Feb 1, 2021

An update on COVID-19.

An update on COVID-19.

Vaccines and new strains dominate the next phase.

I’m Isaac Saul, and this is Tangle: an independent, ad-free, subscriber-supported politics newsletter that summarizes the best arguments from across the political spectrum — then “my take.” You can read Tangle for free, subscribe for Friday editions and you can reach me anytime by replying to this email. If someone sent you this email, they’re asking you to sign up. You can do that by clicking here.

Today’s read: 13 minutes.

Good morning, good afternoon and good evening from a snow-covered New York City. There are six or seven inches of the good stuff on the ground already, and we’re diving into something we haven’t focused on in weeks: COVID-19. Plus, a question about Joe Biden vs. the progressive wing, some reader feedback and a few important quick hits.

President-elect Joe Biden gets the COVID-19 vaccine in December. Image: MSNBC screenshot

Reader feedback.

I got two pieces of feedback about my response to a reader question last week, where I touched on cancel culture and the fear many of my conservative readers tell me they live in because of their political views.

“What you said in this issue about the right's fear-driven thinking, and the left's intolerance and shaming behaviors, is entirely nail-on-the head,” one reader said. “That intolerance drives me crazy. The left is supposed to be ‘the big tent,’ but lately I feel like it's the ‘finger-pointing, zero to sixty, fire and flames’ tent. I'm glad I'm not alone feeling that way. I know we need big, progressive thinking, and it's true that it's high time we called spades spades and racists racist, but there's a difference between teaching and browbeating. I see an unfortunate level of browbeating and dog piling, especially on Twitter — and nobody has ever learned empathy by being harangued.”

Blake from Little Rock, Arkansas, had a different perspective.

"I wanted to say that ‘cancel culture’ isn’t one-sided,” he wrote. “You mentioned that there is fear from right-of-center people to express their views, because of a fear they will lose their jobs, relationships, reputations, etc. In many states, I still have to worry about losing my job or not getting a job offer because of homophobia. Whether the employer is against gay people or just the way that I am gay or express my gay identity, I can’t know for sure. Millions of people live with this fear, or the fear of ex-communication from churches or being kicked out of the house. Others experience purity politics, hair discrimination, and other forms of ‘cancel culture’ in the forms of sexism, racism, transphobia, homophobia, Islamaphobia, etc. And the spectrum of fear covers fear of losing one’s life to the fear of speaking up for oneself.”


Quick hits

  1. 10 Senate Republicans attempting to work with President Biden released a coronavirus relief proposal that costs $618 billion, including $130 billion for $300 weekly unemployment insurance benefits (through June), $220 billion for $1,000 of direct payments (phasing out for singles who make $40,000 a year, joint filers making $80,000 a year) and $20 billion for a vaccination program. (Wall Street Journal, subscription)
  2. President Trump parted ways with five lawyers who were set to handle his impeachment defense after pushing for his defense team to focus on the baseless claim that the election was stolen. (The New York Times, subscription)
  3. Sen. Joe Manchin (D-WV) slammed Vice President Kamala Harris after she appeared on a local West Virginia TV station to discuss her administration’s COVID-19 plan without contacting Manchin. (Politico)
  4. A top ISIS leader was killed in Iraq last Wednesday in a U.S. airstrike that military officials revealed to the public on Friday. (The New York Times, subscription)
  5. The New York attorney general is investigating Gov. Andrew Cuomo’s administration for undercounting COVID-19 deaths in nursing homes, adding another wave of criticism to Cuomo’s handling of the pandemic. (NPR)
  6. BONUS: Wall Street faces major government regulation after retail traders blew up the price of GameStop in last week’s stock trading madness. (Politico)

What D.C. is talking about.

Coronavirus. Here at Tangle, we’ve done our best not to let any single topic dominate our newsletter — but it’s been six weeks since we covered COVID-19 (our last vaccine edition) and while there have been a couple of issues on Joe Biden’s coronavirus relief proposal, it feels as if we’re due for an update on the biggest story in the world.

