The latest on the coronavirus pandemic and vaccines

The relentless surge of Covid-19 patients has strained resources and health care workers at Los Angeles hospitals -- to the point that officials are preparing to ration care with triage officers, who will decide which patients receive what treatment.

Once a hospital reaches a phase called "crisis care mode," triage officers at the county's four public hospitals will be tasked with deciding how to allocate and reallocate scarce resources like ventilators for critically ill patients with a focus of "doing the most good for the most people," according to new guidelines issued by the Los Angeles County Department of Public Health.

"Decisions of allocation will be to decide which patients get which resource, and in some circumstances, may involve decisions to take scarce resources from one patient and give them to another who is more likely to benefit from them," the guidelines said.

The new guidelines were first reported by the Los Angeles Times.

Rising numbers: The extraordinary move comes as Los Angeles County hospitals treat more than 8,000 Covid-19 patients, a growing number that has shown no sign of slowing down as the region continues to report thousands of new cases each day. On Friday, just 54 adult ICU beds were available in the county of 10 million residents.

Some US health care workers not connected to hospitals or health systems are struggling to get Covid-19 vaccines, the president of the American Medical Association told CNN on Friday.

“We are concerned by reports that some physicians and other health care personnel who are not employed by hospitals or health systems are facing difficulties getting vaccinated against Covid-19,” Dr. Susan Bailey said.

Bailey emphasized the importance of keeping all physicians healthy so they can continue to care for patients.

“In addition to contract and hospital-based physicians, office-based physicians are also front line health care workers in the fight against Covid-19, as that is where many patients go first when they become ill,” she added.

Some state and local health departments are setting up sites to vaccinate these health care workers, Bailey noted.

Russia's Gamaleya Institute, which developed the Sputnik V coronavirus vaccine, has applied for emergency use authorization in the Philippines.

The Moscow-based company filed its application on Thursday, according to the Philippines News Agency.

A day before that, Gamaleya withdrew its application to hold clinical trials in the country, according to CNN affiliate CNN Philippines.

Gamaleya is the third vaccine maker -- alongside Pfizer-BioNTech and Oxford-AstraZeneca -- to apply for emergency use authorization in the Philippines. 

It usually takes the Philippines' Food and Drug Administration 21 days to decide if a drug or vaccine will be allowed for use in the country, according to CNN Philippines.

Last November, Russia said the Sputnik V vaccine was at least 91.4% effective and could be more than 95% effective, according to data from its Phase 3 trials.

Dr. Stephen Hahn, commissioner of the US Food and Drug Administration, said during an Alliance for Health Policy event Friday he’s encouraging states to broaden criteria for who can be vaccinated against Covid-19.

Some states have about 30% to 35% utilization of the current vaccine that they have, he said, and “we’re encouraging those states to broaden the criteria for administration.” Several states have opened up vaccination to people in certain age groups, even if they haven’t finished vaccinating health care workers. 

According to the US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, Phase 1a consists of health care workers and residents in long-term care facilities, Phase 1b includes adults ages 75 and older and frontline essential workers and Phase 1c prioritizes adults ages 65 to 75, people ages 16-64 who have high-risk medical conditions and other essential workers. 

“There’s a science and data driven approach to those recommendations, and I feel that those are very reasonable to follow,” Hahn said. But if the first prioritization group isn’t using all the available vaccine, it’s reasonable to move on to the next group, “not going outside of the guardrails of the recommendations of the ACIP, because I think they’re really important, but maybe going down to the next level as you try to use as much vaccine as possible.” 

Oregon Gov. Kate Brown said the state will be using members of the National Guard to help administer the Covid-19 vaccine in an effort to speed up distribution.

“We continue to look at how we can use every single tool we have to swiftly vaccinate Oregonians,” she said in a news conference Friday.

The governor acknowledged the state fell well short of their goal to administer 100,000 doses by the end of the year and need to make up for lost time in order to get to the next phase of vaccinations.

The National Guard will begin assisting with a vaccination event this weekend at the State Fairgrounds in Salem. They are planning a marathon session in the hopes of giving 250 shots per hour.

“Our Guard members will be providing logistical and nursing support,” Brown said.

The United States reported 131,889 current Covid-19 hospitalizations on Friday, according to the Covid Tracking Project (CTP).

This is third highest current hospitalization reporting and the 38th consecutive day that the US has remained above 100,000 current hospitalizations. 

According to CTP data, the highest hospitalization numbers are...

• Jan. 6, 2021: 132,464
• Jan. 7, 2021: 132,370
• Jan. 8, 2021: 131,889
• Jan. 5, 2021: 131,215
• Jan. 4, 2021: 128,206

Moderna believes the second dose of its Covid-19 vaccine can be effectively administered between 21 to 42 days after the first dose, Ray Jordan, a spokesperson for the company, told CNN Friday.

Moderna declined to say whether the company could meet demand for second doses of coronavirus vaccine if the incoming Biden administration releases all vaccine at once, instead of holding back half.

In clinical trials, Moderna's vaccine was given as two doses 28 days apart. On Friday, President-elect Joe Biden’s team said his administration would release all doses of coronavirus vaccines right away, instead of holding back half to ensure second doses are given on time, as the Trump administration has been doing.

When asked if Moderna would be able to produce enough additional vaccine to get second doses administered on day 28, the company declined to directly answer.

"Moderna is not aware of changed requirements associated with the Biden plan but has affirmed its plan to deliver according to the existing government supply contracts," Jordan said. "This includes an expectation of delivering 100 million doses by the end of the first quarter and 200 million doses total by the end of the second quarter. Earlier this week, Moderna reported having already delivered 18 million doses to the US government."

The World Health Organization’s vaccine advisers said earlier Friday that the second dose of Pfizer’s vaccine could also be administered as long as 42 days – six weeks – after the first dose.

There is no evidence the United States has a homegrown variant of coronavirus that’s fueling the recent increased spread of the virus, the US Centers for Disease Control and Prevention said Friday. 

The White House coronavirus task force told states last week “there may be a USA variant that has evolved here, in addition to the UK variant that is already spreading in our communities,” according to reports obtained by CNN.

But the CDC said there was no evidence of that yet.

“Based on scientific understanding of viruses, it is highly likely there are many variants evolving simultaneously across the globe,” a spokesperson said in a statement emailed to CNN.

“Additionally, there is a strong possibility there are variants in the United States; however, it could weeks or months to identify if there is a single variant of the virus that causes COVID-19 fueling the surge in the United States similar to the surge in the United Kingdom,” the spokesperson added.

“Researchers have been monitoring U.S. strains since the pandemic began, including 5,700 samples collected in November and December. To date, neither researchers nor analysts at CDC have seen the emergence of a particular variant in the United States as has been seen with the emergence of B.1.1.7 in the United Kingdom or B.1.351 in South Africa.”

Variants of the virus first seen in Britain and South Africa have patterns of mutations that indicate they could make it easier for the virus to infect human cells, and thus to make it more easily transmitted.

US Centers for Disease Control and Prevention Director Dr. Robert Redfield warned that the riots at the US Capitol on Wednesday was likely a coronavirus “surge event” and “is going to have public health consequences.”

In an interview with the McClatchy newspaper group on Friday, Redfield called the riots a “very, very sad day” and expressed concern that members of Congress and law enforcement could have been exposed by the pro-Trump mob, perpetuating the spread of coronavirus.

“Then these individuals all are going in cars and trains and planes going home all across the country right now. So I do think this is an event that will probably lead to a significant spreading event,” Redfield said.

On Thursday, the US reported more than 4,000 deaths from coronavirus for the first time. Redfield warned that the numbers are likely to increase. 

“We’re going to continue to see mortality in the 2,500-5,000 a day range,” Redfield said. “This is going to continue to get worse through January, and probably parts of February before we really start to turn the corner.”

“We haven’t hit the peak of the current surge,” he added. “Clearly, the amount of mortality we’re seeing, as many of us are trying to stress, is more than we saw on Pearl Harbor or 9/11, over and over and over again. That’s the state of the pandemic unfortunately we’re at right now.”