January 4 coronavirus news

Administering first doses of a Covid-19 vaccine to more individuals instead of withholding available supply for use as a second dose may reduce the number of new cases in the United States, according to a study published in the Annals of Internal Medicine on Monday. 

The US government currently withholds 50% of the available vaccine supply, distributing to states and other jurisdictions weeks later to be administered as the second in a two-dose series. By reducing the amount withheld to 10% for the first three weeks and supplying a steady dose of 6 million doses per week, the US could avoid up to 29% more cases over eight weeks, the study found.

The researchers modeled various scenarios, with variables including vaccine supply, protection provided by the first dose and waning efficacy of first dose if the second dose is delayed. Only in the unlikely worst-case scenario of a collapse in supply and minimal protection among individuals who have received the first dose would the model suggest that withholding 50% of available supply provide better protection.  

Both vaccines authorized for emergency use in the US -- made by Pfizer/BioNTech and Moderna -- are authorized only as a two-dose series, though efficacy estimates allow for partial protection after the first dose. The study modeled scenarios using characteristics of the Pfizer/BioNTech vaccine.

The study assesses the US strategy for vaccine allocation but does not consider delays in vaccine administration at the state level. 

The Biden administration Covid-19 vaccine roll out plan will involve working closely with state-level partners, Rick Bright, a member of President-elect Joe Biden’s coronavirus advisory board, said Monday.

“This is going to be a coordinated, hand-in-hand effort, all the way through to make sure we're getting those vaccines into the arms of people in every pocket, in the rural communities, in the hard-to-reach areas, in the Latinx and Black populations and tribal nations,” Bright told CNN’s Anderson Cooper.

Bright, the former director of the Department of Health and Human Services’ Biomedical Advanced Research and Development Authority, said he is already communicating with states about their needs. 

Bright said that the Trump administration hasn’t been able to deliver the number of doses promised to the American people due to limited coordination with states and local authorities.

“There are problems after delivery into the states, in the health care systems,” he said. “The funding hasn't been provided to allow them to staff up and train people to administer the doses.”

Mexico’s drug administration has approved the AstraZeneca Covid-19 vaccine for emergency use, according to a tweet from Dr. Hugo López-Gatell, the country's deputy health secretary.

It's the second coronavirus vaccine approved in the country, following Pfizer's, which Mexico authorized and began using to vaccinate people in December.

With intensive care units at Southern California hospitals nearly full because of the Covid-19 pandemic, the Los Angeles County Emergency Medical Services Agency (EMS) has directed ambulance crews not to transport patients with little chance of survival to hospitals, and to conserve the use of oxygen.

Los Angeles and Southern California are dealing with one of the country's worst outbreaks of the novel coronavirus. ICU bed capacity plunged to 0% in Southern California last month, as more and more people were admitted to hospital seeking treatment for Covid-19. 

Now, many medical facilities simply do not have the space to take in patients who do not have a chance of survival, according to the agency.   

As of Monday evening, there were 7,544 people hospitalized in Los Angeles due to Covid-19 and just 17 available adult ICU beds, according to county health data. Due to the shortage of beds, the county EMS said patients whose hearts have stopped, despite efforts of resuscitation, should no longer be transported to hospitals.

If there are no signs of breathing or a pulse, EMS will continue to perform resuscitation for at least 20 minutes, the EMS memo said. If the patient is stabilized after the period of resuscitation, the patient would then be transported to a hospital. If the patient is declared dead at the scene or if no pulse can be restored, paramedics will no longer transport the body to the hospital.

Oxygen shortage: A shortage of oxygen in Los Angeles and the nearby San Joaquin Valley, thanks to Covid-19, is putting immense pressure on the system and forcing paramedics to conserve the supply.

In order to maintain normal circulation of the blood to organs and tissue needed for the body to function, EMS said an oxygen saturation of at least 90% will be sufficient. 

California Gov. Gavin Newsom formed a task force to address the issue last week. It is working with local and state partners to help refill oxygen tanks and mobilize them to hospitals and facilities most in need.

More than 500,000 people in the US state of Michigan have contracted Covid-19, Gov. Gretchen Whitmer said Monday.

Despite the rise in cases, Whitmer said the fact that vaccine distribution has begun means there is "hope on the horizon."

However, Whitmer cautioned that "it will take some time for the vaccine to be widely available to all Michiganders, and until then, we must continue to do our part to keep ourselves and our fellow Michiganders safe."

Track US cases here:

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Tracking Covid-19 cases in the US

The United States should be sequencing 10% of its confirmed Covid-19 cases to monitor for mutations, experts told CNN Monday -- yet current figures put the country at less than half a percent.

Angela Rasmussen, a virologist at the Georgetown University Center for Global Health Science and Security and an associate research scientist at Columbia University’s Center for Infection and Immunity, said that the US sequences a "dismal" 0.3% of detected cases.

