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  1. Trial was too small to definitively compare combinations, but Moderna may have an edge. Mixing and matching COVID-19 vaccines for booster doses appears safe and as effective—if not more effective—than sticking with the same vaccine for a booster dose. That's according to preliminary data posted online Wednesday from a clinical trial run by the National Institutes of Health. The trial bolsters what some have long hoped: that mixing and matching vaccines could provide stronger, broader protection against the pandemic virus and all its variants. The trial was not large enough to definitively indicate which combination of vaccines offers the best protection. And the early results, available on a preprint server, have not yet been peer-reviewed. But the preliminary trial findings do hint that Moderna's mRNA vaccine may offer the strongest protection all around—backing up similar findings from earlier vaccine-effectiveness studies. The data also suggests that people who received the one-shot Johnson & Johnson vaccine may want to get a boost with one of the two mRNA vaccines, either Moderna's or Pfizer/BioNTech's. But most clearly, the study found that mix-and-match boosting increases protection and produces only similar side effects as boosting with the same vaccine. Or, in the authors words: "These data suggest that if a vaccine is approved or authorized as a booster, an immune response will be generated regardless of the primary Covid-19 vaccination regimen." Nine combinations For the study, researchers at various trial sites around the country recruited 458 people over the age of 18. Subjects were subsequently split into three groups of roughly 150 each. Those three groups had different initial vaccine regimens: either two doses of the Moderna vaccine, two doses of the Pfizer/BioNTech vaccine, or one shot of the Johnson & Johnson vaccine. From there, each of the three groups of 150 were split into three groups of 50, with each of the smaller groups getting different boosters. So, for example, among the 151 people who received a Moderna vaccine initially, 51 went on to receive a Moderna booster, 51 got a Pfizer/BioNTech booster, and 49 got a Johnson & Johnson booster. The booster doses were given between 12 and 29 weeks after the initial vaccinations. Next, researchers looked at the levels of binding and neutralizing antibodies the day of the booster shot (so before the boosters were able to kick in). The researchers checked those same levels 15 days later and 29 days later. Across all of the combinations, levels of binding antibodies rose between fourfold and 56-fold. They also looked carefully at neutralizing antibodies—the antibodies that bind to and prevent SARS-CoV-2 virus from infecting cells. In people who had received the same type of vaccine for their initial doses and their booster dose, neutralizing-antibody levels rose fourfold to twentyfold. In people who got different vaccines, neutralizing-antibody levels rose sixfold to 76-fold. The fold-changes strongly indicated that the booster doses increased protection across the board while mix-and-match perhaps have an edge. But the fold-changes can obscure some finer points. (You can see the whole table of results here, beginning on page 27) Looking at just the average antibody levels in each group, subjects who initially got the Johnson & Johnson vaccine started with some of the lowest neutralizing-antibody levels on day 1. Their geometric mean titers of neutralizing antibodies ranged from 7.6 to 9 on day 1. As such, they had the smallest and the largest fold-changes after the boosts. Members of the Johnson & Johnson group who got a Johnson & Johnson booster saw their neutralizing-antibody levels rise only fourfold after 15 days (to 31)—the smallest change across all of the groups. But people who got the Johnson & Johnson vaccine followed by a Moderna booster saw a 76-fold rise (to 676)—the largest change. Moderna’s edge Overall, people who got the Moderna booster had the highest neutralizing-antibody levels regardless of what vaccine they got initially. Their geometric mean titers of neutralizing antibodies ranged from 676 to 900 at day 15. The group with the mean of 900—the highest level reported in study—had received the Moderna vaccine for their initial and booster doses. People who had initially gotten the Pfizer/BioNTech vaccine saw their geometric mean titers of neutralizing antibodies rise from about 25 to 786 after a Moderna booster. People initially vaccinated with Moderna also had better starting levels of neutralizing antibodies compared to those seen in people initially vaccinated with the Pfizer/BioNTech vaccine. They had ranges of 58-89 and 19-25, respectively. People initially vaccinated and boosted with Pfizer/BioNTech vaccine saw their levels rise from 21 to 448. But that was still lower than the people initially vaccinated with Moderna and boosted with Pfizer/BioNtech—they saw levels rise from 58 to 678 after 25 days. The researchers noted that previous studies have estimated that a geometric mean titer of neutralizing antibodies at 100 or above correlates with vaccine efficacy of 90.7 percent against symptomatic disease. All of the groups met that threshold, except for the group that got a both a Johnson & Johnson primary dose and booster dose. In all, the study indicates that mixing and matching is a safe and effective way to bolster protection. Researchers will need to conduct larger studies to see if Moderna can maintain the lead it seems to have here, though. But the weak Johnson & Johnson results will provide plenty of fodder for debate when advisors for the Food and Drug Administration meet later this week to consider authorizing Johnson & Johnson booster doses. reader comments 89 Mix-and-match COVID boosters are as good—if not better than—all the same shots
  2. Covid is forcing America to fix its water supply The crisis in Flint wasn’t enough, but the pandemic might have finally redefined the terms of the US water debate A little over a year ago, the US Centres for Disease Control (CDC) revealed a seemingly simple system for fighting Covid-19: soap, water, and about 20 seconds of scrubbing should help keep the virus from spreading. But what if you live in a home where the water from your tap is brown and smells like rotten eggs, or where water doesn’t come from the tap at all? Jean Holloway has spent years working with communities in the US states of Delaware and eastern Maryland where this is a fact of life. Some of these residents have never been able to use the water in their homes because of contaminants. Still others have seen their water shut off because they couldn’t pay their bills during the worst of the pandemic. “To live there is kind of like – there’s a quote about ‘lives of quiet desperation,’” says Holloway, a state manager at the Southeast Rural Community Assistance Project, speaking of one neighbourhood where residents can only use bottled water. “There’s not a lot of morale. And along comes Covid and these people, they need the water even more.” An estimated two million Americans lack access to running water, indoor plumbing, or wastewater treatment. More than twelve percent of US households could not afford their water bills as of 2017, the same year a study projected that that number could triple by 2022. According to a 2019 report, Native American households are 19 times more likely than white households to lack indoor plumbing; Black and Latino households are twice as likely. Meanwhile, more than a year of Covid-19 – of constant hand-washing and bottled water shortages, of shuttered laundromats, community centres, and schools, and of disproportionate death and disease among