Since the emergence of the new coronavirus, called SARS-CoV-2, several researchers have proposed that there is more than one strain, and that mutations have led to changes in how infectious and deadly it is. However, opinions are divided.
Genetic mutations are a natural, everyday phenomenon. They can occur every time genetic material is copied.
When a virus replicates inside the cell it has infected, the myriad of new copies will have small differences. Why is this important?
When mutations lead to changes in how a virus behaves, it can have significant consequences. These do not necessarily have to be detrimental to the host, but in the case of vaccines or drugs that target specified viral proteins, mutations may weaken these interactions.
Since the emergence of SARS-CoV-2, several research studies have highlighted variations in the viruss genetic sequence. This has prompted discussion about whether or not there are several strains, if this has an impact on how easily the virus can infect a host, and whether or not this affects how many more people are likely to die.
Many scientists have called for caution. In this Special Feature, we summarize what researchers currently know about SARS-CoV-2 mutations and hear from experts about their views on what these mean for the pandemic.
SARS-CoV-2 is an enveloped RNA virus, which means that its genetic material is encoded in single-stranded RNA. Inside a host cell, it makes its own replication machinery.
RNA viruses have exceptionally high mutations rates because their replications enzymes are prone to errors when making new virus copies.
Virologist Prof. Jonathan Stoye, a senior group leader at the Francis Crick Institute in London in the United Kingdom, told Medical News Today what makes virus mutations significant.
A mutation is a change in a genetic sequence, he said. The fact of a mutational change is not of primary importance, but the functional consequences are.
If a particular genetic alteration changes the target of a drug or antibody that acts against the virus, those viral particles with the mutation will outgrow the ones that do not have it.
A change in a protein to allow virus entry into a cell that carries very low amounts of receptor protein could also provide a growth advantage for the virus, Prof. Stoye added.
However, it should be stressed that only a fraction [of] all mutations will be advantageous; most will be neutral or harmful to the virus and will not persist.
Mutations in viruses clearly do matter, as evidenced by the need to prepare new vaccines against [the] influenza virus every year for the effective prevention of seasonal flu and the need to treat HIV-1 simultaneously with several drugs to [prevent the] emergence of resistant virus.
Prof. Jonathan Stoye
MNT recently featured a research study by a team from Arizona State University in Tempe. The paper described a mutation that mimics a similar event that occurred during the SARS epidemic in 2003.
The team studied five nasal swab samples that had a positive SARS-CoV-2 test result. They found that one of these had a deletion, which means that a part of the viral genome was missing. To be precise, 81 nucleotides in the viral genetic code were gone.
Previous research indicated that similar mutations lowered the ability of the SARS virus to replicate.
Another study, this time in the Journal of Translational Medicine, proposed that SARS-CoV-2 had picked up specific mutation patterns in distinct geographical regions.
The researchers, from the University of Maryland in Baltimore and Italian biotech company Ulisse Biomed in Trieste, analyzed eight recurrent mutations in 220 COVID-19 patient samples.
They found three of these exclusively in European samples and another three exclusively in samples from North America.
Another study, which has not yet been through the peer review process, suggests that SARS-CoV-2 mutations have made the virus more transmissible in some cases.
In the paper, Bette Korber from the Los Alamos National Laboratory in New Mexico and collaborators describe 13 mutations in the region of the viral genome that encodes the spike protein.
This protein is crucial for infection, as it helps the virus bind to the host cell.
The researchers note that one particular mutation, which changes an amino acid in the spike protein, may have originated either in China or Europe, but [began] to spread rapidly first in Europe, and then in other parts of the world, and which is now the dominant pandemic form in many countries.
Prof. Stoye commented that the results of this study are, in some ways, not surprising.
Viruses are typically finely tuned to their host species. If they jump species, e.g., from bat to human, a degree of retuning is inevitable both to avoid natural host defenses and for optimum interaction with the cells of the new host, he said.
Random mutations will occur, and the most fit viruses will come to predominate, he added. Therefore, it does not seem surprising that SARS-CoV-2 is evolving following its jump to, and spread through, the human population. Clearly, such changes are currently taking place, as evidenced by the apparent spread of the [mutation] observed by Korber [and colleagues].
However, Prof. Stoye does not think that it is clear at this point how mutations will drive the behavior of SARS-CoV-2 in the long term.
Fears about SARS-CoV-2 evolution to resist still-to-be-developed vaccines and drugs are not unreasonable, he explained. Nevertheless, it is also possible that we will see evolution to a less harmful version of the virus, as may well have occurred following initial human colonization by the so-called seasonal coronaviruses.
