The Daily 202: As Moderna submits vaccine for FDA approval, Fauci says ‘close the bars and keep the schools open’

I felt that familiar sense of hope and reassurance when Moderna announced this morning that, if all goes according to plan, the first injections of its coronavirus vaccine may be given in the United States on Dec. 21.

Moderna will file the paperwork today with the FDA for regulatory clearance after its 30,000-person clinical trial found the vaccine was 94 percent effective at preventing illness. All 30 severe cases of covid-19 in the trial were within the group that received a placebo, the biotechnology company said.

“Moderna’s filing marks the fourth Monday in a row with good news about the vaccine effort and means the United States could have enough vaccine to treat 20 million people by year’s end, between doses of Moderna’s vaccine and those of another candidate that is about a week ahead from Pfizer and German firm BioNTech,” Carolyn Johnson reports. “The data have yet to be published or peer-reviewed, but they will be scrutinized closely by regulators and an outside committee of experts in coming weeks. On Tuesday, an advisory committee to the Centers for Disease Control and Prevention will make recommendations on which groups of people should receive the first doses, which will be in short supply for months.

“Pfizer and BioNTech’s vaccine will be debated by a group of expert advisers to the FDA on Dec. 10, and Moderna’s vaccine is expected to be considered a week later, on Dec. 17. … Results reported last week from a third coronavirus vaccine candidate, from AstraZeneca and the University of Oxford, were positive but confusing, and it is unclear yet whether that vaccine can move forward in the United States without more data.”

Anthony Fauci likens the impending first wave of vaccinations to “a light at the end of the tunnel.” But the government’s top infectious-disease expert emphasized Sunday that these vaccines will not come soon enough to avert “a surge upon a surge” of new cases due to Thanksgiving gatherings and travel. In all likelihood, this devastating wave will continue to shatter records for infections, hospitalizations and deaths.

“When you have the kind of inflection that we have, it doesn’t all of a sudden turn around like that,” Fauci said on ABC’s “This Week.” “We don’t want to frighten people, but that’s just the reality.”

Asked how he would advise President-elect Joe Biden, Fauci answered: “Close the bars and keep the schools open is what we really say.”

“Obviously, you don’t have one size fits all,” he said. “The default position should be to try as best as possible, within reason, to keep the children in school or to get them back to school. … The best way to ensure the safety of the children in school is to get the community level of the spread low.”

Local leaders are listening. “New York Mayor Bill de Blasio announced Sunday that he would begin to allow the city’s youngest students and those with special needs to return to classrooms beginning next week, abandoning a previous plan that forced the entire school system to close 10 days ago and marking another disruption in an already challenging school year,” Moriah Balingit reports. “The move, which will be accompanied by ramped-up coronavirus testing, only impacts a fraction of the more than 1 million public school students in New York City, home to by far the largest school system in the nation. About two-thirds of families there have opted for full-time virtual learning. … 

“Gov. Andrew M. Cuomo (D), who has sparred with the mayor over school closures, said in a teleconference Sunday that he supported de Blasio’s move. Given the low rates of coronavirus found in schools, he said he believed ‘it’s literally safer for a child and a teacher to be in the school than in the community.’”

Effective today, bars, gyms, casinos, movie theaters and bowling alleys in Rhode Island will be forced to close for two weeks. “But not Scituate High School — or most other public schools in the state, where Gov. Gina Raimondo (D) has made in-person instruction a priority even as coronavirus cases soar. And so Michael D. Hassell, Scituate’s principal, expects to start Monday as he has for weeks now: happy to be at work but wondering whether he will have enough staff to teach the 130 teenagers who will soon show up for class,” Karin Brulliard, Ariana Eunjung Cha and Balingit report. “‘There is a fair amount of data that schools can be opened safely during the pandemic,’ said David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia, which has advised schools on how to open but also to reconsider when their regions’ rate of positive coronavirus test results surpasses 9 percent. … 

“The federal government has offered scant guidance, leaving school boards, superintendents and elected officials to determine their tipping points amid intense pressure from teacher unions and parents. … In recent weeks, public schools in Boston and Detroit have suspended all or most in-person learning. Other school systems that have remained closed since March, including Seattle’s, are putting plans to reopen on ice. But even in the face of skyrocketing coronavirus cases, officials in Delaware, Vermont and other locations are pushing to keep schools open, at least partially. Michigan Gov. Gretchen Whitmer (D) shuttered high schools in mid-November but left elementary and middle schools open.”

