BEIJING (AP) — A joint World Health Organization-China study on the origins of COVID-19 says that transmission of the virus from bats to humans through another animal is the most likely scenario and that a lab leak is “extremely unlikely,” according to a draft copy obtained by The Associated Press.
The findings offer little new insight into how the virus first emerged and leave many questions unanswered, though that was as expected. But the report does provide more detail on the reasoning behind the researchers’ conclusions.
The team proposed further research in every area except the lab leak hypothesis — a speculative theory that was promoted by former U.S. President Donald Trump among others. It also said the role played by a seafood market where human cases were first identified was uncertain.
The report, which is expected to be made public Tuesday, is being closely watched since discovering the origins of the virus could help scientists prevent future pandemics — but it’s also extremely sensitive since China bristles at any suggestion that it is to blame for the current one.
Matthew Kavanagh of Georgetown University said the report deepened the understanding of the virus’s origins, but more information was needed.
“It is clear that that the Chinese government has not provided all the data needed and, until they do, firmer conclusions will be difficult,” he said in a statement.
Last year, an AP investigation found the Chinese government was strictly controlling all research into its origins. And repeated delays in the report’s release have raised questions about whether the Chinese side was trying to skew its conclusions.
“We’ve got real concerns about the methodology and the process that went into that report, including the fact that the government in Beijing apparently helped to write it,” U.S. Secretary of State Antony Blinken said in a recent CNN interview.
China rejected that criticism Monday.
“The U.S. has been speaking out on the report. By doing this, isn’t the U.S. trying to exert political pressure on the members of the WHO expert group?” asked Foreign Ministry spokesperson Zhao Lijian.
Still, suspicion of China has helped fuel the theory that the virus escaped from a lab in Wuhan, the Chinese city where the virus was first identified. The report cited several reasons for all but dismissing that possibility.
It said that such laboratory accidents are rare and the labs in Wuhan working on coronaviruses and vaccines are well-managed. It also noted that there is no record of viruses closely related to the coronavirus in any laboratory before December 2019 and that the risk of accidentally growing the virus was extremely low.
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The report is based largely on a visit by a WHO team of international experts to Wuhan. The mission was never meant to identify the exact natural source of the virus, an endeavor that typical takes years. For instance, more than 40 years of study has still failed to pinpoint the exact species of bat that are the natural reservoir of Ebola.
In the draft obtained by the AP, the researchers listed four scenarios in order of likelihood for the emergence of the new coronavirus. Topping the list was transmission from bats through another animal, which they said was likely to very likely. They evaluated direct spread from bats to humans as likely, and said that spread to humans from the packaging of “cold-chain” food products was possible but not likely.
That last possibility was previously dismissed by the WHO and the U.S. Centers for Disease Control and Prevention but researchers on this mission have taken it up again, further raising questions about the politicization of the study since China has long pushed the theory.
Bats are known to carry coronaviruses and, in fact, the closest relative of the virus that causes COVID-19 has been found in bats. However, the report says that “the evolutionary distance between these bat viruses and (COVID-19) is estimated to be several decades, suggesting a missing link.”
It said highly similar viruses have been found in pangolins, which are another kind of mammal, but scientists have yet to identify the same coronavirus in animals that has been infecting humans.
The AP received the draft copy on Monday from a Geneva-based diplomat from a WHO-member country. It wasn’t clear whether the report might still be changed prior to release, though the diplomat said it was the final version. A second diplomat confirmed getting the report too. Both refused to be identified because they were not authorized to release it ahead of publication.
WHO Director-General Tedros Adhanom Ghebreyesus acknowledged that he had received the report over the weekend and said it would be formally presented Tuesday.
“All hypotheses are on the table and warrant complete and further studies from what I have seen so far,” he said at a news conference.
The report is inconclusive on whether the outbreak started at a Wuhan seafood market that had one of the earliest clusters of cases in December 2019. Research published last year in the journal Lancet suggested the market may have merely served to further spread the disease rather than being its source.
The market was an early suspect because some stalls sold a range of unusual animals — and some wondered if they had brought the new virus to Wuhan. The report noted that animal products — including everything from bamboo rats to deer, often frozen — were sold at the market, as were live crocodiles.
As the virus spread globally, China found samples of it on the packaging of frozen food coming into the country and, in some cases, have tracked localized outbreaks to them — but has never published convincing data to prove that link.
The report said that the cold chain, as it is known, can be a driver of long-distance virus spread, though the risk is lower than through human-to-human spread. Most experts agree with that.
While it’s possible an infected animal contaminated packaging that was then brought to Wuhan and infected humans, the report said the probability is very low.
“While there is some evidence for possible reintroduction of (COVID-19) through handling of imported contaminated frozen products in China since the initial pandemic wave, this would be extraordinary in 2019 where the virus was not widely circulating,” the study said.
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Keaten reported from Geneva. Associated Press writers Maria Cheng in London, Victoria Milko in Jakarta, Indonesia, and Frank Jordans in Berlin contributed. The AP Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
Global rise in childhood mental health issues amid pandemic
By JOHN LEICESTER
March 12, 2021 GMT
PARIS (AP) — By the time his parents rushed him to the hospital, 11-year-old Pablo was barely eating and had stopped drinking entirely. Weakened by months of self-privation, his heart had slowed to a crawl and his kidneys were faltering. Medics injected him with fluids and fed him through a tube — first steps toward stitching together yet another child coming apart amid the tumult of the coronavirus crisis.
For doctors who treat them, the pandemic’s impact on the mental health of children is increasingly alarming. The Paris pediatric hospital caring for Pablo has seen a doubling in the number of children and young teenagers requiring treatment after attempted suicides since September.
Doctors elsewhere report similar surges, with children — some as young as 8 — deliberately running into traffic, overdosing on pills and otherwise self-harming. In Japan, child and adolescent suicides hit record levels in 2020, according to the Education Ministry.
Pediatric psychiatrists say they’re also seeing children with coronavirus-related phobias, tics and eating disorders, obsessing about infection, scrubbing their hands raw, covering their bodies with disinfectant gel and terrified of getting sick from food.
Also increasingly common, doctors say, are children suffering panic attacks, heart palpitations and other symptoms of mental anguish, as well as chronic addictions to mobile devices and computer screens that have become their sitters, teachers and entertainers during lockdowns, curfews and school closures.
“There is no prototype for the child experiencing difficulties,” said Dr. Richard Delorme, who heads the psychiatric unit treating Pablo at the giant Robert Debré pediatric hospital, the busiest in France. “This concerns all of us.”
