April 22 coronavirus news

CNN chief medical correspondent Dr. Sanjay Gupta answered viewer questions about wearing masks outdoors, eating indoors and vaccination numbers on CNN's "New Day."

Q: Do people need to wear masks outside, particularly those who are vaccinated?

A: The vast majority of Covid-19 transmission is not happening outdoors, according to Gupta. Less than 10% of cases happen outside and it is nearly 19 times more likely for transmission to occur indoors, he said. 

“For the most part, you don't need to wear a mask outdoors,” Gupta said.

But people need to use “common sense,” he said, and should consider if they will be clustered together and the case rate in their area.

“The real question you need to try to answer: what is the likelihood I'm going to breathe in someone else's air? That's basically it. The number of people, type of setting … and what is the overall viral spread in their community,” Gupta said. 

Q: How safe is it to eat inside a restaurant?

A: Ventilation and crowding are the big concerns with indoor dining, according to Gupta. 

“I think most places in the country, certainly full capacity indoor dining, I can't imagine that it would be advised. It's just still too risky. There's still too great a chance that you're going to actually potentially be exposed to the virus,” he said. 

Gupta said he would advise people to be cognizant of limited capacity dining and the rate of transmission in their area before heading indoors to eat. 

Q: If people remain hesitant on getting vaccinated, will the pandemic last longer?

A: Gupta said we may “dip in and out” of herd immunity as more people get vaccinated while others refuse to do so. 

“We may still dip into herd immunity over the summer in part because, you know, the virus will just start to dissipate a little bit with the warmer weather, more people being outside, you may not get as much spread. But we could see a resurgence then in the fall,” he said. 

“The real question we're trying to ask is how many people out there have an immunity to this virus?” Gupta added, which is made up of those who’ve been vaccinated — but also those who’ve been infected with the virus, a number that Gupta said we may never fully know. 

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The European Union is declining an option to order an additional 100 million doses of coronavirus vaccine from AstraZeneca, a spokesman said Thursday.

The move follows months of public criticism of the drug maker by European officials.

The European Commission did not exercise the option to buy the doses and the deadline for it has now passed, Commission spokesperson for health Stefan de Keersmaecker said.

The Commission is focusing on getting delivery of the 300 million doses it initially ordered, he said.

"In the first quarter, 30 million doses were delivered, which is less than what was contractually expected. For the second quarter, the contract provided for 180 million doses. The company said it was able to deliver 70 million doses," he said.

European officials have been publicly furious that AstraZeneca has delivered fewer doses than the EU says it ordered, prompting the bloc to impose export restrictions on doses manufactured in the EU. The company has cited delays in production. 

The news comes a day after Norway announced that it will send 16,000 doses of the AstraZeneca vaccine to Iceland, according to a statement from the Icelandic Directorate of Health.

The Pfizer/BioNTech and Moderna vaccines don’t appear to pose any serious risks during pregnancy, an early analysis of real-world data from the United States shows.

The analysis only looked at Pfizer and Moderna shots, which are both based on newer mRNA technology, so the findings are not relevant to vaccines such as those made by like AstraZeneca or Johnson & Johnson. 

The new data, along with existing research showing mRNA vaccines are effective in pregnant and breastfeeding people, suggest that the benefits of the vaccines outweigh the risks.

The analysis, published Wednesday in the New England Journal of Medicine, looked at the data of more than 35,000 pregnant people who had reported their health status through CDC reporting systems, including a smartphone app, and followed up with a group of 3,958 pregnant participants who had received an mRNA vaccine. 

It found that adverse outcomes, including pregnancy loss and preterm births, were not significantly higher in people who had been given a vaccine.

Read the full story here.

As the world marks Earth Day, it's a good time to look at the newly acquired habits are worth retaining when the pandemic ends.

Some of our behaviors have benefited the environment, like buying locally, reducing our commutes and flying less. Other habits have reduced our odds of catching other illnesses. But retaining those habits is easier said than done.

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The pandemic forced us to create habits that benefit the Earth and ourselves. Here's which behaviors to keep

Mexico's Federal Commission for the Protection against Health Risks (COFEPRIS) has warned that selling counterfeit Pfizer vaccines poses a "health risk" to the population.

Earlier this week, Pfizer said it had identified counterfeit Covid-19 shots in Mexico and Poland.

Responding to the reports, COFEPRIS said:

The commission has warned of fake Pfizer-BioNTech Covid-19 vaccines in the Mexican state of Nuevo Leon in February.

Vaccination against Covid-19 is free and universal in Mexico, COFEPRIS said in the statement, adding that it hasn't issued a license to any company for the sale or import of the vaccines.

"Any unauthorized vaccination report is alarming since it's illegal, irregular, and puts the health of those who receive it at risk," it said.

"People can trust that all the vaccines from the National Vaccination Program against Covid-19 are of quality, safe and effective since they were approved by this commission." 

Spain will donate between 5% and 10% of its Covid-19 shots to the global vaccine sharing scheme once 50% of its population is inoculated, Spanish Prime Minister Pedro Sanchez announced on Wednesday.

"Spain will set aside 7.5 million doses through the multilateral mechanism, COVAX, for Latin America and the Caribbean and this translates into a donation of 5 to 10% of the total vaccines Spain will receive in 2021," Sanchez said during a press briefing in Andorra, Spain. He said the country will activate the scheme once 50% of the population is vaccinated, which he said would be "very soon."

As of Wednesday, Spain has fully vaccinated 7.6% of its population. About 21% have received at least one dose of a the vaccine, according to health ministry data.

Sanchez also encouraged nations to have conversations over Covid-19 vaccine patents, saying that “rights to intellectual property cannot halt, but rather be [one of the] solutions to guarantee soonest vaccination to the world's population."

Spain has secured over 93 million doses of Covid-19 vaccines though the European Union and has so far received a total of 14,924,175 doses.

Black market traders in India are charging up to 10 times the recommended retail price for remdesivir, according to police, as hospitals and pharmacies report a shortage of the antiviral drug amid a second wave of coronavirus in the country.

The official price of the drug is set at 899-3,490 rupees (about $12-47), according to a government memorandum on April 17.

However, a Mumbai police official told CNN three people were recently arrested trying to sell the drug for 20,000 rupees per vial ($266). In Vishakhapatnam, another police official said, four hospital employees were arrested as they tried to sell remdesivir vials for 9,000 rupees each ($200).

Abhijeet Kumar from Raipur, a city in the state of Chhatisgarh, said he was trying to find six doses of the drug online for his Covid-19-positive uncle when he was offered them at more than four times the highest official price.

He said he declined the offer as his family could not afford it. “I have already admitted my uncle in a private hospital and it costs 20,000 rupees per day. I can’t afford more,” he said.

Some background: The benefits of remdesivir in the treatment of Covid-19 are unclear. The Indian government and the US Food and Drug Administration have approved the drug for emergency use within hospitals, though the World Health Organization says evidence does not suggest the drug lessens the risk of dying from Covid-19 or needing mechanical ventilation.

Government action so far: Several ministers across India have acknowledged the issue of black market profiteering of remdesivir. The Delhi chief minister promised the “strictest action” against the malpractice. The soaring demand for the drug has prompted the Indian government to temporarily ban the export of the medication to increase its supply in the domestic market. In addition, the finance ministry has waived import duties on it 

India reported 314,835 new Covid-19 infections on Thursday, the highest daily increase in cases worldwide since the pandemic began.

The country also recorded its highest number of new Covid-19 deaths at 2,104 fatalities.

The stark figures come as health care and other essential services across India are close to collapse amid a second coronavirus wave that is tearing through the country with devastating speed.

The Union Territory of Delhi on Wednesday received less than half of required oxygen to treat Covid-19 patients, with 200-250 metric tons of oxygen against a requirement of 700 metric tons, the advocate for the Delhi government told the high court on Wednesday.

A petition by the Bajaj Medical and Research Centre, which runs a chain of private hospitals, said five of its hospitals in Delhi had between two to 18 hours of oxygen supply left.

While the court was hearing the petition, two of the five private hospitals referred to in the petition had received the supply of oxygen, the court noted.

As of Thursday afternoon, Delhi had 26 vacant ICU beds, according to government data.

Several Indian states have imposed restrictions to curb the spread of the virus, even as Prime Minister Narendra Modi urged states to use lockdown as a last resort.

India's second most populous state of Maharashtra has announced new restrictions on Wednesday. People will be allowed to travel only for essential services or for "unavoidable events" like funerals. All private passenger transport will be allowed to operate at 50% capacity.

The new rules will come into force 8 p.m. local time on Thursday and will remain in place until 7 a.m. on May 1.

India had now recorded a total 15,930,965 cases as of Thursday, according to the India Ministry of Health. The total death toll now stands at 184,657.

Some context: India’s population is nearly four times that of the United States, and its daily cases still falls behind the US when adjusted for population size (in cases per million people). But India’s outbreak is undoubtedly the world’s biggest in absolute numbers at the moment — nearly 28% of all new cases worldwide in the past week came from India, said the World Health Organization on Wednesday.

The US Centers for Disease Control and Prevention are “in the process of putting together further guidance” for vaccinated Americans, White House senior adviser for Covid-19 response Andy Slavitt told CNN.

Slavitt also touted the White House’s newly announced efforts to counter plateauing vaccination rates by offering incentives for businesses to allow their employees to get vaccinated.

“One of the things that's changing most rapidly is we have vaccinated the lion's share of people over 65, and we're doing pretty well with people over 50 -- this week we have started to move in earnest to vaccinate working Americans," he said.