Earlier this year, researchers from Peking University in Beijing, China, published a paper in National Science Review describing two distinct lineages of SARS-CoV-2, which they termed S and L.
They analyzed 103 virus sequence samples and wrote that around 70% were of the L lineage.
However, a team at the Center for Virus Research at the University of Glasgow in the U.K. disagreed with the findings and published their critique of the data in the journal Virus Evolution.
Given the repercussions of these claims and the intense media coverage of these types of articles, we have examined in detail the data presented [] and show that the major conclusions of that paper cannot be substantiated, the authors write.
Prof. David Robertson, head of Viral Genomics and Bioinformatics at the Centre for Virus Research, was part of the team. MNT asked his views on the possibility of there being more than one strain of SARS-CoV-2.
Until there is some evidence of a change in virus biology, we cannot say that there are new strains of the virus. Its important to appreciate that mutations are a normal byproduct of virus replication and that most mutations we observe wont have any impact on virus biology or function, he said.
Some of the reports of, for example, amino acid changes in the spike protein are interesting, but at the moment, these are at best a hypothesis. Their potential impact is currently being tested in a number of labs.
Prof. Stoye thinks that it is more a case of semantics rather than anything else at the moment.
If we have different sequences, we have different strains. Only when we have a greater understanding of the functional consequences of the evolutionary changes observed does it make sense to reclassify the different isolates, he said.
At that point, we can seek to correlate sequence variation with prognostic or therapeutic implications. This may take a number of years.
So, what kind of evidence are skeptical scientists looking for in the debate around multiple SARS-CoV-2 strains?
MNT asked Prof. Mark Hibberd, from the London School of Hygiene and Tropical Medicine in the U.K., to weigh in on the debate.
For virologists, strain is rather a subjective word that does not always have a clear specific meaning, he commented.
More useful in the SARS-CoV-2 situation would be the idea of serotype, which is used to describe strains that can be distinguished by the human immune response an immune response to one serotype will not usually protect against a different serotype. For SARS-CoV-2, there is no conclusive evidence that this has happened yet.
To show that the virus has genetically changed sufficiently to create a different immune response, we would need to characterize the immune protection and show that it worked for one serotype and not for another, he continued.
Prof. Hibberd explained that scientists are studying neutralizing antibodies to help them define a serotype for SARS-CoV-2. These antibodies can prevent the virus from infecting a host cell, but they may not be effective against a new strain.
Several groups around the world have identified a specific mutation in the SARS-CoV-2 spike protein, and they are concerned that this mutation might alter this type of binding, but we cannot be sure it does that at the moment. More likely, this mutation will likely affect the virus binding to its receptor [], which might affect transmissibility.
Prof. Mark Hibberd
We ideally need experimental evidence, [such as a] demonstration of a mutation leading to a functional change in the virus in the first instance, and secondly a demonstration that this change will have an impact in [people with the infection], Prof. Robertson suggested.
He pointed to lessons that experts learned during the 20142018 Ebola outbreak in West Africa, where several research groups had suggested that a mutation had resulted in the virus becoming more easily passed between people and more deadly.
Cell culture experiments showed that the mutated virus was able to replicate more rapidly. However, when scientists subsequently studied this in animal models, they found that it did not behave any differently than stains without the mutation.
Scientists around the world continue to search for answers to the many outstanding questions around SARS-CoV-2. No doubt, we will see more research emerge in the coming months and years that will assess the impact of SARS-CoV-2 mutations on the COVID-19 pandemic and the future of this new coronavirus.
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As Texas inches away from its economic shutdown and people resume sharing public and sometimes confined spaces, the question of whether to wear a face mask has become a way to pick sides in whats quickly becoming a coronavirus culture war.
The decision has led to everything from protests to the threat of criminal prosecutions and, at times, heated wars of words that have escalated to physical altercations. Mask arguments among Texans are happening everywhere from retail stores to the highest levels of government, frustrating public health experts who say masks help slow the spread of the virus.
The disagreements come as more and more businesses in Texas are allowed to open with state officials trying to strike a balance between further economic devastation and thwarting the virus spread. On Monday, Gov. Greg Abbott announced that the state was entering its second reopening phase, immediately opening child care facilities, while allowing bars to reopen at limited capacity later in the week and promising a return of sporting events sans in-person spectators by the end of the month. Some establishments, like gyms, restaurants and movie theaters, were already allowed to open at limited capacity.
