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World

Vaccination Delays Put Global Rebound at Risk

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Timetables for vaccinating enough people to effectively curb Covid-19 are slipping in many countries, raising fears that a large portion of the world will still be battling the pandemic and its economic effects well into 2022 or beyond.

While the U.S. and some other mostly small countries are making progress toward vaccinating most of their populations by late summer, health experts and economists are concluding that much of the planet—including parts of Europe, Asia and Latin America—face a longer slog.

Places from Germany to Mexico are running into serious problems sourcing sufficient vaccines. Other countries with low caseloads are less pressed to start vaccination campaigns and aren’t eager to reopen borders anytime soon.

Just 10 countries are on track to vaccinate more than a third of their population this year. People being vaccinated in Salisbury Cathedral in the U.K. in recent days.



Photo:

neil hall/EPA/Shutterstock

At the current rates of vaccination, only about 10% of the world would be inoculated by the end of the year and 21% by the close of 2022,

UBS

says. Just 10 countries are on track to vaccinate more than one-third of their population this year.

The UBS data includes hard-hit middle-income countries such as South Africa where vaccination rates are expected to be painfully slow, though some countries it measured are expected to increase the pace of vaccinations soon.




Economies on target to vaccinate one-third of the population in 2021

Economies on target to vaccinate one-third of the population in 2021

Economies on target to vaccinate one-third of the population in 2021

Economies on target to vaccinate one-third of the population in 2021

But richer regions such as Europe are also facing delays. European officials in recent days watched as their goal of vaccinating 70% of the population by summer looked unachievable after doses ran out in some places, with just 2% of European Union residents covered so far. 

The differing pace in vaccine rollouts world-wide raises the prospect of divergent economic fortunes for the world’s main economic blocs, at least in the near term. The U.S. economy could grow by 5.1% this year, according to International Monetary Fund forecasts, but recoveries of the eurozone and developing economies have become more uncertain given vaccination delays.

The U.S. and a few other countries could wind up enjoying many benefits of herd immunity but still be unable to fully mend their economies because they are waiting on other places to catch up. With borders shut globally, some businesses even in vaccinated countries would have to rely on domestic demand.

“So long as the pandemic terrorizes part of the world, normality will not be restored anywhere,” said

Erik Nielsen,

chief economist at UniCredit Bank.

Uneven vaccine distribution also means that Covid-19 could keep circulating for years, especially in nations such as Brazil and South Africa, where new infections are vastly outpacing inoculations. Both have become breeding grounds for more infectious new strains. In time, virologists expect the virus could mutate—in particular, modifying the shape of its outer protein spikes—an outcome they fear might ultimately render our current vaccines less effective.

Many scientists and policy makers predicted immunization programs would take a long time. Still, the unusually rapid development of vaccines raised hopes that 2021 would mark a return to normal for most of the world. Economists began upgrading their forecasts.

Global growth is still expected to be strong this year, and residents of many countries including the U.S. will undoubtedly see restaurants filling up and other signs of progress. The recovery is already so strong in some places that supplies of semiconductors are running short.

Mexico, where gravediggers buried a Covid-19 victim in Panteón Sueños Eternos in November, has immunized just 0.5% of its population.



Photo:

Briana Sanchez/The El Paso Times/Associated Press

The U.S. and U.K. also experienced some early delays rolling out vaccine campaigns, only to see distribution pick up as snags were worked out.

Still, the outlook is growing considerably more uncertain elsewhere.

Borders are closing across much of Europe. New Zealand Prime Minister

Jacinda Ardern

said last week the country would continue to bar international visitors through most of 2021. A senior Australian health official recently made a similar prediction, in part because it isn’t clear whether Covid-19 vaccines prevent transmission of the virus or just stop people from getting severely ill.

Even the world’s fastest-vaccinating country—Israel—remains in a lockdown, with international flights banned indefinitely.

“This assumption that when Jan. 1 came we could just burn the old calendar and everything would be fine is proving to be a wildly optimistic view,” said

Robert Carnell,

an ING Group economist in Singapore.

Brazil, where new infections far outpace inoculations, has become a breeding ground for new strains, with hospitals like this one in Manaus on the front lines.



Photo:

Sandro Pereira/Fotoarena/Zuma Press

The World Bank has forecast that remittances to the developing world—a vital lifeline—will fall 7.5% this year, after a 7% drop in 2020. Concert halls and schools might remain closed longer than expected.

Hotels in places such as Southeast Asia and the Pacific aren’t expecting business to fully rebound until the middle of next year. Many international students could be absent from university campuses until mid-2022.

“I’ve just been on the phone this morning to some lovely American clients,” said Mark Fraenkel, who owns Blue Dive Port Douglas, a scuba-diving business near Australia’s Great Barrier Reef. “I said, ‘Let’s not book you for 2021. We’ll just have to cancel.’ ”

Shippers, including DHL, are expecting air freight to get tighter for the first part of this year, not better, because fewer planes are flying to carry cargo. Discussions at the United Nations to normalize air traffic by creating a vaccine passport or even a common set of rules for tests are snagged in U.N. bureaucracy.

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Intercontinental flight traffic won’t return to 2019 levels until 2023 at the earliest, the International Air Transport Association forecasts.

“We’re talking about years rather than months, and it’s partly related to the two-speed vaccination,” said Senior IATA Vice President Nick Careen. “We need governments to agree on a process; we can’t continue to operate like this.”

A central problem is that it is proving hard to scale up vaccine production quickly. Delayed deliveries can have domino effects on other buyers.

In Europe, where several top vaccines are made, production issues emerged last month with factories saying they couldn’t keep up. Frustrated, the EU introduced new measures on Friday that would let it block exports to wealthier countries, such as Canada, Japan or the U.S.

Slow production at a Belgian plant has meant Canadian officials recently received 70% fewer doses of a

Pfizer

vaccine. The same troubles have left Japan struggling to get doses it needs to vaccinate its population by the end of June, a crunch that may mean few fans for Tokyo’s Summer Olympics in July.


“I can’t tell you which month,” said

Taro Kono,

the minister in charge of Japan’s vaccine rollout, when asked when the general public could get immunized.

China also faces challenges. Although it has started inoculations using homegrown vaccines, without providing a firm timeline for reaching herd immunity, approvals and production arrangements have come more slowly than anticipated, according to Trivium China, a consultancy.

In one sign of the difficulties, the Beijing government’s talent office said that vaccine producer Sinovac is struggling to hire new staff.

“The main issue is production volume,” said

Guo Wei,

deputy secretary general of the health-care logistics association at the government-backed China Federation of Logistics and Purchasing, in an interview. He said that based on production estimates by China’s vaccine makers, the country wouldn’t be able to reach herd immunity this year.

Trivium estimates that a total of 850 million doses is the high end of what is possible for China this year, while administering at least 1.68 billion doses would be considered full inoculation. The Economist Intelligence Unit doesn’t rule out some major Chinese cities reaching herd immunity this year but estimates that the country as a whole likely won’t be able to reach it until late 2022.

Any production delays in China could affect other countries. Morocco planned to vaccinate 80% of its population in the coming months, in part using Chinese vaccines, but officials say they haven’t received all the supplies they need and have blamed manufacturers that can’t keep up.

Analysts doubt other countries can reach their stated targets. In Indonesia, officials want to vaccinate 65% of a population of 270 million in 15 months, which would more likely take three to four years, according to analysts at IMA Asia. The Philippines aims to vaccinate 70 million people this year.

A nurse vaccinated a health-care worker in Liege, Belgium, as European Union officials grow concerned that just 2% of EU residents have been vaccinated. 



Photo:

Francisco Seco/Associated Press

“We doubt if half the 2021 goal can be reached,” IMA Asia said in a recent report.

