Career Staff at C.D.C. Developed the Decentralized Covid-19 Vaccine Distribution Plans

(p. A8) “While scientists did their job in discovering vaccines in record time, my predecessor — I’ll be very blunt about it — did not do his job in getting ready for the massive challenge of vaccinating hundreds of millions,” Mr. Biden added.

“It was a big mess,” he said. “It’s going to take time to fix, to be blunt with you.”

Health officials in the Trump administration have pushed back on those suggestions, pointing to hundreds of briefings that officials at the Department of Health and Human Services offered the incoming health team, including on vaccine allocation and distribution.

The highly decentralized plans to distribute and administer the vaccines, giving state and local health departments authority once doses had been delivered, were developed with career staff members at the Centers for Disease Control and Prevention and the Defense Department.

Officials involved in the last administration’s distribution plans said late last year that outside of the first few weeks, when they carefully managed the flow of second-dose reserves, their plan was always to ship out doses as they became available, and that they never intended to stockpile doses.

For the full story, see:

Katie Rogers, Noah Weiland and Sharon LaFraniere. “200 Million More Doses Coming, But the Logistics Are a Challenge.” The New York Times (Friday, February 12, 2021): A1 & A8.

(Note: the online version of the story has the date Feb. 11, 2021, and has the title “With More Vaccines Secured, Biden Warns of Hurdles to Come.”)

FDA Should Approve Faster Clinical Trials for Boosters to Block New Covid-19 Variants

(p. A17) . . . , it is essential to design clinical trials that can be completed within several months, to avert potential outbreaks of new variants. It’s fast, but given today’s scientific capabilities that could be enough time to do the required trials.

Take the South African variant known as B1351. The existing trials will be used to establish that the current vaccines provide clinical protection against Covid disease. But to prove the new versions targeting B1351 work as well as the current vaccines, the FDA can measure the antibody levels in the plasma from patients who have recovered from B1351 and establish a benchmark for the number of antibodies needed to neutralize that virus. Then the FDA can use those antibody levels as a proxy to evaluate whether updated vaccines are able to generate sufficient levels of protection.

This could allow vaccine makers to test new boosters in clinical trials that enroll 300 or 400 patients rather than 40,000, an enormous savings in cost and time. Larger and longer studies can be started at the same time, including ones that follow vaccinated patients.

For the full commentary, see:

Scott Gottlieb. “Another Promising Vaccine, This One From Johnson & Johnson.” The Wall Street Journal (Monday, February 1, 2021): A17.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date January 31, 2021, and has the same title as the online version.)

Chinese Communists Plan Years in Prison for Lawyer-Journalist Who Documented Government Failings in Covid Crisis

(p. 15) In one video, during the lockdown in Wuhan, she filmed a hospital hallway lined with rolling beds, the patients hooked up to blue oxygen tanks. In another, she panned over a community health center, noting that a man said he was charged for a coronavirus test, even though residents believed the tests would be free.

At the time, Zhang Zhan, a 37-year-old former lawyer turned citizen journalist, embodied the Chinese people’s hunger for unfiltered information about the epidemic. Now, she has become a symbol of the government’s efforts to deny its early failings in the crisis and promote a victorious narrative instead.

Ms. Zhang abruptly stopped posting in May [2020], after several months of dispatches. The police later revealed that she had been arrested, accused of spreading lies. On Monday [Dec. 28, 2020], she will go to court, in the first known trial of a chronicler of China’s coronavirus crisis.

Ms. Zhang has continued to challenge the authorities from jail. Soon after her arrest, Ms. Zhang began a hunger strike, according to her lawyers. She has become gaunt and drained but has refused to eat, the lawyers said, maintaining that her strike is her form of protest against her unjust detention.

“She said she refuses to participate in the trial. She says it’s an insult,” Ren Quanniu, one of the lawyers, said after visiting Ms. Zhang in mid-December in Shanghai, where she is being held.

Ms. Zhang’s prosecution is part of the Chinese Communist Party’s continuing campaign to recast China’s handling of the outbreak as a succession of wise, triumphant moves by the government. Critics who have pointed to officials’ early missteps have been arrested, censored or threatened by police; three other citizen journalists disappeared from Wuhan before Ms. Zhang did, though none of the rest has been publicly charged.

