Past Covid-19 Infection Gives Vaccine-Like Immunity For Months, Study Finds

Coronavirus immunity: What do we know? | COVID-19 Special - YouTube

TOPLINE

Most people who have recovered from Covid-19 have similar levels of immunity against future infection to those who received a coronavirus vaccine, a study by Public Health England found, offering early hope against fears of a short-lived immunity spurred on by reports of people catching the virus twice, though the researchers warn that those with immunity may still be able to carry and transmit the virus to others. 

KEY FACTS

Naturally acquired immunity from a previous Covid-19 infection provides 83% protection against reinfection when compared with people who have not had the disease before, government researchers found in a study of more than 20,000 healthcare workers.

The study, which has not yet been peer reviewed for rigor by other scientists, shows that this protection lasts for at least five months and is at a level just below that offered by vaccines from Pfizer-BioNTech (95%) and Moderna (94%) and significantly above that of the vaccine developed by the University of Oxford and AstraZeneca (62%), though manufacturers don’t know for how long this immunity lasts.

The figures suggest reinfection is relatively rare — occurring in fewer than 1% of the the 6,614 people who had already tested positive for the disease — though the scientists warned that while “those with antibodies have some protection from becoming ill with Covid-19 themselves,” early evidence suggests that they can carry and transmit the virus to others.

“It is therefore crucial that everyone continues to follow the rules and stays at home, even if they have previously had Covid-19, to prevent spreading the virus to others,” Public Health England wrote.

The study will continue to follow participants for another 12 months to determine “how long any immunity may last, the effectiveness of vaccines and to what extent people with immunity are able to carry and transmit the virus,” as well as investigate the highly-contagious new variant of coronavirus spreading across the U.K.. 

CRUCIAL QUOTE

Professor Lawrence Young, a virologist and Professor of Molecular Oncology at Warwick Medical School in England, said an important takeaway from the study is that we don’t yet know how long antibody protection will last outside of the five month window. He said it is “possible that many people who were infected during the first wave of the pandemic may now be susceptible to re-infection.” Young said it will be interesting to see whether people previously infected with Covid-19 and are subsequently vaccinated have “an even longer-lived protective immune response” and whether or not these findings hold true for the new virus variant currently spreading in the U.K..

WHAT TO WATCH FOR

The information gathered from reinfection cases could prove important as the pandemic progresses, especially when it comes to designing and implementing an effective vaccination program and deciding whether to ease lockdown measures. Whether or not those who are immune to serious illness are capable of transmitting the infection to others will be a crucial deciding factor.

WHAT WE DON’T KNOW

It’s not yet clear for how long the protection provided by vaccines last. This will have to be studied over time, as with this case of natural immunity, and is something manufacturers are already doing. Moderna believes their vaccine offers at least a year’s protection against disease. Whether or not this protection prevents individuals from infecting others will also need to be figured out. 

BIG NUMBER

384,784. That’s how many people have died from Covid-19 in the U.S. since the pandemic began, according to Johns Hopkins university. According to CDC projections, this figure is set to grow 25% in the next three weeks. At the moment, more than 23 million people have contracted the disease in the U.S..

More than 10 percent of the U.S. Congress has tested positive

Which Members of Congress Have Tested Positive for the Coronavirus - The  New York Times

At least 60 sitting members of Congress — more than one in 10 — have tested positive for the coronavirus or are believed to have had Covid-19 at some point since the pandemic began. The list includes 44 Republicans and 16 Democrats.

That’s a higher proportion than the general population. As of Wednesday, a bit fewer than one in 14 Americans are known to have had the virus, according to a New York Times database, though many more cases have probably gone undetected.

Five House members have reported positive tests since the attack on the Capitol last week, when many lawmakers were holed up in a secure location together and some refused to wear masks — a situation that angered several Democrats, including Representative Pramila Jayapal of Washington, one of those who has since tested positive. Congress’s attending physician warned members afterward that it was possible they were exposed while sheltering and recommended that they get tested.

Congress has struggled to stem the spread within its ranks in recent weeks. Most members who have tested positive have done so since the election in November, as coronavirus cases have surged across the country.

Representative Jake LaTurner, Republican of Kansas, said he received word just after the attack on the Capitol last Wednesday that he had tested positive, and did not return to the House floor for a vote early on Thursday.

Representative Gus Bilirakis of Florida and Representative Michelle Steel of California, both Republicans, were absent from the House floor when the mob entered the Capitol because each had received positive test results earlier that morning. Representative Chuck Fleischmann, Republican of Tennessee, said on Sunday that he had tested positive after exposure to Mr. Bilirakis, with whom he shares a residence.

Covid-19 Live Updates: Distracted by D.C. Political Crisis, U.S. Sets Daily Record for Virus Deaths

Moving a Covid-19 victim from a hospital morgue in Baltimore last month.

More than 4,400 people in the country died of the coronavirus on Tuesday, the day before lawmakers were set to charge President Trump with inciting last week’s violence at the Capitol.

