Coronavirus Disease Weekly News 07March 2021

Written by rjs, MarketWatch 666

The news posted last week for the coronavirus 2019-nCoV (aka SARS-CoV-2), which produces COVID-19 disease, has been surveyed and some important articles are summarized here. The articles are more or less organized with general virus news and anecdotes first, then stories from around the US, followed by an increased number of items from other countries around the globe. Economic news related to COVID-19 is found here.

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Summary:

Covid infections and deaths continue to slow, but at a slower pace than earlier this year; new US infections over the 7 days ending March 6th were 12.8% lower than new cases from the prior 7 days, and are now only 24% of the new case pace of the 2nd week of January, but are still higher than the average of last summer. This week’s US Covid deaths were 8.8% lower than the prior week, and down by 47.5% from the late January peak. Those hospitalized with Covid again fell by more than 15% this week, and are less than a third of the January peak.

There are a number of scary stories here about new mutant strains being discovered in different states, but none of them seem to portend a widespread US outbreak. The last number I saw for US cases of the highly contagious UK strain (B.1.1.7) was 2,500; that appears to be the worst of it. This doesn’t mean it can’t get worse again, though, vaccines notwithstanding; Israel has vaccinated more than half their population – double the US vaccination rate, and late this week one of their major news sites reported that the South African Covid strain, which is not controlled by current vaccines, was “spreading beyond control“.

The chart below from WorldoMeter shows the daily number of new cases for the US, updated through 06 March.

According to Johns Hopkins (graph below), new cases globally are continuing to decline.

Also, Johns Hopkins has a graph for global deaths (below). The downturn in global deaths is now clearly in this graphic.

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Of course, Steven Hansen summarizes and links the latest news related to the pandemic every day, 7 days a week, plus displays over a dozen important graphics updated at least daily. The most recent article at the time this is published: 06 March 2021 Coronavirus Charts and News: A New Variant Identified In Oregon Is A Homegrown Version Of The U.K. Variant.

This article leads the daily newsletter from Global Economic Intersection every day. Newsletter subscription is free.

Here are the rest of the articles for the past week reviewed and summarized:

With a halt in the decline of COVID-19 cases in the US, CDC director warns “the virus is not done with us” – On Friday, the US Centers for Disease Control and Prevention director, Dr. Rochelle Walensky, remarked at the White House briefing on the COVID pandemic, “Things are tenuous. Now is not the time to relax restrictions.” These comments were made in reference to the leveling of declines in new cases of COVID-19, which has public health officials extremely concerned. Since February 20, the seven-day average of COVID-19 cases has remained steady at just above 70,000 cases. Deaths due to COVID-19 have also stalled their decline with approximately 2,000 per day. Meanwhile, the B.1.1.7 variant’s detection has continued to rise, with 2,102 cases detected across 45 states. Though the number of cases is highest in Florida, they are growing fastest in Michigan, which now has 336 detected B.1.1.7 cases. New York and New Jersey, where daily COVID-19 cases continue to remain high, are adding new cases most rapidly by comparison to other states. New York City health officials are attempting to downplay the emergence of a new variant of the coronavirus, B.1.526, that has independently developed the E484K mutation, known to evade immunity, similar to the B1.351 and P.1 variants from South Africa and Brazil, respectively. Since first detected in November, the New York variant has been rapidly growing, representing 12.3 percent of all the variants detected in the northeast of the United States by mid-February. These developments in the pandemic’s epidemiological curves are congruent with the analysis made by the CDC and scientists like Dr. Michael Osterholm, who warned that these variants would become the dominant strains in March. Estimates are that B.1.1.7 accounts for 10 percent of all the SARS-CoV-2 viruses in the US and has a doubling time of seven to 10 days. Given its higher infectiousness compared to the “wild-type,” it implies that the half-measures and limited mitigation strategies in place will not control the virus’s spread.

Scientists discover why blood type may matter for COVID infection. – A new study provides further evidence that people with certain blood types may be more likely to contract COVID-19. Specifically, it found that the new coronavirus (SARS-CoV-2) is particularly attracted to the blood group A antigen found on respiratory cells. The researchers focused on a protein on the surface of the SARS-CoV-2 virus called the receptor binding domain (RBD), which is the part of the virus that attaches to the host cells. That makes it an important target for scientists trying to learn how the virus infects people. In this laboratory study, the team assessed how the SARS-CoV-2 RBD interacted with respiratory and red blood cells in A, B and O blood types. The results showed that the SARS-CoV-2 RBD had a strong preference for binding to blood group A found on respiratory cells, but had no preference for blood group A red blood cells, or other blood groups found on respiratory or red cells. The SARS-CoV-2 RBD’s preference to recognize and attach to the blood type A antigen found in the lungs of people with blood type A may provide insight into the potential link between blood group A and COVID-19 infection, according to the authors of the study. It was published March 3 in the journal Blood Advances. “It is interesting that the viral RBD only really prefers the type of blood group A antigens that are on respiratory cells, which are presumably how the virus is entering most patients and infecting them,” said study author Dr. Sean Stowell, from Brigham and Women’s Hospital in Boston. “Blood type is a challenge because it is inherited and not something we can change,” Stowell said in a journal news release. “But if we can better understand how the virus interacts with blood groups in people, we may be able to find new medicines or methods of prevention.” These findings alone can’t fully describe or predict how coronaviruses would affect patients of various blood types, the researchers noted. “Our observation is not the only mechanism responsible for what we are seeing clinically, but it could explain some of the influence of blood type on COVID-19 infection,” Stowell and his team said.

Study contributes to evidence for potential association between blood group a and COVID-19 –As researchers around the world work to identify and address risk factors for severe COVID-19, there is additional evidence that certain blood types could be associated with greater risk of contracting the disease. A new Blood Advances study details one of the first laboratory studies to suggest that SARS-CoV-2, the virus that causes COVID-19, is particularly attracted to the blood group A antigen found on respiratory cells. In the study, researchers assessed a protein on the surface of the SARS-CoV-2 virus called the receptor binding domain, or RBD. The RBD is the part of the virus that attaches to the host cells, so it is an important research target for understanding how infection occurs. The team assessed synthetic blood group antigens on respiratory and red blood cells found in blood group A, B, and O individuals, and analyzed how the SARS-CoV-2 RBD interacted with each unique blood type. They discovered that the RBD had a strong preference for binding to blood group A found on respiratory cells. It did not display a preference for blood group A red blood cells, or other blood groups found on respiratory or red cells. The capacity of the RBD to preferentially recognize and attach to the blood type A antigen found in the lungs of blood type A individuals may provide insight into the potential link between blood group A and COVID-19 infection.”It is interesting that the viral RBD only really prefers the type of blood group A antigens that are on respiratory cells, which are presumably how the virus is entering most patients and infecting them,” . “Blood type is a challenge because it is inherited and not something we can change. But if we can better understand how the virus interacts with blood groups in people, we may be able to find new medicines or methods of prevention.”Based on their observations, the team sought to determine whether a similar binding preference existed for the RBD of SARS-CoV, the virus that causes severe acute respiratory syndrome (SARS). Although the makeup of the virus differs, the SARS-CoV RBD exhibited the same preference to bind to the group A antigens on respiratory cells.

Covid Deranges the Immune System in Complex and Deadly Ways – There’s a reason soldiers go through basic training before heading into combat: Without careful instruction, green recruits armed with powerful weapons could be as dangerous to one another as to the enemy.The immune system works much the same way. Immune cells, which protect the body from infections, need to be “educated” to recognize bad guys – and to hold their fire around civilians.In some Covid patients, this education may be cut short. Scientists say unprepared immune cells appear to be responding to the coronavirus with a devastating release of chemicals, inflicting damage that may endure long after the threat has been eliminated.“If you have a brand-new virus and the virus is winning, the immune system may go into an ‘all hands on deck’ response,” said Dr. Nina Luning Prak, co-author of a January study on Covid and the immune system. “Things that are normally kept in close check are relaxed. The body may say, ‘Who cares? Give me all you’ve got.’”While all viruses find ways to evade the body’s defenses, a growing field of research suggests that the coronavirus unhinges the immune system more profoundly than previously realized.Some Covid survivors have developed serious autoimmune diseases, which occur when an overactive immune system attacks the patient, rather than the virus. Doctors in Italy first noticed a pattern in March 2020, when several Covid patients developed Guillain-Barré syndrome, in which the immune systems attacks nerves throughout the body, causing muscle weakness or paralysis. As the pandemic has surged around the world, doctors have diagnosed patients with rare, immune-related bleeding disorders. Other patients have developed the opposite problem,suffering blood clots that can lead to stroke.All these conditions can be triggered by “autoantibodies” – rogue antibodies that target the patient’s own proteins and cells.In a report published in October, researchers even labeled the coronavirus “the autoimmune virus.”“Covid is deranging the immune system,” said John Wherry, director of the Penn Medicine Immune Health Institute and another co-author of the January study. “Some patients, from their very first visit, seem to have an immune system in hyperdrive.” Although doctors are researching ways to overcome immune disorders in Covid patients, new treatments will take time to develop. Scientists are still trying to understand why some immune cells become hyperactive – and why some refuse to stand down when the battle is over.