Pablo’s father, Jerome, is still trying to understand why his son gradually fell sick with a chronic eating disorder as the pandemic took hold, slowly starving himself until the only foods he would eat were small quantities of rice, tuna and cherry tomatoes.
Jerome suspects that disruptions last year to Pablo’s routines may have contributed to his illness. Because France was locked down, the boy had no in-school classes for months and couldn’t say goodbye to his friends and teacher at the end of the school year.
“It was very tough,” Jerome said. “This is a generation that has taken a beating.”
Sometimes, other factors pile on misery beyond the burden of the 2.6 million COVID-19 victims who have died in the world’s worst health crisis in a century.
Islamic State extremists who killed 130 people in gun and bomb attacks across Paris in 2015, including at a cafe on Pablo’s walk to school, also left a searing mark on his childhood. Pablo used to believe that the cafe’s dead customers were buried under the sidewalk where he trod.
When he was hospitalized at the end of February, Pablo had lost a third of his previous weight. His heart rate was so slow that medics struggled to find a pulse, and one of his kidneys was failing, said his father, who agreed to talk about his son’s illness on condition they not be identified by their surname.
“It is a real nightmare to have a child who is destroying himself,” the father said.
Pablo’s psychiatrist at the hospital, Dr. Coline Stordeur, says some of her other young patients with eating disorders, mostly aged 8 to 12, told her they began obsessing in lockdown about gaining weight because they couldn’t stay active. One boy compensated by running laps in his parents’ basement for hours each day, losing weight so precipitously that he had to be hospitalized.
Others told her they gradually restricted their diet: “No more sugar, then no more fat, and eventually no more of anything,” she said.
Some children try to keep their mental anguish to themselves, not wanting to further burden the adults in their lives who are perhaps mourning loved ones or jobs lost to the coronavirus. They “try to be children who are forgotten about, who don’t add to their parents’ problems,” Stordeur said.
Children also may lack the vocabulary of mental illness to voice their need for help and to make a connection between their difficulties and the pandemic.
“They don’t say, ‘Yes, I ended up here because of the coronavirus,’” Delorme said. “But what they tell you about is a chaotic world, of ‘Yes, I’m not doing my activities any more,’ ‘I’m no longer doing my music,’ ‘Going to school is hard in the mornings,’ ‘I am having difficulty waking up,’ ‘I am fed up with the mask.’”
Dr. David Greenhorn said the emergency department at the Bradford Royal Infirmary where he works in northern England used to treat one or two children per week for mental health emergencies, including suicide attempts. The average now is closer to one or two per day, sometimes involving children as young as 8, he said.
“This is an international epidemic, and we are not recognizing it,” Greenhorn said in a telephone interview. “In an 8-year-old’s life, a year is a really, really, really long time. They are fed up. They can’t see an end to it.”
At Robert Debré, the psychiatric unit typically used to see about 20 attempted suicide cases per month involving children aged 15 and under. Not only has that number now doubled in some months since September, but some children also seem ever-more determined to end their lives, Delorme said.
“We are very surprised by the intensity of the desire to die among children who may be 12 or 13 years old,” he said. “We sometimes have children of 9 who already want to die. And it’s not simply a provocation or a blackmail via suicide. It is a genuine wish to end their lives.”
“The levels of stress among children are truly massive,” he said. “The crisis affects all of us, from age 2 to 99.”
ROME (AP) — The variant of the coronavirus discovered in Britain is prevalent among Italy’s infected schoolchildren and is helping to fuel a “robust” uptick in the curve of COVID-19 contagion in the country, the health minister said Tuesday.
Roberto Speranza told reporters that the variant, associated with higher transmission rates, has shown pervasiveness “among the youngest age group” of the population.
In recent weeks, Italy’s incidence of new cases among young people has now eclipsed incidence among the older population, a reversal of how COVID-19 afflicted residents in the first months of the pandemic.
Italy, a nation of 60 million people where COVID-19 first erupted in the West in February 2020, has registered nearly 3 million confirmed cases.
Speranza announced stricter directives, contained in the first anti-pandemic decree of new Italian Premier Mario Draghi, aimed at trying to “govern this curve of contagion,” especially among school-age children.
There are “rather robust signs of an uptick in the curve of contagion and terrible variants,” particularly the one discovered in Britain, the minister said.
The president of the government Superior Institute of Health, Silvio Brusaferro, said that as of analyses of cases on Feb. 18, 54% of confirmed COVID-19 cases in Italy involved that variant. But, said Brusaferro, “if measured today surely the percentage would be higher.”
Another variant, found in Brazil, is now involved in 4.3% of recent COVID-19 cases in Italy, Brusaferro said, particularly in central Italy, including the area of Rome’s region.
In recent days, authorities have taken to sealing off many towns and cities in areas where transmission rates are rapidly increasing. The mayor of Bologna, which has 400,000 residents, announced that, starting on Thursday and until March 21, the city will be under strict “red zone” lockdown rules, which means all restaurants and cafes are closed to dining, as are nonessential shops.
Another critical place is Como, the lakeside city near Switzerland. Many of Como’s citizens commute across the border.
The variant found in South Africa is involved in 0.4% of COVID-19 infections in Italy and mainly confined to the Italian Alpine area near the border with Austria, Brusaferro said.
Draghi’s decree, which takes effect on Saturday and lasts until April 6, to just after Easter, tightened measures governing schools. It mandates that all schools, including for nursery and elementary students, in “red zone” regions must be shuttered. Some exceptions will be made for students with special needs.
But the decree loosens restrictions in the world of culture. Starting on March 27, cinemas and theaters can reopen in “yellow zone” regions with low incidence and virus transmission rates, but these venues must limit capacity to 25%. Museums in yellow zones, already permitted to admit the public on weekdays, can open also on weekends starting March 27.
Gyms and pools stay shut. Also remaining is a 10 p.m. to 5 a.m. nationwide curfew, and a ban on travel between Italy’s regions.
Italy’s known death toll of more than 98,000 is the second-highest in Europe, after Britain’s.
Chinese vaccines sweep much of the world, despite concerns
By HUIZHONG WU and KRISTEN GELINEAU
March 2, 2021 GMT
TAIPEI, Taiwan (AP) — The plane laden with vaccines had just rolled to a stop at Santiago’s airport in late January, and Chile’s president, Sebastián Piñera, was beaming. “Today,” he said, “is a day of joy, emotion and hope.”
The source of that hope: China – a country that Chile and dozens of other nations are depending on to help rescue them from the COVID-19 pandemic.
China’s vaccine diplomacy campaign has been a surprising success: It has pledged roughly half a billion doses of its vaccines to more than 45 countries, according to a country-by-country tally by The Associated Press. With just four of China’s many vaccine makers claiming they are able to produce at least 2.6 billion doses this year, a large part of the world’s population will end up inoculated not with the fancy Western vaccines boasting headline-grabbing efficacy rates, but with China’s humble, traditionally made shots.
Amid a dearth of public data on China’s vaccines, hesitations over their efficacy and safety are still pervasive in the countries depending on them, along with concerns about what China might want in return for deliveries. Nonetheless, inoculations with Chinese vaccines already have begun in more than 25 countries, and the Chinese shots have been delivered to another 11, according to the AP tally, based on independent reporting in those countries along with government and company announcements.
It’s a potential face-saving coup for China, which has been determined to transform itself from an object of mistrust over its initial mishandling of the COVID-19 outbreak to a savior. Like India and Russia, China is trying to build goodwill, and has pledged roughly 10 times more vaccines abroad than it has distributed at home.
“We’re seeing certainly real-time vaccine diplomacy start to play out, with China in the lead in terms of being able to manufacture vaccines within China and make them available to others,” said Krishna Udayakumar, founding director of the Duke Global Health Innovation Center at Duke University. “Some of them donated, some of them sold, and some of them sold with debt financing associated with it.”
China has said it is supplying “vaccine aid” to 53 countries and exports to 27, but it rejected a request by the AP for the list. Beijing has also denied vaccine diplomacy, and a Ministry of Foreign Affairs spokesperson said China considered the vaccine a “global public good.” Chinese experts reject any connection between the export of its vaccines and the revamping of its image.
“I don’t see any linkage there,” said Wang Huiyao, president of the Centre for China and Globalization, a Beijing think tank. “China should do more to help other countries, because it’s doing well.”
China has targeted the low- and middle-income countries largely left behind as rich nations scooped up most of the pricey vaccines produced by the likes of Pfizer and Moderna. And despite a few delays of its own in Brazil and Turkey, China has largely capitalized on slower-than-hoped-for deliveries by U.S. and European vaccine makers.
Like many other countries, Chile received far fewer doses of the Pfizer vaccine than first promised. In the month after its vaccination program began in late December, only around 150,000 of the 10 million Pfizer doses the South American country ordered arrived.
It wasn’t until Chinese company Sinovac Biotech Ltd. swooped in with 4 million doses in late January that Chile began inoculating its population of 19 million with impressive speed. The country now has the fifth highest vaccination rate per capita in the world, according to Oxford University.
Chilean Vilma Ortiz got her Sinovac shot at a school in Santiago’s Nunoa neighborhood, along with about 60 other people. Although she considers herself “kind of a skeptical person,” she said she researched the Chinese vaccines on the Internet and was satisfied.
“I have a lot of faith and confidence in the vaccine,” she said.
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In Jakarta, the sports stadium was abuzz as masked healthcare workers filed in to receive their Sinovac shot. Wandering the rows of vaccination stations was Indonesian President Joko Widodo, the first person in the Southeast Asian country to get the Chinese shot, 140 million doses of which he has ordered for his people.
Among those at the stadium was Susi Monica, an intern doctor receiving her second dose. Despite questions over its efficacy, getting the shot was worth it to her, particularly because she didn’t have any adverse reactions to the first dose.
Besides, she said, “Do I have another choice right now?”
The choices are limited for Indonesia and many other low- and middle-income countries clobbered by COVID. Vaccine deployment globally has been dominated by wealthier countries, which have snapped up 5.8 billion of the 8.2 billion doses purchased worldwide, according to Duke University.
China’s vaccines, which can be stored in standard refrigerators, are attractive to countries like Indonesia, a sweltering nation that straddles the equator and could struggle to accommodate the ultracold storage needs of vaccines like Pfizer’s.
The bulk of Chinese shots are from Sinovac and Sinopharm, which both rely on a traditional technology called an inactivated virus vaccine, based on cultivating batches of the virus and then killing it. Some countries view it as safer than the newer, less-proven technology used by some Western competitors that targets the coronavirus’ spike protein, despite publicly available safety data for the Pfizer, Moderna and AstraZeneca vaccines and none for China’s.
“The choice was made for this vaccine because it is developed on a traditional and safe inactivated platform,” said Teymur Musayev, an official with the Ministry of Health in Azerbaijan, which has ordered 4 million Sinovac doses.
In Europe, China is providing the vaccine to countries such as Serbia and Hungary — a significant geopolitical victory in Central Europe and the Balkans, where the West, China and Russia are competing for political and economic influence. This stretch of Europe has offered fertile ground for China to strengthen bilateral ties with Serbia and Hungary’s populist leaders, who often criticize the EU.
Serbia became the first country in Europe to start inoculating its population with China’s vaccines in January. The country has so far purchased 1.5 million doses of Sinopharm’s vaccine, which makes up the majority of the country’s supply, and smaller amounts of Russia’s Sputnik V and Pfizer’s vaccines.
Donning heavy coats against the winter chill, masked-up Serbians have been waiting in long lines for their turn to get the vaccine.
“They have been vaccinating their own people for (a) long period, I assume they have more experience,” Natasa Stermenski, a Belgrade resident, said of her choice to get the Chinese shot at a vaccination center in February.
Neighboring Hungary, impatient over delays in the European Union, soon became the first country in the EU to approve the same Chinese vaccine. On Sunday, Hungarian Prime Minister Viktor Orban got the Sinopharm shot, after recently saying he trusted the Chinese vaccine the most.
Many leaders have publicly supported the Chinese shots to allay concerns. Early on, “people had all these microchip theories in their heads, genetic modification, sterilization, running around on social media platforms,” said Sanjeev Pugazhendi, a medical officer in the Indian Ocean island nation of the Seychelles, whose president recently received a Sinopharm shot on camera. “But the moment we started giving out the vaccines to leaders, religious leaders and health workers, that started to subside.”
Beijing’s vaccine diplomacy efforts are good for both China and the developing world, experts say.
“Because of the competition for influence, the poor countries can get earlier access for vaccines,” said Yun Jiang, managing editor of the China Story Blog at the Australian National University. “Of course, that’s assuming that all the vaccines are safe and delivered in the right way.”
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China’s vaccine diplomacy will only be as good as the vaccines it is offering, and it still faces hurdles.
Ahmed Hamdan Zayed, a nurse in Egypt, was reluctant to receive a vaccine, especially a Chinese one. The frontline health worker would be among the first in the country to get Sinopharm’s shot as part of a mass vaccination campaign. Over 9 million Sinopharm shots have been given outside China.
