Is The US Entering A Fourth Surge? Vaccines And Children : Consider This from NPR Scientists are growing concerned the U.S. may be headed for a fourth wave. COVID-19 cases are rising rapidly, mirroring an increase in many countries around the world.

Harvard epidemiologist Bill Hanage tells NPR he's worried another surge in the U.S. will fuel the spread of the variant known as B.1.1.7.

In the meantime, there's new evidence that vaccines from Pfizer and Moderna are effective at preventing viral spread — and that they produce "robust" antibody response in children ages 12-15. NPR's Joe Palca has more.

In participating regions, you'll also hear from local journalists about what's happening in your community.

Email us at considerthis@npr.org.
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Race To Immunize Tightens As Cases Rise; Promising Vaccine News Released

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Race To Immunize Tightens As Cases Rise; Promising Vaccine News Released

Race To Immunize Tightens As Cases Rise; Promising Vaccine News Released

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  • <iframe src="https://www.npr.org/player/embed/982230658/983176731" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
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AUDIE CORNISH, HOST:

For most of February and March, there was lots to be optimistic about - falling cases, more vaccines, warmer temperatures. But March is over. And for many scientists, the outlook isn't quite so rosy anymore.

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ROCHELLE WALENSKY: I'm going to pause here. I'm going to lose the script, and I'm going to reflect on the recurring feeling I have of impending doom.

CORNISH: CDC director Rochelle Walensky began the week by warning of impending doom as U.S. cases are rising fast, up almost 20% over two weeks ago.

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WALENSKY: We have so much to look forward to. But right now, I'm scared.

CORNISH: Walensky said more Americans are traveling than at any point in the pandemic, that includes the winter holidays. And in many parts of the U.S., people can now dine indoors, go to the movies or a bowling alley or work out at the gym. Hospitalizations are also up sharply in several states, including Michigan and New Jersey. And deaths, which lag behind new cases, are ticking up as well.

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WALENSKY: The trajectory of the pandemic in the United States looks similar to many other countries in Europe, including Germany, Italy and France - look like just a few weeks ago. And since that time, those countries have experienced a consistent and worrying spike in cases.

CORNISH: In Europe, that's meant many countries are reimposing lockdowns and strict public health measures.

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WALENSKY: We do not have the luxury of inaction. For the health of our country, we must work together now to prevent a fourth surge.

CORNISH: CONSIDER THIS - experts are worried the U.S. could be entering a fourth wave of cases as big or bigger than our winter surge. And the race to vaccinate as many people as possible is getting a lot tighter. There's some good news here, too. We'll actually get to that as well.

From NPR, I'm Audie Cornish. It's Wednesday, March 31.

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CORNISH: It's CONSIDER THIS FROM NPR. And it's not just the U.S. Coronavirus cases are rising all over the world.

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DOUG FORD: Folks, be prepared. I'm asking you, don't make plans for Easter. That's what I can tell you.

CORNISH: In Canada, Ontario Premier Doug Ford said Tuesday that he was worried about rising cases with younger people now in intensive care units.

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FORD: I won't hesitate to, you know, lock things down if we have to. I did it before. I'll do it again.

CORNISH: In India...

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UNIDENTIFIED PERSON #1: The number of daily cases has been on a constant rise in recent days.

CORNISH: ...Several cities and states have imposed lockdown measures.

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UNIDENTIFIED PERSON #2: The government of India has said that the COVID-19 situation in the country is turning from bad to worse.

CORNISH: Cases are also surging in Kenya. Hospitals are overwhelmed in Brazil. And German officials say the B.1.1.7 variant could lead to the country's worst wave yet. And in France...

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PRESIDENT EMMANUEL MACRON: (Speaking French).

CORNISH: ...President Emmanuel Macron announced a new round of restrictions on Wednesday, with a nationwide curfew, remote school and many businesses closed for at least three weeks.

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MACRON: (Through interpreter) Shops will be closed across France.

CORNISH: There are more patients in French ICUs than at any point in the past 11 months. Macron said 44% of them are under the age of 65.

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MACRON: (Through interpreter) We are faced with a race against the clock. We can see that the numbers are tragic...

CORNISH: All this underscores the point - the U.S. is not immune from another surge of its own.

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BILL HANAGE: I really am quite worried indeed.

CORNISH: Bill Hanage is a professor of epidemiology at Harvard.

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HANAGE: It's clear, I think, that we are seeing increases in at least some states - not all states and not all at necessarily exactly the same time. And so I think we can expect that we are going to see at least localized surges in terms of infections.

CORNISH: Those surges, Hanage told NPR, could be dangerous in a new way. They'll provide more opportunity for variants to spread, and that includes the variant that originated in the U.K. and has now been detected in almost every U.S. state. Hanage spoke about that variant known as B.1.1.7 with NPR's Ari Shapiro.

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HANAGE: The worrying thing about B.1.1.7 is that it's more transmissible. When you have something more transmissible, the worry is it can infect people more quickly, and so it can get into them before you're able to vaccinate them.

ARI SHAPIRO: But am I correct that the vaccines do appear to be effective against the strain?

HANAGE: That's absolutely right. And this is really important to remember. The vaccines that we've been using here, at least according to lab results, do appear to be giving good protection against all the variants of concern that we've got at the moment. Now, there may be some small reduction in efficacy but not enough to be really worried about. And that really needs to be made clear.

SHAPIRO: When you compare the daily coronavirus caseload right now to this time a year ago, it looks like it's higher. How much of that is because of better testing and so we're capturing more of the asymptomatic or mildly symptomatic cases that might be out there?