Latin America’s two largest countries, Brazil and Mexico, have so far immunized just 0.8% and 0.5% of their populations, respectively. Argentina planned to receive five million doses of Russia’s Sputnik V vaccine in January, but only 800,000 have been delivered because of production delays in Russia.

Nigeria’s 206 million people have only one delivery scheduled, of 100,000 doses, expected next month.

Meanwhile, more people are putting plans on hold.

Mohammed Waqas,

a 25-year-old in London, initially aimed to start a master’s program in teaching at an Australian university in February. Mr. Waqas decided to defer enrollment until at least July because Australia’s border is closed to most international visitors. If the border isn’t open by July, he could defer until 2022.

“I’m one year behind where I would like to be,” Mr. Waqas said.

—Chao Deng, Peter Landers and Samantha Pearson contributed to this article.

Write to Drew Hinshaw at drew.hinshaw@wsj.com and Mike Cherney at mike.cherney@wsj.com

Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

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Business

United Airlines warns thousands of workers that their jobs are at risk

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A United Airlines Boeing 737-800 and United Airlines A320 Airbus on seen approach to San Francisco International Airport, San Francisco.

Louis Nastro | Reuters

United Airlines said the jobs of roughly 14,000 employees are at risk when a second round of federal aid expires this spring, the latest sign of how the industry is struggling to regain its footing in the coronavirus pandemic.

Companies are legally required to inform employees if their jobs are at risk in advance and it does not mean they will ultimately lose their employment. United is turning to new voluntary measures to reduce its headcount.

United and American Airlines recently started recalling thousands of employees they furloughed when the first round of government payroll support expired in the fall. Congress approved additional aid last year for the industry, on the condition that they call back furloughed workers and maintain payrolls until March 31. United told employees last year that the callbacks would likely be temporary.

“Despite ongoing efforts to distribute vaccines, customer demand has not changed much since we recalled those employees,” the airline said in a staff note Friday, which was seen by CNBC. “When the recalls began, United said most recalled employees would return to their previous status as a result of the fall furloughs around April 1.”

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Health

With COVID risk elevated in Bay Area, should you upgrade or double your mask?

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The Bay Area’s worst coronavirus surge yet is finally starting to ease, but in its wake, pandemic risks are higher than before.

And as the region starts to reopen, experts say it’s time to double down on safety measures — which may include upgrading or even doubling your mask for maximum protection.

Such measures are important, they say, because case levels remain high, California’s vaccine rollout has been rocky, and a number of new variants are popping up in the state and around the country. One from the United Kingdom is more infectious and could become the dominant strain by March. One found and being studied in the Bay Area, and others from Brazil and South Africa, could possibly evade antibodies created by the new coronavirus vaccines or maybe even reinfect people a second time, experts say.

“We are at an urgent period of transmission because … we are in our third and worst surge of the pandemic, and our vaccine rollout is still not rapid enough,” said Monica Gandhi, an infectious disease specialist at UCSF. “It is an incredibly important time to do everything we can to tamp down transmission.”

Experts are urging the public to ramp up the familiar safety measures of social distancing, hand washing and wearing masks. With more virus transmission everywhere and the new variants possibly leading to higher rates of infection, vigilance is more important than ever.

In particular, experts are offering new recommendations on whether your masking is up to snuff.

Several European countries, including Germany and Austria, are now requiring everyone to wear surgical or N95 grade masks. Some Asian countries are mailing high-quality masks to their residents.

Gandhi worked with Linsey Marr, an expert on airborne transmission of viruses and a professor of civil engineering at Virginia Tech, on a scientific article about the importance of and science behind face masks. They offer advice on what types of face masks offer the best protection.

What’s the best face mask out there?

Gandhi said N95 masks are the gold standard, but it’s still challenging for the general population to obtain them because they are in shorter supply, they have to be fit-tested, and can be uncomfortable because they are so snug.

Mark Holton wears two masks in Wyoming County, Pa.

