Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization (WHO)
November has been a tumultuous month on the international stage. With cases of COVID-19 rising exponentially in several countries, near-term containment remains elusive. Many countries in Europe have reinstituted lockdowns. Latin America’s epidemic has risen to the level of a humanitarian crisis. And experts worry that a resurgence in India could have devastating consequences.
In the United States, Joseph R. Biden Jr. was declared the nation’s next president against the backdrop of record-setting infection rates in many parts of the country. With hospitalizations due to COVID-19 at an all-time high, the U.S. response is at a critical inflection point. President-elect Biden and Vice President-elect Kamala Harris have pledged to get the epidemic under control.
This week’s edition of Rabin Martin’s COVID-19 Briefing focuses on the implications of the U.S. presidential election on the COVID-19 pandemic. How will new leadership affect the country’s – and the world’s – COVID-19 trajectory? Our earlier COVID-19 Briefings are available here.
From Monday, November 9, through Friday, November 13, WHO Member States are reconvening virtually to continue discussions on the global response to the COVID-19 pandemic and to set the global health agenda for the uncertain times ahead. In recognition of the outstanding dedication and sacrifice of millions of healthcare workers fighting the pandemic this year, the Assembly voted unanimously to name 2021 as the International Year of Health and Care Workers.
The Assembly also focused on turning the tide on neglected tropical diseases (NTDs). On Thursday, November 12, the Assembly adopted an NTD 2030 Roadmap outlining targets and goals to prevent, control, eliminate, and eradicate 20 NTDs and disease groups by 2030. Key among the recommendations is a shift from siloed vertical interventions towards integrated approaches developed in collaboration with national and local governments and communities. Dr. Mwelecele Ntuli Malecela, Director, Department of Control of NTDs, WHO, stated, “At the core of this roadmap are shifts which aim not only to free over a billion people from the impact of disease and disability, but to do so in a way which is sustainable, driven by and for countries, with patients at the center of all activities.”
The U.S. epidemic continues to surpass record highs for both new cases and hospitalizations. This week, the country averaged more than 120,000 new cases each day, and on Tuesday, November 10, reported 139,800 new cases – the most of any country, at any point in the pandemic. On Monday, November 9, the U.S. reported more than 10 million total infections (total reported as of Thursday: 10,488,531). 242,310 deaths have been attributed to COVID-19.
Weeks after European nations began reinstituting restrictions on mobility – with many returning to lockdown – cases across the region continue to surge. Nearly all countries are reporting positivity rates over 4 percent and, as of Sunday, November 8, over half of all new infections reported globally in the preceding week (1,989,636) originated in Europe. Hospitalizations have topped the peak in the Spring, and some of the worst-hit nations, like the Czech Republic, are seeing hospitalization rates increase by nearly 2,000 percent. As a result, countries are running low on available hospital beds, ventilators, and even morgue spaces. Portuguese hospital administrator Fernando Maltez expressed his alarm: “No health service in the world … can withstand a deluge of cases that just keeps coming.” This week, Europe’s total death toll exceeded 300,000, raising concerns that hospitals are at a breaking point.
COVID-19 Tracker World Heat Map (New York Times) Red regions represent countries with average daily cases of more than 14 per 100,00 people in the past week, as of Thursday, November 12
In India, experts worry that the combination of festival season and cooler weather could lead to a dangerous resurgence of the coronavirus. The Indian government imposed restrictive lockdowns during the Spring and Summer to contain the country’s epidemic. These measures appear to have been successful, with lower numbers of reported infections and deaths in recent weeks. However, physicians caution that it is only a matter of time before the country sees new spikes, and they are warning against complacency. There is also continued concern among some scientists and doctors that less reliable tests and less testing may be the reason for the reported drop in infections.
Dr. Deborah Birx, Coordinator, White House Coronavirus Task Force
In the U.S., revived social activity and returns to workplaces have fueled the surge in cases. An analysis from the U.S. Centers for Disease Control and Prevention found that people who tested positive for COVID-19 were twice as likely to report going exclusively to an office or school setting in the two weeks before becoming ill. Some states are reintroducing restrictive measures used early in the epidemic, while others are resisting mask mandates.
U.S. Leadership Changes & COVID-19
Joseph R. Biden Jr., U.S. President-elect
On Saturday, November 7, media outlets announced that Joseph R. Biden Jr. had won the U.S. presidential election against President Donald Trump. The promise of a robust COVID-19 response was a crucial part of the President-elect’s campaign: “Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts,” he said. Forecasts suggest that Biden will assume office during a surge of cases as Winter sets in; he will be sworn in as president on January 20, 2021.
On Monday, November 9, President-elect Biden announced the formation of the Transition COVID-19 Advisory Board to help shape his administration’s response to the pandemic. Dr. Vivek Murthy, former U.S. Surgeon General; Dr. David Kessler, former Commissioner, U.S. Food and Drug Administration (FDA); and Dr. Marcella Nunez-Smith, Associate Dean for Health Equity Research, Yale University, will co-chair the Advisory Board. The 13-member team will consult with local officials to “determine the public health and economic steps necessary to get the virus under control, to deliver immediate relief to working families, to address ongoing racial and ethnic disparities, and to reopen our schools and businesses safely and effectively.”