minority communities – has made it abundantly clear how essential clean water access is. “The pandemic is emphasising the importance of water for public health and how crucial it is to protect it, and that it goes beyond the pandemic,” says Mary Grant, director of the Public Water for All campaign at Food and Water Watch, a nonprofit. “It’s about flushing toilets, washing hands, cooking food, washing clothes. It should be fundamental that everyone has access to water. It's a basic human right, and it's necessary to live a life with dignity.” Now, change could come in the form of the Drinking Water and Wastewater Infrastructure Act, S.914, which will authorise $35 billion (£24.6bn) to upgrade American water infrastructure over the next five years. The bill passed in the Senate 89 to 2 votes at the end of April, and appears to face little opposition in the House. “With more Americans spending time at home during the pandemic, it’s unacceptable that years of failure to make adequate investments in our water infrastructure has led to a status quo where millions of Americans lack basic access to clean, safe drinking water or functioning sewer systems,” says Senator Tammy Duckworth, sponsor of the bill, in an emailed statement. She has written she was driven to act after seeing a mother hold up a baby bottle full of dirty brown water during a House Oversight Committee hearing on the Flint, Michigan, water crisis, where cost-cutting measures led to high levels of toxic lead in drinking water. “Now is the time for federal funding that will help us recover from the effects of the pandemic and to make sure that every American, no matter the colour of their skin or their zip code, has access to clean, safe water,” Duckworth added. The reason such a bill is needed at all arises from a paradoxical contradiction: though US drinking water and sanitation standards have grown more and more stringent for nearly 50 years, federal investment in water systems has not followed suit. Federal investment in water infrastructure peaked in 1977, and has only declined since. As a result, neglected pipes are leaking, breaking, and leaching contaminants into America’s taps — and EPA data shows that these subpar systems are 40 percent more likely in communities with more residents of colour. A push for privatisation of water systems in the 1980s, meanwhile, promised to make water bills cheaper, a claim that hasn’t held water. The new bill will attempt to rectify this spotty history chiefly by providing states with federal funding earmarked for locally-managed projects. These projects must follow very specific criteria, and S.914 contains some provisions that promise to address the very inequities exposed by the pandemic. This includes raising the minimum amount of money that must be spent in disadvantaged communities. It also creates grant programs that will improve sanitation in rural Indigenous villages, as well as help low-income households improve their wastewater management by installing small, decentralised systems that treat sewage close to the source . Such programs will help to address access to clean water in the first place. Yet the pandemic also highlighted another major issue: many Americans cannot afford to pay their water bills, an issue that became heightened by pandemic layoffs and lost income. Though some states and cities enacted moratoria on water shutoffs during the pandemic, most of them were temporary, and many states provided no protection at all. Research by Cornell University and Food and Water Watch found a nationwide moratorium on water shutoffs during the pandemic could have saved more than 9,000 lives and prevented 480,715 infections. These shutoffs disproportionately affect those who were already vulnerable to the effects of Covid-19, including the elderly and minorities. In smaller and poorer communities, the problem has been amplified by pandemic business closures: unlike companies in large cities, water service providers in these towns may have only a handful of big customers; one or two businesses closing can therefore take away a huge chunk of their revenue, pushing them to raise their prices for everyone to make up for the gap. “The pandemic has reminded us that the fundamental problem is, in the US, we treat water as a commodity,” says study co-author Mildred Warner, a professor in Cornell’s city and regional planning department. “In other societies, water is considered a public good.” Many European countries proactively counteract shutoffs by offering discounted water rates based on income, and some have full-fledged water disconnection bans. In the US, no such protections exist. Congress did approve $638 million within the December coronavirus relief package to help pay household water and sewer bills, and followed that with an additional $500 million for water debt in the March relief bill – a grand total of $1.1bn, which has not yet been disbursed. Still, the National Association of Clean Water Agencies (NACWA), which advocates for publicly-owned wastewater and stormwater agencies, estimates that the total cost of unpaid water bills from the pandemic is closer to $8.7bn. Water advocates have been pushing unsuccessfully for federal water assistance for years. In that sense, the pandemic has helped to finally attract congressional attention. Yet, water affordability is “a multi-faceted problem” that doesn’t stop at debt relief, says NACWA managing director of government affairs Kristina Surfus. “You have ageing infrastructure and the need to replace systems, increasing regulations, increasing pollution, the growing costs of a skilled workforce and addressing changing climate. These are all huge costs,” Surfus says. In their most recent reviews of the US water systems, the Environmental Protection Agency (EPA) found that just keeping water systems up-to-date would require $271bn for wastewater and stormwater infrastructure and $472.6bn for drinking water systems over 20 years. All told, that would mean investing the equivalent of the entire Drinking Water and Wastewater Infrastructure Act – $35bn – every single year over two decades. Even with their high dollar values, these bills may therefore be just the first drop in the bucket. There are other bills seeking to address the funding gap, such as the WATER bill, presently under review by the House, which would create a corporate tax-funded trust fund of $35bn each year for water and sewer systems. Another bill being considered by the House would make $150bn in assistance available, but only to companies that agreed to a shutoff moratorium. This faces opposition from water service providers: NACWA asserts that a moratorium would lead to higher water rates for everyone else, potentially pushing more people into being unable to pay their water bills. Instead, several experts suggested, the federal government could offer water assistance programs akin to other “public good” subsidies, like those that help Americans pay for food and household heating. The Drinking Water and Wastewater Infrastructure Act does include a grant to pilot a water assistance program, which will help utilities offer their customers bill discounts, payment plans based on income, or direct financial assistance. Yet the bill only authorises 40 grants under this program, which some see as a missed opportunity “This is our moment: We've got a bill on the table, we’ve got attention to the issue,” says Warner. If the US is going to invest billions into water infrastructure, she asserts, it should also set a standard that ensures everyone can pay for it. As the US begins to move out of the depths of the pandemic, the importance of water may again appear to be out of sight, out of mind. For advocates, it feels similar to the crisis in Flint. Though the city’s polluted water put it in the international spotlight, after Flint’s pipe systems were repaired, lead and other contaminants in water dropped out of public discourse — even though hundreds of communities around the country still face the same problem. Yet the water issues highlighted over the pandemic year strike at some of the deepest inequities that remain in the country, and show the role that the government could play in protecting some of its most vulnerable. “If I had to have one wish, it is that people would recognise the value of water as well as the cost of water,” says Holloway. It may be months or years, she says, for the small communities where she works to stop feeling those costs. “We might recover from a public health standpoint, but it's going to take a while to recover financially. It's a ripple effect, and I think the ripples will continue for a while.” Source: Covid is forcing America to fix its water supply
