COVID-19 Briefing: U.S. Leadership Changes and Global Implications for COVID-19

12 November 2020
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“We might be tired of COVID-19. But it is not tired of us. It pays no heed to political rhetoric or conspiracy theories. Our only hope is science, solutions, and solidarity.”
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.

 

73rd World Health Assembly Resumes
 
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.”

Pandemic Spread

On Sunday, November 8, the world passed the milestone of more than 50 million reported COVID-19 infections. As of Thursday, November 12, at 2:30 pm ET, Johns Hopkins University reported 52,523,976 cases of COVID-19 and 1,289,474 deaths due to COVID-19, globally.
 
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.
 

“We are entering the most concerning and most deadly phase of this pandemic. This is not about lockdowns — It hasn’t been about lockdowns since March or April. It’s about an aggressive, balanced approach that is not being implemented.”
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

“I’m not running on the false promise of being able to end this pandemic by flipping a switch, but what I can promise you is this: We will start on day one doing the right things. We’ll let science drive our decisions. We will deal honestly with the American people, and we’ll never ever, ever quit.”
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.”

Industry Developments

Pfizer Announces Positive Vaccine Results
 
“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.

 

Gilead’s remdesivir has been shown to shorten the time to recovery for hospitalized COVID-19 patients, and recently received FDA approval. However, a new study in the New England Journal of Medicine concluded that the drug had no impact on mortality. The findings align with an October study from the WHO Solidarity Trial which showed that remdesivir, like the other drugs in the trial, has no effect on mortality. A draft of the WHO’s ACT Accelerator purchasing plan indicates that the organization is prioritizing scaling access to monoclonal antibodies and corticosteroids (deprioritizing remdesivir, an antiviral agent).

 

Last week, AstraZeneca began clinical trials of its adenovirus vaccine candidate, AZD1222, co-developed with Oxford University, in Chile and Peru. The additional international trials will bring AstraZeneca closer to the 30,000 participants the company hopes to enroll. Pending enrollment and community infection rates, AstraZeneca expects results by the end of the year. The company will begin discussions with the FDA once the trial produces robust data, even if the data are not specific to the U.S. European authorities have begun a rolling review of the vaccine, and in India, the Serum Institute of India has already produced 30 million vials of the vaccine in preparation for regulatory approval.

 

Early in the pandemic, experts hypothesized that some COVID-19 infections could induce an overactive immune response, known as a cytokine storm, that could prove more fatal than the original illness. Interleukin-6 (il-6) was commonly believed to instigate such cytokine storms, and il-6 blocking agents became standard of care. However, recent studies of il-6 blockers showed no difference in mortality in patients receiving the treatment. Likewise, initial results from a Novartis trial of canakinumab (an interleukin inhibitor) released on Friday, November 6, showed that the anti-inflammatory drug also failed to decrease overall mortality.

 

The FDA, on Monday, November 10, granted an EUA to Eli Lilly’s COVID-19 antibody treatment, bamlanivimab. In a study of 465 adults, those in the bamlanivimab arm reported fewer hospitalizations and ER visits than those receiving the placebo. The treatment is only authorized for use in non-hospitalized patients with mild to moderate COVID-19. Lilly plans to begin shipping stock immediately and to produce enough doses to treat one million people by the end of the year.

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

 

Additional Resources

Reports from International Governments and Bodies

 

Funding and Policy Trackers

 

Resource Pages and Market Research Literature

 

Communications Toolkits

For more information or should you have any questions, please contact us.

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.

 

About Omnicom Public Relations Group

Omnicom Public Relations Group is a global collective of three of the top global public relations agencies worldwide and eight specialist agencies in public affairs, marketing to women, fashion, global health strategy and corporate social responsibility. It encompasses more than 6,000 public relations professionals in more than 330 offices worldwide who provide their expertise to companies, government agencies, NGOs and nonprofits across a wide range of industries. Omnicom Public Relations Group delivers for clients through a relentless focus on talent, continuous pursuit of innovation and a culture steeped in collaboration. Omnicom Public Relations Group is part of the DAS Group of Companies, a division of Omnicom Group Inc. that includes more than 200 companies in a wide range of marketing disciplines including advertising, public relations, healthcare, customer relationship management, events, promotional marketing, branding and research.

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