Tag Archives: Coronavirus

Johnson & Johnson’s one-shot COVID-19 vaccine effective and safe: FDA staff

(Reuters) – Johnson & Johnson’s one-shot COVID-19 vaccine appeared safe and effective in trials, U.S. Food and Drug Administration (FDA) staff said in documents published on Wednesday, paving the way for its approval for emergency use.

The FDA’s panel of independent experts meets on Friday to decide whether to approve the shot. While it is not bound to follow the advice of its experts, the FDA usually does and has authorized vaccines from Pfizer and Moderna.

J&J said in documents submitted to the FDA that its data suggested its vaccine was effective at preventing asymptomatic infections. It said that in a preliminary analysis of its trial, it found 16 cases of asymptomatic cases in the placebo group versus two in the vaccine group, or an 88% efficacy rate.

While asymptomatic infection was not the primary goal of the trial, which studied the vaccine’s ability to stop moderate to severe COVID-19, the reduction of asymptomatic cases implies the shot can also cut transmission of the disease.

J&J’s vaccine was 66% effective in preventing COVID-19 against multiple variants in a global trial involving nearly 44,000 people, the company said last month.

Its effectiveness varied from 72% in the United States to 66% in Latin America and 57% in South Africa, where a new variant has spread, though the vaccine was 85% effective overall in stopping severe cases of the disease.

The vaccine was effective in reducing the risk of COVID-19 and preventing PCR-test confirmed COVID-19 at least 14 days after vaccination, the FDA said in its briefing documents.

Fourteen days after injection, only two vaccine recipients developed COVID-19 severe enough to need medical intervention, compared with 14 in the placebo group. After 28 days, no vaccine recipients developed COVID severe enough to require medical intervention whereas seven in the placebo group did.

Three vaccine recipients had severe side effects in the trial that were likely related to the vaccine, but the FDA said its analysis did not raise any specific safety concerns that would preclude issuance of an emergency use authorization.

The FDA said the most common solicited adverse reactions were injection site pain at 48.6%, headache at 39%, fatigue at 38.2% and myalgia at 33.2%. Other side effects included a fever in 9% of participants and a high fever in 0.2% of those who received the vaccine.

The regulator said one case of pericarditis, a heart disease, may have been caused by the vaccine. It said cases of a rare disorder, Guillain-Barre Syndrome, were unlikely to be related to the shot though data was insufficient to determine whether or not the vaccine had caused these side effects.

J&J had not previously released details of its clinical trial data beyond efficacy rates.

(Reporting by Manas Mishra in Bengaluru; Mike Erman, Caroline Humer and Rebecca Spalding; Editing by Bernard Orr and David Clarke)

COVID-19 vaccine makers tell Congress U.S. supply will surge soon

By Michael Erman and Manojna Maddipatla

NEW YORK (Reuters) – COVID-19 vaccine makers told Congress on Tuesday that U.S. supplies should surge in the coming weeks due to manufacturing expansions and new vaccine authorizations.

Executives from Pfizer Inc, Moderna Inc and Johnson & Johnson – speaking at a hearing at the U.S. House of Representatives – said they would be able to supply enough vaccine to fully inoculate 130 million people in the United States by the end of March.

The drugmakers also reaffirmed their commitments to supply more than enough doses necessary to vaccinate all Americans by the end of July.

Pfizer Chief Business Officer John Young said it was plausible that there could be a surplus of vaccine in the United States sometime in the second quarter of this year.

“We certainly hope that we’re going to be in a position where every eligible adult will be able to receive vaccinations,” Young said.

Around 44.5 million people in the United States had received at least one dose of two-shot vaccines developed by Pfizer and BioNTech or Moderna, as of Tuesday morning.

Johnson & Johnson’s single-dose vaccine will be considered by an outside advisory committee to the U.S. Food and Drug Administration later this week, and emergency use authorization could come shortly afterward.

