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News Brief: COVID-19 Variants, Calif. Lockdown Orders, Drug Overdoses

SARAH MCCAMMON, HOST:

Vaccine manufacturer Moderna says it's creating a booster shot for its COVID-19 vaccine.

RACHEL MARTIN, HOST:

The extra shot is to make sure the vaccine is still highly protective against new versions of the virus that are emerging in several places around the world. Scientists are especially concerned about a variant of the coronavirus coming out of South Africa.

MCCAMMON: And here to explain this news and what it means for people getting the vaccine is NPR's global health correspondent, Michaeleen Doucleff. Good morning, Michaeleen.

MICHAELEEN DOUCLEFF, BYLINE: Good morning.

MCCAMMON: Help us make sense of this. I mean, there's this new version of the coronavirus emerging in South Africa. It's different from a new variant in the U.K., right? And now we're hearing about a strain from Brazil. What's going on?

DOUCLEFF: Yeah. So there are actually three different variants. The one from the U.K. is more contagious, and it's already circulating here in the U.S. at low levels. Just yesterday, Minnesota officials detected a person infected with the variant from Brazil. That is the first known case of that variant in the U.S. And here's the key part - this variant from Brazil and the one in South Africa share some of the same mutations. And there are signs that these mutations are helping the virus outwit or evade the immune system.

MCCAMMON: OK, that doesn't sound good, evading the immune system. What does it mean exactly?

DOUCLEFF: Yeah. So here's where things get a little complicated. To answer that, we need a little information about how the body fights off viruses. One of the main tools is antibodies, right? The immune system makes antibodies that recognize the virus, stick to it and then destroy it or neutralize it. And it turns out the mutations in this variant from South Africa and Brazil change the surface of the virus that many antibodies like to bind to. And so scientists have been trying to figure out if the antibodies to older versions of the virus still work with the new variants. Penny Moore is one of the virologists leading this effort. She's at the National Institute for Communicable Diseases in South Africa. She and her team took blood from people infected with the old version of the virus and looked to see if the antibodies in the blood lost their sensitivity to the new variant.

PENNY MOORE: And that is indeed what we saw. In fact, it was really quite a dramatic drop off in sensitivity. We saw that in half the antibodies were significantly less effective against the new variant.

DOUCLEFF: And so the implications for this could be really big. You know, if a person had COVID-19 with the older version of the virus, they might be able to get infected a second time with this new variant.

MCCAMMON: And a big question is, what about the vaccine, which has given so many people hope? Does it mean the vaccine won't work against these new variants?

DOUCLEFF: Yeah. So scientists don't know exactly yet that answer. They don't know how well these laboratory experiments correlate with real life. And also the immune system has other defenses to help it fight infections besides antibodies. And so all the scientists I spoke to, about a dozen, believe the vaccines will still be effective but maybe a little less so. And remember, you know, the Moderna and Pfizer vaccine, the ones approved here in the U.S., are super effective against the old variant, like 94%. So even a small drop in efficacy means the vaccines will still really work.

MCCAMMON: So bottom line, still get the vaccine if you can.

DOUCLEFF: Absolutely. I talked to Jeremy Luban at the University of Massachusetts Medical School. He says, you know, it's even more important now than ever to be immunized because a vaccine doesn't have to stop the infections entirely to be super helpful.

JEREMY LUBAN: Another possible function of the vaccine is to keep you from getting severely ill. As long as it keeps people from going into the hospital or to intensive care units, that would be really useful.

DOUCLEFF: Luban also points out that so far scientists have not detected the variant from South Africa here in the U.S. However, he says the country isn't doing a great job of looking for it, so it could be here.

MCCAMMON: All right. Well, thanks so much for the update, Michaeleen.

DOUCLEFF: Thank you.

(SOUNDBITE OF MUSIC)

MCCAMMON: One of the first U.S. states with a documented case of the U.K. COVID variant was California. Yesterday, that state lifted its regional stay-at-home orders, citing improving coronavirus numbers.

MARTIN: But that good news is tempered by persistent problems with the vaccine rollout and areas of the state where hospital ICUs are still packed. All those challenges have put the state's governor, Gavin Newsom, under a whole lot of political pressure.

MCCAMMON: And NPR's Eric Westervelt has been following all of this. He joins us now. Good morning, Eric.

ERIC WESTERVELT, BYLINE: Good morning.

MCCAMMON: Eric, while some COVID numbers have improved, as we heard, California is still facing some really big challenges. So why did the governor choose to lift the stay-at-home order right now?

WESTERVELT: Yeah, for weeks. I mean, as you know, LA has been sort of the national hot spot for this winter surge. Hospital capacity in much of the southern part of the state, you know, continues to hover near zero. More than 5,000 people in LA County alone have died in less than a month. The county's death toll is now well over 15,000. So on one hand, you'd say, you know, is it really time to take your foot off the gas of trying to stop this spread? But in lifting the stay-at-home order, the governor and his health experts say, look, the data statewide are all trending in the right direction - declining positivity rates, declines in hospitalizations and critically declines in intensive care admissions. So they're cautiously optimistic that the worst of this winter surge that began, you know, shortly after Thanksgiving may be over - seven long weeks ago. And county and state health officials also emphasize, look, you know, if the numbers change again, we'll move quickly to reimpose restrictions. And they continue to, you know, tell people, as they have for months, of course, you know, don't gather in large groups, take the usual measures of masking and distancing and really sort of voluntarily, you know, continue to stay at home as much as possible as people are, you know, in much of the country.

MCCAMMON: And we also know, as we keep saying, that a big key to getting a handle on this virus is to get as many people as possible vaccinated. Why has that effort been such a struggle for California, which is, of course, the most populous state in the country?

WESTERVELT: Yeah. Well, state health officials say, look, you know, the problem is the state's not getting enough for the vaccine - period. It's what many states have been saying. But it really - it's more than that. Vaccine distribution in California goes through county health departments, and some of them are overwhelmed. Experts, including Dr. David Lubarsky, he's the CEO of UC Davis Health, say it just doesn't make sense to continue to go through counties for all distribution. Fifty-eight counties means 58 different plans, logistics and challenges. It's just not working. Dr. Lubarsky, you know, he wants to see the state take more control over this and to pivot to an age and location-focused plan and get more shots into the arms of those most at risk of dying from COVID-19 where the virus is surging.

DAVID LUBARSKY: When you have a raging forest fire, you got to bring the fire hoses to where the fire is raging. You don't sprinkle water all over the entire state.

MCCAMMON: So, Eric, state officials are wanting a more centralized, targeted command and control approach to getting out the vaccine very soon in California. Do we know what that will mean, what exactly that will look like?

WESTERVELT: Well, we'll see. The state has a history of sort of overpromising when it comes to coronavirus. But Dr. Mark Ghaly, the state secretary of Health and Human Services, told NPR that the increased state role is coming, and it will help bring sort of consistency to the process, as well as better data tracking and clear expectations and more accountability. And additionally, in the next round of vaccinations, the state wants to shift to more of a focus on age-based priorities rather than occupations deemed high risk.

MCCAMMON: All right. That's NPR's Eric Westervelt. Thanks so much, Eric.

WESTERVELT: You're welcome.

(SOUNDBITE OF MUSIC)

MCCAMMON: One of the hidden epidemics during this coronavirus pandemic has been an increase in drug overdoses.

MARTIN: The CDC reported the highest number of overdose deaths for a 12-month period ending in May of 2020. And while there are a lot of reasons for the rise in these kinds of deaths, former White House economist Casey Mulligan is warning that social isolation during the pandemic may have been a contributing factor. To put it simply, people are dying in part because of loneliness.

MCCAMMON: To talk more about that, NPR's Scott Horsley joins us now. Hi, Scott.

SCOTT HORSLEY, BYLINE: Good morning, Sarah.

MCCAMMON: Ordinarily, a spike in unemployment, as I understand it, does not lead to a spike in overdose deaths. So what is different about the pandemic that's causing this spike?

HORSLEY: Typically, people who aren't working may not have the money to buy drugs. But Casey Mulligan at the University of Chicago says the COVID recession's unusual. You know, federal relief payments put more money in people's pockets last spring, just at the time when many of the usual ways to spend it were closed off.

CASEY MULLIGAN: Vacations or eating out or anything group oriented, going to a sports game, concert - and that kind of left the sort of things that you do by yourself. Taking opioids is something that people can do by themselves.

HORSLEY: Mulligan, who was a White House economist during the Trump administration, argues in a recent working paper that increased isolation during the pandemic may have contributed to rising deaths of despair - that is, suicides, alcohol-related deaths and especially drug overdoses.

MCCAMMON: And you talked to some families of victims. Scott, what did they tell you about how the pandemic affected their loved ones?

HORSLEY: Yeah. Through the support group called Parents of Addicted Loved Ones, I was able to speak to a number of people who've lost family members. Karen Butcher's son Matthew had struggled for years with his addiction to opioids. She's convinced the pandemic made it worse. You know, the Kentucky restaurant where Matthew worked had closed its doors just before COVID struck. And Butcher says her son was increasingly isolated.

KAREN BUTCHER: He was lonely. He was depressed. He didn't have a reason anymore to get out and keep going. You know, the job was gone. And then all this money flows in because of unemployment. So you're isolated. You have lots of money and your coping skill has always been drug use.

HORSLEY: Matthew died of a drug overdose last May, just at a time the CDC said overdose deaths appeared to be accelerating.

MCCAMMON: Right. And you can see how the isolation would exacerbate all of this. But it is true that overdose deaths were already climbing well before the pandemic. So is something else driving this staggering number of deaths?

HORSLEY: Well, there are a lot of factors. You know, Princeton economist Anne Case, who co-authored a book called "Deaths Of Despair," is cautious about putting too much blame on the pandemic. She notes that overdose deaths were already rising sharply in 2019. And she suspects a big factor is the nationwide spread of the synthetic opioid fentanyl, which used to be seen mainly east of the Mississippi.

ANNE CASE: There's this horribly dangerous, deadly drug on the market that is responsible for this explosion of drug overdoses.

MCCAMMON: So it sounds like the death tolls from COVID really just don't tell the whole story, Scott.

HORSLEY: That's right. There are deaths that may not be counted in the official numbers but could be collateral damage from the pandemic.

MCCAMMON: NPR's Scott Horsley. And if you or someone you know is struggling with substance abuse, you can call the national helpline 1-800-662-4357 or go to samhsa.gov. Transcript provided by NPR, Copyright NPR.