“We had concerns about vaccines in general,” the 27-year-old father of two said in a phone interview from the Abu Khalifa hospital in the northeastern part of the country. “The Chinese vaccine, in particular, there was insufficient data available compared to other vaccines.”
But Zayed ultimately decided to get the shot after conducting more research. A doctor at his hospital called colleagues in the United Arab Emirates, which had approved the same shot, and they met with Egyptian health officials.
Sinopharm, which said its vaccine was 79% effective based on interim data from clinical trials, did not respond to requests for an interview. Sinopharm’s chairman has said they have not had a single severe adverse event in response to their vaccine.
Chinese vaccine companies have been “slow and spotty” in releasing their trial data, compared to companies like Pfizer and Moderna, said Yanzhong Huang, a global health expert at the U.S. think tank Council for Foreign Relations. None of China’s three vaccine candidates used globally have publicly released their late-stage clinical trial data. CanSino, another Chinese company with a one-shot vaccine that it says is 65% effective, declined to be interviewed.
China’s pharmaceutical business practices also have raised concerns. In 2018, it emerged that one of China’s biggest vaccine companies falsified data to sell its rabies vaccines. That same year, news broke that a Sinopharm subsidiary, which is behind one of the COVID-19 vaccines now, had made substandard diphtheria vaccines used in mandatory immunizations.
With Chinese vaccines, “for a lot of people, the first thing you think about is ‘Made in China,’ and that doesn’t give you much assurance,” said Joy Zhang, a professor at the University of Kent in the UK who studies the ethics of emerging science.
Russia and India have faced similar skepticism, partly because people have less trust in products made outside the Western world, said Sayedur Rahman, head of the pharmacology department at Bangabandhu Sheikh Mujib Medical University in Bangladesh.
“China, India, Russia, Cuba, whenever they develop a vaccine or conduct research, their data is questioned, and people say their process is not transparent,” he said.
A December YouGov poll of 19,000 people in 17 countries and regions on how they felt about different vaccines found that China’s received the second-lowest score, tied with India’s. In the Philippines, which has ordered 25 million Sinovac doses, less than 20% of those surveyed by a research group expressed confidence in China’s vaccines.
Those concerns have been exacerbated by confusion around the efficacy of Sinovac’s shot. In Turkey, where Sinovac conducted part of its efficacy trials, officials have said the vaccine was 91% effective. However, in Brazil, officials revised the efficacy rate in late-stage clinical trials from 78% to just over 50% after including mild infections.
A senior Chinese official said Brazil’s numbers were lower because its volunteers were healthcare workers who faced a higher risk of infection. But other medical experts have said exposure would not affect a vaccine’s effectiveness.
Sinovac’s trials were conducted separately in Turkey and Brazil, and the differences in efficacy rates arise from differences in the populations, a spokesman for the company said in a previous interview with the AP. The company declined to be interviewed for this article. An expert panel in Hong Kong assessed the efficacy of the vaccine at about 51%, and the city approved its use in mid-February.
Globally, public health officials have said any vaccine that is at least 50% effective is useful. International scientists are anxious to see results from final-stage testing published in a peer-reviewed science journal for all three Chinese companies.
It’s also unclear how the Chinese shots work against new strains of the virus that are emerging, especially a variant first identified in South Africa. For example, Sinopharm has pledged 800,000 shots to South Africa’s neighbor, Zimbabwe.
There are concerns among receiving countries that China’s vaccine diplomacy may come at a cost, which China has denied. In the Philippines, where Beijing is donating 600,000 vaccines, a senior diplomat said China’s Foreign Minister, Wang Yi, gave a subtle message to tone down public criticism of growing Chinese assertiveness in the disputed South China Sea.
The senior diplomat said Wang did not ask for anything in exchange for vaccines, but it was clear he wanted “friendly exchanges in public, like control your megaphone diplomacy a little.” The diplomat spoke on condition of anonymity to discuss the issue publicly.
Philippine President Rodrigo Duterte publicly said in a news conference on Sunday that China did not ask for anything, as the donations were flown in.
Meanwhile, opposition legislators in Turkey are accusing Ankara’s leaders of secretly selling out Uyghurs to China in exchange for vaccines after a recent shipment delay. The legislators and the Uyghur diaspora community fear Beijing is trying to win passage of an extradition treaty that could see more Uyghurs deported to China.
Despite all the worries, the pandemic’s urgency has largely superseded hesitations over China’s vaccines.
“Vaccines, particularly those made in the West, are reserved for rich countries,” said one Egyptian official, who spoke on condition of anonymity to discuss the matter. “We had to guarantee a vaccine. Any vaccine.”
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Gelineau reported from Sydney.
Associated Press researcher Chen Si in Shanghai, and AP reporters Patricia Luna in Santiago, Chile; Sam Magdy in Cairo; Jim Gomez in Manila, Philippines; Niniek Karmini in Jakarta, Indonesia; Aida Sultanova in London; Justin Spike in Budapest, Hungary; Dusan Stojanovic in Belgrade, Serbia; Cara Anna in Nairobi, Kenya; Allen G. Breed in Raleigh, North Carolina; and Diane Jeantet in Rio de Janeiro contributed to this report.
PARIS (AP) — In an industrial neighborhood on the outskirts of Bangladesh’s largest city lies a factory with gleaming new equipment imported from Germany, its immaculate hallways lined with hermetically sealed rooms. It is operating at just a quarter of its capacity.
It is one of three factories that The Associated Press found on three continents whose owners say they could start producing hundreds of millions of COVID-19 vaccines on short notice if only they had the blueprints and technical know-how. But that knowledge belongs to the large pharmaceutical companies who produce the first three vaccines authorized by countries including Britain, the European Union and the U.S. — Pfizer, Moderna and AstraZeneca. The factories are all still awaiting responses.
Across Africa and Southeast Asia, governments and aid groups, as well as the World Health Organization, are calling on pharmaceutical companies to share their patent information more broadly to meet a yawning global shortfall in a pandemic that already has claimed over 2.5 million lives. Pharmaceutical companies that took taxpayer money from the U.S. or Europe to develop inoculations at unprecedented speed say they are negotiating contracts and exclusive licensing deals with producers on a case-by-case basis because they need to protect their intellectual property and ensure safety.
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Critics say this piecemeal approach is just too slow at a time of urgent need to stop the virus before it mutates into even deadlier forms. WHO called for vaccine manufacturers to share their know-how to “dramatically increase the global supply.”
“If that can be done, then immediately overnight every continent will have dozens of companies who would be able to produce these vaccines,” said Abdul Muktadir, whose Incepta plant in Bangladesh already makes vaccines against hepatitis, flu, meningitis, rabies, tetanus and measles.
