States file their Covid-19 vaccine plans to CDC without plans to pay for them, state health officials say

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Friday was the deadline for states to submit their plans to the US Centers for Disease Control and Prevention, but they still don’t have the needed federal money to help carry them out, officials said.

“As it stands now, we do not have any capability to fund the imminent implementation of the plan,” James Blumenstock, senior vice president for pandemic response and recovery at the Association of State and Territorial Health Officials, told reporters Monday.

The CDC distributed $200 million to states for preparedness and planning, Blumenstock said, which “certainly would not be sufficient at all for a campaign of this magnitude and duration.”

The association has asked Congress for $8.4 billion to help states distribute and administer vaccines to people once they became available.

“Even if the money was appropriated today, it would take time for those funds to reach the jurisdictions that in turn would need it,” Blumenstock said.

The funding for vaccines isn’t the only problem. Health officials are also having to deal with a very skeptical public. Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said Monday it may be a challenge to get people to take the vaccine.

“It would be a terrible shame if we have — and I think we will have — a safe and effective vaccine but we’re not able to widely distribute it to those who need it,” Fauci said in a virtual event for the National Academy of Medicine on Monday.

People at the highest risk of Covid-19 should get a vaccine once one is shown to be safe and effective, whereas healthy young people could possibly consider waiting for another vaccine, Fauci told CNN Chief Medical Correspondent Dr. Sanjay Gupta on Monday.

The vaccine dilemma comes as Covid-19 cases continue to soar across the country. The next few months will be the “darkest of the pandemic,” Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told NBC’s “Meet the Press” on Sunday.
As of Monday, there were more than 8.2 million cases and 220,088 coronavirus deaths in the United States, according to data from Johns Hopkins University.

Osterholm highlighted the 70,000 cases of Covid-19 reported on Friday, which matched the largest number seen in the peak of the pandemic. Between now and the holidays, the US will see numbers “much, much larger than even the 67 to 75,000 cases,” he said.

Fauci, however, said a nationwide lockdown is not the way forward unless the pandemic gets “really, really bad.”

“No, put shutdown away and say, ‘We’re going to use public health measures to help us safely get to where we want to go,'” he said in an interview on CBS’ “60 Minutes” on Sunday night.

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It has long been anticipated that there will likely be more than one Covid-19 vaccine made available in the coming months.

Fauci said whether people should get the first iteration of vaccine depends on a number of factors, including each individual’s level of risk and how effective the vaccine is shown to be uniformly among different demographic groups.

“If you have an underlying condition and you find that you are in a high-risk situation, and you have a vaccine that’s of reasonable efficacy, I would go ahead and take that vaccine if you’re really at a higher risk. If you’re an otherwise very healthy young person, you might want to wait and see what the next iteration would be,” Fauci said.

When one is made available, Fauci said in the “60 Minutes” interview, he will take it after looking at the data and whether the US Food and Drug Administration has approved it.

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Dr. Nirav Shah, director of Maine’s Center for Disease Control and Prevention, said his state and likely others could probably get started vaccinating frontline health care workers once a vaccine became available, because they will be in easy-to-reach places such as hospitals and clinics.

What will be more difficult, he said, will be reaching the people designated as high risk of severe complications for coronavirus who are not frontline medical and emergency workers, such as people with underlying health conditions.

States will face considerable difficulties distributing coronavirus vaccines, especially as some require special ultra-cold handling conditions.

Record-keeping will also be complicated because some vaccines will require two doses. The vaccines made by different companies have very different formulations, so if more than one is authorized, clinics will have to keep careful note of which vaccines patients get so they get a second dose of the same brand of vaccine.

But Osterholm said that vaccines won’t be available “in any meaningful way” until the third quarter of next year and even when they are, half the US population is skeptical of even taking one.

The vaccine development process has stirred controversy as politicians have called for one to be released quickly, prompting some to question whether the politicization of the issue will affect the safety and efficacy of a possible vaccine. But many health experts have said that the agencies in charge will hold to high vaccine standards.

