There’s a reason why a new, more contagious variant of SARS-CoV-2 appeared first in the UK: The country does a lot of viral genetic sequencing. Since the start of the pandemic, researchers in the UK have uploaded 151,859 individual SARS-CoV-2 sequences to GISAID, an international platform for sharing viral genomic data. That’s the highest number of sequences shared by any country in the world.

If a more contagious strain of SARS-CoV-2 first evolved in the United States, scientists likely would not have noticed so quickly. Despite having a larger population than the UK, a sophisticated biomedical research industry, and tens of millions more cases of Covid-19, to date US labs have only uploaded 69,111 sequences, according to GISAID.

“It’s embarrassing, is all I can say,” Diane Griffin, a microbiologist and immunologist at Johns Hopkins, told Vox.

The US has lagged behind on so many aspects of pandemic response — from an initial lack of testing, to the current strained and clumsy rollout of the Covid-19 vaccines. Lack of genetic surveillance is just another. Without it, we’re kept in the dark: Scientists can’t see, clearly or quickly, how and if the virus is mutating in concerning ways. It also leaves us without another useful tool to deploy in contact tracing studies.

And it’s one this country ought to invest in, and get right, scientists say — at least before the next pandemic strikes.

How the US fails on testing viral genomes

Earlier this year, Griffin was on a committee making recommendations for a recent National Academies of Science report on the state of genomic surveillance in the US. Genomic surveillance is used, routinely, around the world to track flu, and to try to predict which flu vaccine strains will be most effective in a given season. Genetic sequencing tools are not a new technology, and the Academies wanted a report to survey how they were being deployed in the pandemic in the US. Genetic sequencing is of particular import when it comes to coronaviruses because they use RNA as their genetic code, and RNA viruses are known to mutate frequently.

The report, when it was published in July, outlined a bleak landscape of SARS-CoV-2 mutation tracking. It’s not just that the US isn’t collecting enough genome samples of the virus. It’s doing so in an unsystematic, patchwork way.

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“Current sources of SARS-CoV-2 genome sequence data … are patchy, typically passive, reactive, uncoordinated, and underfunded in the United States,” the report concluded. And the data that did exist? The report found it was “inadequate to answer many of the pressing questions about the evolution and transmission of the virus.”

Early on in the pandemic — way back in March — the UK government invested £20 million ($27 million) to launch the COVID-19 Genomics UK (COG-UK) consortium, which coordinates the collection of this data from public health labs. The consortium also tracks viral genetic samples from health clinics, university research labs, and public health research facilities, to help generate a close-to-real-time snapshot of how the virus is changing in the country.

It’s what allows researchers to generate maps like this one, which shows how the new, more contagious strain of the virus spread geographically in the country over time.

The rich genetic data, when paired with case reports, also guides researchers to ask and answer crucial questions, such as: Is this new variant more deadly than other ones? Scientists were able to quickly determine the answer is “no.” (That said, a more contagious virus can still end up killing more people than a more virulent one.)

The US Centers for Disease Control and Prevention does have a genetic surveillance program called SPHERES (SARS-CoV-2 Sequencing for Public Health Emergency Response, Epidemiology, and Surveillance), but it’s less well coordinated than the UK effort. Right now labs have to essentially raise their hands and volunteer to contribute. And the funding for their efforts isn’t consistent. That leads to a patchwork of surveillance across the country. “So you might know what’s going on in Boston, or New York City, but have no idea what’s going on in Iowa,” Griffin says.

“In other words,” says Stanford microbiologist David Relman, who also contributed to the National Academies report, “anybody who has the means and interest to engage in genomics is certainly encouraged to do so.” But genomic sequencing, he says, hasn’t been made a “mainstream central pillar of public health efforts.”

What we lose out on when we don’t collect genetic samples of circulating viruses

The National Academies report was published in July. Has the situation gotten much better since? “No,” Griffin says. There has been a little bit of positive movement: Recently, private genomics companies Illumina and Helix have started to help in the detection of new variants in the United States. Even so, James Lu, president of Helix, told MIT Technology Review the US still needs to go from sequencing a few hundred samples a day to around 7,000 per day.

Viral genomics surveillance doesn’t just allow researchers to spot new variants, it helps them learn crucial lessons about how the virus is spreading.

Scientists take advantage of the fact that viruses are constantly making copies of themselves. And every time they make a copy, they may make a little typo in their genetic code. Most of the time, these mutations are meaningless, but they occur at a regular rate. And that makes it possible to make a family tree of the virus. If one viral sample and another have similar typos, researchers can determine they are more closely related.

This can generate key insights.

