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Citing the spiraling rise in coronavirus cases nationwide, the Centers for Disease Control and Prevention on Wednesday warned Americans not to travel over the holidays, and outlined two ways to shorten the recommended quarantine times for people who may have been exposed to the coronavirus, especially those who may choose to travel anyway.
“The best thing for Americans to do during the holiday season is to stay at home and not travel,” said Dr. Henry Walke, who oversees day to day management of pandemic response for the agency.
The C.D.C. previously had recommended a 14-day quarantine period following potential exposure, and officials said they still supported the longer period as the safest option. But officials also recommended two alternatives.
Those without symptoms may end quarantine after seven days, followed by a negative test for the virus, or after 10 days without a negative test, agency officials said at a news briefing. P.C.R. or rapid tests are acceptable, the agency said, and should be taken within 48 hours of the end of the quarantine period.
“We can safely reduce the length of quarantine, but accepting that there is a small residual risk that a person who is leaving quarantine early could transmit to someone else if they became infected,” said Dr. John Brooks, the C.D.C.’s chief medical officer for the Covid-19 response.
(Quarantine refers to people who are well but may become ill; isolation refers to those known to be ill.)
Agency officials also recommended that Americans who are traveling get tested for the infection one to three days before the trip and again three to five days after returning. Returnees should eliminate nonessential activities for seven days.
A shortened quarantine period may be more palatable to people, with reduced economic impact, and may improve compliance, officials said. But the more relaxed guidance may lead to some infections being missed.
C.D.C. officials also warned strongly against travel over the Christmas holiday.
Dr. Cindy Friedman, chief of the travelers health branch at the C.D.C., reiterated that with cases rising, “the safest thing to do is to postpone travel and stay home,” saying that even a small percentage of infected travelers could “translate into hundreds of thousands of additional infections.”
“Travel is a door-to-door experience that can spread the virus during the journey and into communities where travelers visit or live,” she said. “We know it’s a hard decision, and people need time to prepare and have discussions with family and friends and to make these decisions.”
“Our recommendations are trying to give them the tools they need to make these tough choices,” she said, adding that people should take the time before the Christmas holidays to “think about the safest option for them and their families.”
Britain gave emergency authorization on Wednesday to Pfizer’s coronavirus vaccine, leaping ahead of the United States to become the first Western country to allow mass inoculations against a disease that has killed more than 1.4 million people worldwide.
The decision kicked off a vaccination campaign with little precedent in modern medicine, encompassing not only ultracold dry ice and trays of glass vials but also a crusade against anti-vaccine misinformation.
Britain beating the United States to authorization — on a vaccine codeveloped by the American pharmaceutical giant Pfizer, no less — may intensify pressure on U.S. regulators, who are already under fire from the White House for not moving faster to get doses to people. And it has stirred up a global debate about how to weigh the desperate need for a vaccine with the imperative of assuring people that it is safe.
“Help is on its way with this vaccine — and we can now say that with certainty, rather than with all the caveats,” the British health secretary, Matt Hancock, said on Wednesday, as the government exulted in the authorization.
While the go-ahead bodes well for Britain, which broke from the European Union’s regulatory orbit to approve the shot early, it will have no effect on the distribution of the hundreds of millions of doses that other wealthy countries have procured in prepaid contracts.
It also offers little relief to poorer countries that could not afford to buy supplies in advance and may struggle to pay for both the vaccines and the exceptional demands of distributing them.
The Pfizer vaccine, developed with BioNTech, a smaller German firm, must be transported at South Pole-like temperatures, a requirement that could dictate who will be vaccinated first in Britain: Nursing-home residents were supposed to be the top priority under an advisory committee’s plans, but efforts to limit transportation of the vaccine and ensure it remains cold may mean that National Health Service staff will receive the shots first.
The government said on Wednesday that 800,000 doses would be available by next week for health workers to begin administering. For Britain, which has suffered one of Europe’s highest per capita death tolls from the virus, the decision by its drug regulator testified to a vaccination strategy that has been the most aggressive in the West.
After the government strengthened an old law that allows Britain to step out from under the European Union’s regulatory umbrella in public health emergencies, its Medicines and Healthcare Products Regulatory Agency fast-tracked a review of the Pfizer vaccine, which was 95 percent effective in a late-stage trial.
The White House, concerned that Britain would approve a vaccine first, summoned Dr. Stephen Hahn, the commissioner of the Food and Drug Administration, for a meeting on Tuesday. A panel of outside advisers to the F.D.A. is scheduled to meet on Dec. 10 to decide whether the agency should grant emergency authorization to the Pfizer vaccine.
While American regulators pore over raw data from vaccine makers to validate their results, their counterparts in Britain and elsewhere in Europe lean more heavily on companies’ own analyses. The European Union is set to conduct its own review of the Pfizer and BioNTech vaccine, after the companies submitted their final application to the bloc’s health authorities on Tuesday.
The global race to develop a vaccine is poised to shatter records for time to market. Around the world, researchers are testing 57 vaccines in clinical trials, and nearly 100 others are being tested in animals or cells. China and Russia have approved vaccines without waiting for the results of late-stage trials, known as Phase 3, which experts say raises serious risks.
In Russia, President Vladimir V. Putin announced on Wednesday that mass vaccinations of the general public would begin by the end of next week. In televised remarks, Mr. Putin said that more than two million doses of the Sputnik V vaccine had been produced. The health minister, Mikhail Murashko, said that more than 100,000 people had already received the vaccine.
Britain’s move to grant emergency authorization to Pfizer’s coronavirus vaccine is a crucial step toward mass vaccinations that could end the pandemic. But how did its regulators move so fast?
“If you’re climbing a mountain, you prepare and prepare,” Dr. June Raine, the chief executive of Britain’s Medicines and Healthcare Products Regulatory Agency, said on Wednesday. “We started that in June.”
When early results arrived on Nov. 10, she said, “We were at base camp.” And later, she said, “When we got the final analysis, we were ready for that last sprint.”
Here are three key points about how Britain was able to move quickly.
The United States and Britain vet vaccines differently. While American regulators pore over raw data from vaccine makers to validate their results, their counterparts in Britain and elsewhere lean more heavily on companies’ own analyses, a faster process. American regulators maintain that their thorough approach ensures safety.
British regulators seek opinions from a specialist committee, similar to the outside panel of experts the Food and Drug Administration uses to assess vaccine candidates. But while the F.D.A.’s panel is being convened on Dec. 10, Britain’s committee has met as it needed to about the Pfizer vaccine, for more than 40 hours, its chairman said on Wednesday.
Britain did not have to wait for the European Union to act, owing to emergency regulatory powers that the bloc gives countries in the case of a pandemic. Once Britain consummates its split from the European Union on Dec. 31, those powers to approve vaccines on its own will become permanent.
The major pharmacy chain CVS has reached a deal with the federal government to give out a Covid-19 antibody treatment in patients’ homes and long-term care facilities, the company announced on Wednesday, providing a new way for certain high-risk patients to get a drug that aims to keep them out of the hospital.
The intravenous treatment, called bamlanivimab and developed by Eli Lilly, has been administered mainly at hospitals since it received emergency authorization from the Food and Drug Administration less than a month ago. Since then, the federal government has distributed to state health departments nearly 170,000 doses of the treatment — over half its supply for the rest of this year.
The deal with CVS involves just 1,000 doses of the treatment, enough to treat 1,000 Covid-19 patients over a three-month pilot period. The program will be limited for now to seven metropolitan areas — Boston, Chicago, Cleveland, Los Angeles, Milwaukee, Minneapolis and Tampa. It is not clear how much impact that will have as the virus is spreading rapidly and demand for treatments is surging.
“Even with this partnership, we’re talking about a very limited resource,” said Dr. Robert Goldstein, an infectious disease physician at Massachusetts General Hospital. “We still don’t have a way to deliver it equitably, and I’m not sure that the CVS partnership is necessarily going to improve equity in distribution.”
Still, giving the treatment in residential settings could help avoid the logistical challenges involved in infusing it at hospitals.
“We believe that this is a much more patient-friendly way to treat, in the comfort of someone’s own home or without having to be transferred,” said Dr. Sree Chaguturu, the CVS executive who is helping to lead the planning for the pilot.
For all its size and economic might, California has long had one of America’s lowest number of hospital beds relative to its population. Now state officials warn that this shortfall, combined with acute staffing shortages, may prove catastrophic.
In the spring, California had some of the earliest outbreaks and was the first state to issue a stay-at-home order. By summer, many Californians thought the worst was behind them, only to see an explosion of cases at the end of June. The number of cases dropped, then plateaued, before skyrocketing again this fall.
Now, California is experiencing its largest surge in coronavirus cases as the nation is on the brink of reaching 100,000 hospitalizations for the first time, according to the Covid Tracking Project. On Sunday, California became the first state to record more than 100,000 cases in a week, according to a New York Times database. The state government estimates that about 12 percent of its confirmed cases end up in a hospital.
Complicating the situation for hospitals is the fact that cases are now exploding in nearly all parts of the country, meaning that healthcare workers cannot be brought from other states as an emergency stopgap like they were in the spring, when the pandemic was mostly concentrated in a few coastal states, experts say.
Even though California has some of the country’s most restrictive measures to prevent the spread of the virus, an influx of people with severe cases of Covid-19 may force overwhelmed hospitals to turn patients away by Christmas, Gov. Gavin Newsom warned this week.
A dearth of hospital beds has been a worldwide problem throughout the pandemic, but California, with a population of 40 million, has a particularly acute shortage.
In addition to beds, a shortage of nursing staff will make handling the surge of virus cases “extraordinarily difficult for us in California,” said Carmela Coyle, the head of the California Hospital Association, which represents 400 hospitals across the state.
“This pandemic is a story of shortage,” Ms. Coyle said. “It’s what has made this pandemic unique and different from other disasters.”
At the county level, health officers are counting down the days until their hospitals are full. Dr. Sara Cody, the chief health officer for Santa Clara County, which includes a large slice of Silicon Valley, projects that hospitals in the county will reach capacity by mid-December.
“We have done everything that we can do as local leaders and health officials,” said Dr. Cody, who led the effort in March to put in place the country’s first shelter-in-place order. “We have worked as hard as we can work. We have tried everything that we know how to do. But without bold action at the state or federal level we are not going to be able to slow this down. We are not an island.”
Beyond California, hospitals have been scrambling in recent weeks to handle a new rush of patients, particularly in parts of the Sun Belt and New England that had largely avoided coronavirus spikes in the spring and summer.
In Rhode Island, where infections have rapidly increased in recent weeks, a field hospital opened on Monday in the state’s second-largest city, Cranston. At a cost of $8 million, a former call center for Citizens Bank was converted into a 335-bed field hospital. In New Mexico, a vacant medical center in Albuquerque was being used for recovering coronavirus patients. “We are seeing the worst rates that we’ve seen since the pandemic hit,” Mayor Tim Keller said in a recent interview.
The pandemic is accelerating in Delaware, the state newly thrust into the limelight as President-elect Joseph R. Biden Jr. builds his administration from his home in Wilmington. Daily reports of new Covid-19 cases in Delaware are up 50 percent from two weeks ago, according to a New York Times database.
The state saw relatively few cases through much of the year, but that has changed in the last month.
Delaware had 682 new cases on Tuesday, a record, said Jennifer Horney, the founding director of the epidemiology program at the University of Delaware. The state has averaged about 500 cases a day over the last week, more than triple the average in late October, according to the Times database.
“I think it is sort of like everywhere — people are fatigued and letting down their guard,” Dr. Horney said. “There is more community transmission among people of all ages.”
The number of Covid-19 patients in the state’s hospitals has doubled since the end of October, she said, and the state is bracing for even more patients once the lag time for infections over Thanksgiving has passed.
As of Wednesday morning, there had been at least 36,343 cases in Delaware and 777 deaths since the beginning of the pandemic, according to the Times database.
The state has been fairly consistent from the beginning of the pandemic in asking its residents to follow mitigation methods, including face masks and social distancing. Some of its regulations were tightened right before Thanksgiving, including capping gatherings in homes at 10 people, limiting indoor dining at restaurants to 30 percent of capacity and banning youth sports teams from leaving the state or playing opponents from out of state.
Given Delaware’s small size, residents often travel to the surrounding states — Maryland, Pennsylvania and New Jersey — all of which are seeing increasing cases. Still, the infection rates in the Mid-Atlantic states, relative to population, are still far below those in the upper Midwest.
In Delaware, previous outbreaks had been concentrated among the state’s large chicken farms and around the beach resorts in the southern part of the state. But these days, current cases are less linked to specific clusters and are spread more generally among people in the more populous north, Dr. Horney said.
A Centers for Disease Control and Prevention committee met Tuesday and voted on guidance about who should get the vaccine first. Their recommendation: Health care workers should receive the first doses, along with residents of nursing homes and of long-term care facilities. The C.D.C. director will decide by Wednesday whether to accept the recommendation.
But the agency does not have the final say. The distribution of the vaccine is up to individual states, and they don’t have to follow C.D.C. advice (as we’ve seen with masks or travel restrictions). Still, experts say that most states probably will.
For insight into the vaccine rollout, and when you might get the vaccine, Jonathan Wolfe, who writes our Coronavirus Briefing newsletter, did a quick interview with Carl Zimmer, a science writer for The Times.
We now know who the C.D.C. says should get the vaccine first, but who’s next in line?
We won’t know until the advisory committee votes again later this month. But it’s likely that the next group in line will be essential workers — firefighters, police and so on. And then after that, it may be people over 65, and people with comorbidities like diabetes, obesity, cancer that put them at high risk of death or severe disease.
When should the general public expect a vaccine?
Nobody should be marking their calendar with “Vaccine Day.” But I think it would be reasonable to expect that the general public would be getting vaccines in May or June.
Is that the time frame without other vaccines entering the market?
It will definitely take longer to vaccinate the U.S. with just Pfizer and Moderna than with Pfizer, Moderna, Johnson & Johnson and AstraZeneca. But there are also two other vaccines that are going to go into late-stage clinical trials probably this month. One is from Sanofi, one is from Novavax. If their results come through quickly, and if everything looks good to the F.D.A., they could be also adding their vaccines to the supply, that would speed things up as well.
So after I’m vaccinated, can I just return to normal life?
No. Sorry. You can’t. First of all, you’re going to need two shots. After your first shot, you’re not fully vaccinated. Second of all, after your second shot it’s going to take awhile for you to get maximum immunity. Third of all, we don’t know yet if these vaccines simply prevent people from getting the symptoms of Covid or actually stop the spread of the virus from one person to the next. They might, but we don’t know. So you do not want to be walking around feeling fine and breathing viruses all over people who haven’t gotten vaccinated yet, or people who can’t get vaccinated.
Any thoughts, then, on when normal life will return?
This is an experience that none of us has gone through before, so we’re not going to get the kind of precise timetable that we might want. But Tony Fauci has talked about life getting back to normal by late 2021. But that comes with a big asterisk — that timetable will depend on at least 75 percent of the country getting vaccinated promptly.
As the coronavirus gripped the globe, doctors and other health care workers have been hailed as heroes, cheered nightly with songs and pot-banging in cities across the world.
That enthusiasm appears to be reflected now in a surge of applications to American medical schools, which are up 18 percent over last year. Experts are calling it the “pandemic effect.”
“The pandemic has really motivated folks to pursue medicine,” said Geoffrey Young, senior director for student affairs and programs at the Association of American Medical Colleges.
“For this generation, this might be their 9/11,” Dr. Young said, comparing the interest in medicine now to the rush by some young people to join the military after the 2001 terror attacks.
Other pandemic-related factors may also be playing a role, admissions officers said. In an uncertain job market, people often look for refuge in stable professions like medicine. And the lockdowns gave students more time to reflect on their futures — and to fill out medical school applications.
Some medical schools have made it easier to apply. They extended their application deadlines, shifted to virtual interviews and waived the usual standardized test requirement for portions of their admissions review. They also waived application fees for more students.
At New York University, applications to the Grossman School of Medicine are up 4 percent this year, to about 9,600 applications for 102 spots, said Dr. Rafael Rivera, the associate dean for admission and financial aid.
“The pandemic has clearly put health care in a positive spotlight,” Dr. Rivera said. “Medicine has always been a calling for people, and that call has grown stronger this year.”
At Weill Cornell Medicine, applications are up 10 percent, according to the dean, Dr. Augustine M.K. Choi. He attributed the rise in part to the debt-free policy for financial aid students that the school introduced last year. But he said that Covid-19 also played a role.
“For decades, there has been a correlation between the number of medical school applicants and how well the economy is doing,” Dr. Choi said, meaning a negative correlation — that applications tend to go up when the economy goes down.
Tulane University School of Medicine has seen one of the sharpest rises, with applications up by 35 percent. Along with the “call of service,” Mike Woodson, director of admissions, also connects the increase to an awareness that Black communities were hit hard by the virus. He credits a Black medical student at Tulane, Russell Ledet, for helping boost interest in the school among young Black people: A year ago, he organized a photo of himself and 14 Black classmates in their white coats in front of the slave quarters of a former plantation, to demonstrate progress, unity and resiliency.
“In Louisiana, we don’t like perfect storms,” Mr. Woodson said, “but if you want to call it a perfect storm, it all kind of snowballed into this.”
Brazil’s Health Ministry said Tuesday that it would give Indigenous people and the elderly priority when a vaccine for the coronavirus becomes available, but it remains unclear how soon the first Brazilians will be immunized.
The ministry presented its preliminary vaccination plan after weeks of pressure from critics who say the government of President Jair Bolsonaro has led a reckless, haphazard response to the crisis, which made Brazil one of the epicenters of the epidemic.
When the first doses of a vaccine become available, the government intends to vaccinate people who are 75 or older, elderly people in nursing homes and other long-term care facilities and Indigenous people.
The next groups who will have preferential access to the vaccine include people who are 60 or older, people with certain chronic conditions, teachers, security forces, penitentiary workers and prisoners.
The government expects to cover those vulnerable groups with the roughly 109 million doses of vaccine it has negotiated access to. Brazil expects to get its first doses of the vaccine from AstraZeneca, a pharmaceutical company that developed a vaccine in partnership with the University of Oxford and has conducted trials in Brazil.
Health Minister Eduardo Pazuello said Wednesday that he expects Brazil will receive the first 15 million doses of a vaccine during the early months of 2021. Yet Anvisa, the country’s health regulator, has yet to authorize the use of any vaccine. Mr. Pazuello said he hopes Brazil will have 100 million doses in hand during the first six months of the year.
When Pakistan’s 53-member national cricket squad arrived last week in New Zealand, where strict controls have helped make the country one of the world’s biggest coronavirus success stories, they were hoping to receive an exemption from the country’s 14-day quarantine requirement to train.
Instead, six players tested positive shortly after arrival, even though they had tested negative before leaving Lahore. And an eighth member of the cricket squad tested positive for the coronavirus while in an isolation facility in Christchurch, health officials said on Wednesday, making him the day’s only new case in the nation.
The team has not only been unable to train ahead of their scheduled matches, set to begin in late December, but their behavior led to an official warning from New Zealand’s Ministry of Health after C.C.T.V. footage revealed the squad breached quarantine requirements.
“Rather than being in their own rooms, which is a requirement for the first three days, until that first test comes back, there was some mingling in the hallways, chatting, sharing food, and not wearing masks,” Dr. Ashley Bloomfield, the country’s Director-General of Health, told Radio New Zealand last week.
The decision to warn the players has sparked anger from many in Pakistan, who felt New Zealand officials had disrespected the players and nation. But the team’s chief executive, Wasim Khan, took a more measured approach, urging the players to follow the rules.
“They have told me straight away that one more breach and they will send the whole team back,” Mr. Khan said in a recorded WhatsApp message to players last week, according to a report from The Associated Press.
While New Zealand has been among the countries least affected by the pandemic, with a total of 2,059 cases and 42 deaths, according to a New York Times database, Pakistan has experienced more than 400,000 cases, with 8,166 lives lost.
Here’s what else is happening across the world:
An Olympic committee in Japan unveiled a preliminary coronavirus safety plan for the Tokyo 2020 games, which were postponed to July 2021, that would allow overseas spectators without requiring two-week quarantines upon arrival. Specific countermeasures for visitors, which could include negative tests before arrival and the use of tracking smartphone apps, will be determined by the spring as the plan solidifies. The guidelines call for athletes to comply with a range of safety measures, including testing every four to five days.
New South Wales, the Australian state that includes Sydney, will ease capacity limits as of Monday after going nearly four weeks without a local infection. The new guidelines will lift caps on weddings, funerals and religious services, and allow up to 50 people in gyms and on dance floors, provided they are spaced two square meters apart. Up to 5,000 people will be permitted at ticketed outdoor events.
The International Federation of Red Cross and Red Crescent Societies reported that hundreds of thousands of new volunteers around the world have signed up to help support Covid-19 relief efforts. The American Red Cross saw 78,000 new sign-ups this year; Italy saw 60,000 new volunteers, and Kenya gained 35,000. Even the small Pacific island nation of Tuvalu, which has no reported coronavirus cases, welcomed 130 new volunteers.
Women and the lowest-paid workers in Europe have taken the biggest hit in earnings as a result of the Covid-19 pandemic, the United Nations labor organization said on Wednesday, urging governments to keep in place measures to protect jobs and wages.
Unlike 2009, when the impact of the financial crisis was felt across all sectors of employment, the pandemic has struck hardest at the lowest end of the job market, the International Labour Organization found in an analysis of data for the first half of 2020, mostly from European countries.
“The growth in inequality created by the Covid-19 crisis threatens a legacy of poverty and social and economic instability that would be devastating,” Guy Ryder, the organization’s director general, said in a statement.
Without a significant injection of funds in government job furlough and wage protection schemes, earnings by the lowest half of the work force would have dropped by 17 percent in the first half of the year, Mr. Ryder said.
Those plans absorbed much of the loss of earnings, he said. But in the second quarter of the year, women had still lost a little over 8 percent of their earnings, compared with around 5.4 percent for men.
Mr. Ryder warned against an early exit from wage subsidy and employment protection plans, in which governments have invested an estimated $11 trillion to $12 trillion. As these programs came to an end there would be further downward pressure on wages, he said.
The looming availability of Covid-19 vaccines would provide conditions for people to work with greater confidence, Mr. Ryder said, but it would “not solve the economic and social condition we are in.”
A new examination of how millions of students have fared academically since the coronavirus shut schools down in March shows that students may not have yet suffered as much learning loss as educators and researchers had feared.
New data released this week by NWEA, the Northwest Evaluation Association, a nonprofit research group that provides assessments used by thousands of school districts to measure student growth and proficiency, shows that students lost modest ground in math but held steady in reading on assessments administered this fall.
The analysis, based on the scores of 4.4 million students in grades three through eight in 46 states was on the whole encouraging, but it came with concerning caveats.
“While there’s some good news here, we want to stress that not all students are represented in the data, especially from our most marginalized communities,” Beth Tarasawa, executive vice president of research at NWEA, said in a statement. “This increases the urgency to better connect to students and families who may be weathering the Covid storm very differently.”
Still, the NWEA analysis is the most reliable national data sample to date illustrating the toll the coronavirus has taken on student learning, and is especially valuable now that Education Secretary Betsy DeVos has called for a one-year delay of the National Assessment of Educational Progress, a rigorous exam administered by the research arm of the Education Department. That test’s results are what is known as the “Nation’s Report Card.”
The NWEA study includes both in-school and remote learners who took its trademark MAP Growth test this fall. Students’ average math scores were between 5 and 10 percentile points lower than scores recorded for the same grade levels in the fall of 2019, with the most pronounced losses among students in grades three through five. Reading scores barely budged.
The new data bucked the organization’s own “Covid-19 slide” projections from the spring, which estimated that students could return to school having lost 50 percent of a year, or 9 to 20 percentile points, in math, and 30 percent of a year in reading, which would equate to 6 to 8 points.
“Due to the hard work of teachers, we haven’t seen the loss that we could have,” said Chris Minnich, the chief executive officer of NWEA.
Since the pandemic closed schools in March, the majority of students in all grades made learning gains in both subjects, though math gains were lower than in a typical year, researchers found.
But the organization’s examination of scores of the same cohorts of students who took exams in the winter, January through early March, produced concerning findings. While the majority of students were considered “maintainers” in their math score rankings, double the proportion of students, called “sliders,” moved down in the assessments’ rankings compared to a typical year.
Researchers also found they did not have scores for about 25 percent of students who were in schools that tested in both 2019 and 2020, and those students were disproportionately minority students and lower-achieving students, and attended schools serving high concentrations of students living in poverty.
Megan Kuhfeld, senior research scientist at NWEA, called the count a “high, alarming number,” though researchers could not say whether it represented students who unenrolled from school, or simply weren’t tested for a variety of reasons.
“We do worry both about the missing students and whether they’re disengaging,” Ms. Kuhfeld said, “but as well about the findings — that we could be potentially underestimating both the overall impact as well as the inequalities in the impact.”