In this phase of reopening, masks remain optional. Some local jurisdictions issued mask mandates last month, but in an executive order April 27, Abbott said municipalities cant impose penalties on residents who violate rules about wearing masks in public.
We strongly recommend that everyone wear a mask, Abbott said. However, its not a mandate. And well make clear that no jurisdiction can impose any type of penalty or fine for anyone not wearing a mask.
But without a statewide directive on personal protective gear, further efforts to flatten the curve have essentially amounted to a statewide experiment in cooperation, hinging on the individual decisions of millions.
Public health experts have advised the use of masks, especially in public spaces. The Centers for Disease Control and Prevention also recommends the use of simple cloth face coverings to slow the spread of the virus.
But pushback has been strong.
In San Antonio, a spectator caught a man without a mask yelling at a 99 Cents Only store employee for asking him to put on a face covering or leave.
I dont care. Just because everyones doing it, doesnt make it legal, the man is heard yelling at the masked employee. The Texas governor said its not legal and I dont have to.
Do you hear that? he goes on, addressing a woman walking past him on the phone whos wearing a thin, blue surgical mask. Texas governor says you dont need shit. Call the cops. You think Im scared?
He later pushes someone recording the confrontation.
Police were dispatched to the store for a report of assault in progress, but no arrests were made, according to the Fort Worth Star-Telegram.
Farther south, in Harris County, an April emergency proclamation mandating face coverings led to so much backlash including a lawsuit against the county judge that officials amended a draft of the order to eliminate jail time as a potential threat for noncompliance. Not wearing a face covering could only lead to a hefty fine, though Abbotts order overruled any penalties associated with the mandate hours after it went into effect.
The lawsuit seeking to block the order was filed by Steve Hotze, one of the most active culture warriors on the ideological right. On the day he filed it, Hotze, a vociferous opponent of same-sex marriage and vocal supporter of the failed 2017 bathroom bill that would have restricted the use of certain public facilities for transgender Texans, held a rally against the order in downtown Houston. Attendees waved signs with messages like Dont Mask My Freedom! and Just Say No to masks.
Public health experts have looked on in dismay at the sight of public places and protests where throngs of people crowd together without protective face gear. Experts have described wearing a face covering as a simple and cheap way to protect others nearby and potentially mitigate the spread among asymptomatic carriers of the contagion.
Summer Johnson McGee, the dean of the School of Health Sciences at the University of New Haven, said people need to think about carrying and using masks the same way they think about umbrellas on a cloudy or rainy day.
If there is a chance of rain, we carry an umbrella, and in the same way, if there is any chance of being exposed to someone with the virus, you should carry a mask and use it, she said.
After social distancing, masks are our most effective tool to prevent the spread of the virus, she added.
But the decision not to wear a face covering, for some, has become a rebellion against what they see as a government foray on their personal liberties. For others, the choice is one of availability or convenience. Some Texans, especially those back in the workplace, said they found the facial coverings uncomfortable, hot or hard to breathe in, a nuisance they were not willing to tolerate long term. Others were skeptical of their feasibility.
I accept that masks are necessary in our current environment, but I find them inconvenient and therefore choose not to venture out, said Josh Ellis, 41, who works in the Dallas legal industry.
We should definitely be wearing masks in any public place, said Paige Brann, a student who lives in Spring Branch. That being said, I havent seen anyone wearing them. People roll their eyes when I wear them.
Aaron Reed, a restaurant worker in Austin, has been wearing a mask for eight to 10 hours a day.
Its incredibly insulting to see some people cant be bothered to do it for the 15 minutes they are in a store, Reed said.
But politicians mask decisions have been as inconsistent as the general publics. At the White House, President Donald Trump said during an April 3 news conference that wearing masks would be a voluntary thing he was choosing not to partake in. In the U.S. House, several Texas Republicans declined to wear masks during the debate on a coronavirus relief package, despite a recommendation to do so by the House attending physician.
At the state level, House Speaker Dennis Bonnen, a Republican, promoted mask wearing earlier this month as a simple, cheap, easy step that can protect those around us and accelerate our states return to economic vitality. Still, at news conferences where he huddles near the governor, lieutenant governor and other statewide health officials, its essentially a mask-free zone.
The result has been resigned anger and unease particularly among Texas Democrats.
A pledge: If @govabbott and co wear masks today, then I will not criticize a single action taken today for at least 24 hours, state Rep. Erin Zwiener, D-Driftwood, tweeted ahead of Mondays press conference.
At the local level, some officials have chosen to don face coverings during public meetings.