All over the world, the supply of coronavirus vaccines is falling far short of demand, and the limited amount available is going to rich countries. Nearly 80% of the vaccines so far have been administered in just 10 countries, according to WHO. More than 210 countries and territories with a collective population of 2.5 billion hadn’t received a single shot as of last week.
The deal-by-deal approach also means that some poorer countries end up paying more for the same vaccine than richer countries. South Africa, Mexico, Brazil and Uganda all pay different amounts per dose for the AstraZeneca vaccine — more than governments in the European Union, according to studies and publicly available documents. AstraZeneca said the price of the vaccine will differ depending on factors such as production costs, where the shots are made and how much countries order.
“What we see today is a stampede, a survival of the fittest approach, where those with the deepest pockets, with the sharpest elbows are grabbing what is there and leaving others to die,” said Winnie Byanyima, executive director of UNAIDS.
In South Africa, home to the world’s most worrisome COVID-19 variant, the Biovac factory has said for weeks that it’s in negotiations with an unnamed manufacturer with no contract to show for it. And in Denmark, the Bavarian Nordic factory has capacity to spare and the ability to make more than 200 million doses but is also waiting for word from the producer of a licensed coronavirus vaccine.
Governments and health experts offer two potential solutions to the vaccine shortage: One, supported by WHO, is a patent pool modeled after a platform set up for HIV, tuberculosis and hepatitis treatments for voluntary sharing of technology, intellectual property and data. But not a single company has offered to share its data or transfer the necessary technology.
The other, a proposal to suspend intellectual property rights during the pandemic, has been blocked in the World Trade Organization by the United States and Europe, home to the companies responsible for creating the coronavirus vaccines. That drive has the support of at least 119 countries among the WTO’s 164 member states, and the African Union, but is adamantly opposed by vaccine makers.
Pharmaceutical companies say instead of lifting IP restrictions, rich countries should simply give more of the vaccines they have to poorer countries through COVAX, the public-private initiative WHO helped create for equitable vaccine distribution. The organization and its partners delivered its first doses last week — in very limited quantities.
But rich countries are not willing to give up what they have. Ursula Von der Leyen, head of the European Commission, has used the phrase “global common good” to describe the vaccines. Even still, the European Union imposed export controls on vaccines, giving countries the power to stop shots from leaving their borders in some cases.
In comments Monday on her first day as director-general of the WTO, Nigeria’s Ngozi Okonjo-Iweala said the time had come to shift attention to the vaccination needs of the world’s poor.
“We must focus on working with companies to open up and license more viable manufacturing sites now in emerging markets and developing countries,” she said, according to notes from her closed-door talk with delegates shared with The Associated Press.
The long-held model in the pharmaceutical industry is that companies pour in huge amounts of money and research in return for the right to reap profits from their drugs and vaccines. At an industry forum last May, Pfizer’s CEO Albert Bourla described the idea of sharing IP rights widely as “nonsense” and even “dangerous.” AstraZeneca’s chief Pascal Soriot said if intellectual property is not protected, “there is no incentive for anybody to innovate.”
Thomas Cueni, director general of the International Federation of Pharmaceutical Manufacturers, called the idea of lifting patent protections “a very bad signal to the future. You signal that if you have a pandemic, your patents are not worth anything.”
Advocates of sharing vaccine blueprints argue that, unlike with most drugs, taxpayers paid billions to develop vaccines that are now “global public goods” and should be used to end the biggest public health emergency in living memory.
“People are literally dying because we cannot agree on intellectual property rights,” said Mustaqeem De Gama, a South African diplomat who has been deeply involved in the WTO discussions.
Paul Fehlner, the chief legal officer for biotech company Axcella and a supporter of the WHO patent pool board, said governments that poured billions of dollars into developing vaccines and treatments should have demanded more from the companies they were financing from the beginning.
“A condition of taking taxpayer money is not treating them as dupes,” he said.
In an interview with the Journal of the American Medical Association, Dr. Anthony Fauci, the leading pandemic expert in the United States, said all options need to be on the table, including increasing aid, improving production capacity in the developing world and working with pharmaceutical companies to relax their patents.
“Rich countries, ourselves included, have a moral responsibility when you have a global outbreak like this,” Fauci said. “We’ve got to get the entire world vaccinated, not just our own country.”
It’s hard to know exactly how much more vaccine could be made worldwide if intellectual property restrictions were lifted, because the spare production capacity of factories has not been publicly shared. But Suhaib Siddiqi, former director of chemistry at Moderna, said with the blueprint and technical advice, a modern factory should be able to get vaccine production going in at most three to four months.
“In my opinion, the vaccine belongs to the public,” said Siddiqi. “Any company which has experience synthesizing molecules should be able to do it.”
Back in Bangladesh, the Incepta factory tried to get what it needed to make more vaccines in two ways, by offering its production lines to Moderna and by reaching out to a WHO partner. Moderna did not respond to multiple requests for comment about the Bangladesh plant, but its CEO, Stéphane Bancel, told European lawmakers that the company’s engineers are fully occupied on expanding production in Europe.
“Doing more tech transfer right now could actually put the production and the increased output for the months to come at great risk,” he said. “We are very open to do it in the future once our current sites are running.”
Muktadir said he was also in discussions last May with CEPI, or the Coalition for Epidemic Preparedness Innovations, one of WHO’s partners in a global effort to buy and distribute COVID-19 vaccines fairly, but nothing came of it. CEPI spokesman Tom Mooney said the talks last year with Incepta didn’t raise interest, but that CEPI is still in discussions “about matchmaking opportunities including the possibility of using Incepta’s capacity for second wave vaccines.”
Muktadir said he fully appreciates the extraordinary scientific achievement involved in the creation of vaccines this year, wants the rest of the world to be able to share in it, and is willing to pay a fair price.
“Nobody should give their property just for nothing,” he said. “A vaccine could be made accessible to people — high quality, effective vaccines.”
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Cheng reported from Toronto. Jamey Keaten in Geneva, Jan M. Olsen in Copenhagen, Denmark, Al-Emrun Garjon in Dhaka, Bangladesh, and Andrew Meldrum in Johannesburg, South Africa, contributed to this report.
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Follow AP’s pandemic coverage at https://apnews.com/hub/coronavirus-pandemic, https://apnews.com/hub/coronavirus-vaccine and https://apnews.com/UnderstandingtheOutbreak
Evidence is mounting that having COVID-19 may not protect against getting infected again with some of the new variants. People also can get second infections with earlier versions of the coronavirus if they mounted a weak defense the first time, new research suggests.