Prosecutors accused Ms. Zhang of “picking quarrels and provoking trouble” — a frequent charge for government critics — and recommended between four and five years in prison.

For the full story, see:

Vivian Wang. “Wuhan Citizen Journalist Faces Trial for Posts in Pandemic.” The New York Times, First Section (Sunday, December 27, 2020): 15.

(Note: bracketed dates added.)

(Note: the online version of the story was updated Dec. 27, 2020, and has the title “She Chronicled China’s Crisis. Now She Is Accused of Spreading Lies.”)

Fauci Lied on Herd Immunity Until His “Gut Feeling” Told Him U.S. Was Ready for the Truth

(p. A6) In the pandemic’s early days, Dr. Fauci tended to cite the same 60 to 70 percent estimate that most experts did. About a month ago, he began saying “70, 75 percent” in television interviews. And last week, in an interview with CNBC News, he said “75, 80, 85 percent” and “75 to 80-plus percent.”

In a telephone interview the next day, Dr. Fauci acknowledged that he had slowly but deliberately been moving the goal posts. He is doing so, he said, partly based on new science, and partly on his gut feeling that the country is finally ready to hear what he really thinks.

For the full story, see:

Donald G. McNeil Jr. “How Can We Achieve Herd Immunity? Experts Are Quietly Upping the Number.” The New York Times, First Section (Sunday, December 27, 2020): A6.

(Note: the online version of the story has the date Dec. 24, 2020, and has the title “How Much Herd Immunity Is Enough?”)

Andrew Cuomo Explains Slow New York Rollout of Vaccines: “It’s Bureaucracy”

(p. A1) ALBANY, N.Y. — New York, the onetime center of the pandemic, faced a growing crisis on Monday [Jan. 4, 2021] over the lagging pace of coronavirus vaccinations, as deaths continue to rise in the second wave and Gov. Andrew M. Cuomo came under mounting pressure to overhaul the process.

. . .

(p. A5) The state has had a deliberate approach in distributing the vaccine; until Monday, the vaccinations were almost exclusively given to health care workers, group home residents, and those living and working at nursing homes.

That cautious approach was also evident in the state’s initial guidance to determine which health care employees should be prioritized for vaccines; the state had advised clinics and other facilities to rank employees through a matrix that takes into account age, comorbidities, occupation and the section of the facility where the person works.

. . .

Mr. Cuomo rejected any notion that his administration was at fault for not distributing more vaccines, asserting that the problem was a local issue, and urging Mr. de Blasio and other leaders who oversee public hospital systems to take “personal responsibility” for their performance.

“They have to move the vaccine,” the governor said in Albany. “And they have to move the vaccine faster.”

. . .

“There is no one cause,” he said, noting that he had spoken to dozens of hospitals about the issue.

He did suggest, however, that management was at fault in some cases, saying that there was a lack of “urgency” in certain hospital systems.

“It’s bureaucracy,” he said.

For the full story, see:

Jesse McKinley, Luis Ferré-Sadurní and Emma G. Fitzsimmons. “New York Lags In Vaccinations While Toll Rises.” The New York Times (Tuesday, January 5, 2021): A1 & A5.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date Jan. 4, 2021, and has the title “New Variant Detected in New York Amid Growing Crisis Over Vaccine Rollout.”)

Operation Warp Speed Developed “Vaccines and Therapies in Record-Breaking Time”

(p. A10) . . . , Mr. Trump could have been the hero of this pandemic. Operation Warp Speed, which his administration announced in May [2020], appears on track to deliver vaccines and therapies in record-breaking time. The United States may well become the first country to bring the virus to heel through pharmaceutical prowess.

For the full story, see:

Donald G. McNeil Jr. “Long, Dark Winter Looms Before U.S. Gets Vaccines.” The New York Times (Tuesday, December 1, 2020): A1 & A10.

(Note: ellipsis, and bracketed year, added.)

(Note: the online version of the story was updated Dec. 24, 2020, and has the title “The Long Darkness Before Dawn.”)

Tens of Millions of Masks Were Sold on Etsy in 2020

(p. B1) Kat Panchal hadn’t yet learned how to use her sewing machine when the pandemic started. But in March, on leave from her job as a flight attendant with American Airlines and cooped up alone in her Philadelphia apartment, the 34-year-old taught herself to sew. Soon, she was stitching masks and donating them to health care workers.