Statin users 50% less likely to die from severe COVID-19 – Some 40 million people living in the United States take statins to help reduce their cholesterol levels and risk of heart disease. But statins can also have a strong anti-inflammatory, anti-blood clotting, and antiviral effect, all of which may help limit complications associated with severe COVID-19.That is why researchers are trying to figure out if statin use impacts COVID-19 outcomes.In a new study, a group of researchers, including cardiologists caring for hospitalized COVID-19 patients in New York, set out to compare patient outcomes between people who had used statins before hospitalization and those who had not.“Our study is one of the larger studies confirming this hypothesis, and the data lay the groundwork for future randomized clinical trials that are needed to confirm the benefit of statins in COVID-19,” says co-lead author of the study, Dr. Aakriti Gupta, MD, a cardiologist at NewYork-Presbyterian/Columbia University Irving Medical Center.If a successful clinical trial validates the researchers’ findings, statins could represent a low-cost, easy to access, relatively safe treatment option for COVID-19.Currently, the Food and Drug Administration (FDA) has approved only one drug to treat COVID-19 – remdesivir (Veklury). However, some other medications may be beneficial during certain stages of the disease.The study appears in Nature Communications.

Large number of COVID-19 survivors will experience cognitive complications – A research review led by Oxford Brookes University has found a large proportion of COVID-19 survivors will be affected by neuropsychiatric and cognitive complications. Psychologists at Oxford Brookes University and a psychiatrist from Oxford Health NHS Foundation Trust, evaluated published research papers in order to understand more about the possible effects of the SARS-COV-2 infection on the brain, and the extent people can expect to experience short and long-term mental health issues. The study found that in the short term, a wide range of neuropsychiatric problems were reported. In one examined study, 95% of clinically stable COVID-19 patients had post-traumatic stress disorder (PTSD) and other studies found between 17-42%* of patients experienced affective disorders, such as depression. The main short-term cognitive problems were found to be impaired attention (reported by 45% patients) and impaired memory (between 13-28% of patients). In the long term, neuropsychiatric problems were mostly affective disorders and fatigue, as well as impaired attention (reported by 44% of patients) and memory (reported between 28-50% of patients). “These conditions affect people’s capacity to work effectively, drive, manage finances, make informed decisions and participate in daily family activities. “If even just a fraction of patients experience neuropsychiatric complications, the impact on public health services could be significant.” Academics say that there is likely to be an increase in patients with psychiatric and cognitive problems who were otherwise healthy prior to COVID-19 infection. “Detailed cognitive evaluation and robust monitoring of patients should be considered in order to detect new neurological cases,” continues Dr Kumar. “This will also enable health care providers to plan adequate health care and resources, and improve the quality of life for many COVID-19 survivors.

Administering zinc to covid-19 patients could help towards their recovery –Administering zinc supplements to covid-19 patients with low levels of this element may be a strategy to reduce mortality and recovery time. At the same time, it could help to prevent risk groups, like the elderly, from suffering the worst effects of the disease. These are the findings of a study by physicians and researchers from the Hospital del Mar, which has just been published in the journal Nutrients. The study analysed the zinc levels of 249 adult patients treated at the centre between 9 March and 1 April 2020, with an average age of 65 years. The most common symptoms presented at the time of admission were fever, cough and dyspnea. In all cases, they analysed their blood zinc levels, considering those under 50 μ/dl as being low. As explained by Dr. Güerri, first author of the clinical study, they analysed this parameter because “zinc is an essential element for maintaining a variety of biological processes, and altering its levels causes increased susceptibility to infections and increased inflammatory response”. For this reason, “given the comorbidities associated with zinc deficiency and its immunomodulatory and antiviral actions, zinc levels and zinc supplementation may prove useful tools to tackle the covid-19 crisis”. 1 in 4 patients had low levels of zinc. This group had more severe symptoms and higher levels of inflammation as measured by two markers, C-reactive protein (CRP) and interleukin 6 (IL-6), which mediate the inflammatory response. On average, their length of hospital stay was three times longer than patients with higher levels of zinc (25 days compared to 8). Regarding mortality, zinc levels were significantly higher in patients who survived the infection, 62 μ/dl, versus 49 μ/dl for those who died. Moreover, 1 in 5 patients with low zinc levels died. Conversely, the mortality rate of those presenting higher levels upon admission was 5%. The study reveals that a one-unit increase of zinc in blood plasma is directly linked to a 7% reduction of the risk of dying from covid-19. Dr. Güerri highlights that “we have shown the importance of zinc levels in patients’ blood as an additional predictor of outcome in covid-19, as well as its potential as a therapeutic tool for treatment. We therefore propose this variable as a new parameter to predict the evolution of patients and we propose initiating clinical trials concerning zinc supplementation in patients with low levels admitted for covid-19 and implementing programmes to administer supplements to groups at risk of having low zinc levels to reduce the effects of the pandemic”.

Coronavirus vaccines may reduce or eliminate symptoms of long covid – Some people with long covid, in which individuals have long-lasting symptoms after a covid-19 infection, are reporting improvements in their health after being vaccinated against the coronavirus. The reports are based on anecdotes and a small, informal survey rather than a scientific study, but the trend might offer clues to what causes the persistent symptoms. For most people, covid-19 is a mild or flu-like illness. However, some people are still ill many months after the infection.

How Does the Johnson & Johnson Vaccine Compare to Other Coronavirus Vaccines? 4 Questions Answered — Yves here. We are running this post for one reason: as this article stresses, the testing of the Pfizer and Moderna vaccines was conducted much earlier, when fewer variants were out and about. Therefore the Johnson & Johnson vaccine efficacy gives a much more realistic of what you could expect in terms of protection now. So far, with Pfizer and Moderna, all we have are airy assurances and largely in vitro studies against the new variants. Both companies have discussed the notion of a third “booster: shot to contend with known new variants, which looks an awful lot like an admission that they suspect or even know the efficacy of their current offerings is meaningfully lower against some of the new variants. Another way the efficacy data may not be comparable is in how they screened for Covid infections. Astra Zeneca tested all its clinical trial participants every week. By contrast, Pfizer used the dodgy approach of testing ONLY participants who developed “severe respiratory symptoms”. That means they ignored cases with loss of smell, the most reliable indicator of Covid, ones with digestive symptoms. and other symptom combinations that the CDC (and people I know) have found to be signals of Covid onset: fever, chills, headache, fatigute. And the “severe respiratory infection” only screen also means Pfizer did not catch mild or asymptomatic cases, even though we know they can do serious damage. From CBS News: A Texas trauma surgeon says it’s rare that X-rays from any of her COVID-19 patients come back without dense scarring. Dr. Brittany Bankhead-Kendall tweeted, “Post-COVID lungs look worse than any type of terrible smoker’s lung we’ve ever seen. And they collapse. And they clot off. And the shortness of breath lingers on… & on… & on.” “Everyone’s just so worried about the mortality thing and that’s terrible and it’s awful,” she told CBS Dallas-Fort Worth. “But man, for all the survivors and the people who have tested positive this is – it’s going to be a problem.” In other words, I’m sufficiently suspicious of the Pfizer efficacy numbers as to be willing to give Johnson & Johnson a go, particularly with its one-shot drill.

New Orleans archdiocese calls for Catholics to avoid Johnson & Johnson vaccine – The Catholic Archdiocese of New Orleans urged Catholics on Friday against taking a vaccine for COVID-19 manufactured by Johnson & Johnson because the vaccine is developed from stem cells obtained from two abortions.In a statement on the archdiocese’s website, the organization argued that Johnson & Johnson’s vaccine was “morally compromised.””The archdiocese must instruct Catholics that the latest vaccine from Janssen/Johnson & Johnson is morally compromised as it uses the abortion-derived cell line in development and production of the vaccine as well as the testing,” the statement read. “We advise that if the Moderna or Pfizer vaccine is available, Catholics should choose to receive either of those vaccines rather than to receive the new Johnson & Johnson vaccine because of its extensive use of abortion-derived cell lines,” the archdiocese continued.A request for comment from Johnson & Johnson was not immediately returned. Catholic groups that oppose abortion have long criticized medical companies that use human cell lines from aborted fetuses, while companies including Johnson & Johnson have defended the process as leading to medical breakthroughs on the disease prevention front. “As a research tool, human pluripotent stem cells promise to expand our understanding of normal physiologic processes such as cell growth and differentiation, and to enable new insights into disease, which may lead to new ways to prevent, diagnose and treat a wide variety of disorders,” reads a statement on the company’s website. The Johnson & Johnson vaccine became the third candidate authorized for emergency use in the U.S. earlier this month, joining two others on the market produced by drugmakers Moderna and Pfizer.

Fauci: Military personnel opting out of vaccine are ‘part of the problem’ – Anthony Fauci, the nation’s top infectious disease expert, on Thursday, told U.S. military members that those of them who decide not to get the coronavirus vaccine are inadvertently “part of the problem” of prolonging the pandemic. While speaking in a town hall with Blue Star Families, a nonprofit organization dedicated to serving military personnel and their families, Fauci told service members that they are “part of the solution to this outbreak.” “Because by getting infected, even though you may not know it, you may be inadvertently transmitting the infection to someone else, even though you have no symptoms,” Fauci said during the event, according to CNBC. “In reality, like it or not, you’re propagating this outbreak,” the White House’s chief medical adviser added. “So instead of being part of the solution, you are innocently and inadvertently being part of the problem by not getting vaccinated.” Fauci went on to say that while military members must “think of your own health,” they must also “think about your societal obligation, including people close to you personally as well as other members of families of other individuals.” The remarks come after the Department of Defense last month revealed that a third of service members had decided to opt-out of getting the coronavirus vaccine. Maj. Gen Jeff Taliaferro, vice director for operations at the Pentagon, said during a House hearing on the Armed Forces’ response to COVID-19 that despite the refusal among some service members to get the vaccine, they were still deployable, and that “services and commands” that have been set up over the past year have allowed the Armed Forces to operate in a “COVID environment.” Maj. Gen. Steven Nordhaus also revealed in the hearing that vaccinations were voluntary for military members. A week after the hearing, Defense Secretary Lloyd Austin released a video promoting the safety of the coronavirus vaccine and encouraging military personnel to seek out credible information on the inoculation from agencies like the Centers for Disease Control and Prevention (CDC). The CDC as of Thursday has recorded that more than 54 million people in the U.S. have received at least one dose of the coronavirus vaccine, with about 27.8 million receiving two doses.