Even as infection rates are extremely low among students and teachers in both public and private schools that have returned to in-person learning, there is a growing body of evidence that shuttered schools are taking a toll on the health, welfare and academic progress of the most vulnerable students. Children with disabilities and English-language learners are suffering the most. Remote school is leaving other children sad and angry. A rising emotional toll is hitting the youngest kids the hardest. Teachers also say they face formidable challenges trying to educate students virtually.

Fairfax County Public Schools in Virginia, which has been mostly online since March, published an internal analysis last week showing that, between the last academic year and this one, the percentage of middle school and high school students earning F’s in at least two classes jumped by 83 percent: from 6 percent to 11 percent. “By the end of the first quarter of 2020-2021, nearly 10,000 Fairfax students had scored F’s in two or more classes — an increase of more than 4,300 students as compared with the group who received F’s by the same time last year,” Hannah Natanson reports. “In the Independent School District in Houston, more than 40 percent of students are earning failing grades in at least two of their classes, according to data reported by the Houston Chronicle. Likewise in St. Paul, Minn., where the superintendent recently reported that nearly 40 percent of St. Paul Public Schools high-schoolers have failing marks, local TV station KARE reported.”

Some school systems that have chosen to stay closed face mounting blowback. In Atlanta, high-schoolers continue to attend virtual classes from home, but the district just granted special permission for Hollywood to film the next “Spider-Man” movie inside two school buildings early next year. The Atlanta Journal-Constitution reported that this has generated pushback from some parents and teachers. “As real-life Atlanta Public Schools students have been left without much of a clue as to when they might be able to return to in-person classes, they say a comic-book superhero does not deserve priority during a public health crisis — even if his brief presence at their schools could generate thousands of dollars in additional funding,” Teo Armus reports.

“In person school is not only safe, it’s necessary for learning,” one mother and teacher wrote on Twitter. “Too bad kids don’t generate the millions a movie does, or they’d be back in front of their teacher in a classroom rather than a computer screen.”

“About 95,000 people are currently hospitalized with the disease, according to Adm. Brett Giroir, assistant secretary of health and human services. Roughly 20 percent of all hospitalized people have covid-19,” Jacqueline Alemany reports. “Giroir said that he couldn’t project how much the weekend may have exacerbated spread of the virus. … But he called this moment ‘a really dangerous time.’”

“U.S. hospitals are in danger of buckling beneath the weight of the pandemic and the ongoing needs of other sick people,” Lenny Bernstein reports from Eau Claire, Wis., where he spent two days embedded with doctors and nurses. “In small- and medium-size facilities like this hit hardest by the outbreak’s third wave, that means finding spots in ones and twos, rather than adding hundreds at a time as New York hospitals did when the coronavirus swept the Northeast in the spring. … Marybeth Pichler was filling in on the floor recently when another nurse asked her to sit with a dying covid-19 patient. He had perhaps an hour to live. … ‘I just sat down, and he just talked,’ she said. ‘He talked about how he used to farm and how he had dairy cows and after he sold the dairy cows, he had Black Angus.’ After about 25 minutes, the patient took off the mask that provided him high-flow oxygen and soon passed away. With no visitors allowed, Pichler said she ‘felt it was an honor to be able to sit with him and hear about his life. Otherwise … he would have been alone when he died.’”