RIGHT NOW

More than 10 percent of the U.S. Congress has tested positive.

The fallout from the Capitol siege has overshadowed the surging U.S. virus death toll.

As America slogs through this grimmest of winters, there is no relief in the daily tabulations of coronavirus-related deaths: More than 4,400 were reported across the United States on Tuesday, according to a New York Times database, a number once unimaginable.

Yet even as Covid-19 touches thousands of families, the nation is distracted by the political crisis gripping Washington in the last days of the Trump administration.

Tuesday’s death count, which set another daily record, represented at least 1,597 more people than those killed in the terrorist attacks of Sept. 11, 2001.

The U.S. death toll, already the world’s highest by a wide margin, is now about 20,000 shy of 400,000 — only a month after the country crossed the 300,000 threshold, a figure greater than the number of Americans who died fighting in World War II.

But much of the nation’s attention is focused on the fallout from the Capitol siege, prompted in part by President Trump’s efforts to prevent Congress from certifying Joseph R. Biden Jr.’s victory in the November election.

On Wednesday, the House will vote to formally charge Mr. Trump with inciting violence against the country. House lawmakers have formally notified Vice President Mike Pence that they will impeach the president if Mr. Pence and the cabinet do not remove Mr. Trump from power by invoking the 25th Amendment.

As people in the country wait to see how Mr. Trump’s tenure will end, they have also focused on the stories of the five people who were left dead after last week’s rampage — in particular, the death of Brian D. Sicknick, a Capitol Police officer who was overpowered by the mob and struck on the head with a fire extinguisher.

“Brian is a hero,” his brother Ken Sicknick said. “That is what we would like people to remember.”

Each coronavirus death is no less painful to the families and friends who have lost loved ones. Among the latest victims are a revered basketball coach, a travel writer who loved country winters and an architect who had survived the Holocaust.

The health Secretary Alex M. Azar II tried to highlight the urgency of the crisis on Tuesday as the Trump administration said that it would release all available vaccine doses and instructed states to immediately begin inoculating every American 65 and older.

“This next phase reflects the urgency of the situation we face,” he said. “Every vaccine dose that is sitting in a warehouse rather than going into an arm could mean one more life lost or one more hospital bed occupied.”

Two Dead Every Minute: U.S. Covid-19 Cases Surge In 2021

COVID-19 on pace to become the third-leading cause of death in Arizona this  year - The Gila Herald

TOPLINE

In the first week of 2021, roughly two people died from Covid-19 in the U.S. every minute, amid a struggling national vaccination effort, soaring coronavirus cases and the deadliest day of the pandemic yet.

KEY FACTS

According to data from the Covid Tracking Project, 19,418 people died from the disease in the first seven days of 2021.

The U.S. is the country hardest hit by the novel coronavirus — more than 4,000 people died on Thursday, the deadliest day yet of the pandemic, and over 355,000 people have died from the disease since the pandemic began. 

Experts warn that things are likely to get worse before they get better as hospitals across the country are stretched to breaking point — hospitals in LA are reportedly rationing oxygen and many are running out of beds. 

More than 132,000 Americans are currently admitted in hospitals for Covid-19-related care. 

Widespread vaccination, which could help turn the tide against the virus, has failed to gain momentum and the U.S. is way behind its inoculation targets.

The Centers for Disease Control and Prevention says that only 28% of the more than 21 million vaccines it has distributed have been used —  many are reportedly languishing in storage. 

WHAT TO WATCH FOR

President-elect Joe Biden has said he will release all available Covid-19 vaccine doses for immediate use upon taking office, ending Trump’s strategy of saving doses to ensure people have access to a recommended second shot. Some countries, such as the U.K., have decided to space out doses beyond what manufacturers recommend in a bid to provide as many people as possible with some degree of immunity. Experts are torn on the strategy. The U.S. Food and Drug Administration recommends the vaccines are distributed as intended, with a second shot after a 21 or 28 day gap. The British medical regulator, and more recently the World Health Organization, say the second shot can be delayed, although they do not agree on how long this should be.

CRUCIAL QUOTE

Biden warned that the U.S. is falling “far behind” what is needed to control the pandemic. Trump’s approach would take “years,” he said. 

WHAT WE DON’T KNOW

A highly infectious variant of coronavirus, first discovered in the U.K., could be circulating in the U.S.. At least 52 cases have been reported so far. Fortunately, scientists do not believe the variant is able to evade the recently-developed vaccines. 

U.S. surpasses 300,000 daily coronavirus cases, the second alarming record this week

CDC advises 'universal' masks indoors as US Covid deaths again break records  | Coronavirus | The Guardian

The United States on Friday surpassed 300,000 daily coronavirus cases, the second alarming record this week. The number, which roughly equates to the population of St. Louis, Pittsburgh or Cincinnati, comes about two months after the country reported 100,000 coronavirus cases a day for the first time, and one day after more than 4,000 people died from the virus, also a record.