Richard Nettles, Vice President of Medical Affairs at J&J’s Janssen Pharmaceuticals unit, said the company would be able to ship nearly 4 million doses of its COVID-19 vaccine upon authorization and 20 million doses by the end of March.

Additional doses could also come from AstraZeneca Plc and from Novavax Inc, which are currently running clinical trials of their experimental vaccines.

An AstraZeneca executive said the drugmaker could supply doses necessary to vaccinate another 25 million people by the end of April if their vaccine is authorized by U.S. regulators.

(Reporting by Michael Erman; Editing by Bill Berkrot)

Philippines offers nurses in exchange for vaccines from Britain, Germany

By Neil Jerome Morales

MANILA (Reuters) – The Philippines will let thousands of its healthcare workers, mostly nurses, take up jobs in Britain and Germany if the two countries agree to donate much-needed coronavirus vaccines, a senior official said on Tuesday.

The Philippines, which has among Asia’s highest number of coronavirus cases, has relaxed a ban on deploying its healthcare workers overseas, but still limits the number of medical professionals leaving the country to 5,000 a year.

Alice Visperas, director of the labor ministry’s international affairs bureau, said the Philippines was open to lifting the cap in exchange for vaccines from Britain and Germany, which it would use to inoculate outbound workers and hundreds of thousands of Filipino repatriates.

Nurses are among the millions of Filipinos who work overseas, providing in excess of $30 billion a year in remittances vital to the country’s economy.

“We are considering the request to lift the deployment cap, subject to agreement,” Visperas told Reuters.

Britain is grappling with the world’s sixth-highest coronavirus death toll and one of the worst economic hits from the pandemic, while Germany has the 10th most infections globally.

While the two countries have inoculated a combined 23 million people, the Philippines has yet to start its campaign to immunize 70 million adults, or two-thirds of its 108 million people. It expects to receive its first batch of vaccines this week, donated by China.

The Philippines wants to secure 148 million doses of vaccines altogether.

The British embassy in Manila did not immediately respond to a request for comment while calls to Germany’s mission went unanswered.

In 2019, almost 17,000 Filipino nurses signed overseas work contracts, government data showed.

While Filipino nurses have fought to lift the deployment ban to escape poor working conditions and low pay at home, the workers-for-vaccine plan has not gone down well with some medical workers.

“We are disgusted on how nurses and healthcare workers are being treated by the government as commodities or export products,” Jocelyn Andamo, secretary general of the Filipino Nurses United, told Reuters.

India says virus variants not behind upsurge in cases

By Krishna N. Das and Neha Arora

NEW DELHI (Reuters) – India said on Tuesday mutated versions of coronavirus were not responsible for an upsurge in cases in two states, a potential relief for a country where mask-wearing and social distancing have largely disappeared.

Maharashtra in the west and Kerala in the south account for 75% of India’s current active cases of about 147,000, and both states have seen a sudden rise in new infections in recent days, fueling calls for a faster roll-out of vaccines.

India has reported more than 11 million cases – the most in the world after the United States – and about 156,000 deaths. Actual infections have inched closer to 300 million in the country of 1.35 billion, according to a random study of antibodies done by the government.

A top government health official confirmed the long-time presence of two mutants – N440K and E484Q – in those two states as well as elsewhere in the country and abroad. Authorities have also found the UK variant in 187 people in India, the South African one in six and one case of the Brazilian mutation.

“There is no reason today for us to believe, on the basis of scientific information, that these are responsible for the upsurge of the outbreak,” Vinod Kumar Paul, who heads a government committee on vaccines, told a news conference.

Though cases have come down sharply since a September peak, Paul said India was still vulnerable, especially given that even previously badly affected cities like Pune in Maharashtra were getting hit again. He urged people to wear masks and avoid social events – guidelines openly flouted by both federal and state ministers.

