Tulane Outbreak Daily – March 30, 2021

The Fourth Surge Is Upon Us. This Time, It’s Different – The Atlantic

Across the United States, cases have started rising again. In a few cities, even hospitalizations are ticking up. The twists and turns of a pandemic can be hard to predict, but this most recent increase was almost inevitable: A more transmissible and more deadly variant called B.1.1.7 has established itself at the precise moment when many regions are opening up rapidly by lifting mask mandates, indoor-gathering restrictions, and occupancy limits on gyms and restaurants.

U.S. Covid Deaths Expected to Rise Soon With New Wave Emerging – Bloomberg

Covid-19 deaths in the U.S. are expected to bottom out in the next two weeks and then may inch higher as the nation races to blunt an incipient new wave of cases with its vaccination campaign.

Tourism in Antigua and Barbuda Is Sending Covid Skyrocketing – Bloomberg

Officials contend the problem isn’t resort-goers. But locals aren’t so sure.

Mexico’s Excess Deaths Far Exceed Official Coronavirus Toll – Bloomberg

Excess deaths in Mexico for 2020 and early 2021 exceeded 417,000, more than double the official number of fatalities from the pandemic, the federal government said in a report that also sharply raised what it called Covid-related deaths.

Despite Chile’s Speedy Covid-19 Vaccination Drive, Cases Soar – NYT

Experts say Chile’s government eased restrictions on travel, business and schools much too early, creating a false sense of confidence that the worst of the pandemic was over.

Infections with ‘U.K Variant’ B.1.1.7 Have Greater Risk of Mortality – NIH Director’s Blog

Since the genome sequence of SARS-CoV-2, the virus responsible for COVID-19, was first reported in January 2020, thousands of variants have been reported. In the vast majority of cases, these variants, which arise from random genomic changes as SARS-CoV-2 makes copies of itself in an infected person, haven’t raised any alarm among public health officials. But that’s now changed with the emergence of at least three variants carrying mutations that potentially make them even more dangerous.

As U.S. braces for fourth pandemic wave, one governor asks for more vaccines in hot spots – Washington Post

With new coronavirus infections rising across the United States once again, at least one governor in a hot spot state appealed to the Biden administration for extra vaccine doses to help staunch the worsening spread.

Moderna and Pfizer COVID-19 vaccines may block infection as well as disease – Science News

Vaccines against COVID-19 are about 90 percent effective at blocking coronavirus infections, real-world studies of health care workers, firefighters, police, teachers and other essential workers suggest.

Vaccine Headlines

Germany Restricts Use of AstraZeneca Vaccine for Under-60s – Wall Street Journal

Germany’s government said Tuesday it will restrict the use of the AstraZeneca PLC’s Covid-19 vaccine for people younger than 60 following fresh blood-clotting incidents among recipients, potentially presenting the country’s sputtering vaccine rollout with fresh delays.

Pfizer, Moderna COVID-19 vaccines highly effective after first shot in real-world use, U.S. study shows – Reuters

COVID-19 vaccines developed by Pfizer Inc with BioNTech SE and Moderna Inc reduced risk of infection by 80% two weeks or more after the first of two shots, according to data from a real-world U.S. study released on Monday.

We Need to Talk About the AstraZeneca Vaccine – The Atlantic

The AstraZeneca COVID-19 vaccine is indispensable right now. As one of the first vaccines out of the gate, it’s been at the center of the World Health Organization’s plan to roll out some 2 billion doses to 92 nations by the end of the year. It’s also one of just a handful of vaccines that are already being produced and distributed on such a massive scale that they might change the near-term course of the pandemic.

Clinical Considerations

The role of antirheumatics in patients with COVID-19 – Lancet

The COVID-19 pandemic has resulted in more than 2 million deaths globally. Two interconnected stages of disease are generally recognised; an initial viral stage and a subsequent immune response phase with the clinical characteristics of hyperinflammation associated with acute respiratory distress syndrome. Therefore, many immune modulators and immunosuppressive drugs, which are widely used in rheumatological practice, have been proposed as treatments for patients with moderate or severe COVID-19. In this Review, we provide an overview of what is currently known about the efficacy and safety of antirheumatic therapies for the treatment of patients with COVID-19.