Some LGBTQ People Are Saying ‘No Thanks’ to the Covid Vaccine – At her last doctor’s appointment, Erica Tyler, who lives in Brooklyn, N.Y., joked that she didn’t want to get vaccinated for Covid-19 “because another foot might grow out of my forehead. And I’m not ready for that.”Ms. Tyler, 68, a cancer survivor who has diabetes and high blood pressure, lost her wife to a heart attack nearly a year ago and has been staying home throughout the pandemic to avoid becoming infected with the coronavirus. But when the vaccine became available, she did not rejoice.“I was resistant,” Ms. Tyler said. She described feeling unsettled by the push to vaccinate minorities, especially given how Black people have been underserved or mistreated by the medical establishment in the past.“I felt that they were trying to storm people who they wanted to eliminate out of society,” she said, namely “the elderly and the Black people.” Research has shown that sexual and gender minorities, and especially people of color, are more vulnerable to becoming infected with the coronavirus and also more likely to haveunderlying conditions that could make them severely ill if they were to contract Covid-19. But many of the very people who are most at risk within these communities are also hesitant to take the vaccine, according to a recent study and interviews with health care workers as well as people of color who identify as lesbian, gay, bisexual, transgender or queer.

Among homeless populations, a deep mistrust of vaccines. Here’s how cities are intervening. When it came time for residents and staff at the New York Avenue homeless shelter in northeast Washington, D.C., to receive their first doses of Moderna’s Covid-19 vaccine, David Durham, who’s lived at the men’s shelter for three years, was scared.Like many at the shelter, he’d been bombarded by vaccine misinformation: Neighborhood talk and rumors turned into elaborate conspiracy theories, many of which played into the mistrust that homeless people already have of government services.But he got the shot.“I’ve heard so many conspiracy theories, like they’re putting a chip in you, that they’re going to inject some sort of liquid in you, that you’re going to be a guinea pig,” said Durham, a 34-year-old D.C. native. “But I said, ‘You know what, I have to take it upon myself to lead by example.’”Across the country, many cities and major urban centers have begun the work of vaccinating homeless individuals housed within their shelter systems, but few municipalities have ventured into the streets where the matter is compounded by mistrust, logistical hurdles and limited resources.The newly authorized Johnson & Johnson vaccine, however, has provided a timely solution for cities that have been struggling to administer the two previously available vaccines to their sheltered homeless, and especially their unsheltered homeless, who are more transient and at increased risk amid the pandemic.So far, their methods have been as varied as their preparedness.In Washington, city officials have implemented a multi-agency strategy for vaccinating homeless individuals regardless of age or condition, but have mostly refrained from vaccinating those who are living on the street. Durham was one of the first within his shelter to receive the vaccine, and then became a peer educator, one of about two dozen currently or previously homeless individuals tasked by the city with educating other homeless individuals on the safety and efficacy of the different vaccines.

Should you get vaccinated if you recovered from Covid? Expert advice –With Covid-19 vaccine shortages and problems with slow roll out, do people who already had the virus and have fully recovered need to get the vaccine, too? And is it safe for them?The Centers for Disease Control’s guidance says even people who’ve had Covid can benefit from the getting the vaccine.”Due to the severe health risks associated with Covid-19 and the fact that reinfection with Covid-19 is possible, you should be vaccinated regardless of whether you already had Covid-19 infection,” according to the CDC. Here’s why.When someone is infected with SARS-CoV-2, the virus that causes Covid-19, their immune system creates antibodies, which are proteins that fight off infections and help prevent future infections from occurring. That is called “natural immunity.”(The mRNA vaccines currently available for Covid work by giving cells instructions to make a non-infectious piece of the coronavirus’ spike protein. The immune system detects the copies of the spike protein and creates antibodies against it.)At this stage, there are still lots of questions about how long natural immunity from Covid lasts and whether it could prevent reinfection, Dr. David Wohl, an infectious disease physician at the University of North Carolina, tells CNBC Make It.Studies on people who were exposed to Covid and then recovered have shown that their antibodies remained pretty stable, and only dropped “modestly” after six or eight months. Another promising outcome: coronavirus-specific B and T cells (which work together to remember and destroy infections) also appear to increase and remain high after infection.New research that hasn’t been peer-reviewed yet found that people who have already had Covid tend to have higher antibody responses after their first dose of the mRNA vaccines than two doses of the vaccine in people who haven’t had it. Some immunologists argue that people who’ve recovered from Covid should only need one dose of a vaccine.”If you’ve had Covid-19, [a vaccine] may augment or help increase the durability, and even maybe the breadth, of your immune response against coronavirus,” Wohl says.

From Pfizer to Moderna: who’s making billions from Covid-19 vaccines? – The arrival of Covid-19 vaccines promises a return to more normal life – and has created a global market worth tens of billions of dollars in annual sales for some pharmaceutical companies.Among the biggest winners will be Moderna and Pfizer – two very different US pharma firms which are both charging more than $30 per person for the protection of their two-dose vaccines. While Moderna was founded just 11 years ago, has never made a profit and employed just 830 staff pre-pandemic,Pfizer traces its roots back to 1849, made a net profit of $9.6bn last year and employs nearly 80,000 staff.But other drugmakers, such as the British-Swedish AstraZeneca and the US pharma Johnson & Johnson, have pledged to provide their vaccines on a not-for-profit basis until the pandemic comes to an end.Whether the market remains a money-spinner in the future depends on whether the vaccines become the type that need just a one-off shot – as for measles – or if regular vaccinations will be required, such as for flu. But in the immediate future, there are big financial returns up for grabs.Here, we look at who is in line for the biggest gains – and which shareholders have already made fortunes.

• Pfizer/BioNTechmRNA vaccine Pfizer’s Comirnaty vaccine, developed with Germany’s BioNTech, is based on re-engineered messenger RNA – the molecule that sends genetic instructions from DNA to a cell’s protein-making machinery. It was the first to be approved and has to be stored at ultra-low temperatures (-70C). Governments have ordered about 780m shots, including the US (200m doses for $3.9bn) and the EU commission (300m), while 40m doses will go to lower-income nations via the Covax facility. It costs $39 (£28) for two doses in the US and about $30 in the EU.Expected sales in 2021: $15bn-$30bn Pfizer, which splits costs and profit margins equally with BioNTech, expects $15bn in 2021 sales based on current deals. The final number could be twice as high, as Pfizer says it can potentially deliver 2bn doses this year. The two founders of BioNTech, the husband and wife team Ugur Sahin and fizlem Türeci – both doctors – became multibillionaires last year, when the potential of the vaccine and the deal with Pfizer prompted the shares to surge.
• ModernamRNA vaccine- The vaccine produced by the US biotech firm, based in Massachusetts, must be stored at freezer temperature (-20C). The UK has ordered 17m doses, the EU bought 310m with an option for a further 150m in 2022, while the US government ordered 300m shots. Japan purchased 50m shots. Moderna charges $30 for the required two shots in the US and $36 in the EU.Expected sales in 2021: $18bn-$20bnModerna has said it expects 2021 sales of $18.4bn. Barclays analyst Gena Wang forecasts sales of $19.6bn, $12.2bn in 2022, and $11.4bn in 2023, assuming recurring vaccinations.
• Johnson & JohnsonAdenovirus vaccineJ&J’s jab, the world’s first single-shot Covid-19 vaccine, was developed by its Janssen division in Belgium. It uses adenovirus-26, a rare variant of cold virus. It was approved in the US in late February and can be stored at standard fridge temperatures for at least three months. Big orders include the US, UK (30m doses plus option for 22m), the EU (up to 400m doses), and Covax nations(500m doses through 2022). Expected sales in 2021: up to $10bnThe company aims to deliver at least 1bn doses this year, which would generate $10bn. The US government has ordered 100m doses, with the option to buy 200m more, and is paying $10 a shot.
• AstraZenecaAdenovirus vector vaccineThe vaccine developed with Oxford University uses a modified chimpanzee cold virus and can be kept at fridge temperature. Viral vector vaccines use a harmless virus to deliver a piece of genetic code to cells. Big orders have come from the UK (100m), the EU (up to 400m), the US (300m) and Japan (£120m).Expected sales in 2021: $2bn-$3bnAnalysts at SVB Leerink are forecasting sales of $1.9bn this year and $3bn in 2022. The 2021 figure could be far higher if AstraZeneca achieves its ambitious target of 3bn doses. The company has pledged to supply the vaccine on a not-for-profit basis during this pandemic, and charges $4.30 to $10 for two doses.
• SinovacInactivated virus vaccine The CoronaVac jab has been administered for emergency use in several Chinese cities since last summer, and was approved by China’s regulator in early February. Sinovac, which is based in Beijing, has struck deals with Brazil, Chile, Singapore, Malaysia and the Philippines. In January, Turkey and Indonesia kicked off their vaccination campaigns with the jab. Sinovac also plans to supply 10m vaccine doses to Covax nations. Expected sales in 2021: billions of dollars, but unclearSinovac says it can produce more than 1bn doses this year. The vaccine has been priced at $60 for two shots in some Chinese cities. Sinovac’s Indonesian partner Bio Farma, which has ordered at least 40m doses, said it would cost $27.20 for two doses locally.