The northern state of Punjab, which has also seen a rise in cases, said indoor gatherings would be restricted to 100 and outdoor to 200 from March 1. District heads have also been permitted to decide on night curfews in hotspots, and testing will be increased, the state’s chief minister said.

Punjab is one of the worst performing states in vaccinating their healthcare workers, according to the federal government.

The government on Tuesday asked five states, including Maharashtra and Punjab, to expedite vaccination of their healthcare and frontline workers in light of the surge in cases, according to letters shared by the health ministry.

India has given nearly 12 million doses to its health and frontline workers since beginning the campaign in mid-January, a pace that will have to be increased sharply to meet the target of reaching 300 million people by August.

Health Secretary Rajesh Bhushan said India would very soon start immunizing people over 50 and those with medical conditions, with greater involvement from private hospitals. Government hospitals are now running around 80% of vaccination sites.

The government has recently come under pressure to expand coverage at home given the world’s largest vaccine maker has exported COVID-19 shots to more than two dozen countries.

India is using a vaccine developed by Bharat Biotech and the state-run Indian Council of Medical Research, and another licensed from AstraZeneca and Oxford University. Other vaccines are in the queue, including Russia’s Sputnik V and products from Cadila Healthcare and Novavax.

(Reporting by Krishna N. Das and Neha Arora; Editing by Gareth Jones, William Maclean, Philippa Fletcher and Giles Elgood)

What you need to know about the coronavirus right now

(Reuters) – Here’s what you need to know about the coronavirus right now:

U.S. reaches 500,000 deaths

The United States on Monday crossed the milestone of 500,000 COVID-19 deaths just over a year since the pandemic claimed its first known victim in Santa Clara County, California.

In a proclamation honoring the dead, President Joe Biden ordered the U.S. flag to be flown at half-staff on public buildings and grounds until sunset on Friday.

“On this solemn occasion, we reflect on their loss and on their loved ones left behind,” Biden said in the proclamation. “We, as a Nation, must remember them so we can begin to heal, to unite, and find purpose as one Nation to defeat this pandemic.”

One-way to freedom

Prime Minister Boris Johnson unveiled a map out of lockdown for England on Monday that would keep some businesses shuttered until the summer, saying caution was necessary to ensure there were no reversals on a “one-way road to freedom”.

After imposing one of the strictest lockdowns in the western world in January to counter a highly contagious variant of the novel coronavirus, Johnson said Britain was in a position to enjoy the results of one of the world’s fastest vaccine programs.

Starting in two weeks with the reopening of schools, the phased plan will go through four stages, with at least five weeks in between each stage.

Afghanistan begins vaccination drive

Afghanistan began its first COVID-19 vaccinations on Tuesday, administering doses initially to security force members, health workers and journalists, in a campaign that may face challenges from a sharp rise in violence.

The war-damaged country received 500,000 doses of AstraZeneca’s vaccine from the Serum Institute of India, which is producing the vaccine for mid- and low-income countries, earlier this month.

Taliban insurgents fighting the foreign-backed Afghan government have announced their backing for the vaccination campaign.

Compensation for serious vaccine side effects

The World Health Organization has agreed a no-fault compensation plan for claims of serious side effects in people in 92 poorer countries due to get vaccines via the COVAX sharing scheme, resolving a big concern among recipient governments.

The program, which the WHO said was the first and only vaccine injury compensation mechanism operating on an international scale, will offer eligible people “a fast, fair, robust and transparent process,” the WHO said in a statement.

“By providing a no-fault lump-sum compensation in full and final settlement of any claims, the COVAX program aims to significantly reduce the need for recourse to the law courts, a potentially lengthy and costly process,” the statement said.

Nurses in exchange for vaccines

The Philippines will let thousands of its healthcare workers, mostly nurses, take up jobs in Britain and Germany if the two countries agree to donate much-needed coronavirus vaccines, a senior official said on Tuesday.

