By Vivian Ho, Ph.D.
James A. Baker III Institute Chair in Health Economics
Kirstin R.W. Matthews, Ph.D.
Fellow in Science and Technology Policy
Heidi Russell, M.D., Ph.D.
Associate Professor
Department of Pediatrics and Center for Medical Ethics and Health Policy
Baylor College of Medicine
As of Friday, August 7, data from the Covid Tracking Project showed that the 7-day average (smoothed) number of new U.S. daily cases fell to 54,008, a 15% decrease relative to 63,240 the previous Friday. The smoothed percent of cases testing positive fell to 7.5% from 8.0% one week earlier. The smoothed number of deaths in the U.S. fell 5%, from 1113 one week earlier to 1,053 last Friday. Here in Texas, the number of smoothed daily cases fell 2% between July 31 and August 7, while the smoothed number of daily deaths fell from 341 to 218. The smoothed percent of people testing positive rose from 10.3% on July 31 to 13.3% last Friday.
Risk Factors and Disease Effects
More than 107 million American adults are obese, and researchers are worried that a Covid-19 vaccine will be less effective for obese people. Vaccines engineered to protect the public from influenza, hepatitis B, tetanus and rabies can be less effective in obese adults, who have weaker immune systems.
Pakistan, with a population of 200 million, was down to 727 new cases on August 5. Their success sharply contrasts with their neighbors Iran and India, which each are seeing 40,000 or 50,000 new cases each day and rising. The success is attributed to strong public health messaging.
Health care workers of color were more likely to care for patients with suspected or confirmed Covid-19, more likely to report using inadequate or reused protective gear, and nearly twice as likely as white colleagues to test positive for the coronavirus, a new study from Harvard Medical School researchers found.
A new study in JAMA Internal Medicine found that asymptomatic Covid-19 patients in Korea had viral loads similar to those of symptomatic patients. This finding indicates that asymptomatic people are likely to be infectious to others, which previously was believed based on anecdotal evidence.
Researchers believe Covid-19 is unlikely to cause birth defects. However, doctors are still closely watching pregnancies of mothers-to-be tested positive, especially if a woman tested positive early in the pregnancy.
Vaccines and Treatments
A Kaiser Health News story reports that vaccine clinical trials have drawn thousands of volunteers, who will be randomized to receive an experimental vaccine or a placebo. Some test sites pay volunteers up to $2,000 for completing the two-year study. But a Wall Street Journal article reports that researchers worry the trials will enroll insufficient numbers of racial and ethnic minorities.
Novavax in Maryland received $1.6 billion from Operation Warp Speed for its experimental vaccine that has produced high levels of antibodies against SARS-CoV2, the virus that causes Covid-19, in 56 volunteers. While other vaccine candidates are further along with clinical trials, Novavax’s stands out because it is protein-based — the same proven technology used for existing vaccines against infections like shingles.
Eli Lilly is using customized recreational vehicles to take an experimental antibody drug and personnel to U.S. nursing homes where a resident or staff member has Covid-19. Researchers will give the antibody by intravenous infusion to others at the nursing home who consent. Eli Lilly hopes to enroll 2,400 study subjects to test whether the drug reduces infection rates and disease in the weeks after dosing.
Four former FDA commissioners endorsed The Fight Is In U.S., a broad coalition of public and private institutions working to recruit convalescent plasma donors across the country. However, researchers worry that the rush to treat patients with plasma is discouraging patients from enrolling in randomized clinical trials to confirm that the treatment is indeed effective.
The Serum Institute, owned by the Pune family of India, produces 1.5 billion vaccine doses per year. The company has contracted with AstraZeneca to make 1 billion doses of the Oxford Covid-19 vaccine for India and lower- and middle-income countries, for which it will not charge above costs until the pandemic is over.
Policy Interventions
Seven U.S. governors have formed a purchasing compact they hope will induce companies that make rapid-detection tests to quickly ramp up production. Talks have begun with one of the two companies approved by the Food and Drug Administration (FDA) to sell point-of-care antigen tests that can detect the virus in less than 30 minutes. Each state would request 500,000 tests, or 3.5 million in total.
The U.S. House Subcommittee on the Coronavirus Crisis held a congressional hearing to discuss the risks and benefits of opening schools to in-person teaching. A poll from the Kaiser Family Foundation found that the majority of parents supported postponing opening schools (as opposed to in-person teaching).
An FDA effort to address a shortage of protective masks early in the pandemic has instead opened the floodgates to products of widely varying quality sold by 3,500 Chinese manufacturers, potentially putting the public at risk and leaving some U.S. states with stockpiles of masks they no longer trust as protective gear.
Signing Off
In the months ahead, the Baker Institute will continue to focus on the pandemic across disciplines, through its research centers and events. However, this week marks the end of our weekly blog. The fall semester is rapidly approaching, and we must fully turn our attention to teaching and other academic duties. We pooled our clinical and policy expertise to better understand the Covid-19 pandemic, and it has been a privilege to share our findings with you. We are grateful for the continuing hard work and sacrifices of clinicians, scientists and frontline workers around the world. We applaud experts Anthony Fauci, Deborah Birx, Scott Gottlieb and others for continually offering thoughtful recommendations for controlling the U.S. pandemic. From them we have learned that the country does indeed have the resources to quell this virus, even before a vaccine arrives. Yet we suffer a lack of leadership at the national and state level, along with a corresponding epidemic of misinformation and mistrust. Things may worsen before they improve. But we have faith that progress will be made against Covid-19 in the coming months. We are returning to our efforts to identify strategies to increase access, lower costs and improve the quality of care in a transformed post-pandemic health care system.