• In nine states, more than 1 in every 1,000 people alive at the start of the year are dead now because of coronavirus-related causes. On Friday, South Dakota became the latest state to see at least one covid-19 death for every 1,000 residents, joining New York, New Jersey, Massachusetts, Connecticut, Louisiana, Rhode Island, Mississippi and North Dakota. (Marisa Iati and Hannah Knowles)
• A federal system for tracking hospital beds and coronavirus patients may be providing questionable data, per Science Magazine.
• California has more people hospitalized with covid than at any time since the pandemic began. There were 7,415 such patients in state hospitals on Saturday. The death rate is also rising. Statewide, an average of 75 deaths were reported daily over the seven-day period before Thanksgiving, compared to 40 in mid-November. (Los Angeles Times)
• Hospital beds in Kansas City are running sparse, leaving rural hospitals in Kansas and Missouri to face a new “tidal wave.” Smaller hospitals are being forced to treat more patients in-house, pushing the limits of what care can be provided by the smallest facilities. (Kansas City Star)
• In Anchorage, nurses say they are struggling with low staffing numbers and burnout as patients flood in from the city and from rural corners of the state, where new cases are rising at disproportionate levels to the rest of Alaska. (Anchorage Daily News)
• An Oregon nurse bragged on TikTok about not wearing a mask outside of work. Following online backlash, the nurse’s employer, Salem Health, announced that she had been placed on administrative leave. (Andrea Salcedo)

“Overcoming distrust of a covid-19 vaccine is about ‘survival instincts’ for Shane Lee, a family physician in Perry County, Ala., a rural, mostly African American community of about 9,000 where more than a third of people live in poverty,” Isaac Stanley-Becker reports. “When the outbreak erupted in Alabama’s Black Belt in the summer and ‘swept through hospitals and nursing homes like a grass fire,’ the 59-year-old doctor, a retired Army general, became infected. His heart muscle grew inflamed. Months later, he is still short of breath. The lone doctor at his clinic in Marion, the county seat, Lee watched his two nurse practitioners leave during the pandemic in search of less grueling work. An X-ray technician also quit. ‘I will take the first vaccine that hits the street,’ he said. … But as for when the vaccine will reach Perry County — and whether the rest of the community will agree to take it — the doctor would not hazard a guess. … 

“Some of the steepest obstacles involve doubt about scientific advances championed in Washington. Distrust of the medical establishment permeates the state’s Black community, nearly a half-century after the revelation that syphilis patients in Tuskegee, Ala., were deceived and had treatment withheld to study the natural course of the disease. … Also threatening participation is the ‘unprecedented head wind of disinformation about the virus itself,’ said Jim Carnes, policy director for Alabama Arise, an advocacy group for low-income residents. …

“The logistical hurdles are just as concerning to [Lee]. Shots that require ultracold storage, a specification of the Pfizer vaccine, are ‘not practical’ in rural areas without big hospitals, he said. Drive-up vaccination sites are also not realistic, he noted, because more than 16 percent of households in his county have no vehicle. ‘There are so many logistical issues that they, in total, are mind-blowing,’ said Scott Harris, Alabama’s top health officer, who is overseeing the state’s immunization effort. … Many of Alabama’s obstacles, from rural access to racial disparities, are mirrored across the country, said David Kimberlin, a pediatric infectious-disease specialist at the University of Alabama at Birmingham.”

The U.S. Chamber and Georgia Chamber of Commerce will go on television tomorrow with a positive commercial that urges people to “thank” Republican Sens. David Perdue and Kelly Loeffler for “fighting” to deliver pandemic relief to help small businesses. Both face Democratic challengers in Jan. 5 runoffs that will determine which party controls the Senate. The ad will air on broadcast in the Atlanta, Macon and Savannah media markets for nine days, as well as statewide cable for 14 days.

“National coronavirus test shortages have emphasized testing’s critical role in containing and mitigating the pandemic, but these inconvenient truths remain: A test result is rarely a definitive answer, but instead a single clue at one point in time, to be appraised alongside other clues like symptoms and exposure to those with confirmed cases. The result itself may be falsely positive or negative, or may show an abnormality that doesn’t matter. And even an accurate, meaningful test result is useless (or worse) unless it’s acted on appropriately. These lessons are not unique to covid-19,” Ishani Ganguli reports. “False positives are especially common for screening tests like hepatitis C antibody tests and mammograms that look for medical problems in healthy people without symptoms.” 