Mark Moran / Associated Press

Can I get close to an N95 mask? What about cloth and surgical masks?

The article by Gandhi and Marr cites a study conducted by Marr and some graduate students that tested the effectiveness of 10 different masks. Based on the findings, they recommend a high-quality surgical mask or cloth mask with at least two layers with high thread count for basic protection.

Who should be double-masking?

During an appearance this week on NBC’s “Today Show,” top U.S. infectious disease expert Dr. Anthony Fauci said that wearing two masks “just makes common sense that it likely would be more effective” at preventing droplets from getting through.

But Gandhi said she doesn’t think it’s necessary for everyone to wear two masks all the time, and that “buy-in of masks in this country is still uneven and complicated.” Instead, her recommendations focus on certain individuals and situations:

• Medically vulnerable and older individuals.

• Individuals who work in crowded indoor conditions such as meat processing plants and restaurant kitchens.

• Those in indoor environments with others not in their household, in an area of high transmission. Most of California is in a period of high transmission right now, including the Bay Area.

When looking at the trio of masking, distancing and ventilation, one can diminish the other, Gandhi said. So if you are wearing a single mask but are outdoors, that makes up for the mask. If you are inside and double-mask, that makes up for lack of ventilation.

But if you’re particularly concerned, she said, do what makes you feel most comfortable.

“Anyone who feels more worried about the virus, it’s a great thing to do,” she said.

How can I get the best protection?

According to the study cited by Gandhi, those with concerns have several options for maximum protection:

A tight-fitting cloth mask over a surgical mask, which acts like a filter. Surgical masks tend to fit looser than other masks, so this would improve fit and add protection.

A three-layer, tightly woven cloth mask with a filter pocket. Vacuum or HEPA filters can be used, and many companies now sell affordable, precut filter inserts for masks.

The study found that if the masks fit well, “these combinations should produce an overall efficiency of >90% for particles 1 mm and larger, which corresponds to the size of respiratory aerosols that we think are most important in mediating transmission of COVID-19,” according to the article.

According to the CDC, studies have shown that multilayer cloth masks can block 50% to 70% of large and fine droplets. Masks with multiple layers of tightly woven cloth performed better than single layer masks, filtering almost 50% of fine particles. Surgical masks are 60% to 70% effective at protecting others, and 50% effective at protecting the wearer, according to studies.

Gandhi stressed that users should pair a surgical mask with a cloth mask because a surgical mask blocks viruses electrostatically, while a cloth mask blocks them physically, so layering them uses two different mechanisms. The same goes with the filters and the cloth masks. And when looking for surgical masks, make sure they are made of polypropylene.

Is layering more than two masks even better?

There’s no need to go overboard. Layering more than two masks has “zero utility,” Gandhi said, and the more you pile on, the harder it is to breathe.

What about KN95 masks?

Other N95 versions are offered, including the KN95 from China and the KF94 from South Korea. Gandhi said they are exactly the same as N95 masks but don’t fit as tightly, so people who want more protection should put a cloth mask over them.

Kellie Hwang is a San Francisco Chronicle staff writer. Email: kellie.hwang@sfchronicle.com

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Health

CDC says risk of coronavirus in schools is small

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New research published Tuesday by the U.S. Centers for Disease Control and Prevention (CDC) suggests the risk of COVID-19 spread in classrooms is relatively low, adding new questions over the continued closure of in-person education across the nation.

Published in the JAMA medical journal, researchers discuss the results of several studies looking at COVID-19 exposure among children under the age of 18. One case-controlled study was in Mississippi. Out of 397 participants, 154 were diagnosed with a COVID-19 infection. Attending close social gatherings or interacting with members outside of their households was a leading cause of infection, but in-person school attendance was not. 

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Similar results were recorded when examining 11 school districts in North Carolina, featuring 90,000 students and staff occupying school classrooms for nine weeks. 

Researchers found that within-school transmissions were rare, with only 32 COVID-19 infections traced back to exposure in school settings. A far greater number of infections, 773, were linked to other community sources of transmission.