The United States has reported 21.8 million infections and 367,458 deaths.

Nearly 60% of COVID-19 spread may come from asymptomatic spread, model finds

How asymptomatic cases fuelled spread of coronavirus - Times of India

People with COVID-19 who don’t exhibit symptoms may transmit 59 percent of all virus cases, according to a model developed by CDC researchers and published Jan. 7 in JAMA Network Open. 

Since many factors influence COVID-19 spread, researchers developed a mathematical approach to assess several scenarios, varying the infectious period and proportion of transmission for those who never display symptoms according to published best estimates.  

In the baseline model, 59 percent of all transmission came from asymptomatic transmission. That includes 35 percent of new cases from people who infect others before they show symptoms and 24 percent from people who never develop symptoms at all. Under a broad range of values for each of these assumptions, at least 50 percent of new COVID-19 infections were estimated to have originated from exposure to asymptomatic individuals. 

The more contagious variant first identified in the U.K. and since found in six states underscores the importance of the model findings, said Jay Butler, MD, CDC deputy director for infectious diseases and a co-author of the study.

“Controlling the COVID-19 pandemic really is going to require controlling the silent pandemic of transmission from persons without symptoms,” Dr. Butler told The Washington Post. “The community mitigation tools that we have need to be utilized broadly to be able to slow the spread of SARS-CoV-2 from all infected persons, at least until we have those vaccines widely available.”

Whether vaccines stop transmission is still uncertain and was not a scenario addressed in the model. 

States ranked by percentage of COVID-19 vaccines administered: Jan. 8

E.U. Starts Effort to Vaccinate 450 Million - The New York Times

North Dakota has administered the highest percentage of COVID-19 vaccines it has received, according to the CDC’s COVID-19 vaccine distribution and administration data tracker.

The CDC’s data tracker compiles data from healthcare facilities and public health authorities. It updates daily to report the total number of COVID-19 vaccines that have been distributed to each state and the total number each state has administered.

As of 9 a.m. ET Jan. 7, a total of 21,419,800 vaccine doses have been distributed in the U.S. and 5,919,418 have been administered, or 27.64 percent. That means about 1.8 percent of the U.S. population has been vaccinated. 

Below are the states ranked by the percentage of COVID-19 vaccines they’ve administered of those that have been distributed to them.

  1. North Dakota
    Doses distributed to state: 43,950
    Doses administered: 27,289
    Percentage of distributed vaccines that have been administered: 62.09
  2. West Virginia
    Doses distributed to state: 126,275
    Doses administered: 74,016
    Percentage of distributed vaccines that have been administered: 58.61
  3. South Dakota
    Doses distributed to state: 59,900
    Doses administered: 33,389
    Percentage of distributed vaccines that have been administered: 55.74
  4. New Hampshire
    Doses distributed to state: 77,075
    Doses administered: 37,369
    Percentage of distributed vaccines that have been administered: 48.48
  5. Connecticut
    Doses distributed to state: 219,125
    Doses administered: 100,889
    Percentage of distributed vaccines that have been administered: 46.04
  6. Nebraska
    Doses distributed to state: 132,800
    Doses administered: 53,548
    Percentage of distributed vaccines that have been administered: 40.32
  7. Montana
    Doses distributed to state: 69,025
    Doses administered: 27,693
    Percentage of distributed vaccines that have been administered: 40.12
  8. Tennessee
    Doses distributed to state: 454,800
    Doses administered: 179,811
    Percentage of distributed vaccines that have been administered: 39.54
  9. Iowa
    Doses distributed to state: 191,675
    Doses administered: 74,224
    Percentage of distributed vaccines that have been administered: 38.72
  10. Kentucky
    Doses distributed to state: 244,350
    Doses administered: 94,443
    Percentage of distributed vaccines that have been administered: 38.65
  11. Vermont
    Doses distributed to state: 48,550
    Doses administered: 18,740
    Percentage of distributed vaccines that have been administered: 38.6
  12. Maine
    Doses distributed to state: 96,475
    Doses administered: 37,128
    Percentage of distributed vaccines that have been administered: 38.48
  13. Rhode Island
    Doses distributed to state: 72,175
    Doses administered: 27,696
    Percentage of distributed vaccines that have been administered: 38.37
  14. New Mexico
    Doses distributed to state: 133,125
    Doses administered: 48,306
    Percentage of distributed vaccines that have been administered: 36.29
  15. Colorado
    Doses distributed to state: 361,375
    Doses administered: 130,445
    Percentage of distributed vaccines that have been administered: 36.1
  16. Utah
    Doses distributed to state: 191,075
    Doses administered: 62,662
    Percentage of distributed vaccines that have been administered: 34.8
  17. Oklahoma
    Doses distributed to state: 264,000
    Doses administered: 85,978
    Percentage of distributed vaccines that have been administered: 32.57
  18. Texas
    Doses distributed to state: 1,676,925
    Doses administered: 545,658
    Percentage of distributed vaccines that have been administered: 32.54
  19. New York
    Doses distributed to state: 1,134,800
    Doses administered: 353,788
    Percentage of distributed vaccines that have been administered: 31.18
  20. Massachusetts
    Doses distributed to state: 449,025
    Doses administered: 137,858
    Percentage of distributed vaccines that have been administered: 30.7
  21. Ohio
    Doses distributed to state: 576,250
    Doses administered: 175,681
    Percentage of distributed vaccines that have been administered: 30.49
  22. Indiana
    Doses distributed to state: 409,625
    Doses administered: 123,835
    Percentage of distributed vaccines that have been administered: 30.23
  23. Florida
    Doses distributed to state: 1,355,775
    Doses administered: 402,802
    Percentage of distributed vaccines that have been administered: 29.71
  24. Illinois
    Doses distributed to state: 737,125
    Doses administered: 213,045
    Percentage of distributed vaccines that have been administered: 28.9
  25. Missouri
    Doses distributed to state: 401,050
    Doses administered: 113,369
    Percentage of distributed vaccines that have been administered: 28.27
  26. New Jersey
    Doses distributed to state: 572,250
    Doses administered: 155,458
    Percentage of distributed vaccines that have been administered: 27.17
  27. Maryland
    Doses distributed to state: 371,425
    Doses administered: 100,049
    Percentage of distributed vaccines that have been administered: 26.94
  28. Delaware
    Doses distributed to state: 64,375
    Doses administered: 16,677
    Percentage of distributed vaccines that have been administered: 25.91
  29. Hawaii
    Doses distributed to state: 95,200
    Doses administered: 24,558
    Percentage of distributed vaccines that have been administered: 25.80
  30. South Carolina
    Doses distributed to state: 225,850
    Doses administered: 58,044
    Percentage of distributed vaccines that have been administered: 25.7
  31. Minnesota
    Doses distributed to state: 378,425
    Doses administered: 97,098
    Percentage of distributed vaccines that have been administered: 25.66
  32. Pennsylvania
    Doses distributed to state: 789,250
    Doses administered: 202,498
    Percentage of distributed vaccines that have been administered: 25.66
  33. Wisconsin
    Doses distributed to state: 322,775
    Doses administered: 82,170
    Percentage of distributed vaccines that have been administered: 25.46
  34. Alaska
    Doses distributed to state: 87,325
    Doses administered: 21,830
    Percentage of distributed vaccines that have been administered: 25
  35. Virginia
    Doses distributed to state: 556,625
    Doses administered: 136,924
    Percentage of distributed vaccines that have been administered: 24.60
  36. Oregon
    Doses distributed to state: 262,100
    Doses administered: 61,672
    Percentage of distributed vaccines that have been administered: 23.53
  37. Washington
    Doses distributed to state: 518,550
    Doses administered: 121,354
    Percentage of distributed vaccines that have been administered: 23.40
  38. Wyoming
    Doses distributed to state: 40,400
    Doses administered: 9,324
    Percentage of distributed vaccines that have been administered: 23.08
  39. California
    Doses distributed to state: 2,314,350
    Doses administered: 528,173
    Percentage of distributed vaccines that have been administered: 22.82
  40. Idaho
    Doses distributed to state: 104,925
    Doses administered: 22,822
    Percentage of distributed vaccines that have been administered: 21.75
  41. Louisiana
    Doses distributed to state: 298,825
    Doses administered: 64,664
    Percentage of distributed vaccines that have been administered: 21.64
  42. North Carolina
    Doses distributed to state: 647,450
    Doses administered: 139,474
    Percentage of distributed vaccines that have been administered: 21.54
  43. Nevada
    Doses distributed to state: 187,375
    Doses administered: 39,761
    Percentage of distributed vaccines that have been administered: 21.22
  44. Michigan
    Doses distributed to state: 662,450
    Doses administered: 137,887
    Percentage of distributed vaccines that have been administered: 20.81
  45. Alabama
    Doses distributed to state: 245,100
    Doses administered: 48,888
    Percentage of distributed vaccines that have been administered: 19.95
  46. Arizona
    Doses distributed to state: 453,275
    Doses administered: 88,266
    Percentage of distributed vaccines that have been administered: 19.47
  47. Arkansas
    Doses distributed to state: 212,700
    Doses administered: 40,899
    Percentage of distributed vaccines that have been administered: 19.23
  48. Kansas
    Doses distributed to state: 191,225
    Doses administered: 36,538
    Percentage of distributed vaccines that have been administered: 19.11
  49. Mississippi
    Doses distributed to state: 159,625
    Doses administered: 28,356
    Percentage of distributed vaccines that have been administered: 17.76
  50. Georgia
    Doses distributed to state: 619,250
    Doses administered: 103,793
    Percentage of distributed vaccines that have been administered: 16.76

Fauci says he didn’t expect such a high US death toll from COVID-19

https://thehill.com/homenews/sunday-talk-shows/532405-fauci-says-he-didnt-expect-such-a-high-us-death-toll-from-covid-19

Fauci says he didn't expect such a high US death toll from COVID-19

Anthony Fauci, the nation’s top infectious diseases expert, said Sunday he did not expect the death toll from the coronavirus to be so high in the U.S.

“There is no running away from the numbers,” Fauci told guest host Martha Raddatz on ABC’s “This Week.”

“It’s something that we absolutely have got to grasp and get our arms around and turn that, turn that inflection down by very intensive adherence to the public health measures uniformly throughout the country with no exceptions,” he added.

Statistics held by John Hopkins University show that 350,215 deaths have been recorded in the United States so far, a number that has been quickly growing over the last two months.

“I did not” expect the death toll to reach the recent milestone of 350,000 in the U.S., Fauci said.

“But, you know, that’s what happens when you’re in a situation where you have surges related to so many factors inconsistent adhering to the public health measures, the winter months coming in right now with the cold allowing people or essentially forcing people to do most of their things indoors as opposed to outdoors.”

Raddatz asked Fauci how effective he thought proposals by President-elect Joe Biden would be, such as a 100-day mask mandate and a target of 100 million vaccinations.

“The goal of vaccinating 100 million people in the first 100 days is a realistic goal. We can do 1 million people per day,” Fauci said. “You know we’ve done massive vaccination programs, Martha, in our history. There’s no reason why we can’t do it right now.”

US hits 350,000 COVID-19 deaths amid fear of surge after holiday gatherings

https://thehill.com/homenews/532396-us-hits-350000-covid-19-deaths-amid-fear-of-surge-after-holiday-gatherings

As U.S. inches closer to 350,000 Covid-19 deaths, one model proj -  WRCBtv.com | Chattanooga News, Weather & Sports

More than 350,000 people have died of the coronavirus in the U.S., with another surge of cases and deaths expected in the coming weeks as a result of smaller holiday gatherings.

The country reached the grim milestone early Sunday morning, according to data compiled by Johns Hopkins University. More than 20 million people have been infected since the pandemic began nearly one year ago, according to the tally.

Public health experts attributed a nationwide spike in cases, hospitalizations and deaths in early December to a large number of Americans traveling over the Thanksgiving holiday, and pleaded with citizens to stay home for Christmas and New Year’s celebrations. 

Multiple states have reported a record number of cases, including North Carolina and Arizona, according to the Associated Press. New York hit 1 millions cases total as of Saturday, becoming the fourth state to do so along with Texas, Florida and California.

Last month, federal officials approved two vaccines by Pfizer and Moderna for emergency use. The first round of doses have been administered to doctors, nurses and other front line healthcare workers as well as nursing home residents.

The elderly and other patients deemed “high risk” are the next group of Americans slated to receive vaccines with public health officials estimating younger and healthy citizens can expect to be eligible for vaccination toward the middle to end of spring. 

The Centers of Disease Control and Prevention last week reported more than 2 million people in America have been vaccinated, far short of the 20 million figure the federal government initially said it hoped to top by this time. That number has since grown to 4.2 million as of Sunday. 

“We would have liked to have seen it run smoothly and have 20 million doses into people today by the end of the 2020, which was the projection,” said Dr. Anthony Fauci, the nation’s leading infectious disease doctor. “Obviously, it didn’t happen, and that’s disappointing.”

Fauci said a targeted approach in assisting local governments in vaccine rollout programs is the best way for the federal government to make up for lost time. 

“There really has to be a lot more effort in the sense of resources for the locals, namely, the states, the cities, the counties, the places where the vaccine is actually going into the arms of individuals,” Fauci said. 

Atul Gawande on Coronavirus Vaccines and Prospects for Ending the Pandemic

https://www.newyorker.com/news/the-new-yorker-interview/atul-gawande-on-coronavirus-vaccines-and-prospects-for-ending-the-pandemic

Atul Gawande on Coronavirus Vaccines and Prospects for Ending the Pandemic  | The New Yorker

Atul Gawande is outlandishly accomplished. The son of Indian immigrants, he grew up in Athens, Ohio, and was educated at Athens High School, Stanford, Oxford, and Harvard, where he studied issues of public health. Before working as a surgeon at Brigham and Women’s Hospital, in Boston, he advised such politicians as Jim Cooper and Bill Clinton. He teaches at Harvard and is the chairman of Ariadne Labs, which works on innovation in health-care delivery and solutions, and he recently spent two years as the C.E.O. of a health-care venture called Haven, which is co-owned by Amazon, JPMorgan Chase, and Berkshire Hathaway.

Gawande is also a writer, and he has been publishing in The New Yorker for more than two decades. In 2009, heading into the debate over the Affordable Care Act, President Obama told colleagues that he had been deeply affected by Gawande’s article in the magazine called “The Cost Conundrum,” a study conducted in McAllen, Texas. Obama made the piece required reading for his staff. Gawande’s most recent book, a Times No. 1 best-seller, is “Being Mortal: Medicine and What Matters in the End.”

Since the beginning of the coronavirus pandemic, Gawande has been sharp in his criticism of the Trump Administration and, like Anthony Fauci and other prominent figures in public health, insistent on clear, basic measures to reduce levels of disease. After the election in November, President-elect Biden formed a covid-19 advisory board and included Gawande among its members. Earlier this week, I spoke with Gawande for The New Yorker Radio Hour. In the interview, which has been edited for length and clarity, Gawande says that President Trump’s relative silence on the issue after the election might be a blessing (considering the alternative). He suggests that the development of vaccines promises great things down the line, a return to relative normalcy some months from now. But, before that happens, he says, we may not only see terrible rates of illness and death—we will also experience an almost inevitably contentious rollout of the vaccine. Questions of who gets the vaccine and when will test a deeply divided society. As Gawande put it, “The bus drivers never came before the bankers before.”

We currently have one of the highest death and transmission rates of covid-19 in the world. What went wrong?

There’s so many things that went wrong, but you can boil it down to the difficulty of pulling together. One of the most critical things you have in the toolbox in public health is communications. It’s your ability to have clear priorities and communication about those priorities to your own public and to all of the players who get stuff done. We didn’t get testing started early. We weren’t calling the laboratories together to get testing built and created right from the get-go. And then fast-forward to where we are today. We still are in a world where we have not had clear communications from the top of the government around whether we should be wearing masks and having an actual national strategy to fight the virus. I would boil down what went wrong to not committing to communicating clearly and with one voice about the seriousness of what we’re up against and what the measures are to solve it.

When this began, I read “The Great Influenza,” John M. Barry’s book about 1918 and the horrendous flu that killed millions worldwide, and many hundreds of thousands in the United States. I thought to myself, Well, it’s not possible that we would repeat these mistakes, because, after all, we learn from history, even if the President of the United States does not. How is it possible that we made these same mistakes on such a mass scale? Do you lay it all at the feet of the President?

There’s a big part of this that I lay at the feet of the President. Imagine Pearl Harbor happened, and then we spent seven or eight months deciding whether or not we were going to fight back. And then, seven or eight months into it, a new President is going to come in who says, O.K., we are going to fight now. But you now have substantial parts of the country already arrayed against the idea that fighting it is worthwhile. In the meantime, some states have fought the attack and other states have not, and they’ve had to compete with each other for supplies. That’s the mess we have.

In May, I got to write about this in The New Yorker: the hospitals learned how to bring people to work and have them succeed. It was a formula that included masks, included some basic hygiene, some basic distancing, and testing. That’s been the formula, and is the formula still, for making it possible for people to resume a normal life. But we did not have a commitment from the very top to make this happen on a national basis. And we are continuing to litigate that issue to this very day.

You are now on President-elect Biden’s advisory board on covid-19, and I wonder what kind of coöperation you’re getting from the Trump Administration’s own advisory board.

Well, remember: up until just a few days ago, there was no contact allowed at all between any Administration officials and the Biden-Harris transition team. So only in the last few days have there started to be the contacts that would allow for basic information to be passed. I think it’s too early to say how well those channels of communication are turning out.

I’m sorry to interrupt, Atul, but, just to be clear here: we’re in a public-health emergency. Are you saying that the President’s theories, ill-founded and fantastical theories about the election, held up any communication whatsoever between President Trump’s advisory board and President-elect Biden’s board?

Absolutely. And I want to put a pin in what that means, in concrete fact. Here, we had a vaccine trial that came out three weeks ago showing a successful, effective vaccine, followed, just a few days later, by another vaccine trial. We did not have access to the information they were getting about the status of those trials. We did not have access to information about supplies. So, at the beginning of the year, with Operation Warp Speed, the target was three hundred million vaccines produced by the end of the year. Instead, what we’re seeing is reportedly thirty million or so by the end of [December]. We’re seeing in the press some backtracking from that as well. What were the bottlenecks that meant that this couldn’t be done? Is it a shortage of raw ingredients? Are they having stockpile problems? Is it a problem with the actual production processes?

Here’s another one when I’m talking to colleagues around the country who are going to be involved in distributing the vaccine: We hear about everything from shortages of gloves, uncertainty about supplies of needles and syringes for three hundred and thirty million people to get two rounds of doses. There’s no information yet on how many vaccines will be allocated to a given state or a given big pharmacy company like CVS or Walgreens—places that are an important part of the distribution chain. So there’s a lot of basic information that hasn’t been known. That discovery process is just starting.

The Biden Administration-to-be’s covid-19 task force has got a seven-point plan to stop the pandemic. What are the crucial elements of that plan?

It’s the same story that we’ve known since April: It’s mandating masks—that’s one of the most important tools we have for driving transmission down. It’s testing and being able to make sure that there’s widespread availability of testing. It’s supplies for the places that are going to need proper gloves, masks, et cetera. It’s continuing, based on the level of spread in a given community, to tune how much capacity restriction you have on indoor environments, whether it’s bars and restaurants or weddings or other gatherings that are seen to be currently driving transmission. Those are all critical elements. I’m firmly in agreement with where the President-elect is going on heeding the advice from public-health people that schools can be opened. But, in order for kids to be back in schools, especially elementary and middle schools, there’s still a lot of work to do to insure they have the supplies that they need to maintain distancing, to have the right ventilation.

Thanksgiving was a week ago. Anthony Fauci says that what he fears is a spike on top of a spike, a leap on top of a leap. Do you share that fear?

I do. A lot of people heeded the C.D.C. advice to not travel during Thanksgiving and to limit the size of family get-togethers. And I think that will help a great deal. But clearly large numbers of people did not heed that advice. And that’s the reason for the fear of the spike on top of a spike. We saw that, during the Thanksgiving weekend, we had the highest level of hospitalizations at any time in this pandemic, including the darkest days of spring. That’s going to have consequences in the days to come. I’m concerned that we’ll go into the Christmas holiday week with even higher spikes that will make that holiday all that much more challenging. Spike upon spike upon spike is the fear in this six-week-long period.

One of the signal disasters, as you said earlier, in the Trump Administration was communications, both what the President said about the pandemic and how he said it, the language he couched it in and the attitude he took toward it. Since the election, Trump doesn’t even talk about it on a daily basis.

No, he’s, he’s been awol. He had said in his statements: You know, it’s covidcovidcovid; all they want to talk about is covid. But watch, he said, the news will go away the day after the election. Instead, he’s the one who went away the day after the election. He has hardly spoken on what we’re up against, how bad things are, and what is going to be required. It’s interesting, however. In some ways, that is preferable to his coming in and constantly undermining the public-health messaging. So you have seen the C.D.C. and F.D.A. be able to step up. I can only surmise that what he’s clearly been focussed on is figuring out how to hold on to power. The irony is it’s left the field clear.

President-elect Biden is saying very clearly that this should be thought of as a war. We have to be on a war footing and understand how grave this is. Now you’re getting a unified message that’s coming across, and it’s coming from the President-elect on down and from the career scientists. In the face of the rising levels of disease in the country, you now have some Republican governors who had [opposed] a mask mandate now implementing the mask mandate. And they’re not getting contradicted by the President in that process. So, ironically, look, if I have to have President Trump on the airwaves contradicting everybody, or being awol, I’d rather have him be awol.

Thankfully, we can look forward to a vaccine, but that presents enormous logistical challenges. What are the challenges, and how do you view that rolling out?

Well, this is an undertaking on another scale from anything we’ve been doing in the last year. We have deployed north of a hundred and twenty million coronavirus tests in the course of eight months. This is going to be three hundred and thirty million vaccinations, done twice, and hoping to accomplish it in the course of six months or less. This is with vaccines that are new and that haven’t been produced at this volume before. Their clinical data is just undergoing review for approval by the F.D.A. The task is muddied by the fact that we don’t have a clear understanding of what the supply situation is that we have inherited from the Trump Administration. We also don’t know even what the prioritization is.

I’m concerned that what will happen when the new Administration starts is that they will inherit a lot of public confusion, because each state is now coming to its own conclusion about how they’re going to prioritize things. There’s going to be such demand. People are going to clamor for this vaccine. And, if they think that the system is rigged, we will have even more trouble.

After health-care workers and nursing homes, who gets the vaccine next? It’s almost like some terrible philosophical, moral, ethical conundrum that philosophers are faced with all the time. What are your discussions like when it comes to those next levels?

There are eighty-seven million essential workers who are at heightened risk of exposure. They are, say, meatpackers who are exposed to co-workers, or grocery-store workers or bus drivers who are exposed. You’ll be able to go to your local pharmacy and get a vaccine, but what they need to know is, how do they identify who’s the bus driver and who’s not?

Will the government be able to guarantee us that wealthy people, connected people, won’t be able to jump the line?

I think this is one of the critical tests—and an opportunity. The chance to prove that the system is not rigged should not be underestimated. It’s hard. Think about it. The bus drivers never came before the bankers before. You’re going to have Zoom workers who want to go back to normal, and I cannot blame the number of people who will say, You know, thank God I can finally not be in fear. Let me get the vaccine. What do you mean, I have to wait five months? I can imagine a million ways [of jumping the line], people paying someone twenty-five hundred bucks to get your work I.D. tag. This is all about rallying people together. It can’t just be about the rules. It has to be about how we all understand this and work together to say, These are the folks most at risk. They make our subways work. They make our buses work. They get our food supply to us. They make it possible for me to go grocery shopping, and I’ll just have to wait three or four months for my turn.

What you’re talking about is community and common interest and fairness. Many people are very good about that on the level of rhetoric, but, when it comes to their health and their children’s health or their parents’ health, that’s where rubber meets the road.

The mass debate and antagonism we’ve had over the last few months is nothing compared to the splits we will see over “I want my family to be vaccinated.” You know, one person in the family might get vaccinated. Another person might not because they have an illness profile or they have a job that fits in that way. You’ll have children who some families will want to have vaccinated and others will not want to have vaccinated. Pediatric clinical trials have only just gotten under way, and we won’t see those results for a while.

I have a child with severe autism, and so I pay very close attention to the anti-vaxxer movement. And the statistics, the numbers of people who say they will not be vaccinated, is enormous. Doesn’t that have serious implications not only for them but for our over-all effort?

It does. It seems, if we can get around seventy per cent or so of people vaccinated, that would stop the transmission just through vaccination alone. Now if, once people start getting vaccinated, they start throwing their masks away and you can’t get them to do anything else like distancing, then you’re really relying on vaccination as the sole prong of the strategy come three, four months from now. I think there are lots of things that are pushing in the direction of keeping the numbers of people who resist vaccination smaller than those surveys indicate.

What are the numbers?

The numbers suggest that it’s up to as much as forty per cent, even up to fifty per cent, who have said that they are not ready to take the vaccine [even] if the F.D.A. approves it. Part of the reason it’s good that health-care workers would go first is just demonstrating that we ourselves are willing to get vaccinated. Health-care workers are everywhere, which means we’re all going to know people who got vaccinated, and we’re going to see that they did all right.

The reality is that there are memes around anti-vaccination, like: the vaccine will change your D.N.A., or people are injecting a location transmitter into you, a conspiracy to be tagging everybody in the country. We’ll have to be able to combat crazy conspiracy theories. I’ll just summarize by saying this will be contentious, but I’m quite hopeful that we will get to large enough levels of vaccination so that we will be able to get this under control and return to a significant degree of normalcy.

Has there ever been any kind of distribution effort like this in American history?

I draw on things like the polio campaigns, which, you know, took polio from being an annual summer pandemic, in the early fifties, that left kids paralyzed, to essentially being gone a few years after the vaccines came out. Then you had H1N1, where we were in position to vaccinate seventy-million-plus people. So I think there is some precedent. We have not tried to say, Let’s eradicate this disease in one year. Smallpox took a couple of decades. I think we can get [the coronavirus] under control without necessarily eradicating it.

What would it take to eradicate it—or are we never going to eradicate it?

You don’t have to vaccinate every single human being in order to eradicate it. You need to get enough people vaccinated so that the disease stops spreading and dies out. I’m hopeful that we can get it under control here, but, to get eradication, to go back to global travel like before, you would have to get the whole world vaccinated. And that will take years. If we are well vaccinated here, we will feel comfortable over time lifting our restrictions on travel in the United States. And we will become freer to travel to many places around the world. And we will begin to realize what a lot of public-health people like me have been saying, which is that this can’t just be about distribution of vaccine in the United States. This is also going to need to be about enabling global vaccination.

At what point do you think you will be comfortable eating in crowded restaurants, flying on planes, living the life that you lived a year ago?

I think it will be after I get vaccinated [and we have enough data to know the vaccines are stopping transmission]. I’m actually a trial participant. One of the things that’s running through my brain is when I’m going to feel comfortable—when I find out whether I got a placebo or I got the vaccine.

What trial are you in?

I’m in the Moderna trial. After the booster shot, I got a fever, and I had the whole reaction that you would have expected. So I’m going to guess that I got the vaccine. But I won’t feel comfortable that I got it until I actually get that confirmation. But this isn’t about me. I want to see the evidence that the vaccine is lasting. What is the story three months from now? Are the antibodies showing indications that it lasts? I suspect that we’ll really feel comfortable, that we’re able to largely return to normal, maybe in about six months’ time. But, you know, we’re going to go through this gray-zone period where a lot of people have been vaccinated, and I will feel among them. I’m so desperate to go to a concert! Live music is the thing I’ve missed the absolute most.

Dr. Fauci has been a paragon. At the same time, he said, it could be a year and a half for a vaccine to be deployable. Why was the timeline so much faster in the end?

It was insane, some of the timelines that the scientists hit. For example, from the moment that the genome for the virus got sequenced to the moment when the N.I.H.-Moderna team actually was producing the vaccine, it was days. I think it was like a week or something like that. That’s just beyond belief.

What was the science, the discoveries, that made that possible?

Well, it was years of work to build the platform that could deliver the genetic information. Those first few days of success were built on years of work that folks like Dr. Fauci get credit for, because he’s been contributing to the creation of that kind of platform for some years now, as have many biotech companies and many university labs and the government.

Atul, we’re sitting here and watching the year 2020 end—and not a moment too soon. What do you expect will be our situation in December, 2021?

Well, for one thing, I think we’ll be having normal holiday experiences. We’ll be able to get together with our families and spend time. It’s harder for me to predict from my vantage point with as much confidence, but I think that if that’s happening, we will be on better economic terms as well. Right now, airlines, hotels, and any face-to-face service industry—bars, restaurants, child care, health care—I think all of those things are coming back.