Dr. Rochelle Walensky, Director, U.S. Centers for Disease Control and Prevention (CDC)
Today marks exactly one year since World Health Organization (WHO) declared COVID-19 a “pandemic.” On this day last year, Dr. Tedros Adhanom Ghebreyesus, Director-General, WHO, noted, “Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.”
Over the past year, the COVID-19 pandemic has lived up to its billing. While some nations have made strong progress in containing transmission within their borders, most of the world – regardless of income level – still struggles. In short, the pandemic is far from over.
Nevertheless, serious economic fallout and widespread pandemic fatigue are leading some decisionmakers to lift restrictions. Loosening public health efforts to contain transmission when herd immunity is not yet reached has been criticized as short-sighted by experts around the world. In fact, at the beginning of March, WHO noted that, globally, the number of reported new COVID-19 infections rose for the first time in seven weeks. “We need to have a stern warning for all of us: that this virus will rebound if we let it,” said Dr. Maria Van Kerkhove, Technical Lead on COVID-19, WHO.
This week’s edition of Rabin Martin’s COVID-19 Briefing takes a close look at the ongoing pandemic a year in – with the world now focused on returning to “normalcy.” What concrete steps have lawmakers taken to quell the pandemic’s impact? What changes can we anticipate once mass vaccination becomes available? Our earlier COVID-19 Briefings are available here.
The U.S. accounts a quarter of global cases, reporting 27,356,234 cases and 474,198 deaths.
Global pandemic spread (Johns Hopkins University)
COVID-19 containment continues to elude policymakers and scientists alike. Certain countries that previously reported low incidence rates of COVID-19 are now facing surges. For example, on Monday, March 1, Finland declared a state of emergency after setting a new record of over 700 cases in one day. On Tuesday, March 2, Brazil recorded more than 1,700 COVID-19 related deaths — its highest single-day toll thus far. The more infectious P.1 variant is becoming the leading source of infection in the country and continues to spread. One Brazilian politician described the situation as “an atomic bomb,” pointing to the fact that the country now has the second highest COVID-19 related mortality rate, globally (behind the U.S.).
Wide vaccine roll-out is being hailed as the key to end the pandemic. However, challenges remain. In Germany, over a million COVID-19 vaccine doses have not yet been used, due, in part, to vaccine hesitancy and to a rollout plan described as “dysfunctional.” Meanwhile, other countries are still struggling to procure vaccine doses. In Latin America and the Caribbean, Dr. Carissa Etienne, Director, Pan American Health Organization (PAHO), called for expanding equitable access to COVID-19 vaccines. “Wealthy countries are rolling out vaccines, while many nations have yet to receive a single dose,” she said. “As long as COVID-19 endures in one part of the world, the rest of the world can never be safe.”
The COVAX Facility — a global initiative aimed to advance equitable access to COVID-19 vaccines — is striving to address this inequity and delivered vaccines to more than 20 countries last week. However, countries, led by South Africa and India, and advocacy organizations have called for suspension of patent rights to COVID-19 vaccines and treatments, putting a proposal before the World Trade Organization (WTO). And on Friday, March 5, Dr. Tedros announced that to increase the supply of vaccines, he supports the waiver of intellectual property (IP) rights for COVID-19 related technologies until the end of the pandemic. “These provisions are there for use in emergencies,” he said. “If now is not a time to use them, then when?”
On Friday, March 5, more than two dozen pharmaceutical companies sent a letter to the White House, urging U.S. President Joseph R. Biden Jr. to reject the proposal to the WTO, arguing that “intellectual property protections have been essential not only to speed the research and development of new treatments and vaccines, but also to facilitate sharing of technology and information to scale up vaccine manufacturing to meet global needs.” The companies contend that suspension of IP rights would “undermine the global response to the pandemic, including ongoing efforts to tackle new variants, create confusion that could potentially undermine public confidence in vaccine safety, and create a barrier to information sharing.” They argue that issues surrounding effective distribution of available vaccines remain a critical bottleneck — rather than pricing or patents.
Ngozi Okonjo-Iweala, Director, WTO, called the IP discussions “vitally important,” but said stakeholders must take steps to increase production, particularly in emerging markets: “We must make sure that in the end we deliver so that the millions of people who are waiting for us with bated breath know that we are working on concrete solutions.” She is said to be considering a “third way” to ensure low- and middle-income countries have access to COVID-19 vaccines and treatments. While details are forthcoming, this approach may involve additional licensing deals between global manufacturers and those in lower-income countries — though manufacturing capacity could remain a bottleneck.
The U.S. Response
In the U.S., 62.5 million people (18.8 percent of the population) and 61 percent of those 65 and older have received at least one dose of a COVID-19 vaccine, with 31 percent of the older age group fully vaccinated. However, only 10 percent of the entire population has been fully vaccinated as of Wednesday, March 10 and most states are experiencing escalating community spread. Nonetheless, last week, lawmakers in Alabama, Arizona, Connecticut, Mississippi, Texas, and West Virginia announced they would reduce — or eliminate — statewide COVID-19 restrictions. This includes removing caps on indoor capacity for restaurants, bars, gyms, theatres, and other venues, as well as ending mask mandates. Shortly thereafter, CDC reiterated the importance of continued mask usage (even once vaccinated) and limiting indoor gatherings as critical tools to reduce COVID-19 transmission.
New CDC Recommendations: A Glimpse into What’s to Come?
On Tuesday, March 2, President Biden asserted that the U.S. will have enough COVID-19 vaccine supply for all adults by the end of May. As the scale of vaccine distribution rises, so does hope around a return to pre-pandemic life. On Monday, March 8, CDC issued its “Interim Public Health Recommendations for Fully Vaccinated People.” For this guidance, CDC defines people as “fully vaccinated” two weeks after receiving a second dose of Pfizer/BioNTech’s or Moderna’s vaccine or one dose of Johnson & Johnson’s vaccine.
On Wednesday, March 10, the U.S. House of Representatives approved the Biden Administration’s $1.9 trillion COVID-19 relief plan. Early today on Thursday, March 11, President Biden signed the legislation into law. The American Rescue Plan seeks to provide economic relief for U.S. households hardest hit by the pandemic – including, but not limited to, providing: up to $1,400 stimulus payments to about 90 percent of households; increases to weekly jobless benefits, nutrition and housing assistance, and child tax credits; $350 billion in state and local aid; support for rural hospitals; as well as health insurance subsidies and increased Medicaid funding.
The Plan has a clear focus on scaling-up the manufacturing and distribution of COVID-19 vaccines. “A vaccinated American is the only way to beat the pandemic, get the economy back on track, and for us to get back our lives and our loved ones. That’s why the American Rescue Plan was so critical,” said President Biden. The bill directs:
- Almost $48 billion toward testing and tracking of COVID-19 cases
- $10 billion to support Defense Production Act contracts
- $7.5 billion to track, administer, and distribute COVID-19 vaccines (including supporting community vaccination centers and expanded public communications)
- $2 billion to procure additional supplies, such as personal protective equipment
- $1.75 billion for new genomic techniques for disease surveillance,
- $1 billion to the U.S. Department of Health and Human Services for vaccine confidence programs
- $500 million to the U.S. Food and Drug Administration (FDA) for ongoing operational support
- Along with funding for schools, small-businesses, housing assistance, and more
Beyond the U.S., $11 billion has been earmarked for international assistance, including support for the Global Fund to Fight AIDS, Tuberculosis and Malaria, the CDC’s health preparedness programming, and USAID’s multi-faceted efforts to support international rehabilitation from the pandemic’s impact.
From the Experts
“I’m urging everyone to get the vaccine when it is your turn. I’ve taken the vaccine. It’s about understanding that it’s bigger than you because it really is an extension of ‘love thy neighbor’ and it will save their life.”
Kamala Harris, Vice President, United States of America
Sunday, March 7
“No countries are safe until all countries are safe…We are working on options for donating surplus [vaccine] doses across our wider portfolio to the Pacific and developing countries worldwide.”
Jacinda Arden, Prime Minister, New Zealand
Sunday, March 7
“Every day that goes by that we keep the lid on, things will get better and better because we’re putting… [two] million vaccinations into the arms of individuals each day… So we’re going in the right direction. We just need to hang in there a bit longer.”
Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious Diseases
Sunday, March 7
“Patience, I hate to say it, is still needed. But I think give us the Summer, the early Fall, this is going to be a very different country, in a very good way.”
Dr. Francis Collins, Director, National Institutes of Health
Tuesday, March 9
“We need to be able to roll out vaccines through major cities and also expand into remote areas as quickly as possible. That requires extraordinary logistics and unprecedented efforts that we have never done on the continent. As a matter of fact, the continent of Africa has never vaccinated more than 100 million people in one year, so this is going to be a historic effort.”
Dr. John Nkengasong, Director, Africa CDC
Tuesday, March 9
“This is a moment for celebration [but] we must remain firmly focused on delivering equitable access if we are to stop the endless cycle of lockdowns and illness.”
Dr. Richard Hatchett, CEO, Center for Epidemic Preparedness Innovations
Wednesday, March 10
“[The situation in Brazil] provides a sober reminder of the threat of resurgence: areas hit hard by the virus in the past are still vulnerable to infection today.”
Dr. Carissa Etienne, Director, PAHO
Wednesday, March 10
What We’re Reading
- The Case for an International Pandemic Treaty – Haik Nikogosian and Ilona Kickbusch, BMJ
- Texans Recovering From COVID-19 Needed Oxygen. Then the Power Went Out. – Mike Hixenbaugh and Perla Trevizo, ProPublica
- A Viral Tsunami: How the Underestimated Coronavirus Took Over the World – Joel Achenbach, Ariana Eunjung Cha, and Frances Stead Sellers, The Washington Post
- How America’s Vaccine System Makes People with Health Problems Fight for a Place in Line – Amy Harmon and Danielle Ivory, The New York Times
- Age-Based Vaccine Distribution Is Not Only Unethical. It’s Also Bad Health Policy. – Govind Persad, Emily A. Largent, and Ezekiel J. Emanuel, The Washington Post
- ‘Does Anyone Have Any of These?’: Lab-Supply Shortages Strike Amid Global Pandemic – Chris Woolston, Nature
- What the Coronavirus Variants Mean for the End of the Pandemic – Dhruv Khullar, The New Yorker
- Unlocking the Mysteries of Long COVID – Meghan O’Rourke, The Atlantic
- Dr. Rick Bright Joins The Rockefeller Foundation to Lead Pandemic Prevention Institute Development – The Rockefeller Foundation
Reports from International Governments and Bodies
- WHO COVID-19 Information and Guidance
- WHO Weekly Epidemiological Update: March 9
- WHO Weekly Operational Update: March 8
- CDC Coronavirus Resource Page
- COVID-19 Health Systems Response Monitor
- NCD Alliance COVID resources relevant to NCDs
Funding and Policy Trackers
- International Monetary Fund Policy Tracker
- Kaiser Family Foundation Coronavirus Policy Tracker
- U.S. Chamber of Commerce Foundation Corporate Aid Tracker
- Devex Interactive Funding Tracker
Resource Pages and Market Research Literature
- JAMA Resource Center
- The Lancet COVID-19 Resource Centre
- 2019 Novel Coronavirus Research Compendium (NCRC)
- National Academy of Medicine COVID-19 News and Resources
- WIPO COVID-19 IP Policy Tracker
- The COVID Tracking Project
- PharmaIntelligence: Coronavirus – What will the Impact Be?
- Health Affairs Resource Center
- STAT News COVID-19 Tracker
- Global Health NOW’s COVID-19 Expert Reality Check
- International Association of National Public Health Institutes COVID-19 Resources
- Center for Strategic and International Studies The Reopening and Take as Directed Coronavirus Crisis Update Podcast
- Primary Health Care Performance Initiative Forum
- U.S. Global Leadership Coalition COVID-19 Issue Briefs
- Prevent Epidemics Weekly Science Review
- COVID-19 Watch Weekly Updates
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About Rabin Martin
Rabin Martin is a global health strategy firm working at the intersection of private sector capabilities and unmet public health needs. Rooted in our mission to improve health for underserved populations, we design strategies, programs and partnerships that both deliver public health impact and drive business results. We leverage our deep knowledge and networks across a wide range of geographies and health areas to develop tailored solutions for every client engagement. We have helped many clients create bold global health initiatives and innovative multi-sector partnerships. Our specific areas of expertise include infectious disease and vaccines, non-communicable diseases, rare diseases, maternal and child health, and universal health coverage. Our clients and partners include multinational health care companies, multilateral institutions, government agencies, large foundations and leading NGOs. Rabin Martin is part of the Omnicom Public Relations Group.
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