Harris County Judge Lina Hidalgo and Houston Mayor Sylvester Turner both regularly wear face coverings during livestreamed press briefings.
Turner said earlier this week that the issue shouldnt become partisan. In response to the question, he turned to Houston City Council member David Martin, a Republican, and said, Im affiliated with one party, the mayor pro tem is affiliated with another party, and were both wearing masks.
The political symbolism associated with wearing face coverings though maybe not as charged as a Make America Great Again hat has led some experts to worry about the damage this could do to the general public, too.
Masks help prevent spreading the virus to other people. Its not 100% effective, but its going to reduce the dose of the virus that youre releasing if youre asymptomatic, said Shelley Payne, the director of the University of Texas at Austins LaMontagne Center for Infectious Disease.
Payne said its important for public officials to talk to health experts and get informed opinions to the public. They can model good behavior by wearing masks themselves, she added.
Matthew Cox, a student at the University of Texas at Austin, says he wears a mask on a daily basis. Still, he acknowledged, its hot out and it sucks. Cox said hes in favor of requiring face masks in public, with the caveat that if they are required, they should be easily available and affordable.To protect the public health and welfare, there is no good objection to not wearing a mask, he said.
All of that said, I am a little concerned that the entitled and short-tempered people will go crazy, he added, noting he witnessed a fight Tuesday at a gas station because some guy didnt want to wear a mask.
Lyle Burk, who works at a meatpacking plant near Amarillo, echoed a similar sentiment. If I and the people I work with ... can wear face masks for eight hours while making the food you go shopping for, you can wear one for your 30-minute trip to the grocery store.
Still, the plight of others hasnt been convincing enough to the people who still choose to go without one. The hardline conservative activist Michael Quinn Sullivan tweeted Wednesday that hed rather drive than wear a required mask on Southwest Airlines flights next week.
Im not wearing a mask on a plane unless its an oxygen mask and I am blasting commies from the sky, he wrote.
Disclosure: The University of Texas at Austin has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.
Image caption The Covid-19 Symptom Study app is thought to be the largest study of its kind
The UK's scientists have been trying to trace Covid-19's path through the population ever since the coronavirus arrived on British shores.
In what is thought to be the largest study of its kind in the world, an app developed by King's College London (KCL) and technology company Zoe, which tracks symptoms of the disease, has been downloaded more than three million times in the UK.
Not to be confused with the government's contact-tracing app, the Covid-19 Symptom Study app allows users to report daily whether they feel healthy, and record any symptoms.
The scientists have been using the data to estimate how the virus may have travelled through the population. Here are some of the things the app has taught us so far:
When Prime Minister Boris Johnson called the UK lockdown on Monday 23 March, there were "a lot of infected people who suddenly were stuck together, and they infected each other", says KCL epidemiologist Prof Tim Spector.
The peak of the epidemic came nine days later, the researchers believe, on 1 April. They estimate more than two million people aged 20-69 had Covid-19 symptoms in the UK at this point - or 50 in every 1,000 people. The researchers found their app recorded a peak in infections around two weeks before the peak in hospital admissions, which Prof Spector says shows it is an "early warning device" for future changes in levels of the disease.
The average incubation period of the virus is five days but in some people symptoms take longer to show, meaning that a proportion of cases in the early days of lockdown were caught before it started.
After 1 April, the number of infections plummeted in all the regions, but from different levels. Now the rate of the fall in estimated infections is decreasing, says Prof Spector.
"It was halving every week and then it slowed down. That rate of slowing is interesting - there are still some residual infections going on."
The number of cases in the general population is potentially being "driven" by problems in hospitals and care homes, he says.
The team estimates about 280,000 - or 0.7% - of people aged 20-69 have symptoms of the Covid-19, although they warn their model is less accurate when levels of the virus are low in the population.
If you can't see the slideshow, tap here
The Office for National Statistics (ONS) gives us a lower estimate, although so far it has only surveyed England. A swab test survey of nearly 15,000 people aged over two in the two weeks to 17 May, suggested 137,000 people in England - 0.25% - were infected. The same study by the ONS suggests there are 8,700 new infections a day on average in England, while a study by KCL on a group of 980,000 app-users suggests there are 9,900.
Both estimates come with margins of error of plus or minus a few thousand, so they are not as different as they might seem.
By Maryam Ahmed, BBC News data scientist
The model predicts whether a person has coronavirus using their age, gender, and the symptoms they enter into the app. This gives a daily estimate of how many users aged between 20-69 have coronavirus in each local authority and age bracket. Researchers scale these figures up, using the population and age breakdown in each local authority, to predict the number of coronavirus cases in the general population.
Like all models, it doesn't get it right every time. The researchers say it will miss about 35% of people with coronavirus, and flag about 22% of healthy people. Since the predictions are based on app users, who tend to be younger and more affluent, the model might be less accurate when scaled up to the general population. The model doesn't make predictions for people under 20 or over 69, because of a lack of data.
KCL have been publishing their estimates on a daily basis, so the findings have not yet been peer-reviewed.
Areas that hosted sports events in the days before mass gatherings were cancelled, became infection hotspots, according to the research. Data suggested a high rate of infections in Cheltenham following the Gold Cup horse racing event, and a rise in Liverpool after a Liverpool v Atletico Madrid Champions League football game.
Liverpool City Council has since launched an investigation into the outbreak, but Gloucestershire County Council - which oversees the Cheltenham Festival - said any investigation should be led at a national level.
A map of the symptom-tracking app data demonstrates that, at the peak of the epidemic, the estimated cases were clustered in cities including London, Birmingham, Liverpool and Glasgow. But the researchers were surprised by a heavy concentration of estimated cases in south Wales - around a week before the height of hospital activity in the area.
"We never really understood why it was a hotspot. No-one's come up with a convincing explanation," says Prof Spector.
Although the government initially warned the key symptoms of Covid-19 were a fever or continuous cough, data collected by the symptom-tracking app suggests the disease has a wide range of symptoms. Fatigue, shortness of breath, diarrhoea, delirium, skipped meals, abdominal pain, chest pain and a hoarse voice were all associated with the virus.
But the strongest warning signs of infection are a loss of taste or smell, according to findings from the team, published in the journal Nature Medicine. These symptoms were added to the UK's list of those that people should self-isolate with on Monday, several weeks after Prof Spector and other experts had called for the guidance to be changed.
The KCL scientists have also noticed there are patterns in the different symptoms people with Covid-19 have, which they think form six distinct groups. They hope soon to be able to predict how the disease will progress in a person, based on the symptoms they have on the first day.
Interactive produced by Christine Jeavans and Maryam Ahmed. Design by Sana Jasemi and development by Steven Connor.
Alabama added more confirmed coronavirus cases in the week leading up to Memorial Day weekend than in any previous week, but that may not be as bad as it sounds. The state also vastly increased the number of tests it performed, and the percentage of tests performed that came back positive decreased slightly.
Also, fewer Alabamians died this week due to the virus than in any week in the last month.
Signs may be pointing up in some parts of the state, but things are still far from normal. Alabama is continuing the process of reopening its economy, even as some areas are experiencing the worst of the outbreak. Officials in Montgomery County reported hospitals were strained, and many other rural Alabama counties, especially in the Black Belt, are seeing spikes in cases.
In the last week, as of late Friday afternoon, the Alabama Department of Public Health confirmed 2,260 cases of the virus. More than 1,000 of those were in just five counties - the only five counties to add more than 100 cases over that time.
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Montgomery saw nearly 300 new cases in that time, as the outbreak there continues. Mobile County, which saw a large spike in cases a few weeks ago, continues to see large growth in cases. It added 252 cases last week, and still has the most virus cases and deaths in the state. Jefferson County, home to Birmingham and the most populous county in the state, added 232 cases. It also performed the most tests of any of these five counties, and saw the lowest case-to-test ratio last week of those same counties.
Tuscaloosa County, which has had relatively low numbers to this point, added 133 new cases this week, a 44 percent increase. Franklin County, in northwest Alabama, added 117 cases, for a total of 413. Franklin is home to just 31,000 people, and now has the fourth highest virus rate in the state at 131 cases per 10,000 people.
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Overall, the states 2,200 new cases was the highest weekly total since the pandemic started. But other metrics suggest that raw case number isnt as stark as it may first appear. The state performed more than 33,000 tests this week. Thats by far the most of any week so far this year.
The 2,200 positives equate to a 6.7 percent positive rate, which is down from the previous two weeks, meaning the state is finding fewer cases per test, which suggests reduced community spread.
Across Alabama, 52 people died this week because of the virus. Thats the fewest virus-related deaths for any week since April 17.
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A few rural areas, especially in the Black Belt, are seeing more serious indications of spread than elsewhere in Alabama.