  3. GENEVA (Reuters) - The World Health Organization’s top emergency expert said on Friday it would be “highly speculative” for the WHO to say the coronavirus did not emerge in China, where it was first identified in a food market in December last year. China is pushing a narrative via state media that the virus existed abroad before it was discovered in the central city of Wuhan, citing the presence of coronavirus on imported frozen food packaging and scientific papers claiming it had been circulating in Europe last year. “I think it’s highly speculative for us to say that the disease did not emerge in China,” Mike Ryan said at a virtual briefing in Geneva after being asked if COVID-19 could have first emerged outside China. “It is clear from a public health perspective that you start your investigations where the human cases first emerged,” he added, saying that evidence might then lead to other places. He repeated that the WHO intended to send researchers to the Wuhan food market to probe the virus origins further. The WHO has been accused by the Trump administration of being “China-centric”, allegations it has repeatedly denied. Source
  4. Covid-19: Brazil variant case in England hunted by officials Health officials are trying to trace one person in England who has been infected with a concerning variant of coronavirus first found in Brazil. They are one of six cases of the P1 variant found in the UK in February. The person is understood to have used a home testing kit but did not complete a registration form - prompting an appeal for anyone without a result from a test on 12 or 13 February to come forward. Labour said there had been a lack of a "comprehensive" border system. The P1 variant was first detected in travellers to Japan from Manaus in northern Brazil in January. Health Secretary Matt Hancock will hold a meeting later to update MPs from all parties about the variant. There have been concerns vaccines may not be as effective against the variant, but NHS England's Prof Stephen Powis said vaccines could be "rapidly adapted". Dr Susan Hopkins, from Public Health England (PHE), said the UK was more advanced than many other countries at identifying the variants and mutations, and therefore was able to act quickly. In an attempt to find the unidentified person in England who was infected with the P1 variant, officials are asking anyone who took a test on 12 or 13 February and who has not received a result or has an uncompleted test registration card to come forward immediately by calling 119. The hotel quarantine rule came into force on 15 February. It means that travellers coming to England from 33 countries - including Brazil - must pay to quarantine in a hotel for 10 days, while in Scotland the rule applies to international travellers from all countries. Before that date, travellers arriving into the UK still needed to self-isolate in their homes for 10 days. But Vaccines Minister Nadhim Zahawi said it was not known whether or not the unidentified person had recently been abroad, so it was not clear if they would have been self-isolating while they were infected. "We need to find them as soon as possible," he told BBC Breakfast, adding that PHE was working with the postal service to try to locate them. Mr Zahawi defended the testing system as "pretty robust" and said the UK's strategy of using surge testing to help identify cases of the variant was similar to other countries such as Australia. It is tempting to think that if officials can identify the one missing case, the UK will be able to stamp out the Brazil variant. But it's unlikely this will be possible. There will no doubt be more cases either of this variant or others circulating with the E484 mutation that allows the virus to escape some of the effect of the vaccines. That's because not all positive cases can be checked for variants. The UK carries out nearly half of the genomic sequencing in the world and can check around 25,000 positive tests a week for variants. That means about a quarter of positive cases were checked last week, but a month ago - with infection rates higher - it was under one in 10. What is more, not everyone who is positive comes forward for a test in the first place. We are seeing just the top of the iceberg. So what is the strategy? Keep cases low and where possible try to limit the spread of these variants. And in the future, update the vaccines to work better against the variants if that is needed. Dr Hopkins told BBC Radio 4's Today programme that PHE was "really clamping down" with measures to prevent the spread of variants because the risk of transmission would increase when lockdown is eased - starting with England's schools reopening on 8 March. But Prof Graham Medley, a member of the Scientific Advisory Group for Emergencies (Sage), said variants could threaten the UK's plans to relax restrictions. "We are going to be faced with these [variants] in the next six months as we move towards relaxing measures. There are going to be challenges on the way and there is always a risk that we might have to go backwards, and that's what nobody wants," he told Today. The unidentified England case of the Brazil variant is not linked to five other UK cases. Three of those cases are Scottish residents who flew to Aberdeen from Brazil via Paris and London, the Scottish government said. Holyrood said the three people tested positive while self-isolating. Other passengers who were on the same flight to Aberdeen are now being contacted. The other two cases in England are from the same household in South Gloucestershire after someone returned from Brazil on 10 February - five days before the government's hotel quarantine rule came into force. Two other people in the same household have also since tested positive for Covid - but tests are still ongoing to check if it is the same variant, so they are not included in the overall UK total of six. Flight appeal PHE said officials were tracking down passengers who were on Swiss Air flight LX318 from Sao Paulo to Heathrow, via Zurich, landing on 10 February. Sara Blackmore, South Gloucestershire's public health director, said "fast action" by her local team meant the two cases were a "very contained situation". She told the Today programme that everyone in five postcode areas of South Gloucestershire was being invited to take a Covid test, even if they did not have symptoms. But she said the extra testing was a "precautionary measure" and the risk to the community was "low". Shadow home secretary Nick Thomas-Symonds said the news of the Brazil variant cases was "deeply concerning" and that it was "vital" everything was done to contain it. "This is further proof that the delay in introducing a hotel quarantine was reckless and the continuing refusal