With no sign of her job coming back anytime soon, Ms. Panchal — now furloughed — put her masks on Etsy, the online marketplace where crafters and artists around the globe sell handmade and vintage goods. Since April, she has sold more than 400 masks, raking in over $4,500. Sometimes, she sews until 4 in the morning to keep up with demand.

“It was a really big blessing,” Ms. Panchal said. “It gave me something else to focus on instead of thinking about losing my job.”

Tens of millions of masks have been sold on Etsy this year. The demand has created business opportunities for the likes of Ms. Panchal, but has also turned Etsy into something unexpected: a Wall Street darling.

For the full story, see:

Matt Phillips and Gillian Friedman. “Masks Help Etsy Catch Wall St.’s Eye.” The New York Times (Wednesday, December 9, 2020): B1 & B4.

(Note: the online version of the story has the date Dec. 8, 2020, and has the title “Etsy Was a Twee Culture Punchline. Now It’s a Wall Street Darling.”)

Speed of Development of Vaccine “One of Mr. Trump’s Proudest Accomplishments”

(p. A1) It is a paradox of the pandemic: Helping speed the development of a coronavirus vaccine may be one of Mr. Trump’s proudest accomplishments, but at least in the early stages of the vaccine rollout, there is evidence that a substantial number of his supporters say they do not want to get it.

. . .

(p. A5) For the most part, public opinion has been swinging in favor of vaccination. Seventy-one percent of Americans are willing to be vaccinated, up from 63 percent in September [2020], according to a survey released this week by the Kaiser Family Foundation.

. . .

Experts say that vaccine hesitancy may diminish over time if people see friends and relatives getting vaccinated without incident. Sheri Simms, 62, a retired businesswoman in Northeast Texas who describes herself as a “moderate conservative” supporter of the president, said that while she did not intend to get vaccinated now, that could change.

“As more information comes out, and things appear to work better, then I will weigh the risks of the vaccine against the risk of the coronavirus and make a judgment,” she said.

For the full story, see:

Sheryl Gay Stolberg. “Trump Pushed for a Vaccine, but His Fans Balk.” The New York Times (Saturday, December 19, 2020): A1 & A5.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story was updated Jan. 4, 2021, and has the title “Trump Claims Credit for Vaccines. Some of His Backers Don’t Want to Take Them.”)

“Celebrities Have Access to Better Care Than Ordinary People”

As the passages quoted below suggest, Trump’s friends may have had access to drugs that not everyone had access to. But it also should be acknowledged that Trump was pushing for Covid-19 drugs to be available sooner and with fewer restrictions.

(p. A25) Both the Regeneron and Eli Lilly therapies are meant for people who are at risk of getting sick enough with Covid to be hospitalized, not those who are hospitalized already. The emergency use authorization for the Regeneron treatment specifically says that it is “not authorized” for “adults or pediatric patients who are hospitalized due to Covid-19.”

A physician with experience administering the new monoclonal antibodies, who didn’t want to use his name because he’s not authorized by his hospital to speak publicly, said giving them to Giuliani “appears to be an inappropriate use outside the guidelines of the E.U.A. for a very scarce resource.” Very scarce indeed: According to the Department of Health and Human Services, as of Wednesday the entire country had about 77,000 total doses of the Regeneron cocktail and almost 260,000 doses of Eli Lilly’s monoclonal antibody treatment. That’s less than you’d need to treat everyone who’d tested positive in just the previous two days.

Right now, the criteria for distributing these drugs can be murky. Robert Klitzman, co-founder of the Center for Bioethics at Columbia, said that the federal government allocates doses to states, states allocate them to hospitals and hospitals then decide which patients among those most at risk will get treated. Some states have developed guidelines for monoclonal antibody treatment, “but my understanding is that most states have not yet done that,” Klitzman said.

Hospitals try to come up with ethical triage frameworks, but Klitzman told me there are often workarounds for V.I.P.s. He said it helps to know someone on the hospital’s board. Such bodies typically include wealthy philanthropists. Often, he said, when these millionaires and billionaires ask hospital administrators for special treatment for a friend, “hospitals do it.”

