With COVID deaths climbing, US inks deal for vaccine doses

Vaccine vials and syringe
Vaccine vials and syringe

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The number of daily COVID-19 deaths in the United States topped 1,000 yesterday, the first time in more than a month the country has crossed that threshold.

The increase in COVID-19 deaths has been expected with the spike in infections around the country. The news came on the day that President Donald Trump conducted a briefing on the coronavirus, his first in 3 months.

The president said the outbreak will "probably, unfortunately, get worse before it gets better," and urged Americans to wear masks when they cannot socially distance.

"Whether you like the mask or not, they have an impact, they'll have an effect, and we need everything we can get," Trump said.

But the president also reiterated his contention that the coronavirus would eventually disappear, and insisted that the US response to the pandemic has been better than that of other countries.

The country reported 64,534 new COVID-19 cases yesterday, according to the Johns Hopkins online coronavirus dashboard. Total US cases since the pandemic began to 3,940,059, including 142,677 deaths.

Today, the Trump administration announced a nearly $2 billion agreement with US drug maker Pfizer and German biotechnology company BioNTech for hundreds of millions of vaccine doses pending approval of their COVID-19 vaccine candidate.

COVID-19 deaths increasing

According to the New York Times database, the 1,120 deaths reported yesterday were the highest since May 29, except for 2 days in late June when large numbers of deaths from unknown dates were reported. The 7-day average for deaths reached 810, up from an average of 475 in early July.

Although the US death rate has been well below the peaks seen in April, public health experts have been warning that COVID-19 deaths, which tend to lag a few weeks behind infections, will likely rise with the dramatic increase in cases seen over the last several weeks.

Former Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, told CNBC this morning that the country could reach 300,000 deaths by the end of the year if the current trends continue, even though mortality rates have likely fallen as physicians have learned better ways to treat the virus.

"Even if we end up preserving more life in the hospital, which we're doing, if we end up hospitalizing a whole lot more patients, you're ultimately going to have a lot of casualties, unfortunately, from this virus," he said.

COVID-19 Hospitalizations have been on the rise as well, with California, Arizona, Nevada, and Texas seeing significant increases in the 7-day average of hospitalizations per 100,000 adults, according to data compiled by the University of Minnesota's Carlson School of Management.

Texas currently has the most hospitalized COVID-19 patients in the country, with 10,848. Some hospital executives in Houston said on Jul 20 that they are close to running out of beds, and are turning to emergency plans that were developed as a result of Hurricane Harvey, the Houston Chronicle reported.

California has 7,091 patients hospitalized with COVID-19, nearly double that on Jun 20, according to the San Jose Mercury News. California reported 10,341 new COVID-19 cases yesterday, and today it passed New York for the most cumulative cases, the Associated Press reported.

Vaccine agreement

Under the agreement between the US Department of Health and Human Services (HHS) and Pfizer and BioNTech, the companies will supply 100 million doses of their vaccine candidate to the US government if it demonstrates safety and efficacy in an upcoming phase 3 trial and is approved by the FDA. The $1.95 billion contract allows the US government to buy and additional 500 million doses but does not fund any research and development.

Pfizer and BioNTech are evaluating four vaccine candidates under their BNT162 program. Early data on the most advanced candidate—BNT162b1—showed that it produced neutralizing antibodies in volunteers that were at or above the levels found in the plasma of patients who had recovered from COVID-19. The companies said in a press release that if upcoming trials to evaluate safety and efficacy are successful, they could seek Emergency Use Authorization from the FDA as early as October.

The Trump administration has also signed an agreement with AstraZeneca to secure doses of the vaccine developed by researchers at Oxford University, which also produced an immune response in early trials. Earlier this month, HHS announced a $1.6 billion agreement with Novavax to fund a phase 3 clinical trial and manufacturing of the company's COVID-19 vaccine candidate.

"Through Operation Warp Speed, we are assembling a portfolio of vaccines to increase the odds that the American people will have at least one safe, effective vaccine as soon as the end of this year," HHS Secretary Alex Azar said in a press release.

Who will be the first groups to get that vaccine? Figuring that out will be the task of a committee formed by the National Academy of Science, Engineering and Medicine and the National Academy of Medicine. The committee, which will hold its first meeting on Friday, "will develop an overarching framework to assist policymakers in the United States and global health communities in planning for equitable allocation of vaccines against COVID-19," according to yesterday's press announcement.

The framework will take into account population health disparities, where the virus is actively spreading, and who is at risk based on health status, occupation, or living conditions. The group is expected to release a report in the fall.

More mask mandates

In other news, Minnesota, Ohio, and Indiana today became the latest states to institute a statewide mask mandate.

The Minnesota mandate will require people to wear face masks in stores, public buildings, and other places where people gather indoors, with children age 5 and younger exempt.

"This is a small sacrifice for a potential big gain," Governor Tim Walz told reporters at a press conference, saying that 90 to 95 percent compliance with the mandate could be the quickest, least expensive way back to normalcy, according to Minnesota Public Radio News. The mandate goes into effect on Jul 25.

Ohio will require people older than 9 to wear face masks in indoor settings and outdoors when social distancing isn't possible starting tomorrow, the Washington Post reported. Indiana's mandate, beginning on Jul 27, calls for masks when people can't socially distance.

According to the National Governor's Association, 24 other states currently have full mandatory mask rules.

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