The Philippines, which has among Asia’s highest number of coronavirus cases, has relaxed a ban on deploying its healthcare workers overseas, but still limits the number of medical professionals leaving the country to 5,000 a year.

(Compiled by Linda Noakes; editing by Barbara Lewis)

Trials of retooled vaccines for variants could take months: U.S. FDA

By Michael Erman

(Reuters) – Drugmakers should test any COVID-19 vaccines that have been retooled to combat new variants of the coronavirus in clinical trials designed to track the immune response of hundreds of test subjects, which could take months, U.S. regulators said on Monday.

Vaccine developers may need to modify their shots to provide protection against new variants of the coronavirus that turn up in the United States should they fail to elicit immune response in their current form, the U.S. Food and Drug Administration said in a statement.

The FDA said it believes currently authorized vaccines from Pfizer Inc with partner BioNTech SE and Moderna Inc. are effective against variants currently circulating in the United States.

Acting FDA Commissioner Janet Woodcock said drugmakers should not wait until a mutated virus is demonstrated to be able to escape the vaccines to begin developing new versions.

“We need to anticipate this and work on it, so that we have something in our back pocket before the threshold is upon us,” she said at a news conference.

The emergence of new, more contagious variants has prompted the U.S. government to step up efforts to track coronavirus mutations and try to keep vaccines and treatments effective against any new variants.

Pfizer and Moderna have both said they plan to run clinical trials of versions of their vaccine that have been redesigned to combat the highly contagious COVID-19 variant that has become prevalent South Africa and has turned up in several U.S. States.

The FDA made the comments as part of a newly updated guidance for companies making vaccines, tests and therapeutics for COVID-19.

As part of its updated guidance, the FDA recommended that vaccine makers test any modified vaccines in both previously unvaccinated people and vaccinated people. The manufacturers should compare the immune response of a modified vaccine against both the new variant as well as the original virus.

The FDA also recommended monitoring test subjects’ safety for at least seven days, to support emergency use authorization for modified vaccines.

The agency is trying to allow drugmakers to make the change with a minimal amount of extra data needed, said Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.

Still, the type of trial the agency wants, “might take a few months, whether it be two or three,” Marks said. “I can’t say exactly how long but again, that type of the scale of the amount of time.”

“We want to be ready so that we can move it into production, when it’s ready and when it’s needed,” he said.

(Additional reporting by Manojna Maddipatla and Mrinalika Roy in Bengaluru; Editing by Jonathan Oatis and Bill Berkrot)

‘One-way road to freedom’: Johnson sets out cautious lockdown exit plan

By William James and Elizabeth Piper

LONDON (Reuters) – Prime Minister Boris Johnson unveiled a map out of lockdown for England on Monday that would keep some businesses shuttered until the summer, saying caution was necessary to ensure there were no reversals on a “one-way road to freedom”.

After imposing one of the strictest lockdowns in the western world in January to counter a highly contagious variant of the coronavirus, Johnson said Britain was now in a position to enjoy the fruits of one of the world’s fastest vaccine programs.

Starting in two weeks with the reopening of schools, the phased plan will go through four stages, with at least five weeks in between each stage. The final step, when most restrictions will be lifted, will not start until June 21 at the earliest.

Britain and the world would not eliminate COVID-19 altogether, Johnson said. “And we cannot persist indefinitely with restrictions that debilitate our economy, our physical and mental well-being, and the life chances of our children,” Johnson told parliament.

“And that is why it is so crucial that this roadmap is cautious but also irreversible. We’re setting out on, what I hope and believe, is a one-way road to freedom.”

With almost 130,000 fatalities, Britain has suffered the world’s fifth-highest official death toll from the pandemic and its economy has seen its biggest crash in over 300 years.

But in two months it has already managed to provide an initial vaccine dose to more than a quarter of the population, the fastest rollout of any big country, making it a test case for governments worldwide hoping to return life to normal.

Even with encouraging data on the impact of vaccines, the British government’s cautious approach highlights how slow a process it will likely be for many countries.

UNDER PRESSURE

Johnson has come under pressure, including from many in his Conservative Party, to allow more freedoms to millions stuck at home and offer hope to firms forced to close.

Under his plan schools will reopen on March 8, freeing parents who have had to juggle work and home schooling.

However, easing of social mixing bans will initially be limited and the government will ask people to work from home when possible for some weeks until it has completed a review into social distancing at some point before the summer.

At the end of March, a small number of people will be able to mix outdoors, but non-essential shops, and outdoor-only service in restaurants and pubs, will not reopen until April 12 at the earliest.

As the plan unfolds, lawmakers will have a chance to vote on specific steps. Authorities in Scotland, Wales and Northern Ireland, which are responsible for their own public health, will also ease restrictions over the coming months.

There was mixed reaction from business leaders to the plan. The Confederation of British Industry said it offered hope, but the hospitality industry said it would be hard for many businesses to survive until they could reopen.

“Even with the prime minister’s new roadmap, the future of thousands of firms and millions of jobs still hangs by a thread,” said Adam Marshall, Director General of the British Chambers of Commerce.

There were widespread calls for finance minister Rishi Sunak to extend support, such as schemes that have paid the salaries of workers sent home because of the pandemic. An announcement will not come until Sunak delivers his budget next month, but Johnson promised not to “pull the rug out”.

“For the duration of the pandemic the government will continue to do whatever it takes to protect jobs and livelihoods across the UK,” Johnson told parliament.

SPEEDY VACCINE ROLL-OUT

Johnson, who was treated in intensive care for COVID-19 last year, has been forced to juggle pressure from Conservative lawmakers to restart the economy and from scientific advisers who fear a resurgence of the virus if he unlocks too quickly.

“The message that comes out of all of the modelling is … get (infection) numbers down before you start releasing, go slowly, (and) go in blocks that you can measure the effect of after four or five weeks,” the government’s top science adviser Patrick Vallance told reporters.

England’s vaccine campaign is significantly reducing cases, with a drop of around 70% in infections among healthcare workers who have had a first dose of the Pfizer-BioNTech shot, health officials said on Monday.

Britain moved faster than most countries to secure vaccine supplies and has been inoculating people rapidly since December, a strategy that has driven sterling higher on hopes of an economic rebound. The pound hit a new three-year high of $1.4050 in early London trading on Monday.

Some 17.7 million Britons, over a quarter of the 67 million population, have now received a first dose, behind only Israel and the United Arab Emirates in vaccinations per capita.

(Additional reporting by Alistair Smout, Estelle Shirbon, Guy Faulconbridge, Kate Holton, David Milliken, writing by Michael Holden and Elizabeth Piper, editing by Giles Elgood)

A day that will live in infamy: U.S. crosses 500,000th COVID-19 death

By Maria Caspani and Anurag Maan

NEW YORK (Reuters) – The United States on Monday crossed the staggering milestone of 500,000 COVID-19 deaths just over a year to the day since the coronavirus pandemic claimed its first known U.S. victims in Santa Clara County, California.

The country had recorded more than 28 million COVID-19 cases and 500,054 lives lost as of Monday afternoon, according to a Reuters tally of public health data, although daily deaths and hospitalizations have fallen to the lowest level since before the Thanksgiving and Christmas holidays.

About 19% of total global coronavirus deaths have occurred in the United States, an outsized figure given that the nation accounts for just 4% of the world’s population.

“These numbers are stunning,” Dr. Anthony Fauci, a top infectious disease adviser to President Joe Biden told ABC News’ “Good Morning America” program. “If you look back historically, we’ve done worse than almost any other country and we’re a highly developed, rich country.”

Biden and Vice President Kamala Harris are set to commemorate the huge loss of life due to COVID-19 later on Monday during an event at the White House that will include a speech by the president, a moment of silence and a candle lighting ceremony.

Biden will also order that U.S. flags on federal property be lowered to half staff for five days, White House spokeswoman Jen Psaki told reporters.

The National Cathedral in Washington will also toll its bells 500 times on Monday evening to honor the lives lost to COVID-19 in a livestream event, according to a notice on its website.

In 2020, the virus has taken a full year off the average life expectancy in the United States, the biggest decline since World War Two.

Sweeping through the country at the beginning of last year, the U.S. epidemic had claimed its first 100,000 lives by May.

The death toll doubled by September as the virus ebbed and surged during the summer months.

Pandemic-weary Americans, like so many around the world, grappled with the mountain of loss brought by COVID-19 as health experts warned of yet another coronavirus resurgence during the upcoming fall and winter months.

Americans lost mothers and fathers, husbands and wives, brothers, sisters and friends to the virus. For many, the grief was amplified by the inability to see loved ones in hospitals or nursing homes and by the physical distancing imposed by authorities to curb the virus spread.

By December, the death toll had reached 300,000 as the United States entered a deadly post-holiday season that would claim 230,000 lives in the span of less than three months.

With numbers that made the appalling toll early in the pandemic pale by comparison, deaths recorded between December and February accounted for 46% of all U.S. COVID-19 fatalities, even as vaccines finally became available and a monumental effort to inoculate the American public got underway.

Despite the grim milestone, the virus appears to have loosened its grip as COVID-19 cases in United States fell for the sixth consecutive week. However, health experts have warned that coronavirus variants initially discovered in Britain, South Africa and Brazil could unleash another wave that threatens to reverse the recent positive trends.

Fauci cautioned against complacency and urged Americans to continue public health measures such as wearing masks, physical distancing and avoiding crowds while officials race to inoculate the population, particularly with these more contagious new variants circulating.

“We’ve got be really careful and not just say ‘OK we’re finished now, we’re through it,” he told ABC.

(Reporting by Maria Caspani in New York and Anurag Maan in Bengaluru and Susan Heavey in Washington; Writing by Maria Caspani; Editing by Bill Berkrot and Lisa Shumaker)

COVID-19 heart problems may persist for months; smartphone oxygen meters prove helpful

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

COVID-19 heart problems may remain evident months later

Signs of heart injury in hospitalized COVID-19 patients could be precursors to longer-lasting heart problems, researchers have found. They studied 148 survivors of severe COVID-19 who had high levels of troponin – a protein released when the heart has been injured – while they were hospitalized. An average of two months after they left the hospital, magnetic resonance imaging (MRI) still showed some sort of heart issue in 48% of the patients, including heart attacks, heart muscle inflammation, inadequate blood flow, or some combination of those problems, the researchers reported on Thursday in the European Heart Journal. Among patients with heart attacks or inadequate cardiac blood flow, two-thirds had no past history of coronary disease. “Ultimately, we cannot definitely establish a link between the abnormalities detected on these cardiovascular magnetic resonance scans and the acute COVID-19 infection,” the authors said. But the high prevalence of the abnormalities “suggests a likely link.” Dr. Matthew Toomey, cardiac ICU director at Mount Sinai Morningside Hospital in New York City who was not involved in the study, noted: “We don’t have the benefit of long-term follow-up to see what it will develop into.” He added that he was guardedly optimistic that most patients will not end up with heart failure.

Samsung smartphone oxygen meters could help in COVID-19

A device in Samsung S9 and S10 smartphones that measures oxygen levels in the blood meets U.S. Food and Drug Administration standards and could be used to monitor COVID-19 patients, researchers said. Oxygen saturation levels are usually monitored with devices called pulse oximeters that clip onto a finger. Falling levels can indicate serious disease and need for intervention. Pulse oximeters used in hospitals are expensive, and inexpensive versions sold in drugstores are of variable accuracy, the researchers said in a report posted on Thursday on medRxiv ahead of peer review. The phones they studied have built-in pulse oximetry sensors, and the proprietary Samsung algorithms that interpret the signals “are very good,” said coauthor Sara Browne of the University of California, San Diego. “We are not aware of any other smartphone that has clinical grade pulse oximetry in it. Samsung did an awesome job on this,” she said. Samsung dropped the sensors from their phones for 2020 and 2021, Browne said. “As healthcare practitioners, we would love to see them put back in,” she added. Her team estimates that over 100 million S9 and S10 phones are still in circulation and said they could be particularly useful in countries where access to accurate pulse oximetry is limited.

PTSD often follows serious COVID-19

Italian doctors who interviewed COVID-19 survivors up to four months after their diagnosis found nearly one in three had post-traumatic stress disorder (PTSD). Their study included 381 adult survivors, roughly 80% of whom had been hospitalized. Aside from PTSD, seen in 30% of study participants, other psychiatric issues included depressive episodes (diagnosed in 17%) and generalized anxiety disorders (7%), according to a report published on Thursday in JAMA Psychiatry. Patients with PTSD were more likely to be female, to have been delirious or agitated while hospitalized, and to be suffering from persistent COVID-19 symptoms. The researchers point out that they only studied patients from a single hospital and did not compare them to patients with other serious illnesses, so they cannot say whether PTSD is more common after COVID-19. They note, however, that the prevalence of PTSD in their patients “is in line with findings … reported after other types of collective traumatic events.”

(Reporting by Nancy Lapid and Linda Carroll; Editing by Bill Berkrot)

Fed sees ‘considerable’ risk of ongoing U.S. business failures

WASHINGTON (Reuters) – The risks of ongoing business failures in the United States “remain considerable” even as the economy emerges from the coronavirus pandemic, the Federal Reserve said on Friday in its semi-annual monetary policy report to Congress.

Business borrowing “now stands near historic highs,” the U.S. central bank said in the report. Even though large cash balances, low interest rates, and renewed economic growth may dampen problems in the near term, “insolvency risks at small and medium-sized firms, as well as at some large firms, remain considerable.”

Fed Chair Jerome Powell will present the report in hearings before the U.S. Senate Banking Committee on Tuesday and the U.S. House of Representatives Financial Services Committee on Wednesday.

After presenting his own summary of where the economy stands he will field questions from lawmakers that are likely to focus on how much more help the economy needs from the federal government to reach the point where ongoing COVID-19 vaccinations make it safe to resume normal commerce.

The Biden administration is pushing a $1.9 trillion stimulus plan that has already cleared a major hurdle in the Senate, money on top of the nearly $900 billion approved late last year and the roughly $3 trillion appropriated at the start of the crisis in 2020.

Those federal payments, including one-time checks to families, increased unemployment insurance, and loans to small businesses, led to faster-than-expected economic growth and less-than-anticipated financial stress among households and the banks that hold their mortgages and credit card loans.

But while banks and household balance sheets remain in reasonable shape, the Fed’s reference to business debt highlights the potential economic hangover still to come after a historically trying year.

Along with business failures, the report noted how changes to the economy that are still underway could, for example, cut the market for already highly-valued commercial real estate and lead to “sharp declines” in prices – a potential blow to investors or lenders involved with those properties.

The report also noted that the borrowing and spending used in some countries to fight the pandemic had made their financial systems “more vulnerable” than before, and the situation may be getting worse. Stress in some emerging market nations, the report warned, could spill over “and produce additional strains for the U.S. financial system and economic activity.”

Next week will be Powell’s first appearance on Capitol Hill since Democrats won the White House and control of both chambers of Congress.

The Fed has pledged to keep its current policy of low interest rates and $120 billion in monthly bond purchases intact until the recovery is more complete. That may be tested in coming months if, as expected, the reopened U.S. economy begins to generate rising inflation.

(Reporting by Howard Schneider; Editing by Paul Simao)