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Jordan’s Prince Hamzah says he’s under house arrest amid security crackdown

The half-brother of Jordan’s King Abdullah said Saturday he has been placed under house arrest by Jordanian authorities and accused the country’s leadership of corruption and incompetence.

In a videotaped statement leaked to the British Broadcasting Corp., Prince Hamzah bin Hussein said he was visited early Saturday by the country’s military chief and told “I was not allowed to go out, to communicate with people or to meet with them.”

He said his security detail was removed, and his phone and internet service had been cut. He said he was speaking over satellite internet, but expected that service to be cut as well. The BBC says it received the statement from Hamzah’s lawyer.

In the statement, Hamzah said he had been informed he was being punished for taking in part in meetings in which the king had been criticized, though he himself was not accused of being a direct critic.

He said he told the army chief: “I am not the person responsible for the breakdown in governance, for the corruption and for the incompetence that has been prevalent in our governing structure for the last 15 to 20 years and has been getting worse by the year. I am not responsible for the lack of faith that people have in their institutions. They are responsible.”

General denies arrest

The country’s top general had earlier denied that Hamzah — a former crown prince stripped of the title in 2004 — was arrested or under house arrest, even as authorities announced the arrests of former senior officials close to the ruling monarchy.

Hamzah was asked to “stop some movements and activities that are being used to target Jordan’s security and stability,” said Gen. Yousef Huneiti, the army chief of staff.

He said an investigation was ongoing and its results would be made public “in a transparent and clear form.”

“No one is above the law and Jordan’s security and stability are above all,” he told the official Petra news agency.

Petra had earlier reported that two senior officials who formerly worked for the palace, along with other suspects, had been arrested for “security reasons,” without providing further details.

The Petra report said Sharif Hassan bin Zaid, a member of the royal family, and Bassem Ibrahim Awadallah, a former head of the royal court, were detained. Awadallah, also previously served as planning minister and finance minister and has private business interests throughout the Gulf region.

The agency did not provide further details or name the others who were arrested.

King has ‘our full support,’ says U.S.

“We are closely following the reports and in touch with Jordanian officials,” State Department spokesperson Ned Price said. “King Abdullah is a key partner of the United States, and he has our full support.”

Saudi Arabia’s official news agency said the kingdom “confirmed its full support to Jordan and its king and crown prince in all decisions and procedures to maintain security and stability and defuse any attempt to affect them.”

Abdullah has ruled Jordan since the 1999 death of of his father, King Hussein, who ruled the country for close to a half-century. The king has cultivated close relations with U.S. and other Western leaders over the years, and Jordan was a key ally in the war against the Islamic State group. The country borders Israel, the occupied West Bank, Syria, Iraq and Saudi Arabia.

Jordan’s economy has been battered by the coronavirus pandemic. The country, with a population of around 10 million, also hosts more than 600,000 Syrian refugees.

Jordan made peace with Israel in 1994. The countries maintain close security ties, but relations have otherwise been tense in recent years, largely due to differences linked to Israel’s conflict with the Palestinians. Jordan is home to more than 2 million Palestinian refugees, most of whom have Jordanian citizenship.

Stability in Jordan and the status of the king has long been a matter of concern, particularly during the Trump administration, which gave unprecedented support to Israel and sought to isolate the Palestinians, including by slashing funding for Palestinian refugees.

In early 2018, as then-President Donald Trump was threatening to cut aid to countries that did not support U.S. policies, the administration boosted assistance to Jordan by more than $ 1 billion over five years.

Hamzah stripped of crown prince title

Abdullah stripped his half-brother Hamzah of his title as crown prince in 2004, saying he had decided to “free” him from the “constraints of the position” in order to allow him to take on other responsibilities. The move was seen at the time as part of Abdullah’s consolidation of power five years after the succession.

The current crown prince is Abdullah’s oldest son, Hussein, who is 26.

Jordan’s ruling family traces its lineage back to Islam’s Prophet Muhammad. Abdullah had chosen Hamzah as his crown prince hours after their father died of cancer in February 1999. The designation was out of respect for King Hussein, who was known to have favoured Hamzah the most among his 11 children from four marriages.

Abdullah and Hamzah have not displayed any open rivalry over the years.

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Why Canada is suspending use of AstraZeneca vaccine in people under 55

Canada’s vaccine advisory committee is recommending immediately suspending the use of the AstraZeneca-Oxford COVID-19 vaccine in Canadians under 55 following reports of rare but potentially fatal blood clots in Europe that appear to be connected to the shot.

The National Advisory Committee on Immunization (NACI) updated its guidelines to provinces and territories against the use of the vaccine for younger Canadians on Monday over safety concerns. 

Health Canada said Monday that 300,000 doses of AstraZeneca vaccine have been administered and no cases of the rare blood clotting adverse events have been reported in Canada, but that it was aware of additional cases that have recently been reported in Europe. 

Quebec, Ontario, Alberta, Saskatchewan, ManitobaNewfoundland and Labrador and Prince Edward Island have all suspended the use of the vaccine for anyone below the age of 55. Other provinces and territories are expected to follow. 

Dr. Isaac Bogoch, an infectious diseases physician and member of Ontario’s COVID-19 vaccine task force said that the discovery of a potential connection with the vaccine to blood clots raised a “red flag” that “warrants further exploration.” 

“People should appreciate that not all blood clots are created the same,” he said. “This is a very specific and particular method of blood clotting that likely has an association with the vaccine.” 

Risk of blood clots seems not to affect older age groups: NACI

NACI previously recommended earlier this month that Canadians over 65 not receive the shot, despite emerging evidence from around the world demonstrating its ability to prevent severe COVID-19 in older adults.

But that guidance changed on March 16 after more real-world data on the vaccine’s effectiveness was reviewed by NACI, and CBC News broke the story revealing documents on the federal government’s plans to allow those 65 and older to receive it.

“This vaccine has had all the ups and downs — it looks like a roller coaster,” said Dr. Caroline Quach, chair of NACI and a pediatric infectious diseases expert. “The problem is because data are evolving, we are also evolving our recommendations.” 

Quach said the risk of rare blood clots appears to only occur in younger populations, which is why NACI recommended suspending the vaccine in those under 55.

“What we’re doing is trying to contrast the risks and benefits,” she said. “So if you have that vaccine versus having to wait for two months while COVID is ramping and you’re at risk of catching it and having complications from it, I think that taking the vaccine is the best option at this point.”

Quach added that the vaccine works well in preventing severe outcomes and death in older populations over 55, particularly in those over 70, and the risk of blood clots does not appear to be present in those age groups. 

WATCH | Canada pauses use of AstraZeneca vaccine in people under 55:

“We are being fully transparent. Maybe it’s too transparent, I don’t know,” says Dr. Caroline Quach-Thahn, Chair of the National Advisory Committee on Immunization. NACI issued guidance for the AstraZeneca vaccine for the third time, now recommending a pause for those under 55. 4:34

“What we need to have is continued confidence in our expert review panel that it’s looking at these vaccines and deciding what is going to be best, safest and most effective for Canadians,” said Alyson Kelvin, an assistant professor at Dalhousie University and virologist at the Canadian Center for Vaccinology in Halifax. 

“This is a new vaccine to a new virus, it’s really important that we’re following all the data as closely as possible and as the vaccines are rolling out, we’re understanding them more and reviewing what the guidance should be.”

Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University, said NACI is taking a calculated risk by recommending older Canadians still get the vaccine because they are at higher risk of severe outcomes from COVID-19.

“Scientifically, it makes sense,” he said. “This isn’t saying that everyone under 55 is going to get this complication. It’s the slight risk of this complication seems to be more predisposed in this age group. But again, the raw numbers seem to be very, very low.”

What led to Canada’s decision to suspend AstraZeneca

The decision to halt the use of the vaccine in Canadians under 55 comes after the European Medicines Agency (EMA) investigated 25 cases of the rare blood clots out of about 20 million AstraZeneca shots given. It concluded on March 18 that the benefits from the vaccine far outweigh its possible risks, although a definitive link could not be ruled out.

But 18 of the cases in Europe were of an extremely rare type of blood clot called cerebral venous sinus thrombosis (CVST) — where veins that drain blood from the brain are obstructed and can potentially cause fatal bleeding.

The EMA said on March 18 at least nine deaths have been associated with the adverse events in Europe and the agency is continuing to investigate the situation.

Germany’s medical regulator told The Associated Press on Monday it had received reports of 21 cases of rare blood clots in people who had recently received AstraZeneca’s coronavirus vaccine. 

The Paul Ehrlich Institute also said that seven people affected by the blood clots have died. It added that of the 21 cases reported in Germany until March 25, 12 also involved an abnormally low level of platelets in the patients’ blood.


The National Advisory Committee on Immunization (NACI) updated its guidelines against the use of the vaccine for younger Canadians on Monday. (Dado Ruvic/Reuters)

Nineteen of the 21 cases were in women ages 20 to 63, while two were in men ages 36 and 57. During the period covered by the reports, some 2.27 million first doses of the AstraZeneca vaccine were administered in Germany.

“You cannot ignore the blood clots that have been associated with AstraZeneca globally,” said Bogoch. “It’s not entirely clear what the true incidence of this is, but it does appear to be a rare event.” 

What Canadians need to know about the AstraZeneca vaccine

The federal health ministry said it would be requiring both manufacturers, AstraZeneca and India’s Serum Institute, to conduct risk assessments by age and gender — but is requesting more data before deciding whether or not to change authorization of it in Canada. 

Health Canada had previously updated the vaccine’s label with information on the rare blood clotting events.

Canadian health officials said during a press conference Monday the specific syndrome is being called Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT) and that they are in contact with European officials about it. 


Dr. Isaac Bogoch said that the discovery of a potential connection with the vaccine to blood clots, particularly CVST, raised a ‘red flag’ that ‘warrants further exploration.’ (Cole Burston/The Canadian Press)

“I do understand why Canadians might feel worried,” said Canada’s Deputy Chief Public Health Officer Dr. Howard Njoo.

“What I can say is that the chief medical officers of health of the provinces and territories take vaccine safety very seriously and we want Canadians to have confidence in these vaccines.”

Officials added that Germany’s Paul Ehrlich Institute reported VIPIT has an incidence rate of about one in 100,000, with a mortality rate of about 40 per cent, although more research is needed and that risk is reduced if treated early enough. 

“Where the true rate is, we just don’t know at this point in time,” said NACI Co-Chair Dr. Shelley Deeks. “But we are continuing to follow the data, as it emerges.” 

Symptoms to watch for

The Public Health Agency of Canada released a statement on Monday saying that “there is no cause for concern” for Canadians who have already been vaccinated with AstraZeneca for more than 20 days, but that you should seek immediate medical attention in the rare event you develop the following symptoms four or more days after vaccination:

  • Shortness of breath.
  • Chest pain.
  • Leg swelling.
  • Persistent abdominal pain.
  • Sudden onset of severe or persistent worsening headaches or blurred vision.
  • Skin bruising (other than at the site of vaccination).

PHAC said decisions on the type of second dose that will be offered to those who have been vaccinated with AstraZeneca will be determined based on the “latest evidence and research.” 

Most of the complications in Europe occurred within 14 days of receiving the AstraZeneca shot, and the majority were in women under the age of 55. It’s worth noting that CVST is typically more common in women, particularly during and after pregnancy, while on birth control and hormone replacement therapy.

Germany and Italy resumed vaccinations with the shot on March 19, but France opted to vaccinate only those over 55 with it after discovering several cases of CVST. Denmark and Norway have suspended the use of the vaccine altogether for at least three weeks, while Sweden has resumed the use of the vaccine in those over 65. 

“The real question here is, how common is it, and are there identifiable risk factors for this? That way, we could probably continue to use this vaccine in people with very, very low risks of having a blood clot and selectively vaccinate people who would benefit,” Bogoch said.

“If there is that risk, we would hopefully have better data to support who we could safely and selectively vaccinate with this product.”

Benefits still outweigh risks, says vaccine maker

A spokesperson for AstraZeneca Canada said in a statement the company respects the decision by NACI but stressed that Health Canada’s guidance to health care providers around the use of the vaccine remains unchanged.

“Regulatory authorities in the U.K., European Union, the World Health Organization and Health Canada have concluded that the benefits of using our vaccine to protect people from this deadly virus significantly outweigh the risks across all adult age groups,” the statement read. 
 
“Tens of millions of people have now received our vaccine across the globe. The extensive body of data from two large clinical data sets and real-world evidence demonstrate its effectiveness, reaffirming the role the vaccine can play during this public health crisis.” 

Chagla said NACI’s decision will likely hurt confidence in the vaccine in the eyes of Canadians, especially among those over 55 who may be left “scratching their heads” as to why the vaccine is being recommended for their age group but not younger people. 

“I, unfortunately, envision this vaccine is going to have a limited rollout in Canada moving forward,” he said.

“Even if the dust starts settling, and it’s a completely separate issue or it’s much lower risk than expected, I don’t think you’re going to get many under 55-year-olds to get this vaccine anymore ,and that’s the reality.”

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Immunization committee to recommend provinces stop giving AstraZeneca vaccine to those under 55: sources

Canada’s National Advisory Committee on Immunization (NACI) is expected to recommend today a pause in the use of the AstraZeneca-Oxford COVID-19 vaccine on those under the age of 55 because of safety concerns, sources told CBC News.

The updated guidelines will be issued later today, according to sources who spoke on the condition of anonymity. The expected change comes following reports of rare blood clots in some immunized patients.

Canada is expected to receive 1.5 million doses of this product from the U.S. on Tuesday.

Officials from NACI will provide an update to reporters at 3:10 p.m. ET. CBCNews.ca will carry the remarks live.

Meanwhile, Health Canada — which approved the vaccine for use in Canada in February — said its regulators would be adding “additional terms and conditions on the authorizations” for AstraZeneca and a biologically identical version of the drug manufactured by the Serum Institute of India, which has been branded Covishield.

The manufacturers will be required to conduct a “detailed assessment of the benefits and risks of the vaccine by age and sex in the Canadian context,” information that could lead to “additional regulatory actions.”

“This information will support the ongoing evaluation of these rare blood clotting events, and allow Health Canada to determine if there are specific groups of people who may be at higher risk,” the department said in a press release.

The AstraZeneca shot has not been widely used in people under the age of 55 in this country. Some jurisdictions, such as P.E.I., have been using some of their supply to immunize young people who work in public-facing sectors like grocery and convenience stores. In New Brunswick, the shot was made available to first responders and some teachers last week. 

A spokesperson for P.E.I.’s health department confirmed use of the vaccine had been suspended for those 18 to 29 years of age.

Speaking to reporters in Niagara Falls, Ont., Ontario Premier Doug Ford said today that the province would follow NACI’s guidance and reserve the current supply of AstraZeneca for those in the older cohort.

He said there have been reports of blood clots in younger women in other places.

“I won’t hesitate to cancel that in half a heartbeat. If it’s going to put anyone in harm, we just won’t use it, simple as that,” he said, adding he didn’t want to “roll the dice” by using AstraZeneca on a group that may have an outsized chance of developing complications.

“The guidance from the federal government is that it is safe for people over 55,” Ford said. “I’m talking about younger people taking it, 35 years of age and in that range, that’s where the problem is.”

After a review, the European Union’s drug watchdog, the European Medicines Agency, found the vaccine is not linked to an increase in the overall risk of blood clots.

The EMA said, however, that it could not definitively rule out a link between the vaccine and rare types of blood clots associated with thrombocytopenia, or low levels of blood platelets.

Specifically, it pointed to 18 cases of an extremely rare type of blood clot called cerebral venous sinus thrombosis (CVST), a condition that is much more common in women than men. Most of the cases occurred within 14 days of receiving the AstraZeneca shot, and the majority were in women under the age of 55.

Dr. Joss Reimer, the medical lead on Manitoba’s vaccine implementation task force, said that the province also would pause its deployment of the vaccine among people under 55 because of a “very rare subtype, one specific type of blood clot.”

She said that while there have been no complications reported in Canada, “out of an abundance of caution” Manitoba will restrict the shot to people 55 to 64, for now.

Reimer said it’s not known yet how common this rare blood clot side effect is but early data out of Europe suggest it could be an outcome for 1 out of 100,000 AstraZeneca shots deployed, or even more than that — the science isn’t settled, she said.

“This is a pause while we wait for more information to better understand what’s happened in Europe. This is an important and evidence-based change,” she said, adding this sort of shift is a testament to Canada’s robust vaccine monitoring system.

Reimer said it’s “probably” fine to use the vaccine on all groups — but she’s not comfortable with just “probably” and wants to wait to see more data from Europe.

Last week, the Public Health Agency of Canada said it’s “possible” the vaccine may be associated with “very rare but serious cases of blood clots associated with thrombocytopenia.” Health Canada has maintained that the benefits of the AstraZeneca COVID-19 vaccine continue to outweigh the risks.

Health Canada has said it is aware that researchers in Europe have indicated that they have identified a possible cause for these very rare events, but says little information is available about the findings.

“We have been discussing the rare reports of blood clots and low platelet counts with the European Medicines Agency and other regulators,” Dr. Supriya Sharma, Canada’s chief medical adviser, said on Thursday. “Health Canada will make decisions for Canada based on the science and evidence.

“This is just the latest issue the company has faced over the last three months.

Earlier this year, a number of European countries halted vaccinations in response to questions about the AstraZeneca product’s efficacy in people over the age of 65, only to restart them after new evidence emerged.

After Health Canada approved the shot for all adults, NACI recommended the product be used only on people under the age of 65, citing a dearth of clinical trial data on the vaccine’s effectiveness in older people.

NACI changed course earlier this month after reviewing three “real-world studies,” saying the two-dose viral vector vaccine can and should be used on seniors.

Last week, the U.S. Data and Safety Monitoring Board (DSMB), which keeps an eye on clinical trials, found “outdated information” may have been reported by the company when it released data on U.S. trials. 

Dr. Anthony Fauci, U.S. President Joe Biden’s chief medical adviser and the head of the NIAID, said the monitoring board was surprised by the the better-than-expected efficacy results published by AstraZeneca.

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Moderna begins COVID-19 vaccine trial in kids under age of 12

Moderna Inc. has begun dosing patients in a mid-to-late stage study of its COVID-19 vaccine, mRNA-1273, in children aged six months to less than 12 years, the company said on Tuesday.

The study will assess the safety and effectiveness of two doses of mRNA-1273 given 28 days apart, and intends to enrol about 6,750 children in Canada and the United States.

The vaccine was approved for use by Health Canada on Dec. 23 for Canadians aged 18 and older. Moderna is under contract to deliver two million vaccine doses to the country by the end of March.

The vaccine has also been authorized for emergency use in Americans who are aged 18 and older.

The Moderna vaccine is made from messenger RNA, or mRNA, a type of genetic material that is used by cells to translate instructions found in DNA to make proteins.

In this case, the instructions tell a human cell how to make a stabilized version of the spike protein for SARS-CoV2. That introduces the protein into the body so immune cells can learn to recognize it and produce antibodies against it.

In a separate study that began in December, Moderna is also testing mRNA-1273 in adolescents between 12 and 18 years old.

The latest study is being conducted in collaboration with the National Institute of Allergy and Infectious Diseases and the Biomedical Advanced Research and Development Authority.

