Pandemic year 2: Vaccines, variants, and other developments

President Joe Biden wasted no time after his Jan. 20 inauguration ceremony. He signed 15 executive orders during his first day in office, several of which related to the COVID-19 pandemic. He mandated masks and social distancing in federal buildings, set up a specific department to coordinate the federal response to the pandemic, rejoined the World Health Organization, and extended the moratoriums on foreclosures, evictions, and student loan payments.

Two new, more contagious variants of SARS-CoV-2 were detected in the United States in late January. The P.1 variant made its way to Minnesota by way of a resident who had traveled to Brazil, while the two South Carolina patients carrying the B.1.351 variant from South Africa had no history of travel to countries where the variant has been confirmed.

To vaccinate all 300 million Americans with the necessary two doses, health care providers will need 600 million units of the vaccine. That’s why the Biden administration announced that by summer it will have purchased the additional 200 million shots needed to meet that mark.

Jeffrey Zients, the White House COVID-19 response coordinator, led the Biden administration's first press briefing on the pandemic. Immediate goals include increasing the number of both vaccination sites and health care providers who can administer the vaccines. In general, the message was one of urgency—plus relief to have scientists back at the helm of the nation’s pandemic response.

Preliminary clinical trial results from the United Kingdom showed that the Novavax vaccine was 94% effective against the virus. Results from a study in South Africa were less promising, with only 49% effectiveness.

The White House opened a “special enrollment period” for the Affordable Care Act after determining that millions of Americans eligible for ACA health coverage remain uninsured. President Biden also took steps to roll back Trump-era policies like work requirements for Medicaid and limitations for Americans with pre-existing medical conditions.

Like the Novavax results the day before, clinical trial results for the Johnson & Johnson vaccine disappointed some experts with just a 66% effectiveness against moderate to severe COVID-19. These results varied by location, with effectiveness slightly higher in the U.S. (72%) and lower in Latin America (66%) and South Africa (57%). However, with only a single shot, the vaccine prevented serious disease progression—hospitalization or death—which means it could still find a place in the world’s overall pandemic response.

By the start of February, 32.8 million vaccine doses had been administered in the U.S.—more doses than the number of people who have tested positive since the virus first reached the U.S. in January 2020. Just over 6 million people had already received both doses by this date, and the U.S. continues to administer over a million shots per day.

The more vaccine options, the merrier. Russia announced results from its Sputnik V clinical trials: 91.6% effective against symptomatic COVID-19, and 100% effective against severe disease progression. No severe or moderate cases were reported in the vaccinated group of 14,964 people.

For the first time, the U.S. administered over 2 million vaccinations in a single day, bringing the national tally to over 40 million doses administered and more than 8 million people fully vaccinated.

The WHO task force investigating the origins of SARS-CoV-2 in China held a press briefing on Feb. 9, announcing that they’d found no evidence that the virus jumped straight from bats to humans, or that it could have escaped from the virus lab in Wuhan. An intermediate carrier for the disease is currently the most likely hypothesis, though much more research is needed to confirm.

The White House announced the members of a new COVID-19 task force focused on reducing health inequities exacerbated by the ongoing pandemic. The team will work to analyze issues such as disparities in COVID-19 cases, hospital stays, and deaths among racial and geographic lines.

Two masks are better than one: The Centers for Disease Control and Prevention officially recommended doubling up on masks to improve protection against COVID-19. The CDC especially recommends layering a cloth mask over a surgical mask, but in general, the idea is to improve the seal around the edges of often ill-fitting masks.

Long-awaited guidance on school reopenings arrived on Feb. 12, when the CDC announced new, science-based strategies for determining how and when to reopen K-12 schools. In general, the guidelines say that depending on current community transmission rates, schools may be safe to reopen as long as they follow proper masking, social distancing, handwashing, cleaning, and contact tracing protocol.

The CDC is closely following the progression of the new coronavirus variants in the U.S. The B.1.351 variant, first identified in South Carolina, has now shown up 21 times in 10 states, while the P.1 variant first found in Minnesota has been reported five times in four states. But there's another strain, B.1.1.7, which is ringing alarm bells: It’s up to 1,523 reported cases in 42 states as of Feb. 18.

According to an NBC News tally, the U.S. reached a new milestone on Feb. 21: 500,000 deaths from COVID-19. Other trackers, such as Johns Hopkins and the CDC, haven’t reached this milestone yet due to differences in accounting, but they will likely cross that threshold within a few days. California leads the rankings with over 49,000 deaths.

The U.S. added a third COVID-19 vaccine to its arsenal when the Food & Drug Administration (FDA) gave Emergency Use Authorization to Johnson & Johnson. 3.9 million doses of this vaccine—the first shown to prevent severe COVID-19 disease with a single dose—were shipped out the next day, to be administered during the week of March 1. While that initial 3.9 million doses represents the entirety of Johnson & Johnson's current supply, the pharmaceutical company has promised to ramp up its production. It is expected to deliver 16 million doses to the U.S. by the end of March and 100 million by summer 2021.

Multiple states in the first week of March peeled back mask mandates and other restrictions related to COVID-19. Throughout the pandemic, some states including Alaska and Georgia resisted ever implementing statewide mask mandates.