“In the beginning of the pandemic, we got our hands on some of the first cases that were identified in Connecticut,” says Mary Petrone, a PhD student who works in a molecular biology lab at Yale. Using genomic data, Petrone and her colleagues were able to figure out whether these cases were introduced from abroad, or came from somewhere in the United States. The genetic data revealed that the viruses more closely resembled those circulating on the West Coast than strains from abroad. “It was telling us: there is actually domestic transmission going on,” she says.

Petrone’s lab delivered a key early insight into understanding the virus’s spread in the US. But it wasn’t like the CDC directed them to do so. “Our lab was actually originally set up to do this type of research for mosquito-borne viruses,” she says. “When the pandemic hit we switched over, because there was an urgent public health need to answer some of these questions. So we just happened to really to be set up to do this type of work.”

Setting up more labs to do this work could also help with contact tracing efforts, overall. “For example, if 10 college students test positive,” Julie Segre, a scientist at the National Human Genome Research Institute, writes in an email, “did they come to school already colonized [i.e. infected] or did they transmit the virus while at school.” Genetic evidence can help answer such a question and help prevent future outbreaks.

What needs to happen: coordination, and money

And it’s not necessarily cheap or easy work to do. While the technology that sequences the viral genomes has become relatively inexpensive in recent years (a plug-in USB sequencer will set you back around $1,500), it still takes a lot of skilled lab work to prep samples for analysis. “You definitely don’t need a PhD to be able to do it,” Petrone says. “But you do need to be pretty well trained in molecular biology in the lab. There are a lot of steps where you can contaminate your samples. It can be quite expensive to do.”

Petrone’s lab can do full genome sequencing; that is, they can read every letter of a virus’s genetic code. But not all labs would need to do that to contribute to a surveillance effort. For instance, Petrone’s group is working on a simpler test that can identify the more contagious B117 variant that first was detected in the UK. “That is something you’d be able to run in a clinic,” she says.

But creating a widespread surveillance network for the new variant would require a lot more coordination than what’s currently taking place.

That’s why the US government needs to be more proactive on this, and help set up a nationwide network for genomic data. And that may be coming. According to STAT, the incoming Biden Administration plans to scale up the country’s genomic sequencing efforts as part of a $415 billion emergency Covid-19 spending package it will ask Congress to approve. (Perhaps also auspicious: Biden has selected Eric Lander, a geneticist who co-led the Human Genome Project, to lead the White House Office of Science and Technology Policy, which will be elevated to a Cabinet-level position.)

For a robust genetic surveillance network to be most useful, it needs to be backed up with other rich datasets too. New variants pop up all the time. What matters is whether those variants are linked to worse health outcomes, more reinfections, or faster spread.

“We would ideally have access to good, consistent data about each sample — at the least, geographical location, but more would be better,” Adam Felsenfeld, director of genome sciences at the National Human Genome Research Institute, writes in an email. If possible, too, “one would need details about the medical record of the patients,” he writes, to try to determine if genetic changes in the virus correspond to different disease courses. Again, this would take coordination, as researchers would need informed consent from people to collect this personal data.

A network of viral genome surveillance isn’t just needed for this pandemic, but for future ones too.

“This won’t be the last pandemic,” Griffin says. “If we could get the infrastructure right and get the approach right, then you have things in place you could activate” … for the next time.

For the nearly 100 million people around the world who’ve been infected with the coronavirus, new science offers some comfort: Reinfections appear to be rare, and you may be protected from Covid-19 for at least five months.

The study, the largest of its kind, followed more than 20,000 health workers in the UK, regularly testing them for infection and antibodies. Between June and November, the researchers — from Public Health England (PHE) — found 44 potential reinfections out of the 6,614 participants who had tested positive for antibodies or had a previous positive PCR or antibody test when they joined the study. Meanwhile, of the 14,000-plus people who had tested negative for the virus at the start of the study, there were 409 new infections.

Only two of the 44 potential reinfections were designated “probable” and the rest were considered “possible,” “based on the amount of confirmatory evidence available,” according to the health agency. Fifteen people — or 34 percent — had symptoms.

So if all 44 reinfections are real, that translates to an 83 percent lower risk of reinfection compared to health workers who never had the virus. If only two are confirmed, that rate of protection goes up to 99 percent. Either way, it suggests natural immunity might provide a similar level of protection as the approved Covid-19 vaccines.

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But as with the vaccines, it’s not yet clear how long immunity after an infection lasts. Antibodies may fade after five months or last much longer, something the researchers behind the ongoing study, which will run for a total of 12 months, plan to investigate.

“This [new] study does provide some comfort that naturally acquired antibodies are pretty effective in preventing reinfections,” Akiko Iwasaki, an immunobiologist at Yale University, told Vox. The findings also square with another paper on health workers, published in the New England Journal of Medicine in December: Researchers found people who had Covid-19 antibodies were better protected from the virus for six months than people who did not.

Iwasaki added, “You can also interpret these data to mean that protection against reinfection is not complete — especially for people who had Covid during the first wave, say in March-April 2020.”

People who had the virus may still be able to pass it on if reinfected

The good news for individuals who have had Covid-19 also comes with a warning about the risk they can still pose to other people. While antibodies might protect against a second case of Covid-19 in most people, “early evidence from the next stage of the study suggests that some of these individuals carry high levels of virus and could continue to transmit the virus to others,” PHE warned in its press release.

“We now know that most of those who have had the virus, and developed antibodies, are protected from reinfection, but this is not total,” Susan Hopkins, a senior medical adviser at PHE and the study lead, said in a statement, “and we do not yet know how long protection lasts.”

In other words, even if you’ve had Covid-19, while you’re unlikely to get really sick again anytime soon, you should still consider yourself a potential risk of spreading it to others if you catch the virus again and are asymptomatic. That means continuing to take precautions — like mask-wearing and social distancing, Iwasaki added. And it’s one reason why immunologists have said people who’ve already been infected with the virus should still plan to get the vaccine when their turn comes.

So there’s still a lot more to learn about immunity after Covid-19: How will the new coronavirus variants affect it? Lab data from South Africa, where the 501Y.V2 variant has been spreading, suggests it might be able to escape antibodies produced by prior infections in some people.

Who is most likely to have a strong immune response? We do have some evidence that different individuals mount different antibody responses after Covid-19 infections, but the PHE researchers found no statistically significant difference in rates of protection between people who reported symptoms and those who did not. It’s also possible factors like gender and disease severity influence the strength of a person’s immune response.

For now, though, the research suggests that survivors of the virus might just help us get to herd immunity faster — if their immunity lasts long enough. But given the virus has only been known to humans for a little over a year, it may take a while to authoritatively answer the question.

Scientists are increasingly concerned about a rapidly spreading variant of the virus that causes Covid-19 that was first detected in South Africa. The variant may be more transmissible and could weaken protection from vaccines and prior infections.

There’s evidence from several small, and not-yet-peer-reviewed, studies that mutations in the South Africa variant — known as 501Y.V2 or B.1.351 and already present in at least 23 countries — may lead to reinfections in people who’ve been sick and still should have some immunity.

This 501Y.V2 variant is one of several seemingly more contagious variants of the new coronavirus currently in circulation. For instance, the B.1.1.7 variant that was first identified in the United Kingdom has already spread to several countries, and public health officials expect it will soon become dominant in the US.

But the variant first identified in South Africa is perhaps more alarming because of the prospect that the mutations it contains could limit the effectiveness of existing vaccines, one of the best tools we have for controlling the pandemic.

In their latest report, Moderna — the maker of one of two vaccines on the US market — found the British variant didn’t affect the levels of virus antibodies in the blood of people who had been vaccinated relative to prior variants, but the same wasn’t true for the South Africa strain. “These lower [antibody levels/titers] may suggest a potential risk of earlier waning of immunity to the new B.1.351 strains,” according to a January 25 press release.

The results of this and other recent studies are “a serious indication we have to look hard at how well vaccines might work,” Penny Moore, a virologist at the National Institute for Communicable Diseases in South Africa, told Vox. Taken together, they highlight the dangers of letting Covid-19 spread unchecked, and portend the challenges that lie ahead as the virus continues to evolve.

What the coronavirus variant discovered in South Africa might mean for Covid-19 vaccines

For the Moderna study, which is not yet peer-reviewed, researchers took the blood of eight people who had been vaccinated, as well as two monkeys, and tested it to see how the antibodies responded to the new variants compared with older versions of the virus. The UK variant did not seem to affect an individual’s antibody levels, but the South Africa variant did, reducing them by sixfold relative to older variants.

The company said that even the reduced antibody titers are high enough to still offer protection against the virus, meaning the vaccine will likely still prevent illness stemming from the 501Y.V2 variant. However, it points toward a path of mutations where the level of protection could erode faster than it would against older versions of the virus, increasing the risk of reinfection.

Moderna is now investigating how to reformulate its vaccine to better target the 501Y.V2 variant, while also studying whether an additional booster shot of its current vaccine could increase the levels of antibodies that can neutralize the variant.

The Moderna news comes after studies from other labs have arrived at similar conclusions. For a preprint paper (i.e., non-peer-reviewed) led by Rockefeller University scientists, researchers tested blood samples from 14 people who had received the Moderna vaccine and six who were immunized with the Pfizer/BioNTech vaccine. One particular mutation, named E484K, along with two others found in the South Africa variant, were associated with a “small but significant” drop in antibody activity, the researchers found.

Moore, of the National Institute for Communicable Diseases in South Africa, is the lead author of a new study on 501Y.V2, out as a preprint on BioRxiv. She and her team in South Africa took blood plasma samples from 44 people who had been infected with the coronavirus during the country’s first wave of infections last summer, and checked how their existing antibodies responded to 501Y.V2 as well as older variants.

The researchers sorted the plasma samples into categories — high and low antibody concentrations. In 21 cases — nearly half — the existing antibodies were powerless against the new variant when exposed in test tubes. This was especially true for plasma from people who had a mild previous infection, and lower levels of antibodies, to begin with.

These findings suggest immunity from previous versions of the virus might not help individuals fend off the new variant if they’re exposed, particularly if their prior case was mild or symptom-free.

For Fred Hutchinson Cancer Research Center scientist Trevor Bedford, who was not involved in the research, the study also came as a possible warning sign about the vaccines. As early as autumn this year, manufacturers may need to begin reformulating their shots to respond to the changes in the virus’s genetic code, he wrote on Twitter:

The specific mutation scientists are most worried about

The 501Y.V2 variant carries one mutation of particular concern, known as E484K. This change appears in the part of the virus, the spike protein, that fits into the receptor in human cells. The spike protein is also the major target for the currently available mRNA vaccines, from Pfizer/BioNTech and Moderna.

“This mutation sits right in the middle of a hotspot in the spike,” Moore said. And it’s become notorious among virologists for its ability to elude coronavirus antibodies.

Scientists have demonstrated how this might happen in other cell culture experiments. A new study, also in preprint form from South African researchers, took a similar approach to Moore’s — testing how antibodies from six convalescent plasma donors react to 501Y.V2. But this time they used live virus, considered “the gold standard for these experiments,” said study co-author Richard Lessells, a University of KwaZulu-Natal infectious disease specialist. And their findings pointed in the same direction: 501Y.V2 can — at least in the lab — escape the antibody response elicited from a prior infection, and the E484K mutation “has the clearest association with immune escape.”

In another recently published BioRxiv preprint, researchers in Washington state tracked how mutations altered the effectiveness of the antibody response in convalescent plasma of 11 people — and also found E484K had particularly potent antibody evasion capabilities.

Other variants of concern also carry the E484K mutation, including one first identified in Manaus, Brazil, known as P.1. And one case study suggests reinfection in some people might be possible when they’re exposed to the new variant.

In a preprint, researchers in Brazil documented the case of a 45-year-old Covid-19 patient with no comorbidities, who, months after her first bout with the illness, was reinfected with the new variant. The patient experienced more severe illness the second time around. While it’s limited evidence, it “might have major implications for public health policies, surveillance and immunization strategies,” the authors wrote.

The study’s broader context is also concerning: After up to three-quarters of the population in Manaus, Brazil, was estimated to be infected with the virus during a spring surge, cases are piling up again and hospitals are filling up. Researchers suspect reinfections with the new variant could be a driver.

“The news is not all grim”

But “the news is not all grim,” said University of Utah evolutionary virologist Stephen Goldstein. The Rockefeller University preprint found antibodies from the vaccine may be more potent than antibodies from a previous infection. And the antibodies induced by the vaccines “are so high to start with that the serum was still extremely potent against the mutant.”

To fully understand the threat the mutations pose to vaccines, we’ll need clinical trials involving vaccinated people, Moore said. “These studies flag a problem,” she added, “but how that translates to real life, we can’t tell.”

There’s also huge variation in immune responses among people, Goldstein said. In the Washington paper, the researchers found “extensive person-to-person variation” in how the mutations affected an individual’s antibody response.

“The bottom line there is some reason for concern about reduced efficacy, but efficacy will not fall off a cliff,” Goldstein said. “The vaccines are incredibly potent. … If [they go] from 95% [efficacy] to 85% or even a little lower, we are still in great shape.” That’s why researchers and public health officials are heavily advocating for everyone to be vaccinated as quickly as possible.

Even so, Moore cautioned: “From an immune escape point of view, the variants first detected in Brazil and South Africa are more of a concern, but this is just the beginning. It’s our first indication that this virus can and does change.”

It’s possible that as we learn more, even the E484K mutation won’t turn out to undermine the vaccines. But there may be other changes to the virus lurking out there or evolving that will escape even vaccine-induced antibodies. “So many people now are infected that this is an arms race — the virus is now given every opportunity to mutate,” Moore said, “so it can take those steps on the pathway to immune escape more easily.”

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THE GPA HAVE backed Antrim’s bid to have their Ulster SFC opener against Cavan played at Corrigan Park next month. 

The Saffrons were drawn first out of the hat for the 23 April clash, handing them their first home championship game in nine years.

But an Ulster county board meeting last week saw delegates vote in favour of a Cavan motion to move the game out of the Belfast venue. Only Antrim, Tyrone and Derry voted against the motion.  

The Breffni County requested a change of venue due to Corrigan Park’s capacity of around 3,700. It is being used as Antrim’s home pitch while Casement Park remains closed for a development which has stalled for years.

A switch to a neutral venue in Armagh or Omagh was mooted it the game was moved.

The GPA are standing by Antrim’s case to retain home advantage and insist the game should take place at the original venue.

“So long as the ground can host the game safely which appears to be the case, it is only fair and proper that the game should go ahead in Corrigan Park as per the draw last November,” a GPA spokesperson told The42.

A final decision has not been made on the matter yet. Antrim are set to state their case at an Ulster CCC meeting on Wednesday night.

Meanwhile, Wexford GAA have pulled out of a planned event on Friday due to the GPA’s dispute with the GAA over travel expenses. 

Darragh Egan and a number of hurlers were due to give interviews.

“It has now been decided to postpone the media interview opportunity aspect of the event,” a statement said

“This is due to the current GPA request to players for non-engagement with the media.”

-Additional reporting by Sinéad Farrell

Ireland internationals Devin Toner and Lindsay Peat were our guests for The Front Row’s special live event, in partnership with Guinness, this week. The panel chats through Ireland’s championship chances ahead of the final round of Guinness Six Nations matches, and members of the Emerald Warriors – Ireland’s first LGBT+ inclusive rugby team – also join us to talk about breaking down barriers in rugby. Click here to subscribe or listen below:

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Since December, a handful of fortunate end-of-day shoppers have received coveted doses of the coronavirus vaccine by simply being in the right place at the right time. That place, during a pandemic, could be a Safeway or a Walgreens. Some of these recipients are young and healthy adults, and have likened their surprise immunization to winning the lottery.

As the country embarks on a decentralized Covid-19 vaccine rollout program, grocery stores and pharmacies are at the forefront of inoculating local residents and, in some cases, issuing leftover doses to whoever might be available. Some social media users have joked about hanging around pharmacies near closing time in the hope of receiving a leftover vaccine dose, instead of allowing it to go to waste.

Los Angeles County, for example, has no official standby line for the coronavirus vaccine, but hundreds of “vaccine chasers” — young people, entire families, and even seniors unable to secure an appointment — have flocked to sites countywide in the hopes of receiving an expiring shot. Getting a vaccine depends on who you know and access to local news: The Los Angeles Times reported that those waiting outside clinics “heard about the opportunity through word of mouth in their social and professional networks,” and some hailed from wealthier neighborhoods.

State and local jurisdictions are being recommended by the Centers for Disease Control and Prevention to issue their first vaccine doses to health care personnel, residents of long-term care facilities, and, more recently, adults over 65 and anyone with underlying medical conditions. These are only recommendations, though. Governors and individual vaccination sites are in charge of implementing their own vaccine prioritization plans. As coronavirus cases rise, state officials are amending their vaccine guidelines to include a larger population of people.

The US is lagging behind its projected vaccination goal of 20 million people by the end of 2020; only about 9 million people have received the vaccine’s first dose as of January 11. The two available vaccines, made by Moderna and Pfizer/BioNTech, have to be injected within hours after the doses are thawed from subzero storage temperatures, which complicates their distribution. Health and state officials have begun urging medical providers to consider vaccinating lower-priority groups to minimize vaccine wastage. As a result of these logistical hiccups, a small group of healthy, low-priority people has been administered the vaccine as a measure of last resort.

A number of these random immunizations (that have been publicly documented, at least) have occurred in Washington, DC, where local health officials have encouraged pharmacists to adopt a zero-waste policy. A DC-based law student posted a viral TikTok of his Moderna shot, which he was offered while grocery shopping at a Giant Food. A DC-based reporter was inoculated at Safeway after hearing an in-store announcement that its pharmacy had extra doses left. A DC couple was able to get on a Safeway pharmacy waitlist to receive end-of-day vaccines for when priority patients fail to show up for one.

There have been a few instances reported elsewhere as well: A Louisville couple made news for receiving a Christmas Eve vaccine at a local Walgreens. “[A friend] called us, and we ran right up. It was pure luck,” the recipient told the Courier Journal. The pharmacy later said it sought to prioritize its excess doses to first responders, Walgreens staff, and senior residents as the news garnered attention.

Sudden time-sensitive incidents such as a malfunctioning hospital freezer in Ukiah, California, have forced providers to make rapid distribution decisions with little forethought. But there are also instances of those looking to jump the line if providers are disorganized. The Los Angeles Times reported that at one South LA vaccination site in early January, about 100 people received vaccines without being asked to show proof that they worked in the health care industry.

These stories of circumstantial — even chaotic — vaccinations might provide a semblance of hope for those who fall further down the priority list. According to Business Insider, pharmacies and grocery stores in the DC metro area are already fielding “tons of calls” from interested recipients eager to get on a vaccine waitlist. These last-minute lists in DC, however, have quickly filled up via word of mouth. A pharmacy manager in Pennsylvania told the local Fox News station that it only takes names of those eligible under the state’s 1A categorization, which includes health care workers and residents of long-term care facilities, for its “do not waste” list. (The Food and Drug Administration and the federal government have yet to issue guidelines on who these extra doses should go to.)

These waitlists and random occurrences aren’t necessarily cause for optimism, though, especially as the vaccination timeline for most Americans remains unclear and varies from state to state.

“There has been outsized media and social media attention to the number of people this has happened to,” Josh Michaud, associate director for global health policy of the Kaiser Family Foundation, told Vox. “It’s a good approach to not waste vaccine doses at the end of the day … but in the grand scheme of things, it’s going to be a marginal contribution to vaccinations. The bulk of vaccinations being done at pharmacies are for those who fit into the prioritization groups and made appointments.”

It’s possible that vaccine providers might no longer need to resort to waitlists or last-minute immunizations, Michaud said, since the federal government has revised their vaccine recommendations: “We’re seeing more states moving in that direction, so the phenomenon of finding a random person might become less common, simply because there will be more people who fit into those higher-priority categories.”

The public desperation for a last-minute shot signifies a top-down failure of the federal government: Officials have largely ignored expert warnings of the potential for logistical hindrances, and there is no cohesive communication campaign to inform Americans when they’re available for a shot. Even as providers do their best to minimize vaccine waste, the disorganized rollout makes it harder for higher-risk Americans to receive the first vaccine dose. This approach “undercut[s] the needs-based approach to those who are savvy and to those who realize what’s going on,” Arthur Caplan of the Division of Medical Ethics at New York University told Business Insider.

The US population has a long way to go to reach herd immunity — which may require 70-85 percent of the population vaccinated — in order for normal life to resume. Officials have maintained that the more people who get vaccinated, the better, and so the general interest toward these random store vaccinations is a good thing. But most members of the public won’t be able to skip the wait, unlike the lucky few on social media, no matter how often they stop by their local pharmacy.

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The rapid spread of new variants of the coronavirus, some of which seem to be more contagious than older versions, has experts in the US calling for stricter social distancing and better masking to avoid yet another big surge of new Covid-19 cases and deaths.

Health advocates and epidemiologists are particularly concerned about what will happen once the new variants find their way into prisons, jails, and immigration detention facilities.

Across the US, at least one in five incarcerated individuals has already been infected with Covid-19, and a disproportionate number of them have died. One study found that the 2.3 million Americans living behind bars have twice the risk of dying from Covid-19 as a similar person who is not.

Jaimie Meyer is an associate professor at Yale School of Medicine and a researcher and clinician who specializes in the spread of infectious diseases behind bars. The pandemic “has laid bare [and] exposed the issues around conditions in confinement,” she told Vox, including how difficult or impossible it is to truly safeguard those held behind bars. In its quest to survive, Covid-19 will find “all of the holes [in our public health strategy] … all of the weaknesses, and pressure test them” she added. “If facilities have not done something to keep people safe, a more highly transmissible strain will spread like wildfire.”

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An epidemiological nightmare

Prisoners are at an increased risk of Covid-19 for a simple reason: how the virus spreads. Scientists now know that the illness is mostly passed from person to person through respiratory droplets and sometimes through the air, which is why being in sustained, close proximity to others is so risky — and why crowded prisons and jails are especially dangerous. Contagion also frequently happens even before someone has symptoms, making it impossible to know who to isolate without frequent, rapid, near-universal testing.

“Congregate settings in general, and prisons in particular, are places where physical distancing is impossible,” said Meyer. Moreover, she added, people in prisons are more likely to have certain medical conditions, including obesity and diabetes, that put them at greater risk of infectious diseases.

The epidemiological realities of Covid-19 have been exacerbated by the failures of elected officials and institutions whose job it is to protect those who are incarcerated. Chris Beyrer, a professor of public health and human rights at Johns Hopkins, has been a vocal critic of Maryland’s approach to managing the crisis. In December, cases of the virus in the state’s prisons more than doubled.

“The single most important thing you have to do to deal with Covid in prison is to [reduce] overcrowding,” he told Vox. “We failed at that.” Although prison and jail populations dropped at the outset of the pandemic — mostly because fewer people entered the system due to virus concerns, rather than early release pushes — these populations are now on the rise again.

The second most important thing is to implement policies that can stem the spread of the disease, including social distancing and giving prisoners and staff masks and other essential supplies. “That, too, has been slow, inadequate, and insufficient,” Beyrer said. The Maryland Department of Corrections, he told Vox, isn’t providing free, unlimited bars of soap to people locked up in the state, leaving prisoners unable to do something as fundamental as wash their hands.

And the concerns don’t stop there. In facilities across the country, incarcerated people have reported a range of serious safety issues during the pandemic: correctional officers who refuse, or are not required, to wear masks; insufficient or failed efforts to test staff and incarcerated people; and the creation of new outbreaks by transferring Covid-positive prisoners to new facilities.

Meanwhile, vaccination has not even begun in most of the country’s prisons and jails, while those in other congregate settings — including nursing homes and homeless shelters — have been among the first in line to receive the shot.

“We are living through the failure of the basics of Covid prevention,” said Beyrer.

With all of these systemic shortcomings, many are extremely worried prisons and jails will be even harder hit when more contagious strains breach their walls. Early research has indicated that people infected with the new strain may carry higher viral loads, meaning that engaging in the same conduct — spending extended periods of time indoors without distancing — poses an even greater risk of spreading the virus than it did previously. For prisoners, that means that the worst outbreaks may be yet to come.

“A more infectious virus is only going to infect more people,” Beyrer said. “If more people are going to get infected, more people are going to die.”

“Scared as hell”

With so few resources to protect themselves and, in most places, no vaccine in sight, many prisoners are worried about the future. Jabriel Lewis is incarcerated at Allenwood federal prison in Pennsylvania. “That new strain got everybody in here scared as hell,” he said. “[I]f it gets into the federal institutions it could possibly mean a death sentence.”

For Michelle Angelina, a woman locked up in New Jersey’s Edna Mann facility, the threat posed by the new variants isn’t limited to the virus. The steps the prison system has taken to protect prisoners — shutting down all visitation, ending academic and substance abuse programming, and canceling religious services — will only be extended even further. “It’s putting an immense strain on all of us.”

Her concerns were echoed by Shebri Dillon, a woman incarcerated at Fluvanna Correctional Center at Virginia, who described the difficulty of spending “hours upon hours in a concrete cage, without seeing or hugging our children and family.”

“This new variant means an extension of all that pains us,” Dillon told Vox. “It is not a matter of if it will get in, but when.”

A matter of equity and public health

There are basic ways, however, to protect this large, vulnerable segment of the population — and the rest of the public at the same time.

For epidemiologists, advocates, and incarcerated people, the answer is to implement the policies they’ve recommended all along. “The implications of a more rapidly spreading Covid-19 variant in jails are clear,” said Robert Cohen, a physician who previously worked on Rikers Island and now serves on the Board of Corrections that oversees New York City’s jails. In addition to providing better access to basic PPE, sanitizing supplies, and testing, as many people as possible need to be released from prisons, jails, and other detention facilities, stressed Cohen, and all remaining incarcerated people and staff must be inoculated against the virus sooner rather than later.

In a handful of states, including Massachusetts and California, the vaccinations of prisoners have already begun — but in many places, including New York, they aren’t being prioritized for the vaccine.

Advocates say this reality is just another example of the inequitable impact of the virus on poor people and people of color, given that Black and Latinx individuals are locked up at many times the rate of their white peers. “Despite calling for equity in vaccine distribution, [New York’s] Gov. Cuomo has neglected incarcerated people even while rolling out vaccines to other congregate settings,” including homeless shelters, said Katie Schaffer, director of advocacy and organizing at Center for Community Alternatives, which provides programming and policy work to reduce incarceration across New York state.

While many incarcerated individuals are eager to be inoculated, vaccine hesitancy does exist inside prisons and jails, in no small part due to the long history of medical experimentation inside these facilities. Some agencies are providing incentives to encourage prisoners to participate, including video visits with family members and slightly shortened sentences, while outside initiatives have sought to educate prisoners about the vaccine and its safety. Since the two coronavirus vaccines in the US currently only have emergency approval from the FDA, it’s likely unlawful for correctional authorities to mandate that prisoners or staff receive the shot.

Releasing more prisoners and accelerating the vaccination of those left inside is not only a matter of human rights, say public health officials — it’s also a necessary step to protect the public at large.

There are indications that widespread infection inside these sorts of facilities easily spreads to the community and beyond. One study found that the March outbreak in Chicago’s Cook County jail contributed to about one in seven of the state’s total cases in the following month. Prisons have also incubated especially deadly variants of other illnesses, including strains of multi-drug-resistant tuberculosis.

“This is part of our public health,” said Meyer. “We should all want people who are in any congregate setting to have the best chance of preventing exposure and infection” — for their own health and safety as well as that of everyone else in the country.

Aviva Stahl is an award-winning investigative reporter who writes about how health care policy and scientific debates play out in the prison context. She’s written for a variety of outlets including Vox, the Guardian, and the New York Times, and can be followed at @stahlidarity.

THE TWO SIDES beaten in the 2021 All-Ireland series by the eventual champions Tyrone, met in Tralee on Saturday night.

Kerry and Mayo both entered the game unbeaten in the league to date, and while the spoils went to the home team, both remain in the top two spots in Division 1.

Part of the current leading football group, what can either take from the mid-March meeting on a night of torrential rain?

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Kerry dig deep for victory

There were clear parallels that could be drawn between Kerry’s Round 5 tie on Saturday and their Round 1 game in late January in Newbridge. They were in front 1-10 to 0-9 in the 58th minute against Kildare and were ahead of Mayo 1-10 to 0-10 in the 55th minute in Tralee.

Kerry didn’t move the scoreboard thereafter against Kildare, hauled back for a draw as they leaked the last four points of the match. On Saturday something similar looked set to happen as three Mayo points on the spin drew them level but Kerry found the wherewithal to push ahead twice through David Clifford frees, the last proving the match-winner.

In a bruising battle on a sodden night, it was easy to understand why Jack O’Connor was so satisfied afterwards. He cannot influence how lopsided Munster football has become in his team’s favour, they are standout favourites to add another provincial title to their collection by late May.

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That system will prompt concerns of them being undercooked by the time they reach the All-Ireland series. O’Connor’s awareness of that explains why he stressed after Saturday night’s game, that this was one they had explicitly targeted to collect a win.

Hitting the net and missing the target

A core strength of Mayo teams is their defensive prowess, specialist markers at the back allow them to push on further upfield. Padraig O’Hora and Oisin Mullin were principally detailed to protect the goalmouth on Saturday night, both taking up position next to David Clifford at different stages.

They were really only unlocked once, but it was a critical moment. Tony Brosnan skipped through in the 21st minute after a move he started himself, that availed of Lee Keegan slipping, with the swift passing of Clifford and Adrian Spillane also integral, before the Dr Crokes man slammed his shot to the net.

Kerry forward Tony Brosnan (file photo).

Source: Ben Brady/INPHO

Kerry were clinical when the first-half chance presented itself, Mayo in contrast were not. Aiden Orme’s connection was poor as he dragged a shot wide and Diarmuid O’Connor was denied by Shane Murphy’s intervention, both in the second quarter when raising a green flag would have boosted Mayo’s prospects.

If it seems a simplistic analysis, it’s worth thinking back to that aspect of last year’s All-Ireland final and how this can be a recurring issue for Mayo. Kerry have seven goals in this year’s league to date, joint highest in Division 1 with Armagh, and only bettered by Galway’s tally of nine across the top two tiers.

Absent attackers

Shortly before throw-in, there was a row of seats filled in the main stand at Austin Stack Park. David Moran, Dan O’Donoghue, Gavin White and Sean O’Shea amongst the group that filed in, a reminder of how Kerry’s depth had been tested. The absence of O’Shea, instrumental to Kerry’s progress this spring, was a reminder of how his playmaking talents at 11 will be central to Kingdom aspirations this year. Paul Geaney, a late withdrawal through illness, is another valuable option closer to goal.

Ryan O’Donoghue in action for Mayo against Kerry.

Source: Lorraine O’Sullivan/INPHO

Mayo lacked their own big-name forwards. Tommy Conroy’s season-ending knee problem will continue to be a source of regret for their camp. There has yet to be a sign of Cillian O’Connor in action since his Achilles tendon injury last June brought his year to a halt. Much of Mayo’s attacking strategy on Saturday night revolved around Ryan O’Donoghue as a focal point and if he didn’t score from play, he was a constant menace in winning frees, which he nervelessly converted. Fergal Boland weighed in with three impressive points but Mayo’s forward line lacked the necessary output to win this.

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President Joe Biden on Thursday set a new goal for Covid-19 vaccines in the US: 200 million shots in his first 100 days in office. That’s up from Biden’s original goal of 100 million in 100 days. “I know it is ambitious — twice our original goal,” Biden said.

But the goal of 200 million shots in 100 days is really not that ambitious; it’s achievable if absolutely nothing changes with America’s current vaccine rollout.

That’s a testament to how much America’s vaccine campaign has improved since Biden took office. Before Inauguration Day, the country administered less than 1 million shots a day. Today, the US is at 2.5 million shots a day, on average.

At the current rate, the country could hit Biden’s goal of 200 million shots in 100 days — hitting the goal as soon as April 28, a couple days before Biden’s 100th day in office.

Things stand to improve beyond the current rate. As vaccine manufacturers ramp up production, they’ve already made deals with the federal government to deliver enough vaccines for every adult in the summer. At the very least, that should address questions about the supply of vaccines, though not about distribution or willingness to take them.