DAVID GREENE, HOST:
More than 3,000 people in the United States died from COVID-19 on Wednesday.
NOEL KING, HOST:
That number is a gut punch. But the truth is we're seeing record numbers every single day now. And that's why an FDA meeting today is so important. Experts are going to weigh the benefits and the risks of clearing Pfizer's COVID-19 vaccine for emergency use in the U.S. Now, depending on how this meeting goes, we could know soon when our vaccination program is going to start.
GREENE: And we have NPR science correspondent Richard Harris with us this morning. Richard, hi.
RICHARD HARRIS, BYLINE: Good morning, David.
GREENE: Let's start with just the background of this meeting and exactly what's happening today.
HARRIS: Right. The Food and Drug Administration has a long-standing practice of using advisory committees like this to weigh in on drug approvals. The idea is to get input largely from academic scientists who have an opportunity to raise questions and to do a quick independent evaluation. On Tuesday, the FDA released its recommendations, along with an information packet from Pfizer, and that will be the basis of this daylong discussion. The FDA has built a case that this vaccine should be authorized for emergency use. Now, the meeting starts at 9 a.m. Eastern Time, and streaming video is available for anyone who really wants to get into the weeds. It is part of the government's effort to be as transparent as possible so people have confidence in the process. The FDA review has been compressed as much as possible in order to get to a conclusion as quickly as possible.
GREENE: I mean, big scientific discussions, not normally something I would be watching, but this is so important. It's really tempting to take a look and follow this. So is it mostly a discussion, or is there, like, something specific that this committee is tasked with doing or deciding?
HARRIS: It's a bit of both, but it's mainly supposed to review the two biggest questions. That is, is the vaccine safe, and is it effective? Friday, the chair of this advisory committee, Dr. Arnold Monto, was at a meeting where he expressed optimism.
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ARNOLD MONTO: Unless there are surprises, there will not be an issue in terms of efficacy.
HARRIS: Yeah, the FDA says it's 95% effective across a wide variety of ages, as well as races and gender. The committee will also hear about some related questions, such as when to give vaccines to the more than 20,000 volunteers who received a placebo in the study. And they'll hear about plans for monitoring people long term after they've received the vaccine.
GREENE: What about the question of safety and possible side effects? I mean, we heard yesterday that two people who got the vaccine in Britain had a pretty bad reaction, right?
HARRIS: Right, they did. They were two medical workers who knew that they were at very high risk for an allergic reaction. And so they were prepared, and they managed it OK. Side effects will no doubt, though, be a discussion at the committee meeting. From the briefing materials involving tests in about 40,000 volunteers, we know that a majority of people who get this vaccine do have some kind of a reaction, ranging from soreness at the injection site to headaches or achy joints and so on, but nothing severe. And, you know, that's similar to what people get from other vaccines, like shingles shots. People with a history of allergic reactions were actually excluded from this study because officials already know that vaccines are a risk and can trigger them.
GREENE: So let's get to the central question. Assuming the committee is satisfied with all the questions here, I mean, how soon could the FDA make the ruling and get this vaccine approved here in the United States?
HARRIS: Committees like this usually vote at the end of the day, and then the FDA then spends a bit more time mulling its final decision. But Norman Baylor, a former FDA vaccine official, says a snap decision isn't impossible. He says here's one scenario if the advisory committee's vote is unanimous.
NORMAN BAYLOR: FDA huddles immediately. They could make a determination rapidly that, yep, this is good to go.
HARRIS: And if there is a quick decision, the first doses of this vaccine could get into people's arms within days.
GREENE: Wow. All right. We're hoping. NPR's Richard Harris, thank you so much.
HARRIS: Sure.
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GREENE: So how did Facebook grow so powerful? Two lawsuits are going to take up that question in court, and the answer could have real consequences for the company.
KING: That's right. One lawsuit is from the Federal Trade Commission and the other was brought by 48 attorneys general. They say that Facebook does not compete. It either buys companies that threaten its dominance or it just goes ahead and crushes them.
GREENE: And before we turn to this, we should note that Facebook is a financial supporter of NPR. We have NPR tech correspondent Shannon Bond with us. Hi, Shannon.
SHANNON BOND, BYLINE: Hi, David.
GREENE: OK, so what's the argument here from the FTC, from these attorneys general? I mean, what are they asking for?
BOND: Right. So the FTC and these states have both been investigating Facebook for more than a year, and they're coordinating on these lawsuits. And they've really zeroed in on Facebook's purchases of Instagram, the photo sharing app back in 2012, and messaging service WhatsApp a couple years later. And the lawsuits are both asking - you know, they want the court to decide if Facebook should have to sell or spin off Instagram and WhatsApp, which, of course, are two of its most popular businesses. And they want to make sure that Facebook can't easily swallow up other competitors. And the reason is, they say Facebook is just too powerful, and it's cemented that power by buying rivals, like it did in these cases, or in other cases, they have accused Facebook of cutting off other apps that it saw as potential competitors from critical access to its data and systems. So New York Attorney General Letitia James led the state's investigation. And here's what she said about this strategy. She said Facebook has sent a clear message to the tech world.