• Record numbers of U.S. military personnel are testing positive in Japan’s Okinawa Prefecture. Authorities announced that 72 new cases had been detected among military personnel who underwent PCR testing after arriving from overseas — the highest number to date. (Antonia Farzan) 
• A Singaporean woman gave birth to a child with covid-19 antibodies months after contracting the virus herself. At the time of her infection, the woman was 10 weeks pregnant. When her son was born, he had antibodies but not the virus – but her antibodies seemed to have disappeared. Little is known about whether pregnant women who contract the coronavirus can transmit that infection to the fetus, and exactly how babies are born with antibodies. It’s also unclear exactly how long those antibodies can last, and if they can protect a newborn against the virus. (Antonia Farzan)
• Pennsylvania Republican state Sen. Doug Mastriano abruptly left a White House meeting with President Trump last Wednesday after being informed he had tested positive. Mastriano had gathered with other lawmakers at the White House right after their four-hour public meeting in Gettysburg, where they discussed efforts to overturn Biden’s victory in the Keystone State. Mastriano didn’t wear a mask at the meeting. (AP)
• Colorado Gov. Jared Polis (D) said he and his partner tested positive and are isolating at home but “feeling well.” Polis said he and Marlon Reis are both asymptomatic. (Hannah Knowles)
• The NFL faced widespread complications on Saturday in its attempt to complete its season as the Denver Broncos dealt with a severe quarterback shortage and the San Francisco 49ers were told that they might need to relocate due to local ordinances. The Baltimore Ravens and the Pittsburgh Steelers are also facing issues ahead of a twice-rescheduled game that, if it can’t be played Tuesday, could force the addition of a week to the regular season. (Mark Maske)
• England’s month-long lockdown appears to be paying off. Infections have fallen by about 30 percent, according to a study from Imperial College London and Ipsos MORI. (Farzan)

“Some patients have waited months for their olfactory senses and taste buds to return. I had no idea how I’d do my job if I suffered a similar fate. Fortunately, I never had to worry about it. I lost my appetite for a couple of weeks and I lost weight, but I never lost my ability to taste or smell,” Tim Carman writes. ”Covid had other surprises waiting for me instead. On Wednesday night, just 24 hours into this nightmare, I woke up around 4 a.m., feeling generally uncomfortable. I sat up in bed, and within a matter of minutes, I could feel my body start to turn against me. I felt warm, so I slid to the floor to let the hardwoods cool my skin. That’s when I experienced a pain so profound and all-encompassing I couldn’t put it into words … Then the nausea hit me. … And then, just like that, as if by divine intervention, the pain and nausea disappeared. It was replaced, almost instantaneously, by an overwhelming anger at the current administration, which would prefer that we all experience our own private covid hell.”

“The Greek roots of this word tell a clear story: pan means ‘all’ or ‘every,’ and dēmos means ‘people’; its literal meaning is ‘of all the people.’ The related word epidemic comes from roots that mean ‘on or upon the people.’ The two words are used in ways that overlap, but in general usage a pandemic is an epidemic that has escalated to affect a large area and population. The dēmos of these words is also the etymological root of democracy,” the editors of the dictionary explain. In 2008, “bailout” was the dictionary’s word of the year. In 2010, it was “austerity.” In 2016, it was “surreal.” In 2017, it was “feminism.” What do you think might be the word of the year for 2021?

“Biden, 78, slipped Saturday while playing with his dog Major, one of his two German shepherds, his office said,” Amy B Wang reports. “Late Sunday afternoon, Biden visited Delaware Orthopaedic Specialists in Newark, Del., about a half-hour from his home near Wilmington. After spending about two hours there, Biden traveled to a nearby imaging facility to have a CT scan. A cameraperson traveling with the press pool observed him walking with a limp. A follow-up scan confirmed hairline fractures in Biden’s lateral and intermediate cuneiform bones, in his right mid-foot, according to his physician, Kevin O’Connor. ‘It is anticipated that he will likely require a walking boot for several weeks,’ O’Connor said. … 

“Upon arriving at the first clinic, the van Biden was in maneuvered so reporters and photographers traveling with the president-elect could not see him as he left the motorcade and entered the doctor’s office. The transition team also did not allow journalists off a van while Biden was inside. A Biden spokesperson said the president-elect visited the doctor’s office on Sunday to avoid disrupting the clinic’s regularly scheduled appointments on Monday. … Biden adopted Major from the Delaware Humane Association in 2018. Major is set to become the first rescue dog to live in the White House when Biden takes office in January.” 