Another report out of Wisconsin showcased low transmission among 17 K-12 schools — so long as students and faculty wore masks.

“The investigators concluded that these data, together with the observation that rates of infection among teachers and nonteachers were generally similar, indicated that schools were not associated with accelerating community transmission,” researchers wrote.

However, other reports outside of the U.S. acknowledge outbreaks that occurred in school settings. Contributing factors were crowded classrooms, non-universal face mask usage and recirculated air in closed environments.

Many U.S. schools that have opted to reopen have enforced public health precautions and worked to shrink class sizes to reduce crowded indoor situations. 

President Biden announced new guidelines with the U.S. Department of Education and Department of Health and Human Services with the goal to open schools at the K-8 level in about 100 days. 

Biden asked Congress for about $130 billion in school funding for K-12 schools to help cover reopening costs and support teachers and faculty who have been laid off.

Meanwhile, CDC researchers conclude that while educational settings have a low risk for transmission, congregate living communities, namely college dorms, show higher levels of COVID-19 transmission risk.

A major contributing factor that will support reopening schools will be to reduce transmission outside of the classroom, meaning refraining from being in crowded public spaces and adhering to public health measures. 

“All recommended mitigation measures in schools must continue: requiring universal face mask use, increasing physical distance by dedensifying [sic] classrooms and common areas, using hybrid attendance models when needed to limit the total number of contacts and prevent crowding, increasing room air ventilation, and expanding screening testing to rapidly identify and isolate asymptomatic infected individuals,” authors concluded.

Additionally, while carefully engineered classroom settings may boast a low COVID-19 transmission rate, other school-based activities, including sports, are still high risks for outbreaks. 

“With 2 vaccines now being distributed under Emergency Use Authorizations and more vaccine options anticipated to be available in the coming months, there is much hope on the horizon for a safer environment for schools and school-related athletic activities during the 2021/22 school year,” the report authors forecast. “Committing today to policies that prevent SARS-CoV-2 transmission in communities and in schools will help ensure the future social and academic welfare of all students and their education.”

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Health

Air pollution linked to increased risk of irreversible sight loss

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Researchers from University College London (UCL) found that even low exposure to air pollution across England, Scotland and Wales appears to impact the risk of age-related macular degeneration (AMD).

AMD is the leading cause of irreversible blindness among people over 50 in high-income countries. AMD is linked to the loss of central vision — needed for reading, performing fine detailed tasks and recognizing faces — and the biggest risk factors for the disease are genetics, old age and smoking.

Researchers found that people living in the most polluted areas were at least 8% more likely to report having the condition, in a study published Monday in the British Journal of Ophthalmology.

The team studied data from 115,954 people aged between 40-69, who had participated in the UK Biobank, a large study of half a million people focusing on the medical diagnoses and biological measurements of participants.

Using eye measurements and data from questionnaires, experts studied those who said they did and did not have macular degeneration, and then compared the results to the amount of pollutants estimated to be at their residential addresses.

“People who live in a more polluted area report macular degeneration more frequently,” Paul Foster, a professor of glaucoma studies and ophthalmic epidemiology at UCL and senior author of the paper, told CNN.

Foster said that the main pollutants linked to macular degeneration were particulate matter PM2.5, nitrogen dioxide and oxide nitrogen.

PM2.5 is tiny particulate pollution that can move deep into the lungs when inhaled and enter the bloodstream. The particles, made up of dust, dirt, soot or smoke, originate from construction sites, unpaved roads, fields, smokestacks or fires, and can contain different chemicals. But most particles are a mix of pollutants from power plants, industrial and vehicle emissions.

Nitrogen oxides refers to nitric oxide gas and nitrogen dioxide gas, as well as other gaseous oxides containing nitrogen. The main source of these gases in urban areas are motor vehicle exhausts, indoor gas stoves and kerosene heaters.