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LETITIA JAMES: Don't step on Facebook's turf or, as one industry executive put it, you will face the wrath of Mark.
BOND: And there, she's referring, of course, to Mark Zuckerberg, Facebook's CEO.
GREENE: The wrath of Mark. I assume that Facebook is not just rolling over here and saying, yeah, this is a problem, you should punish us.
BOND: So it says it's going to defend itself vigorously. The company's general counsel says the lawsuits are, quote, "revisionist history." So, first of all, Facebook says there's just - there's plenty of competition. Look at TikTok. Look at Snapchat. And it says the FTC actually had a chance to examine these deals for Instagram and WhatsApp back in the years that they were made years ago. They found no problems. And so it says the government is now asking for a do-over. It wants to punish Facebook for being successful and says that's not fair. That's the government abusing its power.
GREENE: Well - and Facebook isn't the only big tech company under a lot of pressure right now, right? I mean, the Justice Department sued Google recently. Is this coincidence or is there sort of a trend we're seeing right now?
BOND: Well, you know, David, for a long time, you know, regulators and lawmakers in D.C. took this really hands-off approach to these Silicon Valley giants. You know, these companies like Facebook and Google, they were seen as valuable innovators that should be sort of allowed to thrive and just grew so quickly, didn't have a lot of constraints. There has been this sea change. Everyone now, it feels like, is realizing just how powerful a handful of these companies are. Critics argue Facebook and Google have actually made it harder for new companies now to innovate. And so what Letitia James and the other attorneys general say that means is that people's privacy is at stake. They say, you know, we don't have a lot of choices over what search engines or social networks to use. So we give our data to these companies whether we want to or not.
GREENE: NPR tech correspondent Shannon Bond. Thanks, Shannon.
BOND: Thank you.
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GREENE: So if the federal government wants to spend hundreds of billions of dollars keeping businesses and families afloat, where exactly should that money go?
KING: Lawmakers don't agree on an answer to that question. They're debating a COVID relief package that could be folded into a big spending bill next week. Now, a lot of people, of course, would love to get another $1,200 check because a lot of people, of course, are struggling. But cutting those lump sum checks might not actually be the best way to juice the economy.
GREENE: So what is Congress going to do? How is this going to work? We have NPR's Scott Horsley here. Good morning, Scott.
SCOTT HORSLEY, BYLINE: Good morning, David.
GREENE: So who is lobbying for the idea of direct payments to people? And is that camp likely to get its way?
HORSLEY: It's not clear if they're going get their way. Direct payments were not included in that bipartisan proposal that a group of moderates put out last week. They did include help for small businesses, aid to state and local governments, and an extension and increase in unemployment benefits but no blanket payout to individuals and families. And that omission did draw some criticism from people on the left and the right. For example, Vermont Senator Bernie Sanders says he won't support the measure because it didn't include another round of $1,200 payments. And we heard a similar message from Josh Hawley, a conservative senator from Missouri.
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JOSH HAWLEY: Any COVID relief bill needs to include direct payments to people who are in need, to working families and working individuals. They should be the centerpiece, not an afterthought.
HORSLEY: Hawley told KFVS-TV in Missouri he's pressed that case with President Trump and urged the president to veto any relief bill that doesn't include direct payouts.
GREENE: So is that argument making a difference?
HORSLEY: Well, the president and his team are listening. When Treasury Secretary Steven Mnuchin introduced the administration's proposal this week, it did include direct payments, although just $600, not $1,200 like back in the spring. Not surprisingly, polls show a lot of bipartisan support for direct payments. It turns out free money is popular with both Democrats and Republicans.
GREENE: So if there's bipartisan support, what's the holdup? Why not just put this in the relief package?
HORSLEY: Cost, for one thing. The $600 payments in the administration's plan would cost something like $140 billion. And the offset that the administration suggested is to reduce the proposed unemployment benefits. The problem is unemployment benefits deliver a much bigger bang for the buck when it comes to boosting the broader economy. And think about it, David, - if somebody is out of work and they get an extra dollar in unemployment benefits, they're pretty sure to go out and spend that money right away. And that helps their landlord, the grocery store, the gas station and the broader economy. Economist Mark Zandi of Moody's Analytics says that's not necessarily true of direct payments that go out widely to people, whether they need the money or not.
MARK ZANDI: The stimulus checks that went out earlier in the year, a large chunk of that just ended up in people's checking accounts and to this day remains there. They'll spend it, but it will be spent on the other side of the pandemic when it'll do less good for the economy.
HORSLEY: Aid to state and local governments also provides a lot of bang for the buck; grants to small businesses, probably less so, but they're almost sure to be part of any relief package. For all the jockeying, Zandi says the most important thing is that lawmakers pass something before they go home for the holidays. You know, while some kinds of relief are more effective than others, no relief is the worst of all.
GREENE: Yeah, I think a lot of people are feeling that and hoping Congress does something at some point really soon. NPR's Scott Horsley, great talking to you, as always. Thanks, Scott.
HORSLEY: Good to be with you, David. Transcript provided by NPR, Copyright NPR.