How long immunity lasts from natural infection is one of the big questions in the pandemic. Scientists still think reinfections are fairly rare and usually less serious than initial ones, but recent developments around the world have raised concerns.
In South Africa, a vaccine study found new infections with a variant in 2% of people who previously had an earlier version of the virus.
In Brazil, several similar cases were documented with a new variant there. Researchers are exploring whether reinfections help explain a recent surge in the city of Manaus, where three-fourths of residents were thought to have been previously infected.
In the United States, a study found that 10% of Marine recruits who had evidence of prior infection and repeatedly tested negative before starting basic training were later infected again. That work was done before the new variants began to spread, said one study leader, Dr. Stuart Sealfon of the Icahn School of Medicine at Mount Sinai in New York.
“Previous infection does not give you a free pass,” he said. “A substantial risk of reinfection remains.”
Reinfections pose a public health concern, not just a personal one. Even in cases where reinfection causes no symptoms or just mild ones, people might still spread the virus. That’s why health officials are urging vaccination as a longer-term solution and encouraging people to wear masks, keep physical distance and wash their hands frequently.
“It’s an incentive to do what we have been saying all along: to vaccinate as many people as we can and to do so as quickly as we can,” said Dr. Anthony Fauci, the U.S. government’s top infectious disease expert.
“My looking at the data suggests … and I want to underline suggests … the protection induced by a vaccine may even be a little better” than natural infection, Fauci said.
Doctors in South Africa began to worry when they saw a surge of cases late last year in areas where blood tests suggested many people had already had the virus.
Until recently, all indications were “that previous infection confers protection for at least nine months,” so a second wave should have been “relatively subdued,” said Dr. Shabir Madhi of the University of the Witwatersrand in Johannesburg.
Scientists discovered a new version of the virus that’s more contagious and less susceptible to certain treatments. It now causes more than 90% of new cases in South Africa and has spread to 40 countries including the United States.
Madhi led a study testing Novavax’s vaccine and found it less effective against the new variant. The study also revealed that infections with the new variant were just as common among people who had COVID-19 as those who had not.
“What this basically tells us, unfortunately, is that past infection with early variants of the virus in South Africa does not protect” against the new one, he said.
In Brazil, a spike in hospitalizations in Manaus in January caused similar worry and revealed a new variant that’s also more contagious and less vulnerable to some treatments.
“Reinfection could be one of the drivers of these cases,” said Dr. Ester Sabino of the University of Sao Paulo. She wrote an article in the journal Lancet on possible explanations. “We have not yet been able to define how frequently this is happening,” she said.
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California scientists also are investigating whether a recently identified variant may be causing reinfections or a surge of cases there.
“We’re looking at that now,” seeking blood samples from past cases, said Jasmine Plummer, a researcher at Cedars-Sinai Medical Center in Los Angeles.
Dr. Howard Bauchner, editor-in-chief of the Journal of the American Medical Association, said it soon would report on what he called “the Los Angeles variant.”
New variants were not responsible for the reinfections seen in the study of Marines — it was done before the mutated viruses emerged, said Sealfon, who led that work with the Naval Medical Research Center. Other findings from the study were published in the New England Journal of Medicine; the new ones on reinfection are posted on a research website.
The study involved several thousand Marine recruits who tested negative for the virus three times during a two-week supervised military quarantine before starting basic training.
Among the 189 whose blood tests indicated they had been infected in the past, 19 tested positive again during the six weeks of training. That’s far less than those without previous infection — “almost half of them became infected at the basic training site,” Sealfon said.
The amount and quality of antibodies that previously infected Marines had upon arrival was tied to their risk of getting the virus again. No reinfections caused serious illness, but that does not mean the recruits were not at risk of spreading infection to others, Sealfon said.
“It does look like reinfection is possible. I don’t think we fully understand why that is and why immunity has not developed” in those cases, said an immunology expert with no role in the study, E. John Wherry of the University of Pennsylvania.
“Natural infections can leave you with a range of immunity” while vaccines consistently induce high levels of antibodies, Wherry said.
“I am optimistic that our vaccines are doing a little bit better.”
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
NEW YORK (AP) — Despite its world-class medical system and its vaunted Centers for Disease Control and Prevention, the U.S. fell behind in the race to detect dangerous coronavirus mutations. And it’s only now beginning to catch up.
The problem has not been a shortage of technology or expertise. Rather, scientists say, it’s an absence of national leadership and coordination, plus a lack of funding and supplies for overburdened laboratories trying to juggle diagnostic testing with the hunt for genetic changes.
“We have the brains. We have the tools. We have the instruments,” said Ilhem Messaoudi, director of a virus research center at University of California, Irvine. “It’s just a matter of supporting that effort.”
Viruses mutate constantly. To stay ahead of the threat, scientists analyze samples, watching closely for mutations that might make the coronavirus more infectious or more deadly.
But such testing has been scattershot.
Less than 1% of positive specimens in the U.S. are being sequenced to determine whether they have worrisome mutations. Other countries do better — Britain sequences about 10% — meaning they can more quickly see threats coming at them. That gives them greater opportunity to slow or stop the problem, whether through more targeted contact tracing, possible adjustments to the vaccine, or public warnings.
CDC officials say variants have not driven recent surges in overall U.S. cases. But experts worry that what’s happening with variants is not clear and say the nation should have been more aggressive about sequencing earlier in the epidemic that has now killed over 450,000 Americans.
“If we had evidence it was changing,” said Ohio State molecular biologist Dan Jones, “maybe people would’ve acted differently.”
U.S. scientists have detected more than 500 cases of a variant first identified in Britain and expect it to become the cause of most of this country’s new infections in a matter of weeks. Another troubling variant tied to Brazil and a third discovered in South Africa were detected last week in the U.S. and also are expected to spread.
The British variant is more contagious and is believed to be more deadly than the original, while the South Africa one may render the vaccines somewhat less effective. The ultimate fear is that a variant resistant to existing vaccines and treatments could eventually emerge.
Potentially worrisome versions may form inside the U.S., too. “This virus is mutating, and it doesn’t care of it’s in Idaho or South Africa,” Messaoudi said.
But the true dimensions of the problem in the U.S. are not clear because of the relatively low level of sequencing.
“You only see what’s under the lamppost,” said Kenny Beckman, director of the University of Minnesota Genomics Center, which started analyzing the virus’s genetics last spring.
After the slow start, public health labs in at least 33 states are now doing genetic analysis to identify emerging coronavirus variants. Other states have formed partnerships with university or private labs to do the work. North Dakota, which began sequencing last week, was the most recent to start that work, according to the Association of Public Health Laboratories.
