Delta variant pushes U.S. cases, hospitalizations to 6-month high

By Maria Caspani

NEW YORK (Reuters) – Coronavirus cases and hospitalizations in the United States are at a six-month high, fueled by the rapid spread of the Delta variant across swathes of the country grappling with low vaccination rates.

Nationwide, COVID-19 cases have averaged 100,000 for three days in a row, up 35% over the past week, according to a Reuters tally of public health data. The surge of the disease was strongest in Louisiana, Florida and Arkansas.

Hospitalizations rose 40% and deaths, a lagging indicator, registered an 18% uptick in the past week with the most fatalities by population in Arkansas.

The intensifying spread of the pandemic has led to cancellation of some large high-profile events. One notable exception is an annual motorcycle rally in South Dakota which has been proceeding as planned.

Florida set records for hospitalizations for eight days in a row, according to the analysis. In that state, most students are due back in the classroom this week as some school districts debate whether to require masks for pupils.

The head of the nation’s second-largest teachers’ union on Sunday announced a shift in course by backing mandated vaccinations for U.S. teachers in an effort to protect students who are too young to be inoculated.

The number of children hospitalized with COVID-19 is rising across the country, a trend health experts attribute to the Delta variant being more likely to infect children than the original Alpha strain.

With the virus once again upending Americans’ lives after a brief summer lull, the push to vaccinate those still reluctant has gained fresh momentum.

States including California, New York and Virginia have mandated vaccinations or weekly testing for state employees, as well as several cities.

The administration of President Joe Biden set new rules late last month requiring federal workers to provide proof of vaccination or face regular testing, mask mandates and travel restrictions.

In the private sector, a growing number of companies are also mandating COVID-19 vaccinations. United Airlines, meatpacker Tyson Foods Inc and Microsoft are requiring employees get vaccinated.

STURGIS CROWDS

The evolving pandemic and the rapid community spread spurred by the Delta variant have already prompted the cancellation of some large-scale events. Last week, organizers canceled the New York Auto Show that had been set for later this month.

The New Orleans Jazz Fest was canceled for the second straight year as Louisiana fights a severe outbreak.

But fears about the Delta variant seem to not have dampened the mood in Sturgis, a small town in South Dakota that welcomes hundreds of thousands of motorcycle enthusiasts for the annual Sturgis Motorcycle Rally.

This year’s gathering, taking place Aug. 6-15, might already be attracting record crowds.

“It is one of the biggest crowds I have seen,” Meade County Sheriff Ron Merwin said in an email. “I think there will definitely be some spread.”

The city of Sturgis has partnered with health officials to provide COVID-19 self-test kits to rally-goes but the event does not require proof of vaccination or mask-wearing.

Last year, the rally became the super-spreader event that many feared it would become.

While cases and hospitalizations were relatively low in South Dakota when the event started on Aug. 7, 2020, three months later the state set a record for hospitalized COVID-19 patients and new infections.

In the month of November alone, the state lost 521 people to COVID-19, nearly three times the number of deaths reported in October, according to a Reuters tally.

(Reporting by Maria Caspani, Editing by David Gregorio)

Florida COVID hospitalizations surge, New York urges business push on vaccines

(Reuters) – New York’s governor on Monday urged businesses to turn away unvaccinated customers while Florida is grappling with a surge in hospitalized COVID patients, both sparked by rising cases of the Delta variant that could result in new restrictions on daily life.

Florida, whose governor has resisted mask or vaccine mandates, has one of the worst outbreaks in the nation and about one-quarter of the country’s hospitalized COVID patients, according to data from the U.S. Department of Health and Human Services.

The head of Florida’s hospital association said the current surge sent COVID hospitalizations skyrocketing to 10,000 from 2,000 in less than 30 days, although deaths have remained well below the previous peak.

“It is a much younger population that is being hospitalized today,” Mary Mayhew told MSNBC on Monday. At one Jacksonville hospital, the average age is 42, she said. “We have 25-year-olds in the hospital in intensive care on ventilators,” she told the cable network. “We’ve got to convince 25-year-olds, 30-year-olds, that this is now life-threatening for them.”

New York Governor Andrew Cuomo also sounded the alarm, urging but not mandating bars, restaurants and other private businesses to require all customers be vaccinated before entering. The Democratic governor also said that vaccines could become mandatory for nursing home workers, teachers and healthcare workers if case numbers do not improve.

