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  1. Google tells employees to work from home to prevent coronavirus spread Google wants all North American employees to work remotely through April 10. Enlarge / Exterior view of a Googleplex building, the corporate headquarters of Google and parent company Alphabet, May 2018. Getty Images | zphotos 39 with 32 posters participating The threat of the new coronavirus is making working from home a more and more popular option for tech companies, and yesterday Google expanded its work-from-home recommendation to all North American employees. In a memo obtained by CNN, Google's vice president of global security, Chris Rackow, said, "Out of an abundance of caution, and for the protection of Alphabet and the broader community, we now recommend you work from home if your role allows." For now, Google's work-from-home recommendation extends through April 10, with the company saying it is "carefully monitoring the situation and will update the timeline as necessary." Alphabet, Google's parent company, employs around 120,000 people, and as a US-based company, the majority of those employees are based in North America. The new coronavirus has led to the cancellation of most of this year's large trade show gatherings. Mobile World Congress, which was scheduled for February, was canceled at the last minute. Google killed Google I/O 2020 just last week, Facebook shut down F8, and E3 was canceled yesterday. Big gatherings present a higher risk for spreading the virus, and along the same lines of thinking, going to work at your big tech campus is also a vector for infection. In a blog post yesterday, Google said it is "establishing a COVID-19 fund that will enable all our temporary staff and vendors, globally, to take paid sick leave if they have potential symptoms of COVID-19, or can’t come into work because they’re quarantined. Working with our partners, this fund will mean that members of our extended workforce will be compensated for their normal working hours if they can’t come into work for these reasons." Source: Google tells employees to work from home to prevent coronavirus spread (Ars Technica)
  2. US coronavirus cases top 550 with 22 deaths as virus spreads to over 30 states The case count rises despite testing difficulties. Enlarge / KIRKLAND, Wash.: A patient is shielded as they are put into an ambulance outside the Life Care Center of Kirkland on March 7, 2020. Several residents have died from COVID-19, and others have tested positive for the novel coronavirus. Getty | Karen Ducey 209 with 98 posters participating The coronavirus situation in the United States continues to escalate with the country’s case total well over 550 and over 30 states reporting cases as of Monday. There have been 22 deaths. Cases in the United States rose fivefold just over last week. But it’s important to keep in mind that these aren’t necessarily new cases. The boom in disease detection stems from ramped-up testing by state and local health departments in the past week, revealing a backlog of cases that in some places may have been spreading quietly for weeks. The slowed access to tests has hobbled the country’s response to the virus. The US Centers for Disease Control and Prevention developed a test for the coronavirus early last month, but the test quickly ran into technical problems that the agency was slow to resolve. Those technical issues are now worked out, federal regulators have relaxed rules on who can develop additional tests, and commercial test kits are coming on line. Still, the US is struggling to meet testing demands as the disease has continued to spread and more people have potentially been exposed. While case numbers are ever shifting, data compiled by researchers at Johns Hopkins University suggests at least 565 cases in the US as of the time of publication. Those reports are coming from at least 34 states and the District of Columbia. Three states are particularly hard hit: Washington state, which reported the country’s first case in January; California, which has housed hundreds of quarantined citizens repatriated from China and a coronavirus-stricken cruise ship; and New York state, largely due to an outbreak in Westchester County, a suburb of New York City. Currently, Washington state is reporting 136 cases and 19 deaths. Many of the deaths are linked to a skilled nursing home in King County in the Seattle area that is experiencing an outbreak. California is reporting 114 cases, including 24 in repatriated citizens, 37 travel-related cases, and at least 14 from spread in a community. At least one death has been reported in California. New York state is reporting 105 cases, including 82 from Westchester. There have also been two deaths reported in Florida. Two Princesses The US case count includes 45 cases in repatriated citizens who were passengers on the Diamond Princess cruise ship and 21 cases on passengers of the Grand Princess cruise ship. The Grand Princess is currently off the coast of San Francisco but is expected to dock later today. The more than 3,500 on board will be returned to their home countries or placed under a 14-day quarantine. The Diamond Princess, which was docked in Japan for an onboard quarantine that ended last month, had an outbreak involving at least 696 cases. As the disease spreads in the United States, experts have been talking more about social-distancing measures in the US to try to halt the virus’ march. That includes the CDC and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. In an interview with The New York Times, Dr. Fauci advises Americans: “Don’t go to crowded places, think twice before a long plane trip, and for goodness’ sake, don’t go on any cruises.” And for those who are older and/or have underlying health conditions, he advised: “Don’t wait for community spread. Now is the time to do social distancing, whether there is spread in your community or not.” Source: US coronavirus cases top 550 with 22 deaths as virus spreads to over 30 states (Ars Technica)
  3. Blood donors will help researchers figure out how long novel coronavirus antibodies last The Red Cross is giving antibody tests to every donor A blood drive in Chicago at the Field Museum of Natural History. Photo by Scott Olson/Getty Images The American Red Cross is testing all donated blood for novel coronavirus antibodies and will use that information to learn more about the spread of COVID-19. They’ll also check back in with donors to find out how long their antibodies last. If someone has antibodies to the novel coronavirus, it’s a sign that they were, at one point, infected with the virus. While the tests on the market now aren’t perfect, many people are still interested in getting them — including people who thought they had COVID-19, but weren’t able to get tested when they were sick. One goal of the antibody testing initiative is to encourage more people to donate blood, says Susan Stramer, vice president of scientific affairs at the Red Cross. Stay-at-home orders meant fewer people than usual donated blood over the past few months, and supplies have been running low. The organization has seen about an 150 percent increase in the number of donation appointments since the antibody testing started on June 15th. When someone donates blood to the Red Cross, they consent to allow their blood samples to be used in research studies. Thousands of people all over the country donate blood each month, which gives the organization a huge pool of blood samples to analyze. By testing all of those samples for novel coronavirus antibodies, the organization will also be able to get a sense of how widespread the virus is. “We collect 40% of the nation’s blood supply, so we have an easy picture to answer questions around how many people are antibody positive,” Stramer says. So far, with two weeks of data, around 1.2 percent of blood donors have novel coronavirus antibodies. The Red Cross will reach out to donors who have antibodies and ask them if they’re interested in participating in an additional follow-up study to test how their antibody levels may change over time. These antibodies probably help protect people against getting sick from the virus again, but a lot more research still needs to be done. Researchers still don’t have a good sense of how long antibodies against this virus actually stick around in the body. Some preliminary data suggests novel coronavirus antibodies might only linger for a few months, especially in people who didn’t have symptoms when they were infected. The study will check in once a month to retest participants’ antibody levels. “We hope to enroll as many people as possible, but I think if we get over 30 percent, we would consider that a success,” Stramer says. The Red Cross is also participating in a nationwide antibody study, with support from the Centers for Disease Control and Prevention. That study will include multiple blood donation organizations and will check the percentage of the population with novel coronavirus antibodies this fall and again in 2021. “It’s certainly the largest serosurvey I’ve ever been involved with,” Michael Busch, who’s helping lead the efforts as director of the Vitalant Research Institute, told Science. Each of those surveys will include 50,000 blood samples. The projects are similar but different in scope. “Ours is really a deep dive into the details of our donors and the antibody duration, whereas the CDC program will look at changes over time,” Stramer says. Blood donation centers have taken advantage of the thousands of samples at their disposal for scientific research for decades. Studies started through the National Heart, Lung, and Blood Institute began studying donated blood in 1989 over concerns about the impact of HIV on blood transfusion safety. Since then, donated blood has helped scientists understand more about diseases like Zika and West Nile virus. Donated blood won’t give us a perfect snapshot of a population. Some groups are also excluded from donating blood entirely. Men who’ve had sex with another man in the past three months are ineligible, which effectively excludes non-abstinent gay men from donation. The Red Cross is also advertising their antibody tests, so people who were sick might be more likely to volunteer as blood donors — which could skew the data they’re collecting and make it more heavily weighted toward people who have antibodies. The organization is surveying donors to ask why they decided to donate, though, so they’ll have that information to accompany the study. People also have to be entirely healthy in order to donate blood, and because COVID-19 can linger, there could be a time lag between when people are sick and when they’d be counted in these types of studies. It’s still valuable to understand how many people who are currently healthy have novel coronavirus antibodies, Stramer says. “It really represents those individuals who may not know they were infected, or who were infected and are now symptom-free.” Blood donors will help researchers figure out how long novel coronavirus antibodies last
  4. Draft landscape of COVID-19 candidate vaccines Overview These landscape documents have been prepared by the World Health Organization (WHO) for information purposes only concerning the 2019-2020 global of the novel coronavirus. Inclusion of any particular product or entity in any of these landscape documents does not constitute, and shall not be deemed or construed as, any approval or endorsement by WHO of such product or entity (or any of its businesses or activities). While WHO takes reasonable steps to verify the accuracy of the information presented in these landscape documents, WHO does not make any (and hereby disclaims all) representations and warranties regarding the accuracy, completeness, fitness for a particular purpose (including any of the aforementioned purposes), quality, safety, efficacy, merchantability and/or non-infringement of any information provided in these landscape documents and/or of any of the products referenced therein. WHO also disclaims any and all liability or responsibility whatsoever for any death, disability, injury, suffering, loss, damage or other prejudice of any kind that may arise from or in connection with the procurement, distribution or use of any product included in any of these landscape documents. WHO Team: R&D Blueprint Number of pages: 9 Download draft landscape documents (401.7 kB) Source
  5. Humans aren’t the only creatures at risk from dying of covid-19, it seems. In recent weeks, the state of Utah has been dealing with mass die-offs at mink farms that health officials believe are linked to the viral pandemic—outbreaks that likely began from contact with infected human handlers. So far, nearly 10,000 minks in Utah are thought to have died during these outbreaks in the span of two weeks. According to Utah Department of Agriculture and Food (UDAF), these deaths have been concentrated among nine fur farms in the state. Shortly before dying, UDAF veterinarian Dean Taylor told NBC News, these minks experience respiratory symptoms like trouble breathing or runny noses and eye discharge, similar to what happens in people sick with covid-19. As with people, older minks seem to be more susceptible to dying from the coronavirus, he added. For months now, scientists have known that minks and other weasels, like ferrets, can become infected with the coronavirus that causes covid-19, and that they can catch it from infected humans. Unlike cats, dogs, and other animals that the virus has infected through human contact, however, weasels seem to be especially vulnerable to more serious illness. That’s made these animals a useful model for studying the virus outside of a petri dish in the lab, but it’s also made them an easy target for the virus in the real world. Indeed, Utah’s outbreaks are not the first to have hit mink farms. Earlier outbreaks in the Netherlands and Spain prompted officials there to cull more than 1 million minks to prevent the infection from spreading further. So far, no minks in Utah have been killed as a precaution during these recent outbreaks, though affected farms have enacted quarantines. The UDAF is also working with the Centers for Disease Control and Prevention and other federal agencies to secure more personal protective equipment and training for farmers working with minks in the state. As dire as these outbreaks have been for the mink industry, the danger to people seems to be low. Though people can spread the virus to minks and other animals, the risk of these animals then spreading the infection back to other susceptible people is thought to be very low, according to the CDC. That said, the original strain of the coronavirus that became responsible for covid-19 likely came from an unknown animal source, possibly bats. Source
  6. Musk stated last week that his rapid tests were inconclusive, but he had an additional test this week. Tesla CEO Elon Musk says that he has "fully" recovered from his bout with a mild fever or cold about a week after he took to Twitter to say he tested positive for coronavirus. Last week, Musk caused a stir on Twitter after he called into question the accuracy of the coronavirus tests he took. "Something extremely bogus is going on. Was tested for covid four times today. Two tests came back negative, two came back positive. Same machine, same test, same nurse. Rapid antigen test from BD," Musk tweeted last week. BD is the maker of the testing equipment. Musk went on to say that he was "getting wildly different results from different labs, but most likely I have a moderate case of covid." Then this week, Musk took a more reliable PCR test that he said showed "unequivocal" evidence that he had Covid. He described his symptoms as being the same as a "minor cold, which is no surprise, since a coronavirus is a type of cold." In March, Musk announced that Tesla would be leaving California over "absurd and medically irrational behavior in violation of constitutional civil liberties," as the state looked to stop production in the early days of the coronavirus pandemic. Musk was still threatening to leave California as recently as August. On Wednesday, Morgan Stanley raised Tesla to overweight for the first time in more than three years, predicting that the electric carmaker is on the verge of a “profound model shift” from selling cars to generating high-margin software and services revenue. “To only value Tesla on car sales alone ignores the multiple businesses embedded within the company,” Jonas said in a research note to clients as he upgraded the shares from equal-weight and raised his price target by 50% to $540 from $360, suggesting 22% additional upside for the stock. Source
  7. Viral weak spots — COVID-19: the biology of an effective therapy We already know lots about coronavirus biology. Enlarge Aurich Lawson / Getty 45 with 29 posters participating, including story author A coronavirus vaccine may not arrive for at least a year—so what are the chances of finding a useful therapy that could stave off the worst effects of the virus in the meantime? Earlier coronavirus outbreaks like SARS and MERS raised warning flags for public health officials. Fortunately, they also alerted the biological research community that this large family of viruses was worth studying in more detail. Recent research has built on a large body of knowledge about coronaviruses that have long caused significant diseases in livestock, and so SARS-CoV-2 does not arrive as a total unknown. Indeed, we are actually in a decent position to understand what might make a good potential therapy. While some of the therapies being tested may seem random—we're trying chloroquine, an antimalarial drug?—there's serious biology behind what's being done. Genes without DNA A basic challenge confronts all viral therapies: most viruses have just a handful of genes, and they rely on proteins in the cells they infect (host cells) to perform many of the functions needed to reproduce. But therapies that target host cell proteins run the risk of killing uninfected cells, making matters worse. So antiviral therapies usually target something unique about the virus—something important enough that a few mutations in the virus won't make the therapy ineffective. Those of you who didn't sleep through high school biology may remember that genetic information is carried by DNA. When a protein needs to be built, the relevant bit of DNA is read and the cell makes a temporary copy of the information using a very similar chemical called RNA. This piece of RNA is then translated into a sequence of amino acids, which form the protein. While there are some exceptions to this—many RNAs perform important functions without ever being translated into proteins—all RNA in our cells is made by transcribing a DNA sequence. But we've known for a long time that this process doesn't hold for viruses. Many viruses, including HIV and the influenza virus, use RNA for their basic genetic material. The coronavirus is also an RNA virus; it consists of a single, 30,000-base-long RNA molecule. This is a problem for the virus. The host cells it infects only have proteins that copy DNA, not RNA, so how can more copies of the virus get made? Target: reproduction It turns out that the virus carries its own solution with it. When virus' RNA genome first enters a cell, it interacts with the host's protein-making machinery, using it to make proteins that can copy RNA molecules. These RNA-copying proteins, called "polymerases," make an enticing target for therapies. Because host cells don't naturally have them, therapies that target these RNA-making proteins should have a lower chance of off-target effects. Block these RNA polymerases, and the virus can no longer reproduce, stopping an infection. That's the good news. The bad news is that DNA and RNA are so closely related that it can be difficult to make a drug that affects only one type of polymerase. We saw this with some of the first therapies against HIV, which targeted the enzymes that copied the virus' RNA genome: they did slow the virus down, but they also harmed any rapidly dividing cells in the host. Enlarge / The 30,000 base long coronavirus genome is used to produce a large variety of proteins. Sawicki, Sawicki, and Siddell/J. Virology So the work is tricky. But many such drugs have been developed that don't interact as well with our own DNA polymerases. Some have even been tested for safety in humans, since they were developed for earlier threats like HIV or Ebola. Now, several are being quickly tested against coronavirus. One such drug, remdesivir, was originally developed in the hope that it would limit Ebola virus and its relatives. While that hasn't worked out, the drug was safe for human use and showed promise in its ability to limit the spread of another coronavirus (MERS-CoV) in cultured cells. As a result, it was quickly tested against SARS-CoV-2, and the results were also positive. The National Institutes of Health started a clinical trial against COVID-19 in February. Vincent Racaniello is a faculty member at Columbia University and the host of the This Week in Virology podcast. He believes that RNA polymerases are so similar across a range of coronaviruses that we might find a single molecule that inhibits them all. To Racaniello, our response to SARS and MERS wasted a great opportunity. "We could have had a broadly acting antiviral that targeted RNA polymerase by now," he told Ars. "We could have had people isolating the gene from various bat coronaviruses and doing screens to see if we could find compounds that could have inhibited them all. That's the kind of thing that's doable and should have been done. And if we had such antivirals ready, they could have been used right at the onset in China." Target: processing RNA copying polymerases aren't the only potential therapeutic targets for a coronavirus. Their RNA polymerases are initially made in forms that aren't fully functional; instead, they must have small pieces snipped out in order to adopt their mature configuration. Coronavirus RNA therefore encodes two or three proteins that do this cutting. They belong to a class of proteins collectively termed "proteases" for their protein-cutting ability. Proteases typically have a very specific site where the cutting takes place, and any chemicals that can fit into this site might shut the protease down. Not surprisingly, such chemicals are called protease inhibitors. This approach has been used successfully against other viruses, notably including HIV. Scientists have now found that protease inhibitors targeted to HIV might have activity against coronavirus, despite the fact that these viruses are unrelated. Because proteases are present in small numbers in infected cells and have a catalytic activity that depends on a single, specific site, Racaniello views them as some of the most promising targets for therapies. We've also got large libraries of chemicals that are known to inhibit similar proteins, many of which are already approved for use in humans. So, while the news around protease inhibitors has been somewhat limited, expect it to pick up dramatically as more of these molecules are screened. Enlarge / The structure of a coronavirus protease. Protein Database Japan Target: packaging After replication, viral RNA can't continue an infection until it is packaged up into a mature virus and gets outside of the host cell. This requires special packaging proteins. (In coronavirus, these proteins do double duty by also helping the viral RNA link up with its copying enzymes.) This packaging step would seem to provide a great opportunity for targeted therapy, as disrupting it should limit the amount of functional virus that gets made and exported from any particular cell. But drugs that try to block viral packaging are rare—Racaniello can only think of one, a treatment for Hepatitis B that causes the mature virus particles to form without any genetic material inside. "That's been a very unusual antiviral," Racaniello said. "There's no other like it." Part of the problem, he said, is that structural proteins like this are present in high numbers, since they're part of every single virus particle that's produced. And you have to interfere with all these copies to be effective. Another problem is that the interactions among proteins and genetic material during packaging of a virus tend to involve extensive contacts between multiple molecules. These are a bit harder to disrupt specifically, and doing so may require large molecules that don't diffuse in and out of cells well. So, while we know which protein binds to the RNA and helps package it inside the virus particle, this protein is not an obvious target for therapies. It's also hard to disrupt newly packaged viruses as they are moved out of the cell. Once packaged, coronaviruses leave their host cell via an export system that's normally used to send material to the cell's surface (a process called exocytosis). This process is fairly generic—it works with a huge variety of proteins in addition to those encoded by coronaviruses—making it vital for cell survival. As a result, there are not many places where we can intervene without shutting down exocytosis in healthy cells as well. Target: the viral shell Once we have a mature virus particle, its behavior is controlled by the proteins that form the exterior structure of the virus. In the coronavirus, two of these proteins (called "membrane" and "envelope") combine with some of the cell's membrane to form the virus' shell. There's also the spike protein, which creates a halo (or "corona," meaning "crown") around the virus that gives it its name—and which serves to latch on to cells to enable infection. In some coronavirus strains, the envelope protein can be eliminated without blocking the virus from infecting cells, which means it's a lousy target for therapies. The membrane protein is the most abundant protein on the surface of the virus, but it's small and buried within the membrane (as its name implies). Not much of it is accessible to the outside world. Combine that with the fact that it doesn't appear to have an enzymatic function, and it's not an ideal target, either. That leaves the spike protein. Spike is a complicated protein that provides a wealth of targets for potential therapies. As the most prominent feature of the virus' exterior, spike is the main target of antibodies against the virus produced by the immune system. We've already got the structure of the coronavirus' primary surface protein. Wrapp et. al. This reality has already led to one option for therapies: purifying plasma from people who have fought off a coronavirus infection, on the assumption that the plasma contains antibodies that can neutralize the virus. This plasma can then be infused into sick people, where the antibodies should help the immune system clear the virus. While it's only a temporary fix—antibodies don't survive indefinitely in the blood stream—it may give a patient's own immune system sufficient time to develop its own antibodies. There are unknowns about whether infected individuals produce effective antibodies—more on that immediately below. But the big issue here is scaling, as plasma treatment relies on having enough healthy, formerly infected individuals who are willing to donate blood plasma. If used strategically—on the most at-risk patients, or to help infected health care professionals—it could be a helpful tool, but isn't likely an effective general therapy. A different approach to antibodies But antibodies therapies aren't limited to infusing blood plasma. Once the immune system generates cells that produce anti-coronavirus antibodies, we can pull out the genes that encode these antibodies, insert the genes into plant cells, and get those cells to pump out large quantities of the antibodies. With a bit of time, we might even produce a cocktail of several antibodies that all bind to coronavirus, and do so in quantities that could make this an effective therapy for those infected. (This approach was tried during an Ebola virus outbreak.) This approach will take longer to develop and vet for safety, so it won't be the quick fix provided by blood plasma. But it does offer the promise of scale, producing sufficient quantities of the therapy to treat entire populations. It also provides us with the ability to carefully select the antibodies we produce. While our immune systems produce antibodies to viruses like HIV and influenza, many of these bind to parts of the virus that can easily change through mutations. That makes them ineffective, since the virus has an opportunity to evolve. What we need are "broadly neutralizing" antibodies, which seem to bind to parts of the virus where mutational changes can't occur without compromising its basic function. In many cases, broadly neutralizing antibodies turn out to stick to the parts of the virus that latch on to human cells to start new infections, and thus they block the virus' ability to infect anything. At the moment, we simply don't know how much the proteins on the surface of SARS-CoV-2 can change while still retaining their function. We can make some inferences based on what we've seen in other coronaviruses, but experts have reached somewhat different conclusions. This is a research area to watch carefully, because the rate of change in the surface proteins will dictate how effective antibody-based therapies are—and how easy it will be to develop a vaccine. Fortunately, things are moving quickly, with one company announcing on Wednesday that it has identified hundreds of antibodies that target SARS-CoV-2. It estimates that it could have sufficient production for testing by the summer and be making hundreds of thousands of doses a month by the end of the summer. Target: new infections The final step in the virus' life cycle is infecting a new cell. Typically, what is taught here is a "lie of simplification," which goes: the virus latches on to a protein on the cell's surface, then uses that protein to gain entry into the cell. This is true as far as it goes, but for most viruses, things are considerably more complicated. Coronaviruses definitely fall into the "more complicated" category in this regard. SARS-CoV-2 does latch on to a protein on the surface of cells in the respiratory tract; we've already confirmed that it's the same protein as the one used by the original SARS-CoV. But that doesn't immediately result in viral contents entering the cell. Instead, the complex of virus and receptors stays on the outside of the cell membrane. That membrane, however, gets pulled into the cell and "pinched off" from the cell's surface, creating a sac within the cell that now contains "outside" material. Enlarge Aurich Lawson Once this occurs, the virus is technically inside the cell, but it's still on the wrong side of a membrane from everything it needs to reproduce. The cell takes over this compartment, lowering its pH and adding enzymes to break down its contents. Corona and other viruses actually take advantage of these changes to enable their infection. In the case of coronavirus, a protease made by the host cell cuts the viral spike protein. Once cut, the spike protein triggers a merger between the membrane in the virus' coat and the membrane of the compartment it is trapped in. This finally places the virus' genome inside the cell, where it can proceed with the infection. This series of events provides potential targets for therapies. One of these targets is the drop in pH. This is the step that's targeted by chloroquine, the antimalarial drug. Chloroquine can cross membranes and so can enter the sac containing the virus. Once there, it can neutralize the pH. That's significant, because many proteases are only active at lower pH. If the pH inside the sac doesn't change, it's possible that the coronavirus spike protein won't be cut and thus won't be activated. This appears to be the case in cultured cells infected by the virus, and there are anecdotal case reports of chloroquine helping COVID-19 patients. The host cell proteases themselves also make a tempting target. A paper we mentioned above identified a protease that appears to be essential for the coronavirus spike protein's activation. That team showed that an inhibitor of this protease blocked coronavirus infections in cultured cells. The inhibitor has been approved for use in humans by Japan, so this may be another promising avenue for tests. (Racaniello notes that this protease is also used to activate influenza viruses.) The risk here is that the protease in question might also play an essential role in healthy cells. Finally, it's tempting to directly target the interactions between the spike protein and the protein it binds. But Racaniello says that these interactions are extensive, and they can be difficult to disrupt with a single molecule. It's been tried with HIV but mostly came up short. The only thing that has worked is a 30-amino-acid-long protein that mimics part of the protein HIV binds to, but that can't be stored in water, and it needs to be mixed up and injected for use—not the sort of thing likely to be helpful when a pandemic is limiting healthcare resources. Beyond the obvious There are plenty of options for interfering with coronavirus based on what we already know about its biology. But there are still many things we don't know. A recent article in the New York Times described how scientists have identified hundreds of proteins made by host cells that interact with proteins encoded in the coronavirus genome. We don't know the significance of most of these interactions and whether or not they're important or coincidental, but any of them could potentially lead to a therapy. That would, however, probably take longer than a targeted therapy, since there are more steps involved in screening for effective drugs than there are in, say, screening a library of known protease inhibitors against the coronavirus' proteases. There's also the potential to intervene at the level of the body's response to the virus, rather than targeting the virus itself. The more damaging consequences of some infections come from an exaggerated immune response to the virus. Biotech giant Genentech, for example, announced on Thursday that it was starting clinical trials of an immune-dampening treatment on hospitalized coronavirus cases. The potential return for having any useful therapy is so large that it's worth following as many of these paths as we can at once. The easiest way to understand why is to return to the epidemiological model we covered earlier this week. The model indicated that any steps short of extreme isolation measures would likely allow the virus to overwhelm the healthcare system—and any easing off of restrictions could lead to a resurgence within weeks. Extreme restrictions, however, will probably cause severe economic problems, especially if the only hope is a vaccine that might be over a year off. But the model has an obvious gap: it doesn't account for an effective therapy. If any of the approaches described above—or one we didn't consider—is even moderately effective, it could radically change our circumstances. It could ensure that far fewer coronavirus cases need hospitalization, and that fewer of those that do require critical care. A country's healthcare system could then continue functioning in the presence of a higher rate of infection, which in turn could mean that less dramatic social restrictions are required. If carefully managed, this might even allow countries to allow enough infections so that they achieve herd immunity before the availability of a vaccine. We are just beginning clinical trials on a small subset of these ideas now, so we're still facing difficult times in the months to come. And it's important to emphasize that there's no guarantee that any of these approaches will work. But finding a therapy does offer hope that the difficult months of isolation in our immediate future might not stretch to the end of the year. Source: COVID-19: the biology of an effective therapy (Ars Technica)
  8. As US fumbles COVID-19 testing, WHO warns social distancing is not enough The US is still struggling to ramp up testing as disease continues to spread. Enlarge / WESTMINSTER, MD - MARCH 16, 2020: Dawn Canova, clinical manager for outpatient wound care at Carroll Hospital, takes samples from people to test them for the coronavirus at a drive-thru station in the hospital's parking garage. Not open to the general public for testing, the station was set up to take samples from people who had spoken with their doctors and received explicit direction to get a test for the novel coronavirus called COVID-19. Chip Somodevilla 261 with 143 posters participating As the United States continues to struggle to ramp up basic testing for COVID-19, experts at the World Health Organization on Monday emphasized that countries should prioritize such testing—and that social-distancing measures are not enough. “We have a simple message for all countries: test, test, test,” WHO Director General Tedros Adhanom Ghebreyesus (aka Dr. Tedros) said in a press briefing March 16. Dr. Tedros noted that, as the numbers of cases and deaths outside of China have quickly risen, many countries—including the US—have urgently adopted so-called social-distancing measures, such as shuttering schools, canceling events, and having people work from home. While these measures can slow transmission and allow health care systems to better cope, they are “not enough to extinguish this pandemic,” Dr. Tedros warned. What’s needed is a comprehensive approach, he said. “But we have not seen an urgent-enough escalation in testing, isolation and contact tracing, which is the backbone of the response,” Dr. Tedros said. “The most effective way to prevent infections and save lives is breaking the chains of transmission,” he went on. “And to do that, you must test and isolate. You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected.” Unnecessary The message was a sharp one for the United States, which has struggled to ramp up its testing capacity. While other countries have performed hundreds of thousands of tests since the outbreak mushroomed out of China’s Hubei Province in January, some estimates suggest that the US has tested a mere 38,000 people or so—a majority in just the last couple of weeks. By contrast, South Korea has been testing nearly 20,000 people every day. In a series of press conferences in recent days, members of the Trump administration’s Coronavirus Task Force, led by Vice President Mike Pence, have announced plans to dramatically increase the country’s testing capacity, including partnerships with private companies. The officials have suggested that the country will soon be able to tests tens of thousands if not hundreds of thousands of people per week. But confidence in the plans have been shaken by clumsy descriptions and overstatements. That includes an announcement Friday by President Trump that Google was developing a website that would allow people nationwide to determine if they should get tested and help them set up testing at a local lab. The announcement reportedly took Google by surprise. Its sister company, Verily, has since released such a site, but it only serves people in California’s Bay Area and, so far, doesn’t provide any useful information or services. Additionally, while experts at the WHO recommend thorough testing of suspected cases and contacts to get ahead of transmission, the Trump administration has so far emphasized mainly testing people with noticeable symptoms who largely self-identify as candidates for being tested. Officials also said testing would be prioritized for health care workers and those 65 years and older who had symptoms. “We don’t want everybody taking this test. It’s totally unnecessary,” President Trump said in a press briefing Friday. So far, the US has detected over 4,200 cases in 49 states and the District of Columbia. This number is expected to be far lower than the actual number of cases due to the delayed and limited testing. There have been 74 reported deaths in the US. Worldwide, there are over 181,000 cases in at least 148 countries. More than 7,000 people have died. Read our comprehensive 8,000 word explainer about the novel coronavirus. Source: As US fumbles COVID-19 testing, WHO warns social distancing is not enough (Ars Technica)
  9. What are the rules of social distancing? Staying home will stem the coronavirus outbreak, but what if you’re healthy — and bored? Is it ethical to go to the gym, get your hair done, or order delivery? Many Americans in recent days have received emails directing them to start working remotely, or announcing that schools would be canceled for weeks in light of the coronavirus pandemic. Major events are also being called off with a domino-like effect, including Coachella and South by Southwest, March Madness and virtually all sports events, business conferences, even religious services across the country. In many cases, the action is prophylactic — no one at work or school may be sick yet — though with each passing day, more of these decisions are being made in response to a community member testing positive for Covid-19, or the risk that contact with large groups of people could exacerbate transmission of the virus. The closures are a way to enforce social distancing, a crucially important public health intervention that can help stop coronavirus transmission by avoiding crowds and large gatherings such as weddings, concerts, conferences, sporting events, and mass transit. Best practice requires maintaining at least a six-foot distance between yourself and others. You may have already come into contact with an infected person — the woman who rode the bike before you at SoulCycle, the kindly fellow who coughed while standing next to you in line at Costco, or someone who touched your mail as it made its way to your mailbox. (At least one study estimates that about 25 percent of transmissions of coronavirus may have occurred in pre-symptomatic stages — meaning it may be spread by people who don’t yet know they have the virus.) With Covid-19, “many people in the US will at some point, either this year or next, get exposed to this virus,” the Centers for Disease Control and Prevention’s immunization czar announced this month. Social distancing, health authorities argue, can dramatically slow the rate at which the infection is spreading, easing the burden on the health care system. To that end, the CDC is now urging all gatherings of more than 50 people to stop for the next eight weeks. But how should social distancing affect your visits to the gym? Your weekly manicure? Play dates for your kids? Your weekend reservation at the buzzy Michelin-starred omakase spot you’ve been dying to try? Are those risky for an ostensibly healthy person like yourself? What do you, as a responsible, socially conscious human being, owe to your fellow men and women — particularly those who are sick, immunocompromised, and older? Are you breaking the social contract by going to hot yoga? Or, by not going, are you overreacting and hurting the economy? Vox spoke with six experts in public health, medicine, psychology, and bioethics for answers. (Please remember that as the Covid-19 landscape transforms week by week, so, too, will the advice.) I feel healthy. Why shouldn’t I get out a little bit to make this time pass easier? Vox’s Kelsey Piper makes a strong argument for choosing to stay home as much as possible, inconvenient as it may seem, to help your fellow human. “If you are young and healthy, you ought to take precautions because doing so can end up saving someone’s life,” she writes. Leah Lagos, a New York City-based psychologist and author of Heart, Breath, Mind, agrees. “Now is the time to do something for your fellow community members,” she says. Staying home as much as possible, even if you believe you aren’t infected, is the type of altruistic decision that, when performed en masse, has the potential to slow the infection rate, Lagos says. Christina Animashaun/Vox Considering — and prioritizing — the welfare of strangers is difficult, she acknowledges, but it helps to think of them instead as someone else’s parent, grandparent, or child. “It can be an interesting experiment in compassion for people we don’t know.” “A lot of us might be relatively healthy and think we might be able to withstand the rigors of an infection,” adds Jonathan Kimmelman, director of the Biomedical Ethics Unit at McGill University in Montreal, “but there’s the concern about spreading it to vulnerable individuals, as well as the pressure this outbreak will place on our health care system.” Kimmelman invokes the idea of “social solidarity,” saying “we have an ethical obligation to curtail activities, practice social distancing, and substitute activities with safer alternatives,” like teleconferencing instead of in-person work meetings, or changing a first date from a wine bar to a walk outside. But should you even be going on dates, period? If the messages are confusing, understand that “there are different levels of social distancing” in effect around the world, and that local health departments’ recommendations vary currently depending on known cases, says Syra Madad, an NYC-based special pathogens specialist who was featured in Netflix’s docuseries Pandemic: How to Prevent an Outbreak. In Washington state’s King County, for example, the current recommendation is that “social interaction is still vitally important to the mental health of young people, and it is still possible for families to have safe gatherings among children and parents.” The county recommends, however, limiting indoor groups to 10 or fewer children and outdoor groups to 50 or fewer, and for residents to avoid parties, retail spaces, and movie theaters. Still, Madad notes, “It is better to operate under the pretense that there is transmission in your community already. There’s going to be disruption to daily life, but we want people to feel empowered by this. The decisions you make will ultimately affect the trajectory of this outbreak.” An empty restaurant in New York City on March 13, 2020. Jeenah Moon/Getty Images If I have to go out, how can I do it in the safest way possible — to protect myself as well as others? Kate Vergara, a public health and infectious disease specialist based in Chicago and New York City, has spent time fighting polio in Ethiopia and helping Ebola survivors in Sierra Leone (without contracting either disease). In order to even begin to approach the ethics of social distancing, she says, we must have a firm grip on how the virus is spreading. “Covid-19 is not airborne,” she says. “It is transmitted through droplets — being coughed on, or touching something that someone coughed on, for example, and then touching your face and allowing that pathogen to get into your system through your eyes, nose, or mouth.” The CDC and the WHO recommend several basic measures to help prevent the spread of Covid-19: Wash your hands often for at least 20 seconds. Cover your cough or sneeze with a tissue, then throw the tissue in the trash. Clean and disinfect frequently touched objects. Stay home when you are sick. Contact a health worker if you have symptoms; fever and a dry cough are most common. DON’T touch your face. DON’T travel if you have a fever and cough. DON’T wear a face mask if you are well. Guidance may change. Stay informed, and stay safe, with Vox’s guide to Covid-19. It’s important to practice good hygiene, like hand-washing — which protects not only you but others as well. When considering the ethics of spending time out and about, Vergara suggests reframing your view of hand-washing in the following way: “Wash your hands before you go out to protect others, and wash them again after the activity to protect yourself.” If you’re low-risk and itching to hit the gym, wash your hands first so you’re touching machines and weights with pristine hands; that protects others. Then, after your workout, wash them again to scrub off anything you may have picked up. And wipe down your exercise equipment, or anything else you might have touched. The same goes for getting a haircut, visiting the ATM, and the like. Should I feel guilty for wanting to go to the gym, or on a date? Between the relentless news alerts, social media memes, and gossipy texts, it’s easy to feel overwhelmed, anxious, and scared. We need self-care more than ever, says LaMar Hasbrouck, a public health physician and past medical epidemiologist with the CDC. “It’s important during these times to hold fast to any sense of normalcy that you can.” But try to find prudent ways to do so. Hasbrouck now picks off-peak hours to exercise to minimize contact with others; other options include walking, jogging, or biking outdoors. The more ventilated an area, the lower the risk of transmission, plus “if you cough, nobody is around and the droplets just fall and hit the ground,” he says. Better yet: breaking a sweat at home with help from an app or online video. Grocery shopping will need to happen, but instead of going at noon on a Saturday when the place is sure to be packed, try going really early on a weekday morning. If it’s still possible, order online. And wipe down any deliveries, just to be safe. Should I keep using grocery delivery services ... and ride-hailing companies … and restaurants? Hasbrouck encourages those who have access to services such as Postmates, Grubhub, Lyft, and Instacart to use them. “It’s a good way to social distance,” he says, noting that two main factors when it comes to Covid-19 transmission are closeness of contact and duration. “The handoff is five seconds, you go inside and wash your hands. Or just have them leave it at your doorstep.” (Last week, Instacart introduced a “Leave at My Door Delivery” option.) This poses some ethical questions, however: Having milk and bread delivered is convenient for you, minimizing your exposure to the virus. But what about the person doing your grocery shopping or picking up your Thai food? Or the Uber driver ferrying you to your significant other’s apartment? Is it right to ask them to assume the risk of being out and about? Yes, say both Hasbrouck and Vergara. However, contaminated hands pose a risk to drivers and riders, so be ultra-diligent about hand hygiene, washing or sanitizing hands before getting in the car and not touching your face at all. Cracking a window is a smart move for both you and the driver, as it promotes airflow. As for restaurants, honor upcoming reservations or attend gatherings as necessary. Unlike norovirus or hepatitis A, “food isn’t known to be a way of transmitting this or other respiratory viruses,” says Benjamin Chapman, a professor and food safety extension specialist at North Carolina State University. “You mainly need to be mindful about the surfaces you touch: menus, the table, condiments, things that other patrons might have used.” But the choice to dine out may soon be very limited for many Americans: Governors of several states, including Illinois and Washington, this week ordered all restaurants and bars closed; major cities such as New York and Los Angeles are following suit. Chapman, who continues to dine out, says that while he might not know who touched that soy sauce bottle or pepper shaker before him, “I do know I can break the pathway of transmission by using hand sanitizer or washing my hands.” With social distancing in mind, opt for establishments where it’s easy to keep six to eight feet between yourself and other diners (maybe save sitting at the packed bar for after the pandemic ends) and feel free to be “a public health nerd” like Chapman and ask if they’re using Environmental Protection Agency-approved sanitizing products, which they should be. Chapman notes that he lives in North Carolina, which is not currently a Covid-19 hot spot. “I’d have a different response if I was in New Rochelle, New York, or Seattle,” he says, two cities where the risk of transmission is greater due to higher numbers of community-acquired infections. In cities such as those, he would advocate taking advantage of the “great infrastructure we have set up for home delivery of food.” Should I cancel play dates? What are the rules for my kids? In Ireland, public health officials are encouraging a “no parties, no playdates, no playground” policy, per the Irish Times. Muireann Ní Chrónín, a consultant respiratory pediatrician at Cork University Hospital, told the paper: “Children will get through this no problem. [But] remember with corona, children are vectors, not victims. In most epidemics, young children are the transmitters.” Here in the US, school closures are smart, Vergara says. “It’s a responsible practice for schools to shut down. That’s several hundred kids interacting in close quarters, and kids aren’t known for washing their hands very well.” But that leaves millions of working parents frantic about career responsibilities, and unsure of whether it’s appropriate to schedule play dates or try to split child care duties with friends. The experts interviewed for this story had differing opinions about whether play dates should continue in a pandemic. Vergara says that, if following healthy practices, small play dates are feasible, but before the kids come over, use disinfecting wipes to clean high-touch items like doorknobs, remote controls, and the table where they’ll be playing. Replace the hand towel in the bathroom with a fresh one, and when the visiting kiddos show up, everyone — your children included — should wash their hands thoroughly. Lagos worries that play dates during school closures are essentially “quasi-quarantines, defeating the purpose of social distancing.” Kimmelman concurs, and though he says no one knows the exact right answer, “we don’t know how things are going to unfold, and from my standpoint, the risks of underreaction are so much more catastrophic than the risks of overreaction.” Alyssa F. Westring and Stewart D. Friedman, co-authors of Parents Who Lead, writing in the Harvard Business Review, recommended finding inventive ways for children to play together virtually. “While it may not be feasible to trade-off childcare responsibilities (depending on quarantine restrictions),” they wrote, “consider other ways in which you can make things easier for one another — whether it’s sharing creative activities to keep the kids entertained or taking turns grocery shopping. … Be open to new ways of doing things.” When should I completely self-quarantine? The CDC has issued recommendations for travelers arriving from dozens of countries with widespread cases to stay home for 14 days. If someone at your work or school was definitely exposed, it’s also time to assess your own risk of exposure, and of spreading the coronavirus. “If you say, ‘Well, I know I’ve been mostly in my office, avoiding meetings and conference rooms, and I’ve been washing hands a lot,’ you could probably go about your daily routine with some social distancing to protect yourself, not so much to avoid infecting others,” Hasbrouck says. But if you have a fever or receive new information — that it was John, in the cubicle next to you, who was exposed — “you’re going to want to radically change your assessment.” That likely means self-quarantining, because that’s “the ethical decision and you don’t want to expose others. It’s a constant risk assessment, and it’s more of an art than a science. It’s about protecting yourself but also being socially responsible.” How far should we take social distancing advice? “Look at the trajectory of what’s happening in Italy. We’re 11 days behind Italy,” where a national lockdown that began March 10 has curtailed all travel and shuttered nearly all shops, schools, museums, movie theaters, and bars, says Madad. “Measures like travel bans and quarantining entire localities — you may not see that here,” she says. But we can undertake distancing measures ourselves. “One of the things we’ve learned from the H1N1 pandemic is that if you educate people, they will listen. You have to give them the facts, and speak with one voice.” The Vox guide to Covid-19 coronavirus Source: What are the rules of social distancing? (Vox)
  10. Amazon Prime deliveries delayed by coronavirus Spike in shopping and disrupted supplies may impact Prime deliveries (Image credit: Future) Amazon has revealed that the coronavirus outbreak may be impacting some of its Prime deliveries. The company has said that due to the sudden spike in online purchases, many household items are going out of stock, and as its supply chain is also impacted currently, the “delivery promises are longer than usual”. A notice has been added to the website informing customers that “Inventory and delivery may be temporarily unavailable due to increased demand. Confirm availability at checkout.” Coronavirus impact In a blog post, Amazon revealed that it is working round the clock with its supplier partners to get the products back in stock, as well as getting additional capacity to cover increased demand. Amazon has not revealed how much of the delay is caused due the unavailability of the staff. The company had advised its employees to work remotely like most other companies and also offered unlimited unpaid time off for the rest of March to its warehouse workers. Amazon has also offered two weeks of paid “quarantine time” for the employees, both full time and part-time warehouse workers, who’re diagnosed with the coronavirus. This could be one of the rare events when Amazon’s Prime delivery service, which offers one day and two-day deliveries, may face a disruption. Prime is a paid-for service where users pay an extra amount as a subscription or one-time charge to get the products delivered faster. As of now, there are approximately 150 million Prime members across the globe. The virus outbreak has infused panic among the shoppers and has resulted in people hoarding products like bottled water, hand sanitizers, protective face masks, disinfectant wipes, and toilet papers etc. Amazon has also banned sellers who were found abusing the marketplace policies and removed thousands of listings of products with high demand for price gouging. Source: Amazon Prime deliveries delayed by coronavirus (TechRadar)
  11. 3D printing could prove a lifesaver in helping treat coronavirus Out-of-stock parts for vital medical equipment can be 3D-printed (Image credit: 3D Printing Media Network / Lonati SpA) 3D printing could be a lifesaver in the face of supply shortages caused by coronavirus, with a 3D printer providing vital medical supplies to an Italian hospital. The hospital in Brescia – located in an area of northern Italy suffering at the hands of the virus outbreak – was running out of replacement valves for ‘reanimation’ machines which provide desperately needed respiratory aid to those who have contracted coronavirus. With no way to get replacement valves thanks to the supplier running out of stock – another side-effects of the virus – the solution was to use a 3D printer. A company by the name of Isinnova responded to a call for help from Massimo Temporelli (founder of The FabLab in Milan), and Isinnova’s CEO, Cristian Fracassi, personally brought a 3D printer into the hospital, managing to replicate and produce the missing valve. The very next day, Saturday, March 14, these 3D-printed replacements were proved to work, and 10 patients were soon on functioning machines that helped them breathe while using a part produced by the 3D printer. Vital replacements Doubtless there will be other cases where replacements for vital equipment are needed, and may indeed be provided by 3D printing – a lot of lives could be potentially saved. More valves were being produced by another printing outfit, Lonati SpA – as pictured in the above image – except in this case they are using a polymer laser powder bed fusion process (as opposed to filament extrusion, which was employed by Isinnova’s CEO). Source: 3D printing could prove a lifesaver in helping treat coronavirus (TechRadar)
  12. American Amazon warehouse worker gets COVID-19 The Queens warehouse is operating again after a deep cleaning, Amazon says. Enlarge Paul Hennessy/NurPhoto via Getty Images 98 with 50 posters participating An Amazon worker at a warehouse in Queens, New York, has been infected by the coronavirus, Amazon acknowledged in an email to Ars Technica. "We are supporting the individual who is now in quarantine," a spokesperson wrote. This appears to be the first Amazon warehouse worker to contract the virus in the United States. Multiple workers have been diagnosed with COVID-19, the disease caused by the coronavirus, in Europe. Amazon says that after learning about the infected worker, the company sent employees home with pay and performed a deep cleaning of the facility. The warehouse has now been re-opened. "We’re following all guidelines from local officials about the operations of our buildings," the spokesperson wrote. "We have implemented proactive measures to protect employees including increased cleaning at all facilities, maintaining social distance, and adding distance between drivers and customers when making deliveries." The coronavirus pandemic has only increased the importance of Amazon to the American economy. As customers have grown fearful of catching the virus in brick-and-mortar stores, they've been placing more orders with Amazon. Amazon said this week that it plans to hire an extra 100,000 people to help cope with the surging demand. However, there's a risk that more Amazon warehouse workers could catch the coronavirus. Amazon says that it's taking a number of precautions to protect workers. The company says it is maintaining a three-foot separation between workers and has eliminated stand-up meetings during workers' shifts. The company has staggered break times and spread out the chairs in break rooms to minimize contact between employees. Workers also have unlimited unpaid sick time through the end of the month, and Amazon says it's requiring workers to stay home if they feel unwell. Correction: I misread Amazon's statement and wrote that employees had unlimited paid sick time in March. In fact they have unlimited unpaid time off. Source: American Amazon warehouse worker gets COVID-19 (Ars Technica)
  13. Why the Coronavirus Hit Italy So Hard The country has the second-oldest population on earth, and its young mingle more often with elderly loved ones. Photograph: Antonio Masiello/Getty Images With the world descending deeper and deeper into coronavirus chaos, we all face unnerving unknowns: how long we’ll have to remain in isolation, when the pandemic will peak, the depths to which the stock market will tumble. But what’s abundantly clear is that this novel disease is most deadly for the elderly. The young may not present any symptoms at all, and this is especially dangerous to their elders, because they can pass the virus on to them without realizing it. Italy has been hit particularly hard, with some 2,000 deaths thus far. Overwhelmed hospital staffers have had to make devastating decisions about who to treat and who they must let perish. The reason why Italy is suffering so badly, write University of Oxford researchers in a new paper in the journal Demographic Science, may be twofold: The country has the second-oldest population on earth, and its young tend to mingle more often with the elderly, like their grandparents. Such demographic research will be critical in facing down the threat elsewhere, as more countries grapple with a deadly pandemic that’s just getting started and we learn more about how the virus is transmitted within families and communities. In Italy, 23 percent of the population is over age 65, compared to the US, where that population is 16 percent. “Extended longevity has played some role in changing the population structure,” says University of Oxford demographer and epidemiologist Jennifer Beam Dowd, lead author of the new paper. “But it actually has most to do with how rapid the decline in fertility has been in a population.” That is, it’s affected more by Italians having having fewer children than it is by them living longer. At the same time, young Italians tend to interact a lot with their elders. Dowd’s Italian coauthors note that young folks might live with their parents and grandparents in rural areas but commute to work in cities like Milan. Data on the composition of Italian households bears out this familial arrangement too. The study’s authors argue that this frequent travel between cities and family homes may have exacerbated the “silent” spread of the novel coronavirus. Young people working and socializing in urban areas interact with large crowds, where they may pick up the disease and take it home. If they have no symptoms, they’ll have no clue that they’re infecting their elders, the most vulnerable population. “We know now that the mortality is higher in older individuals, but what's not clear yet is why,” says Carlos Del Rio, executive associate dean of the Emory School of Medicine at Grady Health System, who wasn't involved in this research. For example, it could be a matter of older people having weaker respiratory systems, which could also lead to a higher mortality rate among seniors for diseases like pneumonia. Other researchers studying why children don’t seem to get that sick from Covid-19 have pointed out the corollary: Kids tend to have “pristine” lungs that have not already been damaged by a lifetime of inflammation caused by allergies, pollutants, and diseases. This might make them more resistant to attack by the new virus. Despite a full lockdown in place in Italy since the weekend, the virus has already spread far and wide. But with this kind of demographic knowledge, public health officials can better confront the threat elsewhere, Dowd says. “One of the points that we were trying to make is that it's not necessarily just about isolating the older population—we are identifying that they're the most vulnerable—but the general social distancing that's being encouraged to flatten the curve,” says Dowd. Flattening the curve means slowing the rate of new infections, buying researchers time to develop treatments and vaccines, and giving hospitals some respite. “I think our point was that's actually more important when you have a higher fraction of your population that is vulnerable,” she says. But while separating younger and older people might work in theory, it can create practical problems. For example, desperate to flatten the curve, local officials in the US are closing schools. If parents can’t look after their children—because they’re still working out of the home, or because they’re ill themselves—that care might fall on grandparents. To complicate matters even further, a study in Italy doesn’t exactly track with what we might expect in a massive country like the US, where the demographics vary greatly from place to place. Some cities might have far more young people than seniors, and some suburbs are likely just the opposite. Or think about Florida and its masses of retirees. “Florida is like an uber-Italy,” says Andrew Noymer, a demographer at the University of California, Irvine, who wasn’t involved in this research. “Florida is going to be a tough situation, I would predict.” In a place with so many elderly people, many of them living close together in retirement homes, social distancing will be extra important to avoid disaster. “It’s not destiny to say Florida is going to be absolutely clobbered by this,” Noymer says. “There is time with social distancing to flatten the peak. Maybe we can make this the dog that didn’t bark, so to speak.” An aging population doesn’t have to mean a devastating Covid-19 outbreak. In Japan, where over 28 percent of the population is over age 65, by March 16 there had been only 814 confirmed cases and 24 deaths, compared with Italy’s 24,747 cases and 1,809 deaths, according to WHO figures. Japan, along with neighbors including Hong Kong and Singapore, had rapidly ramped up testing in the early days of the outbreak and instituted strict travel controls. But Dowd says we can use Italy’s example to take practical steps in fighting the pandemic. We might pinpoint areas with older populations and try “to anticipate a little bit where the burden of care is going to be the most severe.” After a long delay in the rollout of mass testing in the US, on Friday the FDA approved the use of two commercial coronavirus tests. This may help Americans keep infected young people and healthy elders apart. In the meantime, if you want to check in with your grandparents, do it by phone. WIRED is providing unlimited free access to stories about the coronavirus pandemic. Sign up for our Coronavirus Update to get the latest in your inbox. Source: Why the Coronavirus Hit Italy So Hard (Wired)
  14. Taiwan Is Beating the Coronavirus. Can the US Do the Same? The island nation’s government is staying ahead of the virus, but don’t ascribe it to “Confucian values.” Credit democracy and transparency. Taiwan's swift, comprehensive response to the Covid-19 outbreak allowed the island nation to get ahead of the pandemic. Residents lined up to buy face masks from a pharmacy in New Taipei City on March 17, 2020.Photograph: SAM YEH/Getty Images As of Wednesday, the nation of Taiwan had recorded 100 cases of Covid-19, a remarkably low number given the island’s proximity to China. Some 2.71 million mainland Chinese visited Taiwan in 2019 and as recently as January there were a dozen round trip flights between Wuhan and Taipei every week. But despite its obvious vulnerabilities, Taiwan has managed, so far, to keep well ahead of the infectious curve through a combination of early response, pervasive screening, contact tracing, comprehensive testing, and the adroit use of technology. As millions of citizens in the US shelter in place while girding themselves for the double whammy of an accelerating outbreak and a vicious economic recession, it is natural enough to look at Taiwan’s example and wonder why we didn’t we do what they did, or, more pertinently, could we have done what they did? But a common theme in the recent press coverage of Taiwan’s (and Singapore’s) efforts to contain Covid-19 has included a consistent cautionary note. With particular attention to the technologically intrusive surveillance-state aspects of Taiwan’s response—notably, its real-time integration of national healthcare databases with customs and travel records and its use of government issued cell phones to remotely monitor quarantine orders—we keep seeing the culturally embedded assumption that East Asian-style state social control just won’t fly in the good old, individualist, government-wary, freedom-loving United States. The New York Times: People in “places like Singapore... are more willing to accept government orders.” Fortune: “There seems to be more of a willingness to place the community and society needs over individual liberty.” Even WIRED: “These countries all have social structures and traditions that might make this kind of surveillance and control a little easier than in the don’t-tread-on-me United States.” Here, once again, rising from the mausoleum like a zombie-infected terra-cotta warrior, we see the classic “Confucian values” (or “Asian values”) argument that has historically been deployed to explain everything from the economic success of East Asian nations, the prevalence of authoritarian single political party rule in Asia, and even, most recently, China’s supposed edge in AI research. So, yeah, kudos to Taiwan for keeping its people safe, but here in America we’re going to do what we always do in a crisis—line up at a gun-store and accuse the opposing political party of acting in bad faith. Not for us, those Asian values. But the truth is that Taiwan, one of Asia’s most vibrant and boisterous democracies, is a terrible example to cite as a cultural other populated by submissive peons. A closer look reveals that Taiwan’s success containing Covid-19 can be explained by the unique historical contingencies that have shaped this young nation. Taiwan’s self-confidence and collective solidarity trace back to its triumphal self-liberation from its own authoritarian past, its ability to thrive in the shadow of a massive hostile neighbor that refuses to recognize its right to chart its own path, and its track record of learning from existential threats. There is no doubt that in January it would have been difficult for the US to duplicate Taiwan’s containment strategy, but that’s not because Americans are inherently more ornery than Taiwanese. It’s because the United States has a miserable record when it comes to learning from its own mistakes and suffers from a debilitating lack of faith in the notion that the government can solve problems that dates at least as far back as the moment in 1986 when Ronald Reagan said “the nine most terrifying words in the English language are: ‘I’m from the government and I’m here to help.’” The Taiwan-US comparison is the opposite of a clash of civilizations; instead, it’s a deathly showdown between competence and incompetence. To be fair, there are some cultural aspects of East Asian societies that may work in Taiwan’s favor. There is undeniably a long tradition in East Asia of elevating scholars and experts to the highest levels of government, and that’s especially evident in today’s Taiwan: The country’s president Tsai Ingwen, boasts a PhD from the London School of Economics, and the vice president, Chen Chien-jen, is a highly regarded epidemiologist. (As Matthew Sommer, a historian of China at Stanford, told me via Facebook, “Taiwan actually has a functioning democratic government, run by sensible, well-educated people—the USA? Not so much.”) Joel Fetzer, a political scientist at Pepperdine University and the co-author of Confucianism, Democratization, and Human Rights in Taiwan, wrote in an email that “the traditional Chinese view of politics assumes a relatively large role in society for the government... and the idea of mutual solidarity inherent in the [Confucian] value of social harmony could help Taiwanese put up with the many inconveniences of measures that are needed to reduce the aggregate infection rate.” But when I posed the question of whether “traditional values” explained Taiwan’s success in containing Covid-19 to a private Facebook group of China-focused academics, the consensus view skewed strongly in the opposite direction. Several key points emerged. First, and most important was Taiwan’s experience battling the SARS outbreak in 2003, followed by the swine flu in 2009. In the middle of the worst of the outbreak in 2003, the current vice president, Chen Chien-jen, was appointed minister of health and won widespread praise for taking quick and decisive action. The threat of SARS put Taiwan on high alert for future outbreaks, while the past record of success at meeting such challenges seems to have encouraged the public to accept socially intrusive technological interventions. (Jason Wang, a Stanford clinician who co-authored a report on Taiwan’s containment strategy, also told me via email that the government’s “special powers to integrate data and track people were only allowed during a crisis,” under the provisions of the Communicable Disease Control Act.) Taiwan’s commitment to transparency has also been critical. In the United States, the Trump administration ordered federal health authorities to treat high level discussions on the coronavirus as classified material. In Taiwan, the government has gone to great lengths to keep citizens well informed on every aspect of the outbreak, including daily press conferences and an active presence on social media. Just one example: On March 15, vice president Chen posted a lengthy analysis of international coronavirus “incidence and mortality rates” on Facebook that racked up 19,000 likes and 3,000 shares in just two days. Several of the Facebook group respondents also noted that the international isolation forced on Taiwan by mainland Chinese pressure, as well as the ever-present threat of military invasion and the heightened levels of hostile rhetoric from the mainland in the five years since Xi Jinping took control of the People’s Republic of China, have bred a strong sense of solidarity. “Do not forget that Taiwan has been under China’s threat constantly,” wrote Wan Cheng-hua, a professor of art history at Princeton, “which has raised social consciousness about collective action. When the collective will supports government, then all of the strict measures implemented by the government make sense.” But Taiwan’s own success at building a functional democracy is probably the most potent rebuke to the Asian values thesis. The democracy activists who risked their lives and careers during the island nation’s martial law era were not renowned for their willingness to accept government orders or preach Confucian social harmony. Stevan Harrell, an anthropologist at the University of Washington who has conducted field research in both China and Taiwan, suggested that some of the current willingness to trust what the government is telling the people is the direct “result of having experienced the transition from an authoritarian government that lied all the time, to a democratic government and robust political dialogue that forced people to be able to evaluate information.” Because of the opposition of the People’s Republic of China, Taiwan is not a member of the United Nations or the World Health Organization, a fact that may paradoxically have contributed to Taiwanese faith in their own government, according to Patrick Tung, a native of Taiwan and a specialist in Song dynasty history. “The reality of being isolated from global organizations,” wrote Tung, “also makes Taiwanese very aware of the publicity of its success in handling a crisis like this. The more coverage from foreign media, the more people feel confident in government policy and social mobilization.” The more detailed the picture, the more Taiwan seems like a model for how a democracy should guard the public’s health. So where does that leave the United States? Given what we know about Taiwan’s hard-won historical experience, could the US have implemented a similar model? The answer, sadly, seems to be no. For one thing, on a purely practical basis, as David Fidler, a specialist in international law and infectious diseases, wrote in an email, it would be impossible for the US to successfully integrate a health care database with customs and travel records because there is no national health care database in the United States. “The US health care system is fragmented, making it difficult to organize, integrate, and assess data coming in from its various government and private-sector parts,” wrote Fidler. But even more tellingly, continued Fidler, “the manner in which the United States has responded to Covid-19 demonstrates that the United States did not learn the lessons from past outbreaks and is struggling to cobble together a semblance of a strategy. ” And there’s the rub. There’s where the contrast between the United States and Taiwan becomes most salient. The US is not only bad at the act of government but has actively been getting worse. Over the past quarter-century, Taiwan’s government has nurtured public trust by its actions and its transparency. But over that same period powerful political and economic interests in the US have dedicated themselves to undermining faith in government action in favor of deregulated markets that have no capacity to react intelligently or proactively to existential threats. And instead of learning from history, US leaders actively ignore it, a truth for which there could be no better symbolic proof than the Trump administration’s dismantling of the National Security Council pandemic office created by the Obama administration in the wake of the Ebola outbreak. Finally, instead of seeking to keep the public informed to the best of our ability, some of our political leaders and media institutions have gone out of their way to muddy the waters. In Taiwan, one early government response to the Covid-19 outbreak was to institute a fine of $100,000 for the act of spreading fake news about the epidemic. There are obvious First Amendment issues involved in instituting the same policy in the United States, but the difference is still galling: In the US the most popular television news network in the country routinely downplayed or misrepresented the threat of the coronavirus, until the severity of the outbreak became too large to ignore. If there is any silver lining here, it’s that the disaster now upon us is of such immense scope that it could finally expose the folly of the structural forces that have been wreaking sustained havoc on American governmental institutions. So maybe we are finally about to learn that competence matters, that educated leaders are a virtue, and that telling the truth is a responsibility. Maybe next time a deadly disease rears its hydra-head we can be more like Taiwan. “I’m really hoping it doesn’t turn out the way I think it will,” wrote H.S. Sum Cheuk Shing, a graduate student studying medieval China at the University of Chicago, “but Americans might have to learn this the hard way like we did in Hong Kong and Singapore.” We’re about to find out how hard it’s going to be. But will we learn? Source: Taiwan Is Beating the Coronavirus. Can the US Do the Same? (Wired)
  15. COVID-19 anxiety taking a toll? There’s a subreddit for that Reddit might not be reliable for COVID-19 information, but it could be the internet’s best support group COVID-19 is all anyone can talk about in real life, which means it’s all anyone can talk about on the internet, which means it’s all anyone is discussing on Reddit. There’s r/Coronavirus (1.4 million members), r/Covid19 (101,000 members), and the racist-ly named r/China_flu (101,000 members, disappointingly). These subreddits have quickly been overflowed with people seeking news about how the pandemic has thrown world economies and health care systems into collapse. They exist to disseminate information — and of course, are victim to misinformation. But there’s one much smaller, more intimate COVID-19 subreddit — Covid19_support, which boasts only 11,900 members — that is doing something different. The service it provides Reddit users is not one of news and information, but emotional support. One post in the r/Covid19_support group asked if anyone else had trouble going grocery shopping for fear of being sick, with one user responding, “I’m not so worried I’ll get the virus, I think just seeing shelves empty or a ton of people buying it will stress me out.” Others replied with worries for workers who have been deemed “essential.” Many of the posts focus on a topic that concerns many people. What about our parents and grandparents? People are having to make the difficult decision to isolate from family during a period that you want to be with them more than ever. Luckily, on r/Covid19_support, members are not alone in this struggle. Governments around the world have laid out varying instructions on how to mitigate the spread of COVID-19 which, for many people, has meant staying at home. But there’s been little direction on how to actually live through a pandemic. How does one reckon with quarantine life? What about those with mental health issues strained by isolation? How about the self-quarantining individuals who are navigating symptoms but are not in need of immediate hospitalization — who is speaking to them? As people spend more time inside the house globally, those with the privilege of having access to a phone or a computer with a clear Wi-Fi signal can try to find support for the varied problems that inevitably come with staying put, avoiding illness, or simply attempting to navigate the financial hardship that has already hit many working class people. r/Covid19_support also offers a space for those who have been let down the most by our systems — those who may not be guaranteed sick leave and can’t work from home — to seek some sort of advice on how to handle the realities they face. One member with asthma (and elderly parents) posted about having to leave work early because co-workers were joking about “survival of the fittest” and they couldn’t take it anymore. “I do think people need online forums more as the outbreak goes on, though,” moderator u/JenniferColeRhuk tells The Verge. “They want to ask questions that are very specific to them and to their situation, which aren’t going to be easily answered by FAQs or government advice. Or they see something they don’t quite understand and want someone to clarify it for them.” Unlike most subreddits, which are a free-for-all, r/Covid19_support has strict rules about who can post. It’s not that they want to censor the way people cope with the crisis, but moderators are attempting to make the community “troll-proof.” u/JenniferColeRhuk considers this paramount when “you’ve got people who are looking for reassurance and support” in creating a space for people to feel their emotions freely about a grim reality. The subreddit requires only a little moderation for misinformation, since most users are sharing their personal stories, not news. Naturally, the moderators come down the hardest on things that are emotional. u/JenniferColeRhuk explains there is zero tolerance for redditors who don’t show other users support, especially if they’re provoking others. People can get banned for telling someone to “get a grip.” r/Covid19_support originated out of a post in r/Coronavirus by u/thatreddittherapist inquiring what everyone was doing for their mental health. That idea got picked up by u/JenniferColeRhuk, so the two of them created r/Covid19_support. “[The] main difference from the other COVID-19 subs is that it’s mainly self-posts from people who are struggling with various aspects of the outbreak — worried about their friends and family, or their own health, or what will happen to their jobs,” u/JenniferColeRhuk says. Those realities are existential. Members of the subreddit, like the rest of the world, brace for the “new normal” as we look onward at a pandemic that has yet to be contained, an economy collapsing, and a global workforce no longer able to work. Internet access has become an indisputable necessity as many people socially distance in their homes or nervously await news of what is to come as they journey to their jobs, risking illness to be able to pay their rent. Subreddits such as r/Covid19_support will continue to be more important as this pandemic tolls on. As the world awaits what is to come, there is some solace to be found in anonymous strangers on the internet sharing that they too miss their parents, that they also can’t handle the boredom with their ADHD, and that they as well have struggled with layoffs due to the virus. There is an understanding hand of humanity reaching out in a latex glove to give you a pat on the back. Having been in my own house for eight days, I’ve often visited r/Covid19_support to find some sort of relief for the various stresses that this has brought on. I scroll the subreddit as I stress about whether there will actually be a rent freeze, as I wait for phone calls from home about my family members getting sick because they’re in jobs deemed “essential,” as the boredom only heightens all of my anxieties. Until the pandemic is over, whenever that is, r/Covid19_support may be one of the many ways that people are trying to cope with the crisis, together and alone in our bedrooms. Source: COVID-19 anxiety taking a toll? There’s a subreddit for that (The Verge)
  16. The Covid-19 Pandemic Is a Crisis That Robots Were Built For Robots can help doctors distance from patients, and help those in isolation cope. But getting the machines into hospitals is fraught with difficulties. An engineering student configures a robot modified to screen and observe COVID-19 patients. A group of roboticists is today calling for the field to fast-track development of such medical machines.Photograph: Lillian Suwanrumpha/Getty Images We humans weren’t ready for the novel coronavirus—and neither were the machines. The pandemic has come at an awkward time, technologically speaking. Ever more sophisticated robots and AI are augmenting human workers, rather than replacing them entirely. While it would be nice if we could protect doctors and nurses by turning more tasks over to robots, medicine is particularly hard to automate. It’s fundamentally human, requiring fine motor skills, compassion, and quick life-and-death decision-making we wouldn’t want to leave to machines. But this pandemic is a unique opportunity to jumpstart the development of medical robot technologies, argue a dozen roboticists in an editorial out today in the journal Science Robotics. Perhaps “people start to reflect that for situations such as this, how robots can be used not only to help with in terms of social distancing, but also that can be used for increasing social interaction,” said Guang-Zhong Yang, founding editor of the journal, during a press conference. The editorial serves as a call to arms for more research. “Robotics and automation could play a major role in combating infectious diseases, such as COVID-19,” Yang and his fellow editors write in their piece. In particular, they argue: “Robots have the potential to be deployed for disinfection, delivering medications and food, measuring vital signs, and assisting border controls. As epidemics escalate, the potential roles of robotics are becoming increasingly clear.” Additionally, robots could enable a form of telemedicine that would keep humans out of areas of contagion. “COVID-19 could be a catalyst for developing robotic systems that can be rapidly deployed with remote access by experts and essential service providers without the need of traveling to front lines,” they write. A cruel irony of the coronavirus pandemic is that medical professionals know better than anyone that social distancing is critical for slowing the rate of new infections, yet they’re forced to be the closest to the disease. And those that need social interaction perhaps more than anybody—the elderly—are the ones who need to isolate the most, as they’re the most susceptible to the disease. But if machines can help care for patients, it’s less likely that human caregivers will themselves get infected. Autonomous robots, for instance, can roam rooms, disinfecting surfaces with UV light. Or they can deliver supplies, as a robot named Tug is already doing. Smarter AI can help diagnose people with Covid-19, and the article’s authors suggest that engineers might develop mobile robots to perform simple tasks like taking a patient’s temperature. This could all go a long way to lightening the burden on human health care providers and helping them keep their distance from the infected. That could help stave off future bottlenecks, in which so many workers are ill or quarantined after potential exposure that hospital staff cannot adequately care for incoming patients. There’s plenty of precedent for machines helping humans do their jobs, notes MIT roboticist Kate Darling, who wasn’t involved in the editorial. “ATMs allowed banks to expand teller services,” she says. “Bomb disposal robots let soldiers keep more distance between themselves and danger. There are cases where automation will replace people, but the true potential of robotics is in supplementing our skills. We should stop trying to replace and start thinking more creatively about how to use technology to achieve our goals.” It’s not hard to imagine a future in which delivery robots bring food and supplies to quarantined people’s homes, preventing delivery workers from potentially infecting them. Quarantined folks are already keeping in touch with friends and relatives via Zoom and FaceTime, but social robots could also keep people company in the absence of human peers. The telepresence robot, often something as simple as a screen on wheels, has begun appearing in nursing homes to help family members connect with otherwise isolated elders. In hospitals, such robots could “teleport” a specialist doctor in London to a patient in San Francisco. Still, you’d be hard-pressed to find a more sensitive interaction between humans than the doctor-patient relationship, and this has remained a thorny problem in hospital robotics. A doctor has to keep people alive, but also keep them well, empathizing in a particularly difficult time. Robots don’t do empathy. How well a robot can tackle a health worker’s task depends, in some measure, on whether it’s replacing that human interaction, or simply channeling it. “It does depend on: Is the robot acting as a medium for a doctor or another healthcare provider or professional? Or is the robot in itself supposed to be running some sort of task?” asks Julie Carpenter, a roboticist and research fellow at the Ethics and Emerging Sciences Group at Cal Poly San Luis Obispo, who wasn’t involved in the new paper. “Certainly making them less threatening to people is important.” Take that Tug robot, for example. It’s more or less a rolling box that autonomously roams hospital corridors. It tells you in a friendly voice if it’s waiting for an elevator, and some hospitals even dress it up in costumes for the kids. Robots need to balance functionality and the patient experience. “For example, a robot may need to be very big in order to lift a patient, but then its sheer size can be intimidating,” says Carpenter. “Mitigating someone's psychological stress should absolutely be a significant and thoughtful part of designing robots, especially in caregiving scenarios.” Engineers also have to consider their hospital worker users when designing medical robots—which they haven’t really been doing up to this point. “They’re designed by engineers, for engineers,” says Henrik Christensen, the director of the UC San Diego Contextual Robotics Institute and a coauthor on the editorial. Nurses and doctors are already stressed and strapped for time. If you tell them it’ll take two hours to teach them to use a robot, “then you've already lost them,” Christensen adds. “We're not good enough today at designing robots that are truly fluent.” One of the bolder ideas to come out of the Science Robotics press conference was a competition for medical robots. Darpa famously ran a robotics competition in 2015 that pitted humanoid machines against one another, greatly furthering research in robot autonomy. Now Darpa is running another challenge for robots to navigate underground environments. (Not to mention the Darpa Grand Challenge, which offered $2 million to the first team that could race an autonomous vehicle between cities in California and Nevada; the Stanford Racing Team won the prize in 2005.) So why not set up a robotics challenge in a hospital? “No doubt," says Christensen, "this is a way of crowdsourcing innovation.” WIRED is providing unlimited free access to stories about the coronavirus pandemic. Sign up for our Coronavirus Update to get the latest in your inbox. Source: The Covid-19 Pandemic Is a Crisis That Robots Were Built For (Wired)
  17. Employees at nine Amazon warehouses have contracted the coronavirus Amazon has more than 750,000 workers worldwide. Enlarge Lawrence Glass / Getty 82 with 52 posters participating A week after the first Amazon warehouse worker tested positive for COVID-19 at a facility in Queens, New York, a total of nine Amazon warehouses have seen employees contract the virus, according to local news reports. Workers have tested positive for the virus at Amazon distribution facilities near Oklahoma City, Louisville, Houston, Jacksonville, and Detroit. There have also been coronavirus cases at Amazon facilities on Staten Island, New York; Wallingford, Connecticut, and most recently Moreno Valley, California, east of Los Angeles. “We are supporting the individuals, following guidelines from local officials, and are taking extreme measures to ensure the safety of all the employees at our sites,” an Amazon spokesman told Ars. Amazon has more than 750,000 employees, many of whom work at distribution facilities around the country. So recent cases represent a tiny fraction of Amazon's warehouse workforce. Amazon says that it is taking a number of precautions to minimize the spread of the virus. The company has stepped up efforts to clean and sanitize its distribution facilities. It has also limited face-to-face meetings and staggered start and break times to promote social distancing. But some workers say Amazon isn't doing enough to protect workers. A worker petition calls on Amazon to offer paid sick leave to all workers, offer workers time-and-a-half hazard pay, and suspend productivity quotas that could make it impractical for workers to take precautions against the spread of the coronavirus. Customers have become increasingly reliant on Amazon deliveries as they have limited travel outside their homes. Amazon has seen customer demand surge in recent weeks, forcing the company to delay deliveries of non-essential items so it can focus on delivering essential goods like baby products, health items, and pet food. The company announced last week that it is looking to hire 100,000 more workers to help deal with increasing order volumes. Source: Employees at nine Amazon warehouses have contracted the coronavirus (Ars Technica)
  18. The US Army Corps of Engineers Deploys Against Coronavirus The US is desperate for hospital beds. The USACE can build thousands of them in a matter of days. Rather than responding to a disaster, the US Army Corp of Engineers is racing to help avert one by converting sites like New York’s Javits Center into field hospitals.Photograph: BRYAN R. SMITH/Getty Images The Jacob K. Javits Center occupies over 22 million square feet on the west side of New York City, a block or so down from where the Lincoln Tunnel splashes into the Hudson River. This week, it had been scheduled to host the World Floral Expo until coronavirus fears scuttled those and most other nonessential plans. Instead, thanks to the US Army Corps of Engineers, the convention center is being transformed into four field hospitals with 1,000 total beds. And that’s only the beginning. Since its founding in 1802, the USACE has often played a central role in times of crisis; its mission is to provide engineering services that strengthen national security and reduce risks from disasters. Recently, that has meant stepping in to speed recovery after the attacks of 9/11 and the devastation of Hurricane Katrina. The novel coronavirus presents a different kind of challenge. It requires national mobilization, not the localized efforts that those specific traumas demanded. Rather than responding to a disaster, the USACE is racing to help avert one by providing enough hospital beds to keep the health care system afloat. “I’ve never seen anything as unique as this in my lifetime,” says Fletcher Griffis, a professor at New York University’s Tanden School of Engineering who spent decades in the USACE, including as commander and chief engineer in the New York district. For parallels to the scale and scope of the Corps’ coronavirus mission, Griffis reaches back to World War II, and even further to helping map out the railroads that drove westward expansion in the 1800s. The stakes are impossibly high. Take New York City, the current epicenter of the coronavirus in America and also the locus of the USACE’s efforts. New York governor Andrew Cuomo estimated Tuesday that the state would need 140,000 hospital beds to care for the incoming wave of Covid-19 patients, with an apex coming within 14 to 21 days. There are 53,000 beds under normal circumstances. Cuomo has ordered hospitals to increase capacity by 50 percent, and more if they’re able, but that still leaves a shortfall. Enter the USACE. New York governor Andrew Cuomo toured construction of temporary hospital space at the Javitz Center this week.Photograph: Don Pollard/Office of Governor Andrew M. Cuomo Specifically, enter a standardized design, created by the Corps, that with a few site-specific modifications can turn any hotel or dorm space—or convention center—into a makeshift hospital. The USACE has created a model that can be replicated in any city in the country, quickly. “This is an unbelievably complicated problem, and there’s no way we’re going to be able to do this with a complicated solution,” Lieutenant General Todd Semonite said in a briefing last week. “We need something super simple.” That simplicity belies the incredible logistical efficiency required to go from design to construction, from the USACE, state governments, and the Federal Emergency Management Agency, which funds the efforts and helps prioritize where to send the Corps. Take the timeline of New York, as described by Semonite and Cuomo’s office. FEMA approved the funds to identify and refit the sites last Tuesday. That Thursday, a USACE inspection team and New York state officials toured Javits and some State University of New York dorms. By the end of the week, they’d hit 10 more potential sites, and narrowed down the group to four viable candidates for field hospitals on Saturday. On Monday, the Javits conversion was already well underway. It should be finished sometime next week. “This was never an anticipated use, but you do what you have to do,” Cuomo said at a press conference at Javits Monday. “That’s the New York way, that’s the American way.” The USACE has created standard plans that allow contractors to convert any convention space, or hotel or dorm, into makeshift hospitals in a matter of days.Photograph: Ron Adar/Getty Images Each of the four hospitals that will occupy Javits will take up about 40,000 square feet on the main floor. Together, the hospitals will provide 1,000 beds, staffed by 320 federal workers total. The USACE is also working on a separate facility at Javits that can support an additional 1,000 beds. The Westchester Convention Center will get a similar large-space makeover. But it’s the dorm locations, at SUNY Stony Brook and SUNY Old Westbury, that will follow the template the USACE hopes to replicate more broadly. Like most higher learning institutions, the SUNY campuses are closed for the remainder of the semester. “Think of the second floor of a standard hotel,” Semonite said at last week’s briefing. “The rooms would be like a hotel room, and then we would build nurse’s stations in the halls, we would have all of the equipment, wireless, going into the nurses stations so you could monitor.” Hotels and dorms are the preferred sites for these kinds of conversions not only because they're largely empty at the moment. They also often have self-contained air-conditioning units, which you can adjust to create negative pressure inside the room, a measure taken in hospitals to reduce the chances of cross-contamination. “You adjust that unit to be able to suck more air out down through the bathroom vent to be able to have negative pressure,” said Semonite. “On the door you put a great big piece of plastic with a zipper on it so you can zip in, go into the room. It’s a relatively simple process.” Each room will have the same standardized set of supplies, as determined by FEMA and the Department of Health and Human Services. Elsewhere, the plan allows for modifications if, say, the hotel has central air or other deviations. The Corps itself typically won’t do the actual construction, but will issue contracts to its expansive network of builders. Each room comes with standardized medical supplies like those pictured here.Photograph: BRYAN R. SMITH/Getty Images New York is the first state to implement the Corps' coronavirus plan. Where exactly the USACE sets up shop from here depends on state governments and FEMA. States nominate proposed sites for pop-up hospitals, FEMA cuts a check, and Corps engineers and their outside contractors make the necessary modifications. The USACE is looking at California and Washington as likely places to expand the project next, but the Corps has people ready in all 50 states to assess potential sites. Semonite also urged states to move forward without their help if they have the means. The Corps can’t be everywhere at once, but its network of partners can. And they've given states a playbook for how to use them. “They have a team of contractors and engineers and architects that they use, and depending on how they use that team they can do almost unlimited work,” says Griffis. “The Corps provides the leadership. It’s just a very effective way of getting construction done.” New York will likely need more than the Javits Center and some dormitories to weather its Covid-19 outbreak. Other cities will likely find that there simply aren’t enough empty hotels and dorms to accommodate the impending overflow. But each additional bed represents one patient that doesn’t get turned away, and buys just a little more time before the health care system becomes totally overwhelmed. Creating that kind of capacity in a matter of weeks is unlike anything the Army Corps of Engineers has ever done before. It’s also exactly what the Corps was built to do. WIRED is providing unlimited free access to stories about the coronavirus pandemic. Sign up for our Coronavirus Update to get the latest in your inbox. Source: The US Army Corps of Engineers Deploys Against Coronavirus (Wired)
  19. At Trump’s request, Ford and GM help ventilator makers boost output It's not easy to build a ventilator assembly line from scratch. Enlarge Taechit Taechamanodom 90 with 51 posters participating One of the most crucial things the United States can do to prepare for the surging coronavirus outbreak is to beef up our stockpile of ventilators. These mechanical breathing machines are crucial for keeping patients with severe cases of COVID-19 alive. The United States currently has around 170,000 of the devices; experts say that may not be enough if the number of coronavirus cases continues to grow exponentially. On Sunday, President Donald Trump tweeted that "Ford, General Motors and Tesla are being given the go ahead to make ventilators and other metal products, FAST!" (Presumably he meant "medical products.") This is an apparent reference to new guidance from the Food and Drug Administration, published Sunday, that dramatically loosens the agency's normally strict oversight of ventilator technology. The new policy not only gives medical professionals broader latitude to modify existing FDA-approved ventilators, it also creates a streamlined process for complete newcomers to the ventilator market to get FDA approval. So car companies have been swinging into action. GM announced a partnership with ventilator manufacturer Ventec last Friday. On Tuesday morning, Ford announced its own ventilator partnership with GE Healthcare. But ventilators are complex machines that can cost as much as $50,000 apiece. Reliability is crucial, since even a brief malfunction or loss of power could cost a patient his or her life. So it wouldn't be practical for any company to design and build ventilators from scratch in a few months. Instead, car companies are looking for ways to help existing vendors expand their output. GM and Ford are supporting existing ventilator companies Enlarge / Operators and assemblers assemble medical face shields. Ford is aiming to produce 100,000 plastic face shields per week. In a Friday press release, GM announced a partnership with medical device company Ventec. "Ventec will leverage GM’s logistics, purchasing and manufacturing expertise to build more of their critically important ventilators," the two companies wrote in a joint press release. GM's main contribution seems to be helping Ventec beef up its supply chain. Like other automakers, GM sits at the apex of a vast network of suppliers, some of which have sophisticated manufacturing capabilities. GM is working to connect Ventec with suppliers who can supply scarce parts, allowing Ventec to boost output. Dustin Walsh, writing for Crain's Detroit, points to one example where GM has been helping Ventec. A GM supplier called Meridian is "helping GM procure six different ventilator compressor parts made of magnesium for an estimated 200,000 ventilators," Walsh wrote. Meridian's own machines couldn't produce the necessary parts, but Meridian connected GM with two other companies—competitors of Meridian—that were able to produce them. Another GM supplier "plans to start manufacturing foam parts for ventilators," according to Walsh. On Tuesday, Ford announced it was also getting into the ventilator business, though the details remain hazy. "Ford and GE Healthcare are working together to expand production of a simplified version of GE Healthcare’s existing ventilator design to support patients with respiratory failure or difficulty breathing caused by COVID-19," Ford said in a press release. "These ventilators could be produced at a Ford manufacturing site in addition to a GE location." Ford says that "work on this initiative ties to a request for help from US government officials." Ford is also planning to manufacture other medical equipment, including respirators (in partnership with 3M) and face shields. Other ventilator makers are expanding on their own Tesla, meanwhile, has talked to leading medical device company Medtronic. "Just had a long engineering discussion with Medtronic about state-of-the-art ventilators," Elon Musk tweeted on Saturday. "Very impressive team!" Medtronic's own tweet about the meeting was cordial but noncommittal: " We are grateful for the discussion with @ElonMusk and @Tesla as we work across industries to solve problems and get patients and hospitals the tools they need to continue saving lives," the company wrote. Medtronic has been working to boost its output without help from Tesla. Last week, the company announced that it was on track to double its rate of ventilator production and said it intended to double the workforce at its ventilator factory in Ireland. "Ventilator manufacturing is a complex process that relies on a skilled workforce, a global supply chain and a rigorous regulatory regime to ensure patient safety," Medtronic said in its press statement. Meanwhile, existing ventilator makers have been rushing to increase their output. GE's Health Care division announced plans to increase ventilator production—including having staff work around the clock. Swedish medical device company Getinge, Swiss company Hamilton, and Dutch electronics giant Philips are also working to boost ventilator production. The importance of government orders One of the most important things governments can do to promote ventilator production is to commit to buying ventilators in the future. Right now, medical device companies are able to sell ventilators as fast as they come off their existing assembly lines. But big increases in ventilator output will require companies to make expensive investments in new manufacturing capacity. That's a risky bet because the investments might become worthless if the coronavirus crisis peters out after a few months. The world could wind up with a big surplus of ventilators. Hospitals, too, may be reluctant to spend tens of thousands of dollars on ventilators that they might only need for a few months. Governments can reduce the risk manufacturers face by placing big orders for ventilators now. Having big orders in hand will make manufacturers more willing to make up-front investments to fill those orders. Of course, that creates a risk that the government will end up with a glut of ventilators it doesn't need. But it seems better to risk having too many ventilators in a few months than to risk having too few. Source: At Trump’s request, Ford and GM help ventilator makers boost output (Ars Technica)
  20. The 'Fearless Girl' statue stands across from the New York Stock Exchange (NYSE) wearing a coronavirus mask. Photograph: Luiz Roberto Lima/Getty Images How Long Will the Outbreak Last? It Depends on What We Do Now People are working with a vast amount of uncertainty about Covid-19. But in two weeks, we might have enough data to take action with precision. Just before midnight Sunday, President Trump unleashed an all-caps tweet signaling a change of heart on national Covid-19 containment strategy. “We cannot let the cure be worse than the problem itself,” he wrote. “At the end of the 15 day period we will make a decision as to which way we want to go!” The immediate reaction to the tweet broke down along familiar lines. Either it was yet another example of erratic leadership from a president more concerned with how the state of the economy will affect his re-election prospects than with the public health, or it was a bold attempt to avert an oncoming devastating recession that has been fueled by partisan media hype. There are clearly a range of different economic consequences associated with different strategies for fighting the Covid-19 epidemic, although the chorus of right-wing economists who pounced on the President's tweet to argue that it was already time to end stay-at-home orders and send people back to work don’t appear to have thought through just how economically devastating a wholly unmitigated outbreak would be. More importantly, few, if any respondents to the tweet took time to note that the content actually mapped to what many public health experts and epidemiologists are telling us about Covid-19. In the not-so-far-away future we will know a great deal more than we do right now about every aspect of the disease, and we will be able to make much more finely tuned decisions on how to tackle it. “What I’ve been saying to policy folks,” says Ashish Jha, a professor of global health at Harvard, “is we are at least a couple of weeks, two to three, away, and then we have data, we have evidence and I can imagine some communities starting to loosen things up.” There are a myriad of caveats to Jha’s prediction. For it to come true will first require that the general public must aggressively embrace social distancing to a degree unthinkable just a few weeks ago. We will also need a vast ramp-up in testing, so policy makers and government officials can get a handle on hot spot locations and be equipped to do contact tracing and targeted quarantines. And we have to acknowledge that there will be immense regional variations; it’s hard to imagine New York, the current American epicenter of the outbreak, or Florida, which arrived late to the shut-down party, “loosening up” in the very short term. There also appears to be a depressingly high likelihood that a succession of recurrent Covid-19 flareups throughout the next year might require the reinstitution of shelter-in-place orders on an ad hoc basis. But if one of the most crippling aspects of the current dystopia is the vast amount of uncertainty that permeates our lives, as we try to get through our days with zero clarity on when schools or restaurants will re-open or how many people will get sick and die or how long-lasting the economic shock will be, there may be a ray of hope. With the passage of each day we will know a little more. We will know more about how the disease is spreading, we will better understand the biological nature of the disease, we will begin to develop effective treatments for it, and at the end of the rainbow, we should have a vaccine. None of it will be easy, but there is a reasonable argument to be made that we are poised right now to confront the worst of the crisis, and within a matter of weeks we will start to get some traction on the immense challenge of reducing its severity. “There is a massive execution risk,” Jha says. “There is a massive risk that we could just screw this up. But we know enough that if we execute it really effectively, we can thread this needle, and we can get through this.” Anyone who has ever played a real-time strategy game knows that the most vulnerable moments often come early on in the struggle, before you’ve marshaled resources, educated your population, developed key technologies, and built a thriving economy. At that point, avoiding mistakes and executing with precision has enormous repercussions, but eventually, if you do everything right, a tipping point arrives, momentum becomes unstoppable, and triumph is guaranteed. We’ve just started our moves. As of Monday, twelve states had instituted stay-at-home orders affecting about one in four Americans. Only five states (Idaho, Iowa, Maine, Nebraska and Wyoming) still have schools open. One of the consequences of what might be charitably described as laissez-faire federal leadership is that local governments are making up their own rules as they go along, resulting in what is in effect a national laboratory of randomized experiments in how to contain Covid-19. For example, on March 16, the San Francisco Bay Area became the first region in the United States to order shelter in place, at a point when only 335 cases of Covid-19 and six deaths had been recorded in the state of California (by contrast, Italy did not order a national lockdown until registering 9,172 cases and 473 deaths). The Bay Area and California writ large (which instituted a statewide stay-at-home order on March 19) will therefore be one of the first areas to generate useful data for epidemiologists on the impact of social distancing. Texas and Florida, two states that have taken more relaxed approach to implementing social controls, may produce data of a different kind—potentially indicating that a more lackluster response will result in higher growth rates for total cases and deaths. What’s already happened elsewhere provides the background for current US policy. Italy’s shocking surge in deaths served as a key incentive to California’s precipitous action. The release last Monday of a dire report from the UK’s well-regarded Imperial College predicting as many as a million deaths from Covid-19 in the United States, even with “the most effective mitigation strategy examined,” further focused international policy makers on the pressing need for immediate, sweeping action. Some critics attacked the Imperial College methodology and advocated for more aggressive containment strategies akin to China’s massive Wuhan lockdown or South Korea’s comprehensive testing and contact-tracing regimen, but public health experts cautioned against expectations that such models could be duplicated here. The United States, Jha says, does not have the bureaucratic or totalitarian capacity to put into effect a Wuhan-style lock down, and the moment when massive testing and contact tracing could have kept a national outbreak in check is long gone. But Jha also warned against putting too much credence into any specific death toll estimation. “If anyone is completely confident,” Jha says, “you should not be listening.” (In support of Jha’s point, a survey of American infectious disease researchers conducted on March 16-17 estimated death totals in 2020 in a range from 4,000 to one million.) Without any mitigation in the form of social distancing and stay-at-home orders, epidemiologists fear a massive spike in cases that will overwhelm the health care infrastructure. Spreading out that blow over a longer period of time has been the primary concern inspiring calls to "flatten the curve" by changing our behavior. But a second benefit of flattening the curve is that it also buys time to ramp up testing and understand where and how the disease is spreading. The latest data from Italy, where the percentage rise of new cases and the total number of new deaths has fallen over the last two days, precisely two weeks after a national lockdown was put into place, is a heartening sign that aggressive social distancing measures do work. Jha speculates that over the next 10 days to two weeks the US is “going to see the exponential rise starting to shift and plateau. The percentage growth in cases will slow.” And over that same period, he says, much more extensive new testing capabalities will come online, something that we are already seeing in New York. “Not as much as I would like,” he says, but enough “to identify everybody who is infected and to do contact tracing.” There are still vast challenges ahead, acknowledges Jha, who says that even with a major increase in testing it will still be difficult to track what’s happening with asymptomatic virus carriers. But for some observers, that problem is primarily a logistical question that can be tackled with the application of enough resources. As a widely shared Twitter threat by Trevor Bedford, a computational biologist at the University of Washington argued last week, “this is the Apollo project of our times. Let's get to it.” With more data in hand, a wider spectrum of containment strategies becomes possible. “You could imagine in two or three weeks,” Jha says, “in places where it looks like things are really slowing down, we could start saying, all right, we’re going to open up offices and restaurants and let people go back to work [but at the same time] we’re not going to open up Major League baseball because we don’t want 30,000 fans in a stadium.” During the same period policy makers and public health experts in the US will start benefiting from data acquired from China and Italy and elsewhere on how the disease has spread. And in the longer run, judging by the vast amount of scientific resources currently being targeted at Covid-19, we will be well on the way to a more complete biological understanding of the disease that will enable effective treatments (which will lower mortality rates and reduce pressure on ICU wards), and, eventually, the holy grail of a vaccine. The obvious weakness in the theory that over the next few weeks the United States will start to gain an upper hand on the outbreak is the unavoidable reality that our execution to date has been anything but perfect. Our testing rollout has been a disaster, our efforts to supply our health infrastructure with the required protective gear and ventilators has been a national disgrace, and our federal government has been woefully unable to provide clear guidance to local governments on best practices. The angry suspicion that greeted President Trump’s signaling of a potential end to national lockdown policy in the short term was just one more data point describing a system in which broken politics has contributed to a widespread lack of faith in effective government leadership. It seems clear that the president’s desire to restart the economy is not linked to any data on the effectiveness of social distancing strategies on containment, but is instead a consequence of his alarm at the disastrous economic impacts of the nationwide shutdown. (Larry Kudlow, Trump’s top economic adviser, was pretty explicit about this Monday, telling Fox News “The president is right. The cure can’t be worse than the disease. And we’re going to have to make some difficult trade offs.”) Now, more than ever, say health experts like Jha, we need to be patient and give the new rules a chance to work. Then we’ll know how and where we can send people back to work. Today, no one can say exactly when schools will reopen or when it will be safe to congregate in bars or how long the economy will be in a downturn or how many people will die, but in 15 days we will be significantly less ignorant than we are now. We will know how and if social distancing works. We will know where the most drastic measures must be deployed and where we can let up on the reins. Right now we’re hitting everything with a hammer because that’s the only tool we have. In a few weeks, maybe we’ll be armed with scalpels. WIRED is providing unlimited free access to stories about the coronavirus pandemic. Sign up for our Coronavirus Update to get the latest in your inbox. Source: How Long Will the Outbreak Last? It Depends on What We Do Now (Wired)
  21. Scientists are racing to find the best drugs to treat COVID-19 The WHO is launching a multicountry trial to collect good data Photo: Feature China / Barcroft Media via Getty Images Part of A guide to the COVID-19 pandemic Three months into the novel coronavirus pandemic, it’s still unclear which drugs could combat the viral disease and which won’t — despite public figures like President Donald Trump extolling the unproven promise of some medications. With public health on the line, the scientific community is searching for answers faster than ever. When the novel coronavirus tore through China in January and February, researchers and doctors quickly launched dozens of clinical trials to test existing medications against COVID-19, the disease caused by the novel coronavirus. But the research done so far in China hasn’t generated enough data for conclusive answers. “We commend the researchers around the world who have come together to systemically evaluate experimental therapeutics,” said Tedros Adhanom, director-general of the World Health Organization (WHO), in a press briefing. “Multiple small trials with different methodologies may not give us the clear, strong evidence we need about which treatments help to save lives.” In their fight for “clear, strong evidence,” the WHO is launching a multicountry clinical trial to test four drug regimens as COIVD-19 therapies: an experimental antiviral drug called remdesivir, the antimalarial drug chloroquine (or the related hydroxychloroquine), a combination of two HIV drugs, and those same two HIV drugs along with the anti-inflammatory interferon beta. The trial will be flexible and could add or drop additional treatment approaches or locations over time. In that way, it appears to be similar to the adaptive trial that the National Institute of Allergy and Infectious Diseases started in the US in February, which initially set out to test remdesivir but could expand to other drugs. The US is not currently involved in the WHO trial. Hundreds of other clinical trials are underway, and other groups also continue to test the medications that the WHO selected — here’s a breakdown of some of the drugs that researchers are zeroing in on. Chloroquine and Hydroxychloroquine Studies found that hydroxychloroquine and the related chloroquine can stop the novel coronavirus from infecting in cells in the lab, and anecdotal evidence suggests that it may help patients with COVID-19. Because the drug has been around for decades as an antimalarial treatment, scientists have experience with it. “It’s a known medicine,” says Caleb Skipper, an infectious disease postdoctoral fellow at the University of Minnesota who’s working on a smaller trial of the drug. “Little blips of lab data over the last several years show this drug has activity against viruses.” Skipper’s trial is looking to see if hydroxychloroquine can prevent people who are exposed to the virus from developing severe disease. They’re hoping to recruit health care workers, who are at a high risk of exposure to the virus, to participate in the trial. The goal, Skipper says, is to get the drug in people’s systems early. “Particularly with viruses, the earlier you inhibit their ability to replicate the better off you’re going to be. If a drug is going to work, it is more likely to work early on in disease,” he says. “If you catch someone really early and provide treatment early virus will have replicated a lot less.” The existing evidence on hydroxychloroquine points in the right direction, Skipper says, but all of the research on the drug is still in very early stages. “It’s a long ways from being proven effective,” he says. Despite the limited evidence available, public figures, including Elon Musk and Trump, are pushing the message that hydroxychloroquine and chloroquine are the solutions to the outbreaks. “I feel good about it. That’s all it is, just a feeling, you know, smart guy. I feel good about it,” Trump said in a press conference on Friday. As a result of the hype, demand for the drug has spiked, and manufacturers are increasing production. In Nigeria, two people overdosed on the medication after Trump said it could cure COVID-19. People who take it for other conditions, like lupus, are struggling to access their usual supply. To be very clear, there is still no conclusive evidence that chloroquine will treat COVID-19. And treatments that appear promising based on anecdotal reports or “feelings” often don’t end up working, which scientists know well: the majority of clinical trials fail, and they’re seeing that reinforced in coronavirus treatment efforts. lopinavir–ritonavir In February, doctors in Thailand said they saw their COVID-19 patients improve on the combination of two HIV drugs, lopinavir–ritonavir. The WHO is testing the drug combination in their trial, along with anti-inflammatory interferon beta, which the body produces naturally to ward off viruses. The drug combination was used in patients during the SARS and MERS outbreaks, and it appeared to help. But a clinical trial of those two drugs in China just found that patients with COVID-19 who were given the drugs did not improve more quickly than patients who didn’t receive it. The study, which was published this week, focused on a group of 199 severely ill patients, which may be why the drug wasn’t effective — the patients were already too sick. But Timothy Sheahan, a coronavirus expert and assistant professor at the University of North Carolina Gillings School of Global Public Health, says he wasn’t surprised the drug didn’t work. “We’ve done work on that particular drug cocktail,” he says. “The fact it failed is totally in step with everything we’ve done in the past.” Remdesivir The antiviral drug remdesivir was first developed to treat Ebola, but research later showed that it could also block MERS and SARS in cells. Lab tests have shown that it can inhibit the novel coronavirus in cells as well. There’s also anecdotal evidence that remdesivir helps treat COVID-19 patients, but that’s also no guarantee that a clinical trial will show that it works better than a placebo. That’s why the data collected on the drug through the WHO trial, the US adaptive trial, and the other studies is so important: before giving it to sick people en mass, doctors have to be sure that it actually works. Other drugs Though not a part of the WHO trial, Chinese officials also reported that the Japanese anti-flu drug favipiravir, which it tested in clinical trials, was effective in treating COVID-19 patients. Japan is studying the drug more closely, though data from those trials on the drug has not yet been published. Based on the drug’s antiviral activity in cells, Sheahan says he’d be surprised if this drug ultimately ended up being effective. It doesn’t work against MERS in cells, he says, and MERS is similar to the novel coronavirus. In addition, some pharmaceutical companies are looking to repurpose anti-inflammatory drugs to try to calm lung inflammation in people with severe cases of COIVD-19; others are identifying the protective antibodies that people develop after they’re infected with the virus in an effort to manufacture a treatment. Clinical trials take time to collect data properly, so there likely won’t be concrete evidence until next month or later. Patients are already receiving these drugs through compassionate use programs, which allows doctors to order experimental medications in certain cases, and under off-label use, where doctors prescribe drugs outside of what they’re approved for. But ensuring the clinical trial process takes place alongside that, before jumping to conclusions about the best course of action, ensures patients can be treated based on evidence. The sheer number of trials going on around the world for each particular treatment approach will give researchers more data to work with and data from different groups of people. “The more populations you can show a particular intervention works or does not work for, the more valuable that is,” Skipper says. “The bigger amount of data available, the better.” A guide to the COVID-19 pandemic Source: Scientists are racing to find the best drugs to treat COVID-19 (The Verge)
  22. UK scientists have a smart plan to supply more respirators for coronavirus patients OxVent project aims to scale production of ventilators as required in local areas (Image credit: OxVent Project) A team of engineers and medics from Oxford University and King’s College London are collaborating in a project to test and build respirators that can be produced in university labs and SME workshops, in a bid to help treat coronavirus sufferers. The need for such ventilators to help those whose breathing is badly affected by the virus has been well-documented at this point, and the so-called OxVent project hopes to have a working prototype which can satisfy relevant safety standards in a ‘matter of weeks’, according to a report by Electronics Weekly. It would have to comply with MHRA (Medicines and Healthcare products Regulatory Agency) requirements, and if the initiative proceeds at the projected pace, the researchers believe a manufacturing network could be scaled up to produce the respirators within two to three months. The hope is that universities, small to medium enterprises and manufacturing facilities would be able to produce these ventilators on assembly lines close to local NHS services, scaling to the needed demand for respirators in any particular area. One of the OxVent team, Professor Farmery of Oxford’s Nuffield Department of Clinical Neurosciences, observed: “Ordinarily, to develop a medical device such as this would be a huge task, and would take years. We have designed a simple and robust ventilator which will serve the specific task of managing the very sickest patients during this crisis. “By pooling available expertise from inside and outside the University, and making the design freely available to local manufacturers, we are pleased to be able to respond to this challenge so quickly.” Dr Formenti, another researcher on the project, added: “Thinking beyond the current pandemic, we are also aiming to share the know-how and refinement of this relatively inexpensive approach with other countries.” Prototype ventilator The scientists have already uploaded a video of the results of their first week of working on the prototype ventilator, as you can see above. The accompanying blog explains: “The Ambu or bag valve mask is confined within a rigid perspex box. This box can be pressurised from a 4 bar line. When it is pressurised, the Ambu compresses, providing an inhalation. When the pressure is switched off, the Ambu re-inflates.” This is one of many initiatives we’ve seen concerning producing medical equipment to help combat coronavirus, such as a call to produce an open source respirator, and Prusa kicking off a drive to make DIY 3D-printed face shields to help protect medical professionals who are treating patients with the virus. Meanwhile, over in the US, we’ve also heard that the big car makers Ford, GM and Tesla have been given the ‘go-ahead’ to make ventilators, and make them ‘fast’, President Trump made clear on Twitter. These car manufacturers have already been looking into how this might work, and indeed Ford could also be working with the UK government in producing necessary medical devices like respirators. Source: UK scientists have a smart plan to supply more respirators for coronavirus patients (TechRadar)
  23. Paul's Twitter account said he "is feeling fine and is in quarantine." Rand Paul, R-Ky., on Sunday became the first senator known to have tested positive for COVID-19. "Senator Rand Paul has tested positive for COVID-19," Paul's account tweeted. "He is feeling fine and is in quarantine. He is asymptomatic and was tested out of an abundance of caution due to his extensive travel and events. He was not aware of any direct contact with any infected person." "He expects to be back in the Senate after his quarantine period ends and will continue to work for the people of Kentucky at this difficult time," the thread continued. "Ten days ago, our D.C. office began operating remotely, hence virtually no staff has had contact with Senator Rand Paul." Paul's chief of staff later clarified that he "decided to get tested after attending an event where two individuals subsequently tested positive for COVID-19, even though he wasn't aware of any direct contact with either one of them." Sen. Jerry Moran, R-Kan., told colleagues at Sunday's policy meeting that he saw Paul at the Senate gym earlier in the day, his communications director confirmed on Twitter. Paul's account later tweeted that he visited the gym before he found out he had tested positive. Paul is the third member of Congress to announce a positive test for the coronavirus, following Reps. Mario Diaz-Balart, R-Fla., and Ben McAdams, D-Utah. Several Republican lawmakers also self-quarantined this month after they learned that they had interacted with someone who tested positive for the virus at the Conservative Political Action Conference. The White House said President Donald Trump, who attended CPAC and also interacted with multiple people at his Florida resort who later found out they were infected, tested negative for the virus. Source
  24. Alma Clara Corsini, 95, from Modena, Italy, was admitted to hospital on March 5 The grandmother who was diagnosed with coronavirus has since recovered Pensioner able to recover without 'antiviral therapy', according to Italian media Coronavirus symptoms: what are they and should you see a doctor? A 95-year-old grandmother who was diagnosed with the coronavirus this month has become the oldest patient in the Italian province of Modena to recover from the illness. Alma Clara Corsini, from Fanano, was rushed to a hospital in the city's northern province of Pavullo on March 5 after showing signs of the virus- which has now claimed the lives of 5,476 in the nation. However medical staff have now confirmed the pensioner's body has shown a 'great reaction' and made a full recovery. Ms Corsini told Italian newspaper Gazzetta Di Modena: 'Yes, yes, I'm fine. They were good people who looked after me well, and now they'll send me home in a little while. ' Grandmother Alma Clara Corsini (centre), 95, from Fanano, Modena, Italy, has recovered from the coronavirus The pensioner, who was rushed to a hospital in the city's northern province of Pavullo on March 5, has made a full recovery, staff confirmed The 95-year-old has since been been discharged and has returned home. Specialists at the hospital added that the grandmother was able to recover without 'antiviral therapy'- medications which are administered to a patient to help them fight a viral infection. According to the Italian paper, Ms Corsini became the 'pride of the staff' during her stay at the hospital which has been trying to cope with the the rising number of cases of COVID-19 in the country. The latest recovery comes after doctors announced a 79-year-old Italian man, from Liguria, with the virus had recovered with the help of an experimental Ebola drug after 12 days in hospital. The drug also showed success in a critically-ill woman in the US and 14 Americans who tested positive for the coronavirus after catching it on the Diamond Princess cruise ship. Today it was confirmed the death toll in Italy's worst-hit region had surpassed 3,450 in the last 24 hours after a rise of 360 fatalities in the northern region of Lombardy. Ministers in Rome were forced to place all 60million citizens into lockdown as the pandemic continued to spread with force across the country. The recovery comes as the government banned travel within the country in yet another attempt to slow the spread of the virus. Pictured: A nearly empty Porta Nuova station in Turin, Italy on March 22 Pictured: Medical staff carry away man who was lying unconscious on the ground in Rome, Italy, as the country continues its nationwide lockdown Italy, which recorded its first coronavirus death in February, now has more fatalities than China with 5,476, as well as having 59,138 infections with 7,024 recoveries. The third worst hit country is Spain with 1,720 fatalities and 28,572 cases, Iran with 1,685 fatalities and 21,638 cases, followed by France with 674 deaths and 16,018 cases, and the United States with 390 deaths and 31,057 cases. On Sunday, Italy banned travel within the country in yet another attempt to slow the spread of the coronavirus. A month after the first death from the highly infectious virus was registered in Italy, the government also issued an order freezing all business activity deemed non-essential in an effort to keep ever more people at home and off the streets. The businesses have until Wednesday to shut down operations and will have to remain closed until April 3. Source
  25. Harvey Weinstein has tested positive for the novel coronavirus in prision. Just days after being transferred to the Wende Correctional Facility from NYC’s Rikers Island, the Oscar winning producer and convicted rapist is now in medical isolation, an Empire State law enforcement official confirms to Deadline. Under the policy that they “cannot comment on an individual’s medical record,” New York State’s Department of Corrections representatives did not respond to request for direct confirmation. “Our team …has not heard anything like that yet,” said Weinstein PR chief Juda Engelmayer on Sunday. “I can’t tell you what I don’t know,” the producer’s personal rep added. Moved to Wende on March 18, the just turned 68 years old Weinstein is one of two prisoners at the 961 capacity maximum security facility just east of Buffalo who was put in isolation after testing positive for the coronavirus. As the global pandemic spreads and surges, New York state has taken the biggest hit domestically of the ever expanding coronavirus. To that, he more than 43,000 prisoners in the state’s already over burdened system are increasingly seen as a high risk category. Already around 40 inmates at Rikers have reportedly been found positive for COVID-19 in the past week, coinciding with Weinstein’s time in that NYC Hellhole. It is unclear if Weinstein himself contracted the disease at the East River complex or when he was in hospital in Manhattan over the past few weeks. In a testament to the power of local journalism, among other things, the Niagara Gazette first reported Weinstein’s condition earlier today On February 24, the once mercurial mogul was found guilty by a New York jury of two sex crime felony charges after a nearly six week trial. Allegedly hobbled by health issues and often in court with a much mocked walker, Weinstein was sentenced to 23 years behind bars on March 11. Suffering from chest pains, the Pulp Fiction producer was back in NYC’s Bellevue that same day for second stint, literally. First admitted to America’s oldest public hospital almost immediately after being convicted late last month, Weinstein had only been out of Bellevue a mere six days. A few days after the second Bellevue sojourn, Weinstein was moved again to Rikers’ vast North Infirmary Command, where he remained until the move to Wende last week. In an America that has already shut down in many respects, today’s news will add a further complication, to put it mildly, to plans for an appeal of the New York case and the extradition of Weinstein to Los Angeles to face multiple sex crimes charges out West – charges that were made public by re-election seeking L.A. County D.A. Jackie Lacey on January 6, the opening day of Weinstein’s NYC trial. First arrested New York in late May 2018, Weinstein initially faced two counts of predatory sexual assault, one count of criminal sexual act in the first degree and one count each of first-degree rape and third-degree rape in New York. Subject to travel restrictions reinforced last August 7, he had been out on a $5 million bail after entering a not guilty plea on July 9, 2018. Weinstein entered a plea of not guilty again on August 26 last year when a new indictment was added. Accused by Ashley Judd in a now temporarily halted case, failing to get a sex-trafficking class action tossed out, and the subject of a more recent lawsuit from a woman who says he abused her when she was 16 in 2002, Weinstein is also facing allegations from close to 100 other women who say he sexually assaulted or sexually harassed them. Over the past few months, several of those individuals are refusing to participate in a potential $25 million over-arching settlement that is part of an overall $45 million deal on the table. Using terms like “insulting” to describe the proposed settlement,on March 9, several Weinstein accusers publicly called on New York Attorney General Letitia James to reject that proposed multimillion-dollar settlement with Weinstein and his former company – a deal that would see millions more for lawyers and former members of the Weinstein Company board with no admission of guilt on the part of Weinstein himself. Source
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