Foster told CNN that the pollutants enter the body through the lungs, and seem to cause particular damage to the eyes because of high blood flow in the eye wall.

“It’s people breathing the stuff in, and it going down into the lungs, being absorbed into the blood, carried round in the blood,” he said.

“There’s definitely a relationship between the more disadvantaged members of society and higher risk of getting this condition,” he added.

Air pollution kills an estimated seven million people worldwide every year, according to the World Health Organization (WHO), which says such deaths occur largely as a result of increased mortality from stroke, heart disease, chronic obstructive pulmonary disease, lung cancer and acute respiratory infections.

WHO data shows that nine out of 10 people breathe air that exceeds guideline limits on high levels of pollutants.

Chris Inglehearn, a professor of molecular ophthalmology at the University of Leeds said that the UCL research is similar to a 2019 study from Taiwan. “Both show a link between air pollution and age-related macular degeneration, a common cause of blindness in older people,” he told the Science Media Centre.

“The profile of pollutants the two groups looked at is slightly different but the source is the same, combustion. Of course, correlation does not prove causation, but the fact that these two independent studies reach similar conclusions gives greater confidence that the link they make is real,” Inglehearn, who was not involved in the UCL study, said.

Inglehearn said such studies “provide further evidence that links air pollution with detrimental impacts on human health.”

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Health

U.K. Coronavirus Variant Probed for Increased Risk to Younger People

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LONDON—Doctors began noticing the change last month as the U.K.’s new coronavirus variant spread. In hospital critical-care units, they were seeing more younger people and women with serious cases of Covid-19, a disease that previously inflicted its worst symptoms largely on older patients and men.

The shift—backed up now by statistical studies—is part of an urgent puzzle preoccupying British public-health officials as they race to understand a strain of the virus that is more transmissible and, some studies indicate, could be deadlier than earlier versions.

One early hypothesis, scientists say, is that one of the virus’s genetic mutations makes it better at invading a greater number of cells inside the body, leading to serious sickness in people who with previous Covid-19 variants would only have had mild or no symptoms.

David Strain, a physician and instructor at the University of Exeter’s medical school who is also treating Covid-19 patients, said initial research paints a picture of a virus variant that is like a burglar that has become better and breaking and entering—into vulnerable cells in this case, not houses.

“We think that’s why it’s making people sicker as well as being more transmissible,” Dr. Strain said.

Virologists suspect that it is a particular mutation known as N501Y on the new variant’s spike protein that has enhanced its ability to enter and infect human cells and to move more efficiently through the human body.

Some doctors, such as Dr. Strain, think that is behind the rise in younger people and women—who for most of the pandemic have become ill at lower rates—ending up in the hospital.

Some things, doctors and scientists say, don’t seem to have changed with the new variant. Once hospitalized, patients seem to have the same chance of survival as before and doctors can’t tell from symptoms which variant a patient has.

In London, the southeast and east of England, where the new variant was first identified in a test sample from Sept. 20, the mean age of patients admitted to intensive-care units fell from 61.4 years between September and the end of November to 58.9 years from Dec. 1 to Jan. 21.

The proportion of women admitted into ICUs rose from 30.1% to 35.1% in the same period. Data from the rest of the country show a similar pattern.

As new coronavirus variants sweep across the world, scientists are racing to understand how dangerous they could be. WSJ explains. Illustration: Alex Kuzoian/WSJ

Through December, the proportion of 18- to 54-year-olds admitted to English hospitals with Covid-19 also began to trend up, before a national lockdown was imposed on Jan. 4.

Not all doctors are convinced this is explained by mutations in the new variant. Some think it could also be a matter of behavior changes, with more people, especially younger ones, mixing during the holiday season and becoming infected.

Luke Allen, a local doctor in Oxford, for instance, said he has been treating more younger patients but that he is seeing more Covid-19 patients in general, and the ratio of people seems to be the same as in the first peak.

Parts of London have been hit particularly hard by the new virus variant.