“The commissioner of the FDA has been very public that he will not let politics interfere. We have an advisory committee to the FDA who are made up of independent people who I trust,” Fauci said. “Put all those things together, if the final outcome is that the FDA approves it, I will take it.”

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In an open letter published Friday by Pfizer Chairman and CEO Albert Bourla, the company said it plans to apply for emergency use authorization from the FDA for its Covid-19 vaccine as early as the third week of November.

Once a vaccine is approved in the US, CVS and Walgreens pharmacies have been designated to help distribute free vaccines to long-term care facilities, federal officials confirmed.

Health and Human Services Secretary Alex Azar said he believes there will be enough vaccines by the end of December to vaccinate the most vulnerable populations in the United States. By the end of January, he said, there will be enough to vaccinate all seniors and health care workers and first responders.

“By the end of March, early April, we believe we will have enough vaccine produced to vaccinate anybody in the United States who wanted to get vaccinated,” Azar said.

27 states reporting rising numbers of new cases

New coronavirus cases have been climbing across nearly all of the country over the past week.

Florida’s daily case count has remained above 2,000 for six days in a row, CNN’s tally shows.

At least 18 West Virginia Covid-19 outbreaks linked to church services, governor says

The state is among 27 that have seen a 10% increase or greater of average daily cases over the week. The others are: Alabama, Arizona, Colorado, Connecticut, Idaho, Illinois, Indiana, Kansas, Massachusetts, Michigan, Minnesota, Mississippi, Nebraska, Nevada, New Jersey, New Mexico, North Dakota, Ohio, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Washington, West Virginia and Wyoming.

Hospitalizations have also increased lately, according to a CNN analysis. A total of 42 states have seen hospitalizations from Covid increase by more than 5% and 14 states have seen peak hospitalizations in the last week, and 17 states are currently at 10% peak hospitalizations.

West Virginia Gov. Jim Justice said Monday that 13 counties in the state have reported a total of 18 active Covid-19 outbreaks stemming from church services.

“We all know that church is a place that absolutely this killer can really thrive. We’re singing, we love to see all those that we love and that are in our church family with us,” Justice said. “It’s an absolute place where a lot of our elderly go and we’ve got to wear a mask, stay a pew apart, and from the standpoint of our elderly, you can get your services online or something like that.”

The state also has reported 43 outbreaks at long-term care facilities, and 12 new cases at three correctional facilities. Schools have reported 19 outbreaks with 59 confirmed cases.

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Over the weekend the significant surge in case counts continued, with counts reaching levels not seen since the middle of the summer surge. Sunday had 48,210 new cases nationwide, which is the second most reported cases for a Sunday since July 26.

The seven-day average of new cases has climbed above 56,000, a level not seen in the past 12 weeks, and is 14% higher week over week, according to John Hopkins data.

Over the past two weeks, Chicago has been averaging 500 new cases daily, Mayor Lori Lightfoot said Monday. The city had one day of more than 800 new cases, the largest single-day number since May 21, she said.

Contact tracing revealed two out of three Chicagoans who tested positive for Covid-19 contracted the virus from someone they know, according to Dr. Allison Arwady, Chicago’s health commissioner.

“This is the second surge that Dr. Fauci and Dr. Arwady has been warning us about since March,” Lightfoot said. “We are now in it.”

Pennsylvania reported 1,103 new cases Monday, the 14th consecutive day in which the state has recorded more than 1,000 new cases in a single day.

Data compiled from voluntary responses submitted to Pennsylvania’s Covid-19 contact tracing app showed 50% of people who tested positive for Covid-19 had been at a restaurant recently before experiencing symptoms.

CORRECTION: An earlier version of this story overstated the number of coronavirus cases that had been reported in the US as of early Monday. More than 8.1 million cases had been reported.

CNN’s Dave Alsup, Lauren del Valle, Andrea Diaz, Shelby Lin Erdman, Maggie Fox, Jamie Gumbrecht, Jason Hanna, Jacqueline Howard, Chuck Johnston, Nadia Kounang, Christina Maxouris, Nakia McNabb, Brandon Miller, Andy Rose, Samira Said and Ben Tinker contributed to this report.

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