Franklin County, which saw a large increase in cases relative to its size, also saw a low number of tests performed, especially compared to the other counties with the most new cases. Just 403 tests were done there over the last week, resulting in a case-to-test ratio of 29 new cases per 100 tests. That was third highest in the state last week behind Choctaw county at 41 cases per 100 tests, and Lowndes County with 36 cases per 100 tests.
Lowndes County has the highest per capita rate of infections in Alabama, with 171 cases per 10,000 people. And numbers are not falling there. Lowndes, next door to Montgomery County, added 47 cases this week, for a total of 166.
Lowndes saw a rate of 48.3 new cases per 10,000 people this week, second in the state behind Bullock County, which saw a new case rate of 48.5 per 10,000. They were followed by Sumter, Choctaw and Franklin counties in terms of new cases per capita over the last week.
[Cant see the map? Click here.]
Do you have an idea for a data story about Alabama? Email Ramsey Archibald at rarchibald@al.com, and follow him on Twitter @RamseyArchibald. Read more Alabama data stories here.
Updated 9:36 p.m.: Revised to include information about nursing home testing.
Dallas County Judge Clay Jenkins said Saturday that this weeks COVID-19 hospitalization rate and new daily case average signaled good news for the county, but cautioned that the decisions of residents in the coming days and weeks will determine whether the county sees a steady decline in cases.
The county reported 172 new cases Saturday, closing out the week with a new daily case average of 200, down from 233 last week, Jenkins said. He said the county had 40 deaths this week, up from 27 the previous week, but that hospitalizations, ICU admissions, and emergency room visits for COVID-19 have remained flat compared to last week.
Overall, this week has been good news and we will hopefully begin to see a decline, but that is entirely up to you, Jenkins said in a written statement. We must all make good decisions and focus not on what is legal, but on what is safe Avoid crowds, when you must be in a crowd wear a face covering and maintain 6 foot distancing, and practice good hygiene by washing your hands regularly.
Jenkins added that residents should still stay home whenever possible and continue to follow guidance outlined in the countys color-coded chart, which was created by health experts and details what precautions residents should take as the outbreak continues. On Saturday, the county was still in the red zone.
The new cases bring the countys total to 8,649. The county also reported three additional COVID-19 deaths Saturday, bringing the total number of deaths to 210.
Two of the individuals had underlying health conditions: a man in his 70s who was a resident of a long-term care facility in Richardson and a man in his 80s who was a resident of a long-term care facility in Mesquite. The third death was of a Seagoville woman in her 80s.
The county said more than one-third of all deaths reported to date have been associated with long-term health care facilities. Dallas County does not report coronavirus recoveries.
The county said of patients who were hospitalized and reported employment, more than 80% have been critical infrastructure workers in sectors like health care, transportation, food and agriculture and first responders.
Two-thirds of hospitalizations have been in people under 65, and half of all hospitalized patients didnt have high-risk chronic health conditions. Diabetes has been a high-risk health condition in about a third of hospitalizations.
Tarrant County announced 52 new cases of the novel coronavirus on Saturday, pushing the countys total during the pandemic to 4,951.
Meanwhile, two new deaths were reported, lifting the countys death toll from COVID-19 to 143.
According to county data, 201 COVID-19 patients remain hospitalized, while 1,832 have recovered. Just under 65% of the countys hospital beds are occupied, and 29% of its ventilators are in use.
Men have made up 58 percent of cases in Tarrant County and 61% of deaths, according to the county website.
Denton County reported seven more novel coronavirus cases Saturday, bringing its total to 1,212.
The county said 616 people have recovered, and 566 cases are still active. The county has had 30 deaths related to the virus.
Collin County reported four new cases of the novel coronavirus on Saturday, bringing its total to 1,136 thus far during the pandemic.
No new deaths were reported, leaving the countys total deaths from COVID-19 at 33.
Current cases number 300, including 21 patients in the hospital and 279 people isolating at home. A total of 803 people have recovered, the county reported.
North Texas fire chiefs announced the creation of a task force Friday to help expand testing for COVID-19 at North Texas nursing homes.
The task force, which was created in collaboration with the Texas Division of Emergency Management, is in response to an order earlier this month by Gov. Greg Abbott that requires all Texas nursing home residents and staff to undergo testing.
The task force will help conduct COVID-19 testing at 139 nursing homes in Collin, Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall counties. Fire departments and agencies from Dallas, Cedar Hill, Plano, Red Oak, Desoto, Ovilla, Lewisville, Corsicana, Ennis, Frisco, Garland, McKinney, Richardson, Sachse and Garland are included in the effort.