US labs have submitted only about 57,700 sequences of the coronavirus to the genomic database GISAID. In comparison, the UK has submitted more than 146,000, despite having far fewer confirmed cases. Rasmussen said a lack of public funding for surveillance was a "big problem," because it's important that officials continually sequence detected cases in order to monitor for mutations to the virus that render vaccines less effective.

The UK sequences about 10% of its detected cases. Rasmussen said in an email that the US "should shoot for at least half of what the UK does, but ideally we should be at 10% or better,” Rasmussen said via email.

Variants detected in Britain and in South Africa both have patterns of mutation that trouble scientists and appear to make the virus more easily transmitted. Only a handful of these variants have been reported in the US so far although experts believe the mutation first found in Britain is likely fairly widespread.

Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, also said the US should aim to sequence 10% of its confirmed cases.

Over the next two weeks, the US Centers for Disease Control and Prevention hopes to double the number of samples it genetically sequences to 6,500 per week, according to an agency official, who also noted that the UK has a more centralized system for genetic sequencing while the US relies on a patchwork of federal, state, academic and private labs. 

Anyone who receives the Moderna or Pfizer vaccine must get both doses, two top US Food and Drug Administration officials said Monday. 

They said people who are speculating about the possibility of making do with just one dose are misinterpreting the data.

“We have been following the discussions and news reports about reducing the number of doses, extending the length of time between doses, changing the dose (half-dose), or mixing and matching vaccines in order to immunize more people against COVID-19,” FDA Commissioner Dr. Stephen Hahn and Dr. Peter Marks, who heads FDA’s vaccine division, said in a statement.

“The available data continue to support the use of two specified doses of each authorized vaccine at specified intervals. For the Pfizer/BioNTech COVID-19 vaccine, the interval is 21 days between the first and second dose. And for the Moderna COVID-19 vaccine, the interval is 28 days between the first and second dose.”

British officials have said they will allow more than 21 days between doses of Pfizer’s vaccines and would consider allowing people to get vaccinated with two different vaccines. Hahn and Marks dismissed these ideas for the US, saying while there is speculation that a single dose offers protection, there is not enough hard evidence to show it will.

“What we have seen is that the data in the firms’ submissions regarding the first dose is commonly being misinterpreted. In the phase 3 trials, 98% of participants in the Pfizer-BioNTech trial and 92% of participants in the Moderna trial received two doses of the vaccine at either a three- or four-week interval, respectively,” they wrote.

“Those participants who did not receive two vaccine doses at either a three-or four-week interval were generally only followed for a short period of time, such that we cannot conclude anything definitive about the depth or duration of protection after a single dose of vaccine from the single dose percentages reported by the companies.”

It’s understandable that people may want to stretch the vaccine supply, they said. But it’s not advisable.

A feared holiday surge of coronavirus infections has begun in Los Angeles County, where about one in five residents getting tested for Covid-19 are now testing positive, officials in the hard-hit region announced Monday, calling the situation a “human disaster” and predicting the death toll could soar to more than 1,000 people per week.

L.A. County Public Health Director Barbara Ferrer said Covid-19 hospitalizations in the county have reached an all-time high with 7,697 patients, 21% of whom are in intensive care, a figure she called “distressing.”

“The anticipated surge from the winter holiday gatherings has begun,” said Ferrer. “The increases in cases are likely to continue for weeks to come as a result of holiday and New Year’s Eve parties and returning travelers.”

County health officials reported 77 new deaths on Monday, raising the total number in the county to 10,850, and an additional 9,142 cases. Ferrer pointed out Monday’s lower than average numbers reflect a lag in reporting from the holiday weekend and the closure of some testing sites.

According to Ferrer, one person is now dying from the virus every 15 minutes in L.A. County. 

According to the L.A. County Department of Medical Examiner-Coroner’s office, with hospitals and mortuaries full of bodies, the county coroner’s office has been storing additional victims, a growing toll that has risen to 757 bodies, a coroner’s spokesperson told CNN.

L.A. County Supervisor Hilda Solis called the situation in the county, which has doubled its total number of Covid-19 cases since the start of the pandemic in the last month alone, “a human disaster.” 

With infections continuing to surge out of control in the nation’s most populous county, Solis warned the situation, which is already “beyond our imagination, could become beyond comprehension.”

This post has been updated to reflect that one in five LA residents who were tested for the virus tested positive.

The United States reported 128,210 current Covid-19 hospitalizations on Monday, setting a new record high since the pandemic began, according to the Covid Tracking Project (CTP).

This is the 34th consecutive day that the US has remained above 100,000 current hospitalizations.

According to CTP data, the highest hospitalization numbers were recorded on these days: