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The study, which has not yet been peer reviewed for rigor by other scientists, shows that this protection lasts for at least five months and is at a level just below that offered by vaccines from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..
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 testssince 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.
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.
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.
“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.”
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.
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.
Wednesday’s storming of the U.S. Capitol did not just overshadow one of the deadliest days of the coronavirus pandemic — it could have contributed to the crisis as a textbook potential superspreader, health experts warn.
Thousands of Trump supporters dismissive of the virus’s threat packed together with few face coverings — shouting, jostling and forcing their way indoors to halt certification of the election results, many converging from out of town at the president’s urging. Police rushed members of Congress to crowded quarters where legislators say some of their colleagues refused to wear masks as well.
“This was in so many ways an extraordinarily dangerous event yesterday, not only from the security aspects but from the public health aspects, and there will be a fair amount of disease that comes from it,” said Eric Toner, senior scholar at the John Hopkins Center for Health Security.
Experts said that resulting infections will be near-impossible to track, with massive crowds fanning out around the country and few rioters detained and identified. They also wondered if even a significant number of cases would register in a nation overwhelmed by the coronavirus. As Americans shared their shock and anger at the Capitol breach Thursday, the United States reported more than 132,000 people hospitalized with the virus, and more than 4,000 deaths from covid-19, the disease caused by the coronavirus — making it the highest single-day tally yet.
“It is a very real possibility that this will lead to a major outbreak but one that we may or may not be able to recognize,” Toner said. “All the cases to likely derive from this event will likely be lost in the huge number of cases we have in the country right now.”
Trump devotees who flocked to the capital this week said they were unconcerned by the virus, belittling common precautions known to slow its spread and echoing the president’s dismissive attitude toward rising case counts. Trump had encouraged them to gather in defiance of his election loss: “Big protest in D.C. on January 6th,” he tweeted last month. “Be there, will be wild!”
Mike Hebert, 73, drove two days from Kansas to participate. Marching toward the Capitol on Wednesday with an American flag, he said he did not feel the need to wear a face covering.
“I am as scared of the virus as I am of a butterfly,” said Hebert, adding that he is a veteran who was shot twice in Vietnam.
Sisters Courtney and Haley Stone left New York at 11 p.m. to make it to the Capitol by morning so they could quietly counterprotest, draped in Biden gear. “Do you want a mask? I have one,” Haley, 22, asked a Trump supporter, only to be rebuffed.
“Oh, you believe in the mask hoax?” the woman replied.
Health experts predicted Wednesday’s events will contribute to an ongoing case surge in the greater Washington region. The average number of daily new infections in Virginia, Maryland and the District of Columbia reached a record high Thursday, and current covid-19 hospitalizations in the District have risen 19 percent in the past week.
They also noted differences with other large gatherings such as Black Lives Matter protests. Fewer people wore masks during the Capitol protests and riot, they said, and crowds were indoors.
“If you wanted to organize an event to maximize the spread of covid it would be difficult to find one better than the one we witnessed yesterday,” said Jonathan Fielding, a professor at the schools of Public Health and Medicine at UCLA.
“You have the drivers of spreading at a time when we are bearing the heaviest burden of this terrible virus and terrible pandemic,” he said.
Calling in to CBS News Wednesday, Rep. Susan Wild (D-Pa.) described her evacuation to a “crowded” undisclosed location with 300 to 400 other people.
“It’s what I would call a covid superspreader event,” she said. “About half the people in the room are not wearing masks, even though they’ve been offered surgical masks. They’ve refused to wear them.”
She did not identify the lawmakers forgoing face coverings beyond saying they were Republicans, including some freshmen. The Committee on House Administration says it is a “critical necessity” to mask up while indoors at the Capitol, and D.C. has a strict mask mandate.
“It’s certainly exactly the kind of situation that we’ve been told by the medical doctors not to be in,” Wild said.
“We weren’t even allowed to get together with our families for Thanksgiving and Christmas,” she said, “and now we’re in a room with people who are flaunting the rules.”
At least one member of Congress has tested positive since the mob spurred an hours-long lockdown. Newly elected Rep. Jacob LaTurner (R-Kan.) tested positive for the coronavirus late Wednesday evening, according to a statement posted on his Twitter account. It said he is not experiencing symptoms.
“LaTurner is following the advice of the House physician and CDC guidelines and, therefore, does not plan to return to the House floor for votes until he is cleared to do so,” the statement said.
Luke Letlow, a 41-year-old congressman-elect from Louisiana, died of covid-19 last month.
Any infections among members of Congress and their staff will be far easier to contact-trace than those among rioters, said Angela Rasmussen, an affiliate at the Center for Global Health Science and Security at Georgetown University.
“It certainly would have been easier if they were detained by Capitol police and identified, but testing suspects may be something to consider as law enforcement begins to identify them,” Rasmussen said in an email.
She noted that some may try to evade identification and criminal charges, and said she is deeply concerned for the households and communities they might expose.
“I think really rigorous contact tracing of people who are not identified as being present on Capitol grounds will not be possible,” she said.
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.”
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,” saidDr. 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 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 covid, covid, covid; 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.
The first month of the pandemic was also supposed to be the month I got pregnant, but my clinic closed and plans changed. Doctors and nurses needed personal protective equipment to tend to patients with covid-19, not women with recurrent miscarriages.