In the week following Abbotts order on May 11, local fire departments were able to conduct testing at 50 nursing homes using their own resources, Dallas Fire-Rescue said in a news release.
The regional response involves the use of eight, three-person testing squads, the release said. That effort began a week after the governors order.
Dallas Fire-Rescue said 82 facilities in the region are still in need of testing. Testing has been scheduled at 27 of those facilities.
Ellis, Johnson, Kaufman and Rockwall counties did not provide updates on COVID-19 cases Saturday.
How likely are you to answer an unknown number popping up on your caller ID? And if you were to pick up, how likely is it that you would disclose personal information about yourself and your family, friends and colleagues to the stranger on the other end of the line?
Ask any census worker, public opinion pollster or cold caller, and they will tell you the answer to both questions is not likely. Indeed, the pickup rate for unfamiliar or unidentified numbers in those circumstances is as low as 6 percent. And the people who do answer are often wary and uncooperative, if not abusive.
That resistance is the crux of the problem with contact tracing, which health experts say is essential to containing the coronavirus.
The idea is to reach out to everyone who has tested positive for the virus, find out whom they might have inadvertently exposed and encourage them all to avoid infecting others. But an army of 180,000 contact tracers provisioned with telephone headsets and scripts does not guarantee that anyone will want to talk to them, much less follow their advice.
A storied group of venereal disease investigators from the last century provides some clues on what it might take for contact tracing to be effective and whether the current patchwork of city and state programs is missing the mark.
The best contact tracers that we have ever had came out of the V.D. investigation program started after World War II, said Dr. William Foege, a former director of the Centers for Disease Control and Prevention who is credited with devising the global strategy that led to the eradication of smallpox in the 1970s.
This was an elite cadre of carefully vetted and trained individuals, who, starting in 1948, were tasked by the Public Health Service to contact trace cases of venereal disease, particularly syphilis. Syphilis was a scourge back then; during wartime, approximately 25,000 positive tests were reported annually in New York City alone.
The shame associated with syphilis made it especially difficult to get infected people to talk. And tracking down contacts was a challenge when often all you had to go on was, the girl who frequents the red-door bar downtown or a guy who said he was a brush salesman from Topeka. Nevertheless, public health advisers, or P.H.A.s, as the investigators were called, were astoundingly effective. By the mid-1950s, syphilis rates were the lowest they had ever been. (Also of note, it was a relentless P.H.A. who blew the whistle on the infamous Tuskegee experiment.)
They had to be psychiatrists, detectives and problem solvers all at once, Dr. Foege said. He worked closely with many public health advisers who ended up at the C.D.C. spearheading efforts to contain other infectious diseases, such as smallpox, measles, H.I.V./AIDS, cholera and Ebola.
The boss of the operation was the poker-playing biostatistician Lida Usilton. Under her direction, all P.H.A.s went through the same selection process. They had to have a college degree, liberal arts preferred, and a variety of work experiences and backgrounds was a plus. One put himself through school working as a dishwasher and a lumberjack. Another was a former farmhand and football player. Some were prisoners of war.
The thinking was that contact tracers had to be able to talk as easily with a Wall Street banker as with a migrant worker. They were interviewed extensively to see whether they had the kind of emotional intelligence that made people want to talk to them and whether they could easily manage conversational curveballs, like when a female contact revealed she was biologically a man.
They didnt have to be rocket scientists but they had to be able to connect with other people to talk in a way that indicated to us they were very approachable and reasonable human beings who could be sensitive and persuasive, said Frederick Stuart Kingma, a 92-year-old retired P.H.A. who trained and recruited other tracers in the 1950s.
Today the process is different. Coronavirus tracers are hired according to various state or local health authorities requirements, for jobs paying from $15 to $30 an hour. In New York City, where 10,000 people have applied for 2,500 coronavirus contact tracing jobs, officials said preference was being given to clients of local food-assistance and social-support organizations. In San Francisco, they are hiring primarily furloughed city employees, such as librarians, city attorneys and tax assessors. And in Massachusetts, where 45,000 people applied for 1,700 positions, rsums were sorted first by algorithm and final decisions were based in large part on videos that applicants submitted explaining why they wanted the job.
Were still learning who the best people are to do this, said Dr. John Welch, who is overseeing recruitment and training of contact tracers for Massachusetts in collaboration with the nonprofit Partners in Health. A furloughed doctor or nurse may not have that empathetic ear thats critical.
