It’s an exciting time in particle physics. The results of a new experiment out of Fermilab in Illinois — involving a subatomic particle wobbling weirdly — could lead to new ways of understanding our universe.
To understand why physicists are so excited, consider the ambitious task they’ve set for themselves: decoding the fundamental building blocks of everything in the universe. For decades, they’ve been trying to do that by building a big, overarching theory known as the standard model.
The standard model is like a glossary, describing all the building blocks of the universe that we’ve found so far: subatomic particles like electrons, neutrinos, and quarks that make up everything around us, and three of the four fundamental forces (electromagnetic, weak, and strong) that hold things together.
But, as Jessica Esquivel, a particle physicist at Fermilab, tells Vox, scientists suspect this model is incomplete.
“One of the big reasons why we know it’s incomplete is because of gravity. We know it exists because apples fall from trees and I’m not floating off my seat,” Esquivel says. But they haven’t yet found a fundamental particle that conveys gravity’s force, so it’s not in the standard model.
Esquivel says the model also doesn’t explain two of the biggest mysteries in the universe: dark matter, an elusive substance that holds galaxies together, and dark energy, an even more poorly understood force that is accelerating the universe’s expansion. And since the overwhelming majority of the universe might be made up of dark matter and dark energy, that’s a pretty big oversight.
The problem is, the standard model works really well on its own. It describes the matter and energy we’re most familiar with, and how it all works together, superbly. Yet, as physicists have tried to expand the model to account for gravity, dark matter, and dark energy, they’ve always come up short.
That’s why Esquivel and the many other particle physicists we’ve spoken to are so excited about the results of a new experiment at Fermilab. It involves muons — subatomic particles that are like electrons’ heavier, less stable cousins. This experiment might, finally, have confirmed a crack in the standard model for particle physicists to explore. It’s possible that crack could lead them to find new, fundamental building blocks of nature.
Esquivel worked on the experiment, so we asked her to walk us through it for the Unexplainable podcast. What follows is a transcript of that conversation, edited for clarity and length.
Noam Hassenfeld
What was this muon experiment?
Jessica Esquivel
So at Fermilab, we can create particle beams of muons — a very, very intense beam. You can imagine it like a laser beam of particles. And we shoot them into detectors. And then by taking a super, super close measurement of those muons, we can use that as kind of a probe into physics beyond our standard model.
Noam Hassenfeld
So how, exactly, does this muon experiment point to a hole in the model, or to a new particle to fill that gap?
Jessica Esquivel
So the muon g-2 experiment is actually taking a very precise measurement of this thing that we call the precession frequency. And what that means is that we shoot a whole bunch of muons into a very, very precise magnetic field and we watch them dance.
Noam Hassenfeld
They dance?
Jessica Esquivel
Yeah! When muons go into a magnetic field, they precess, or they spin like a spinning top.
One of the really weird quantum-y, sci-fi things that happens is that when you are in a vacuum or an empty space, it actually isn’t empty. It’s filled with this roiling, bubbling sea of virtual particles that just pop in and out of existence whenever they want, spontaneously. So when we shoot muons into this vacuum, there are not just muons going around our magnet. These virtual particles are popping in and out and changing how the muon wobbles.
Noam Hassenfeld
Wait, sorry … what exactly are these virtual particles popping in and out?
Jessica Esquivel
So, virtual particles, I … see them as like ghosts of actual particles. We have photons that kind of pop in and out and they’re just kind of like there, but not really there. I think a really good depiction of this, the weirdness of quantum mechanics, is Ant-Man. There’s this scene where he shrinks down to the quantum realm, and he gets stuck and everything is kind of like wibbly-wobbling and something’s there, but it’s really not there.
That’s kind of like what virtual particles are. It’s just hints of particles that we’re used to seeing. But they’re not actually there. They just pop in and out and mess with things.
Noam Hassenfeld
So quantum mechanics says that there are virtual particles, sort of like ghosts of particles we already know about in our standard model, popping in and out of existence. And they’re bumping into muons and making them wobble?
Jessica Esquivel
Yes. But again, theoretical physicists know this, and they’ve come up with a really good theory of how the muon will change with regards to which particles are popping in and out.So we know specifically how every single one of these particles interacts with each other and within the magnetic field, and they build their theories based on what we already know — what is in the standard model.
Noam Hassenfeld
Got it. So even though there are these virtual ghost particles popping in and out, as long as they’re versions of particles we know, then physicists can predict exactly how the muons are going to wobble. So were the predictions off?
Jessica Esquivel
So what we just unveiled is that precise measurement doesn’t align with the theoretical predictions of how the muons are supposed to wobblein a magnetic field. It wobbled differently.
Noam Hassenfeld
And the idea is that you have no idea what’s making it do that extra wobble, so it might be something that hasn’t been discovered yet? Something outside the standard model?
Jessica Esquivel
Yeah, exactly. It’s not considered new physics yet because we as physicists give ourselves a very high bar to reach before we say something is potentially new physics. And that’s 5 sigma [a measure of the probability that this finding wasn’t a statistical error or a random accident.] And right now, we’re at 4.2 sigma. But it’s pretty exciting.
Noam Hassenfeld
So if it clears that bar, would this break the standard model? Because I’ve seen that framing in a bunch of headlines.
Jessica Esquivel
No, I don’t think I would say the standard model is broken. I mean, we’ve known for a long time that it’s missing stuff. So it’s not that what’s there doesn’t work as it’s supposed to work.
It’s just that we’re adding more stuff to the standard model, potentially. Just like back in the day when scientists were adding more elements to the periodic table … even back then, they had spots where they knew an element should go, but they hadn’t been able to see it yet. That’s essentially where we’re at now. We know we have the standard model, but we’re missing things. So we have holes that we’re trying to fill.
Noam Hassenfeld
How exciting does all of this feel?
Jessica Esquivel
I think it’s like a career-defining moment. It’s a once-in-a-lifetime. We’re chasing new physics and we’re so close, we can taste it.
What I’m studying isn’t in any textbook that I’ve read or peeked through before, and the fact that the work that I’m doing could potentially be in textbooks in the future … that people can be learning about the dark matter particle that g-2 had a role in finding … it gives me chills just thinking about it!
The future of America’s Covid-19 epidemic can now be distilled into this: long-term confidence and hope, but short-term uncertainty and, perhaps, even despair.
Vaccines are rolling out quickly, setting up the country to crush the outbreaks that have warped our lives for the past year.
But in the short term, perhaps the next month, the US faces a few potential paths. The worst scenario: A fourth surge of the coronavirus outpaces vaccinations and kills thousands more people even as the country nears the finish line with Covid-19. The best possibility: The accelerating vaccine rollout and continued vigilance keep the virus at its current level or, hopefully, results in fewer infections — letting the US cross the finish line safely and with more lives saved. Then there’s a middle path: Cases rise, but vaccines shield the country from more hospitalizations and deaths.
The path the US takes, though, will be decided by one of the most unpredictable things of all: human behavior.
The public could loosen up on Covid-19 precautions too quickly, discarding masks and failing to social distance before enough people are vaccinated. As has already been done in some areas, policymakers could push the country in this direction by ending restrictions before the vaccine rollout is truly at critical mass. Either of those things, or a combination of both, could lead to a fourth surge.
But if Americans hold out just a bit longer, and vaccination rates continue to pick up, the US could reach the end of the current large outbreaks — as cases dwindle down close to zero — before that happens.
The good news is, an end seems to be in sight. At current vaccination rates, the country could inoculate its entire adult population by July, leaving us ample time over the summer to start getting our lives back to normal and, hopefully, celebrate with others. One country that has vaccinated the bulk of its population, Israel, has shown this is possible, reopening its economy and crushing the Covid-19 curve at the same time.
“Yes, there are some near-term concerns,” Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation, told me. “But so far we’re — cautiously — on the other side of it. … If we push ahead and really accelerate vaccination, by the summer we’ll be in a much, much better place.”
The question now is what lies between here and there.
The worst short-term scenario: Cases, hospitalizations, and deaths rise in a fourth surge
This is the worst-case scenario — the one that CDC Director Rochelle Walensky said fills her with a feeling of “impending doom.”
Here’s how it could play out: In the next few weeks, states continue to loosen the restrictions they put in place to combat Covid-19, opening up businesses (particularly indoor locations) and revoking their mask mandates. The public follows suit, embracing the near-end of Covid-19 by going out and engaging in close-contact activities with family, friends, and strangers, even if they’re not yet fully vaccinated. The vaccine campaign can’t keep up with all of this new social activity, and more people catch the virus than are inoculated.
So the coronavirus spreads, jumping between all these vulnerable people mingling together again, while more-infectious coronavirus variants spread rapidly at the same time, pushing the wave even higher. (B.1.1.7, the variant that appears to have originated in the UK, is now the dominant cause of new infections in the US, Walensky said Wednesday.)
That said, it doesn’t seem like the US overall is heading toward the worst-case scenario, at least not yet. A recent uptick in Covid-19 cases might have hit a plateau. The US still has a lot of daily new Covid-19 cases — nearly 500 times that of Australia after controlling for population — but it may not be getting worse.
The concern is that could all change — and quickly — due to exponential spread, which causes infections to pick up at an accelerating pace. During the US’s third surge in the fall, it took roughly a month for daily new cases to double from about 40,000 to 80,000. But it took only around two weeks for daily new cases to double once again, from 80,000 to 160,000.
This might already be happening in Michigan, which has been hit hard by Covid-19 in the past few weeks. The state’s current surge isn’t quite as bad yet as its previous one, but it’s still leading to more hospitalizations and deaths. If it’s already happening there, it could happen elsewhere.
The middle short-term path: Covid-19 cases rise, but not hospitalizations and deaths
Throughout the pandemic, Covid-19 deniers have claimed rises in cases were only a “casedemic,” meaning that cases rose but hospitalizations and deaths didn’t, and therefore there was nothing to worry about.
That was nonsense for much of the past year, fueled by a crucial misunderstanding: Increases in hospitalizations and deaths tend to lag behind increases in cases because it takes time for people to get sick, land at the hospital, and die after getting infected.
But something like this could happen now, thanks to the vaccines. So far, the populations more vulnerable to Covid-19, based on age, have gotten more of the vaccine. The result is that more than 76 percent of adults 65 and older have gotten at least one dose, and more than 57 percent have been fully vaccinated (either by the one-shot Johnson & Johnson vaccine or a two-shot vaccine from Moderna or Pfizer). Over the past year, this age group represented around 80 percent of all Covid-19 deaths in the US.
With much of the vulnerable vaccinated, a rise in Covid-19 cases may not translate to a significant rise in hospitalizations and deaths. Younger people may contract the virus, but they won’t show up at the hospital or die at the same rates as older individuals. The virus would lose the race to the vaccines.
So the US may still see a fourth surge in cases. But, as Amesh Adalja at the Johns Hopkins Center for Health Security told me, “It’s going to be of a different flavor than prior waves” because the vaccines “have defanged the virus,” including the variants that have been discovered so far.
This is still speculative.
“I think it’s a bit too early to tell,” George Mason University epidemiologist Saskia Popescu said about that scenario. Reducing a fourth surge to a “casedemic” still requires action — ensuring vaccines continue to go out quickly, especially to vulnerable populations.
The best short-term scenario: No fourth surge at all
This scenario — where cases, hospitalizations, and deaths all hold steady or continue to fall — is contingent on policymakers not reopening their states too quickly, the American people continuing to follow public health guidelines such as social distancing and masking, and the vaccine rollout improving, or at the very least, maintaining its current pace.
It could also be helped along by warmer weather in most of the country in the coming weeks, pushing Americans to do more in outdoor spaces where the virus doesn’t spread as easily.
History might not give much reason for optimism. America has generally done a bad job with its policy approach and public adherence throughout the pandemic (hence America’s high death toll relative to many of its developed peers). As Popescu put it, “The US has really struggled when it comes to maintaining vigilance when the finish line is in sight.”
But the country could do it. If Americans hold out a little while longer — possibly just several weeks — we could suddenly find ourselves in a world where most US adults have gotten at least one shot of the vaccine. If we get there and avoid the first scenario on this list, it could translate to tens of thousands more of us being around to celebrate.
The longer-term scenario is more certain — and hopeful
For all the uncertainty surrounding the short term, there’s a longer-term scenario that seems very likely: Thanks to the vaccines, the US will reach the end of the large outbreaks, and the summer will be the beginning of our return to normal.
There’s a real-world example that should fill Americans with hope: Israel. Thanks to good planning and flexibility, Israel has fully vaccinated more than 56 percent of its population, including the vast majority of older demographics. That’s allowed it to almost fully open its economy again as Covid-19 cases plummet to levels not seen since summer 2020.
This is incredibly encouraging. It shows that the vaccines work and are truly a way out of the pandemic. “It’s there,” Adalja said. “The real-world data shows what future we’ll eventually achieve if everything stays on track and we continue to vaccinate.”
The US is well on its way to that point. Already, more than 19 percent of the US population is fully vaccinated. With more than 3 million doses being administered a day, the country will be able to fully inoculate the majority of its population in a little more than a month — and all adults within three months. If that trend continues, the US could reproduce Israel’s crushed curve in just months or even weeks.
Then it will finally happen. We’ll find ourselves back at parties with family, at dinners with friends, and in movie theaters with strangers. What was considered too risky just months ago will be the normal we’ve desired for a year.
“I reckon that point will become apparent in retrospect,” Bill Hanage, an epidemiologist at Harvard, previously told me. “We will suddenly realize that we are laughing, indoors, with people we don’t know and whose vaccine status is unknown, and we will think, ‘Wow, this would have been unimaginable back when …’”
There are still major challenges ahead. Avoiding the deadliest of the short-term scenarios could save tens of thousands of lives. Ensuring enough people get vaccinated — by both improving access and addressing vaccine hesitancy — will be crucial. And it’s a race against time: The possibility that worse variants will emerge increases as the virus continues to spread and mutate.
It’s important to help the rest of the world in its efforts too — not simply for humanitarian reasons, but because the coronavirus and its variants could creep back into the US from other countries.
Still, the happier future now looks like a matter of when, not if. After a year of our futures constantly seeming so uncertain, we now have this respite to look forward to — and it’s likely just a matter of time.
In the coming months, America could reach a point when it has more Covid-19 vaccines than people want.
Between efforts from the federal government and drug companies to step up manufacturing and distribution, the US’s vaccine supply is truly increasing: At least 150 million doses are expected through March — a rate of more than 3 million shots a day, the kind of speed the country needs to reach herd immunity, when enough people are protected against the virus to stop its spread, this summer.
But public health experts are increasingly warning of what may come as America inches closer to the finish line in its vaccine campaign: After the majority of people who want a vaccine get one, there’s a large minority of people who have voiced skepticism in public surveys. And if these people don’t change their minds in the coming months, they could doom any chance the US has of reaching herd immunity.
“There’s going to be a point … where there’s going to be vaccine available, and getting people to take it will be the primary issue,” Emily Brunson, a medical anthropologist at Texas State University, told me.
To reach herd immunity, experts generally estimate that we’ll need to vaccinate at least 70 to 80 percent of the population — though it could be more or less, because we don’t really know for sure with a new virus. Yet according to a recent AP-NORC survey, 32 percent of Americans say they definitely or probably won’t get a Covid-19 vaccine. If that holds and the herd immunity estimates are correct, it would make herd immunity impossible.
Public health experts say there are ways to make people more willing to get vaccinated, but such efforts have to be flexible to match the different concerns about a vaccine different communities and individuals may hold. What might sway skeptical white Republicans who don’t see Covid-19 as a threat won’t necessarily work for Black communities that are distrustful of a medical establishment that has long neglected and even abused them.
Whatever anti-hesitancy campaigns take shape, though, must happen quickly. With every day the coronavirus continues to spread across America, the country sets itself up for hundreds if not thousands more deaths a day — not to mention the constant need for social distancing, a weakened economy, and potentially harsher restrictions on daily life. Each day of uncontrolled spread also brings the risk of new, more dangerous coronavirus variants, as each replication of the virus carries the risk of a mutation that catches on more widely.
Now, the days when hesitancy becomes the top vaccine problem may still be up to months away. But if the pandemic should have taught us anything, it’s that it’s better to be proactive than reactive. It’s not too late to get ahead of this problem before it becomes the next major bottleneck in America’s efforts to end its outbreak.
The US’s vaccine supply problem is getting better
The past few weeks have brought a lot of genuinely good news on the vaccine front.
The number of shots delivered has increased dramatically, from less than 1 million a day in mid-January to around 1.7 million in mid-February. (Though recent snowstorms likely slowed that down.) As bad as America’s initial rollout was, the US is still ahead of all countries except Israel, Seychelles, the United Arab Emirates, and the United Kingdom in vaccination rates — and it’s improving quickly enough, so far, to sustain that lead.
There have also recently been fewer mishaps at the state level. There were some alarming reports during the first few weeks of the rollout — machines breaking down, staffing issues, doses going unused. These problems still pop up (the US is big, and someone is always causing trouble here), but they seem to be happening less frequently as states and localities get the hang of the process. To this end, states are using much more of their vaccines: While it was rare for a state to report administering more than 60 percent of vaccine doses in January, it’s now pretty common for them to report using more than 80 or 90 percent.
Meanwhile, President Joe Biden’s administration has made some strides to improve both the supply of vaccines sent to states and communication with states on what supplies they can expect. The latter is particularly important because it lets states plan for the doses they’re getting — something they weren’t often able to do in the early stages of the vaccine rollout, as they would find out how many vaccines they were getting as late as the day they got the doses. That might help explain why states have been doing better.
There are still plenty of problems. The current rate of 1.7 million shots a day is still too slow; experts would like the country to get to 2 million or 3 million to get through the bulk of vaccine efforts this summer. While the country seems to be on track to get enough doses to do that next month, the question then becomes whether it has the distribution capacity to actually turn those doses into shots in arms — and the logistical challenges there will be immense.
Still, a world where there are enough vaccines to go around is rapidly approaching. Biden said vaccines will be available to all Americans by the end of July, while Anthony Fauci, the top federal infectious disease expert, took a slightly more optimistic outlook in saying it would be “open season” in late May or early June.
At that point, vaccine hesitancy may make supply less of a problem than demand.
America has a hesitancy problem
The views of one-third of Americans may not always amount to a national crisis, but those views matter a lot when the country needs to do something that requires nearly everybody on board. That’s the case with the Covid-19 vaccination campaign, where 70 or 80 percent — or more — of the country will need to get vaccinated to reach herd immunity. So surveys that show as many as one-third of Americans are skeptical amount to a real public health crisis.
Compounding that is the reality that a Covid-19 vaccine still hasn’t been approved for children — and that might not happen until later this summer or even 2022. Given that kids make up 22 percent of the population, herd immunity probably can’t happen without them. But even if herd immunity only requires the lower estimate of 70 percent of Americans, that still will be impossible if more than 30 percent of adults refuse a vaccine.
Based on public surveys, particularly in-depth ones from the Kaiser Family Foundation, the skeptical report a variety of concerns regarding the Covid-19 vaccine.
A major one is concerns about side effects, particularly long-term health consequences. The Covid-19 vaccines do have side effects, but they’re almost entirely minor — temporary aches, fever, and cold-like symptoms — aside from rare allergic reactions, which require monitoring but are treatable. Still, people worry about the risks.
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Some of the skeptics worry that the vaccine approval process, given its record speed, was rushed. But the Covid-19 vaccines still went through the three-phase clinical trial process required by the Food and Drug Administration, testing for safety and efficacy. The vaccines have also been out in the real world for months now, with still no reports of previously unknown and serious effects.
Some people of color also distrust the health care system, based on their experiences with a system that’s often discriminatory and a history of experimentation on Black bodies, such as the Tuskegee study. Surveys show that Latinos and Black people, in particular, are less likely to trust doctors and hospitals in general. That’s likely fed into distrust toward the vaccine, too.
A segment of the population, particularly on the right of the political spectrum, is also skeptical they even need a Covid-19 vaccine. Encouraged by people like former President Donald Trump, they tend to believe the threat of the coronavirus has long been overplayed in the media. Given other potential concerns, for instance about side effects and a rushed process, they question whether they should get a vaccine, believing that Covid-19 isn’t really a threat to them. The reality is it’s a threat to everyone — killing more people under 55 alone than all murders in a typical year — but the perception remains.
Then there are the concerns that fall more in the conspiracy theory camp, whether about certain wealthy people’s involvement in the vaccine process or more traditional (and debunked) anti-vaxxer concerns. But those tend to make up a very small minority of the US public and even Covid-19 vaccine skeptics.
There’s no one-size-fits-all solution
As the list above demonstrates, concerns about vaccines tend to vary and can differ significantly from community to community. Some concerns may not even show up in national surveys at all — they might be too localized to ever appear. This is a critical fact of public health, but it especially applies here: Local problems require local solutions, meaning messaging to combat vaccine hesitancy will have to be tailored differently from community to community.
“There will be similarities, and I think there will be some overlapping issues,” Brunson said. “But there will be local iterations of this that can vary quite widely.”
That doesn’t mean states or federal governments have no role to play. To the contrary, a big federal campaign about the basic facts, particularly the benefits, of the vaccines could be really helpful — and, in fact, experts have repeatedly told me such a campaign should have started months ago. Federal and state governments can also provide support, with money, personnel, guidance, and expertise, that local governments will need to execute on their plans.
The underlying theme of these campaigns, experts say, should be to meet people where they are. That begins with really hearing the community’s concerns, then transparently and honestly walking through why the vaccines’ benefits still dramatically outweigh any downsides. Doing that could require, at some points, acknowledging that people have a point — for example, the US health care system really does have a history of racism — but making the case that the evidence for vaccines is still strong and they’re still worth taking.
The messaging will have to be tested, and what works best will, again, likely differ from place to place and person to person. But experts pointed to several ideas: Campaigns can point to the evidence that the vaccines are very effective, particularly that they, based on the clinical trials, drive Covid-19 deaths down to zero and hospitalizations to almost zero. They can highlight the importance of everyone getting vaccinated to reach herd immunity and, subsequently, protect not just yourself but your friends, family, and community. They can tap into trusted or beloved sources, including doctors but also potentially celebrities.
A more controversial idea is to tell people about the personal benefits of the vaccines. Some of the public health messaging in the US has actually obscured this — telling people that even if they get a vaccine, they won’t be able to go back to their normal, pre-coronavirus lives right away.
Still, some experts argue that the restrained messaging can drive people to ask, “Why bother?” Masking and social distancing should be encouraged until America reaches herd immunity or close to it because we don’t yet know how effective vaccines are in driving down transmission. But people should be trusted with factual information about how vaccines will make certain activities less risky for them and others who get inoculated — and maybe they could safely enjoy some of those activities with their vaccinated friends and family once again.
“People undersell the vaccine,” Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, told me. “They don’t understand that if you tell people nothing changes when they get a vaccine — which I don’t think is true — then they’re not going to have an incentive to get the vaccine.”
Whatever form a pro-vaccine effort takes, experts are in agreement — and they have been for a long time — that some kind of big anti-hesitancy campaign needs to get going soon. Really, it should have started yesterday or last year. But there’s still time to act before the country gets to the point where supply is outstripping demand.
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This winter is brutal. The cold weather has made it hard to socialize outdoors, coronavirus variants are spreading, and the US is about to surpass half a million Covid-19 deaths. Many of us are feeling anxious about how we’re going to make it through the lonely, bleak weeks ahead.
I see a lot of people trying to cope with this anxiety by drumming up one-off solutions. Buy a fire pit! Better yet, buy a whole house! Those may be perfectly fine ideas, as far as they go — but I’d like to suggest a more effective way to think about reducing your suffering and increasing your happiness this winter.
Instead of thinking about the myriad negative feelings you want to avoid and the myriad things you can buy or do in service of that, think about a single organizing principle that is highly effective at generating positive feelings across the board: Shift your focus outward.
“Studies show that anything we can do to direct our attention off of ourselves and onto other people or other things is usually productive and makes us happier,” said Sonja Lyubomirsky, a psychology professor at the University of California Riverside and author of The How of Happiness: A Scientific Approach to Getting the Life You Want. “A lot of life’s problems are caused by too much self-focus and self-absorption, and we often focus too much on the negatives about ourselves.”
Rather than fixating on our inner worlds and woes, we can strive to promote what some psychologists call “small self.” Virginia Sturm, who directs the Clinical Affective Neuroscience lab at the University of California San Francisco, defines this as “a healthy sense of proportion between your own self and the bigger picture of the world around you.”
This easy-to-remember principle is like an emotional Swiss Army knife: Open it up and you’ll find a bunch of different practices that research shows can cut through mental distress. They’re useful anytime, and might be especially helpful during this difficult winter (though they’re certainly no panacea for broader problems like mass unemployment or a failed national pandemic response).
The practices involve cultivating different states — social connectedness, a clear purpose, inspiration — but all have one thing in common: They get you to focus on something outside yourself.
A sense of social connectedness
Some of the practices are about cultivating a sense of social connectedness. Decades of psychology research have taught us that this is a key to happiness.
In fact, Lyubomirsky said, “I think it is the key to happiness.”
That’s what Harvard’s Study of Adult Development discovered by following the lives of hundreds of people over 80 years, from the time they were teenagers all the way into their 90s. The massive longitudinal study revealed that the people who ended up happiest were the ones who really leaned into good relationships with family, friends, and community. Close relationships were better predictors of long and pleasant lives than money, IQ, or fame.
Psychiatrist George Vaillant, who led the study from 1972 to 2004, summed it up like so: “The key to healthy aging is relationships, relationships, relationships.”
Other studies have found evidence that social connections boost not only our mental health but also our physical health, helping to combat everything from memory loss to fatal heart attacks.
During our pandemic winter, you can socialize in person by, yes, gathering around a fire pit or maybe doubling your bubble. But there are other ways to make you feel you’re connected to others in a wider web. A great option is to perform an act of kindness — like donating to charity, or volunteering to read to a child or an older person online.
“I do a lot of research on kindness, and it turns out people who help others end up feeling more connected and become happier,” Lyubomirsky told me.
Lyubomirsky’s research shows that committing any type of kind act can make you happier, though you should choose something that fits your personality (for example, if you don’t like kids, then reading to them might not be for you). You may also want to vary what you do, because once you get used to doing something, you start taking it for granted and don’t get as much of a boost from it. By contrast, people who vary their kind acts show an increase in happiness immediately afterward and up to one month later. So you might call to check up on a lonely friend one day, deliver groceries to an older neighbor the next day, and make a donation the day after that.
A sense of purpose
Other practices are about cultivating a sense of purpose. Psychologists have found that having a clear purpose is one of the most effective ways to cope with isolation.
Steve Cole, a researcher at the University of California Los Angeles, studies interventions designed to help people cope with loneliness. He’s found that the ones that work tend to focus not on decreasing loneliness, but on increasing people’s sense of purpose. Recalling one pilot program that paired isolated older people with elementary school kids whom they’re asked to tutor and look out for, Cole told Vox, “Secretly, this is an intervention for the older people.”
Philosophers have long noted the fortifying effects of a clear sense of purpose. “Nietzsche said if you find purpose in your suffering, you can tolerate all the pain that comes with it,” Jack Fong, a sociologist who researches solitude at California State Polytechnic University, Pomona, told me. “It’s when people don’t see a purpose in their suffering that they freak out.”
Experienced solitaries confirm this. Billy Barr, who’s been living alone in an abandoned mining shack high up in the Rocky Mountains for almost 50 years, says we should all keep track of something. In his case, it’s the environment. How high is the snow today? What animals appeared this month? For decades, he’s been tracking the answers to these questions, and his records have actually influenced climate change science.
Now, he suggests that people get through the pandemic by participating in a citizen science project such as CoCoRaHS, which tracks rainfall.
“I would definitely recommend people doing that,” he told WAMU. “You get a little rain gauge, put it outside, and you’re part of a network where there’s thousands of other people doing the same thing as you, the same time of the day as you’re doing it.” (Notice, again, that this is really about sensing you’re part of the larger world around you.)
Other citizen science projects are looking for laypeople to classify wild animals caught on camera or predict the spread of Covid-19.
If citizen science isn’t your jam, find something else that gives you a sense of purpose, whether it’s writing that novel you’ve been kicking around for years, signing up to volunteer with a mutual aid group, or whatever else.
A sense of inspiration
Finally, some practices are about cultivating a sense of inspiration — which can take the form of gratitude, curiosity, or awe.
Regularly feeling gratitude helps protect us from stress and depression.
“When you feel grateful, your mind turns its attention to what is perhaps the greatest source of resilience for most humans: other humans,” David DeSteno, a psychology professor at Northeastern University and the author of Emotional Success, told me. “By reminding you that you’re not alone — that others have contributed to your well-being — it reduces stress.”
So one thing you can do this winter is try gratitude journaling. This simple practice — jotting down things you’re grateful for once or twice a week — has gained popularity over the past few years. But studies show there are more and less effective ways to do it. Researchers say it’s better to write in detail about one particular thing, really savoring it, than to dash off a superficial list of things. They recommend that you try to focus on people you’re grateful to, because that’s more impactful than focusing on things, and that you focus on events that surprised you, because they generally elicit stronger feelings of thankfulness.
Another practice is to write a letter of gratitude to someone. Research shows it significantly increases your levels of gratitude, even if you never actually send the letter. And the effects on the brain can last for months. In one study, subjects who participated in gratitude letter writing expressed more thankfulness and showed more activity in their pregenual anterior cingulate cortex — an area involved in predicting the outcomes of our actions — three months later.
Feeling a sense of curiosity or awe about the world around you is likewise shown to boost emotional well-being.
“Awe makes us feel like our problems are very trivial in the big scheme of things,” Lyubomirsky said. “The idea that you are this tiny speck in the universe gives you this bigger-picture perspective, which is really helpful when you’re too self-focused over your problems.”
For example, a study recently published in the journal Emotion investigated the effects of “awe walks.” Over a period of eight weeks, 60 participants took weekly 15-minute walks outdoors. Those who were encouraged to seek out moments of awe during their walks ended up showing more of the “small self” mindset, greater increases in daily positive emotions, and greater decreases in daily distress over time, compared to a control group who walked without being primed to seek out awe.
“What we show here is that a very simple intervention — essentially a reminder to occasionally shift our energy and attention outward instead of inward — can lead to significant improvements in emotional wellbeing,” said Sturm, the lead author.
So, bottom line: When the world between your two ears is as bleak as the howling winter outside, shifting your attention outward can be powerfully beneficial for your mental health. And hey, even in the dead of winter, a 15-minute awe walk outdoors is probably something you can do.
If you or anyone you know is anxious, depressed, upset, or needs to talk, there are people who want to help. Text CRISIS to 741741 for free, confidential crisis counseling.
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We’ve reached half a million deaths from the coronavirus in the US. But most of these deaths — and the grueling medical ordeals leading up to them — have remained largely hidden from view. The majority of terminally ill Covid-19 patients typically spend their last days or weeks isolated in ICUs to keep the virus from spreading.
“Most of what I’m seeing is behind closed curtains, and the general public isn’t seeing this side of it,” says Todd Rice, a critical care and pulmonology specialist at Vanderbilt University Medical Center. Even “families are only seeing a little bit of it,” he says. As a result, most of us have been “protected and sheltered from seeing the worst of this disease.”