to put in place a comprehensive system leaves us exposed to mutations coming from overseas," he added. He later said he had written to Home Secretary Priti Patel calling for stricter measures at the border. Chair of the Home Affairs Select Committee of MPs, Labour's Yvette Cooper, said officials must "learn lessons" from how other countries were enabling international travel during the pandemic. She told the Today programme there were "gaps and weaknesses" in the measures to prevent variants from entering the UK and that "stronger measures" were needed. Ms Cooper gave the example of South Korea's international travel arrangements, which include testing people at airports and providing contained transport for people from airports to their homes, so that they do not have to use public transport. COPYRIGHTGETTY IMAGES All travellers to the UK also need to present a negative Covid test taken a maximum of 72 hours before their departure. It comes as the UK announced another 6,035 cases of coronavirus on Sunday and reported that a further 144 people had died within 28 days of a positive test. But a milestone in the vaccination programme has been reached, with more than 20 million people having received their first dose of the vaccine. Source: Covid-19: Brazil variant case in England hunted by officials
  5. Trapped in Germany’s COVID nightmare The purported home of efficiency is lagging behind on vaccination. Has German Chancellor Angela Merkel made mistakes during the pandemic? | Pool photo by Christian Marquardt/Getty Images Matthew Karnitschnig is POLITICO’s chief Europe correspondent. BERLIN — As the coronavirus pandemic raged through the United States last summer, an old school friend from Arizona wrote me full of admiration for Germany’s handling of the crisis. For years, he, along with other American friends and my family, drew boundless schadenfreude imagining the daily difficulties I must face as an American among the supposedly humorless “krauts.” But now, as the U.S. struggled to cope with the pandemic, they looked across the Atlantic with envy, even humility. In contrast to the U.S., where politicians had fumbled the pandemic response from the beginning, Germany appeared to many Americans to have done everything right. By any measure, from the availability of PPE to the infection rate, to total deaths, Germany’s handling of COVID-19 was far superior to the U.S.’s. How “crazy” it must be, my friend wrote, to be “an American journalist in Germany watching from afar as the U.S. basically falls apart.” My German friends agreed. I was lucky, they told me, to reside in a country that functions, one led by a trained scientist and not an “incompetent lunatic.” But six months later (most of them spent in the confines of my home), I don’t feel so lucky. This week, Germany will enter its fifth-straight month of lockdown with no end in sight. Though infection rates have declined in recent weeks, it remains unclear when schools and shops, not to mention restaurants and bars, will reopen. Amid the uncertainty, small businesses across the country are facing ruin. Such fears, coupled with frustration over the seemingly neverending restrictions, have soured the national mood. The U.S., meanwhile, is turning the corner. Schools are slowly reopening, unemployment is falling and the economy is slowly rumbling back to life. America’s visceral optimism, which has always befuddled Europeans, has also begun to reemerge. The reason for this reversal of fortune can be explained in a single word: vaccines. As of Friday, the U.S. had administered about 68 million doses of coronavirus vaccine, reaching about 14 percent of the population with at least one shot. For its part, Germany had delivered about 5.7 million jabs, covering about 4.5 percent of the population. In other words, less than a third the rate of the U.S. The problem isn’t that Germany doesn’t have enough vaccines but rather that it has been slow to get them into people’s arms. Of the 8.5 million doses Germany has received so far, it has only used 68 percent. That compares to a rate of 75 percent in the U.S. Germany isn’t just a laggard compared to the U.S. or international standouts like Israel and the U.K. Other EU countries, including neighboring Denmark, have proved more efficient than the purported home of efficiency. Germany may have spawned some of the world’s biggest and most successful companies, from software giant SAP to BASF to Mercedes, yet somehow it can’t figure out how to accelerate the rollout of a lifesaving vaccine to its own population. So what happened to Germany’s famed organizational and logistical prowess? It would seem to have disappeared down a fax-line somewhere between Berlin and Brussels. The reasons for Germany’s vaccination struggle are both structural and political. While the country’s leaders have sought to explain away the problems by pointing to structural hurdles, such as Germany’s decentralized federal structure or the involvement of the EU in procuring vaccines, the most glaring shortcomings are rooted in their own political failures. Take the fax machines. A technological dinosaur elsewhere in the West, fax machines remain a mainstay in many medical practices and government health offices. That has made coordination across Germany’s nearly 400 health offices particularly difficult. Health Minister Jens Spahn has spent millions trying to put German health care online, so far with only mixed results. The fax is merely a symptom of a deeper problem, however. Angela Merkel has talked for years of the necessity to “digitalize” German society, a goal that many other advanced economies have long made a reality. Indeed, the first thing many new arrivals in Germany notice is its lack of connectivity, from the dearth of free Wifi in cafes and restaurants to slow internet speeds. The fact that the German federal government itself still employs nearly 1,000 fax machines in its various ministries tells you everything you need to know about how successful Merkel’s digital revolution is. That said, the 1970s technology is comparatively modern to the pen and paper still in use across Germany’s medical profession. That a government can’t rely on antiquated communications tools to immunize Germany’s 83 million inhabitants quickly should be obvious. Yet it’s not, especially to those Germans (a majority of the population) worried about that holiest of all German rights – Datenschutz (data privacy). As part of its deal with BioNTech-Pfizer, Israel, which has immunized more than half its population of 9 million, agreed to provide the drugmaker with a wide swath of anonymous data on those receiving the vaccination, including age and gender. The data agreement was one reason Israel was at the front of the line for vaccine deliveries. In privacy-obsessed Germany, the idea of embracing such data collection meets a lot of resistance. It is important “that we undertake as many confidence-building measures as possible and prioritize Datenschutz in order to build trust in immunizations,” Merkel said earlier this month. In other words, any German who dies of COVID-19 because they didn’t get a vaccine on time can take solace in the knowledge that her data will be safe and secure in the ever after. What’s particularly striking to an outsider like me about Germany’s handling of the pandemic is the amount of energy the country puts into identifying and dissecting the problems, rather than resolving them. For months, millions of Germans have tuned into one of the country’s nightly primetime political talk shows to watch their leaders talk about the pandemic, often out of both sides of their mouths. The coronaporn attracts an audience with a false promise of fresh insight (the title of one recent