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September 17, 2020

CDC director, Trump spar over vaccine timing and face masks

Daily Briefing

    As the Trump administration unveiled a plan to distribute a novel coronavirus vaccine, CDC Director Robert Redfield on Wednesday said he expects a vaccine would be in "very limited supply" at the end of year, but would become widely available to the general public by next summer or fall—prompting pushback from President Trump.

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    US new coronavirus cases near 6.7M, deaths top 196K

    As of Thursday morning, U.S. officials reported a total of 6,653,200 cases of the novel coronavirus virus since the country's epidemic began—up from 6,614,100 cases reported as of Wednesday morning.

    According to data from the New York Times, the rates of newly reported cases are "staying high" in 13 states that have had comparatively high case rates, meaning a daily average of at least 15 newly reported cases per 100,000 people over the past week. Those states are Arkansas, Idaho, Kansas, Kentucky, Missouri, Nebraska, North Dakota, Oklahoma, South Carolina, Tennessee, Texas, Utah, and Wisconsin.

    Meanwhile, the rates of newly reported cases over the past seven days are "going down" in Alabama, Georgia, Guam, Iowa, Mississippi, and South Dakota, which had previously seen elevated case rates.

    In eight states that have had comparatively low case rates, rates are now "going up," according to the Times. Those states are Colorado, Connecticut, Maine, Michigan, New Hampshire, New Jersey, West Virginia, and Wyoming.

    In the remaining states and U.S. territories, rates are "staying low," according to the Times' analysis.

    U.S. officials as of Thursday morning also reported a total of 196,680 deaths linked to the coronavirus since the country's epidemic began—up from 195,683 deaths reported as of Wednesday morning.

    Trump admin outlines plan to release new coronavirus vaccine

    As the new coronavirus continues to spread throughout the country, drugmakers including AstraZeneca, Moderna, and Pfizer are assessing vaccine candidates in late-stage clinical trials in the United States, the Times reports.

    To prepare for a vaccine's approval, HHS, CDC, and the Department of Defense (DOD) outlined a plan for vaccine distribution in a report to Congress and a playbook for states, tribal, territorial and local public health programs, The Hill reports.

    HHS in the 57-page playbook laid out the distribution plan into four steps. First, the public health programs will communicate with local officials to promote the vaccine. Second, they will distribute the vaccine and, third, ensure the supply chain's reliability. Finally, they will monitor the vaccine's administration.

    Under the administration's plan, officials said McKesson will distribute a vaccine to administration sites 24 hours after the vaccine receives an Emergency Use Authorization or Biologics License Application approval from FDA.

    The administration plans to distribute the vaccine in three phases. Initial doses of the vaccine will be distributed to essential employees, including health workers, and people in vulnerable groups in the final months of 2020 through 2021. By the final phase, public and private health programs are expected to integrate the vaccine into routine care.

    According to the Times, DOD will provide logistical support to determine how vaccine doses will be stored and shipped. In addition, DOD will track who has received a vaccination and whether they have received one or two doses of the vaccine.

    Health officials said the administration's plan is flexible because many questions remain unanswered regarding a potential vaccine, including dosage and storage requirements. 

    "We're dealing in a world of great uncertainty," Paul Mango, deputy chief of staff for policy at HHS, said during a call with reporters. "We don't know the timing of when we'll have a vaccine, we don't know the quantities, we don't know the efficacy of those vaccines ... so this is a really, quite extraordinary, logistically complex undertaking."

    State health programs are required to submit their vaccine distribution plans to CDC by Oct. 16.

    Redfield says vaccine will be available for the public by next summer or fall

    Separately, Redfield during a Senate Appropriations subcommittee hearing on Wednesday said he expects a vaccine to be in "very limited supply" at the end of 2020.

    "I think there will be vaccine that will initially be available sometime between November and December, but very limited supply, and it will have to be prioritized" for first responders and people at the greatest risk of infection, Redfield said.

    However, Redfield said the vaccine likely will be available to the general public by next summer or fall.

    "If you're asking me when is it going to be generally available to the American public so we can begin to take advantage of vaccine to get back to our regular life, I think we're probably looking at … late second quarter, third quarter 2021," he said.

    Redfield said CDC will need $6 million in additional funds to help cities and states prepare their vaccine distribution plans.

    In addition, Redfield said although a vaccine will play a critical role in the containing the new coronavirus, face masks could be even more important in bringing the country's coronavirus epidemic under control.

    "We have clear scientific evidence they work, I might even go so far as to say that this face mask is more guaranteed to protect me against COVID than when I take a COVID vaccine, because the immunogenicity may be 70 percent and if I don't get an immune response, the vaccine's not going to protect me, this face mask will," Redfield said.

    Following Redfield's comments, Trump at a White House news conference on Wednesday said Redfield made a "mistake" when he said a vaccine would not be available to all Americans until 2021.

    "I think he made a mistake when he said that. It’s just incorrect information," Trump said. "That is incorrect information."

    Trump suggested that, once a vaccine is approved, it will be available to the public immediately. "When we go we go. We are not looking to say, gee in six months we're going to start giving it to the general public," Trump said—apparently contradicting the phased approach described in the just-released vaccine distribution plan.

    Trump also pushed back on Redfield's comment concerning face masks, saying they are "not more effective by any means than a vaccine."

    After the news conference, Redfield in a tweet on Wednesday wrote, "I 100% believe in the importance of vaccines and the importance in particular of a #COVID19 vaccine. A Covid-19 vaccine is the thing that will get Americans back to normal everyday life."

    He added, "The best defense we currently have against this virus are the important mitigation efforts of wearing a mask, washing your hands, social distancing and being careful about crowds."

    Top HHS official takes leave of absence after accusing government scientists of 'sedition'

    Also on Wednesday, HHS announced Michael Caputo, whom the White House appointed to serve as HHS' assistant secretary for public affairs, will take a 60-day medical leave of absence to address health issues.

    "Today, [HHS] is announcing that HHS Assistant Secretary for Public Affairs Michael Caputo has decided to take a leave of absence to focus on his health and the well-being of his family," HHS said Wednesday.

    In a separate statement, Caputo said he would be taking medical leave he "to pursue necessary screenings for a lymphatic issue discovered last week," according to Politico.

    In the meantime, Ryan Murphy will assume the role of acting assistant secretary for public affairs, a position that he had held before Caputo became HHS' assistant secretary of public affairs (Raman, Roll Call, 9/16; Weixel, The Hill, 9/16; AP/Modern Healthcare, 9/16; Thomas, New York Times, 9/16; Ansari/Lubold, Wall Street Journal, 9/16; Siddons, Roll Call, 9/16; Sullivan, The Hill, 9/16; Diamond/Cancryn, Politico, 9/16; New York Times, 9/17; Axios, 9/17).

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