personal care services, malls, offices, hair salons and barbershops.
“If the state adds more restrictions, we will of course follow them. And if conditions in our city don’t improve, we can also choose to close additional businesses and activities as well,” Breed said.
The city had a low of 26 people hospitalized with Covid-19 in mid-June, down from a high of more than 90 people in April, Breed said. There are now 80 people in the city hospitalized with the coronavirus, she said.
“What I’m afraid of is the complacency,” Breed said during a press conference. “People are tired of the virus, but the virus is not tired of us.”
This is a developing story. Please check back later for updates.
Johnson & Johnson products on a shelf in a store in New York.
Lucas Jackson | Reuters
Johnson & Johnson’s second-quarter profit slid 35% from the same time last year as the coronavirus pandemic forced hospitals to postpone elective surgeries, hitting the company’s medical device business hard.
J&J earned $3.63 billion, or $1.36 per share, during the three months ended June 30, a 34.6% drop from $5.6 billion a year earlier as sales in its medical device unit fell, the company said Thursday. The decline in its medical device unit was partially offset by higher sales for its over-the-counter products such as Tylenol and its Listerine mouthwash.
Shares of J&J were less than 1% higher in premarket trading.
Overall, the company beat earnings expectations, reporting adjusted earnings of $1.67 per share, higher than the $1.49 per share expected. Revenue came in at $1.83 billion, higher than the $17.6 billion expected.
“Our second quarter results reflect the impact of COVID-19 and the enduring strength of our Pharmaceutical business, where we saw continued growth even in this environment,” J&J CEO Alex Gorsky said in a press release. “Thanks to the tireless work of our colleagues around the world and our broad range of capabilities, we continue to successfully navigate the external landscape, and we remain focused on advancing the development of a vaccine to help address this pandemic and save lives.”
This is a developing story. Please check back for updates.
Emergency Medical Technicians (EMT) lift a patient that was identified to have coronavirus disease (COVID-19) into an ambulance while wearing protective gear, as the outbreak of coronavirus disease (COVID-19) continues, in New York City, New York, U.S., March 26, 2020.
Stefan Jeremiah | Reuters
The United States reported 67,417 new cases of the coronavirus on Tuesday, setting yet another fresh record for new cases reported in a single day, according to data collected by Johns Hopkins University.
Cases in the U.S. keep climbing, averaging about 62,210 new cases per day over the past seven days — more than triple the number just a month ago and up more than 21% compared with the seven-day average a week ago, according to a CNBC analysis of the data from Hopkins.
Texas, California and Florida accounted for 31,847 new cases on Tuesday, nearly half of all new cases reported across the country.
President Donald Trump on Tuesday again attributed the increase in cases to ramped up testing.
The country processed 760,282 tests on Tuesday, the second-highest number of tests conducted in a single day, according to data compiled by the Covid Tracking Project, an independent volunteer organization launched by journalists at The Atlantic. The U.S. has processed an average of more than 665,000 tests per day between July 1 and July 12, according to a CNBC analysis the Covid Tracking Project’s data. That’s up from a daily average of just over 174,000 diagnostic tests processed nationally per day through April, according to CNBC’s analysis.
“Think of this, if we didn’t do testing, instead of testing over 40 million people, if we did half the testing we would have half the cases,” the president said Tuesday evening. “If we did another, you cut that in half, we would have, yet again, half of that. But the headlines are always testing.”
Trump’s medical advisors, including Director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci, have said the recent surge in cases is a sign of an expanding outbreak, not the increased testing.
With new cases surging, especially in so-called hot-spot states across the South and West, the country’s testing infrastructure, however, is struggling to keep up. Quest Diagnostics and LabCorp, two of the largest diagnostic labs in the country, said earlier this week that the increased demand for testing is slowing their turnaround time. Quest said results for patients who are not “priority 1” now take more than seven days, which public health specialists say makes the tests almost useless to trace cases and isolate people who’ve been exposed.
Quest said in a statement Monday it won’t be able to “reduce our turnaround times as long as cases of COVID-19 continue to increase dramatically across much of the United States. This is not just a Quest issue. The surge in COVID-19 cases affects the laboratory industry as a whole.”
The Centers for Disease Control and Prevention on Tuesday called on Americans to wear masks to help contain the spread of the virus. Director Dr. Robert Redfield told Dr. Howard Bauchner of the Journal of the American Medical Association in an interview Tuesday the U.S. could get its outbreak under control in one to two months if every American wore a mask.
“The time is now,” Redfield said. “I think if we could get everybody to wear a mask right now I think in four, six, eight weeks we could bring this epidemic under control.”
As public health officials urge the public to take action to bring the virus under control, the race toward a vaccine is progressing. Moderna said Tuesday that its potential vaccine to prevent Covid-19 produced a “robust” immune response in all 45 patients in its early stage human trial, according to data published Tuesday evening in the peer-reviewed New England Journal of Medicine.
All 45 patients produced neutralizing antibodies, which scientists believe is important for building immunity and provided more promising data that the vaccine may give some protection against the coronavirus. Moderna’s stock rose more than 16% in after-hours trading on the news.
The company is due to start its phase three trial on July 27, according to a posting published Tuesday on ClinicalTrials.gov. The trial, which will be the most comprehensive test of the potential vaccine yet, will enroll 30,000 participants across 87 locations, according to the website.