Official Reporting for March 31, 2021

World Health Organization

Weekly Epi Update March 29, 2021

Confirmed Cases: 127 349 248

Deaths: 2 787 593

Johns Hopkins

Confirmed Cases: 128,125,926
Deaths: 2,801,858

Centers for Disease Control and Prevention (CDC)

Total cases: 30,147,895 (+60,699 New Cases)
Total deaths: 547,296 (+592 New Deaths)

Science and Tech

T cells recognize recent SARS-CoV-2 variants – NIH

When variants of SARS-CoV-2 (the virus that causes COVID-19) emerged in late 2020, concern arose that they might elude protective immune responses generated by prior infection or vaccination, potentially making re-infection more likely or vaccination less effective. To investigate this possibility, researchers from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and colleagues analyzed blood cell samples from 30 people who had contracted and recovered from COVID-19 prior to the emergence of virus variants. They found that one key player in the immune response to SARS-CoV-2—the CD8+ T cell—remained active against the virus.

Psychological and Sociological Impact

‘I’m empty.’ Pandemic scientists are burning out—and don’t see an end in sight – Science

When not caring for COVID-19 patients—her latest was a man with bacterial lung and blood infections superimposed on SARS-CoV-2 pneumonia—Krutika Kuppalli has been helping oversee the rollout of pandemic vaccines at the Medical University of South Carolina (MUSC), where she’s an infectious disease physician. She has also been meeting with vaccine-hesitant hospital staff, sitting on a committee that reviews all planned COVID-19 clinical trials at MUSC, applying for funding to study patients with Long COVID, and handling online harassment that has followed her numerous media appearances and two rounds of congressional testimony last summer.

Evicted And Homeless Due To Pandemic — ‘I Literally Had To Sleep In My Car’ – NPR

Getting evicted can hurt you in a bunch of different ways. You don’t have to tell that to 57-year-old Gregory Curry in Dothan, Ala. “I’ll be honest with you, I was petrified by this situation,” Curry says. “What I’ve had to go through over this last year.”

‘Fiasco Waiting To Happen’: Millions At Risk Of Losing Power Over Unpaid Bills – NPR

Millions of people are at risk of losing electricity in the coming weeks because of unpaid power bills, even as Congress has authorized billions of dollars in supplemental relief.

Published Research

Efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 variant of concern 202012/01 (B.1.1.7): an exploratory analysis of a randomised controlled trial – Lancet

The emerging plasticity of SARS-CoV-2 – Science

Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers — Eight U.S. Locations, December 2020–March 2021 – CDC MMWR

Misinformation, Disinformation, and Conspiracy Theories

How vaccine skeptics created a movement – Bloomberg Prognosis Podcast

A few decades ago, nobody really questioned vaccines. They were viewed as a standard part of staying healthy and safe. Today, the number of people questioning vaccines risks prolonging a pandemic that has already killed hundreds of thousands of Americans. Doubt, a new series from Prognosis, looks at the forces that have been breaking down that trust. We’ll trace the rise of vaccine skepticism in America to show how we got here — and where we’re going.

Part One: Rumor Has I‪t‬

In the series premiere of “Doubt,” we meet Jon, a New York City paramedic struggling to decide whether he should get vaccinated. Bloomberg health reporter Kristen V. Brown shows how the pandemic has led many people like him to question vaccines for the first time — and how this distrust threatens to prolong the pandemic.

Part Two: The Man Behind The Myt‪h‬

Meet the man behind all the myths: Andrew Wakefield. Wakefield’s retracted 1998 study linking autism to vaccines helped kickstart the modern vaccine hesitancy movement. We’ll explore the forces that helped propel Wakefield into the spotlight and show how groundwork Wakefield laid decades ago helped seed the mistrust we’re seeing in the age of the coronavirus.

Part Three: The Happiest Place on Eart‪h‬

The 2015 Disneyland measles outbreak was a pivotal moment in explaining the vaccine hesitation we see today. The outbreak made clear that number of people opting out of vaccination was significant. But it also changed the people protesting vaccines. Before that, activists speaking out about vaccines had mainly been parents concerned about the safety of their kids. California’s push to get rid of vaccine exemptions in the wake of the outbreak changed the conversation. It became political. It became about choice and freedom and democracy.

My Osage tribe is swimming in vaccines — but the people won’t take them – Washington Post

Downtown Pawhuska, Okla., is busy these days with filmmakers working on preproduction of the upcoming Martin Scorsese film “Killers of the Flower Moon.” You can tell who is in the film crew by the N95 face masks they wear. The locals don’t wear face masks.

Coping in 2020 (and probably most of 2021)

Creative coping – Washington Post

Pet chickens, pink hair, an old plane: Here’s what’s keeping readers going through the pandemic