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Brazil’s hospitals under stress as cases surge: ‘We don’t know what’s yet to come’

Brazil’s hospitals are faltering as a highly contagious coronavirus variant tears through the country, while the president insists on unproven treatments and the only attempt to create a national plan to contain COVID-19 has just fallen short.

For the last week, Brazilian governors sought to do something President Jair Bolsonaro has rejected: cobble together a proposal for states to help curb the nation’s deadliest COVID-19 outbreak yet. The effort was expected to include a curfew, prohibition of crowded events and limits on the hours non-essential services can operate.

The final product, presented Wednesday, was a one-page document that included general support for restricting activity but without any specific measures. Six governors declined to sign on.

Piaui state’s Gov. Wellington Dias told The Associated Press that unless pressure on hospitals is eased, growing numbers of patients will have to endure the disease without a hospital bed or any hope of treatment in an intensive care unit.

“We have reached the limit across Brazil; rare are the exceptions,” said Dias, who leads the governors’ forum. “The chance of dying without assistance is real.”

Those deaths have already started. In Brazil’s wealthiest state, Sao Paulo, at least 30 patients died this month while waiting for ICU beds, according to a tally published Wednesday by the news site G1. In southern Santa Catarina state, 419 people are waiting for transfer to ICU beds. In neighbouring Rio Grande do Sul, ICU capacity is at 106 per cent.


Gravediggers wear protective suits as they bury a person who died from COVID-19 at Vila Formosa cemetery in Sao Paulo. (Carla Carniel/Reuters)

According to a tracking tool maintained by Johns Hopkins University, as of Thursday, Brazil had seen more than 11.2 million cases of COVID-19 and more than 270,650 deaths.

‘I have a lot of colleagues who … stop to cry’

Alexandre Zavascki, a doctor in Rio Grande do Sul’s capital, Porto Alegre, described a constant arrival of hospital patients who struggle to breathe.

“I have a lot of colleagues who, at times, stop to cry. This isn’t medicine we’re used to performing routinely. This is medicine adapted for a war scenario,” said Zavascki, who oversees infectious disease treatment at a private hospital.

“We see a good part of the population refusing to see what’s happening, resisting the facts. Those people could be next to step inside the hospital and will want beds. But there won’t be one.”

The country, he said, needs “more rigid measures” from authorities.

Over the president’s objections, the Supreme Court last year upheld cities’ and states’ jurisdiction to impose restrictions on activity. Even so, Bolsonaro consistently condemned such moves, saying the economy needed to keep churning and that isolation would cause depression.

P1 variant on the rise

The most recent surge is driven by the P1 variant, which Brazil’s health minister said last month is three times as transmissible as the original strain. It first became dominant in the Amazonian city Manaus and in January forced the airlift of hundreds of patients to other states.


Eurenice Melo, 87, who suffers from COVID-19, is helped by a nurse at her home in Manaus, Brazil, as her daughter, Cintia Melo, 50, looks on. (Bruno Kelly/Reuters)

Brazil’s failure to arrest the virus’s spread since then is increasingly a concern not just for Latin American neighbours, but also as a warning to the world, Tedros Adhanom Ghebreyesus, director of the World Health Organization, said in a March 5 press briefing.

“In the whole country, aggressive use of the public health measures, social measures, will be very, very crucial,” he said. “Without doing things to impact transmission or suppress the virus, I don’t think we will be able in Brazil to have the declining trend.”

Last week’s tally of more than 10,000 deaths was Brazil’s highest since the pandemic began, and this week is on track to be even worse, after the country posted nearly 2,300 deaths on Wednesday — blowing away the prior day’s total, which was also a record.

Brazil has decades of experience with mass immunization campaigns, but rollout has been hobbled by delays. So far, 5.5 per cent of its population has been vaccinated.

“Governors, like a lot of the population, are getting fed up with all this inaction,” said Margareth Dalcolmo, a prominent pulmonologist at the state-run Fiocruz Institute. She added that their proposed pact is vague and will remain symbolic unless it becomes far-reaching and confronts the federal government.

Brazil’s national council of state health secretaries last week called for the establishment of a national curfew and lockdown in regions that are approaching maximum hospital capacity. Bolsonaro again demurred.

“I won’t decree it,” Bolsonaro said Monday at an event. “And you can be sure of one thing: My army will not go to the street to oblige the people to stay home.”

Wait list for ICU beds

Restrictions can already be found just outside the presidential palace, after the Federal District’s governor, Ibaneis Rocha, implemented a curfew and partial lockdown. Rocha warned Tuesday that he could clamp down harder, sparing only pharmacies and hospitals, if people keep disregarding rules.

Currently, 213 people in the district are on the wait list for an ICU bed.

Bolsonaro told reporters Monday that the curfew is “an affront, inadmissible,” and said that even the WHO believes lockdowns are inadequate because they disproportionately hurt the poor.

While the WHO acknowledges “profound negative effects,” it says some countries have had no choice but to impose heavy-handed measures to slow transmission, and that governments must make the most of the extra time provided to test and trace cases, while caring for patients.

Such nuance seems lost on Bolsonaro, whose government continues its search for silver-bullet solutions that so far has served only to stoke false hopes.

Bolsonaro’s government spent millions producing and distributing malaria pills, which have shown no benefit in rigorous studies. Still, Bolsonaro endorsed the drugs. He has also supported treatment with two drugs for fighting parasites, neither of which have shown effectiveness. He again touted their capacity to prevent hospitalizations during a Wednesday event in the presidential palace.

‘Every day is a new surprise’

Bolsonaro also dispatched a committee to Israel this week to assess an unproven nasal spray that he has called “a miraculous product.” Fiocruz’s Dalcolmo, whose younger sister is currently in an ICU, called the trip “really pathetic.”


Brazilian President Jair Bolsonaro removes his mask to address a ceremony in Brasilia, Brasil, to sign a law that expands the federal government’s ability to acquire vaccines on March 10, 2021. (Eraldo Peres/The Associated Press)

Meanwhile, the city of Araraquara, in Sao Paulo’s interior, has seen new cases turn downward weeks after declaring lockdown amid a crippling surge dominated by the P1 variant. Mayor Edinho Silva told the AP in a message that, without mass vaccination, there was no alternative.

Camila Romano, a researcher at the University of Sao Paulo’s Institute of Tropical Medicine, hopes a test her lab developed to identify worrisome variants, including P1, will help monitor and control their spread. She also wants to see stricter government measures, and citizens doing their part.

“Every day is a new surprise, a new variant, a city whose health system enters collapse,” Romano said. “We’re now in the worst phase. Whether this will be the worst phase of all, unfortunately we don’t know what’s yet to come.”

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Support for essential workers could bring COVID-19 under control faster in Canada, doctors say

Doctors are calling for more supports for essential workers facing “life-or-death” inequities, saying it will do more to control coronavirus outbreaks than high-profile punishments of those who break the rules.

COVID-19 has exacerbated existing problems — not only among long-term residents bearing the brunt of deaths from the virus — but also for people struggling to get by despite working on the front lines on farms, in warehouses and grocery stores.

Now, these vulnerable workers can face additional challenges from authorities such as breaking Quebec’s curfew order or living in cramped, poorly ventilated quarters that make it easy for the coronavirus to spread. 

Nav Persaud, a family physician in Toronto who holds the Canada Research Chair in health justice, said he’s “dispirited” by how little attention inequity receives. 

“It’s always been a life-or-death issue, health inequities,” Persaud said. “People not being able to afford basic necessities like healthy food, medication, safe housing has always killed people and put people’s health in jeopardy.”


An Amazon warehouse north of Calgary in Balzac, Alta., that reported an outbreak of COVID-19 last spring. Doctors say warehouse workers need immediate access to paid sick leave to help control coronavirus outbreaks. (Jeff McIntosh/The Canadian Press)

He said much of the coronavirus transmission happening now in the Greater Toronto Area is from people going to work or interacting in ways that won’t be stopped by charging those holding large parties, for instance. 

“I think the people who benefit most from those punishments are the authorities, because they can exert their power and give off the impression that they’re being helpful when they’re not,” Persaud said. “It would be better if they were providing supports.”

In Toronto, Persaud said people who rely on public transit to get to work from priority neighbourhoods with a disproportionately higher number of COVID-19 cases may face long, crowded commutes on buses. That’s why the greater supports he’s seeking also includes extended public transit.

But providing more supports is harder for politicians from all levels to do than chastising individual rule breakers, he said. 

“I’m in favour of there being rules and the rules do need to be enforced, but I think these are relatively unimportant incidents in the grand scheme of things.”

A recent opinion article by three physicians points to how Ontario’s modelling showed three times more daily confirmed cases among communities with the most essential workers compared with communities with the least. Researchers in California reported a similar observation that hasn’t yet been peer reviewed by outside experts.

Call for supports to control outbreaks faster

Martha Fulford, an associate professor of infectious diseases at McMaster University in Hamilton, Ont., would like to see an immediate “liveable support” such as paid sick leave as a fundamental for essential workers. 

“It’s extremely easy to stay home and be in isolation for somebody like me. I have a big house, I have a big yard, I can click on Amazon and get my stuff delivered,” Fulford said. “But who’s delivering it? What choice does the person delivering to my house have?

“If we don’t provide the same sorts of supports for all the essential workers, this is never going to come under control.” 

Doctors say if essential workers are now a key driver of transmission then the coronavirus won’t be contained unless they’re able to stay home when sick or potentially exposed without having to worry about putting food on the table. 


Dr. Nav Persaud, seen here in 2018, favours rules to control the COVID-19 pandemic, but said some some infractions by individuals aren’t a priority, compared to broader supports that are needed. (Craig Chivers/CBC)

Fulford also noted that the highest rates of transmission are among people living in crowded conditions or working in large warehouses

“I’m not an economist, I’m just a physician, but I can’t help but think in the long term, it would be far more cost effective to invest money in the areas where we’re seeing the highest transmission, and support them, than shut down an entire economy.”

Facilitate work from home when possible

Persaud said punishments such as charges and fines for violating COVID-19 safety rules often hit individuals rather than institutions such as employers. 

He sees the charges laid against Cargill for the country’s largest workplace outbreak in High River, Alta., as an exception and “a fairly extreme example.” The allegations haven’t been tested in court.

For other workplaces, Persaud suggested addressing larger, underlying issues contributing to outbreaks, such as office managers asking staff to come in to perform duties that could be done from the safety of home.

WATCH | Why Peel Region’s workplaces struggle with COVID-19 outbreaks:

Ontario’s Peel Region, just west of Toronto, has long been a hotspot for COVID-19, but the high number of warehouses and transportation facilities may be partly to blame. 2:15

Another recent high-profile case of charges being laid include a couple in Durham, Ont., east of Toronto, who are accused of obstructing contract-tracing efforts of public health officials investigating the introduction of the B117 variant of the coronavirus first identified in the U.K.

A third involves a penthouse owner in Vancouver who welcomed party goers. 

In contrast to charges, Fulford highlights a role model for countering conditions for outbreaks: hospitals.

“We have had hospital outbreaks and we’re not pointing fingers or getting angry because we understand, we do a root-cause analysis to figure out where we went wrong and we do better next time,” Fulford said.

Despite the best efforts of employers and workers, outbreaks can sometimes happen because of sheer bad luck.

Fulford said when an outbreak occurs in a workplace, bringing in infection prevention and control experts is a more productive approach than laying charges

“It’s a very unusual situation for me that we would be criminalizing public health interventions.”

Fulford said drug-resistant tuberculosis is one of the few instances that the Quarantine Act has been enforced for individuals. 

In the context of COVID-19, Fulford gives the example of someone who decides to meet family members from outside their household at a park and gets charged for breaking pandemic public health rules.  

In such a case, Fulford favours educating people and explaining why such behaviour is a problem to encourage them not to do it again — not naming and shaming. Otherwise, there could be unforeseen consequences for public health.

“Contact tracing is going to become a hundred times more difficult if the fear is that you’re going to be charged, your name is going to be in the newspaper.”

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Ontario permits indoor dining for NHL teams while province under stay-at-home order

The Ontario government announced Monday that teams competing in the NHL’s all-Canadian North Division will be permitted to dine inside certain Ontario restaurants despite ongoing stay-at-home orders within the province.

When asked why it is considered safe for NHL personnel to dine indoors but not the public, Premier Doug Ford yielded to the province’s chief medical officer of health, Dr. David Williams, who pointed to the league’s strict COVID-19 testing policy.

“The rules of the NHL are very much strict with their protocols, with their frequent testing, their isolation of their players to the extent, and especially very tight transport within Canada,” Williams said. “They do not leave the country, so they’re staying in this country the whole time. There are some players, of course, this is not their home, and [they] require some place to have some eating and food facilities.

“The NHL has procured that in a tight level of restriction and control. So that’s all part of their bubble, if you may use that term, which they have strictly laid out in their protocol. And so far, as far as I’m concerned, they’ve been adhering to it.”

Canadian-based NHL players say they have had an easier time avoiding COVID-19 due to tighter rules and restrictions compared with those in the United States. There are currently no Canadian-based players on the league’s protocol list, but that has largely been the result of limiting potential exposure and following strict routines.

WATCH | Ontario announces it will allow indoor restaurant dining for NHL players:

Ontario’s Chief Medical Officer of Health Dr. David Williams on why the provincial government is allowing NHL staff and players to eat inside restaurants while the remainder of the province remains under stay-at-home orders. 1:15

Prior to the Ontario government’s decision, travelling players and coaches in Canada were only permitted at the hotel, arena or airport during the division-only season.

The league will submit a plan for approval to the Office of the Chief Medical Officer of Health that will specify a full list of Ontario businesses and places that will be used by the NHL.

Along with certain restaurants, the list will include selected bars and facilities for recreational fitness.

Every business or establishment listed in the NHL’s plan must comply with certain conditions, including not allowing spectators. Hotels must also ensure that their facilities are open only for the use of NHL personnel.

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Myanmar lawmakers say they’re confined and under guard following military coup

Hundreds of members of Myanmar’s Parliament remained confined inside their government housing in the country’s capital on Tuesday, a day after the military staged a coup and detained senior politicians including Nobel laureate and de facto leader Aung San Suu Kyi.

Suu Kyi’s National League for Democracy (NLD) party, meanwhile, released a statement calling for the military to honour the results of last November’s election and release of all of those detained.

“The commander-in-chief seizing the power of the nation is against the constitution and it also neglects the sovereign power of people,” the party said in a statement on one of its Facebook pages.

One of the lawmakers said he and 400-some parliament members were able to speak with one another inside the compound and communicate with their constituencies by phone, but were not allowed to leave the housing complex in Naypyitaw. He said police were inside the complex and soldiers were outside it.

The lawmaker said the politicians, comprised of members of Suu Kyi’s NLD party and various smaller parties, spent a sleepless night worried that they might be taken away but were otherwise OK.

“We had to stay awake and be alert,” said the lawmaker, who spoke on condition of anonymity out of concern for his safety.


A man looks at newspapers displayed at a newspaper stall in Yangon, Myanmar, Tuesday. Hundreds of members of Myanmar’s parliament remained confined inside their government housing in the country’s capital. (Thein Zaw/The Associated Press)

The takeover came the morning lawmakers from all of the country had gathered in the capital for the opening of the new parliamentary session and follows days of worry that a coup was coming.

The military said the seizure was necessary because the government had not acted on the military’s claims of fraud in November’s elections — in which Suu Kyi’s ruling party won a majority of the parliamentary seats up for grabs — and because it allowed the election to go ahead despite the coronavirus pandemic.

Setback for democracy

An announcement read on military-owned Myawaddy TV on Monday said Commander-in-Chief Senior Gen. Min Aung Hlaing would be in charge of the country for one year. Late Monday, the office of the commander-in-chief announced the names of new Cabinet ministers. The 11-member Cabinet is composed of military generals, former military generals and former advisers to a previous government headed by former general Thein Sein.


A portrait of detained leader Aung San Su Kyi attached on a tourism building in Yangon, the country’s biggest city, on Tuesday. Yangon streets were quieter than usual but taxis and buses were still running and there were no outward signs of heavy security. (Anadolu Agency via Getty Images)

The coup is a dramatic backslide for Myanmar, which was emerging from decades of strict military rule and international isolation that began in 1962. It now presents a test for the international community, which had ostracized Myanmar while it was under military rule and then enthusiastically embraced Suu Kyi’s government as a sign the country was finally on the path to democracy. U.S. President Joe Biden threatened new sanctions, which the country had previously faced.

On Tuesday in Yangon, the country’s biggest city, the streets were quieter than usual but taxis and buses were still running and there were no outward signs of heavy security.

The English-language Myanmar Times headlined the state of emergency, while other state-owned newspapers showed front-page photographs of Monday’s National Defence and Security Council meeting, which the newly appointed Acting President Myint Swe and Min Aung Hlaing attended with other military officials.

The military has maintained that its actions are legally justified — citing a section of the constitution it drafted that allows it to take control in times of national emergency — though Suu Kyi’s party spokesman as well as many international observers have said it amounts to a coup.


Soldiers stand guard on a blockaded road to Myanmar’s parliament in Naypyidaw on Monday after the military detained the country’s de facto leader Aung San Suu Kyi and the country’s president in a coup. (Photo by STR/AFP via Getty Images)

The takeover marks a shocking fall from power for Suu Kyi, a Nobel peace laureate who had lived under house arrest for years as she tried to push her country toward democracy and then became its de facto leader after her party won elections in 2015.

Suu Kyi had been a fierce critic of the army during her years in detention. But after her shift from democracy icon to politician, she needed to work with the generals, who despite allowing elections had never fully given up power.

While the 75-year-old has remained popular at home, Suu Kyi’s deference to the generals — going so far as to defend their crackdown on Rohingya Muslims that the United States and others have labelled genocide — has left her reputation tarnished abroad.

UN and U.S. condemn coup

The coup was met with international condemnation and many countries called for the release of the detained leaders.

Biden called the military’s actions “a direct assault on the country’s transition to democracy and the rule of law” and said Washington would not hesitate to restore sanctions.

“The United States will stand up for democracy wherever it is under attack,” he said in a statement.

U.N. Secretary-General Antonio Guterres called the developments a “serious blow to democratic reforms,” according to his spokesman. The Security Council will hold an emergency meeting on the military’s actions — probably on Tuesday, according to Britain, which currently holds the council presidency.

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Under house arrest after contested election, Uganda’s Bobi Wine still hopes to inspire country’s youth

Uganda’s Bobi Wine is a pied piper of a figure who dared raise the hopes of the country’s youth, only to be beaten in an election with the odds tipped against him by a man who has had his hands on the levers of power for 35 years. 

So what now for the self-styled “ghetto president”?

Two days after Uganda’s electoral commission announced that President Yoweri Museveni had decisively won last week’s ballot, Wine and his wife, Barbara, remained under house arrest at their home in Magere, just north of the capital, Kampala.

“Nobody is allowed in, nobody is allowed out. We are stuck,” Wine said in a telephone interview with CBC News on Monday morning, adding that government security forces had not only surrounded his house but “jumped over the fence and taken control of my compound.” 

“We demand that they release me and they release all the political prisoners so we can be able to assemble freely, like is provided for by the law, and discuss the way forward.”


Wine said it was clear Museveni was trying to prevent him from speaking to his supporters.

“[The government is] worried I will make a statement that will make the people go active. We’ve been telling the people of Uganda and we continue to tell them that they must be non-violent, but that they must be assertive.”  

Wine said his National Unity Platform (NUP) plans to launch a legal challenge to the results, which accorded him 35 per cent of the vote, and to present proof of electoral tampering once internet access is restored to the country.

Museveni ‘looking beyond this election’

The government shut internet providers down just a day before the vote on Jan. 14 and one day after military tanks and security forces paraded through opposition neighbourhoods in Kampala, in a show critics say was intended to intimidate opposition supporters already hurting from weeks of violence and arrests by government security forces.  

Few analysts thought Wine stood a chance of winning the elections, given Museveni’s determination to hold on to power and the tools available to him. But they say Wine nonetheless remains a threat to Museveni’s hold on power, and that it’s clear Museveni sees him as such.  

Although not necessarily from the ballot box.

“People are right to say Mr. Museveni is looking beyond this election,” said Fred Muhumuza, a lecturer in economics at the University of Makerere in Kampala. 


Yoweri Museveni has been Uganda’s president for more than three decades and still enjoys support among older and rural voters. (Jack Taylor/Getty Images)

“His biggest worry is the ideology that has started, this thinking that is beginning to come. We’ve seen it in the Arab Spring: Once citizens feel they are not being well provided for by services that have been given by government, it becomes very hard to govern them. So I think there are concerns about the governability of the country going forward.”  

In a speech on Saturday, Museveni claimed the election to be the fairest in Uganda’s history.

His support and that of his party, the National Resistance Movement (NRM), comes in large part from rural voters and those old enough to remember the stability he brought to the country after the bloody legacies of Idi Amin and Milton Obote in the 1970s and ’80s.  

“For the older generation, the Museveni [appeal] has to do with security,” said Muhumuza. “There are people who think [support for Wine] might have to do with other governments or foreign interests trying to take advantage of the youth and cause some kind of insecurity in the country.”  

Wine appeals to younger Ugandans

But two-thirds of Uganda’s population is under the age of 30, offering up a powerful constituency for Wine in a country where jobs are scarce and many voters will have known no other president than Museveni. 

“They need to get opportunities to work and for the first time they have a younger person representing them who is in their age bracket,” said Muhumuza. 

Now 38, Wine grew up in a Kampala slum, which earned him the moniker of the “ghetto president.” He grew first to be a successful musician, changing his name from Robert Kyyagulanyi to Bobi Wine and writing songs about social injustice. In 2017, he stood for the national parliament and won.


Bobi Wine is seen taking an injured supporter into a medical centre on Dec. 1, 2020 in Jinja, Uganda. This election season was marred by violence. (Getty Images)

“He’s been a public commentator. Every time in Uganda we had a very sensitive issue, Bobi Wine had a song, [and was] making an intervention. The music that made him a star was music about HIV/AIDS,” said Yusuf Serunkuma, a social researcher at Makerere University.

Serunkuma also thinks Museveni is worried about Wine’s ability to mobilize the street. The 2018 protests in nearby Sudan, which led to the ousting of president Omar al-Bashir after 30 years in power, offer a fresh reminder of what public demonstrations can do.  

Serunkuma also said opposition activists understand that it’s almost impossible to win an election in a dictatorship that disguises itself as a democracy. 

“So what happens is that you mobilize the constituents that make it difficult for [the government] to continue. And I think that this is what Bobi Wine is doing.” 

Serunkuma said it’s that possibility that Museveni has been preparing for, rather than the election.

Election observers kept away 

The president’s supporters say he has every right to order security forces onto the streets to prevent what they say could be a potential insurrection.  

Andrew Mwenda, a journalist with close ties to Museveni and his inner circle, said he knows Bobi Wine “very well.”

“I don’t have a problem with him, even though I think he is intellectually handicapped to understand the complexities of government,” said Mwenda, the founder and managing editor of a newsmagazine called the Independent.

He dismisses Wine’s supporters as thugs and hooligans. “They are incapable of tolerating dissent. It’s not in their DNA. They make Trump’s supporters look like the most liberal democrats the world has ever seen.”

On the other hand, Mwenda describes Museveni as a “very tolerant man” — even though the editor almost boasts that he himself was once jailed by Museveni, presumably for criticizing the government. 

He said recent attacks by security forces against reporters covering the Bobi Wine campaign — or trying to — were “regrettable,” but not a “reflection of the freedom that exists” in Uganda.

WATCH | CBC news crew deported from Uganda ahead of election:

A CBC News crew was deported from Uganda despite having media credentials, as a contentious election approaches. It has already been marred by violent crackdowns on protesters. 2:31

Canada joined several European Union countries, the United Kingdom and the United States in expressing concern over the harassment of journalists and media freedom ahead of the election.  

Election observers from the U.S. were refused permission to monitor the vote while the European Union pulled out its own team late last year, citing Uganda’s failure to implement previous recommendations on electoral reform.

A coalition of civil society groups making up Africa Elections Watch issued a statement saying their observers found that the vote did not “meet the threshold of a democratic, free, fair and transparent credible electoral process.”  

Wine happy to ‘inspire young people’

Wine’s challenge to Museveni is the story of this election and is potentially a defining moment for the country. But it makes it no easier to predict his future.

On the phone on Monday, Wine was endlessly gracious, but the fatigue in his voice came through. 

Serunkuma has described Wine’s popularity as contagious. He acknowledged that Wine has “really been successful, but I’m not sure whether what he’s done is sustainable. Ugandans do not take to the streets.” 


Wine, centre, is escorted by a police officer in 2020 as he is arrested on charges of unlawful assembly before his first public meeting ahead of the 2021 election season. (Stringer/AFP via Getty Images)

When they did in November, it came with a heavy price — at least 54 people were killed by security forces when protests erupted after one of Wine’s arrests, allegedly for breaking COVID-19 restrictions. 

“I don’t think anything is going to happen because the president has done so much to prepare for the moment after the election,” said Serunkuma. “It started way, way back.”

Muhuzuma said “there are people who think the election will simply be an event in a long process of what will eventually remove Mr. Museveni.”

The question is, will his regime crack down even harder on civil liberties or will some of those in power be rattled enough to try and change something from within?

“A lot of [Museveni’s] supporters have, I think, picked up that signal, to say we can’t just keep growth that is not inclusive, that is not creating opportunities for youth,” said Muhuzuma.

For his part, Wine said he is determined to see Uganda through to a new chapter. If that means merely serving as an inspiration for real change, it will be enough.

“I came in not saying that I am the alpha and the omega, but I wanted to spark the mind that would change the world, to influence and inspire young people, and I am very glad to see that happening,” he said.  

Wine also said he continues to fear for his safety and that of his wife.  

“We hope the world continues to put the focus on Uganda and to hold General Museveni accountable for our lives.”

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Biden unveils $1.9 trillion plan to get COVID-19 under control in U.S.

U.S. president-elect Joe Biden unveiled a $ 1.9 trillion coronavirus plan Thursday to turn the tide on the pandemic, speeding up the vaccine rollout and providing financial help to individuals, states and local governments and businesses struggling with the prolonged economic fallout.

Called the “American Rescue Plan,” the legislative proposal would meet Biden’s goal of administering 100 million vaccines by the 100th day of his administration, while advancing his objective of reopening most schools by the spring.

Speaking from Wilmington, Del., Thursday evening, Biden said that “this will be on the most challenging operational efforts we have ever undertaken as a nation” but that “we will have to move heaven and earth to get more people vaccinated.”

On a parallel track, it would deliver another round of aid to stabilize the economy while the public health effort seeks the upper hand on the pandemic, said aides who described the plan ahead of Biden’s speech.

It includes $ 1,400 cheques for most Americans, which on top of $ 600 US provided in the most recent COVID-19 bill would bring the total to the $ 2,000 US that Biden has called for. The plan would also extend a temporary boost in unemployment benefits and a moratorium on evictions and foreclosures through September.

And it shoehorns in long-term Democratic policy aims such as increasing the minimum wage to $ 15 an hour, expanding paid leave for workers, and increasing tax credits for families with children. The last item would make it easier for women to go back to work, which in turn would help the economy recover.

The political outlook for the legislation remained unclear.


U.S. president-elect Joe Biden speaks about his plan to tackle the COVID-19 pandemic during an event at the Queen Theater, on Thursday, in Wilmington, Del. (Matt Slocum/The Associated Press)

Narrow margins in House, Senate

In a joint statement, House Speaker Nancy Pelosi and Senate Democratic leader Chuck Schumer praised Biden for including liberal priorities, saying they would move quickly to pass it. But Democrats have narrow margins in both chambers of Congress and Republicans will push back on issues that range from increasing the minimum wage to providing more money for states, while demanding inclusion of their priorities, such as liability protection for businesses.

“Remember that a bipartisan $ 900 billion #COVID19 relief bill became law just 18 days ago,” tweeted Republican Sen. John Cornyn.

The emergency legislation would be paid for with borrowed money, adding to trillions in debt the government has already incurred to confront the pandemic. Aides, speaking on condition of anonymity, said Biden will make the case that the additional spending and borrowing is necessary to prevent the economy from sliding into an even deeper hole. Interest rates are low, making debt more manageable.

Biden has long held that economic recovery is inextricably linked with controlling the coronavirus. “Our work begins with getting COVID under control,” he declared in his victory speech. “We cannot repair the economy, restore our vitality or relish life’s most precious moments until we get it under control.”


People wait in cars for a vaccination against the coronavirus at a new ‘vaccination superstation,’ on Monday, in San Diego, Calif. (Gregory Bull/The Associated Press)

$ 400B to combat pandemic

The plan comes as a divided nation is in the grip of the pandemic’s most dangerous wave yet. So far, more than 385,000 people have died of COVID-19 in the U.S. And government numbers out Thursday reported a jump in weekly unemployment claims, to 965,000, a sign that rising infections are forcing businesses to cut back and lay off workers.

Under Biden’s multipronged strategy, about $ 400 billion would go directly to combating the pandemic, while the rest is focused on economic relief and aid to states and localities.

About $ 20 billion would be allocated for a more disciplined focus on vaccination, on top of some $ 8 billion already approved by Congress. Biden has called for setting up mass vaccination centres and sending mobile units to hard-to-reach areas.

The plan provides $ 50 billion to expand testing, which is seen as key to reopening most schools by the end of the new administration’s first 100 days. About $ 130 billion would be allocated to help schools reopen without risking further contagion.

The plan would fund the hiring of 100,000 public health workers, to focus on encouraging people to get vaccinated and on tracing the contacts of those infected with the coronavirus.

Call for Americans to mask, avoid gatherings

There’s also a proposal to boost investment in genetic sequencing, to help track new virus strains including the more contagious variants identified in the United Kingdom and South Africa.

Throughout the plan, there’s a focus on ensuring that minority communities that have borne the brunt of the pandemic are not shortchanged on vaccines and treatments, aides said.

With the new proposals comes a call to redouble efforts on the basics.


A man receives a COVID-19 vaccine at Englewood Health in Englewood, N.J., on Thursday. (Seth Wenig/The Associated Press)

Biden is asking Americans to override their sense of pandemic fatigue and recommit to wearing masks, practising social distancing and avoiding indoor gatherings, particularly larger ones. 

Biden’s biggest challenge will be to “win the hearts and minds of the American people to follow his lead,” said Dr. Leana Wen, a public health expert and emergency physician.

With the backing of Congress and the expertise of private and government scientists, the Trump administration has delivered two highly effective vaccines and more are on the way. Yet a month after the first shots were given, the nation’s vaccination campaign is off to a slow start with about 10.3 million people getting the first of two shots, although more than 29 million doses have been delivered.

Biden believes the key to speeding that up lies not only in delivering more vaccine but also in working closely with states and local communities to get shots into the arms of more people. The Trump administration provided the vaccine to states and set guidelines for who should get priority for shots, but largely left it up to state and local officials to organize their vaccination campaigns.

“This is going to entail coordination at all levels, as well as resources,” said Dr. Nadine Gracia, executive vice president of the nonpartisan Trust for America’s Health. “There is a commitment the [incoming] administration has articulated to address the needs of communities.”

Biden has set a goal of administering 100 million shots in his first 100 days. The pace of vaccination is approaching one million shots a day, but 1.8 million a day would be needed to reach widespread or “herd” immunity by the summer, according to a recent estimate by the American Hospital Association. Wen says the pace should be even higher — closer to three million a day.

It’s still unclear how the new administration will address the issue of vaccine hesitancy, the doubts and suspicions that keep many people from getting a shot. Polls show it’s particularly a problem among Black Americans. “It’s important to acknowledge the reasons why it exists and work to earn trust and build vaccine confidence in communities,” said Gracia.

Next Wednesday, when Biden is sworn in as president, marks the anniversary of the first confirmed case of COVID-19 in the United States.

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