“Biden is expected to nominate Neera Tanden, the chief executive of the left-leaning Center for American Progress, as director of the influential Office of Management and Budget. … Tanden, whose parents immigrated from India, would be the first woman of color to oversee the agency,” Annie Linskey reports. “[Biden] will also appoint Princeton University labor economist Cecilia Rouse as chair of the three-member Council of Economic Advisers, with economists Jared Bernstein and Heather Boushey serving as the other members. Rouse, who is African American, would be the first woman of color to chair the council. … 

“Jennifer Psaki, a veteran Democratic spokeswoman, will be Biden’s White House press secretary, one of seven women who will fill the upper ranks of his administration’s communications staff. It is the first time all of the top aides tasked with speaking on behalf of an administration and shaping its message will be female. Biden’s team will be steered by Kate Bedingfield, a longtime Biden aide who was his campaign communications director and will hold the same title in his White House. … Unlike the team that Biden has chosen, Trump’s communications staff includes spokesmen who are regularly quoted. … 

“The odds are very high that if it’s a story about the Biden administration, any aspect of it, at least one quote in the story will be from a woman,” said Anita Dunn, a top Biden campaign aide. 

“Other Republicans focused their ire on Tanden, who will need to be approved by the Senate to take on her job. Drew Brandewie, the communications director for Sen. John Cornyn (R-Tex.), said via Twitter that she ‘faces zero chance of being confirmed’ because of her critiques of GOP senators. … Tanden will be under pressure from conservatives to rein in government spending but will probably play an instrumental role in crafting the Biden administration’s response to the current economic downturn. … Brian Deese, who served as a senior economic official during the Obama administration, will also be named the director of the White House National Economic Council …

“Rounding out the White House press team will be Karine Jean-Pierre, a campaign adviser and former top official with the liberal group MoveOn, as principal deputy press secretary. Pili Tobar, who worked for America’s Voice, a liberal immigration reform group … will become deputy White House communications director. … Harris’s communications director will be Ashley Etienne, a senior adviser to Biden’s campaign … Symone Sanders, a former senior adviser to Biden’s campaign, will become Harris’s chief spokeswoman. … The head of the incoming East Wing communications team, who will work with Jill Biden, was also named: Elizabeth E. Alexander, a former campaign adviser who served as Biden’s spokeswoman when he was vice president.”

• Biden also named Adewale Adeyemo, a former Obama administration international economic adviser, as Janet Yellen’s No. 2 at the Treasury Department. Adeyemo, who immigrated here from Nigeria with his family as a child, would be the department’s first Black deputy secretary, per the Wall Street Journal.
• Tom Donilon is no longer in the running to be CIA director. Donilon, a former national security adviser in the Obama administration, intends to remain in the private sector, CNN reports. 
• Rahm Emanuel is still being considered for Transportation secretary despite blowback from the left. (Axios)
• Meanwhile, at least a dozen Trump political appointees have now “burrowed” into civil service positions where they can wreak havoc on Biden’s agenda from the inside. “They include a high-ranking official at the U.S. Department of Veterans Affairs, at least seven political appointees in the U.S. Department of Justice and four appointees in the U.S. Department of Interior, among others,” NBC 4 reports.

“A Humvee laden with explosives and backed by gunmen struck a government base in central Afghanistan on Sunday, killing at least 30 people and wounding 24, according to local officials. Most of the casualties were members of the Afghan security forces,” Aziz Tassal and Susannah George report. “It was one of the deadliest attacks in recent months in Afghanistan, where violence has been on the rise despite ongoing peace talks between the Taliban and Afghan government representatives in Doha, Qatar. … No group immediately claimed responsibility for the attack. As of Sunday night, the Taliban had not issued a statement denying involvement, as it does normally. But some local officials were already blaming the group, citing its history of carrying out such attacks.”

