World Leaders Call for Sweeping Public Health Treaty

The heads of dozens of nations argued for measures to fight future pandemics. New York expanded vaccine eligibility. Here’s the latest on Covid-19.,

LiveUpdated March 30, 2021, 5:42 a.m. ETMarch 30, 2021, 5:42 a.m. ET

The heads of more than two dozen nations argued for an international understanding to combat future pandemics. In the U.S., New York has opened inoculations to all those over 30.

Vaccinations at a market in Bangkok this month. The suggested treaty is an acknowledgment that the current system of international health institutions has proved inadequate.
Vaccinations at a market in Bangkok this month. The suggested treaty is an acknowledgment that the current system of international health institutions has proved inadequate.Credit…Adam Dean for The New York Times

BRUSSELS — Citing what they call “the biggest challenge to the global community since the 1940s,” the leaders of more than two dozen countries, the European Union and the World Health Organization on Tuesday floated an international treaty to protect the world from pandemics.

In a joint article published in numerous newspapers across the globe, the leaders warn that the current coronavirus pandemic will inevitably be followed by others at some point. They outline a treaty meant to provide universal and equitable access to vaccines, medicines and diagnostics, a suggestion first made in November by Charles Michel, the president of the European Council, the body that represents the leaders of the European Union countries.

The article argues that an international understanding similar to the one that followed World War II and that led to the United Nations is needed to build cross-border cooperation before the next global health crisis upends economies and lives. The current pandemic is “a stark and painful reminder that nobody is safe until everyone is safe,” the leaders write.

The suggested treaty is an acknowledgment that the current system of international health institutions, symbolized by the relatively powerless World Health Organization, an agency of the United Nations, is inadequate to the problem.

“There will be other pandemics and other major health emergencies. No single government or multilateral agency can address this threat alone,” the leaders note. “We believe that nations should work together toward a new international treaty for pandemic preparedness and response.”

The treaty would call for better alert systems, data sharing, research and the production and distribution of vaccines, medicines, diagnostics and personal protective equipment, they said.

“At a time when Covid-19 has exploited our weaknesses and divisions, we must seize this opportunity and come together as a global community for peaceful cooperation that extends beyond this crisis,” the leaders write. “Building our capacities and systems to do this will take time and require a sustained political, financial and societal commitment over many years.”

The article is not clear, however, about what would happen should a country choose not to cooperate fully or to delay sharing scientific information, as China has been accused of doing with the W.H.O.

China has not signed the letter, at least so far. Neither has the United States.

In a news conference on Tuesday in Geneva, the director general of the World Health Organization, Tedros Adhanom Ghebreyesus, said that when discussions on a treaty start, “all member states will be represented.”

Asked if the leaders of China, the United States and Russia had been asked to sign the letter, he said that some leaders had chosen to “opt in.”

“Comment from member states, including the United States and China, was actually positive,” he said. “Next steps will be to involve all countries, and this is normal,” he added. “I don’t want it to be seen as a problem.”

As well as European countries and the W.H.O., the letter’s signatories included nations in Africa, Asia and Latin America.

The line outside a vaccination site in the Bronx on Thursday.
The line outside a vaccination site in the Bronx on Thursday.Credit…James Estrin/The New York Times

New York can begin vaccinating anyone 30 or older on Tuesday and will make all residents 16 or over eligible on April 6, beating President Biden’s goal of making every adult eligible for a coronavirus vaccine by May 1, Gov. Andrew M. Cuomo announced on Monday.

New York was one of only a few states that had not yet set a timeline for universal adult eligibility. Five states had already expanded eligibility fully by the end of last week; six did so on Monday; seven more will follow later this week, and another six on April 5. At least 11 states have said they will wait until May 1.

Though Mr. Cuomo has gradually loosened vaccine eligibility criteria over the last month, he expressed reluctance last week to set a specific target date for doing away with the state’s requirements. The governor said he did not want to outline a timeline for more widespread vaccination until he was more confident that New York would have adequate vaccine supply on hand for its population.

“I just want to make sure that the allocation projections that we’re getting from the feds are right, frankly,” Mr. Cuomo said at a news conference last week. “I don’t want to say, ‘We’re going to open up to 30-year-olds in three weeks,’ and then something happens with the allocation.”

Mr. Cuomo’s announcement comes as New York has been adding new virus cases at one of the highest rates among U.S. states. As of Monday, the state had a seven-day average of 49 new virus cases a day for every 100,000 residents, according to a New York Times database, second only to New Jersey. (The nation as a whole was averaging 19 new cases per 100,000 people.)

Even as the number of new cases continues to mount, the state has not faced anywhere near the level of devastation that it experienced a year ago, when hospitals were overwhelmed with patients and morgues were overflowing.