Photo:

May James/Zuma Press

He attributes the increased numbers to the greater transmissibility of the new variant and increased socializing over the holidays. “That increases the chances of their contact with us,” Dr. Allen said.

There is still considerable debate around whether the new variant is in fact deadlier, as some research suggests.

The new variant, which has become the dominant version across the U.K., is estimated to be 30% to 70% more infectious than earlier varieties. Last week, a government health advisory panel said studies suggest there was a realistic possibility that it also could be 30% to 40% deadlier than the previous variant.

The advisers say their conclusions are tentative. “Although there’s uncertainty, we can’t always wait for certainty,” said

Peter Horby,

chairman of the panel, the New and Emerging Respiratory Virus Threats Advisory Group, or Nervtag.

Julian Tang, a clinical virologist and professor of respiratory medicine at the University of Leicester, said more evidence was needed to prove that the new variant was deadlier, given that social mixing was allowed during the winter months, greatly accelerating hospitalization rates.

“Viruses generally mutate to be more transmissible and less lethal,” he said.

The new variant’s spread has coincided with huge increases in the number of people hospitalized with Covid-19 and a rise in the number of people dying from the disease in the U.K., placing the state-run health service under unprecedented strain. Covid-19-related deaths in the U.K. are close to 100,000 since the start of the pandemic.

The disease caused by the variant so far doesn’t appear any different from that provoked by its ancestors, but because the virus itself is able to move around a patient’s system more easily, it can outpace the body’s immune response, doctors suspect.

“If you are getting much stronger binding you may need a lower infectious dose to become infected, which would increase the risk of transmission,” Dr. Horby said. “Then, if it’s been able to spread between cells much quicker within the lungs, then that may increase the rate of disease and the rate of inflammation which may then progress quicker than your body can respond to.”

To determine whether the new variant was deadlier, scientists looked at data from around 850,000 cases of the coronavirus tested in the community where they knew which variant of the virus each person had, including between 1,400 and 1,900 people who died.

“You have to compare people who are as similar as possible to each other,” said

John Edmunds,

an author of one of the studies by the London School of Hygiene & Tropical Medicine.

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The researchers matched groups of people based on age, sex and ethnicity as well as income and where they lived, to reduce the effect that pressure on hospitals might have had on death rates.

Dr. Edmunds’s group found that if two similar people had the coronavirus, the one who had the new variant was around 30% more likely to have died from the disease it causes. A group from Imperial College London found a similar likelihood of mortality with the new variant compared with its ancestor. University of Exeter researchers found a 91% increase in the risk of mortality from the new variant, though that could be because the population it examined skews older, Dr. Strain said.

Another study by Public Health England put the chances of dying after infection with the new variant around 65% higher than with the old version.

The results are preliminary and because only in around 10% of all the cases in the U.K. is the virus variant known, may not be representative of the population as a whole.

Write to Joanna Sugden at joanna.sugden@wsj.com and Max Colchester at max.colchester@wsj.com

Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

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Health

If This Sounds Like You, You’re at Risk for Severe COVID, Says Doctor 

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One of the most curious aspects of COVID-19 is that when infected, some people remain completely asymptomatic, while others end up hospitalized and unable to breathe. Since the start of the pandemic, health experts and researchers have been studying the highly infectious virus in hopes of understanding why the type of infections varies so dramatically on a person-by-person basis. According to one infectious disease expert, it boils down to three factors. Read on to find out the three most common factors that influence the type and severity of COVID symptoms—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had Coronavirus. 

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The first and only controllable part of the equation is how the individual is infected and the dose of the virus they receive, says Carlos R. Oliveira, MD, Ph.D., Yale Medicine pediatric infectious disease doctor. “For example, if an individual infected with COVID-19 coughs directly on you, you will likely get a much higher dose of the virus than if you are infected by touching a contaminated surface,” he points out. “A higher infectious dose usually leads to more rapid onset and more severe symptoms.” 