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The CDC believes a minimum of 5,000 to 10,000 samples should be analyzed weekly in the U.S. to adequately monitor variants, said Gregory Armstrong, who oversees the agency’s advanced molecular detection work. And it’s only now that the nation is hitting that level, he acknowledged.
Still, it is a jumble of approaches: Some public health labs sequence every positive virus specimen. Some focus on samples from certain outbreaks or certain patients. Others randomly select samples to analyze.
On top of that, labs continue to have trouble getting needed supplies — like pipette tips and chemicals — used in both gene sequencing and diagnostic testing.
President Joe Biden, who inherited the setup from the Trump administration, is proposing a $1.9 trillion COVID-19 relief package that calls for boosting federal spending on sequencing of the virus, though the amount has not been detailed and other specifics have yet to be worked out.
“We’re 43rd in the world in genomic sequencing. Totally unacceptable,” White House coronavirus response coordinator Jeff Zients said.
For more than five years, U.S. public health labs have been building up their ability to do genomic sequencing, thanks largely to a federal push to zero in on the sources of food poisoning outbreaks.
At the pandemic’s outset, some labs began sequencing the coronavirus right away. The Minnesota Department of Health, for example, started doing so within weeks of its first COVID-19 cases in March, said Sara Vetter, an assistant lab director. “That put us a step ahead,” she said.
The CDC likewise worked with certain states to sequence close to 500 samples in April, and over a thousand samples in May and June.
But many labs didn’t do the same — especially those overburdened with ramping up coronavirus diagnostic testing. The CDC’s Armstrong said that at the time, he couldn’t justify telling labs to do more sequencing when they already had their hands full and there wasn’t any evidence such analysis was needed.
“Up until a month ago, it wasn’t on the list of things that are urgently necessary. It was nice to have,” said Trevor Bedford, a scientist at the Fred Hutchinson Cancer Research Center in Seattle. “There was definitely lack of federal resources assigned to doing exactly this.”
At the same time, because of stay-at-home orders imposed during the outbreak, researchers at some labs were told not to go in to work, Messaoudi said.
“Instead of having a call to arms,” she said, “they sent everyone home.”
Over the summer, though, a group of scientists sounded the alarm about the state of genomic surveillance in the U.S. and began pushing for something more systematic.
In November, the CDC began to roll out a national program to more methodically pull and check specimens to better determine what strains are circulating. Then in December, the U.S. got a wake-up call when British researchers announced they had identified a variant that seems to spread more easily.
The CDC reacted by announcing its surveillance program would scale up to process 750 samples nationally per week. The agency also contracted with three companies — LabCorp, Quest Diagnostics and Illumina — to sequence thousands more each week. State labs are doing thousands of their own.
Meanwhile, the outbreak is almost certainly seeding more COVID-19 mutations.
“Where it has free rein of the place, there’s going to be significant variants that evolve,” Scripps Research Institute scientist Dr. Eric Topol said. “The more genomic sequencing, the more we can stay ahead of the virus.”
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This story has been updated to correct the spelling of Illumina, which had been misspelled “Ilumina.”
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
PHILADELPHIA (AP) — When Philadelphia began getting its first batches of COVID-19 vaccines, it looked to partner with someone who could get a mass vaccination site up and running quickly.
City Hall officials might have looked across the skyline to the world-renowned health providers at the University of Pennsylvania, Temple University or Jefferson Health.
Instead, they chose a 22-year-old graduate student in psychology with a few faltering startups on his resume. And last week, amid concerns about his qualifications and Philly Fighting COVID’s for-profit status, the city shuttered his operation at the downtown convention center.
“Where were all the people with credentials? Why did a kid have to come in and help the city?” said the student, Andrei Doroshin, in an interview with The Associated Press.
“I’m a freaking grad student. But you know what? We did the job. We vaccinated 7,000 people,” the Drexel University student said. “This was us doing our part in this crazy time.”
City officials said they gave him the task because he and his friends had organized one of the community groups that set up COVID-19 testing sites throughout the city last year. But they shut the vaccine operation down once they learned that Doroshin had switched his privacy notice to potentially sell patient data, a development he calls a glitch that he quickly fixed.
It’s not clear when the city will find a new site operator.
“They were doing a reasonably good job on giving the vaccinations. They decided apparently that they were going to monetize some of this information, which was wrong, and we terminated our relationship with them,” Mayor Jim Kenney said at a news conference Tuesday, citing the work of local news outlets in raising the concerns. “And that’s the end of them.”
Doroshin also conceded that he took home four doses of the Pfizer vaccine and administered it to friends, although he is neither a nurse nor licensed health practitioner. He said he did so only after exhausting other options. There were 100 extra doses set to expire that night, and the site was able to round up just 96 eligible recipients, he said.
“They either had to go into an arm or be thrown out,” said Doroshin, who said he had done intramuscular injections before. “I felt OK ethically. … There’s nothing that I did that was illegal.”
State and local prosecutors are now pondering the question.
Many believe the situation speaks to a larger point about the health care system, in Philadelphia and nationwide.
Public health budgets had been hard hit before the pandemic, leaving local and state governments ill-equipped to roll out a mass vaccination program. That left them scrambling for COVID-19 partners.
“I think there is a place in our health system for our innovative partners,” said Julia Lynch, a health policy expert who teaches at Penn. “But maybe this isn’t the time to be experimenting with disruptors? Maybe this is the time we should be turning to a health service delivery infrastructure that operates like a well-oiled machine?”
She is also distressed that city data shows just 12% of the city’s vaccinations have gone to Black residents, who make up 42% of the city’s population. She, like others, hoped the job might have gone to a more established group such as the Black Doctors Consortium, which has been testing and vaccinating people in low-income areas of the city this past year.
Lucinda Ayers, 74, had jumped at the chance to book a Feb. 12 appointment through Doroshin’s website at the Pennsylvania Convention Center and wonders if the city shouldn’t have helped him get in compliance.
“They were vaccinating people. I’m on the fence about it,” said Ayers, who hasn’t had any luck finding another appointment despite spending hours online. “There’s so much lack of clarity on the information coming out.”
Doroshin, while working on his graduate degree, switched gears from the COVID-19 testing operation to the vaccine work when he heard about the city’s need. He said he borrowed $250,000 from a family friend for startup costs, and the city — through nothing more than a verbal agreement — gave him a cut of its vaccine supply, with the top priority being health care workers.
He said he agreed to pay $1 million to lease the convention center for six months and expected to charge the city $500,000 a month once he was fully up and running. He hired about 30 people, although at least some of the doctors, nurses and nursing students doing the injections were volunteers, he said.