Univ. of Miami finds New York and Brazil COVID-19 variants in South Florida – Researchers at the University of Miami are uncovering several more COVID-19 variant strains right here in South Florida, including three cases of two different Brazil variants and now a case of the so-called New York variant.Dr. David Andrews of UM’s Miller School of Medicine calls it “really eye-opening.”“We’re discovering variants of many different varieties,” he adds. “From many different locations, from an array of countries and array of sources.”Andrews, an associate professor in the Department of Pathology and Laboratory Medicine, says the researchers were “very surprised in our first couple hundred sequencing results we turned up three variants originating from Brazil.”The mutation from the United Kingdom is so far the most prevalent variant strain circulating throughout Florida – and believed to be more easily spread. In their latest statistics posted Thursday, the Centers for Disease Control and Prevention had verified 500 cases of that U.K. variant in Florida, most of any state in the country.Furthermore, of a random sampling of COVID-19 positive results, the University of Miami researchers found that 25% had the U.K. variant.But the concern with the newer New York variant, much like the Brazilian strain, is its suspected ability to bypass immunity, including from a vaccine.“We entered into this not expecting to find any particular variant, and we found a case of the New York variant, and yes the concern for the New York variant is an immune escape mechanism as well,” Andrews says.So, what about the millions statewide already vaccinated? While vaccines have shown to be effective against the U.K. variant, Andrews says they should be at least partially effective at protecting against other mutations.“Both Pfizer and Moderna are starting clinical trials with slight variations of the vaccine to be able to address those structural differences in the spike protein,” he says.The CDC’s latest data on Thursday showed only one verified case of the Brazilian variant,which Local 10 News previously reported was located in Miami-Dade County..The new variants discovered at the University of Miami add to that.UM says it is one of “a handful” of academic medical centers across the U.S. testing COVID-19 samples for variants and sequencing them.“Because of our geographic location, it’s very important for us to develop these capabilities,” said Dr. Stephen D. Nimer, director of the Sylvester Comprehensive Cancer Center, who developed the school’s COVID-19 testing program. “If we are able to find other variants, we can then determine whether they are covered by our vaccines and whether they actually cause more severe disease, and all of this information is helpful for the world to know.”The Florida Department of Health has said that the state’s higher numbers of confirmed variants are in part a result of greater efforts to sequence and look for those other strains than other states.

Fearing Covid-19 Surge, Florida Officials Crack Down on Spring Breakers – WSJ – Nearly a year after some Florida spring breakers refused to let the coronavirus interrupt their parties and helped trigger a wave of lockdowns, this city is bracing for a fresh crop of revelers. Though many colleges have canceled spring break to prevent students from congregating in vacation spots, officials here are expecting a large influx over the coming weeks. Flights and hotels are cheap. Brutal winter storms in much of the country left people yearning for an escape. And Florida’s pandemic rules on bars and nightclubs are more lenient than those in many states. “We could potentially see a truly outsized spring break at a time when the last thing we want are major gatherings,” said Miami Beach Mayor Dan Gelber, a Democrat. He cited public-health specialists’ concerns that such crowds could generate another surge of Covid-19 cases. Bars, restaurants and clubs will be open at no less than 50% capacity, because the city can’t shut them down under a state executive order. But Miami Beach – a barrier island known for its stylish hotels and spirited nightlife – is taking a zero-tolerance approach. Officials have beefed up restrictions from Feb. 22 to April 12 and expect peak activity in March. They have also launched an ad campaign urging young people to vacation responsibly. More police officers and code-compliance staffers are patrolling to enforce measures including a midnight curfew and bans on alcohol and boom boxes on the beach. Music at venues can’t exceed ambient noise levels. Beach patrols are ensuring groups maintain social distance and wear masks when appropriate.

March 1 COVID-19 Test Results and Vaccinations – NOTE: The Covid Tracking Project will end daily updates on March 7th. From Bloomberg on vaccinations as of Mar 1st. “In the U.S., more Americans have now received at least one dose than have tested positive for the virus since the pandemic began. So far, 76.9 million doses have been given. In the last week, an average of 1.82 million doses per day were administered.”Here is the CDC COVID Data Tracker. This site has data on vaccinations, cases and more. The US has averaged 1.5 million tests per day over the last week. The percent positive over the last 7 days was 4.4%. Based on the experience of other countries, for adequate test-and-trace (and isolation) to reduce infections, the percent positive needs to below 1%, so the US has far too many daily cases – and percent positive – to do effective test-and-trace. There were 1,224,488 test results reported over the last 24 hours. There were 48,092 positive tests. Over 1,200 US deaths have been reported in March. See the graph on US Daily Deaths here. This data is from the COVID Tracking Project. And check out COVID Act Now to see how each state is doing. (updated link to new site) This graph shows the 7 day average of positive tests reported and daily hospitalizations. The dashed line is the post-summer surge low for hospitalizations.

U.S. Cases Fell 61% Last Month; WHO Issues Warning: Virus Update -Covid-19 infections in the U.S. had the biggest monthly decline in February, plunging 61% to about 2.42 million, data compiled by Johns Hopkins University and Bloomberg show. That helped lower the death count from January by 25% to 71,772. Overall, almost 514,000 Americans have succumbed to Covid-19 and about 28.7 million residents — or 8.7% of the population — have been infected by it. A new Covid variant detected in New York is being watched “very, very closely” by U.S. health officials, Anthony Fauci said. The variant, known scientifically as B.1.526, likely started off in the Washington Heights section of Manhattan, Fauci, a top adviser to President Joe Biden on the pandemic, said. It is one of five concerning variants now being tracked nationally by health officials. Johnson & Johnson is looking for manufacturing partnerships to increase supply of its vaccine, which was cleared Saturday by U.S. regulators. The European Commission is set to unveil a proposal this month for a digital vaccine passport, which could ease a return to normality for those who are immunized. But critics say it may be discriminatory and infringe on privacy.U.K. Prime Minister Boris Johnson moved to reassure the public over the emergence of a Brazilian variant. Italy will tighten curbs in some cities, Oslo will close restaurants and shops, and Finland has triggered a state of emergency. France needs another four to six weeks before the government can start lifting curbs, President Emmanuel Macron signaled.Key Developments:

• Global Tracker: Cases pass 114 million; deaths exceed 2.5 million
• Vaccine Tracker: More than 242 million shots given worldwide
• U.S. Spotlight: Hospitalization flare-ups are reminder it’s not over
• J&J’s Covid vaccine could protect millions — if people take it
• Vaccine challenge shifts from supply to demand, official says
• What to Know About Severe Reactions to Covid Vaccines: QuickTake

Dozens of Whole Foods employees at a Detroit store have tested positive for COVID-19 and health officials are now sending a warning to customers — A Whole Foods Market in Detroit is being pummeled by COVID-19 after 24 employees tested positive for the virus, Detroit’s health department said in a public health notice. So far, no customers have reported catching the virus as a result of the outbreak, but the city’s health department is asking shoppers who visited the store from February 12 to 22 to monitor themselves for potential symptoms. Employees are not allowed to return to the store until they’ve quarantined, showed no symptoms, and tested negative, according to the health department. It’s now also working with the Amazon-owned grocer for vaccine access and safety procedure monitoring. “The safety of our team members and customers remains our top priority, which is why we are taking comprehensive action to address this issue and have rolled out extensive measures to keep people safe in our stores,” a Whole Foods spokesperson told Insider in an email statement. The spokesperson also noted the mandatory negative test result before workers can return to the store. Marc Perrone, the international president of the United Food and Commercial Workers International Union, has called the Detroit Whole Foods outbreak “another wake-up call to grocery companies and elected leaders.” “The fact is that this pandemic is far from over and national grocery companies are failing to do what is necessary to protect essential workers and the customers who depend on them every day,” Perrone said in the press release. In December, a worker at the afflicted Whole Foods store sent a mass email to employees asking the grocer to update its policies to better protect its employees. In the letter, the unnamed employee asked for several changes, including the reintroduction of hazard pay and health benefits, and a face mask or shield mandate. “If we allow this to continue, the company will remain completely disconnected from the interest of their workers, taking advantage of our fear and desperation in these trying times,” the email read. “No one would argue that the COVID outbreak is … Amazon’s fault, but the company has no excuse for such a cruel reaction to this pandemic.”

Concerns rise over impact of Texas power failure on spread of COVID-19 – Concerns are spreading over the potential for the disaster caused by last month’s winter storm – which forced people across Texas to huddle together in homes, cars and warming shelters and wait in long lines for food and water – to lead to an increase in COVID-19 infections. During the week that millions across Texas were without water and power, coronavirus case reporting plummeted in the state. Since then, the number of confirmed cases has risen sharply but it is still too early to confirm the cause of the uptick. Experts warn the circumstances during the storm were conducive to the development of a massive “superspreader” event. “There are very real possibilities that the coronavirus either had superspreader events or was more easily transmissible because people were congregated indoors for long periods of time,” Dr. Katelyn Jetelina, and epidemiologist at UTHealth School of Public Health in Dallas, told the New York Times. “It is a little bit worrying.” Without a way of keeping warm in their homes amid subfreezing temperatures, families were forced to temporarily stay with friends and family. The homeless had to choose between weathering the storm outdoors or staying in overcrowded warming shelters. Reports from multiple cities indicate thousands of people sought shelter during the cold. The Texas Tribune reported nearly 200 people took refuge at a convention center in Fort Worth. In Dallas, another convention center held about 650 people. Approximately 500 people were staying in emergency shelters in Austin, while one warming center in Houston housed almost 800 people. At the peak of the state’s water crisis, more than 14 million Texas did not have access to water. This means millions could not practice basic hygiene, something crucial in the middle of a pandemic. In fact, Texas’ water issues are ongoing. As of Monday, about 390,000 Texans are still under boil water advisories. Even in large cities like Houston, residents are entering their second week without water. “Even though the power is on and the water pressure is normalized, there are thousands of homes and apartments that have been affected because of busted pipes,” Houston Mayor Sylvester Turner reported in a press release Sunday. “They still do not have water, so there is a tremendous need.” Texas has yet to calculate the full impact of the storm, but experts note Texas’ infrastructure failure created conditions ideal for a rise in infections.

Biden Slams “Neanderthal-Thinking” Republicans Over Texas, Mississippi COVID Policy President Biden has slammed Texas and Mississippi for lifting COVID-19 restrictions, calling it “Neanderthal thinking.””I think it’s a big mistake…It’s critical, critical, critical that they follow the science…” said Biden. Newly minted CDC Director Rochelle Walensky wants residents of Texas and Mississippi to continue wearing face masks despite the governors there lifting COVID-19 restrictions amid a decline in cases.”I think we, the CDC, have been very clear that now is not the time to release all restrictions,” said Walensky during a White House pandemic briefing in response to a question about reopening Texas. “Every individual is empowered to do the right thing here, regardless of what states decide.”On Tuesday, Texas Governor Greg Abbott enraged the left after announcing that the state would lift its mask mandate and reopen businesses next week, while also banning counties from fining or jailing people who disregard local measures.Effective March 10, all businesses will be allowed to open at 100% of capacity, Abbott said during a media briefing in Lubbock on Tuesday. His executive order allows county judges to reinstate anti-virus rules should hospitalizations surge.

Houston Methodist finds multiple cases of significant coronavirus mutations, including Brazil strain — Houston Methodist discovered 28 cases of coronavirus variants in its latest batches of virus genomes sequenced from patients with positive COVID-19 tests, including what might be the state’s first confirmation of four cases of the Brazil variant known as P.1. Houston is the first city in the U.S. to have all the major variants documented by genome sequencing. “There is evidence to indicate that the Brazil P.1 variant may spread faster and be resistant to certain vaccines and monoclonal antibody therapies – much like the South Africa variant known as B.1.351 – and may still be able to cause disease in some people who are inoculated with Pfizer or Moderna vaccines,” said James M. Musser, M.D., Ph.D., chair of the Department of Pathology and Genomic Medicine at Houston Methodist. “The numbers of the major variants we have identified in our large sequencing study are disquieting. The genome data indicate that these important variants are now geographically widely distributed in the Houston metropolitan region.” To get ahead of the virus and detect mutations that may correlate with patient outcomes, such as causing more severe disease or detrimentally impacting antibody treatments and vaccines, Houston Methodist began sequencing strains of the COVID-19 virus from positive tests beginning in February 2020. Processing sometimes as many as 1,700 samples per week, Houston Methodist is leading the SARS-CoV-2 genome sequencing efforts in the U.S., thus far sequencing 20,453 of Houston’s coronavirus genomes since the start of the pandemic. In the most recent batches of 3,000-plus genomes, the U.K., South Africa and Brazil variants were detected. These three types represent the major “variants of concern” designated by public health and medical authorities. The concern is that these three variants may be more transmissible and perhaps less susceptible to some vaccines and monoclonal antibody therapies. The California and New York variants were also detected.Given the immediate community impact of these findings, a report was posted on the preprint server medRxiv. The manuscript, titled “Sequence Analysis of 20,453 SARS-CoV-2 Genomes from the Houston Metropolitan Area Identifies the Emergence and Widespread Distribution of Multiple Isolates of All Major Variants of Concern,” has also been submitted for peer-review to a medical journal.

The importance of refining our search for mutant coronavirus strains — The great Greek tragedian Sophocles said “Look and you will find it – what is unsought will go undetected.” This holds true today. In the Memphis regional area, local laboratory directors looked. We conducted COVID-19 testing with sequencing to identify mutant strains, and we found them. Since Jan. 1, we sequenced 453 random and selected samples, about 2.3% of the positive cases. We found 12 UK strains, 1 South African strain, 2 Brazilian P2 strain, 7 California strains and 1 New York strain. When we called our counterparts in sister cities, they had few or no reported mutant strains. They are simply not looking. They are not sequencing for mutant strains. Across America this is the norm. Over a year ago, when life was “normal,” COVID-19 was stealthily penetrating our country. CDC was woefully behind in testing and we did not act with sufficient urgency. The virus epidemiologically evolves through three critical stages: seeding, clustering and community transmission. Seeding occurs when a few cases from outside enter the region, as from China and Europe to the United States. Then there is clustering. Locally one case leads to others which can be linked with aggressive contact tracing. Lastly, there is community transmission when cases are occurring in large numbers with no easy identifiable common link. The consequences of letting the original virus evolve were devastating with over a half million Americans dead and trillions in economic losses in one year.

Coronavirus dashboard for March 3: as good news on vaccinations accumulates, the Dakotas already appear to be shambling towards herd immunity -There is more and more good news on the vaccination front. In addition to the fact that the single-dose Johnson and Johnson vaccine has been approved, President Biden has made use of the Defense Production Act to enlist competitor Merck in additional production of the J&J vaccine. Biden also announced that there would be enough vaccine produced to supply doses for every American adult by the end of May.Further, the pace of vaccination has picked up to new highs since the setbacks due to recent weather, with the 7 day average just short of 2 million per pay at 1.946 million as of yesterday:And just shy of 80 million doses have been administered – 78.6 million as of yesterday: By about Memorial Day weekend, the principal obstacle to herd immunity is going to be anti-vaxxers and other vaccine-hesitant people, primarily stupid GOPers. I wonder if by that time employers will make being vaccinated a condition of returning to work facilities.In the meantime, one other recent development has jumped out from the graphs: it looks increasingly like both North and South Dakota have shambled towards herd immunity already. That’s because both States’ levels of total infections look close to perfect representations of an “S”-shaped type of exponential curve called a logistical curve. This occurs when a population approaches a saturation point.Here’s the graphic evidence in a nutshell: Both North and South Dakota have the highest rate of *confirmed* infections at roughly 13% of their entire populations. Further, South Dakota is close to, and North Dakota is already among, the lowest 10 States for the level of new confirmed infections. Since neither one of these two jurisdictions is exactly known for their aggressive anti-COVID restrictions, we are either seeing a recent onset of panic among the populace after their late autumn outbreaks or else we are seeing a virus that is facing an ever-thinning number of susceptible individuals.Most notably, during the autumn outbreaks At least South Dakota had close to a 60% positivity rate among people who were tested, which went on for several weeks – where 3% is the rate at which it is thought that testing is probably picking up close to all actual infections: In other words, during the weeks that roughly 10% of their entire populations are *confirmed* to have contracted the disease, it’s entirely likely that some multiple of that percentage were in fact infected, but either weren’t able or just didn’t bother, to get tested. If during those weeks for every one confirmed positive there were 4 actual but unconfirmed infections, then by Christmas an outright majority of the population of both North and South Dakota had actually contracted the disease.I want to emphasize that I’m not claiming that either State has actually arrived at herd immunity yet. For that to be the case I would expect the rate of current infections to be closer to 1 in 100,000 daily than 10 in 100,000 – and I would expect to see continuing declines, which really hasn’t been the case in the past several weeks. And I am *certainly* not claiming that the result is the case of good government! Far from it, both North and South Dakota have among the highest confirmed death rates from COVID at roughly 1 death for every 500 persons, putting them in the top 10 States: I would love to see what a comparative graph of excess deaths above normal looks like for those 10 States because I suspect that a significant part of the Dakotas’ death toll was never reported.

March 4 COVID-19 Test Results and Vaccinations — NOTE: The Covid Tracking Project will end daily updates on March 7th.From Bloomberg on vaccinations as of Mar 4th. “In the U.S., more Americans have now received at least one dose than have tested positive for the virus since the pandemic began. So far, 82.6 million doses have been given. In the last week, an average of 2.04 million doses per day were administered.”Here is the CDC COVID Data Tracker. This site has data on vaccinations, cases and more. The US has averaged 1.5 million tests per day over the last week. The percent positive over the last 7 days was 4.2%. Based on the experience of other countries, for adequate test-and-trace (and isolation) to reduce infections, the percent positive needs to below 1%, so the US has far too many daily cases – and percent positive – to do effective test-and-trace. There were 1,595,613 test results reported over the last 24 hours.There were 65,487 positive tests.Over 7,000 US deaths have been reported in March. See the graph on US Daily Deaths here.This data is from the COVID Tracking Project.And check out COVID Act Now to see how each state is doing. (updated link to new site) This graph shows the 7 day average of positive tests reported and daily hospitalizations. The dashed line is the post-summer surge low for hospitalizations.