“Private businesses – I am asking them and suggesting to them to go to vaccine-only admission,” Cuomo told a briefing Monday. “I believe it’s in your best business interest. If I go to a bar and I want to have a drink and I want to talk to the person next to me, I want to know that that person is vaccinated.”

Cuomo also announced that all employees of the Metropolitan Transportation Authority, which runs the trains and subways, and all the workers from his state for the Port Authority of New York and New Jersey, which oversees the region’s bridges, airports, and tunnels, would need to be vaccinated by Labor Day on Sept. 6 or submit to weekly testing.

“If you are unvaccinated the Delta variant should be a major concern to you and you should be worried about it,” Cuomo said.

The push by Cuomo marks the latest attempt by government leaders to spur reluctant Americans to get vaccinated as the Delta variant of the coronavirus surges nationwide, infecting mostly unvaccinated people.

Cuomo’s announcement comes on the heels of a decision by President Joe Biden to require millions of federal workers and contractors to show proof of vaccination or be subject to weekly or twice-weekly COVID-19 tests.

Even as cases have exploded, Governor Ron DeSantis has resisted mask mandates. Earlier this year, he and the Republican-controlled state legislature limited local officials’ ability to impose COVID-19 restrictions, and on Friday he issued an executive order barring schools from requiring face coverings when classes resume this month.

That order came days after the Broward County school board voted to require masks for students and staff. The superintendent of Miami-Dade schools had also said the district would reconsider whether to require masks in light of the surge.

Some local governments have also sought to impose public health measures despite DeSantis’ opposition. The village of Key Biscayne began requiring masks on Monday for all employees as well as any visitors to government buildings.

Both Miami-Dade and Palm Beach counties last week said that all adults would be required to wear masks when inside county facilities. Orange County, home to Disney World, has ordered all employees to get vaccinated, with an Aug. 31 deadline for the first dose.

(Reporting by Joseph Ax in Princeton, New Jersey and Nathan Layne in Wilton, Connecticut; Editing by Lisa Shumaker)

How the Delta variant upends assumptions about the coronavirus

By Julie Steenhuysen, Alistair Smout and Ari Rabinovitch

(Reuters) – The Delta variant is the fastest, fittest and most formidable version of the coronavirus that causes COVID-19 the world has encountered, and it is upending assumptions about the disease even as nations loosen restrictions and open their economies, according to virologists and epidemiologists.

Vaccine protection remains very strong against severe disease and hospitalizations caused by any version of the coronavirus, and those most at risk are still the unvaccinated, according to interviews with 10 leading COVID-19 experts.

But evidence is mounting that the Delta variant, first identified in India, is capable of infecting fully vaccinated people at a greater rate than previous versions, and concerns have been raised that they may even spread the virus, these experts said.

As a result, targeted use of masks, social distancing and other measures may again be needed even in countries with broad vaccination campaigns, several of them said.

Israel recently reinstated mask-wearing requirements indoors and requires travelers to quarantine upon arrival.

U.S. officials are considering whether to revise mask guidance for the vaccinated. Los Angeles County, the most populous in the United States, is again requiring masks even among the vaccinated in indoor public spaces.

“The biggest risk to the world at the moment is simply Delta,” said microbiologist Sharon Peacock, who runs Britain’s efforts to sequence the genomes of coronavirus variants, calling it the “fittest and fastest variant yet.”

Viruses constantly evolve through mutation, with new variants arising. Sometimes these are more dangerous than the original.

The major worry about the Delta variant is not that it makes people sicker, but that it spreads far more easily from person to person, increasing infections and hospitalizations among the unvaccinated.

Public Health England said on Friday that of a total of 3,692 people hospitalized in Britain with the Delta variant, 58.3% were unvaccinated and 22.8% were fully vaccinated.

In Singapore, where Delta is the most common variant, government officials reported on Friday that three quarters of its coronavirus cases occurred among vaccinated individuals, though none were severely ill.

Israeli health officials have said 60% of current hospitalized COVID-19 cases are in vaccinated people. Most of them are age 60 or older and often have underlying health problems.

In the United States, which has experienced more COVID-19 cases and deaths than any other country, the Delta variant represents about 83% of new infections. So far, unvaccinated people represent nearly 97% of severe cases.