“I was going to take a salary,” he said. “In a perfect world, I wanted to vaccinate Philly in six months and then apply for my Ph.D.”
Dr. Thomas Farley, the city’s health commissioner, said this week the group had a good track record of doing the testing, so “we decided to give them the opportunity to run mass clinics, and the first mass clinic went quite well.”
For now, the city has pledged to make sure people who got their first vaccines there can get their booster shots.
“It certainly shows why we need a real public health care system,” said Council Member Helen Gym, who noted that two private hospitals in the city have closed since 2019, while the city remains one of the few large U.S. cities without a public hospital.
She called the aborted vaccine rollout “an egregious, profound failure.”
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Follow Maryclaire Dale on Twitter at https://twitter.com/Maryclairedale.
Straining to handle record numbers of COVID-19 patients, hundreds of the nation’s intensive care units are running out of space and supplies and competing to hire temporary traveling nurses at soaring rates. Many of the facilities are clustered in the South and West.
An Associated Press analysis of federal hospital data shows that since November, the share of U.S. hospitals nearing the breaking point has doubled. More than 40% of Americans now live in areas running out of ICU space, with only 15% of beds still available.
Intensive care units are the final defense for the sickest of the sick, patients who are nearly suffocating or facing organ failure. Nurses who work in the most stressed ICUs, changing IV bags and monitoring patients on breathing machines, are exhausted.
“You can’t push great people forever. Right? I mean, it just isn’t possible,” said Houston Methodist CEO Dr. Marc Boom, who is among many hospital leaders hoping that the numbers of critically ill COVID-19 patients have begun to plateau. Worryingly, there’s an average of 20,000 new cases a day in Texas, which has the third-highest death count in the country and more than 13,000 people hospitalized with COVID-19-related symptoms.
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According to data through Thursday from the COVID Tracking Project, hospitalizations are still high in the West and the South, with over 80,000 current COVID-19 hospital patients in those regions. The number of cases reported in the U.S. since the pandemic’s start surpassed 25 million on Sunday, according to Johns Hopkins University.
Encouragingly, hospitalizations appear to have either plateaued or are trending downward across all regions. It’s unclear whether the easing will continue with more contagious versions of the virus arising and snags in the rollout of vaccines.
In New Mexico, one surging hospital system brought in 300 temporary nurses from outside the state, at a cost of millions of dollars, to deal with overflowing ICU patients, who were treated in converted procedure rooms and surgery suites.
“It’s been horrid,” said Dr. Jason Mitchell, chief medical officer for Presbyterian Healthcare Services in Albuquerque. He’s comforted that the hospital never activated its plan for rationing lifesaving care, which would have required a triage team to rank patients with numerical scores based on who was least likely to survive.
“It’s a relief that we never had to actually do it,” Mitchell said. “It sounds scary because it is scary.”
In Los Angeles, Cedars-Sinai Medical Center ran into shortages of take-home oxygen tanks, which meant some patients who could otherwise go home were kept longer, taking up needed beds. But the biggest problem is competing with other hospitals for traveling nurses.
“Initially, when the COVID surges were hitting one part of the country at a time, traveling nurses were able to go to areas more severely affected. Now with almost the entire country surging at the same time,” hospitals are paying twice and three times what they would normally pay for temporary, traveling nurses, said Dr. Jeff Smith, the hospital’s chief operating officer.
Houston Methodist Hospital recently paid $8,000 retention bonuses to keep staff nurses from signing up with agencies that would send them to other hot spots. Pay for traveling nurses can reach $6,000 per week, an enticement that can benefit a nurse but can seem like poaching to the hospital executives who watch nurses leave.
“There’s a lot of these agencies that are out there charging absolutely ridiculous sums of money to get ICU nurses in,” Boom said. “They go to California, which is in the midst of a surge, but they poach some ICU nurses there, send them to Texas, where they charge inordinate amounts to fill in gaps in Texas, many of which are created because nurses in Texas went to Florida or back to California.”
Space is another problem. Augusta University Medical Center in Augusta, Georgia, is treating adult ICU patients, under age 30, in the children’s hospital. Recovery rooms now have ICU patients, and, if things get worse, other areas — operating rooms and endoscopy centers — will be the next areas converted for critical care.
To prevent rural hospitals from sending more patients to Augusta, the hospital is using telemedicine to help manage those patients for as long as possible in their local hospitals.
“It is a model I believe will not only survive the pandemic but will flourish post pandemic,” said Dr. Phillip Coule, the Augusta hospital’s chief medical officer.
Hospitals are pleading with their communities to wear masks and limit gatherings.
“There just hasn’t been a lot of respect for the illness, which is disappointing,” said Dr. William Smith, chief medical officer for Cullman Regional Medical Center in Cullman, Alabama. He sees that changing now with more people personally knowing someone who has died.
“It has taken a lot of people,” he said of the virus, adding that the death toll — 144 people in six months in a county of 84,000 — “has opened their eyes to the randomness of this.”
The Alabama hospital’s ICU has been overflowing for six weeks, with 16 virus patients on ventilators in a hospital that a year ago had only 10 of the breathing machines. “You can see the stress in people’s faces and in their body language. It’s just a lot for people to carry around,” Smith said.
“Just the fatigue of our staff can affect quality of care. I’ve been encouraged we’ve been able to keep the quality of care high,” Smith said. “You feel like you are in a very precarious situation where errors could occur, but thankfully we’ve managed to stay on top of things.”
Hospitals say they are upholding high standards for patient care, but experts say surges compromise many normal medical practices. Overwhelmed hospitals might be forced to mobilize makeshift ICUs and staff them with personnel without any experience in critical care. They might run out of sedatives, antibiotics, IVs or other supplies they rely on to keep patients calm and comfortable while on ventilators.
“It’s really daunting and mentally taxing. You’re doing what you believe to be best practice,” said Kiersten Henry, a nurse at MedStar Montgomery Medical Center in Olney, Maryland, and a board director for the American Association of Critical-Care Nurses.
In Oklahoma City, OU Medicine Chief Medical Officer Dr. Cameron Mantor said while the vaccines hold promise, hope still seems dim as ICU cases keep mounting. The number of COVID-19 hospitalizations at OU Medicine has declined from more than 100 daily in recent weeks to 98 on Wednesday, Mantor said.
“What is stressing everybody out,” Mantor said, “is looking at week after week after week, the spigot is not being turned off, not knowing there is a break, not seeing the proverbial light at the end of the tunnel.”
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Associated Press writers Marion Renault in Rochester, Minnesota, Nomaan Merchant in Houston and Ken Miller in Oklahoma City contributed.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
