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Thursday, February 25, 2021

‘Amazing’ — and alarming

A nursing home resident in Brooklyn received a vaccination last month.Yuki Iwamura/Reuters

‘Amazing’ — and alarming

There are two new pieces of encouraging news about the pandemic — and two worrisome developments. Let’s take them one at a time, starting with the positive.

1. Nursing homes deaths are way down.

They have plummeted, falling by more than 60 percent between late December and early February. The main cause is straightforward: Nursing home residents have been among the first people to be vaccinated.

This chart — from my colleagues Matthew Conlen, Sarah Mervosh and Danielle Ivory — tells the story:

Sources: New York Times database and U.S. Department of Health and Human Services

It’s another sign of how powerful the vaccines are. The decline in deaths happened surprisingly fast, said Dr. Sunil Parikh, a Yale University epidemiologist. It occurred even though most nursing home residents and employees have not yet received both of their vaccine shots — and it has likely continued over the past two weeks, which are not shown in this chart.

“I’m almost at a loss for words at how amazing it is and how exciting,” said Dr. David Gifford, the chief medical officer for the American Health Care Association, which represents long-term-care facilities.

The nursing home data add to the evidence that the vaccines don’t just work in research trials — they work in the real world, too. (A new study of Israel, published yesterday in The New England Journal of Medicine, offered the same message.)

2. Another vaccine looks excellent.

The Food and Drug Administration released a report about a vaccine that it has not yet approved — from Johnson & Johnson — and the data were extremely positive.

Like the two vaccines that are already being administered in the U.S. — from Moderna and Pfizer — Johnson & Johnson’s eliminated both death and hospitalization in its research trial: About 20,000 people received the vaccine in the trial, and not a single one was hospitalized with Covid-19 symptoms a month later.

“I’ll never stop being amazed at zero hospitalizations among vaccinated in study after study,” Dr. Aaron Richterman of the University of Pennsylvania wrote. “It’s astonishing.” Dr. Isaac Bogoch, an infectious disease expert, called the results “terrific.” Dr. Kavita Patel wrote: “I would definitely recommend it for myself and my patients.”

The Johnson & Johnson vaccine also substantially reduced the number of moderate and asymptomatic Covid cases. It didn’t eliminate them, but the vaccines don’t need to eliminate all Covid cases in order to end the crisis. A sharp reduction — and sharper reduction in severe cases — can eventually turn this terrible coronavirus into yet another manageable virus.

(The nursing home data help make this point, as well: The number of confirmed cases has fallen by more than 80 percent, which is even bigger than the decline in deaths.)

A key advantage of the Johnson & Johnson vaccine is that it requires only one shot, making it easier to administer than the Moderna and Pfizer vaccines, which require two. An F.D.A. committee will meet on Friday, and the agency could approve the vaccine shortly afterward.

3. But caseloads are no longer falling.

The number of new cases has stopped declining in the U.S.:

By The New York Times | Sources: Health agencies and hospitals

The same is happening worldwide:

By The New York Times | Sources: Health agencies and hospitals

I don’t want to overreact to one week of data. But you can see a change in those lines. The most likely explanation is the more contagious variants of the virus, like the B.1.1.7 variant, which was first detected in Britain.

Tellingly, cases first stopped falling in much of Europe, where that variant is more widespread. On Friday, a top health official in Germany warned that country could be heading toward another “turning point,” after weeks of falling infections.

It’s a reminder that the pandemic is far from over. The variants have the potential to cause new outbreaks, especially if unvaccinated people become lax about mask wearing and social distancing.

4. And vaccinations have stalled.

This is not a good trend:

By The New York Times | Source: Centers for Disease Control and Prevention

The storms of the past week are the major cause of the vaccination slowdown, having temporarily closed sites and delayed vaccine shipments. Whatever the reason, though, it will have consequences: Fewer vaccinations mean more deaths.

The biggest task facing the Biden administration over the next two months is accelerating the pace from the current 1.4 million vaccines per day to about three million per day.

Other Covid developments:

  • The federal government is backing the test of an online portal to help the public find vaccines.
  • Moderna said it would test vaccines modified to protect against a variant first discovered in South Africa.
  • A new variant is spreading in New York City, researchers say.
  • Ghana and other West African countries will begin vaccinating people as part of Covax, a global vaccine-sharing initiative. But as rich countries buy most of the supply, inequalities remain.
  • Corruption scandals are exposing how powerful and well-connected people in South America jumped the vaccine line.

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