So, what’s new? The kinds of coronavirus out there, unfortunately. Two new strains of the virus are raising alarm amongst scientists. One strain is already wreaking havoc in the United Kingdom. Hospitalizations are up and the U.K. has gone back into lockdown. The new variant appears to be more contagious, and some scientists are contending it’s also more deadly, though the jury is still out on the latter. Fortunately, the many available vaccines appear to work against the British strain too. Unfortunately, the strain could spread faster than the vaccines can be administered.

Then there’s the South African strain. This is the one that really has caused consternation amongst epidemiologists. Some researchers believe this variant is 50% more contagious, though so far there’s no indication it causes more serious cases. Again: the vaccines appear to be effective against this strain, too, though perhaps less effective than they are against the British strain. And, again: the concern is that the mutated virus is spreading faster than vaccines, and the CDC director says we have community spread of both strains in the U.S. already.

This weekend, Dr. Michael Osterholm, an infectious disease expert at the University of Minnesota who advised the Biden transition team on COVID-19, offered an unsettling warning. He believes the U.K. variant of COVID will become the main strain of the virus here in the U.S.

“The fact is that the surge that is likely to occur with this new variant from England is going to happen in the next six to 14 weeks. And, if we see that happen, which my 45 years in the trenches tell me we will, we are going to see something like we have not seen yet in this country,” Osterholm said. “You and I are sitting on this beach, where it’s 70 degrees, perfectly blue skies, gentle breeze, but I see that hurricane — Category 5 or higher —  450 miles off shore… Telling people to evacuate on the nice, blue sky day is going to be hard. But I can also tell you that the hurricane is coming.”

(Editor’s note: Please, someone lead me to the 70 degree, blue-sky beach Osterholm thinks we’re enjoying right now.)

So, what’s the good news? The good news is we are consistently testing millions of people a week, and our cases and hospitalizations have eased in recent weeks. New cases are down 32% over the last 14 days. This is, to be sure, a great sign. It doesn’t undercut the fact the virus is still raging, and new strains are here, but it’s worth remembering:

The better news is that the vaccines we have, even the latest Johnson & Johnson single-shot vaccine, are absolute studs. They are not perfect at preventing the spread of the virus, but they are damn good at ensuring you don’t get a serious case of COVID-19. If the vaccine turns coronavirus into the regular flu, or a couple of days with some body aches, that’s a huge win. Their effectiveness puts a lot of pressure on the Biden administration to get those vaccines out as quickly as they can.

So far, the U.S. has administered 30 million doses of the vaccine, and about 25.2 million people have gotten at least one dose. We fell short of the goal to give out 20 million shots by the end of 2020, but the pace is picking up (despite today’s storm closing down some vaccination clinics in the northeast). 1.3 million doses a day were administered in the last week, compared to less than one million a day the week before. President Biden says he hopes to get to 1.5 million doses administered a day soon, and the Centers for Disease Control and Prevention (CDC) is hoping to make them available in local pharmacies beginning next month.

Below, we’ll take a look at some views from across the spectrum on where we are.


What the left is saying.

The left is encouraged by the new administration’s plan and insists that Americans remain diligent — even if they have been vaccinated against the virus. There’s also a growing call for the Biden administration to update its vaccine plan to give as many people a single shot as soon as possible, because even one shot has been shown to reduce the severity of COVID-19 cases.

In The New York Times, Drs. Adam Finn and Richard Malley, two infectious disease experts and physicians, endorsed the initial dose plan.

“We think more lives would be saved by providing as soon as possible (a) just one dose of vaccine (b) to all people who face the highest risk of dying from Covid-19, whatever the reason (advanced age, other medical conditions, severe obesity), and (c) just forgetting about any boosters for a while, maybe even a very long while,” they wrote. “Second doses should be deferred for the time it takes to achieve this primary goal. The two vaccines’ manufacturers and the F.D.A. have been reluctant to endorse any change to the vaccination schedules that were tested in Phase 3 clinical trials… under current circumstances, it is dangerously overcautious.

“In trials for another Covid-19 vaccine not currently available in the United States — this one developed by Oxford-AstraZeneca — study subjects were supposed to get a booster one month after the first shot but some received it up to 12 weeks later,” they added. “Results for the latecomers were outside the trials’ formal ambit, but they are available, and they suggest that the subjects who waited to get their booster beyond the recommended delay displayed better immune responses than the subjects who got it on time… In both the Pfizer-BioNTech and Moderna Phase 3 trials, the first dose achieved at least 89 percent efficacy starting two weeks after immunization. Preliminary data from Israel’s mass inoculation campaign suggest likewise, with significant protection against infection reported in the first 430,000 individuals who received an initial shot.”

The Washington Post editorial board responded to news that a sizable portion of health care workers were hesitant to get the coronavirus vaccine.

“The most frequent explanation for hesitancy is mistrust and misinformation. David Grabowski of Harvard University told The Post that earlier missteps in fighting the pandemic, including fumbles over personal protective equipment, combined with low wages and poor working conditions, have created a well of distrust, especially among the Black and Latino workers who dominate the nursing home industry,” the board wrote.

“Other reasons for hesitancy are that many medical front-line workers are young and may feel invincible,” it added. “Social media abounds with misinformation. Some may simply want to wait, fearful of being in the first wave. Others who have already survived a bout with covid-19 might not want to be at the head of the line. But even they should not neglect the vaccine. Maximizing the number of people vaccinated is our best chance to minimize spread, especially as new variants of the virus emerge. These workers are everyday heroes. They save lives and serve those who often cannot serve themselves. They willingly go every day to the front lines. We implore them to reject the misinformation, surmount the distrust and believe in the science: The vaccines can save lives, including yours.”

In Vox, Umair Irfan said there is reason to be optimistic — but everyone should keep their masks on for the coming months.

“The main problem is that while the Covid-19 vaccines now available are amazingly effective at protecting recipients, it’s not clear how much they can prevent them from spreading the virus to other people,” he wrote. “So scientists generally agree: The vaccines are essential for ending the pandemic, though they will take weeks or months to blunt the spread of Covid-19 across the population. Until that time, it’s necessary to keep up mask-wearing and social distancing in public.”


What the right is saying.

The right is optimistic about the spring, giving credit to President Trump’s Operation Warp Speed and calling on Joe Biden to continue to cut red tape in order to speed up the vaccination process for Americans.

In National Review, Robert Zubrin called on Biden to take the Moderna vaccine — which taxpayers paid to help develop — and license it out to other pharmaceutical companies who can produce more of it.

“Moderna is a very innovative company, and it deserves a lot of credit for its development of a highly effective vaccine against COVID-19 in two days in January 2020,” he wrote. “But within the $1.3 trillion per year pharmaceutical industry, Moderna stands as a pygmy among giants. In 2019, Moderna’s total revenue from drug sales was $187 million. By contrast, the top-20 American pharmaceutical companies, starting with Roche at $48 billion in 2019 revenue and continuing on down to Biogen at $11.3 billion, collectively possess thousands of times the production capability of Moderna. To take one example, Merck, which has given up its own vaccine-development effort, has, by itself, over 200 times Moderna’s drug-production capacity.

“Instead of waiting months or years for little Moderna to produce its — or rather our — vaccine in sufficient quantities to meet the emergency, the Biden administration should license it to Merck and every other qualified company who can produce it, and put in large orders.”

The Wall Street Journal editorial board praised Operation Warp Speed chief Moncef Slaoui for how he positioned the Biden administration on the vaccine rollout.

“Operation Warp Speed removed the financial risk for drug makers by financing trials and manufacturing in advance so vaccines could roll out as soon as they are approved,” the board wrote. “This is the reason some 20 million Americans have already been inoculated. President Biden this week ordered another 200 million doses from Pfizer and Moderna to be delivered this summer. These extra doses may or may not be needed if other vaccines are approved—J&J could add 100 million this spring—but the reason they will be available is contracts that Operation Warp Speed negotiated with drug makers that gave the feds the option to order more.

We point this out because White House officials have been griping that they are ‘starting from scratch,’” the board said. “That’s false. Operation Warp Speed created the incentives for vaccine development, and assisted with rapid approvals and distribution infrastructure, which Mr. Biden will undoubtedly claim credit for as the rollout gains speed and breadth. The Biden team showed its gratitude by deposing Mr. Slaoui via a nasty news leak that criticized his good work.”

Former Food and Drug Administration Commissioner Scott Gottlieb, who sits on the board of Pfizer, said the new Johnson & Johnson vaccine was encouraging — and that the FDA needs to stay nimble to address vaccine development and boosters for new strains.

“The virtue of the new vaccines is that they are derived through synthetic processes using the sequence of the coronavirus’s RNA,” he wrote. “That means the vaccines are relatively straightforward to update when new variants emerge. Another priority should be developing antiviral drugs. We need more tools that go after central features of how the viruses replicate and don’t depend on targeting proteins found on the virus’s surface. These drugs could remain effective even if the virus mutates.

“The best backstop against the wide transmission of mutant strains is still the same: a public that takes precautions like social distancing and masks—paired with a thoughtful and nimble system for developing vaccines.”


My take.

Something about this feels like a heavyweight boxing match. We’ve got the best scientists, the most money, the will of the people on one side. We’ve got a novel, changing, deadly, frustratingly easy to spread virus on the other side. Haymakers are being thrown back and forth as the world watches, hoping like hell the scientists can win.

Mutations were always going to happen. We knew this, and the scientists warned us about them, and now they’re here. It’s important to note that we still know very little about the mutations. Yes, the United Kingdom has swung into lockdown and seen a surge in cases — as has South Africa, where another new strain was found. But buried in almost every story about those surges is the fact that some scientists believe they are tied more to the actions of the public (i.e. reduced social distancing) and not necessarily transmissibility of the new strains. Or, in a middle ground scenario, it’s a little bit of each.

Regardless, I’m optimistic. And I think the science, money, and will of the people are winning.

First, I know quite a few people who have now gotten at least one vaccine. Many of the health care workers I know have been fully vaccinated, which was key to the Trump and Biden plans. My mom is scheduled for a shot, my aunt is fully vaccinated, and every day I hear about Americans over the age of 65 getting in line. This is crucial. 1.3 million vaccinations a day is a lot. Think about it this way: there are 209 million adults here. If vaccines are only going to adults, which they most assuredly are, then a week from today another 9.1 million — or 4.3% of American adults — will have at least one vaccine dose. And that’s if the vaccine administration clip stays the same, rather than rising as hoped.

If the one-dose crowd is right — and I think there is good evidence they are — the 25 million people who have already gotten a single dose will have almost 90% immunity approximately two weeks after getting the shot. By next week, there will be over 34 million who have received one dose, and in three weeks it’ll probably be over 50 million — that’s about 23% of the adult population given their first shot, with significant protection from the virus by early March. All these numbers could be even higher if Biden goes the “get one dose in first” route, and the pace of vaccination picks up, both of which look possible.

It’s also true that the Johnson & Johnson single-dose vaccine tested very well. Like every American, I am reading news reports about it being around 70% effective — which sounds a lot worse than the 90% or 95% Pfizer and Moderna achieved. But the other positive news is astounding: the vaccines all appear to be at least somewhat effective against variants and they all are very, very good at eliminating deaths and drastically reducing very serious cases of the virus. These are the two most important things.

As The New York Times’ David Leonhardt notes:

“Of the roughly 75,000 people who have received one of the five in a research trial, not a single person has died from Covid, and only a few people appear to have been hospitalized. None have remained hospitalized 28 days after receiving a shot. To put that in perspective, it helps to think about what Covid has done so far to a representative group of 75,000 American adults: It has killed roughly 150 of them and sent several hundred more to the hospital. The vaccines reduce those numbers to zero and nearly zero, based on the research trials. Zero isn’t even the most relevant benchmark. A typical U.S. flu season kills between five and 15 out of every 75,000 adults and hospitalizes more than 100 of them. I assume you would agree that any vaccine that transforms Covid into something much milder than a typical flu deserves to be called effective.”

All told, here’s the good news:

Cases are dropping as we speak. Millions of Americans are being vaccinated every week. The vaccines work, the pace of vaccinations is heading in the right direction, and we’re in the dead of winter so you have no reason to go outside anyway. Even you suckers in southern California with no seasons — I know you think 65 degrees is cold. Keep social distancing!

We are not out of the woods yet. We can’t relent, and nearly all of us are still living in high-risk counties for infection. Having vaccines on the horizon is not the same as having taken vaccines. But the “hope” here — the light at the end of the tunnel — is not an illusion. A storm could be coming, and we need to be prepared for the direction of our battle to change, but for now we need a few more months of collective precautions and widespread enthusiasm for vaccinations to turn this pandemic into a flu season. We’ve got what we need, the rest is up to us.


Your questions, answered.

Q: What are your thoughts on the dynamic between moderate and progressive Democrats and what does that mean for the future of the Democratic Party?

— Sean, Somerville, Massachusetts

Tangle: Before Biden entered office, there was a pretty clear narrative, one that was repeated here in Tangle: the progressive wing of the party was going to try to push Biden to the left, and Biden was going to hold the center. But since he’s entered office, after 12 days of watching his presidency, a new narrative is emerging.

This one is the inverse: that Biden is taking a more progressive tack than anyone imagined, and that centrist Democrats — like Joe Manchin — are going to be holding the line. Of course, this is the scenario many on the right feared, and now believe is coming to fruition before our eyes.

Axios put it like this: “Joe Biden ran as a unifying centrist destined to be in conflict with activist liberals. Turns out, Biden is governing as an activist liberal constrained by centrists.” In The New York Times, Gail Collins and Bret Stephens wrote that “The president has been much more left-wing out of the gate than many predicted. What comes next?”

What’s behind this narrative shift? A number of early policy efforts. Namely, Biden’s immigration plan, which goes further left than any before it has. His wave of executive orders on climate change — and killing the Keystone XL pipeline — also help, as does the prominence of a movement toward racial equity. Then there’s his $1.9 trillion coronavirus relief plan, and his team’s apparent willingness to push it through via reconciliation (i.e. with no Republican votes). Allowing Bernie Sanders to take the lead on the fight for a $15 minimum wage doesn’t hurt, either.

I think from Biden’s perspective, he wanted to hit the ground running and dominate the news with action — by executive order or bold proposals — and send a message that he was going to run the most progressive presidency yet. If I were a progressive liberal worried about Biden, I’d be thrilled. And maybe that’s the point: get the questions answered for the Democratic base most concerned about whether Biden would represent them.

But we’ll see if it holds. We’re just 12 days in. Taking stock of proposals and executive orders is a lot different than seeing what kind of legislation Biden pushes and where he lands when Republicans join the negotiations. I still believe he’s going to lead from the center-left, and that he’ll be far closer to Barack Obama than Bernie Sanders. But there’s no doubt that so far he’s upended the narrative that dominated the final days of his campaign.


A story that matters.

In 2019, scam victims reported a stunning loss of $3.5 billion to scam callers who gained access to their bank accounts or computers with trumped-up reasons for calling. Some said they were on the line about student loans, or tax debts, or an anti-virus computer software they once downloaded. One Harris Poll found that 22% of American respondents said they had lost money to a phone scam in the past 12 months. One study estimates $20 billion has been lost to these scam artists. But who are they? And how are they getting away with this? The New York Times has a new report that goes deep into the world of phone scams.


Numbers.

  • 13 of 14.The number of Biden’s executive actions in his first week that had a majority of Americans’ support, according to a FiveThirtyEight analysis done on polling of 14 of those actions.
  • $255.4 million. The amount of money former President Donald Trump raised in the eight weeks he sought to overturn the election results.
  • 5,100. The number of protesters arrested in Russia this weekend who hit the streets to oppose the jailing of opposition leader Alexei Navalny.
  • 1,875. The number of reported COVID-19 deaths in America on January 31st.
  • 5.7 million. The number of Americans who have been fully vaccinated for COVID-19.
  • 98.3 million. The number of global doses of the coronavirus vaccine given, according to data collected by Bloomberg.

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Have a nice day.

Speaking of vaccinations, how is this for a story? A group of Oregon health care workers were on their way from one vaccine clinic to another when they got stuck behind a tractor-trailer in a snowstorm. As it became obvious they’d be stranded for hours, the workers realized their last six Moderna vaccines were going to spoil in their vehicles. So they started walking down the highway, knocking on drivers’ windows, asking if they wanted a vaccine. Yup. Roadside, snowstorm vaccinations. Amazingly, they managed to administer all six of the doses before they spoiled, even if “Most drivers laughed at the offer of a roadside coronavirus vaccine and politely declined.” For the record, I would have taken it!

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