such program: “Lockdown instead of a way forward – Is there really no alternative to Germany’s pandemic strategy?”) only to leave the questions unanswered, sending viewers to bed unfulfilled. Most of the discussions revolve around the question of who should be held responsible for the mess. These days, most fingers are pointing in Spahn’s direction. And while the minister is no doubt guilty of overpromising and underdelivering on everything from the speed of the vaccine rollout to the availability of self-administered coronavirus tests, I’ve been struck by how little criticism his boss has received. Just as Germans were confounded by the allegiance of millions of Americans to Donald Trump in the face of his obvious incompetence, I’m mystified by Germans’ willingness to give Merkel a pass on her management of the pandemic. Despite the deep problems with Germany’s COVID-19 response and the uncertain outlook, Merkel remains the country’s most popular politician with an approval rating approaching 70 percent. History is unlikely to be so forgiving. Merkel’s biggest mistake during the pandemic — arguably of her entire tenure as chancellor — came last June when she agreed to strip responsibility from her own government to procure vaccines and hand it to European Commission President Ursula von der Leyen. Of the many qualities von der Leyen showed in her years in Merkel’s Cabinet, competence was rarely among them. That’s why it should have surprised virtually no one that the procurement process turned into a fiasco, marked by protracted negotiations and delays, which will force Germany and other EU countries to maintain restrictions for much longer than would have otherwise been necessary. Even if Germany had gotten its act together on the logistics of delivering the vaccines to its citizens, it would have quickly run out anyway due to the lack of supply. A wiser course would have been for Germany, which had formed a negotiating alliance with France, Italy and the Netherlands, to proceed in talks with the drug companies, negotiating and even footing the bill to vaccinate the entire EU in a beau geste of European solidarity. Of course, that would have only worked if scientist Merkel had remembered how and where to produce enough vaccine. She need only have listened to Bill Gates who had been raising alarm bells for months over the need to ensure adequate production capacity. Instead, Germany and Europe did next to nothing, letting the lull in the pandemic over the summer come and go only to realize early this year that the drug companies faced massive production shortfalls. “We need a massive state subsidy to build out vaccine production,” Clemens Fuest, the head of the Ifo Institut, a Munich-based economic think tank, said this week. The immunization delays, he warned, are throttling Germany’s economy, a fact the country’s political class seems to take in stride as they bemoan the inevitability of it all on television. The violations of citizens’ basic rights, be they to run a business, receive an education or simply meet with friends in the park, is only temporary, they assure us. This summer, my old school friend was hoping to visit us in Berlin. By the look of things, it’s probably better if we go see him in Arizona instead. Source: Trapped in Germany’s COVID nightmare
  6. Covid: Vaccinating by age not job 'will save the most lives' - Hancock The UK's decision not to prioritise key workers such as teachers or police officers for a Covid jab is "the moral thing to do" and will "save the most lives", the health secretary has said. Matt Hancock confirmed the second phase of the vaccine rollout would follow expert advice to focus on age groups. More than one in three adults in the UK have now had their first jab. One of England's top medics said Covid death rates were lower for teachers than several other professions. Prof Jonathan Van-Tam said ONS data on occupations with the highest Covid death rates begin with restaurant and catering establishment managers or proprietors, followed by metal-working and machine operatives, food, drink and tobacco process operatives, chefs, and taxi and cab drivers. Speaking at a coronavirus news conference at Downing Street, England's deputy chief medical officer also said the death rates for men in each of these groups were more than 100 deaths per 100,000, compared with 18.4 deaths per 100,000 male teachers. "When we're getting down into phase two of the vaccine campaigns... being in the queue is more important than where you are in it," Prof Van-Tam added. The government aims to give a jab to all over-50s and those in specific at-risk groups by 15 April, in what is known as phase one of the UK's Covid vaccine rollout. It has pledged to complete phase two - where all other adults are offered their first dose - by 31 July. The decision on what order to give phase two vaccines in comes after experts advising the government said priority based on occupation would be "more complex" and could slow down the programme. All four UK nations will follow the approach recommended by the Joint Committee on Vaccination and Immunisation (JCVI). Mr Hancock said: "Thankfully, teachers are no more likely to catch Covid than any other member of the population who goes to work, and so trying to come up with a scheme which prioritises one professional group over another would have been complicated to put in place and wouldn't have done what we asked the JCVI to do... which is to make sure that we minimise the people who die." More than 19 million people in the UK have received a first dose so far. Unions representing teachers and police have criticised the decision. Dr Patrick Roach, general secretary of the teachers' union NASUWT, said the government was "failing to take all steps possible" to ensure schools remained open "without the risk of further closures or of further damaging disruption to children's education". John Apter, from the Police Federation, said there was "palpable anger" from officers, adding: "What is expected of policing does put them at risk. It does put them at risk of transmitting this virus." A statement from the chief constables in Wales said: "Now the most vulnerable have been vaccinated we should seek to vaccinate those that risk their own safety and health." Why the focus on age not occupation? Analysis by Philippa Roxby, BBC health reporter The next phase of the vaccination programme aimed at the under-50s is all about speed. The more quickly they can be vaccinated, the more lives can be saved from Covid-19 which reduces pressure on hospitals and makes it more likely the road map out of lockdown can be delivered. The government's committee of vaccine experts says that means people should be vaccinated according to what age they are and not what job they do. It would be more complicated and more time-consuming to invite all teachers or police officers for their first dose than to make an offer to all those in their 40s, for example. Research by the Office for National Statistics suggests a number of occupations have higher-than-average death rates, including restaurant workers, taxi drivers, metal workers and shop assistants - so which group would be prioritised first and how would they be identified? The conclusion is that a fast, efficient rollout to all adults, by age group, is the best way to achieve the target of giving all adults a first dose by the end of July. The health secretary also urged people to continue to observe the stay-at-home rules, saying: "We're nearly there - let's not blow it." Mr Hancock pointed to a range of data that he said showed the pandemic "isn't over yet", including one in five local authority areas seeing a rise in cases in the past week. Prof Van-Tam also urged people to continue following lockdown rules after receiving a Covid jab. He said there were "some worry signs" that some people who have had the jab were "relaxing" their compliance with restrictions on socialising. "It's a bit like being 3-0 up in a [football] game and thinking 'well we can't possibly lose this now'. But how many times have we seen the other side take it 4-3? Do not wreck this now, it is too early to relax," he said. Covid infections are continuing to decline with strict lockdown measures in place across the UK. A further 345 people have died in the UK within 28 days of a positive coronavirus test, according Friday's daily figures, as well as 8,523 new confirmed cases of the virus. Meanwhile, former Prime Minister Theresa May, 64, has received her first dose of the vaccine. She said in a tweet that the jab was "effective and painless". I just had my first Covid-19 jab. It is safe, effective & painless. When it’s your turn, please #TakeTheVaccine. Only by protecting each other can we defeat this virus. Thanks to all the brilliant researchers, volunteers, NHS & military personnel for their truly heroic efforts. pic.twitter.com/I74lKRPVlB — Theresa May (@theresa_may) February 26, 2021 The BBC is not responsible for the content of external sites.View original tweet on Twitter Source: Covid: Vaccinating by age not job 'will save the most lives' - Hancock
  7. Covid: Millions of pupils going back to school in England Queuing for Covid tests at the Harris Academy Beckenham Millions of children in England are going back to school after more than two months studying at home in the latest lockdown. Many secondary schools will have a phased return during the week, allowing pupils to take Covid tests, and face masks will be worn in classrooms. Most primary schools are expected to open for all pupils from Monday. Prime Minister Boris Johnson described the return as an important first step towards a "sense of normality". It marks the first step of the "roadmap" out of the national lockdown, which has been in place since the beginning of January. The government is now considering various measures to help pupils in England catch up on lost learning, including longer school days and shorter holidays, according to Education Secretary Gavin Williamson. So, how will school life be different for pupils returning to classrooms this week? Testing but no exams This fourth big return to school in England since the start of the pandemic will come with questions about catching up on missed lessons, young people's wellbeing and a replacement exam system. Schools have set up up Covid testing centres as part of the return Secondary school pupils will have regular Covid testing, with three tests in school before switching to being tested at home. A survey from head teachers suggested 76% of secondary schools would have a phased return, with different year groups starting on different days, to allow time for testing. "There will be a full return but it will be from - not on - Monday, 8 March," said Geoff Barton, leader of the ASCL head teachers' union - describing the testing sites in schools as looking like "field hospitals". The Covid tests, with swabs of nose and throat, are voluntary - and there have been warnings from school leaders that getting parental consent has been the biggest difficulty. Primary schools will be welcoming back children again Face masks are expected to be worn in secondary school classrooms, where social distancing is not possible, at least for the remaining weeks of this term. The latest lockdown has seen the cancellation of A-level, GCSE and vocational exams, and pupils will return to study for a new system based on teachers' grades. Jules White, head of Tanbridge House School in Horsham, West Sussex, said there would be a mix of "immense relief tied to a little apprehension" and meeting friends would be as important for pupils as getting back to learning. In his school of 1,500 pupils, testing began last week and the phased return will stretch into next week. Ryedale School in North Yorkshire will be opening for all pupils from Monday Ryedale School in Nawton, North Yorkshire, tested all its pupils last week and all year groups will return to face-to-face teaching from Monday. Parents supporting Primary schools will be expected to fully reopen - and pupils will not have to take Covid tests or wear masks. The challenge would be "supporting pupils socially and emotionally, not just academically", said Paul Whiteman of the National Association of Head Teachers. Secondary schools will have masks worn in classrooms UK chief medical adviser Prof Chris Whitty has said "everything is strongly in favour" of pupils returning to school - with extra safety measures in place, such as testing, the wider use of masks and an early "natural firebreak" of the Easter holidays. A survey of 6,000 parents from the Institute for Fiscal Studies found widespread support for the return to school - with nine in 10 saying they would have sent their children back even if it had not been compulsory. But two-thirds of parents were "concerned that their child has lost out on learning". A joint letter from teachers' unions called for "flexibility" for schools over safety measures - and a check during the Easter holidays for any spikes in infections. Schools have remained open for vulnerable and key workers' children and about a quarter of pupils have been attending primary schools. Catch-up classes But for many pupils, apart from one day in January before the lockdown, this will be the first week back in school this year. The ambition is that this fourth return - following the short-lived attempt in January and returns last June and September - will be the last needed. Testing at the Harris Academy in Beckenham - pupils will have three Covid tests at school The government has appointed Sir Kevan Collins as an "education recovery commissioner", who will begin the process of helping pupils make up for the disruption and lost time in school. Ofsted inspectors have warned that disadvantaged children are more likely to have been adversely affected - and the government has announced £1.7bn to support catch-up schemes, such as tutoring and summer clubs. There have also been suggestions of changes to holidays and the school day. Labour leader Sir Keir Starmer has called for schools to have "catch-up breakfast clubs". Schools are running Covid test centres as pupils return There have been concerns about children's mental health during the pandemic - and a study by researchers at the universities of Essex, Surrey and Birmingham reports a "significant rise in emotional and behavioural difficulties". In Scotland, younger primary pupils went back last month - with more primary and secondary years returning from 15 March. In Wales, younger primary pupils went back last month, with further primary and secondary groups back between 15 March and mid-April. In Northern Ireland, younger primary pupils are returning on 8 March, with some secondary years starting 22 March. England's Education Secretary Gavin Williamson said the return to school would be a "moment of joy" when students would get back to their teachers and friends. "I do not underestimate how challenging the last few months have been with some children in class and most at home, but I do know how important it is for all children to be back in school, not only for their education but for their mental health and wellbeing," said Mr Williamson. Source: Covid: Millions of pupils going back to school in England