One year since pandemic hit New York, new strain emerges in upper Manhattan – A new strain of the coronavirus, known as B.1.526, is proliferating vigorously across New York City, after having originated in February in a part of upper Manhattan known as Washington Heights. “I am concerned about its immune escape,” Dr. Eric Topol told Yahoo News, a reference to the strain’s heightened ability to evade the body’s antiviral armaments, including a vaccine. Vaccines remain broadly effective against the coronavirus, including B.1.526, but the emergence of new varieties will require constant vigilance from virologists. The eventual goal is a universal coronavirus vaccine that could defang any and all versions of the spiky pathogen. The new variant’s arrival comes along exactly a year after New York City began reporting coronavirus cases. The city became the epicenter of the nation’s fight against the pandemic, and it has only recently begun to emerge from months of life under lockdown. Restaurants have been allowed to seat diners inside only sinceFebruary. “The variants are the X factor here,” New York City Mayor Bill de Blasio said Tuesday, even as he warned that people should not attribute “mythological powers” to the new coronavirus variants. Public health officials have maintained that proper face coverings and social distancing remain effective in preventing transmission. “There’s nothing different that we need people to do in New York,” said Dr. Jay Varma, an adviser to the mayor on the pandemic. For emphasis, he held up his face covering: a magenta cloth mask and, underneath it, an ordinary surgical mask. Public health officials now believe that double masking should be the norm. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, raised concerns about the new variant during a Monday briefing by the White House coronavirus task force. The Brooklyn-born immunologist said that the strain was “now gaining” and the Biden administration was taking it “very seriously.”

Scientists Discover Mutation of U.K. Coronavirus Strain in Oregon –SCIENTISTS IN OREGON have discovered a mutated version of the highly transmissible variant of COVID-19 first discovered in Britain.Researchers have identified just one case of the variant in Oregon, but genetic analysis suggests it was contracted from the community and did not originate in the patient. They also warned that this variant has a mutation that may make it less susceptible to vaccines. The find was published in a database shared by scientists.The U.K. variant of the coronavirus was first detected in September and has been spreading rapidly across the U.S., currently accounting for at least 2,500 cases in 46 states, according to The New York Times. However, this version of that variant appears to be more contagious and more deadly than the original version and could account for most of the infections in America in the near future. Discovered in a patient in Portland, it is similar to the U.K. strain but carries a mutation seen in variants of the virus being spread in South Africa, Brazil and New York City. This mutation has also already been observed in Britain. The mutation was in a sample scientists collected from an outbreak in a health care setting. Of the 13 samples analyzed, 10 were the U.K. strain and one was the new mutation. “We didn’t import this from elsewhere in the world – it occurred spontaneously,” Brian O’Roak, a geneticist at Oregon Health and Science University who led the work, told the Times. The discovery is “of growing concern” because clinical trials in South Africa have indicated that the current COVID-19 vaccines could be less effective against the mutation. However, Pfizer and Moderna have already begun testing new versions of their vaccines against variants.

Pfizer’s Sordid Vaccine Sales Practices in Latin America Could Be a Big Boon for China and Russia Vaccine politics could end up nudging countries in the region even deeper into China’s orbit. As vaccines fail to materialise in many countries, doctors turn to cheap, widely available off-patent drugs such as Ivermectin.It is a time-honoured custom of business that manufacturers provide certain basic guarantees to prospective buyers about their product’s quality and safety. But U.S. pharma giant Pfizer wants to turn this on its head as it sells its experimental mRNA vaccine to desperate governments around the world. For Pfizer, it’s the buyer – not the seller – that should provide all of the guarantees. And that includes countries putting up sovereign assets, such as federal bank reserves, embassy buildings and military bases, as insurance against the cost of any future legal cases involving Pfizer BioNTech’s vaccine, reports the Bureau of International Journalism (TBIJ):In the case of one country, demands made by the pharmaceutical giant led to a three-month delay in a vaccine deal being agreed. For Argentina and Brazil, no national deals were agreed at all. Any hold-up in countries receiving vaccines means more people contracting Covid-19 and potentially dying.Officials from Argentina and the other Latin American country, which cannot be named as it has signed a confidentiality agreement with Pfizer, said the company’s negotiators demanded additional indemnity against any civil claims citizens might file if they experienced adverse effects after being inoculated. In Argentina and Brazil, Pfizer asked for sovereign assets to be put up as collateral for any future legal costs.One official who was present in the unnamed country’s negotiations described Pfizer’s demands as “high-level bullying” and said the government felt like it was being “held to ransom” in order to access life-saving vaccines.Campaigners are already warning of a “vaccine apartheid” in which rich Western countries may be inoculated years before poorer regions. Now, legal experts have raised concerns that Pfizer’s demands amount to an abuse of power.“Pharmaceutical companies shouldn’t be using their power to limit life-saving vaccines in low- and middle-income countries,” said Professor Lawrence Gostin, director of the World Health Organization’s Collaborating Center on National and Global Health Law. “[This] seems to be exactly what they’re doing.”

It’s in America’s best interest to lead global COVID-19 vaccine distribution — Although we now have the tools we need to end the coronavirus pandemic – the COVID-19 vaccines that have been authorized and put to use, along with social distancing, masking, and other public health guidelines – we are now facing the growing threat of new COVID-19 variants. Here in the U.S., the South African variant of COVID-19 has been detected in multiple states, and in New Jersey, one person who hadcontracted the UK COVID-19 variant has already tragically passed away. We know that the more this virus continues to spread unchecked throughout the world, the more opportunities there will be for it to mutate into new strains – strains that have the potential to be more infectious, more deadly, and more resistant to existing vaccines.That’s why our humanitarian interest in ending the global pandemic – averting hundreds of thousands of needless deaths in poorer countries and ending the global economic calamity that is on track to push 170 million more people in the developing world into poverty – now aligns exactly with our self-interest.As we work here in the United States to get this virus under control and ramp up vaccine distribution in every state and every community – and especially expand access for Black and Brown communities who have been hardest hit by the virus – we also need to lead a cooperative, global effort to make more vaccines available everywhere. Doing that means making more vaccines. While wealthy countries have claimed the vast majority of COVID-19 vaccines currently available, many low-income countries have been unable to reserve enough doses to even cover the most vulnerable portions of their population in the near future. Despite important efforts to ensure some vaccines are made available for poorer countries, on our present trajectory it may take four years for everyone to get vaccinated, with the poor last in line. So rather than focusing only on how to allocate a limited supply of vaccines, we need to think about how the United States can spearhead an effort to produce as much as the world needs, as fast as possible. The U.S. government, under the leadership of President Biden, has authority under existing law to do things that will dramatically ramp up global vaccine access.

Japan urges China to waive anal swab virus test – The Japanese government has asked China not to conduct coronavirus tests using anal swabs on Japanese people visiting the country. Chief Cabinet Secretary Kato Katsunobu told reporters on Monday that the government had made the request to the Chinese Foreign Ministry and Beijing city authorities. Kato said China is carrying out such tests on people in quarantine and some of those who enter the country. He explained that the Japanese Embassy in Beijing has been contacted by Japanese nationals who said they had to undergo the procedure and suffered significant psychological strain. Kato said Chinese officials have not responded to Japan’s request and that the government will continue to urge the change. He also said the government doesn’t know how many Japanese have undergone this type of test. He added that it has not been confirmed whether other countries conduct such tests. Chinese Foreign Ministry spokesperson Wang Wenbin told reporters on Monday that China is adjusting its preventive measures from a scientific viewpoint, depending on the infection situation. Wang did not mention whether authorities will waive the procedure. Chinese media quote experts as saying that samples taken from infected people by anal swabs remain positive longer than those taken by nasal and throat swabs, which helps prevent officials from overlooking carriers of the virus.

China Mandates Anal Swab COVID Tests For All Visitors, Despite “Psychological Pain” –Amid two international relation debacles:

• 1) US diplomats were forced (China has denied forcing them) to undergo an anal test for COVID-19 in order to enter the country.
• 2) Tokyo has asked Beijing to stop performing COVID-19 anal swabs on its citizens after complaints that the procedure causes “psychological pain.”

Chinese officials have decided to make the humiliating anal swab tests for the coronavirus mandatory for almost all international arrivals.Chinese health experts claim the anal swab is much more accurate than a nasal cavity or cheek swab and can avoid ‘false negatives’ which has been a trend with the more common tests. Chinese officials have recently identified the anal swab as the #2 (no pun intended) most prominent COVID test in the country. “Chinese citizens are clenching up at an invasive new form of COVID-19 testing in the country: anal swabs,” one international report noted.It’s yet unclear just how many American diplomats were subject to the “probe”.As BBC describes, “Anal swabs involve inserting a cotton swab 3-5cm (1.2-2.0 inches) into the anus and gently rotating it.”