Buoyed by its vaccination progress, the state has also been gradually reopening businesses in the last several weeks. Mr. Cuomo allowed sporting events and concerts to resume at large venues last month and movie theaters to bring back audiences this month. Restaurants in New York City are now allowed to serve diners indoors at 50 percent capacity, their highest level of indoor dining since Mr. Cuomo closed them last year at the onset of the pandemic.

As of Monday morning, 29.6 percent of people in New York State had received at least one shot of a vaccine, while 16.8 percent were fully vaccinated, according to the state’s data.

Currently, all people 50 and over are eligible to receive the vaccine in New York, in addition to teachers, some essential workers and people with certain medical conditions that make them more susceptible to serious illness from the virus.

Peter Ben Embarek, a member of the World Health Organization team tasked with investigating the origin of the coronavirus, in Wuhan, China, in February.
Peter Ben Embarek, a member of the World Health Organization team tasked with investigating the origin of the coronavirus, in Wuhan, China, in February.Credit…Thomas Peter/Reuters

A joint inquiry by the World Health Organization and China into the origins of the coronavirus has yielded a 124-page report full of new detail but no profound new insights. And it does little to allay Western concerns about the role of the Chinese Communist Party, which is notoriously resistant to outside scrutiny and has at times sought to hinder any investigation by the W.H.O.

The report, which was leaked to the media on Monday, a day before its scheduled official release, is also not clear on whether China will permit outside experts to keep digging.

Earlier this year, an international team of experts spent 27 days in Wuhan, the Chinese city where the virus was first detected in late 2019. They visited hospitals, live animal markets and government laboratories, conducted interviews and pressed Chinese officials for data, but came away still far from understanding the origins of the pandemic that has killed nearly 2.8 million people worldwide.

“The investigation runs the risk of going nowhere, and we may never find the true origins of the virus,” said Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations.

The report says that China still does not have the data or research to indicate how or when the virus began spreading. Some skeptics outside the country say that China may have more information than it admits.

The expert team also dismisses as “extremely unlikely” the possibility that the virus emerged accidentally from a Chinese laboratory, even though some scientists say that is an important question to explore.

The Chinese government, while granting some degree of access and cooperation, has repeatedly tried to bend the investigation to its advantage. The report was written jointly by a team of 17 scientists from around the world, chosen by the W.H.O., and 17 Chinese scientists, many of whom hold official positions or work at government-run institutions, giving Beijing great influence over its conclusions.

Jesse Bloom, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle, said after seeing a copy of the report that he was not convinced that a laboratory leak was extremely unlikely. He said he agreed with the report that the virus could have come from a natural zoonosis, but he did not see any reasoning in the report to dismiss the possibility of a lab escape.

One member of the team of experts, Peter Daszak, a disease ecologist who runs EcoHealth Alliance, pushed back against the criticism of the team’s work and of China’s level of cooperation, calling the lab leak hypothesis, which has been promoted by some Trump administration officials, “political from the start.”

The prevailing theory remains that the virus originated in bats, jumped to another animal, and then mutated in a way that enabled it to transmit to humans, and from human to human. But the process of tracing the origins of a virus is notoriously painstaking.

To answer numerous remaining questions, the report recommends further retrospective studies of human infections, including the earliest cases, and more virus testing of livestock and wildlife in China and Southeast Asia. But it is unclear to what degree China would cooperate.

In Washington on Monday, the White House press secretary, Jen Psaki, said experts across the U.S. government, including leaders in veterinary medicine and biosecurity, were currently reviewing the report.

“We have been clear that an independent, technically sound investigation is what our focus is on, and once this is reviewed we’ll have an assessment about the steps forward,” she said.

Earlier in the day, Dr. Anthony S. Fauci, the leading expert in infectious diseases in the United States, and Dr. Rochelle Walensky, the head of the Centers for Disease Control and Prevention, said they had not yet seen the report.

A mass vaccination site at the Kentucky State Fair and Exposition Center in Louisville this month.
A mass vaccination site at the Kentucky State Fair and Exposition Center in Louisville this month.Credit…Jon Cherry for The New York Times

The coronavirus vaccines made by Moderna and Pfizer-BioNTech are proving highly effective at preventing symptomatic and asymptomatic infections under real-world conditions, federal health researchers reported on Monday.

Consistent with clinical trial data, a two-dose regimen prevented 90 percent of infections by two weeks after the second shot. One dose prevented 80 percent of infections by two weeks after vaccination.

The news arrives even as the nation rapidly broadens eligibility for vaccines, and the average number of daily shots continues to rise. The seven-day average of vaccines administered hit 2.76 million on Monday, an increase over the pace the previous week, according to the Centers for Disease Control and Prevention.

