COVID-19 Timeline: April 2021

February 17, 2022

At Bioethics.com we have kept up with the spread of COVID-19 and the related bioethical questions that this pandemic brings. The posts that follow highlights news from April 2021 and were originally posted at Bioethics.com. These posts focus on the bioethical issues that medical professionals, bioethicists, public health officials, and scientists grappled with as SARS-CoV-2 swept the globe.

April 1: “CDC Adds New Medical Conditions to COVID-19 High-Risk List” by Miriam E. Tucker, Medscape

The US Centers for Disease Control and Prevention has added several new medical conditions to its list of those that predispose adults to more severe COVID-19 illness. Conditions that had previously been categorized as “might be” placing individuals at increased risk — but now are listed as high risk — include type 1 diabetes (in addition to type 2), moderate-to-severe asthma, liver disease, dementia or other neurological conditions, stroke/cerebrovascular disease, HIV infection, cystic fibrosis, and overweight (in addition to obesity).

April 2: “Pfizer COVID-19 Vaccine Protects for 6 Months or More, Study Shows” by Damian McNamara, Medscape

The Pfizer/BioNTech COVID-19 vaccine affords at least 6 months of protection after the second dose, the companies announced today. The vaccine was 91.3% effective against COVID-19 in an analysis of 927 symptomatic people through March 13, as indicated by real-world data compiled since the vaccine was given emergency use authorization.

April 2: “Johnson & Johnson’s Vaccine Is Delayed by a U.S. Factory Mixup” by Sharon LaFraniere and Noah Weiland, The New York Times

Workers at a plant in Baltimore manufacturing two coronavirus vaccines accidentally conflated the ingredients several weeks ago, contaminating up to 15 million doses of Johnson & Johnson’s vaccine and forcing regulators to delay authorization of the plant’s production lines. The plant is run by Emergent BioSolutions, a manufacturing partner to both Johnson & Johnson and AstraZeneca, the British-Swedish company whose vaccine has yet to be authorized for use in the United States.

April 2: “Ethical Questions Surround Plans for COVID Vaccine Passports” by Marcia Frellick, Medscape

As discussions about “vaccine passports” accelerate with more people worldwide completing their COVID-19 shots, ethical quandaries are coming into focus.

April 2: “Johnson & Johnson Has Begun Testing Its Vaccine in Adolescents” by Apoorva Mandavilli, The New York Times

Johnson & Johnson on Friday became the third company to enter the race to expand the use of its coronavirus vaccine to adolescents. Researchers have begun testing the drug maker’s vaccine in adolescents 12 to 17 years old, the company announced.

April 5: “Vermont to Give Minority Residents Vaccine Priority” by Phil Galewitz, Kaiser Health News

States have tried with limited success to get covid vaccines to people of color, who have been disproportionately killed and hospitalized by the virus. Starting Thursday, Vermont explicitly gave Black adults and people from other minority communities priority status for vaccinations.

April 5: “Study: COVID-19 Vaccine Is Safe During Pregnancy And May Protect Baby, Too” by Jane Greenhalgh, NPR

Since the pandemic began, pregnant people have faced a difficult choice: to vaccinate or not to vaccinate. The risk of severe disease or even death from COVID-19 — while small — is higher during pregnancy.

April 6: “Vaccinating Africa: Countries Struggle to Deliver the Few Shots They’ve Got” by Dave Lawler, Axios

The first shipment of long-awaited coronavirus vaccines finally arrived in the Democratic Republic of the Congo on March 3. One month later, they’re still sitting in a warehouse in the capital, Kinshasa. Why it matters: Africa is at the back of the global line for vaccines, and most countries only expect enough doses to cover a fraction of their populations this year. But in some cases, even those limited supplies may not be fully deployed before they expire.

April 6: “Covid-19’s Ground Zero Shifts to India” by Eric Bellman and Vibhuti Agarwal, The Wall Street Journal

Ground zero of the world’s Covid-19 outbreak shifted to India Monday as it recorded more than 100,000 fresh cases for the first time, topping the daily totals everywhere else in the world. The South Asian nation is locking down neighborhoods and restricting travel again even as it tries to ratchet up its vaccination drive to save lives and salvage its nascent economic recovery.

April 7: “UK Variant of COVID-19 Is Now Most Common Strain in United States: CDC” by Susan Heavy and Carl O’Donnell, Reuters

The highly contagious variant of COVID-19 first discovered in the United Kingdom has become the most common strain of the virus in the United States as cases continue to climb, a top U.S. health official said on Wednesday. The strain, known as B.1.1.7, was identified in Britain last fall and has since been detected in 52 jurisdictions in the United States, U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky told reporters at a White House briefing.

April 7: “EU Drug Regulator: Unusual Blood Clot Is ‘Very Rare AstraZeneca Side Effect’” by BBC

The EU’s medicines regulator says unusual blood clots should be listed as a very rare side effect of the AstraZeneca vaccine for Covid-19. After a study looking at 86 European cases, the European Medicines Agency (EMA) concluded the benefits of the vaccine outweighed the risk. The report reflected data on 25 million Europeans administered with the jab.

April 8: “‘Beyond a Reasonable Doubt’: COVID-19 Brain Health Fallout Is Real, Severe” by Sarah Edmonds, Medscape

COVID-19 survivors face a sharply elevated risk of developing psychiatric or neurologic disorders in the six months after they contract the virus — a danger that mounts with symptom severity, new research shows. In what is purported to be the largest study of its kind to-date, results showed that among 236,379 COVID-19 patients, one third were diagnosed with at least one of 14 psychiatric or neurologic disorders within a 6-month span.

April 8: “Countries Worldwide Hit New Records for Virus Cases, Deaths” by Michelle R. Smith, Associated Press

Nations around the world set new records Thursday for COVID-19 deaths and new coronavirus infections, and the disease surged even in some countries that have kept the virus in check.

April 8: “12 Months of Trauma: More Than 3,600 US Health Workers Died in Covid’s First Year” by Jane Spencer, The Guardian and Christina Jewett, Kaiser Health News

More than 3,600 U.S. health care workers perished in the first year of the pandemic, according to “Lost on the Frontline,” a 12-month investigation by The Guardian and KHN to track such deaths. Lost on the Frontline is the most complete accounting of U.S. health care worker deaths.

April 8: “Study: Around 40,000 US Children Lost a Parent to COVID-19” by Aris Folley, The Hill

According to a study published in the American Medical Association’s JAMA Pediatrics journal on Monday, an estimated 37,300 to 43,000 U.S. children experienced the loss of at least one parent due to COVID-19 in the past year. A closer look at the data found that the burden, which authors of the study acknowledge will likely “grow heavier” amid the ongoing pandemic, has landed disproportionately on Black children.

April 9: “Japanese Doctors Perform World’s First Living Donor Lung Transplant to a Covid-19 Patient” by Julia Hollingsworth and Emiko Jozuka, CNN

A Japanese woman whose lungs were severely damaged by Covid-19 has received what doctors say is the world’s first lung transplant from living donors to a recovered coronavirus patient.

April 9: “No Region in the World Spared as Virus Cases, Deaths Surge” by Venessa Gera, Associated Press

Hospitals in Turkey and Poland are filling up fast. Pakistan is restricting domestic travel to bring a surge in coronavirus infections under control. Even Thailand, which has weathered the coronavirus pandemic far better than many nations, is now struggling to contain a new COVID-19 surge. Even countries where vaccine rollouts are finally getting some momentum, infections, hospitalizations and deaths are surging.

April 9: “EU Agency Examines Reports of Blood Clots with J&J Covid Vaccine” by The Guardian

The EU’s drug regulator has launched a review of possible links between the Johnson & Johnson coronavirus vaccine and blood clots after reports of four cases, one of them fatal. The European Medicines Agency (EMA) said its safety committee had “started a review of a safety signal to assess reports of thromboembolic events” in people who had received the shot.

April 12: “Recent Rise in U.S. Covid-19 Cases Driven by Younger People” by Melanie Grayce West and Talal Ansari, The Wall Street Journal

Younger people who haven’t been vaccinated are helping drive a rise in new Covid-19 cases, health officials are finding. Five states—Michigan, New York, Florida, Pennsylvania and New Jersey—account for some 42% of newly reported cases. In Michigan, adults aged 20 to 39 have the highest daily case rates, new data show. Case rates for children aged 19 and under are at a record, more than quadruple from a month ago.

April 12: “Chinese Covid-19 Vaccine Efficacy Is ‘Not High,’ Top Health Official Admits” by Nectar Gan, CNN

The efficacy of Chinese Covid-19 vaccines is “not high” and authorities are weighing options to bolster protection — including mixing different shots, China’s top disease control official has said. “The protection rates of existing vaccines are not high,” Gao Fu, director of the Chinese Center for Disease Control and Prevention, told a conference in the southwestern city of Chengdu on Saturday.

April 12: “More Colleges Say They’re Require Students to Have Covid-19 Vaccines for Fall” by Elissa Nadworny, NPR

Duke University in North Carolina has announced that it will require students to have a COVID-19 vaccine when they return this fall. And the list of campuses with such policies is growing. Rutgers University in New Jersey was the first, and since then more than a dozen residential colleges have followed. The University of Notre Dame; two Ivy League universities, Brown and Cornell; and Northeastern University in Massachusetts are among those requiring the vaccine for the fall. Cleveland State University will do so for all students living on campus.

April 13: “COVID-19 Surge in Canada Prompts Alarm, Stay-in-Place Orders” by Damian McNamara, Medscape

As millions more US residents are receiving COVID-19 vaccinations each day — including a record-breaking 4.6 million on April 10 — Canada is facing an increasingly dire situation. Over the weekend, the per capita rate for new SARS-CoV-2 infections surpassed the rate in the United States.

April 13: “US Recommends ‘Pause’ for J&J Shots in Blow to Vaccine Drive” by Zeke Miller, Lauren Neergaard, and Matthew Perrone, Associated Press

The U.S. on Tuesday recommended a “pause” in using the single-dose Johnson & Johnson COVID-19 vaccine to investigate reports of rare but potentially dangerous blood clots, setting off a chain reaction worldwide and dealing a setback to the global vaccination campaign.

April 13: “Covid Spawns ‘Completely New Category’ of Organ Transplants” by JoNel Alecci, Kaiser Health News

Nearly six months later, the transplant landscape has radically changed. Covid-related transplants are surging as hospitals grapple with a growing subset of patients whose organs — most often hearts and lungs — are “basically destroyed by the virus,” said Dr. Jonathan Orens, a lung transplant expert at Johns Hopkins University School of Medicine in Baltimore.

April 13: “Three Virus Patients Die at a Hospital in Romania After Its Oxygen Supply Malfunctions” by Kit Gillet, The New York Times

Three people infected with the coronavirus died at a hospital in Bucharest on Monday evening after the oxygen supply stopped functioning, according to the authorities, the latest incident involving oxygen failure, which in many countries has driven up the virus death toll. It was also another fatal setback for Romania’s ageing and overwhelmed health care system, which has suffered two fires in Covid-19 wards in recent months, killing at least 15 people.

April 14: “ Hospitalization Not Rare for Children With COVID, Study Says ” by Carolyn Crist, Medscape

About 12% of U.S. children with COVID-19 were hospitalized in 2020, and nearly a third of those had severe disease that required mechanical ventilation or admission to an intensive care unit, according to a new study published in JAMA Network Open on Friday. That means about 1 in 9 kids with COVID-19 needed hospitalization, and about 1 in 28 had severe COVID-19.

April 16: “COVID-Related Inflammatory Syndrome Tied to Neurologic Symptoms in Kids” by Erik Greb, Medscape

About half of children with pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) have new-onset neurologic symptoms, research shows. These symptoms involve the central and peripheral nervous systems but do not always affect the respiratory system. In addition, neurologic symptoms appear to be more common in severe presentations of this syndrome.

April 16: “Vaccines Carry Far Lower Risk for Rare Blood Clots Than COVID, Study Shows” by Peter Russell, Medscape

The risk of developing cerebral venous thrombosis (CVT) from COVID-19 was “many-fold” higher than from receiving the AstraZeneca/Oxford or the mRNA vaccines from Pfizer and Moderna, researchers have concluded.

April 16: “Shortage of Intubation Drugs Threatens Brazil Health Sector” by Diane Jeantet and David Biller, Associated Press

Reports are emerging of Brazilian health workers forced to intubate patients without the aid of sedatives, after weeks of warnings that hospitals and state governments risked running out of critical medicines. One doctor at the Albert Schweitzer municipal hospital in Rio de Janeiro told the Associated Press that for days health workers diluted sedatives to make their stock last longer. Once it ran out, nurses and doctors had to begin using neuromuscular blockers and tying patients to their beds, the doctor said.

April 20: “India’s New Delhi Locks Down as Covid-19 Stretches Healthcare System to Its Limits” by Vibhuti Agarwal and Shan Li, The Wall Street Journal

India imposed a lockdown on its capital city and said it would expand its vaccination program to all adults, as the country struggled to keep the world’s fastest-growing surge of Covid-19 infections from overwhelming its healthcare system.

April 20: “Brazil Has S. Hemisphere’s Highest Overall COVID-19 Death Rate” by Medical Xpress

Brazil, the country with the world’s second-highest COVID-19 death toll after the United States, also leads the Americas and the entire southern hemisphere in terms of its overall recorded death rate. With 176 deaths per 100,000 since the beginning of the outbreak, the country of 212 million has recently overtaken Peru (174 per 100,000), the United States (172 per 100,000) and Mexico (165 per 100,000) according to data gathered by AFP from official country reports.

April 20: “EU Agency Links J&J Shot to Rare Clots, Says Odds Favor Use” by Maria Cheng, Associated Press

The European Union’s drug regulatory agency said Tuesday that it found a “possible link” between Johnson & Johnson’s COVID-19 vaccine and extremely rare blood clots and recommended a warning be added to the label. But experts at the agency reiterated that the vaccine’s benefits outweigh the risks.

April 20: “‘No Place for You’: Indian Hospitals Buckle Amid Virus Surge” by Aniruddha Ghosal and Neha Mehrotra, Associated Press

Tests are delayed. Medical oxygen is scarce. Hospitals are understaffed and overflowing. Intensive care units are full. Nearly all ventilators are in use, and the dead are piling up at crematoriums and graveyards. India recorded over 250,000 new infections and over 1,700 deaths in the past 24 hours alone, and the U.K. announced a travel ban on most visitors from the country this week. Overall, India has reported more than 15 million cases and some 180,000 deaths — and experts say these numbers are likely undercounted.

April 21: “Pfizer Identifies Fake Covid-19 Shots Abroad as Criminals Exploit Vaccine Demand” by Jared S. Hopkins and Jose de Cordoba, The Wall Street Journal

Pfizer Inc. PFE 1.28% says it has identified in Mexico and Poland the first confirmed instances of counterfeit versions of the Covid-19 vaccine it developed with BioNTech SE, BNTX 3.60% the latest attempt by criminals trying to exploit the world-wide vaccination campaign.

April 21: “FDA Inspection Found Problems at Factory Making J&J Vaccine” by Linda A. Johnson, Associated Press

The Baltimore factory hired to help make Johnson & Johnson’s COVID-19 vaccine was dirty, didn’t follow proper manufacturing procedures and had poorly trained staff, resulting in contamination of material going into a batch of shots, U.S. regulators said Wednesday.

April 22: “Do Kids Really Need to Be Vaccinated for Covid? Yes. No. Maybe.” by Sara Talpos, Undark

Pfizer is not alone. Rival drugmakers Moderna and Johnson & Johnson are also testing their vaccines in teenagers, and all three companies have begun early trials in infants as young as six months old. It’s part of a groundswell of pharmaceutical science and public health messaging around what many experts view as the urgent next step in ending the Covid-19 pandemic: vaccinating adolescents and younger children.

April 22: “UK Reports 32 Deaths from Clots After AZ Jab” by Medical Xpress

A total of 168 people have suffered rare blood clots after taking the AstraZeneca coronavirus vaccine in Britain, and 32 have died, the UK’s medicines regulator said Thursday. The figures for clots or “thromboembolic events” run up to April 14, by when 21.2 million people had received first doses of the vaccine, according to the Medicines and Healthcare products Regulatory Agency (MHRA).

April 22: “Covid-19: Delhi Hospitals Run Out of Oxygen Supplies” by BBC

Six hospitals in the Indian capital Delhi have completely run out of oxygen and doctors say other hospitals have just a few hours’ worth of supply left. A number of people have died while waiting for oxygen, and more than 99% of all intensive care beds are full.

April 23: “Healthcare Providers Rarely Catch COVID-19 on the Job” by Reuters Staff, Medscape

Healthcare workers on the frontlines of the COVID-19 pandemic in the United States rarely become infected with SARS-CoV-2 through patient care, new research suggests. Researchers evaluated SARS-CoV-2 infections in a group of healthcare personnel (HCP) and found that most infections could not be linked to a patient or co-worker – suggesting that good adherence to infection-control procedures offer significant protection to HCP caring for COVID-19 patients.

April 23: “Japan Issues 3rd Virus Emergency in Tokyo, Osaka Area” by Mari Yamaguchi, Associated Press

Japan declared a third state of emergency for Tokyo and three western prefectures on Friday amid skepticism it will be enough to curb a rapid coronavirus resurgence just three months ahead of the Olympics.

April 26: “Millions Are Skipping Their Second Doses of Covid Vaccines” by Rebecca Robbins, The New York Times

Millions of Americans are not getting the second doses of their Covid-19 vaccines, and their ranks are growing. More than five million people, or nearly 8 percent of those who got a first shot of the Pfizer or Moderna vaccines, have missed their second doses, according to the most recent data from the Centers for Disease Control and Prevention.

April 26: “CDC Panel: End Pause of J&J Vaccine, but Add Warning” by Marcia Frellick, Medscape

Use of the Johnson and Johnson COVID-19 vaccine should resume in the United States for all adults 18 and over, an advisory panel for the Centers for Disease Control and Prevention (CDC) decided Friday.

April 26: “Virus Surge in Crowded Gaza Threatens to Overwhelm Hospitals” by Fares Akram, Associated Press

More than a year into the coronavirus pandemic, some of the worst fears are coming true in the crowded Gaza Strip: A sudden surge in infections and deaths is threatening to overwhelm hospitals weakened by years of conflict and border closures. Gaza’s main treatment center for COVID-19 patients warns that oxygen supplies are dwindling fast. In another hospital, coronavirus patients are packed three to a room.

April 27: “Iraqi Medics Recount Horrors from Baghdad’s Hospital Inferno” by Samya Kullab and Abdulrahman Zeyad, Associated Press

It was a night of unimaginable horror as flames engulfed the intensive care unit of a Baghdad hospital: deafening screams, a patient jumping to his death to escape the inferno and relatives staying by their loved ones, refusing to abandon coronavirus patients tethered to ventilators.

April 29: “Pfizer and Moderna Vaccines Appear Safe, Effective During Pregnancy” by Jaleesa Baulkman, Medscape

The Pfizer and Moderna COVID-19 vaccines appear to be safe in pregnant patients, according to preliminary findings published in the New England Journal of Medicine. The Centers for Disease Control and Prevention have said pregnant people have an increased risk of being severely ill from COVID-19; however, this group was excluded from major clinical trials that led up to the current vaccine approvals.

April 29: “Brazil Covid-19 Variant Tears Through South America in Warning to World” by Luciana Magalhaes and Samantha Pearson, The Wall Street Journal

The surge here offers lessons for the rest of the world. The P.1 variant has spread to countries including Canada, where in the province of British Columbia, officials have recorded 2,062 cases of P.1 as of April 26, up from 974 as of April 9. Turkey and Hungary have struggled with large surges partly fueled by the more infectious U.K. variant. Doctors in India are studying whether new variants there might be adding to a record rise in cases and deaths. One variant, B.1.617, has already popped up in the U.S. and 18 other countries.

April 29: “Indians Turn to Black Market, Unproven Drugs as Virus Surges” by Aniruddha Ghosal and Neha Mehrotra, Associated Press

As India faces a devastating surge of new coronavirus infections overwhelming its health care system, people are taking desperate measures to try to keep loved ones alive. In some cases they are turning to unproven medical treatments, in others to the black market for life-saving medications that are in short supply.

April 30: “MIS-C More Likely to Strike Hispanic, Black Children” by Ronnie Cohen, Medscape

Hispanic, Black and poor youngsters are more likely to be diagnosed with multisystem inflammatory syndrome in children (MIS-C) than wealthier, white children, a small new study finds.

 

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