So what have these 500,000 people endured as the infection took over and their bodies failed? The terrible details have been strikingly absent from most of our personal and national discussions about the virus. But if we have been thus far (perhaps somewhat willfully) blind to the excruciating ways Covid-19 takes lives, this milestone is an opportunity to open our eyes.
Four physicians, who collectively have cared for more than 100 dying Covid-19 patients over the past 11 months, shared with Vox what their patients have gone through physically and mentally as the virus killed them. Their experiences reveal the isolating and invasive realities of what it is typically like for someone to die from Covid-19.
Lungs “full of bees” and a “sense of impending doom”
The torture of Covid-19 can begin long before someone is sick enough to be admitted to a hospital intensive care unit.
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Since the coronavirus attacks the lungs, it hampers the intake of oxygen. People with worsening Covid-19 typically show up in the emergency room because they are having trouble breathing.
As their lungs deteriorate further, they have a harder and harder time getting enough oxygen with each breath, meaning they need to breathe faster and faster — up from an average of about 14 times per minute to 30 or 40. Such gasping can bring about a very real sense of panic.
Imagine trying to breathe through a very narrow straw, says Jess Mandel, chief of pulmonary, critical care, and sleep medicine at UC San Diego Health. “You can do that for 15 to 20 seconds, but try doing it for two hours.” Or for days or weeks.
Patients struggling through low oxygen levels like this have told Kenneth Remy, an assistant professor of critical care medicine at Washington University School of Medicine in St. Louis, that it feels like a band across their chest or that their lungs are on fire. Or like a thousand bees stinging them inside their chest. Others might have thick secretions in their lungs that make it feel like they are trying to breathe through muck. Many people say it feels like they’re being smothered.
The ordeal is so taxing that many wish for death. “You hear the patients say, ‘I just want to die because this is so excruciating,’” Remy says. “That’s what this virus does.”
Others feel that death is coming no matter what they do. Rice notes that is much more so for his Covid-19 patients than others he has treated. There seems to be something about Covid-19, he says, “that makes people prone to having a feeling of, ‘I really believe I’m going to die.’”
Meilinh Thi, who specializes in critical care and pulmonology at the University of Nebraska Medical Center, has witnessed the same thing. “A lot of patients, regardless of age, have this sense of impending doom,” Thi says. Many have told her outright they felt like they were going to die. Eerily, “Everyone who has told me that has passed away,” she says.
Isolated
The agony of being critically ill with Covid-19 isn’t just borne by the body but also by the mind. “It doesn’t only put your lungs on fire or give you a horrible headache or make you feel miserable or make you breathe really fast,” Remy says. “It also wreaks havoc on your mental state.”
For one, from the time anyone with Covid-19 is admitted to the hospital, they are essentially cut off from almost everything that is familiar. Most Covid-19 deaths have occurred in hospitals, but Centers for Disease Control and Prevention data shows that some are also dying in long-term care facilities (about 10 percent) or at home (about 6 percent).
“A lot of patients have told me how isolating and how lonely it is,” Thi says. And many get depressed. It is also incredibly scary to reach that point of illness with a disease that we know has already killed so many people, she and others point out.
All of these challenges have a cumulative effect. “If you can understand being in the hospital for two, three weeks, continuously breathing that fast, not having good interactions with your family because they can’t come and visit you — it’s extremely anxiety-provoking. It’s scary,” Remy says.
Being in the ICU for any reason also vastly increases a person’s risk for delirium, a state of confusion that can result in agitation, fear, and anger. Medications used to sedate people or relieve pain (both common in Covid-19 treatment) are part of the reason for this risk, as are the constant monitoring and physical disturbances — and subsequent sleep disruption.
Being a Covid-19 patient increases this likelihood of disorientation even more. Some estimates put the rate of delirium among adult ICU Covid-19 patients at about 65 percent.
One reason for this extra risk is that the only people patients see are covered in head-to-toe PPE, often with only their eye area visible behind a shield or goggles, rendering them even more anonymous and unfamiliar. (ICU nurses have described working alongside the same people for decades and now not recognizing them due to all the protective gear.) “That for sure increases the risk of delirium,” Thi says.
As a Covid-19 patient, “You’re just devoid of human contact to a large degree,” Mandel says.
And that is no small thing. With loved ones relegated to video calls, personal connection through in-person visits — typically a mainstay during an intensive hospital stay — is gone.
“If your mom or dad or spouse was in the hospital and was very sick, you would be at their bedside holding their hand,” Remy says. With fatal Covid-19, your last meaningful contact with family, before your final hours, might be as you get admitted into the ER, days or weeks before.
Doctors often have to use many invasive procedures to try to save lives
Anyone unwell enough to be in the ICU for any reason will be hooked up to lots of machines. But people with severe Covid-19 face a particularly grueling and invasive experience.
When people can no longer breathe for themselves and still aren’t getting enough oxygen from external sources (like short nose tubes or a BiPap machine, like those some people wear for sleep apnea), the next step is usually putting them on a ventilator.
To do this, patients are put on IV-based sedation and pain medication so they can tolerate the procedure. A tube is inserted into the mouth and down the airway so the machine can pump air into the lungs. The tube can remain there for days or weeks, during which time that person will remain heavily sedated and unable to talk. (This sedation can also mask other problems that arise during their illness, such as major strokes.)
Those who have survived the ordeal often don’t even remember the day leading up to being put on ventilation, Thi says. “They say they really just lost that portion of their life.”
The ventilator itself is not without risks. For example, if the machine is set to deliver too much air, it can cause additional lung damage. And the breathing tube only tends to be safe to keep in place for about two to three weeks, Thi notes. After that, it can start to deteriorate. At that point, doctors might surgically insert a tube into the patient’s neck — a procedure known as a tracheostomy — to connect them to the ventilator.
For some, even mechanical ventilation can’t get them enough oxygen. These patients often get put on “heart-lung” machines, which pump blood out of the body, through a machine that oxygenates it, and back in. (These are also sometimes used for people who have suffered a heart attack, and are known to have numerous side effects, such as increased risk for strokes as well as for agitation and delirium.) This process requires two large catheters (long tubes) inserted into a major artery or vein, so the machine can effectively pump enough blood in and out of the body.
Flipping people onto their stomachs has also helped get more air into their systems. During this practice, called proning, the sick individual is typically put on a medication to paralyze them so they cannot move. (Medical staff also turn incapacitated patients in bed every couple of hours “to make sure their skin doesn’t break down,” Thi says.)
A significant proportion of people — somewhere between about 1 in 5 and 1 in 3 — who get very sick with Covid-19 also end up with kidney failure. To prevent this from killing them, they’re put on dialysis machines, which take blood out of the body and filter it before returning it to the body. This procedure can cause nausea, cramping, and chronic itching. Anyone getting dialysis will need two additional large catheters put into another major blood vessel.
But these aren’t all of the tubes critically ill Covid-19 patients need. They also have a central venous catheter to administer medication. This long tube usually gets inserted into a major vein in the clavicle or groin, then is pushed through the vein until it reaches the heart, where it will stay until that person recovers or dies. Another catheter, sometimes put in near the groin, will take the person’s blood for analysis.
Other catheters will be inserted into the urethra to drain urine (which is monitored closely) and the rectum to frequently evacuate their feces (which is especially important because Covid-19 often causes diarrhea). Additional IVs, such as for hydration and medications, will poke patients in smaller vessels as well. People this ill with Covid-19 will also have a tube put into their mouth or nose and down into their stomach, to deliver a nutritious slurry to prevent malnutrition.
On top of all of these tubes and needles, a number of other beeping and humming devices monitor a person’s vitals. Leads attached to the chest track heart function, and a pulse oximeter on the finger keeps tabs on oxygen saturation. A standard cuff monitors blood pressure, but people often get an additional catheter into yet another vessel to measure blood pressure from within that artery.
All of these incredibly invasive interventions have a goal of sustaining the body simply so that it can try to fight off the virus and heal. “The technology we have is very powerful in terms of keeping people alive but less powerful at turning things around,” Mandel says. “It’s always a race.”
But even all of these procedures — alongside treatments like dexamethasone and remdesivir — are not enough to save everyone with Covid-19. Some people decline to go through some or all of this, or at least to endure it indefinitely, but that does not guarantee a lack of suffering. And for those most unlucky 1.8 percent of people confirmed to have Covid-19 in the US, death will then be imminent.
The end
Once someone is sick enough with Covid-19 that they need a ventilator, their chance of survival is somewhere between 40 and 60 percent, notes Remy. “You flip a coin, and you may be one of those people who die,” he says.
Remy recalls one particularly difficult week during the fall surge when he cared for a number of people in their 40s and 50s who ultimately died. Most of them were obese but otherwise healthy when they caught Covid-19 by not wearing a mask.
“One of the[se] patients specifically told me before I put the breathing tube in, ‘Let everyone know that this is real, my lungs are on fire. It’s like there’s bees stinging me. I can’t breathe. Please let them know to wear a mask … because I wouldn’t wish this on my worst enemy.’”
Right after that patient died, Remy made a precautionary video that he posted on Twitter.
If a patient’s breathing deteriorates slowly, hospitals can often arrange a way for them to talk with family members before they get intubated. Because after the tube goes in, they might not be conscious or able to talk again before they die. Regardless, the last person they have conscious contact with is typically a member of the medical staff before they are heavily sedated to receive the ventilator tube. In essence, “It could be anybody,” Rice says.
Despite the strict isolation for Covid-19 patients, “We try to make sure patients don’t die alone,” Thi says. For those who quickly nosedive, there often isn’t time to bring in family. Those people die surrounded by medical staff, either receiving CPR or, if they had do not resuscitate orders, with staff standing by.
For those who fall toward death, family — in full PPE — are now typically allowed in (which wasn’t usually the case at the beginning of the pandemic). At that point, “We would proceed with comfort measures only,” Thi says. In this scenario, the dying person will be on heavy medication as the ventilator tube is removed. Even still, once it gets taken out, people often gasp or cough as the body fights for air before they die.
Despite the palliative care and the possibility for family to now be present for a person’s actual death, doctors describe Covid-19 as a uniquely terrible way to die. “Covid is just so different,” Thi says. “I don’t think anything could be comparable to it. … I don’t wish it on my worst enemy.”
Remy agrees. After having cared for patients dying from infectious diseases all over the world, he says, “I don’t know a disease that wreaks such havoc on the body and on the mind.” Which is perhaps why his dying patient was pleading with him so desperately just before being intubated to tell people to wear their masks and take the virus seriously.
Because otherwise, it will continue to take thousands of lives this way each day in the US until we can get vaccines to almost everyone.
Katherine Harmon Courage is a freelance science journalist and author of Cultured and and Octopus! Find her on Twitter at @KHCourage.
The power was still out in my Dallas housing complex early last Tuesday, so I grabbed the survival hatchet from my emergency bag to chop up a couple of fallen trees, which were covered with six inches of down-soft snow dropped by Winter Storm Uri.
The trees broke easily, and after 30 minutes of hacking, I’d cut enough for two small blazes. I divided the wood — one half for my apartment, the other for my neighbor.
My wife Joy and I cooked beans over the fireplace and burned some old clothing to keep the temperature in the apartment above 40 degrees. After our fire died, our complex issued an “Important Message For Residents” warning that Dallas might ration water as treatment plants froze: “Please take action NOW to fill pots/pitchers, bathtubs and other storage containers … use this water to flush toilets.”
Joy, who had recently moved here from Bolivia, had seen her WhatsApp fill up with worried messages from loved ones who’ve watched America’s panoply of recent crises unfold. They asked if she was safe from the horrors on their televisions: the world’s worst Covid-19 numbers, horned defectors with assault weapons, and now infrastructure that abandons people during natural disasters.
After reading the hoard-water note, she turned to me and joked, “I thought the United States was a first-world country?”
In her eyes, a developed country and its state leaders should take care of its citizens. Millions of Texans have seen their electricity cut out for hours and days at a time in a deadly rolling crisis that began with snowfall on Valentine’s Day. Though most power is now restored, millions of Texans are still without water as treatment plants recover. The crisis has been a burden, not just for the state or the power company at fault, but for its residents to bear.
You see, we’re individuals, and, like one Texas mayor wrote on Facebook, we shouldn’t expect state institutions to help. “No one owes you or your family anything; nor is it the local government’s responsibility to support you during trying times like this! Sink or swim, it’s your choice!” then-Mayor Tim Boyd of Colorado City, a town of fewer than 5,000 people a four-hour drive west of Dallas, told constituents in a typo-laden Facebook post. (That same day, he announced his resignation, but he didn’t say whether his exit stemmed from the backlash.)
We were on our own.
We lost power for most of Monday and Tuesday, but luckily, we never lost water. Many Texans fared worse. Houston firefighters had to deal with low water pressure when dousing residential fires started by candles, displacing dozens of Houstonians. Prison inmates had to live with overflowing, unusable toilets for days. Exotic animals, including a chimpanzee and other primates, froze to death in a San Antonio rescue. By last Tuesday, hospitals had treated more than 50 people for carbon monoxide poisoning; desperate to get warm, they’d heated their homes with gas stoves and running cars. A woman near Houston filed a wrongful death lawsuit against power utilities after her 11-year-old son froze to death in his bed.
The disaster worsened existing crises in average Texans’ lives. My neighbor, a nurse who underwent several major surgeries this year amid the pandemic, began to seem less social and more withdrawn. My boss’s mother suffered a stroke just before the storm, and his energies were split between caring for her and making sure his water pipes didn’t freeze. Iwas depressed and disagreeable.
I draw a line from this catastrophe to America’s fetishized individualism for which Texas, home to a fierce secessionist movement, is the poster child. Texas is where the West starts, home of high-riding cowboys and oilmen who project an image of self-reliance — all they needed to prosper was a government that stayed out of their way.
I work for a manufacturer that makes devices for the power industry, and I can’t conjure a better example of the Texas government’s light touch than its relationship to the electric grid. As electricity infrastructure evolved in the 1930s, the federal government regulated energy across state lines. But Texas had its own grid network, the Texas Interconnected System, and a flourishing oil trade. So the state shrewdly spurned interstate grids.
In the 1970s, the Electric Reliability Council of Texas, or ERCOT, was formed to manage the state’s electricity distribution. But in 2002, Texas deregulated its energy market, creating an environment in which electricity retailers compete for business. The lowest bidder would win customers in the marketplace, but that encouraged power generators to delay or neglect weatherizing critical equipment. In 2011, the Federal Energy Regulatory Commission warned ERCOT that power plants must winterize their equipment. Electricity providers, beholden only to the market, largely ignored the advice.
Put simply, this market created a larger disaster when the freezing weather hit. Because the function of the Texas power industry is to provide cheap electricity, it has no incentive to make costly preparations to its infrastructure for comparatively rare cold weather.
As Uri intensified, enough people were using electric heaters and enough generation equipment had frozen that demand outpaced supply, and the grid’s frequency began to destabilize. Officials told the Texas Tribune Thursday the grid was “minutes” from a full crash, which would’ve taken weeks to restore. ERCOT then mandated statewide “rolling blackouts” to reconcile the grid’s burden with power generation.
It initially said the outages would last less than 45 minutes, but when I woke up that morning, the lights and heat were out. I spent an hour on a dying cellphone navigating overwhelmed service hotlines for any nugget pointing to restored power. I learned the outage could, in fact, last hours, and I gave up calling. Local officials gave suggestions on how to make do. The city of Fort Worth told constituents to close their blinds and stuff towels in cracks to retain heat.
This disaster doesn’t appear to have inspired sober reflection among many of our politicians. On Fox News last week, Republican Gov. Greg Abbott blamed wind turbines for the crisis; in fact, natural gas equipment is responsible for the bulk of the losses. Cranking up the invective, Abbott fingered as a culprit the Green New Deal, a policy framework to address climate change that Congress rejected in 2019. And, of course, our climate-change-denying Republican Sen. Ted Cruz famously jetted off from Houston to Cancun with his family mid-crisis as Texans froze to death.
Individualist thinking justifies this mentality. It says that states and individuals should marshal and deploy their own resources, a notion as American as apple pie. If you lack the resources to get to a Mexican beach resort, hike your sleeves, chop firewood, and don’t burn down your home.
I ended up chopping wood. I’m lucky that I had the option to — it allowed us to stay warm for part of Tuesday morning, and it was better than huddling in a darkened bedroom. But not everyone lives in a forested apartment complex, and others were forced to turn to potentially deadly methods, like a grandmother who spent a night in her car to keep warm.
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The fact that I even had a survival hatchet feels ironic. I’m mostly skeptical of prepper culture, partly because it reeks of that individualism. Yet Joy and I frantically built our emergency bags in January after Trump supporters attacked the US Capitol. A friend who works in logistics told me corporations were preparing for a doomsday scenario after the DC raid — cutting emergency credit cards for employees, making extraction plans. Our form of government forces us to prep, and when you’re on your own, it pays to have the tools.
Still, during Uri, ordinary Texans didn’t just help themselves. They distributed food, donated and organized mutual aid funds, and, if they had electricity, took shivering strangers into their homes. A coworker ran errands for neighbors who can’t drive in snow. An acquaintance brought an elderly woman coolers full of water so she could flush the loo.
Tuesday night, our neighbor knocked on our door with an Ikea tote full of more black willow. “They cut this firewood, you want some?”
It was sweet to be cared for by our community. But it’d be better if our government looked after us instead.
Aaron Hedge is a Dallas-based writer and a reader at Longform.org.
A panel of expert advisers to the Food and Drug Administration (FDA) voted unanimously on Friday afternoon to recommend the one-dose Covid-19 vaccine developed by Johnson & Johnson for an emergency use authorization. The next step is for the FDA to accept the recommendation, which could happen as soon as this weekend, clearing the way for distribution.
Earlier this week, the FDA posted a briefing going over the results of the phase 3 clinical trials of the Johnson & Johnson vaccine, which included 40,000 participants in several countries divided randomly into placebo and treatment groups.
The most important finding: The vaccine was 100 percent effective after 28 days at preventing deaths and hospitalizations from Covid-19 among the clinical trial participants who received the treatment. (Two vaccine recipients were hospitalized with Covid-19 two weeks after receiving the injection.)
The vaccine was also 66.1 percent effective at preventing symptomatic Covid-19 illness after four weeks, with consistent results across all age groups. When looking at blocking severe and critical cases of Covid-19, the Johnson & Johnson vaccine was 85.4 percent effective.
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Mathai Mammen, global head of research and development for Janssen Pharmaceutical Companies, said during a press conference last month that the vaccine also had “plain vanilla safety results,” with the vast majority of recipients experiencing no problems. Most of the reported symptoms were mild, including fatigue, arm pain, and fever.
The efficacy levels against severe to critical Covid-19 changed depending on where the vaccine was tested. It was 85.9 percent in the United States after four weeks, while in South Africa, where a coronavirus variant with worrisome mutations that help it escape vaccines has been spreading widely, efficacy against severe disease was reduced to 81.7 percent.
Health officials say that while the Johnson & Johnson efficacy results are not as high as those from Moderna and Pfizer/BioNTech, the two vaccines that have already received emergency use authorizations from the FDA, the new vaccine’s performance is still superb.
“If this had occurred in the absence of a prior announcement and implementation of a 94, 95 percent efficacy [vaccine], one would have said this is an absolutely spectacular result,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, during the press conference last month. The vaccine was developed by Janssen Pharmaceuticals, a division of Johnson & Johnson based in Belgium, together with Boston’s Beth Israel Deaconess Medical Center.
But unlike the vaccines from Moderna and Pfizer/BioNTech, Johnson & Johnson’s doesn’t require a booster shot, circumventing the two-dose problems posed by its competitors. There’s no need to track people down for their second dose, which means more people could be vaccinated faster. The shots also don’t require deep-cold storage, which means they’re less costly and somewhat easier to distribute.
“It’s a complete game changer,” said Georgetown University health law professor Lawrence Gostin. “It completely changes the equation.”
The Johnson & Johnson vaccine is also different in another way. It uses an adenovirus vector to deliver instructions for making the spike protein of the coronavirus, which is also less expensive to manufacture than the mRNA platform used for the other vaccines. (It’s estimated to cost around $10 per vaccine dose — roughly half the cost of the Pfizer/BioNTech vaccine.)
Johnson & Johnson has promised enough vaccines for 20 million Americans by the end of March and 100 million Americans by the end of June despite production challenges. It would be a huge boost to the 65 million Covid-19 vaccine doses that have been administered in the US so far.
So even with an overall efficacy level that’s lower than the two other vaccines on the US market, the Johnson & Johnson vaccine could become a major player. It’s the vaccine that “can increase equity,” said Saad Omer, the director of the Yale Institute for Global Health, particularly “if it’s deployed strategically in nations that are hard to reach and where that would be a particular challenge under a two-dose schedule.” Johnson & Johnson expects to distribute a billion doses of its vaccine worldwide this year.
But as amazing as it is to see several effective Covid-19 vaccines developed in record time, it’s now clear that the technology alone won’t save the day. An orchestra of supply chains, manufacturing, logistics, staff, and public trust needs to harmonize in order to actually get billions of shots into arms around the world and finally draw the pandemic to a close. And we also have other hurdles to overcome: controlling the spread of variants that seem to be threatening the effectiveness of all the vaccines we have.
What we learned about the safety and efficacy of the Johnson & Johnson Covid-19 vaccine
Johnson & Johnson launched separate clinical trials testing both a one-dose and a two-dose regimen to see how well these strategies provided long-term protection against Covid-19. The one-dose phase 3 trial arm yielded efficacy results first.
But hints that this vaccine could be safe and effective have been trickling out for months. The company published some of its early phase 1 and phase 2 trial data in a preprint paper in September, and the final version of the paper in January, in the New England Journal of Medicine. The papers showed the vaccine was well tolerated among the participants, and seemingly very effective: With one dose, after 29 days, the vaccine ensured that 90 percent of participants had enough antibodies required to neutralize the virus. After 57 days, that number reached 100 percent.
“When I looked at that, I thought, wow, this Johnson & Johnson product is very powerful after the first dose in terms of immunogenicity,” said Monica Gandhi, a professor of global medicine at the University of California San Francisco. “The Pfizer and Moderna vaccines needed two doses to get that level of [virus] neutralization.”
Like Pfizer/BioNTech, Johnson & Johnson “didn’t rush to phase 3 [trials],” said Hilda Bastian, a scientist who has been tracking the global vaccine race. Instead, it tested multiple vaccine doses and candidates at the outset to figure out which might perform the best in humans, and then proceeded through clinical trials.
The vaccine was also tested in nine countries — the largest single international phase 3 trial in the world, with more than 60,000 participants — meaning many ethnic groups were represented in the data, Bastian said. “As if all that’s not enough, it’s one of the ones that could be manufactured in South Africa and other places,” since Johnson & Johnson has manufacturing capacity around the world, even in countries hard-hit by the pandemic that have been waiting for vaccine supplies, she added.
The day this vaccine gets approval “is going to be a big day for the future of this pandemic [and] a ticket out of this disease for a larger part of the world,” said Nicholas Lusiani, a senior adviser at Oxfam America.
How adenovirus vector vaccines work
Part of the appeal of this vaccine lies in the technology behind it. Adenoviruses are a family of viruses that can cause a range of illnesses in humans, including the common cold. They’re very efficient at getting their DNA into a cell’s nucleus. Scientists reasoned that if they could snip out the right sections of an adenovirus’s genome and insert another piece of DNA code (in this case, for a fragment of the new coronavirus), they could have a powerful system to deliver instructions to cells.
For decades, scientists have experimented with adenovirus vectors as a platform for gene therapy and to treat certain cancers, using the virus to modify or replace genes in host cells. More recently, researchers have found success using adenoviruses as vaccines. Already, an adenovirus vector vaccine has been developed for the Ebola virus.
In addition to Johnson & Johnson and AstraZeneca/Oxford, CanSino Biologics of China is also developing an adenovirus vector Covid-19 vaccine; Russia’s Sputnik V Covid-19 vaccine uses this platform, too.
To make one of these vaccines, the adenovirus is modified so that it can’t reproduce but can carry the instructions for making a component of a virus. In the case of Covid-19, most adenovirus vector vaccines code for the spike protein of SARS-CoV-2, the part the virus uses to begin an infection.
Human cells then read those instructions delivered by the adenovirus and begin manufacturing the spike protein. The immune system recognizes the spike proteins as a threat and begins to build up its defenses.
Since adenoviruses exist naturally, they tend to be more temperature-stable than the synthetic lipid nanoparticles that are used to deliver the mRNA in the Moderna and Pfizer/BioNTech vaccines.
“The nice thing about the adenovirus vector vaccines is that they’re a little more tolerant to a longer shelf life, to the conditions of storage,” said Angela Rasmussen, a virologist at Georgetown University. Adenovirus vector vaccines can be stored at refrigerator temperatures, while mRNA vaccines need freezers, with Pfizer/BioNTech’s vaccine requiring temperatures of minus 80 degrees Celsius.
This helps lower the cost and complexity of manufacturing, distribution, and administration of adenovirus vector vaccines compared to other platforms. And simply having another vaccine on the market, made by a major pharmaceutical company with its own manufacturing infrastructure, is a big step forward. “The more vaccine doses we can have, the better,” Rasmussen said.
What comes next
The next challenge for Johnson & Johnson, after getting a green light from the FDA, is actually delivering doses to millions of arms.
But with three vaccines eventually on the market, should people hold out for any one vaccine in particular?
“Right now when people ask me, which, you know, which vaccine should I get? It’s pretty easy to answer that question because it’s whichever one you get offered,” said Paul Sax, a professor of medicine at Harvard Medical School. Vaccine supplies are limited, the transmission of the virus is high, and hospitals are close to capacity, so few people can be picky about what they get.
On the other hand, once vaccine supplies stabilize, having multiple vaccines with different characteristics could allow doctors and public health officials to optimize how the shots are distributed. “If the efficacy [of a given vaccine] is lower but still pretty good, there may be a scenario that one vaccine is recommended for low-risk populations and another one is for a high-risk population,” Omer said.
Though the Johnson & Johnson vaccine does have some key advantages over its competitors, it could face some of the same distribution snags that have hit other vaccines, like miscommunication between the government and hospitals, and production hurdles.
Researchers say that all the manufacturers also need to start working to get vaccines to the rest of the world. The new variants that have emerged in the UK, Brazil, and South Africa and have been detected in other parts of the world are reminders that the virus continues to evolve, and that a partially vaccinated population could exert more selection pressures that accelerate these mutations. So vaccination has to happen fast, and globally — and Johnson & Johnson’s vaccine may be a critical tool to do this.
“Long term, we need to be thinking about getting vaccines out equitably to the entire world, and having vaccines that are easier to distribute in terms of the cold chain requirements is going to be huge in that regard,” Rasmussen said.
But even as these vaccines roll out, there’s still more to learn: how long protection from vaccines last, whether there are any rare complications to consider, whether they prevent transmission as well as disease, and how well these vaccines work against the new variants. There are already some troubling signs of how these variants might eventually be able to evade vaccines. Continuing clinical trials will be critical, Sax said.
“You know, we’ve got millions of people who’ve received these vaccines already, which is exciting,” he added. “We’re on our way.”
One big reason to be excited about the new Johnson & Johnson vaccine for Covid-19, which was authorized by the Food and Drug Administration over the weekend for emergency use in the US: Unlike the Moderna and Pfizer vaccines already in use, it requires only one shot for full protection.
That’s a big deal. From a practical standpoint, it means that the new vaccine could really speed up America’s vaccination campaign — certainly more than another two-dose vaccine would. It also fixes a problem that’s long bedeviled medical treatments that require multiple doses: A lot of patients tend to drop off after the first appointment.
“Especially when you’re trying to think about a massive public health program like this vaccine rollout, a single-dose vaccine would have made it much, much simpler” if it were the first to get approval, Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, told me.
Some have been skeptical of the Johnson & Johnson vaccine because the reported data on its efficacy was lower than that from the Moderna and Pfizer vaccines. Initially, the vaccine was reported at 66 percent effectiveness against Covid-19, which paled in comparison to 90-plus percent for the other two authorized vaccines.
But in many ways, that’s looking at the wrong number. The vaccine’s effectiveness at preventing people from getting sick with symptoms is arguably much less important than the vaccine’s effectiveness against hospitalization and death. And there is the promising news: In trials, the Johnson & Johnson vaccine brings both of those down to zero. It squashes the biggest thing that made Covid-19 so threatening to people: its ability to kill.
Given the ongoing supply constraints and high demand, experts say people should get whichever vaccine is first available to them — that’s how we’ll beat Covid-19 as quickly as possible.
But for people who are bad at follow-up appointments (including me) and from a broader public health perspective where speeding and smoothing the vaccine rollout is crucial, the Johnson & Johnson vaccine and other one-shot inoculations are genuine game changers.
1) The one-shot vaccine we have is really effective
In non-pandemic times, Americans deal with common infectious illnesses that don’t force society to shut down schools, businesses, and other interactions with people outside our households. Nobody likes getting the common flu or cold, but because most of us don’t expect it to hospitalize or kill us, we by and large just live with them. (Though, seriously, more people should get their flu shots — that would still save lives.)
This is the marvel of the Covid-19 vaccines approved so far: They turn the coronavirus into something much more manageable, like a cold or flu. Some people who get the vaccine may still develop sniffles or even a fever if the virus infects them. But based on the clinical trial and some real-world data, the risk of severe illness, hospitalization, and death drops massively — to zero or almost zero, particularly for hospitalizations or deaths.
The Johnson & Johnson vaccine is no different in this regard. According to data released by the FDA last week, the clinical trials found an efficacy rate of about 72 percent in the US. But that’s the number that only tells us about any symptomatic infection, down to the sniffles or a short-lived fever. For hospitalizations and death, the Johnson & Johnson vaccine reported 100 percent effectiveness after 28 days (all of the vaccines so far take weeks to build up the body’s defenses).
So Johnson & Johnson’s vaccine might not be as effective as the competition against the milder symptomatic cases, but it’s as effective for the kinds of illnesses that make Covid-19 truly scary.
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“I would take it,” Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation, told me. “A lot of us who look at the data say we would definitely take a vaccine that’s that effective.”
One of the big concerns right now is whether the vaccines work against Covid-19 variants. There, too, is good news: Johnson & Johnson ran part of its trials in South Africa, where the variant with the most confirmed effect on immunity has shown up. The vaccine still worked, with a 64 percent overall effectiveness against any symptomatic disease and 100 percent effectiveness against hospitalization and death.
There are still some genuine unknowns about the vaccine. We don’t know how much it stops the spread of the disease, although the early data suggests it likely has at least some effect. Some of the data indicated the vaccine might not be quite as effective among older populations with comorbidities like heart disease or diabetes, but the sample size was too small to draw hard conclusions.
For the vast majority of people, though, the Johnson & Johnson vaccine does exactly what you would want it to do: It makes it so Covid-19 is no longer deadly — the kind of pathogen you can give as much thought to in any given year as a common flu or cold.
2) A vaccine that doesn’t require follow-up is a big deal
In health care, simply getting people in the door can be the first big hurdle. People in need might not have health insurance or be able to afford care. Even if they have insurance, they can have other problems — inconsistent transportation or an inflexible job schedule — that make them less likely to end up at a doctor’s office. Or people might think too much of their own health because they’re young and fit, or they might not like going to the doctor.
This is a well-known problem in public health. For some people, getting multiple doses of a treatment is “a lot,” Saskia Popescu, an infectious disease epidemiologist at George Mason University, told me. “That’s why it’s really hard to get people to get their full hep B vaccine.”
Studies back this up. As Dylan Scott wrote for Vox:
[B]ased on research that evaluated compliance with other multi-dose vaccines, patients are really, really bad at getting their second dose. Bad as in, as many as half of patients never do. Studies conducted in both the US and UK on the hepatitis B vaccine — which, like the Covid-19 vaccines, is supposed to have around a one-month period between the first and second doses — found that roughly 50 percent of patients failed to get their follow-up shot within a year after their first.
Maybe the numbers will look better for the Covid-19 vaccines. The stakes of a deadly pandemic are much higher, and perhaps people will react accordingly. But if a significant number of people fail to get their second shots, and the first dose of Moderna’s and Pfizer’s vaccines proves to not be enough, that could doom the prospects of herd immunity, when enough of the population is vaccinated to stop the spread of the virus.
On the flip side, some people may simply be unable to schedule a follow-up appointment, especially as supply and distribution problems with vaccines persist. This will likely become less of a problem over time, as the vaccine rollout steadily expands and improves. But in the meantime, it creates an additional risk of people missing their second shot.
All of this is no longer hypothetical. In the US, about 14 percent of the population has gotten the first dose of a Moderna or Pfizer vaccine, while just 7 percent has gotten the second dose, according to the New York Times. Some of this is because the rollout is still in its early stages, but nearly 3 million Americans haven’t received their second vaccine doses on time.
How much the gap between first and second doses closes — or widens — will show the need for Johnson & Johnson’s vaccine and other one-shot vaccines.
3) A one-shot vaccine could really speed our path to herd immunity
One of the most obvious benefits to a one-shot Covid-19 vaccine is it could dramatically speed up — literally double — the US’s vaccine rollout.
Over the past couple of weeks, America has hovered around 1.5 million vaccine doses a day. That number had been steadily climbing until the recent snowstorms, which temporarily slowed things down. But imagine the US somehow gets stuck at the current rates.
Under that scenario of 1.5 million doses a day, the requirement for two shots means the US wouldn’t get to a threshold of herd immunity of 80 percent — a number that could be too high or too low; we just don’t know yet — until spring 2022.
But if the US somehow replaced all its vaccines with a one-shot vaccine — not at all likely, but it’s helpful for demonstration purposes — the current pace would be enough to reach herd immunity toward the end of summer. In a more realistic scenario, where one-third of vaccines are one-shot, the US would reach herd immunity by the end of this year.
Now imagine that the US manages to get to 3 million shots a day (which no longer seems unlikely). At that rate, two-dose vaccines would get us to herd immunity at the end of the summer, and a one-shot–only approach would get us there before summer. If one-third of vaccines are one-shot versions, we reach herd immunity by mid-summer — leaving the rest of the summer to, hopefully, live much closer to normal than the last year.
You shouldn’t take these numbers too seriously. We don’t know, because we don’t have a crystal ball, how much the US vaccination campaign will ramp up in the coming months. We don’t know how much Johnson & Johnson, which has already reported manufacturing problems, will scale its vaccine production from the 20 million the company promised by the end of March to the 100 million it promised overall. We don’t know if the 30 percent of Americans who currently report vaccine hesitancy will remain hesitant, which would doom the prospects of herd immunity. And we don’t yet have a vaccine authorized for use in children — and since those under 18 make up about 20 percent of the population, that could also ruin the chance of herd immunity.
But the numbers, at least, demonstrate the potential of a one-shot vaccine like Johnson & Johnson’s. It could speed up the vaccination process in the US by weeks or even months.
With thousands of people still dying every day from Covid-19, that boost could translate to upward of tens of thousands of lives saved.
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The world is now locked in an arms race with Covid-19, as multiple effective vaccines are being deployed (at staggeringly different rates) around the world. At the same time, new variants of the SARS-CoV-2 virus have been rapidly spreading.
The Covid-19 vaccines that are being distributed in the US, as well as the newly authorized Johnson & Johnson vaccine, have been shown to almost eliminate deaths and hospitalizations from the disease, even for people infected with the new mutations. For a disease that has infected more than 114 million people around the world in just over a year, this is tremendously good news.
But it’s no time to kick back.
There’s evidence that the virus is evolving in ways that can reduce the effectiveness of Covid-19 vaccines — particularly when they’re up against the variant discovered in South Africa. Both Johnson & Johnson and Novavax’s vaccine efficacy rate dropped in the South Africa arm of their clinical trials (from 72 in the US to 64 percent in South Africa and from 89 in the UK to 49 percent, respectively).
The vaccines still worked against their new foe in the majority of trial participants. The human immune response, after all, is robust and multi-layered. It can adapt to different versions of the virus that come along, which is why vaccine-induced immunity is unlikely to “fall off a cliff and go from 95 percent to zero,” as University of Utah evolutionary virologist Stephen Goldstein told Vox.
However, the situation is still dicey. “Eventually, when the majority of the susceptible population is vaccinated with effective vaccines, the variant better suited for survival in the new host will be one that has the ability to evade the vaccine-induced immunity,” researchers warned in a March 1 letter published in Nature. Such a variant could “decrease, and even abolish, the beneficial effects of a broad immunization program.”
And the more people the virus infects, the more mutations it acquires — mutations that may eventually evade the protection provided by prior infections or from vaccinations. The slow pace of the global vaccine rollout, particularly in low- and middle-income countries, then means that even if people in rich countries like the US are fully vaccinated, variants may still emerge in less vaccinated regions, increasing the risk of new outbreaks everywhere.
That’s why, while global health groups work to get more vaccines to more people around the world, vaccine developers are quickly trying to find new strategies to cope with the variants. They’ve already brought new vaccines to the market in record time. Now they are investigating everything from booster shots to entirely reformulated vaccines.
What we know about the coronavirus variants and Covid-19 vaccines
All viruses mutate as they move through populations, and until recently, the mutations in SARS-CoV-2 weren’t cause for much concern. (A mutation is a change in the genetic makeup of a virus, while a variant is a virus that has a suite of mutations that alter how it behaves.) That changed in mid-December, when a more contagious variant known as B.1.1.7 was discovered in Britain, just as the first Covid-19 vaccines were coming online.
That was only the beginning of a new chapter in the pandemic. Since then, several new variants and mutations of concern — what the WHO calls changes to the virus that are worrisome — have surfaced in dozens of countries around the world, becoming the dominant strain in some.
The Centers for Disease Control and Prevention predicted that B.1.1.7 could overtake other versions of the virus in the US this month. And evidence is mounting that B.1.1.7 is not only more transmissible but potentially also deadlier than prior versions of the virus.
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Another variant, B.1.351, first identified in South Africa, has proven more difficult to immunize against. And still another immune-evading variant discovered in Brazil, known as P1, has already spread to at least 25 other countries, including the US. Scientists reported that in several instances, the P1 variant was behind reinfections in people who already survived an earlier course of the illness. And two new variants may have emerged in the United States, in New York and in California. These new variants of concern stand to undermine precious progress against the pandemic because they’re either more contagious, potentially more dangerous, or threaten the vaccines we have. And perhaps even more ominously, they’re a reminder that far more — and perhaps even more threatening — variants will emerge in the future.
Adding to the threat is that many parts of the world, including the US, are not doing enough genetic sequencing of SARS-CoV-2. That makes it harder to identify and prepare for new variants when they emerge, increasing the chances of them spreading undetected.
The good news is that, for the most part, vaccines still seem to provide good protection against the SARS-CoV-2 variants discovered so far. So does prior infection.
But there have been some worrying signs that current Covid-19 vaccines are less effective against some new variants — again, B.1.351, first identified in South Africa.
How can seemingly minor mutations change the virus’s susceptibility to a vaccine? When a vaccine is administered, the human immune system responds by producing targeted antibodies, proteins that can stick to a specific pathogen. Antibodies that prevent that pathogen from causing an infection are said to be neutralizing.
Studies show that the vaccines developed by Pfizer/BioNTech and by AstraZeneca/Oxford lead to a lower concentration of neutralizing antibodies to B.1.351 than to the older versions of the virus, explained Benhur Lee, a professor of microbiology at the Icahn School of Medicine at Mount Sinai. However, these vaccines generate such a high level of neutralizing antibodies to begin with that the reduced protection is still effective.
Antibodies are also just one component of the immune response. A recent preprint found that immune protection provided by T cells generated in response to a Covid-19 vaccine was just as potent against the new variants.
“This is probably the reason why you see other vaccines still being efficacious in South Africa,” Lee said in an email. So a drop in efficacy doesn’t mean the vaccines are rendered useless, but it does mean they’ll be less protective in environments where variants like B.1.351 are spreading.
In South Africa, the AstraZeneca/Oxford vaccine, which has not been approved in the US, has been pulled from the country’s vaccination campaign. Officials found that it was less effective against the new variant, but the findings came from a small trial of roughly 2,000 people. “Since they had the option of Pfizer and J&J coming down the line, South Africa chose to go ahead with those other vaccines,” Lee said.
The vaccines may also provide less resistance to milder forms of Covid-19 spawned by the new variants. Even if they don’t land someone in the hospital, such infections can still reduce quality of life, especially for people with other preexisting health conditions. And we’ve already seen that even seemingly mild cases of the disease can have lasting effects: persistent fatigue, brain fog, and so on.
Another public health concern with regard to vaccines is how well they block transmission of the virus. This is a crucial factor in controlling the pandemic in the population, particularly when vaccination rates are still so far away from reaching herd immunity.
For now, there is less information about how well vaccines block transmission than there is when it comes to stopping the disease in people. Identifying infections, particularly asymptomatic cases, requires aggressive testing for the virus within a study, an expensive and time-consuming task. But the research that is emerging so far is encouraging.
A recent preprint study from the UK reported that the full course of Pfizer/BioNTech vaccine reduced the chances of developing a transmissible infection by 86 percent. Another preprint study, looking at Covid-19 vaccines in Israel, saw an 89.4 percent drop in transmissible infections.
Will the variants also erode protection against transmission?
It’s possible, but there’s little research to date. The variants already seem to cause more cases of disease with symptoms — early evidence about B.1.1.7 suggests this is the case — so it’s likely that infected people may generate and shed more virus, helping it spread. If SARS-CoV-2 variants lead to more infections breaking through the protection barrier of vaccines, those infections in turn could spur further transmission.
But as with the vaccine protection for individuals, a barrier to transmission, even if it’s lower, would still slow the spread of the virus within a community.
“Even a less efficacious vaccine will be an important tool to tamp down a highly transmissible strain,” Lee said.