But the virus may be gaining renewed momentum. According to a New York Times database, the seven-day average of new virus cases as of Sunday was 63,000, an increase of more than 16 percent over the past two weeks.

Similar upticks over the summer and winter led to major surges in the spread of disease, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said at a news briefing on Monday. She said she had a sense of “impending doom” about a possible fourth surge of the virus.

The nation has “so much reason for hope,” she said. “But right now I’m scared.”

Scientists have debated whether vaccinated people may still get asymptomatic infections and transmit the virus to others. The new study, by researchers at the C.D.C., suggested that since infections were so rare, transmission was likely rare, too.

There also has been concern that variants may render the vaccines less effective. The study’s results do not confirm that fear. Troubling variants were circulating during the time of the study — from Dec. 14, 2020, to March 13, 2021 — yet the vaccines still provided powerful protection.

The C.D.C. enrolled 3,950 people at high risk of being exposed to the virus because they were health care workers, first responders or others on the front lines. None had previously been infected.

Most participants — 62.8 percent — received both shots of the vaccine during the study period, and 12.1 percent had one shot. They collected their own nasal swabs each week, which were sent to a central location for P.C.R. testing, the most accurate type of test. The weekly swabs allowed the researchers to detect asymptomatic infections as well as symptomatic ones.

The investigators asked participants about symptoms associated with infection, including fever, chills, cough, shortness of breath, sore throat, diarrhea, muscle aches, or loss of smell or taste. They also analyzed patients’ medical records to detect illnesses.

Fifty-eight percent of the infections were detected before people had symptoms. Just 10.2 percent of infected people never developed symptoms.

Among those who were fully vaccinated, there were .04 infections per 1,000 person-days, meaning that among 1,000 persons there would be .04 infections in a day.

There were 0.19 infections per 1,000 person-days among those who had had one dose of the vaccine. In contrast, there were 1.38 infections per 1,000 person-days in unvaccinated people.

Dr. Walensky urged Americans to continue taking precautions and to waste no time getting the shots as soon as they are eligible.

“I am asking you to just hold on a little longer, to get vaccinated when you can, so that all of those people that we all love will still be here when this pandemic ends,” she said.

Sandra Medeiros taking a photo of her husband, Daryl Bedard, as he received the AstraZeneca vaccine in Toronto this month.
Sandra Medeiros taking a photo of her husband, Daryl Bedard, as he received the AstraZeneca vaccine in Toronto this month.Credit…Nathan Denette/The Canadian Press, via Associated Press

Canada has become the latest country to suspend the use of the AstraZeneca vaccine for people 55 and under, over concerns that it might cause rare, dangerous blood clots, particularly in middle-aged and younger women.

The country joined France and the nordic European countries in taking a precautionary approach to the vaccine, even after the European Union’s top drug regulator cleared it as safe earlier this month.

“More study needs to be done,” Dr. Caroline Quach-Thanh, the chair of the National Advisory Committee on Immunization, said at a video news conference on Monday. “Given alternative vaccines are available in Canada, N.A.C.I. feels it is very important to study the risks and benefit as a precautionary measure.”

The decision was made after reviewing evidence emerging from Germany, where the Paul-Ehrlich Institut reported that one in 100,000 people receiving the AstraZeneca vaccine developed blood clots, resulting in a condition called thrombocytopenia, which can be fatal in approximately 40 percent of cases, panel members said. This came after the European Medicines Agency reported a lower rate: one in one million.

No cases have been reported in Canada.

The country’s health authority continues to recommend the AstraZeneca vaccine for the country’s older population, who are much more susceptible to serious cases of Covid-19, and have not appeared to develop blood clots in the studies conducted in Europe, the panel members said.

“We want to prevent hospitalizations and severe disease for those over 55,” Dr. Quach-Thanh said.

The vaccine, created by Oxford University, was approved in late February for use in Canada but has suffered setbacks. Soon after its approval, N.A.C.I. recommended it not be administered to people 65 and older, because of a lack of data about the vaccine’s efficacy in that age group. Two weeks later, N.A.C.I. waived its initial concerns and approved the vaccine for all adults.

Health Canada has asked AstraZeneca for more data on the vaccine by age and gender, “in the Canadian context,” said Dr. Howard Njoo, the country’s deputy chief public health officer.

The vaccine was the third approved in the country, two months after Pfizer-BioNTech and Moderna. Just over 300,000 AstraZeneca doses have been administered — about 6 percent of the total doses given out in the country. Twelve percent of the population has received at least one dose of any of the vaccines.

Earlier this month, the Biden administration promised to loan Canada 1.5 million doses of the vaccine, which still has not been approved for use in the United States.

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