Global DEVELOPMENTS

• Europe has largely reopened to American tourists. The UK is not far behind, with planned lifting of quarantine restrictions on 19 July for those vaccinated through the NHS arriving from "amber list" countries. Fully vaccinated American tourists will be allowed into the UK later in the summer. See below map for breakdown.
• New cases are surging in Spain, the UK, and the Netherlands; however, deaths remain relatively flat, highlighting the power of vaccines in reducing hospitalizations and deaths.
  
• Southeast Asia, which has for the most part managed the pandemic well, is in the midst of a spike in cases, hospitalizations, and deaths due to the spread of the highly contagious Delta variant. Indonesia, Thailand, Malaysia, and the Philippines may experience shortages of hospital beds and oxygen in the coming weeks. Many countries in the region have imposed new restrictions.
  
• Latin America and southern Africa remain global hotspots for COVID-19 cases and deaths amid presence of variants and low vaccination rates.

UNITED STATES LATEST DEVELOPMENTS

• Maryland-based Novavax recently announced promising Phase 3 trial results for its protein-based vaccine. The two-dose vaccine has an estimated efficacy of 90.4% based on a study of 30,000 volunteers in the U.S. and Mexico. It expects to seek emergency authorization use later this year. It does not require special refrigeration and could be the key to vaccinating the third world. 
  
• Only Washington, Oregon, New Mexico, and Michigan have not fully reopened. Michigan and Washington will be open by 1 July while New Mexico and Oregon are waiting for residents to hit key vaccine milestones. 
  
• The U.S. announced it will buy 500 million doses of the Pfizer vaccine for distribution to 100 low-and middle-income countries.

For the latest United States case counts, click here.

UNITED STATES LATEST DEVELOPMENTS

• The U.S. CDC announced on 13 May that vaccinated individuals could resume activities that they had stopped doing during the pandemic. Masks are no longer recommended except when flying or taking public transit, when visiting health care facilities, and in congregate settings like prisons and homeless shelters. 
  
• Multiple states in the U.S. changed, or announced they were considering changes to mask mandates. Some private businesses will continue to require masks in their stores, likely until state-by-state vaccination rates meet an internal threshold.
  
• The potential lifting of mask mandates following the new CDC guidance raises questions about vaccination verification. It is likely each state will have a different system in place to deal with proof of vaccination. Some states have banned entities from requiring proof of vaccination. 
  
• There is optimism that being able to stop using a mask will incentivize those vaccine holdouts. Other states have implemented free food schemes, while Ohio took the extraordinary step of holding $1 million lottery once a week for vaccinated individuals in the state, in an effort to get more people vaccinated. 
  
• So far, around 154 million people have received at least one vaccine dose. This will increase as teenagers and adolescents get vaccinated. The CDC recently approved Pfizer's vaccine for use in 12-15 year-old children.

For the latest United States case counts, click here.

SPOTLIGHT: INDIA

• India has seen near exponential growth in daily new cases and deaths due to COVID-19. The public healthcare system has effectively collapsed, while private hospital systems are also facing resource issues. Nationwide shortages of oxygen have caused hundreds of deaths and hospitals are overwhelmed, turning away patients. The densely populated cites of India already had a low number of hospital beds per-capita compared to Western hospitals. The COVID-19 crisis has exacerbated this issue.
• On 27 March, India recorded 62,000 new cases. One month later, the daily case count stood at 360,000. The seven-day rolling average for daily deaths continues to rise, and is currently at 2700. Official tallies for new cases and deaths are both significant undercounts. Experts estimate the true death count is two to five times higher than reported.
• Despite being a major COVID-19 vaccine producer, less than 10 percent of Indians have received even one dose. Amid the surge in cases, the country has halted exports of vaccines to use domestically instead. This will leave major shortfalls to those countries relying on Indian production and export.
• A "double mutant" variant known as B.1.617 could possibly be responsible for much of the uncontrolled spread of COVID-19. It contains mutations found in two other strains that may make it more contagious and vaccine-resistant.
• Global Guardian is actively assisting clients in India with tele-medicine, security and medical evacuations, and sourcing of oxygen concentrators.

UNITED STATES LATEST DEVELOPMENTS

• The European Union announced that during the summer, vaccinated travelers from the U.S. would be able to enter the bloc, a welcome sign for global re-opening of the tourist and business-travel economy. No firm date has been announced for when this could go into effect.  
  
• Federal regulators recently ended the pause on the J&J vaccine after studying reported blood clots. Women between 30 and 39 appear to be at greatest risk, with 11.8 cases per million doses given. There have been seven cases per million doses among women between 18 and 49. The FDA will add a warning label to the vaccine.
  
• Nearly 2.75 million shots were administered on average in the last seven days. This is down compared to the 3.3 million doses administered per day on average two weeks ago. The decline is likely due to the pause in use of the Johnson & Johnson vaccine. So far, around 141 million people have received at least one vaccine dose.
  
• At current pace, 70% of the population will have been at least partially vaccinated by mid-July, with herd immunity, estimated between 70-90% reached in mid-August. These projections will likely improve as the J&J vaccine rollout resumes.

For the latest United States case counts, click here.