How Covid-19 vaccine manufacturers are preparing for the variants
One advantage that we have in this race against the variants is that the new vaccines being rolled out around the world so far are also very nimble.
The Pfizer/BioNTech vaccine and the Moderna vaccine both use a molecule called mRNA as their platform. This molecule delivers instructions to the body to make a spike protein found on the SARS-CoV-2 virus, educating the immune system to fend it off if it encounters the actual virus in the future.
Meanwhile, the vaccine developed by the University of Oxford and AstraZeneca that recently received approval in the UK (but not yet in the US) uses a reprogrammed version of another virus, an adenovirus, to shuttle DNA that codes for the SARS-CoV-2 spike protein to use as target practice. The one-dose Johnson & Johnson vaccine that recently received an emergency use authorization from the FDA also uses an adenovirus vector.
In both of these fairly new vaccine platforms, developers only need to modify the code of DNA or mRNA to tweak the vaccine to reorient it to new variants, something they can do quickly if necessary.
But while it may be possible to alter the vaccine to adapt to new mutations, it’s not ideal: It requires expensive changes in the vaccine production process and eats up valuable time.
“It takes time to manufacture hundreds of millions of doses,” Lee said.
Another approach is to build off of existing vaccine formulations but add on another shot. For example, companies like Pfizer are considering adding a third, booster dose to their two-dose Covid-19 vaccine regimen to solidify the response to the new variants. “We believe that the third dose will raise the antibody response 10- to 20-fold,” Pfizer CEO Albert Bourla told NBC News on February 25.
In an email, a Pfizer spokesperson explained that the company hasn’t seen a loss of protection against the new variants in its laboratory studies, but is proactively gaming out several responses, like a booster dose, through further clinical trials. “We need to focus both on vaccinating the world with an initial regimen and be driven by the science of our clinical studies for the boost,” according to the spokesperson. “We are focused on enrolling the full study and should have the findings soon.”
Moderna, meanwhile, announced on February 24 that it has sent a version of its vaccine optimized to handle the South Africa variant to the National Institutes of Health for further study. The company is also investigating a booster dose.
Johnson & Johnson’s phase 3 clinical trial commenced after those from other manufacturers, so they were able to capture the efficacy of their vaccine against some of the new variants. “The [Johnson & Johnson] Covid-19 vaccine candidate also provided protection against multiple Covid-19 variants,” according to a spokesperson for the company. Johnson & Johnson is also studying a two-dose version of its vaccine.
For its part, the FDA announced it is streamlining the approval process for vaccines to target the new SARS-CoV-2 variants, making the procedure similar to approvals for annual influenza vaccines.
“If Covid-19 becomes an endemic, potentially seasonal virus, we can establish a regulatory pathway that will allow us to move expeditiously to update and validate an updated vaccine, similar to what is done with the flu every year,” said a Pfizer spokesperson.
However, researchers say one shouldn’t hold out for a reformulated vaccine and should take the first shot they’re offered. Whether a vaccine manufacturer opts for a booster, a reformulation, or decides to stick with the existing protocol, timing is critical, and people need to be vaccinated as fast as possible to contain the pandemic.
What do variants and vaccines mean for how the pandemic ends?
There are at least several possibilities for how the pandemic will fade away. Covid-19 could become a largely intermittent threat, with sporadic outbreaks. It could also become seasonal, with surges in the fall and winter. These possibilities make the evolution of the pandemic in 2021 even less predictable than 2020.
“The question mark is going to be next fall, next winter. Is there going to be a new variant that becomes dominant again? Are we going to see efficacy from the vaccines start to wane by that time?” said Anish Mehta, medical director for clinical quality and virtual health at Eden Health, and an assistant clinical professor of medicine at the Icahn School of Medicine at Mount Sinai. “That’s what’s really going to be the big test for us.”
One thing we do know is that the suite of public health strategies used so far — social distancing, hand-washing, mask-wearing — remain useful. “A lot of the things that we’ve been doing throughout this pandemic will continue to work when it comes to these variants,” said Gigi Gronvall, a senior scholar at the Johns Hopkins Center for Health Security, during a press call.
If vaccination rates continue rising while new infections decline, the United States may be able to stay ahead of the virus. Life could return to something approaching normal for most Americans by this summer, according to Mehta.
But it’s turning out that many parts of the world, especially developing countries, aren’t able to keep up. There are places that still aren’t able to get vaccines at all — and probably won’t for a couple of years. As SARS-CoV-2 continues to spread, the likelihood of even more mutations arising will increase. And as has already been demonstrated, new variants don’t stay behind borders for long.
That’s part of why it’s so important to work toward equity in Covid-19 vaccine distribution around the world. As long as the virus can spread anywhere, it’s a threat everywhere.
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The Senate on Wednesday took an important step forward on limiting emissions — and meeting its commitments to curb global warming — by voting to limit the unbridled release of methane molecules, often a byproduct of natural gas production, into the atmosphere.
The 52-42 vote reinstates the Oil and Natural Gas New Source Performance Standards, a handful of Obama-era regulations on methane emissions rolled back by former President Donald Trump in August 2020. The measure drew support from every Senate Democrat, as well as Republican Sens. Susan Collins (R-ME), who has opposed GOP efforts to deregulate methane emissions in the past; Lindsey Graham (R-SC); and Rob Portman (R-OH). The rule is expected to be taken up and passed by the House of Representatives in May.
The standards alone won’t be sufficient to meet President Joe Biden’s pledge to slash greenhouse gas emissions by 50 to 52 percent compared with 2005 levels by 2030 — a goal meant to help keep global warming this century to 1.5 degrees Celsius — but it represents an important step toward meeting that commitment, given that methane is increasingly seen as a driver of climate change. The vote did not receive the support of 10 Republicans — the number Democrats need, barring any changes to the filibuster, to pass more sweeping climate legislation — but the fact three GOP senators signed on suggests Democrats have at least some hope of winning over Republicans on at least some climate-related issues.
This rule change required only 51 “yes” votes, as Democrats took advantage of the Congressional Review Act, which allows legislators to undo laws passed by previous administrations in their lame-duck periods with a simple majority in each chamber of Congress. It’s filibuster-proof. Trump’s methane regulation, adopted by the EPA last summer, is the first rule for which Democrats are using the legislative procedure, which Republicans used 14 times in the first 16 weeks of Trump’s presidency four years ago.
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When it comes to oil and natural gas pipelines, methane leaks are disconcertingly common and a major contributor to the methane currently in the atmosphere. Obama’s regulations, passed in 2016, were meant to change that; they required energy companies to monitor pipelines for leaks and plug any they found. Bringing those regulations back is “absolutely common sense,” Sen. Martin Heinrich (D-NM), a member of the Senate Energy and Natural Resources Committee and a cosponsor of the resolution, said at a Tuesday press conference.
Notably, some energy companies, including BP, Shell, and Exxon, are on record as being on board with increased methane regulation. Heinrich said that’s because complying with its rules would actually save money: Pristine pipes and plugged-up leaks lead to higher yields and greater profits, enough that the costs of securing infrastructure are offset.
And Dan Zimmerle, a senior research associate in the Energy Institute at Colorado State University, said companies also appreciate methane regulations because they lead to increased accountability, making methane — a major component of natural gas, which is often promoted as an alternative to coal — seem safer to consume than it actually is.
“The largest threat to natural gas is not the cost of regulation, it’s the reputation of natural gas,” Zimmerle said.
Republicans, with the noted exception of Collins, Graham, and Portman, have thus far opposed any attempts at energy regulation, including this one, arguing that there are other, less regulatory and more business-friendly ways to take care of the climate. But Democrats argue that regulation of greenhouse gases is critical — and that without it, the United States will fail to ward off the dangers of climate change.
Why reducing methane emissions is critical, briefly explained
Senate Majority Leader Chuck Schumer cast the Senate’s move as “one of the most important votes, not only that this Congress has cast but has been cast in the last decade, in terms of our fight against global warming.”
In a lot of ways, Schumer is right.
Greenhouse gases work by inhibiting the free movement of the sun’s rays that heat the Earth. Gasses such as carbon dioxide and methane absorb the radiation that comes up from the Earth’s surface toward space, trapping it. If emissions continue to increase at the current rate, the atmosphere could warm by 3 to 4 degrees Celsius by the end of the century. The results could be catastrophic.
The problem with methane is that it traps heat incredibly effectively — about 25 times more effectively than carbon dioxide, according to the EPA. While it accounts for only about 16 percent of the world’s greenhouse gas emissions, the manner in which it traps heat means any significant reduction would likely have a positive impact on climate change.
Limiting emissions, as the rules change would, helps address the fact that methane’s presence in the atmosphere is increasing exponentially as a byproduct of human activities such as farming and energy production. In fact, even as the world locked down amid the Covid-19 pandemic, carbon dioxide and methane emissions hit record highs. And it’s possible they could rise further as countries begin to reopen.
All that makes methane reduction key to keeping global warming as low as possible. A 2021 report in Environmental Research Letters found that concerted efforts to reduce man-made methane emissions could decrease global warming by as much as 30 percent.
More methane regulation is needed
Given the current severity of methane emissions, many scientists worry the Obama-era regulations will never be enough to tangibly curb methane emissions.
Robert Howarth, a professor of ecology and environmental biology at Cornell University, was one of the scientists invited to give a briefing on methane emissions to senior White House staff in May 2016, just before the regulations were drawn up. Howarth said one issue with the Obama rules is that they’re missing mechanisms to verify that energy companies are complying with the regulations.
“Methane is a colorless, odorless gas; you can’t see it with the naked eye,” Howarth said. “A layperson can’t see — I can’t see — if the facility is leaking or not. If you don’t have an independent means by skilled people who are verifying what the emissions are, then you’re simply relying on industry to say ‘we’re taking care of it.’ That doesn’t work for me.”
Howarth argued it’s a loophole that can be closed with today’s technology. Microsatellites tuned to measure methane, managed and owned by global governments and private companies, can look for unchecked and unplugged methane emissions. That technology didn’t exist four years ago.
Zimmerle, the Colorado researcher, called the development promising but said that “there are other places, like gas schematics or a whole variety of other specific sources, where everybody knows the emissions are larger, but for whatever reason, they’re not the point of attention.”
There have been other, similar critiques about the limits of the Obama-era rules. For instance, some experts have noted the rules apply only to new extraction sites, leaving older, leaky sites to continue operating.
As senior Vox reporter Rebecca Leber has written, the Biden administration has acknowledged that just bringing back old regulations that don’t go far enough won’t suffice. Exactly how it plans to address the loopholes and reach its target is unclear, but the White House has promised to release details by September. In the meantime, however, the rules change represents a small step forward — and a little less methane in the air.