The Moderna vaccine is now in some Americans’ arms as COVID-19 cases in the US pass 18 million

As the number of COVID-19 cases reported in the United States passed 18 million, the second vaccine given emergency authorization was being administered Monday for the first time outside of clinical trials.

One of the first people to get a public dose of the Moderna COVID-19 vaccine was a doctor in Texas who has gone to work, fighting the virus for 277 consecutive days.

“This is like having gold,” Dr. Joseph Varon told CNN as he held a box of doses shortly before he was vaccinated. “I don’t cry, but I came very close … You know how many lives you can save with this?”

Varon was the first at his hospital to get the vaccine in an effort to assure staff and the largely minority community he serves that the vaccine is safe.

As of Monday, at least 18.01 million people have been infected with coronavirus, and more than 319,000 people in the US have died, according to Johns Hopkins University.

Varon, a critical care doctor and chief of staff at United Memorial Medical Center in Houston, said he has signed far more death certificates during this pandemic than he could have ever imagined. And some of his staff members have fallen sick with COVID-19.

Varon said those working in the COVID unit will get the vaccine first followed by staff assigned to the emergency room.

President-elect Joe Biden and his wife, Jill, received their first doses of the Pfizer-BioNTech vaccine on Monday at a hospital in Newark, Delaware..

“We owe these folks an awful lot,” Biden said, thanking those involved in the vaccine’s development and distribution and frontline health care workers.

Biden said the Trump administration deserved “some credit” for Operation Warp Speed, the federal government’s vaccine program, and their role in making coronavirus vaccinations possible.

Dr. Anthony Fauci, Dr. Francis Collins, and Health and Human Services Secretary Alex Azar will be vaccinated against COVID-19 on Tuesday.

Collins, the director of the National Institutes of Health (NIH), said on Twitter that he will receive Moderna’s vaccine, alongside Azar, Fauci, the director of the National Institute of Allergy and Infectious Diseases, and other NIH frontline workers.

As of Monday morning more than 614,000 Americans have received a vaccine shot, according to the US Centers for Disease Control and Prevention’s COVID Data Tracker.

Most Americans will have to wait months before getting their inoculations.

In the meantime, new infections, hospitalizations and deaths keep soaring, prompting health experts to urge the public to stay home this Christmas week.

“This is really not the time to be traveling,” epidemiologist Dr. Celine Gounder said.

But millions of airline passengers ignored such advice and traveled over the weekend.

Now travelers risk getting infected with a variant of coronavirus that might be even more contagious.

‘These viruses mutate all the time’

A variant of the virus is spreading rapidly in the UK, prompting dozens of travel bans and raising concerns about what this means for the world.

England’s Chief Medical Officer Chris Whitty warned Saturday that the variant “can spread more quickly” and was responsible for 60% of new infections in London.

On Monday, an epidemiologist from the World Health Organization explained why the variant might be infecting more people.

“We are hearing that it could spread up to 70% faster, but what that means is there are scientists in the UK that are evaluating the surveillance data, the genomic sequencing data, and looking at the spread in parts of England and across England,” said Maria Van Kerkhove, the technical lead for COVID-19 for the WHO.

“What they’re seeing is that the reproduction number — so this is the number of individuals that an infected person transmits to — has increased from 1.1 to 1.5 … I just want to put into context this up to 70% increase.”

Van Kerkhove said scientists are trying to determine “how much of that is associated with the variant itself, as well as behavioral differences in individual that this variant has infected. So they’re still working through that right now.”

The increase is happening even as interventions are in place across England, she said.

“It does mean that we have to work a little bit harder about preventing the spread,” she said. “But, what we do know is that the interventions that work about preventing the spread for this variant also work for the viruses that are circulating around.”

Those interventions include physical distancing and wearing masks. “These viruses mutate all the time,” Van Kerkhove said.

Operation Warp Speed chief science adviser Moncef Slaoui said while there’s “clear evidence that there is more of it in the population,” so far “there is no hard evidence that this virus (variant) is actually more transmissible.”

There’s also no evidence so far to suggest the new variant is more lethal, or that current vaccines wouldn’t work against it, Whitty said.

But a virus that spreads more easily could result in more infections, which in turn might lead to more hospitalizations and deaths.

Backward tracing using genetic evidence suggests the new UK variant emerged in September and then circulated at very low levels in the population until mid-November, according to Public Health England.

At least 24 countries are now banning passenger travel from the UK, including Canada, Russia, France, Chile, Italy, Iran and Sweden.

As of Monday morning, there are no plans to enact a US travel ban against the UK, US Assistant Secretary for Health Adm. Brett Giroir said.

British Airways, Delta Airlines and Virgin Atlantic have agreed to require a COVID-19 test before allowing passengers to board planes traveling from the UK to New York, Gov. Andrew Cuomo told CNN.

Gounder said a travel ban might not do much good now. “We have seen this virus circulating within the UK for at least a few months now,” Gounder said. “Because this virus has been circulating for some period of time in the UK already, the cat’s out of the bag. It has spread elsewhere, including the United States.”

Travel bans can also backfire, Gounder said.

“As we saw when there were efforts to ban travel from China before, people rushed to travel. So the likelihood (is) that that could backfire — that people will actually travel more, all of a sudden, in advance of impending bans.”

Will the vaccines work against the new variant?

Both the Pfizer/BioNTech vaccine and the Moderna vaccine have shown efficacy rates of around 95% in clinical trials. But many are questioning whether the vaccines would work on variants of the virus — like one that is spreading in the UK.

“Up to now, I don’t think there has been a single variant that would be resistant to the vaccine,” Slaoui sad. “We can’t exclude it, but it’s not there now.”

He said the novel coronavirus may be prone to variance. But critical aspects of the virus, such as the spike protein involved in a vaccine, are very specific to the novel coronavirus and unlikely to mutate much.

Giroir also said he thinks the current vaccines will work against the variant.

“Remember, our vaccines develop antibodies against multiple parts of that spike protein — not just one that’s the mutated one,” he said.

Scientists at the Walter Reed Army Institute of Research are examining the variant and expect to know in the next few days whether vaccines might not work against it.

But most Americans can’t get vaccinated for months.

“So I think what we really need to be doing is focusing on the things we know will prevent spread of this new variant — which is the same thing that works against spread of the coronavirus in general,” Gounder said.

“That is masks, social distancing. If you’re going to be around other people, do it outdoors. And with the holidays coming up, this is really not the time to be traveling.”

No more ICU capacity

The US recently broke records for daily COVID-19 infections reports, hospitalizations and deaths.

Health officials Monday reported the nation reached an all-time high of 115,351 current patients.

In Los Angeles County, an estimated one in every 64 residents is infected with coronavirus and “actively infecting others,” county health services director Christina Ghaly said Monday.

The county’s hospitals are full. About half of all intensive care unit patients are suffering from COVID-19 and about a third of regular hospital beds are filled with coronavirus patients, Ghaly said.

ICU capacity in Southern California and in the San Joaquin Valley remains at zero, with just 2.1% of ICU beds available statewide.

Guidelines on how Los Angeles County hospitals could prioritize patients by rationing care have been circulated among doctors at some area hospitals, the Los Angeles Times reported. Without enough staff to save every patient, doctors may soon be faced with just trying to save as many as possible.

“It’s heartbreaking, really, to see where we’re at,” Ghaly said.

Correction: An earlier version of this story and headline incorrectly described Assistant Secretary for Health Adm. Brett Giroir’s comments on vaccine distribution. Health officials are working to have enough doses for 20 million people distributed by the first week of January. He did not promise that 20 million people would be inoculated by that time.