• Australia demanded an apology after a Chinese Foreign Ministry official tweeted a graphic, computer-generated fake illustration of a grinning Australian soldier holding a knife to the throat of an Afghan child. (Gerry Shih)
• In the wake of Friday’s killing of Iran’s top nuclear scientist, Mohsen Fakhrizadeh, the questions have quickly shifted from who carried out the brazen daylight attack to why. Commentators have brushed aside Israel’s refusal to comment and instead focused on what Israeli Prime Minister Benjamin Netanyahu might have to achieve. Some believe he seized the opportunity to take Fakhrizadeh out in hopes that Iran would show restraint in its response, as it has since the attack. (Steve Hendrix and Shira Rubin) 
• Jared Kushner is headed to Saudi Arabia to meet with Crown Prince Mohammed bin Salman to try to make a deal before Biden takes over. (Reuters)
• At least 110 people were killed in a suspected Boko Haram attack on a village in northeast Nigeria, according to the United Nations. Assailants targeted farmers on the rice fields of the village of Koshobe. (Guardian)

“The recount of presidential ballots in Wisconsin’s two largest counties reconfirmed Sunday that Biden beat President Trump in the key swing state by more than 20,000 votes, the latest example of the president’s flailing efforts to undo the election results,” Rosalind Helderman and Amy Gardner report. “His campaign has vowed to appeal to the U.S. Supreme Court, though it has yet to do so. … Under Wisconsin law, Trump was required to foot the bill — meaning his campaign paid $3 million, only to see Biden widen his margin [by 87 votes]. … Four of the six states where Trump has questioned the results have already certified their vote tallies. … 

“Meanwhile, two new court decisions in Pennsylvania late last week rejected the Trump campaign’s attempts to halt the vote count in that state … The last key vote certifications could come Monday, when Arizona is set to finalize its results, along with Wisconsin, which announced Sunday it would complete its state canvass then. Republicans, including the three who sit on Wisconsin’s six-member election commission, may attempt to delay certification. However, under state law, the chair of the commission — currently a Democrat — has the authority to finalize the results. … Even if the Trump campaign were to pull out a surprise courtroom win — which legal experts said is unlikely — it would do little to change the outcome of the White House race, which Biden won with 306 electoral votes. The electoral college will meet on Dec. 14 to formalize his victory.”

“‘My mind will not change in six months,’ Trump told host Maria Bartiromo by telephone on Fox News Channel’s ‘Sunday Morning Futures.’ ‘There was tremendous cheating here,’” Felicia Sonmez reports. “He claimed that some foreign leaders have been calling and telling him that this was the most ‘messed-up’ election they have ever seen, although he did not name any of the leaders. … Bartiromo did not dispute any of Trump’s false claims.”

“This redraw will be most painful in the roughly ten states which are on track to lose a district, particularly ones with smaller populations. That could mean bare-knuckled maneuvering between the two Democrats in Rhode Island and three Republicans in West Virginia — states likely to drop a seat,” Politico reports. Among the current and future members considered most at risk in reapportionment, according to lawmakers, operatives and map makers in both parties across seven states: Rhode Island Democrat Jim Langevin, West Virginia Republicans David McKinley and Alex Mooney, Republicans Barry Moore and Jerry Carl in Alabama; and Democrats Lucy McBath and Carolyn Bourdeaux in Georgia. 

Rep. Paul Mitchell (R-Mich.) asked Trump to “stop the stupid”:

Trump sent well wishes to Biden after news broke that he hurt his foot:

The cast of the “West Wing” joked about the opening scene of the show’s first episode, in which President Jed Bartlet also suffered a minor injury:

Chris Krebs, a lifelong Republican fired by Trump as the director of the Cybersecurity and Infrastructure Security Agency, debunked Trump’s theories on “60 Minutes.” Krebs was fired after he said the 2020 election was “the most secure” in U.S. history, and he said he remains confident in the results:

Vanderbilt kicker Sarah Fuller became the first woman to play in a Power Five football game: