It’s all about science

WASHINGTON — The White House Covid-19 Response Team on Wednesday presented its first public health press briefing and outlined the state of the Covid-19 pandemic as seen through the eyes of the Biden administration.

The briefing was moderated by White House Covid-19 Response Coordinator Jeff Zients, who was joined by Rochelle Walensky, MD, MPH, director of the CDC; Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases; Marcella Nunez-Smith, MD, MHS, chair of the Covid-19 Health Equity Task Force; and Andy Slavitt, senior advisor to the White House Covid-19 Response Team.

Notably, President Biden did not make an appearance at the briefing—and Slavitt, after letting his fellow panelists speak first, made the reason quite clear: “…It’s important to send the message to the public that the White House respects and will follow science, and scientists will speak independently, and that our core values of science, public health, and equity are going to drive our actions here at the White House.”

In his remarks, Slavitt acknowledged that the White House faces two primary challenges in vaccinating the U.S.: getting the vaccine supply distributed quickly, and getting it administered quickly. “We are taking action to increase supply and increase capacity, but even so, it will be months before everyone who wants a vaccine will be able to get one.”

He added that, in addition to distributing the national stockpile of Covid-19 vaccine that the Trump administration had created, the Biden administration is looking to acquire low dead-volume syringes to take advantage of the additional doses of Pfizer’s Covid-19 vaccine that can be extracted from each vial.

The State of the Pandemic

Walensky kicked off the briefing by pointing to what she saw as “hopeful signs” in the past month, nothing that, while 78,000 individuals were hospitalized with Covid-19 on Jan. 24 and 419,827 people have died over the course of the pandemic to date, the 7-day average number of cases dropped by 21% last week, and hospital admissions fell by 15%.

“Though I am encouraged by these trends, these case rates remain extraordinarily high, and now is the time to remain vigilant,” she added, noting that unless these numbers continue to drop, the CDC is projecting to hit between 479,000 and 514,000 deaths by Feb. 20.

She also pointed out two important updates to the CDC’s vaccination recommendations that should help keep U.S. citizens on track with their vaccinations. First, while the CDC still recommends that people get their second shot as close to the FDA-recommended dosing schedule as possible — 3 weeks for the Pfizer vaccine, 4 weeks for Moderna’s — the organization added that the second dose can be given up to six weeks after the first dose if absolutely necessary. Second, while the CDC maintains that Covid-19 vaccines are not interchangeable, in instances where it is unclear which of the two authorized mRNA vaccines was administered with the first shot, any available mRNA Covid-19 vaccine may be administered as the second shot. Walensky also touched on the issue of SARS-CoV-2 variants, which, so far, appear to be more transmissible than the original virus. As of Jan. 26, the B.1.1.7 variant, which originated in the U.K. and is projected to become the dominant strain in the U.S. by the end of March, was identified as the culprit strain in 308 cases across 26 states so far. Meanwhile, the U.S. also saw its first case of the P.1 variant from Brazil this past week—the B.1.351 strain from South Africa has not yet been identified in the U.S., Walensky noted.

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Fauci also touched on these Covid-19 variants, acknowledging their potential impact on the efficacy of vaccines and monoclonal antibody products. Fortunately, the B.1.1.7 seems to have little to no impact on the efficacy of either, Fauci said; the B.1.351 strain, on the other hand, may prove to be a bigger issue. Current findings show that the South Africa strain reduces the efficacy of antibodies for fighting the virus, and, while the vaccine’s efficacy is still “well within the cushion of protection,” further virus evolution may change that.

Fortunately, Fauci noted, the phase III efficacy results for the Johnson & Johnson adenovirus vaccine — the results of which should be coming soon — will contain data on vaccine efficacy in both South Africa and Brazil in addition to the U.S., which should give public health experts a better sense of what to expect from both the P.1 and the B.1.351 variants.

Unveiling the Health Equity Task Force

Nunez-Smith appeared at the briefing to discuss the role of the White House’s Covid-19 Health Equity Task Force, which is “responsible for providing specific recommendations to the President, through the Covid-19 response coordinator [Zients], for mitigating the health inequities caused or exacerbated by the Covid-19 pandemic,” she explained. “And also for preventing these kinds of inequities in the future.”

Black, Latino, and Native communities in the U.S. have been hit particularly hard by the Covid-19 pandemic, largely due to inequities in health care, Nunez-Smith pointed out. To alleviate these issues and ensure equal access to health care and Covid relief, she explained that the Health Equity Task Force will work to:

  • Make it convenient and accessible for individuals in underprivileged communities to access vaccination sites.
  • Increase the clinical and community-based workforce for outreach, education, vaccination, and wraparound services.
  • Make sure transportation and paid time off are available so people can make it out to get their vaccine.
  • Facilitate information-sharing between local and state public health officials on how to address disparities in care.
  • Launch a national public education campaign regarding the safety and efficacy of Covid-19 vaccines.

“All Americans, everyone in our country, should have the benefit of a safe, effective vaccine that can prevent them from getting sick or dying from Covid-19,” Nunez-Smith said. “It takes intention and deliberate action to advance equity in this vaccine distribution process.”

John McKenna, Associate Editor, BreakingMED™

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