  8. Covid testing expanded to more workplaces in England Employers will be able to access rapid lateral flow tests Workplace Covid testing is being offered to more companies in England, for staff who cannot work from home during lockdown, the government says. Businesses with more than 50 employees are now able to access lateral flow tests, which can produce results in less than 30 minutes. Previously only firms with more than 250 staff qualified for testing. Health Secretary Matt Hancock urged businesses and employees to take up the offer to "stop this virus spreading". "When you consider that around one in three people have the virus without symptoms and could potentially infect people without even knowing it, it becomes clear why focusing testing on those without symptoms is so essential," he said, adding that firms should regularly test staff. The government said the wider criteria would "hugely" increase the number of different businesses that are able to sign up, with small and medium sized companies now able to take part. A website has been launched for more businesses to register for the rapid testing programme. It comes as England's national lockdown continues, and the UK's daily reported coronavirus deaths and cases remain high. The latest figures showed another 828 people in the UK have died within 28 days of a positive Covid test, and there were a further 18,262 cases. As of Friday, the UK had given a first jab to nearly 11.5 million people. Meanwhile, GPs in England will be paid an additional £10 by the NHS for every housebound patient they vaccinate against Covid-19. As well as offering vaccinations at their practices, GPs have been visiting patients to provide jabs to often vulnerable people who cannot leave their homes. The extra £10-per-visit funding is to recognise the extra staff time and complexity of vaccinating housebound people, NHS England said. Business Secretary Kwasi Kwarteng said the expanded workplace testing regime would complement the rollout of Covid vaccines in the drive to "reopen the economy and recover our way of life as soon as it is safe to do so". And the British Chambers of Commerce said it would be "working hard to ensure that eligible businesses take up this opportunity". But union officials said employers could not rely on lateral flow testing alone to ensure the safety of staff, citing that Public Health England (PHE) found examples of missed asymptomatic positive cases during the mass testing pilot in Liverpool last year. Dan Shears, GMB union's health, safety and environment director, said: "These rapid tests are not a magic bullet, and it is vital that employers understand the limitations and take steps to address them. Labour's shadow health secretary Jonathan Ashworth welcomed the extra testing but said "so much more needs to be done to make workplaces Covid-secure including improving ventilation and upgraded PPE (personal protection equipment) standards". "This is even more important when the most recent data shows hundreds of outbreaks in workplaces since the start of January," he said. Some 112 UK organisations have so far signed up to take part in workplace testing, with employees being tested across 500 sites, according to government figures. This includes private sector organisations in the food, manufacturing, energy and retail sectors, and public sector employers such as job centres, transport networks, and the military. NHS Test and Trace said that, as of 29 January, it had provided Transport for London (TfL) staff with 2,173 tests, identifying 28 positive cases who would have otherwise continued working alongside colleagues. But a CBI survey found that 87% of UK businesses were not currently testing in the workplace, citing reasons such as the availability of NHS testing for individuals, unclear guidance, and the operational, logistical and/or regulatory complexity of offering testing. Of those not carrying out workplace testing, 69% said they were not planning to offer testing in the next three months. The CBI said the government had "a big role" to provide guidance and make it simple to introduce workplace testing. According to the Department of Health, tests are currently being provided free to both public and private sector employers until at least 31 March, and the government's support will be kept under review. NHS Test and Trace will support organisations to deliver the asymptomatic testing by supplying the kits, and offering guidance and training for delivery. The additional funding for GPs is retrospective and will apply to any vaccinations that have already been delivered to those who cannot leave their homes. More than 1,000 GP services are part of the NHS vaccination programme, alongside over 250 hospital hubs and nearly 200 services run by high street pharmacies. The UK's devolved nations have the power to set their own coronavirus regulations. Scotland, Wales and Northern Ireland each offer their own advice on testing. Source: Covid testing expanded to more workplaces in England
  9. China’s Lunar New Year plan shows what living with Covid really means Swift local lockdowns, mass testing, and people being confined to residential compounds until there are no locally transmitted remain key to China’s pandemic response Kevin Frayer / Getty Images One year ago, things in China were very different. Around the time of the 2020 Lunar New Year people had already brought Covid-19 back to their families, hospitals in Wuhan were overwhelmed and doctor Li Wenliang, who tried to warn his the world of the virus, had passed away. This year, China’s central government in Beijing has advised people to stay where they are for the holiday. The government hasn’t banned travel but people are following official guidance. The number of passengers travelling during the three-day pre-festival rush fell 70 per cent year on year. Usually billions of trips are made across China for the Lunar New Year period. Train tickets sell out weeks in advance. Stations are mobbed in the days running up to the holiday. This year, they're not. But while the central government isn’t forcing people to stay at home, some bosses are. Any controls are happening at a local level, instead. Zhang* a law professor at a university in Shijiazhuang, the provincial capital of Hebei, says his workplace had banned him and other teachers from travel. A cluster of Covid-19 cases emerged there last month. While the city has reported no locally transmitted cases over the last few days, his university administration is still on alert. Zhang’s workplace, or danwei, sees the government’s voluntary advice as mandatory. In April last year, they requested teachers hand in their passports, to stop them travelling abroad. Zhang told them he’d lost his to avoid giving it over. Eight months on, near the end of the year, his danwei had each of its employees self-report their travel itineraries in its WeChat groups. They said, one by one, whether they had been to recent virus hotspots. These messages were collected into reports that were sent to the university’s Prevention and Control department. When it comes to social distancing in the most fundamental way – discouraging travel altogether – danwei have been crucial in ensuring compliance. Danwei were key to how Mao-era China governed. They’re less central to people’s lives now but still powerful. Most people are in a WeChat group with the leader of their danwei – their boss. When your boss tells you it’s a bad idea to travel home across the country, it can be hard to argue otherwise. China’s epidemic prevention effort has leaned on social organisation, not technology. Feng Ouxing, a state-owned enterprise researcher, is back in her home province of Fujian. To leave Beijing she had to fill in a form stating a reason for why she was leaving, where she was going and what transport she would take. Her work unit was relatively relaxed about her returning to see her family. That is not the case