This is a prime example of why wearing a mask and social distancing is so crucial in protecting yourself and others. Multiple studies have concluded that masks are effective in preventing tiny, infected viral particles from transmitting from person-to-person. While they might not stop all of them, they will certainly help reduce the viral load, likely resulting in a less serious infection. 

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Another crucial factor in determining the type and severity of COVID symptoms is “the health status at the time of infection,” according to Dr. Oliveira. Early on in the pandemic, it became clear that people with certain pre-existing conditions were more prone to severe infection than others. 

According to the CDC, anyone who is suffering from cancer, chronic kidney disease, COPD (chronic obstructive pulmonary disease), Down Syndrome, heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies, an immunocompromised state (weakened immune system) from solid organ transplant, obesity (body mass index [BMI] of 30 kg/m2 or higher but < 40 kg/m2), severe Obesity (BMI ≥ 40 kg/m2), sickle cell disease, type 2 diabetes mellitus, are pregnant, or a smoker, are at the highest risk of severe infection. 

“It is especially important for people at increased risk of severe illness from COVID-19, and those who live with them, to protect themselves from getting COVID-19,” the CDC warns. 

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Age is also a very important factor, according to Dr. Oliveira, influencing not only the severity of the virus but the symptoms it can manifest. “Several studies (including Agyeman, Mayo Clinic, 2020) have shown that in adults, loss of smell is a common early manifestation, occurring in up to 40-60% of infections. It may also be the only manifestation of infection in some adults,” he points out. 

In contrast, loss of smell is rarely seen in children, he adds, citing the COVID Symptom Study. “In fact, gastrointestinal symptoms, like abdominal pain, loss of appetite, and diarrhea, are frequent initial manifestations in children, occurring in about 1 in 3 cases.”

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“As is the case for many infectious diseases, the progression of discernible symptoms can be quite variable,” Dr. Oliveira says.

RELATED: 7 Tips You Must Follow to Avoid COVID, Say Doctors

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Due to the fact that asymptomatic spread is a common characteristic of COVID, taking precaution even when you feel healthy is crucial in order to prevent the spread of the virus. So follow Dr. Anthony Fauci‘s fundamentals and help end this surge, no matter where you live—wear a face mask, social distance, avoid large crowds, don’t go indoors with people you’re not sheltering with (especially in bars), practice good hand hygiene, get vaccinated when it becomes available to you, and to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID. 

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World

Germany cautious to end latest COVID-19 lockdown due to risk of more contagious variant

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Amid its latest COVID-19 lockdown and a promising decline in new coronavirus infections, Germany is hesitant to ease restrictions because of the risk posed by a more contagious variant.

Chancellor Angela Merkel and Germany’s 16 state governors on Tuesday decided to extend the country’s lockdown by two weeks until Feb. 14 and tighten some measures, for example requiring surgical masks — rather than just fabric face coverings — in shops and on public transportation.

On Thursday, Germany’s disease control center said that 20,398 new cases were reported over the past 24 hours, nearly 5,000 fewer than a week ago. The number of new cases per 100,000 residents over seven days stood at 119, the lowest since the beginning of November — though still well above the level of 50 the government is targeting. There were 1,013 more deaths, bringing Germany’s total so far to 49,783.

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The new variant, which has been detected in Germany and many other European countries, isn’t yet dominant there, but “we must take the danger from this mutation very seriously,” Merkel told reporters.

“We must slow the spread of this mutation as far as possible, and that means … we must not wait until the danger is more tangible here,” she said. “Then it would be too late to prevent a third wave of the pandemic, and possibly an even heavier one than before. We can still prevent this.”

Merkel said that Germany won’t be able to open up everything at once whenever the lockdown ends, declaring that schools must open first.

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“We must be very careful that we do not see what happens in many countries: they do a hard lockdown, they open, they open too much, and then they have the result that they are back in exponential growth very quickly,” she said.

She pointed to Britain’s experience in December, when the new variant took hold.

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