100,000 Spanish dead in pandemic: PSOE-Podemos regime ends restrictions – Over 100,000 people have died in Spain as a result of the coronavirus pandemic, according to Spain’s National Institute of Statistics (INE), an official state agency. The INE reports that in the year between 9 February 2020 and 13 February 2021, there were a total of 471,447 deaths in Spain, 103,512 more than in the same period the previous year. February 13 also marked a year since the first officially recognised coronavirus death in Spain, that of a 69-year-old man from the town of L’Eliana, Valencia, recently returned from a trip to Nepal. The INE figures back up findings by Spain’s funerary services, which report that between 14 March 2020 – when Socialist Party (PSOE) Prime Minister Pedro Sflnchez declared a state of alarm – and 19 January 2021, 119,113 lives were lost as a result of the pandemic. Juan Antonio Alguacil, a registered undertaker and member of the US National Funeral Directors Association announced the findings, declaring, “staff organisations of civil registries obtained this figure after determining that [in this period] an average of 383 people were registered every day who had died from coronavirus.” Alguacil also denounced the PSOE-Podemos government for presenting a falsified death toll well below the figures he was announcing: “These figures exceed all the [official] calculations and, now more than ever, this information transparency is necessary.” The numbers “do not square and are not going to square” with the government’s figures, Alguacil stated, “because it is clear that they do not want us to know the real death toll.” Alguacil added, “The explanation for this is clear: all those in charge are a disgrace. Ultimately, I have come to think that we will never know the total death figures because right from the very first minute they were lying, they weren’t telling the truth, they were hiding things.” While news sites such as El Pa’s, El Mundo and El Diario were silent on the INE findings and Alguacil’s comment, instead parroting figures from the PSOE-Podemos government, the INE’s findings of over 100,000 deaths from the pandemic were widely reported in other press outlets. On 13 February, the date on which the INE figures are based, the government’s Spanish death count was only 64,747, almost 40,000 less than the INE’s excess mortality estimate. As of last Friday, this had risen to 68,813, still far below these other figures. An average of 291 coronavirus deaths were reported by the government every day last week and nearly 8,000 daily infections, bringing the total number of cases to well over 3 million. The Spanish Health Ministry only includes deaths in its official tally if the victim tested positive for the coronavirus, even though very few COVID-19 tests were carried out in the first wave of the pandemic last spring, and the government’s testing program remains inadequate today.10:06 AM

Brazil worsening pandemic: a threat to humanity – After crossing the grim milestone of 250,000 deaths and 10 million COVID-19 cases last week, Brazil has faced a sharp escalation of the pandemic in recent days. This week, the country has seen two record death tolls in a row, with a total of 1,726 on Tuesday, and 1,840 on Wednesday. As another 1,699 deaths were registered on Thursday, the death toll in Brazil reached 260,970. The country also recorded the highest number of new infections in the world on Wednesday, 74,376 in total, which was even larger on Thursday, surpassing 75,000. As Brazil rapidly emerges as the world epicenter of the pandemic, the country’s ruling class and all its political parties are clashing ever more directly with the scientific prescriptions for combating the coronavirus. Major Brazilian scientific authorities point to the catastrophic risks posed by the rampant growth of the virus in Brazil, not only to the country’s population, but to all of humanity. In an article published by in the Guardian on Wednesday, neuroscientist Miguel Nicolelis described Brazil as an “open-air laboratory for the virus to proliferate and eventually create more lethal mutations.” He added: “This is about the world. It’s global.” This “open-air laboratory” for the anti-scientific policy of herd immunity has already been responsible for the creation of a dangerous mutation of the coronavirus in the Brazilian state of Amazonas. A new study published in the scientific journal The Lancet suggests that this Brazilian variant, known as P.1, “might escape from neutralizing antibodies induced by an inactivated SARS-CoV-2 vaccine,” as is the case with the main vaccine being distributed in Brazil, Coronavac. The study also indicates that the new strain is “able to escape from responses generated by prior SARS-CoV-2 infection, and thus, reinfection may be plausible.” In another interview, conducted by El Pa’s just hours before the report of Wednesday’s record deaths, Nicolelis made a serious warning: “The possibility of crossing 2,000 daily deaths in the coming days is absolutely real. The possibility of crossing 3,000 deaths daily in the next few weeks is now real. If you have 2,000 deaths per day in 90 days, or 3,000 deaths in 90 days, we are talking about 180,000 to 270,000 people killed in three months. We would double the number of deaths. That’s already a genocide, it’s just that no one has used the term yet.” Faced with this prognosis, Nicolelis argues that “we need to enact lockdowns of at least 21 days and pay financial aid so that people stay home.” The most open enemy of this policy is Brazil’s fascistic President Jair Bolsonaro, who since May of last year has decreed a “war on lockdowns.” Responding to the soaring death toll of the last week, Bolsonaro denounced the spread of “panic” over the pandemic. “The problem is there, we are sorry. But you cannot live in panic,” he told his supporters and the far-right press on Wednesday. “As far as I’m concerned, we will never have a lockdown. Never,” he added. Expressing his intention to smash any policy of social isolation that is implemented in Brazil, the president tweeted on Thursday: “ESSENTIAL ACTIVITY IS EVERYTHING NECESSARY FOR A HEAD OF HOUSEHOLD TO BRING BREAD INSIDE HIS HOME!” The true meaning of this grotesque statement is: “essential activity is everything necessary for the financial oligarchy to pour exorbitant profits into their accounts!” Although Bolsonaro expresses it most nakedly, the policy of social murder is being widely adopted by governments all over Brazil. In an article entitled “Catarinenses are being sent to ‘death row’ in the name of the economy,” journalist Dagmara Spautz of NSC Total compared the situation in Santa Catarina, one of the most severe in the country, to the health care collapse in Bergamo, Italy, in March of last year: “There are no army trucks carrying our dead. But we have an army of people circulating from Monday to Friday, with few restrictions and high risk of infection. Meanwhile, the waiting line for ICU beds has already reached 260 people. …

Brazilian Covid variant in Scotland: Three Scots test positive for mutant strand ** THREE cases of the Brazil variant of Covid-19 have been detected in Scotland. Following a return to north-east Scotland from the South American country, three Scots tested positive for the mutant strain of coronavirus. All three have been self-isolating since their return to Scotland. The tests were completed in early February and passed to the UK’s advanced sequencing capabilities programme – which detected this new variant. Due to the potential concerns around this variant, other passengers on the flight used by the three individuals from London to Aberdeen are being contacted. These three cases are not connected to three cases also identified in England. Health protection teams, including local clinicians, have assessed each case and their contacts and are arranging protective measures for this small number of potentially exposed individuals. To provide an extra layer of safety, teams are ensuring people who could have been infected by these first line contacts are also isolated and tested. This is to ensure all possible precautions are taken as experts learn more about this particular variant. Clinical and trial data continues to be assessed to examine how the new variant may respond to current Covid-19 vaccines. Health Secretary Jeane Freeman said: “The identification of this new variant is a concern but we are taking every possible precaution. “We have identified these cases thanks to our use of advanced sequencing capabilities which means we are finding more variants and mutations than many other countries and are therefore able to take action quickly. “This new variant demonstrates how serious Covid is and reinforces the need to minimise the spread of the virus. “We would encourage everyone across the country to adhere to the necessary public health restrictions by staying at home except for essential purposes as this is the single best way of staying safe and stopping the spread of this virus. “It is now also illegal for anyone to travel to or from Scotland unless it is for an essential reason.

Study of Aggressive Covid-19 Strain in Brazil Suggests Limits of China Vaccine – WSJ – As an an aggressive coronavirus strain from the Amazon ravages Brazil, a preliminary study has provided the first evidence that the country’s principal vaccine, China’s CoronaVac, might not be as effective against it. The small-scale study, which has yet to be peer-reviewed, comes as doctors warn of a humanitarian catastrophe in Brazil over coming weeks, with surging deaths as the disease overwhelms hospitals across the country. Researchers from Brazil, the U.K., and the U.S., found that plasma from eight people vaccinated five months ago with CoronaVac “failed to efficiently neutralize” the new Amazonian strain, called P.1. The study didn’t show if CoronaVac can still stop people getting sick from the variant, one of the main goals of vaccination campaigns. While the study’s sample size was small and requires further testing, the fact that all eight samples produced the same result is a “notable phenomenon,” suggesting CoronaVac is less capable of thwarting infections of P.1 than of versions of the virus previously found in Brazil, said William de Souza, of the University of São Paulo in Ribeirão Prêto, one the study’s authors. Sinovac, the Chinese firm that produces CoronaVac, didn’t respond to requests for comment. In an interview with state-backed broadcaster CGTN that Sinovac released this week, Chief Executive Officer Yin Weidong said that, if necessary, it would take less time to develop a vaccine for the variants than from scratch.

Israel fears South African COVID strain spreading beyond control – Israeli efforts to stop the spread of the South African variant of the coronavirus, which included the shut down of Ben-Gurion International Airport last month, have brought little results, data shows. Closing Israel’s borders did not stop this coronavirus strain from entering: Dozens are being infected each day. Israel vaccine data shows it’s the only variant with less inoculation effectiveness.Over 450 cases of the infection have been diagnosed so far in Israel, and health professionals estimate that dozens more are being infected each day. The Health Ministry’s committees on vaccinations and the pandemic said two weeks ago that the variant was spreading beyond control.The focus on variants was supposed to prevent a scenario in which Israel would be forced to deal with a more infectious and virulent strain of the coronavirus that would turn out to be less sensitive to the Pfizer vaccine. But ministry experts had cautioned that shutting the airport would not prevent the strain from reaching the country. Israel had already missed out on stopping the entry of the British variant, which is responsible for 90 percent of newly confirmed COVID-19 cases. Now the South African variant has been identified in hundreds of patients despite airport measures and isolating passengers in hotels.