HANAGE: That's absolutely right. This time a year ago, there was a huge iceberg of undetected cases, which is never really recorded. We got better at testing, and that's why we saw the summer surge, you'll remember from last year. Again, we seem to have more cases, but that's because more of them were being detected. And now we have a pretty good handle on where the pandemic is. And we can be clear that cases are starting to increase again in multiple places.

SHAPIRO: We also, at this point, have more hospital capacity, more knowledge about how to treat the disease, vaccines, of course. I mean, do you think that could be enough to stave off another wave?

HANAGE: This is a complicated answer. While we are going to see cases increasing, the relationship between increasing cases and hospitalizations is going to change because some people, at least, have been vaccinated, and the vaccines are really good at preventing severe disease and death, so that's good. However, it doesn't take a large number of infections in the most vulnerable groups to cause serious problems. And of course, a lot of people still haven't received vaccinations. So if we were to go back to exactly how we were before, then, yeah, we would expect there to be a pretty large surge, and that would have effects on health care.

SHAPIRO: As you point out, the most vulnerable people were among the first in line to get vaccines. And so could you envision a scenario where we might see a huge spike in new cases, but we don't see a corresponding spike in hospitalizations and deaths?

HANAGE: That can be envisioned. I would caution, though, that we have not managed to get vaccine into the arms of all of the most vulnerable. And like I say, it doesn't really take a huge number of them to be infected for them to be causing serious problems. One of the biggest, most recent spikes that we've seen has been in Michigan. And it's looking as if maybe in the most recent data, there's a little uptick in deaths as well. I don't want to get too far out ahead of my skis on that, but it's looking as if we are going to be needing to watch these very, very, very carefully in order to understand how the pandemic is changing.

CORNISH: Harvard epidemiologist Bill Hanage. Now, you heard him mention Michigan. According to NPR's member station there, the recent increase in cases is landing people in their 30s and 40s in the hospital and at rates similar to what was seen over the winter, around 60 people each day. But what's different from the winter surge is that far fewer older people are winding up in the hospital, and experts think that's because more of them have been vaccinated. And that brings us to some good news.

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WALENSKY: Our data from the CDC today suggests, you know, that vaccinated people do not carry the virus, don't get sick, and that it's not just in the clinical trials, but it's also in real-world data.

CORNISH: Vaccinated people may be far less likely to carry the virus. CDC Director Rochelle Walensky said that on MSNBC Tuesday. It makes sense. If you can't get sick with the virus, you can't spread it. And scientists have suspected this, but it's now starting to be confirmed by real-world studies. And with the U.S. vaccinating nearly 3 million people a day, a more immunized population may help blunt a coming surge.

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WALENSKY: It could very well be, given that we've done so well in vaccinating the, you know, more senior members of our society that deaths might not be what we would have expected with prior surges.

CORNISH: There was another piece of hopeful vaccine news this week. Pfizer announced Wednesday that the vaccine it developed with BioNTech appears to work in children as young as 12. That conclusion comes from a study of some 2,300 children aged 12 to 15 that began last October. NPR science correspondent Joe Palca has more on Pfizer's announcement. He also spoke to Ari Shapiro.

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SHAPIRO: All right, this sounds like positive news. What did the study show?

JOE PALCA: Well, as you said, there were about 2,300 children - 2,260, to be precise. Half got two shots of the vaccine; half got two shots of a placebo. Now, over the course of the study, 18 participants got sick with COVID, and all 18 cases were in the placebo group, none in the vaccine group. So at least from this study, the vaccine was 100% effective in preventing disease.

SHAPIRO: It sounds like you couldn't hope for any better results than that. Was this a surprise?

PALCA: No, that's about as good as it gets. I put that question to Yvonne Maldonado. She's a pediatric vaccine expert at Stanford University School of Medicine.

YVONNE MALDONADO: We do know that children tend to have very good immune responses relative to adults for other vaccines, so we were hoping for this kind of information.

PALCA: So not a surprise, although 100% is always a little bit - wow, that was something. But the study also showed that the children who got the vaccine had the kinds of antibodies in their blood that would protect them if they ever were exposed to the virus. And the company says that the study showed that the vaccine was safe to administer to children.

SHAPIRO: Children don't seem to get COVID as often as adults. And when they do, they don't seem to get as sick. So how important is it for kids to get vaccinated?

PALCA: Well, what you say is true, of course. But Maldonado says there are a lot of children in this country, about 85 million people younger than 18. And she says they do sometimes get sick.

MALDONADO: Over 3 million children under 18 have been infected so far in this country, accounting for about 13% of all the cases in the U.S. So it's not insignificant.

PALCA: The other thing is that if you're going to achieve this thing called herd immunity, where you've got enough people in the society who are immune to the virus that the virus will actually die out, you probably have to include children in the vaccination effort.

SHAPIRO: I'm sure parents of young kids are thinking, what about children under the age of 12?

PALCA: Well, the company announced last week that it would begin testing kids as young as 6 months, and Maldonado will be involved in those studies. The first step will be to figure out what dose of the vaccine to use because you can probably use a smaller dose in these smaller people to get the same kind of immune protection.

SHAPIRO: Any idea when kids can start getting vaccinated?

PALCA: Well, this is a regulatory question. The first thing that has to happen is that Pfizer will go to the FDA, the Food and Drug Administration, and they'll also go to the European equivalent and ask for what's called authorization or in this country, emergency use authorization for the vaccine. And that usually takes a little while. And then there's this expert committee that reviews what the FDA wants to do. So it's still going to be a while. But the other piece of good news today, well, is that the Moderna, the other company that makes a very effective vaccine, is testing its vaccine in younger people. So there could be two before too long.

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CORNISH: That's NPR's Joe Palca. It's CONSIDER THIS FROM NPR. I'm Audie Cornish.

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