The other members of the Advisory Board are Dr. Luciana Borio, In-Q-Tel; Dr. Rick Bright, formerly with the Biomedical Advanced Research and Development Authority; Dr. Ezekiel Emmanuel, University of Pennsylvania; Dr. Atul Gawande, Brigham and Women’s Hospital; Dr. Celine Gounder, NYU Grossman School of Medicine; Dr. Julie Morita, Robert Wood Johnson Foundation; Dr. Michael Osterholm, University of Minnesota; Loyce Pace, Global Health Council; Dr. Robert Rodriguez, UCSF School of Medicine; and Dr. Eric Goosby, UCSF School of Medicine.
The Advisory Board will help guide the refinement and implementation of President-elect Biden’s COVID-19 plan. The seven-point plan supports policies that (1) ensure all Americans have access to regular, reliable, and free testing; (2) guarantee the supply of personal protective equipment; (3) provide clear, consistent, evidence-based national guidance, as well as associated resources; (4) plan for equitable distribution of treatments and vaccines; (5) protect at-risk populations; (6) support mechanisms to predict, prevent, and mitigate pandemic threats; and (7) implement mask mandates nationwide.
President-elect Biden also announced that he will reverse the Trump administration’s decision to withdraw from the WHO as early as his first day in office. On Monday, November 9, Dr. Tedros welcomed the opportunity to work with the new administration: “We congratulate President-elect Joe Biden and Vice President-elect Kamala Harris, and we look forward to working with this administration very closely.”
“This vaccine could have a serious impact on bending the curve of this outbreak.”
Dr. Saad B. Omer, Director, Yale Institute for Global Health.
On Monday, November 9, Pfizer released positive preliminary results from Phase III trials of its COVID-19 vaccine candidate, co-developed with German biotechnology firm BioNTech. The results suggest the vaccine, BNT162b2, is over 90 percent effective in preventing COVID-19 symptoms. Pfizer may have the data to apply for emergency use authorization (EUA) from the FDA as soon as next week. If the application progresses as expected, U.S. officials plan to begin vaccinating high-risk Americans in December. The U.S. has a $1.95B contract to purchase 100 million doses of the vaccine, pending FDA approval.
Dr. Anthony Fauci, Director, U.S. National Institute of Allergy and Infectious Disease, responded optimistically to the news, noting the promise of other vaccine candidates that also use mRNA technology. Such vaccine candidates, including Moderna’s, are “likely [to] have similar results,” said Dr. Fauci. Additionally, on Tuesday, November 10, CureVac, another company developing an mRNA vaccine, released results suggesting its candidate triggers an immune response.
While many celebrated the success of the mRNA platform, there are acknowledged challenges in distribution. The vaccine must be stored at ultra-cold temperatures, and maintaining an extreme cold chain may be difficult in resource-limited settings. Even in the U.S., rural hospitals report being unable to afford the super-cold freezers that would be needed to hold supply of the vaccine.
From the Experts
“Social distancing policy is not an on/off switch — this is a dial that needs to be calibrated to the temperature.”
Dr. Thomas Tsai, Faculty, Harvard Global Health Institute
Monday, November 9
“While the latest news on a vaccine looks encouraging, we could still face recurring cycles of accelerating viral spread and tightening restrictions until widespread immunity is achieved. The recovery may not be linear, but rather unsteady, stop-start, and contingent on the pace of vaccine roll-out.”
Christine Lagarde, President, European Central Bank
Tuesday, November 10
“The only way we’ll truly ‘build back better’ is to offer incoming policymakers at the federal and Congressional levels what they need to take meaningful steps toward protecting and advancing global health, by aligning with today’s realities.”
Loyce Pace, President, Global Health Council
Tuesday, November 10
“The news of the Pfizer vaccine and Biden COVID-19 task force are reasons for optimism. But both sources of hope will be sorely challenged in coming months by Trump administration inaction, soaring COVID-19 infections, and the lack of a genuine infrastructure across the U.S. for mass immunization.”
Laurie Garrett, Author, The Coming Plague
Tuesday, November 10
What We’re Reading
- COVID-19 Risks and Impacts Among Health Care Workers by Race/Ethnicity – Samantha Artiga, Matthew Rae, Olivia Pham, Liz Hamel, and Cailey Muñana, Kaiser Family Foundation
- The Hidden Public Health Hazard of Rapid COVID-19 Tests – Joia Crear-Perry, STAT News
- COVID-19 in Latin America: A Humanitarian Crisis – Editorial Board, The Lancet
- How A ‘Warm Vaccine’ Could Help India Tackle Coronavirus – Soutik Biswas, BBC News
- COVID Infections in Animals Prompt Scientific Concern – James Gorman, The New York Times
- ICU Doctor on the Impact of COVID-19 on Communities of Color – Christianna Silva, National Public Radio
- ‘Virus Hunters’ A Conversation with Christopher Golden, PhD and Kendra Phelps, PhD – David Ignatius, The Washington Post
- Health Experts Want to Prioritize People of Color for a COVID-19 Vaccine. But How Should It Be Done? – Nicholas St. Fleur, STAT News
- The Vaccine News is Good. Here’s the Bad News. – Laurie Garrett, Foreign Policy
Reports from International Governments and Bodies
- WHO COVID-19 Information and Guidance
- WHO Weekly Epidemiological Update: November 10
- WHO Weekly Operational Update: November 6
- 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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