Speedy Variants Power Virus Surge Sweeping Europe (AP) – The virus swept through a nursery school and an adjacent elementary school in the Milan suburb of Bollate with amazing speed. In a matter of just days, 45 children and 14 staff members had tested positive. Genetic analysis confirmed what officials already suspected: The highly contagious coronavirus variant first identified in England was racing through the community, a densely packed city of nearly 40,000 with a chemical plant and Pirelli bicycle tire factory a 15-minute drive from the heart of Milan. “This is the demonstration that the virus has a sort of intelligence, even if it is a single-cell organism. We can put up all the barriers in the world and imagine that they work, but in the end, it adapts and penetrates them,’’ lamented Bollate Mayor Francesco Vassallo. Bollate was the first city in Lombardy, the northern region that has been the epicenter in each of Italy’s three surges, to be sealed off from neighbors because of mutant versions that the World Health Organization says are now powering another uptick in infections across Europe. The variants also include versions first identified in South Africa and Brazil. Europe recorded 1 million new COVID-19 cases last week, an increase of 9% from the previous week and a reversal that ended a six-week decline, WHO said Thursday. “The spread of the variants is driving the increase, but … also the opening of society, when it is not done in a safe and a controlled manner.” The so-called U.K. variant is spreading significantly in 27 European countries monitored by WHO and is dominant in at least 10 by the agency’s count: Britain, Denmark, Italy, Ireland, Germany, France, the Netherlands, Israel, Spain and Portugal. It is up to 50% more transmissible than the virus that surged last spring and again in the fall, making it more adept at thwarting measures that were previously effective, WHO experts warned. In Lombardy, which bore the brunt of Italy’s spring surge, intensive care wards are again filling up as more than two-thirds of new positive tests are of the UK variant, health officials said this week. After putting two provinces and some 50 towns on a modified lockdown, Lombardy’s regional governor announced tightened restrictions on Friday and closed classrooms for all age groups. Cases in Milan schools alone surged 33% in a week, the head of the provincial health system said. The situation is dire in the Czech Republic, which registered a record-breaking total of nearly 8,500 patients in the hospital with COVID-19 this week. Poland is opening temporary hospitals and imposing a partial lockdown as the variant has grown from 10% of all infections in February to 25% now. Kluge cited Britain’s experience as cause for optimism, noting that well-considered restrictions and the introduction of the vaccine have helped tamp down the variants there and in Israel. The vaccine rollout in the European Union, by comparison, is lagging, mostly because of supply problems.

Coronavirus latest news: UK most likely place in the world for mutant coronavirus variant, says health minister Britain is the most likely place in the world where a mutant strain of the coronavirus will occur due to the prevailing conditions, a health minister has said.Giving the stark assessment at Westminster, Tory frontbencher Lord Bethell said “if there’s one place in the world where a mutant variation is likely to happen it will be in an area where you have a high infection rate and a large amount of suppression of the virus by either a lockdown or a vaccine programme.”If you look around the world that country is most likely to be Britain and we must be on the balls of our feet to be prepared for unhelpful news on that front,” he said.The Conservative peer made his comments as a top scientist warned the risk of a dangerous new variant against which there was no defence was “eventually likely to be inevitable”.”We are not post-vaccine. We are at best mid-vaccine – 20 million people is an enormous achievement but there is a hell of along way to go,” the minister added.Here’s a run down of the day’s main stories…

• A further 242 people died within 28 days of testing positive for Covid-19 as of Thursday, bringing the UK total to 124,025.
• Separate figures – tracking fatalities where Covid-19 is mentioned on the death certificate – suggest a higher total of 145,000.
• Another 6,573 lab-confirmed cases of coronavirus are recorded in the UK, taking the country’s total to more than 4.2 million.
• A total of 20,982,571 people have now received their first dose of a coronavirus vaccine – and 963,862 have had their second jab.
• Around one in five people aged 16 to 64 in England are likely to have had their first dose of Covid-19 vaccine, NHS England figures suggest.
• Police have arrested three men on suspicion of theft after “boxloads” of coronavirus tests destined for schools were stolen from a lorry.
• The EU’s vaccination campaign should be able to inoculate “all those who need” by the end of summer or perhaps sooner, an official said.
• Italy will administer a single vaccine dose to those recently recovered from Covid-19, a move apparently aimed at saving shots amid a stuttering EU inoculation rollout.
• Iraq has signed an agreement with Russia to import 1 million doses of the Sputnik V coronavirus vaccine, Iraq’s oil ministry said.
• South African police have seized hundreds of fake Covid-19 vaccines and arrested four suspects in connection with the haul, Interpol said.

Jokowi: 4.6 Million Doses of AstraZeneca Vaccine Will Land This Month – – President Joko “Jokowi” Widodo announced that the Covid-19 vaccine made by AstraZeneca will soon arrive in Indonesia this March 2021, totaling 4.6 million doses of ready-to-use vaccines. “Inshallah, there will be another 4.6 million doses of ready-to-use vaccine from AstraZeneca this March. This means, [the national] vaccination can be accelerated,” said the President on Thursday evening, March 4, 2021. Indonesia had already secured 38 million doses of the Covid-19 vaccine. A total of 3 million doses were ready-to-use vaccines, and 35 million in the form of bulk raw materials that were processed by state pharmacy PT Bio Farma. Jokowi hoped that the arrival of this vaccine will speed up the national target to inoculate 60-70 percent of the population or as many as 181.5 million people. Thus, the country requires 364 million doses to achieve the target. Earlier reported, the upcoming arrival of the AstraZeneca vaccine was carried out through multilateral cooperation with Global Alliance for Vaccine and Immunization (GAVI)-Covax Facility in the first quarter of this year. The Health Ministry’s spokesperson Siti Nadia Tarmizi stated on Sunday, January 31, that the AstraZeneca vaccine was safe for use on elderlies aged over 60 years.

India administers over 17 million vaccines to date – India has reported 17,407 new covid-19 infections in the last 24 hours, even as 1,093,954 vaccine doses were given till 7pm on Thursday, the 47th day of the nationwide covid-19 vaccination. India has so far administered over 17.7 million covid-19 vaccine doses through 3,23,064 sessions. India’s active caseload was at 11,171,166, or 1.55% of total positive cases. At least 89 deaths were reported in the last 24 hours. Six states account for 85% of the cases, the number of patients identified with The surge in the mutant virus cases has been a cause of concern for health authorities amid the resurgence in daily case count after India saw daily infections decline to around 7,000 in end-January. A new modelling study published in the American Association for the Advancement of Science said the UK variant, which emerged in south-east England in November, is more transmissible than pre-existing variants. The authors warned that it will lead to large resurgences of covid-19 cases. “Without stringent control measures, including limited closure of educational institutions and a greatly accelerated vaccine roll-out, covid-19 hospitalizations and deaths across England in 2021 will exceed those in 2020,” it said. As on 15 February, the new strain accounted for 95% of new infections in the UK and has spread across at least 82 countries, including India. Public health experts expressed concern over the mutant strains and the recent surge in covid cases despite India rolling out the nationwide vaccination programme. “The coronavirus is mutating and spreading in the population because of reasons such as pressure of drugs, vaccines, immune-compromised hosts. These mutations sometimes become significant mutations in a particular country and with the movement of population these mutations also move as in the case of covid-19 as well. The main mutations that cropped up include those from the UK, South Africa, and Brazil. They’ve become endemic in their own countries and they’ve all shown different characteristics,” said professor N.K. Ganguly, president, Jawaharlal Institute of Post Graduate Medical Education and Research, and former director general of the Indian Council of Medical Research (ICMR). Ganguly said recently mutant strains were also identified in the US, the New York and California variants, but that the UK mutant has higher transmissibility, while the one from South Africa is more virulent. “They’re also creating a lot of challenges. For example, the US Food and Drug Administration brought out two documents a few days ago on how these mutations will affect diagnostics, surveillance, drugs, and vaccine programme. They will necessitate a shift in some of the practices being observed currently,” said Ganguly.

A behind-the-scenes look at why Canada delayed 2nd doses of COVID-19 vaccines — Danuta Skowronski was poring over Pfizer-BioNTech vaccine data on a Friday night in mid-December when she had an “aha!” moment. The epidemiology lead at the British Columbia Centre for Disease Control realized she could actually “correct” the data Pfizer had submitted to the U.S. Food and Drug Administration on the effectiveness of just one dose of its vaccine. In clinical trials, Pfizer couldn’t accurately determine the efficacy of a single shot because participants had already received their second dose after three weeks, and there was no comparative one-dose study done. Pfizer reported an efficacy of 52 per cent for one shot, compared to the more commonly cited 95 per cent after the second. But Skowronski, who has been working on vaccine effectiveness analyses for more than 15 years, realized the company had included in its analysis the two-week time period immediately after vaccination – before the body’s immune response typically kicks in. She told CBC News vaccines are never expected to protect “instantaneously,” and that there is always a “grace period” of a couple of weeks that factors into vaccine effectiveness. “What we found was that they were underestimating the efficacy of the first dose, and rather than the efficacy being 52 per cent, it was actually 92 per cent, ” she said. “For us, that was a game changer.” The finding led the National Advisory Committee on Immunization (NACI) to change the recommended time between doses of COVID-19 vaccines from three weeks to an unprecedented four months. B.C. announced it would be delaying second doses earlier this week. Ontario, Quebec, Alberta, Manitoba and Newfoundland and Labrador quickly followed suit. Canada is now an outlier in the global vaccination rollout. No other country in the world has delayed second doses up to four months, and there is no evidence yet on the long-term effect it could have on immunity to COVID-19. NACI says if second doses are stretched to four months across the country starting this month, close to 80 per cent of Canadians over 16 could get at least one shot of the Pfizer-BioNTech or Moderna vaccine by the end of June.But Canada’s chief science adviser, Mona Nemer, says the decision to delay doses amounted to a “population level experiment.””The comment from the chief science adviser was most unfortunate,” said Skowronski. “It did not reflect the careful risk-benefit analysis that went into this decision, and frankly, that is a science and an art to be able to do that.”

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