for everyone – civil servants in other areas of China are expected to set an example and so most are required to stay where they work, unless there are “special circumstances.” While Feng says it’s possible that some employees might hide the fact that they’ve travelled from their danwei, she believes the psychological pressure of false reporting and the worry that something might go wrong will dissuade people. She also notes that the app released by the State Council tracks GPS locations shared by telecom companies and can show which jurisdictions you’ve been to within the last 14 days. She’s more worried about sudden policy changes made by local governments than getting infected. Feng remembers how last year, when she returned to Beijing, she had to quarantine for two weeks. It was already April, far later than she’d expected to be able to return. Sudden changes in Covid-19 related policies have been part of China’s overall response. If there are new cases in a city, the local government’s response follows a set pattern. There is a swift lockdown, mass testing, and everyone waits within their residential compounds until there are no locally transmitted cases. While it may be effective for eliminating the virus, it has a huge impact on people’s lives. They are often stuck, in cities where they don’t work, for months on end without salaries. And once they do return, that can mean facing another quarantine. The thought of facing quarantine can be enough to put some off travel. From Dongxindian village on Beijing’s periphery, migrant worker Ren Shanhu called his neighbourhood committee back home in Shanxi. They told him that even if he tested negative for coronavirus, he would have to quarantine for 14 days if he returned. His family would also have to stay inside. Ren heard stories of committees in the same village enforcing quarantine on one returnee while another, who returned at the same time, was simply advised not to leave. He decided not to return – the uncertainty was too much. Last year, he hadn’t been able to return until June and had to pay months of rent as soon as he returned. An announcement by the Party’s discipline and inspection commission acknowledged that while preventing travel altogether might lead to fewer headaches for officials, it “increases social conflicts” adding that “damage to the image of the Party and government must be corrected.” Many migrant workers who decided to return had to quarantine for two weeks. Delivery driver Wang Xiaowang was one of those. He returned to his hometown in Hongtong county, Shanxi province, a month ago, where he observed local traditions like staying up until sunrise, as there’s a local saying that equates it with living longer. He had gotten compassionate leave from work as his father had passed away – from non-coronavirus-related causes. But the logistics company Wang works for, SF Express, wants its couriers to keep working. It has offered them bonuses as the online shopping habits of consumers have only become more entrenched since the Covid-19 outbreak. It’s not alone in offering incentives for workers to stay – local governments have offered subsidies, gifts, and shopping discounts. Had Wang stayed in Beijing, he would have received a bonus of around £100 a day of the holiday, on top of his usual RMB10,000 (£1120) each month. It was not enough to keep him there. Even if his father hadn’t passed, he says he would have still returned out as his mother needs company—the bonuses and the self-quarantines can’t trump family. “You can never work enough, and never make enough money,” he says. *Names have been changed Source: China’s Lunar New Year plan shows what living with Covid really means
  10. South African breweries adapt to survive alcohol ban Some breweries fear the industry may never recover after the alcohol ban. / © AFP "This place is definitely not what it used to be," said Eben Uys, gently wiping the dust from the counter of his bar. Like more than 200 South African microbrewery and restaurant owners, Uys is fighting to keep his business afloat after a new ban on alcohol sales to combat the soaring numbers of coronavirus cases. But like some others he has managed to adapt to survive. The 36-year-old chemistry graduate runs trendy bar and restaurant Mad Giant Brewery in the smart district of Newtown, in the heart of South Africa's economic capital of Johannesburg. Today, his business is at a virtual standstill. He has nine staff instead of roughly 40 in normal times. Julian Pienaar (C) has trained some of the employees of his brasserie-restaurant to bottle and pack beer cans / © AFP "What happened? Covid happened," he said. It's now less a question of how to make money, he said, but of "survival." "Every day you wonder how many days you have left and you just hope that something is gonna come in and just get you and buy you another day or another week." His beer barrels are full. In a few months, if the ban on the sale and consumption of alcohol is not lifted, the beer will all be poured down the sewers. South Africa is by far the worst hit country in the continent, with more than 1.3 million coronavirus cases and over 36,000 deaths. South Africa has been badly hit by coronavirus. At the Steve Biko Academic Hospital in Pretoria, health workers take oxygen tanks into a temporary ward for Covid patients / © AFP Last March, it was one of the first countries to ban alcohol sales to fight the pandemic, and President Cyril Ramaphosa last month reimposed the measure as the second wave hit. He said data showed "excessive alcohol consumption" led to an increase in trauma cases reported at hospitals, putting "an unnecessary strain on our already stretched public health facilities". Beer is the most popular alcoholic drink in South Africa, and some of the local manufacturers, who employ around 30,000 people, fear the industry may never recover. Already, 30 percent of the 215 microbreweries in the country have had to close their doors since the first ban, according to the Craft Beer Association South Africa. But some have found imaginative ways to convert their businesses to survive, at least temporarily. - Reconversion - In Benoni, about 40 kilometres (30 miles) east of Johannesburg, Julian Pienaar has trained some of the employees at his brasserie to fill and pack beer cans. In the middle of the room, behind a small improvised assembly line, former chef Sipho Nkomo puts lids on aluminium cans. Uys said he is fighting to keep his business afloat after the new alcohol ban / © AFP "It's been hard, you do a thing with passion and all of a sudden you're doing a new thing and you don't even have a clue", said Nkomo. Uys has switched to producing hand sanitizers. During the first wave of the pandemic, this business allowed him to stay afloat. But this time it's harder. "When you spray a little bit in your hand that's just a couple of millilitres, when you drink a beer that's 500 ml (a pint)," he said. A worker fills a jerrycan of sanitiser at the Mad Giant Brewery, in Newtown, Johannesburg / © AFP "The ban on alcohol kills the business and it's not going to cure the Covid," complained CBASA president Wendy Pienaar. South African Breweries, one of the country's largest, announced Friday is has cancelled a 136-million-euro ($164 million) investment planned for this year. "South Africans are paying with their lives and their jobs because President Ramaphosa and his ministers have not done what they promised us they would do" in tackling the pandemic, the main opposition Democratic Alliance said in a statement. It said 165,000 people have lost their jobs in the drinks industry. Source: South African breweries adapt to survive alcohol ban
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