It took almost exactly one month to go from 400,000 dead to 500,000. However, with falling rates of new cases and dropping hospitalization, there’s a good chance that the total number of American dead in the pandemic will come in at fewer than 700,000. Possibly even below 600,000. Those are still hideous numbers—almost exactly matching the 1918-1919 flu pandemic. But they are certainly a break from where the nation appeared to be headed in January.

On Wednesday, COVID-19 Response Coordinator Jeff Zients stepped in front of cameras at a White House briefing to say that the administration is going to be sending out 25 million free masks and making them available to Americans who may have some difficulty in finding this basic item of personal safety.

The masks will be “high quality” washable multilayer masks that meet the current CDC recommendations. The White House will distribute these masks to more than 1,300 community health centers and over 60,000 community food pantries beginning in March.

“Masks are widely available in many different shapes and sizes,” said Zients, “but many low-income Americans still lack affordable access to this basic protection. That’s why we’re taking this important action to keep Americans safe … These masks will be made in America, and will not impact availability of masks for health care workers.” The estimate is that this action may provide masks to as many as 15 million Americans who currently don’t have masks, or don’t have a mask that meets CDC guidelines.

Johnson & Johnson vaccine meets experts on Friday

Johnson & Johnson’s COVID-19 vaccine was submitted to the Food and Drug Administration (FDA) for a potential emergency use authorization (EUA) at the end of January. Since then, experts both inside and outside the agency have been reviewing the data, looking for evidence of effectiveness as well as reviewing any concerns over safety.

On Friday, the FDA’s panel of outside experts will get a final presentation from Johnson & Johnson scientists, following that up with a discussion session. At the end of that session, they’ll have a vote on whether to recommend the drug to the FDA. The votes in favor of both Pfizer and Moderna’s vaccine were overwhelming (though not without drama as last-minute concerns over age limits on Pfizer’s vaccine brought the whole process to a temporary halt). Based on the available data, Johnson & Johnson’s vaccine is likely to be just as enthusiastically approved, but … it’s not a sure thing. After all, the experts are privy to more information that has been covered in public so far, and the efficacy of Johnson & Johnson’s offering has been rated in a different way—one that looks at moderate and severe cases rather than the overall rate of infection—from other vaccines.

In any case the hearing should be informative, and Daily Kos will be listening in. If the expert panel gives this vaccine the thumbs up, the FDA can be expected to authorize its use within a few days. That could mean a third vaccine starts to roll out as soon as next week. That’s good. And considering that this is a single-shot vaccine with very reasonable storage requirements, it’s even better.

Enough vaccine for herd immunity by spring

As Bloomberg reports, Johnson & Johnson says they are prepared to ship 4 million doses immediately following FDA authorizing an EUA, and another 16 million doses in March. At the same time, both Pfizer and Moderna have increased their rate of production.

As of Wednesday, the CDC reports that 82 million vaccinations have been delivered, and 65 million have been administered. 44.5 million Americans have received at least one dose of a COVID-19 vaccine. That’s 17% of the population over 18 years of age.

But by the end of March, manufacturers expect to have delivered enough vaccine to treat 130 million Americans. Which would be over half of the adult population. That’s the kind of number that would begin to have an impact on the spread of the virus, and places the nation on the way to the idea of “herd immunity by April.” In fact, add in the over 10% of the adult population that has already tested positive for COVID-19 at this point, and herd immunity might even be achieved by the first of April. 

If the vaccine production is maintained as expected, by early summer every adult in the United States should have at least been offered a COVID-19 vaccine. Though that doesn’t mean they will have taken it.

California variant carries worrisome mutations

But before the nation starts to celebrate the end of the pandemic—and certainly before anyone thinks of taking off their mask—there are some reasons for concern. While most talk of variants has been focused on the fast-spreading strain from the U.K. or the vaccine-evading viruses from South Africa or Brazil, it turns out one of the worst might be found right in the United States.

As The Los Angeles Times reports, a variant that emerged in California last year already appears to pack a number of changes to the critical “spike protein” that may make it more contagious, more virulent, and more evasive for vaccines.

This variant, called B.1.427/B.1.429, appears to be connected with the huge surge of cases that hit California beginning in November. That surge led to an increased rate of both hospitalizations and deaths, showing a strong association between this new variant—now approaching 90% of the infections in that state—and bad outcomes.

It also appears that this variant is more evasive of antibodies produced by past infection or vaccine. However, California has not experienced a large number of people becoming reinfected, so it’s apparently not that evasive. There is also every reason to believe that while vaccines may be less effective against this variant, they will remain highly effective.

A big concern is that this California variant could mingle some genes with the U.K., South Africa, and Brazil variants to produce a new strain that combines the worst qualities of all three. The best way to avoid this: wear a mask, keep social distancing, and keep increasing vaccination rates. Since California has seen a 70% drop in new cases since the beginning of January, it seems to be working for the Golden State.

Predictions from the past

One year ago today, I stopped simply laying out the progress of the then just-named COVID-19 and ventured into the land of speculation.

Today’s the day that I’m going to do what I’ve held off doing from the start—look at the possible range of effects from an unchecked global COVID-19 pandemic. … 

So what does all this really mean? What follows is a back-of-the envelope analysis of “How bad could COVID-19 really be?” It’s going to be long. It’s going to be grim. If you don’t want to take that ride, please check out now. It’s a lovely, globally warmed winter day in much of the United States. Plus, there are puppies. Go and find them. But if you’re sticking around, here we go. … Because it means that the number of deaths from COVID-19 in the United States alone would be (deep breath) 450,000 to 900,000.

If that makes it seem like I was all too accurate in my assessment … nope. Because here’s what I said next.

Now that I’ve cranked up the panic-o-meter to 12, let me dial it back several notches: This is not going to happen. It’s simply not. Governments are moving to prevent the kind of unchecked pandemic that was seen in 1918. And they’ve gotten much better at this. Every effort is being made to slow the spread of the disease, to isolate outbreaks, and to prevent general exposure. Even in Wuhan, where the infection began, the case count appears to be less than 1% of the population. Actions can be extremely effective.

All of the assessments of the situation from a year ago seem pitifully uninformed and sadly optimistic. We’ve all learned a lot in the last year. Not much of it good.

Though I would really recommend this focaccia recipe.

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