Why? “Hospitals have huge financial problems, especially at the moment with Covid,” he said. They’ve had to shut down profitable elective surgeries and treat many people without insurance. More than ever, he said, they “need money that is given philanthropically from potential donors.”

In other words, Giuliani was right: Celebrities have access to better care than ordinary people. “When someone is in the public eye, or if someone is a potential donor, or has already been a donor to a hospital, then there’s folks in the hospital hierarchy, in the administration, who are keenly aware if they’re coming in, if they’re present, if they need something,” said Shoa Clarke, a cardiologist and professor at Stanford University School of Medicine. Covid, which is leading to rationing of medical resources, only magnifies this longstanding inequality.

For the full commentary, see:

Michelle Goldberg. “Why Trump Cronies Get Covid Meds.” The New York Times (Saturday, December 12, 2020): A25.

(Note: the online version of the commentary has the date Dec. 10, 2020, and has the title “Covid Meds Are Scarce, but Not for Trump Cronies.” The passage quoted above includes several sentences, and a couple of words, that appear in the online, but not in the print, version of the commentary.)

Why Canadian Regulators Approved Vaccine Quicker: “We’re Just Better”

(p. A8) OTTAWA — Canada on Wednesday become only the second Western country to approve a coronavirus vaccine, a week after Britain did so and a day before U.S. regulators will meet to consider taking that step, opening the possibility that Canadians will start being inoculated next week.

. . .

“It’s a testament to the work of regulators internationally,” said Dr. Supriya Sharma, the chief medical adviser at Health Canada, the regulator. “It’s an exceptional day for Canada.”

The go-ahead means that Canadians could receive the vaccine — which requires two doses, weeks apart — before Americans do, though Pfizer is based in the United States. That is likely to aggravate President Trump, who has demanded faster action by the F.D.A. and was angry that Britain, which began inoculating people on Tuesday, [Dec. 28, 2020] had acted before the United States.

. . .

When asked why her group was able to approve the vaccine ahead of the F.D.A. in the United States, Dr. Sharma said, apparently jokingly, “we’re just better.”

For the full story, see:

Ian Austen. “Canada Approves Covid Vaccine, Becoming 2nd in West to Reach Milestone.” The New York Times (Thursday, December 10, 2020): A8.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story was updated Jan. 7, 2021, and has the title “Canada Approves Vaccine and Could Start Shots Next Week.”)

Members of the Elite Exempt Themselves from Rules They Impose on the Hoi Polloi

(p. 12) SAN FRANCISCO — It was an intimate meal in a wood-paneled, private dining room in one of California’s most exclusive restaurants. No one around the table wore masks, not the lobbyists, not even the governor.

Photos that surfaced this week of a dinner at the French Laundry, a temple of haute cuisine in Napa Valley where some prix fixe meals go for $450 per person, have sparked outrage in a state where Democratic leaders have repeatedly admonished residents to be extra vigilant amid the biggest spike in infections since the pandemic began.

. . .

The photos of the gathering, taken by a diner at a nearby table and shared with a local television station, also showed the chief executive for the California Medical Association and the organization’s top lobbyist.

. . .

In a 2019 review of the French Laundry and two other Napa restaurants, the New York Times critic Tejal Rao described being “overwhelmed by the opulence” and feeling as if transported onto a “spaceship for the 1 percent, now orbiting a burning planet.” Mr. Newsom said in October that his children, who attend private school, returned to in-person classes even as most of the state struggles with remote learning.

“Newsom and the first partner eschewed state public health guidelines to dine with friends at a time when the governor has asked families to scale back Thanksgiving plans,” wrote the Sacramento Bee editorial board on Friday. It added, “If the governor can eat out with friends — and if his children can attend their expensive school — why must everyone else sacrifice?”

For the full story, see:

Thomas Fuller. “Officials’ Lavish Meal Out Spurs Outrage Among Californians.” The New York Times, First Section (Sunday, November 22, 2020): 12.

(Note: ellipses added.)

(Note: the online version of the story has the date Nov. 18, 2020, and has the title “For California Governor the Coronavirus Message Is Do as I Say, Not as I Dine.” The online version says that the title of the New York print version was “California Governor Calls” and appeared on Thursday, Nov. 19, 2020. The title of my National print version was “Officials’ Lavish Meal Out Spurs Outrage Among Californians” and appeared on Sunday, November 22, 2020.)