Dr. Monica Gandhi, an infectious diseases doctor at the University of California, San Francisco, said many vaccinated people are “so disappointed” that they are not 100% protected from mild infections. But the fact that nearly all Americans hospitalized with COVID-19 right now are unvaccinated “is pretty astounding effectiveness,” she said.

‘TEACHING US A LESSON’

“There is always the illusion that there is a magic bullet that will solve all our problems. The coronavirus is teaching us a lesson,” said Nadav Davidovitch, director of Ben Gurion University’s school of public health in Israel.

The Pfizer Inc/BioNTech vaccine, one of the most effective against COVID-19 so far, appeared only 41% effective at halting symptomatic infections in Israel over the past month as the Delta variant spread, according to Israeli government data. Israeli experts said this information requires more analysis before conclusions can be drawn.

“Protection for the individual is very strong; protection for infecting others is significantly lower,” Davidovitch said.

A study in China found that people infected with the Delta variant carry 1,000 times more virus in their noses compared with the original version first identified in Wuhan in 2019.

“You may actually excrete more virus and that’s why it’s more transmissible. That’s still being investigated,” Peacock said.

Virologist Shane Crotty of the La Jolla Institute for Immunology in San Diego noted that Delta is 50% more infectious than the Alpha variant first detected in the UK.

“It’s outcompeting all other viruses because it just spreads so much more efficiently,” Crotty said.

Genomics expert Eric Topol, director of the Scripps Research Translational Institute in La Jolla, California, noted that Delta infections have a shorter incubation period and a far higher amount of viral particles.

“That’s why the vaccines are going to be challenged. The people who are vaccinated have got to be especially careful. This is a tough one,” Topol said.

In the United States, the Delta variant has taken hold just as many Americans – vaccinated and not – have stopped wearing masks indoors.

“It’s a double whammy,” Topol said. “The last thing you want is to loosen restrictions when you’re confronting the most formidable version of the virus yet.”

The development of highly effective vaccines may have led many people to believe that once vaccinated, COVID-19 posed little threat to them.

“When the vaccines were first developed, nobody was thinking that they were going to prevent infection,” said Carlos del Rio, a professor of medicine and infectious disease epidemiology at Emory University in Atlanta. The aim was always to prevent severe disease and death, del Rio added.

The vaccines were so effective, however, that there were signs they also prevented transmission against prior coronavirus variants.

“We got spoiled,” he said.

(Reporting by Julie Steenhuysen in Chicago, Alistair Smout in London, Ari Rabinovitch and Maayan Lubell in Jerusalem; Editing by Will Dunham and Bill Berkrot)

U.S. coronavirus cases rise, fueling fears of resurgence

By Maria Caspani

NEW YORK (Reuters) – A rapid increase in coronavirus cases in the United States and abroad is fueling fears of a pandemic resurgence and sending shockwaves through the stock market as the highly contagious Delta variant takes hold and vaccinations lag in several states.

Largely due to outbreaks in parts of the country with low vaccination rates, the number of new cases, hospitalizations and deaths due to COVID-19 have been on the rise in recent weeks.

The vaccines work against the Delta variant, but lab tests have shown them to be less effective than they were against the original form of coronavirus.

Studies have also shown that two shots of the Pfizer/BioNTech vaccine and of the AstraZeneca vaccine are much more effective than one shot against being infected with the virus, making it more important for people to be fully vaccinated.

Concerns the outbreaks could derail an economic recovery sent the Dow down more than 2% on Monday.

In a speech about the U.S. economy, President Joe Biden said the recovery hinges on getting the pandemic under control. He said four states with low vaccination rates accounted for 40% of all cases last week.

“So please, please get vaccinated,” Biden said. “Get vaccinated now.”

The average number of new COVID-19 cases per day has tripled in the past 30 days in the United States, according to an analysis of Reuters data. In the month from June 18 to Sunday, it climbed from 12,004 to 32,136.

The average number of people hospitalized with COVID-19 has gone up 21% over the past 30 days to over 19,000, up from 16,000, according to the same Reuters analysis.

Deaths, which can lag weeks behind a rise in cases, rose 25% last week from the previous seven days with an average of 250 people dying a day.

Some states have been especially hard hit. All but two of the 75 Arkansas counties have substantial or high levels of transmission, according to data from the U.S. Centers for Disease Control and Prevention (CDC).

But even in states with higher vaccination rates, such as New York, officials have expressed concern about fresh outbreaks, pointing to the significantly more contagious Delta variant.

So far, the variant has been detected around 100 countries globally and is now the dominant variant worldwide, top U.S. infectious disease expert Anthony Fauci told reporters last week.

In California, Los Angeles County reimposed a mask mandate at the weekend. It followed six straight days of more than 1,000 new COVID-19 cases in the county, with nearly 400 people hospitalized with COVID-19 as of Wednesday, up 275 from the week before.

While New York City Mayor Bill de Blasio acknowledged a rise in the number of cases, he told a daily news conference on Monday there were no plans to reintroduce mask mandates. He vowed instead to redouble vaccination efforts.

Overseas, COVID-19 restrictions are being reimposed in countries experiencing worrying spikes. The Netherlands announced it was re-imposing work-from-home guidelines due to soaring COVID-19 infections, just weeks after lifting them, as well as some restrictions on bars, restaurants and nightclubs.

Britain ended over a year of COVID-19 lockdown restrictions on Monday but the so-called “Freedom Day” was marred by surging infections and grim forecasts.

The U.S. Centers for Disease Control and Prevention on Monday issued a more severe warning against travel to the United Kingdom, elevating the nation to “Level Four: COVID-19 Very High,” the CDC’s highest level.

(Reporting by Maria Caspani in New York; Additional reporting by Anurag Maan, Sharon Bernstein and Caroline Humer; Editing by Howard Goller)

U.S. CDC director urges teens to get vaccinated after hospitalizations rise

(Reuters) – The U.S. Centers for Disease Control and Prevention director urged teenagers to get vaccinated, as new data from the agency’s researchers showed one in three teenagers who were hospitalized due to COVID-19 early this year needed ICU admission.

“I am deeply concerned by the numbers of hospitalized adolescents and saddened to see the number of adolescents who required treatment in intensive care units or mechanical ventilation,” CDC Director Rochelle Walensky said in a statement on Friday.

The rate of hospitalization due to COVID-19 increased among adolescents aged 12 to 17 in April to 1.3 per 100,000 people from a lower rate in mid-March, the CDC said in its Morbidity and Mortality Weekly Report (MMWR).

Among 204 adolescents, who were hospitalized mainly for COVID-19 between Jan. 1 and March 31, 31.4% were admitted to an intensive care unit and about 5% required mechanical ventilation, the agency said.

“Much of this suffering can be prevented,” Walensky said.

The CDC’s latest data was based on a surveillance system of laboratory-confirmed COVID-19–associated hospitalizations in 99 counties across 14 states, covering approximately 10% of the U.S. population.

The data adds to previous information showing that hospitalizations due to severe COVID-19 occur in all age groups even though they occur more often in older adults. The CDC released the data as part of the United States’ push to vaccinate teenagers with Pfizer Inc and German partner BioNTech SE’s vaccine.

The shot was authorized for use in 12 to 15 year old’s in May. Nearly 50% of the U.S. population, 12 years and older, has been fully vaccinated, according to the agency’s data.

The increased hospital admission rates in teens may be related partly to the circulation of more infectious variants of the coronavirus and a large number of children returning to schools, the agency said.

(Reporting by Manojna Maddipatla in Bengaluru; editing by Caroline Humer and Amy Caren Daniel)

More unvaccinated U.S. adolescents hospitalized; myocarditis may be rare vaccine side effect in teens

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

COVID-19 hospitalizations up among U.S. adolescents

COVID-19 hospitalizations rose among U.S. adolescents in March and April, and nearly a third of those hospitalized needed intensive care, according to data from more than 250 hospitals in 14 states released by the Centers for Disease Control and Prevention (CDC) on Friday. “Rates of COVID-19-associated hospitalization among adolescents also exceeded historical rates of seasonal influenza-associated hospitalization during comparable periods,” researchers reported in the CDC’s Morbidity and Mortality Weekly Report. The hospitals reported a total of 204 adolescents hospitalized for COVID-19 in March and April. “Until they are fully vaccinated, adolescents should continue to wear masks and take precautions when around others who are not vaccinated to protect themselves, and their family, friends, and community,” CDC Director Rochelle Walensky said in a statement on Friday. “I ask parents, relatives and close friends to join me and talk with teens about the importance of these prevention strategies and to encourage them to get vaccinated.”

Heart inflammation may be rare vaccine side effect in teens

Temporary heart inflammation may be a rare side effect of the Pfizer/BioNTech COVID-19 vaccine in teenagers, according to pediatricians who reported on seven cases from across the United States. The previously healthy adolescents – all boys – developed chest pain within four days after their second dose. MRI exams showed myocarditis, or heart muscle inflammation. “Fortunately, none of our patients was critically ill,” the authors reported on Friday in Pediatrics. The boys’ symptoms resolved “rapidly” with medication. Measures of cardiac status had returned to normal at check-ups performed after one-to-three weeks. Myocarditis is a known rare adverse event following other vaccinations, the authors noted. There is no proof, however, that the vaccine caused these cases. “So far, over 2.2 million teenagers (aged) 16-17 have already received 2 doses of Pfizer vaccine, and over 3 million kids 12-15 years old have received dose #1,” said coauthor Dr. Judy Guzman-Cottrill of Oregon Health & Science University. “These are huge, very reassuring denominators.” COVID-19 itself can cause myocarditis, she noted. “After looking at the risks and benefits, the data support getting kids vaccinated.”

Measuring longer-lasting COVID-19 immunity feasible

Along with testing for antibody levels after COVID-19 or vaccination to gauge a person’s immunity to the virus, measuring the response of the immune system’s T cells could provide important information, according to researchers based at Cardiff University. While antibody levels wane over time, T cell responsiveness can last for months or years. But T cells have been harder to measure in cost-effective ways. Adapting a method widely employed to measure immune responses to other types of infections, the researchers took blood samples from adults and children and stimulated T cells with small proteins specific to the SARS-CoV-2 virus. T cells that recognize these proteins, because the person has been previously infected or vaccinated, “are triggered to produce chemicals like interferon which can be easily measured,” said study coauthor Andrew Godkin. The results were about 96% accurate, researchers reported on Tuesday on medRxiv ahead of peer review. “The test is very sensitive and seems to be accurate at identifying people previously exposed to the virus,” Godkin said. “The test is widely available, easy to employ, and should play a very useful role in monitoring this pandemic.”

Virus unlikely to insert genetic fragments into patients’ genetic code

A new study refutes the controversial claim made by researchers last month in PNAS that small fragments of genetic instructions from the coronavirus became integrated into the genome of infected cells, in test tube experiments. In principle, coronavirus RNA generated by such integrated snippets, while probably not harmful, might cause positive COVID-19 PCR tests long after a patient has recovered, the authors of that study said. But when researchers in Australia sought to find signs of SARS-CoV-2 genetic code integrated into the DNA of infected cells, they could not find any. “This was despite using the same sequencing technology and cell type (as in the PNAS study) and performing substantially more DNA sequencing,” said Geoffrey Faulkner of the University of Queensland. The new finding were posted on Sunday on bioRxiv ahead of peer review. The researchers did find copies of hepatitis B virus integrated into liver tissue, and copies of other DNA elements integrated into the cells they experimented with, “suggesting our approach would have found SARS-CoV-2 copies” if they were present, he said. His team agrees with others who suggest the PNAS findings may have reflected unintended effects of experimental methods. “We think SARS-CoV-2 integration into DNA is possible in human cells even if it is likely to be incredibly rare in patients,” Faulkner said.

(Reporting by Nancy Lapid and Christine Soares; Editing by Bill Berkrot)

UK daily COVID cases highest in a month, Indian variant rising sharply

LONDON (Reuters) – Britain reported its highest daily total of new coronavirus infections in a month while cases of a variant of concern first found in India continue to climb, official statistics showed on Thursday.

The overall incidence of infections in Britain is still low, while the number of people in hospital with COVID-19 fell to its lowest level since September on Thursday.

But clusters of the B.1.617.2 variant, believed to be more transmissible than the dominant Kent variant, are growing quickly, and could derail Prime Minister Boris Johnson’s plans to reopen England’s economy by the summer.

British cases of the B.1.617.2 variant first found in India have risen to 3,424, up by 2,111 compared to comparable figures last week, Public Health England said.

It also represents a steep rise compared to figures given on Wednesday, when Health Minister Matt Hancock said there had been 2,967 cases of the variant.

“PHE will continue to monitor all variants closely, paying particular attention to the impact on hospitalizations and deaths which will help us to understand the protective effects of the vaccine,” said Meera Chand, COVID-19 Incident Director at PHE.

Britain reported 2,874 new COVID-19 cases on Thursday, the highest daily figure for new cases since April 19

The uptick comes as Johnson eases restrictions in England, and as a quick rollout of vaccines decouples the link between case numbers and hospitalizations and deaths.

On Thursday, the total number of patients in hospital fell below 900 for the first time since September.

Britain recorded another 7 deaths within 28 days of a positive COVID-19 test, and the statistics portal showed 37.25 million people had been given a first dose of vaccine.

(Reporting by Alistair Smout; editing by Kate Holton and Giles Elgood)

U.S. COVID-19 cases rise for third straight week, hospitalizations also up

(Reuters) – New cases of COVID-19 in the United States rose 5% to more than 450,000 last week, the third week in a row that infections have increased, according to a Reuters analysis of state and county data.

The average number of COVID-19 patients in hospitals rose 4% to more than 37,000 in the week ended April 4, breaking a streak of 11 weeks of falling admissions.

Health officials have expressed concerns about the increase in travel around the Easter holiday and school spring breaks, at a time when more infectious variants of the coronavirus are circulating.

While flu viruses tend to be seasonal, with cases falling as the weather warms, health officials said they have not seen similar trends with the novel coronavirus, pointing to a surge in COVID-19 cases in some regions last summer.

“I don’t think we should even think about relying on the weather to bail us out of anything we’re in right now,” Dr. Anthony Fauci, the nation’s top infectious disease expert, said at a news briefing on Monday.

Twenty-seven out of 50 states reported increases in new cases last week compared with the previous seven days, according to the Reuters analysis.

Per 100,000 people, Michigan, New Jersey and New York reported both the highest number of new cases and the highest number of hospitalizations.

Deaths from COVID-19, which tend to lag infections by several weeks, fell 17% to about 5,800 last week, or about 834 per day. Health officials have said the country’s vaccination effort could limit deaths even with rising cases.

For a sixth week, vaccinations set a record, with an average of 3.1 million shots given per day last week. As of Sunday, 32% of the U.S. population has received at least one dose and 19% was fully vaccinated, according to the CDC.

(Graphic by Chris Canipe, writing by Lisa Shumaker, editing by Tiffany Wu)

French COVID-19 ICU figures at a more than 14-week high

PARIS (Reuters) – The number of people treated in French intensive care units (ICUs) for COVID-19 reached a 14-1/2-week-high on Monday, at 3,849, while total hospitalizations for the disease increased for the second day running, to 25,195.

The number of people in ICUs is still almost two times lower than the 7,184 peak recorded in April 2020 but remains well above a government target level of 2,500-3,000 for easing coronavirus limits on the circulation of people.

Illustrating the stress on the French health system, medical authorities of the greater Paris region – which accounts for roughly one-sixth of the French population – have ordered hospitals to cancel 40% of their planned normal activity to make space for COVID-19 patients in critical condition.

French health authorities also reported 5,327 new coronavirus infections over the past 24 hours on Monday, a high for a Monday since Dec. 21, versus 21,825 on Sunday.

COVID-19 case reporting on Mondays typically dips as fewer tests are done over the weekend. The seven-day moving average, which smooths out daily reporting swings, stands at 21,270, a five-day high.

The total of cases since the outbreak of the disease more than a year ago is now over 3.91 million, the sixth-highest in the world.

An additional 359 people died from the disease, pushing the total to 88,933, the world’s seventh-highest toll. On Sunday, 130 new deaths were reported.

(Reporting by Benoit Van Overstraeten; Editing by GV De Clercq and Jonathan Oatis)

J&J adds to COVID-19 vaccine armory with 66% efficacy in global trial

By Julie Steenhuysen

(Reuters) – Johnson & Johnson said on Friday that its single-dose vaccine was 66% effective in preventing COVID-19 in a large global trial against multiple variants which will give health officials another weapon to tackle the coronavirus.

In the trial of nearly 44,000 volunteers, the level of protection against moderate and severe COVID-19 varied from 72% in the United States, to 66% in Latin America and just 57% in South Africa, from where a worrying variant has spread.

A high bar has been set by two authorized vaccines from Pfizer/BioNTech and Moderna, which were around 95% effective in preventing symptomatic illness in pivotal trials when given in two doses.

Those trials, however, were conducted mainly in the United States and before new variants emerged.

The top U.S. infectious disease specialist Anthony Fauci said the variations in effectiveness around the world underlined the need to vaccinate as many people as quickly as possible to prevent new variants from emerging.

“It’s really a wake up call for us to be nimble and to be able to adjust as this virus will continue for certain to evolve,” Fauci said.

J&J’s main goal was the prevention of moderate to severe COVID-19, and the vaccine was 85% effective in stopping severe disease and preventing hospitalization across all geographies and against multiple variants 28 days after immunization.

That “will potentially protect hundreds of millions of people from serious and fatal outcomes of COVID-19,” Paul Stoffels, J&J’s chief scientific officer, said of the results, which were based on 468 symptomatic cases.

SEEKING APPROVAL

J&J plans to seek emergency use authorization from the U.S. Food and Drug Administration next week. It has said it plans to deliver 1 billion doses in 2021 and will produce the vaccine in the United States, Europe, South Africa and India.

Public health officials are counting on the J&J vaccine to increase much-needed supply and simplify immunization in the United States, which has a deal to buy 100 million doses of J&J’s vaccine and an option for an additional 200 million.

J&J said the vaccine would be ready immediately upon emergency approval, but Stoffels declined to say how many doses.

“Right now, any protection and additional vaccine is great. The key is not only overall efficacy but specifically efficacy against severe disease, hospitalization, and death,” Walid Gellad, a health policy associate professor at the University of Pittsburgh, said.

Michael Breen, Director of Infectious Diseases and Ophthalmology at research firm GlobalData said “Most countries are still desperate to get their hands on doses, regardless of whether or not the vaccine is considered highly effective. Moderately effective will do just fine for now.”

None of the vaccine recipients in the J&J trial died from COVID-19, compared with 5 in the placebo group, the National Institutes of Health said. Three deaths in the vaccine group overall, but none were determined to be from the virus. That compares with 16 deaths overall in the placebo arm, it added.

Unlike the Pfizer and Moderna vaccines, J&J’s does not require a second shot weeks after the first or need to be kept frozen, making it a strong candidate for use in parts of the world where transportation and cold storage are an issue.

SOUTH AFRICAN VARIANT

Several studies have emerged this month showing that a South African variant has mutated in areas of the virus that are key targets of vaccines, reducing their efficacy.

“What we are learning is there is different efficacy in different parts of the world,” Stoffels told Reuters.

In a sub-study of 6,000 volunteers in South Africa, Stoffels said, the J&J vaccine was 89% effective at preventing severe disease. In the South Africa portion of the trial, 95% of cases were infections with the South African variant.

“I am overwhelmed by the fact that this vaccine protected against severe disease even in South Africa,” said Glenda Gray, the joint lead investigator of the South African vaccine trial.

Gray, who is the chief executive of the South African Medical Research Council, said this is by far the best vaccine for South Africa to fight the mutant strain and can prevent a large number of hospitalizations and deaths.

A mid-stage trial of a Novovax coronavirus vaccine in South Africa also showed lower efficacy, proving to be 60% effective among volunteers who didn’t have HIV. In a separate, late-stage trial in Britain it was 89.3% effective.

In the J&J trial, which was conducted in eight countries, 44% of participants were from the United States, 41% from Central and South America and 15% from South Africa. Slightly more than a third of the volunteers were over 60.

J&J’s vaccine uses a common cold virus to introduce coronavirus proteins into cells in the body and trigger an immune response, whereas the Pfizer/BioNTech and Moderna vaccines use a new technology called messenger RNA (mRNA).

(Reporting by Julie Steenhuysen; Additional reporting by Manas Mishra, Dania Nadeem and Manojna Maddipatla in Bengalaru and Rebecca Spalding and Michael Erman in New York; Writing by Alexander Smith; Editing by Caroline Humer, Peter Henderson, Edwina Gibbs and Keith Weir)