When the clinic reopened several months later, it turned out my husband and I had only been delaying yet another loss: In late August, he obeyed the medical center’s strict coronavirus protocols by waiting anxiously in the car while I trudged inside, masked and hand-sanitized, to receive a miscarriage diagnosis alone. I searched the ultrasound screen for the rhythmic beat of a heart, and then accepted that whatever had once been there was now gone.
But that was 2020 for you, consistent only in its utter crappiness. For every inspiring video of neighbors applauding a shift change at the hospital, another video of a bone-tired nurse begging viewers to believe covid was real, it wasn’t a hoax, wear a mask.
For every protest organized by activists who understood racism is also a long-term crisis, an appearance by the Proud Boys; for every GoFundMe successfully raising money for a beloved teacher’s hospital bills, a bitter acknowledgment that online panhandling is our country’s version of a safety net.
Millions of citizens stood in line for hours to vote for the next president and then endured weeks of legal petitions arguing that their votes should be negated. The basis for these legal actions were conspiracy theories too wild to be believed, except that millions of other citizens believed them.
And that was 2020 for you, too: accepting the increasingly obvious reality that the country was in peril, built on iffy foundations that now buckled under pressure. My loved ones who worked as waiters or bartenders or physical therapists were choosing between health and paychecks, and even from the lucky safety of my work-from-home job, each day began to feel like watching America itself arrive at a hospital in bad shape, praying that doctors or clergy could find something they were able to save.
Is there a heartbeat?
You want the answer to be yes, but even so, it was hard to imagine how we would come back from this.
What kind of delusional person would even try to get pregnant in this world? In my case it would never be a happy accident; it would always be a herculean effort. And so it seemed I should have some answers.
How do you explain to a future child: Sorry, we can’t fix climate change; we can’t even get people to agree that we should wear masks in grocery stores? How do you explain the frustration of seeing brokenness, and then the wearying choice of trying to fix it instead of abandoning it? How do you say, Love it anyway. You’re inheriting an absolute mess, but love it anyway?
I found myself asking a lot of things like this in 2020, but really they were all variations of the same question: What does it mean to have hope?
But in the middle of this, scientists worked quietly in labs all over the world. They applied the scientific method with extraordinary discipline and speed. A vaccine was developed. Tens of thousands of volunteers rolled up their sleeves and said, Try it out on me.
It was approved, and a nurse from Long Island was the first American televised receiving it. Her name was Sandra Lindsay, an immigrant from Jamaica who had come to the United States 30 years ago and who had spent the last year overseeing critical care teams in back-to-back shifts. She said she had agreed to go first to show communities of color, long abused, brushed-off or condescended to by the medical system, that the vaccine was safe.
Here was hope. And more than that, here was hope from a woman who had more reason than most to be embittered: an exhausted health-care worker who knew too well America’s hideous racial past and present, who nonetheless also knew there was only one way out of the tunnel. Here she was, rolling up her own sleeve, and there were the lines of hospital employees ready to go after her, and there were the truck drivers ferrying shipments of syringes.
I can’t have been the only person to watch the video of those early inoculations, feeling elated and tired, and to then burst into tears. I can’t have been the only person to realize that even as 2020 revealed brokenness, it also contained such astounding undercurrents of good.
The scientific method works whether you accept it or not. Doctors try to save you whether you respected public-health guidelines or not. Voter turnout was astronomical because individual citizens realized they were all, every one of them, necessary pieces in a puzzle, even if they couldn’t see what the final picture was supposed to look like.
The way to believe in America is to believe those things are passed down, too.
Sometime in October, a couple of months after my last miscarriage — when the country was riding up on eight months of lonely and stoic birthdays, graduations, deaths and weddings — I went into the bathroom and saw a faint second line on a First Response pregnancy test. It was far from my first rodeo, so I knew better than to get excited. I mentioned it to my husband with studied nonchalance, I told him that I’d test again in a few days but that we should assume the worst would happen.
Two weeks after that, I had a doctor’s appointment, and then another a week later, each time assuming the worst, but each time scheduling another appointment anyway, until eventually I was further along than I’d ever gotten before — by one day, then three days, then thirty.
I am not a superstitious person. I don’t believe that good things always come to those who deserve them. I believe that stories regularly have sad endings and that it’s often nobody’s fault when they do, and that we should tell more stories with sad endings so that people who experience them know that they’re not alone.
But 2020 has taught me that I am, for better or worse, someone who wants to hope for things. To believe in the people who developed vaccines. In the people who administered them. In Sandra Lindsay. In the people who delivered groceries, who sewed masks, who have long cursed America’s imperfect systems and long fought to change them, who still donate $10 to a sick teacher’s GoFundMe.
At my most recent appointment, the doctor’s office was backed up in a holiday logjam. I sat in the exam room for nearly three hours while my husband again waited anxiously in the car. I texted him sporadic updates and tried to put hope in a process that so far had not seemed to warrant my hope.
It all felt precarious. The current reality always feels precarious.
And yet there we all are together, searching for signs of life, hoping that whatever we emerge to can be better than what we had before, and that whatever we build will become our new legacy. The sonographer finally arrived and turned on the machine.
HENRY KOTULA 