Training is similarly all over the map, with some health agencies requiring online courses lasting a few hours and others demanding eight to 20 hours of in-person training, or a combination of both. Much of the training focuses on education about the coronavirus, confidentiality rules and data entry protocols. Relatively little instruction is given on how to build rapport with and earn the trust of people, particularly when they might be reluctant to reveal their contacts, like, say, a married lover or an undocumented employee.
For example, just one hour of the six-hour online training program developed by Johns Hopkins Bloomberg School of Public Health, which New York City and the state of New York are using, is devoted to interviewing techniques. It recommends memorizing catchphrases to use during calls such as I hear you and This is a difficult time. That is, the kinds of canned responses that might send someone into a blind fury when calling tech support.
Dr. Emily Gurley, an infectious-disease epidemiologist who developed the Bloomberg training, said that if people realize that the person on the other end of the line is trying to help them, then I think your interviewing skills dont need to be that great to really get and give the information that you need to.
P.H.A.s, by contrast, were taught that everything depended on their interviewing skills. They were sent away to a kind of interpersonal-skills boot camp where they spent an intense two weeks learning interviewing techniques, shadowing other contact tracers and interviewing people themselves under close supervision. Their success in the field was then closely monitored in terms of numbers of cases reached and contacts generated, as well as how many contacts got tested and treated.
An informal survey of coronavirus contact tracing programs across the country revealed that none had settled on definite metrics of success. We are looking for a set of various measures, said Dr. Umair Shah, the executive director of Harris County Public Health in Texas, which serves Houston and the surrounding area. But ultimately the juice is worth the squeeze if youre only reaching 5 percent of the people, at some point you have to ask why and decide maybe this is not the tool we should use.
This brings us back to getting people to pick up the phone, on which so much depends. Some health authorities are sending text messages first, encouraging people to answer, while others are working on social media campaigns and radio jingles to raise awareness and improve participation. It recalls P.H.A.s in the 1950s driving around the countryside broadcasting songs about syphilis over loudspeakers. They passed out comic books about venereal disease with titles like Little Willie and That Ignorant Cowboy and gave out free samples of Dentyne chewing gum to anyone who got tested.
It was a long time ago, said Mr. Kingma, who, some 70 years after working as a P.H.A., can still make you want to tell him everything moments after getting on the phone with him. But maybe some of the things we learned back then can be of use.
Kate Murphy is a journalist in Houston who contributes frequently to The New York Times and the author of Youre Not Listening: What Youre Missing and Why It Matters.
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A little over a month ago, health experts were saying Japan risked becoming one of the worlds coronavirus disaster zones.
Its government was already facing criticism over its decision to quarantine passengers and crew aboard the Diamond Princess cruise liner, and had been accused of underplaying the Covid-19 threat while it clung to the increasingly faint hope of hosting the Olympics this summer.
Japan was testing too few people, critics said, opting instead to focus on clusters of cases rather than overburden its healthcare system with patients displaying no or only mild symptoms who, by law, had to be admitted to hospital. One of the worlds richest countries, they said, was bungling its response.
But today, Japan can make a strong case for being another coronavirus success story, albeit one that has failed to resonate globally in the same way as those in South Korea, Hong Kong and Taiwan.
So far, Japan a country of 126 million people with one of the biggest elderly populations in the world has confirmed 16,433 infections and 784 deaths, out of a global death toll of more than 300,000 people.
In Tokyo, where almost 14 million people live, new cases have remained below 40 for more than a fortnight, with just five cases reported on two consecutive days this week. That compares with a peak of 206 new cases reported on 17 April. On Friday, the public broadcaster NHK reported just three new cases in the capital in the previous 24 hours.
Achieving such low figures barely seemed possible in early April when, just as the number of cases began to rise sharply in Tokyo and other major cities, neighbouring South Korea with its widely praised regime of testing, tracing and treating was flattening the curve.
On 7 April, the prime minister, Shinzo Abe, belatedly declared a state of emergency in the capital and other affected areas that was later expanded to include all 47 of the countrys prefectures.
But Japans version of lockdown requests to avoid unnecessary outings, work from home and observe social distancing came across as a timid response to a situation that risked spiraling out of control. The dispatch of two reusable masks to every household was met with derision, as people posted photographs on social media of the small, and in some cases dirty, Abenomasks a play on the leaders economic policy dubbed Abenomics.
Abes performance throughout the crisis has been uneven, according to Tobias Harris, an expert on Japanese politics at Teneo consultancy. I think he has struggled to stay ahead of events since the beginning, has not communicated effectively, and has been poorly served by his lieutenants.
Japan has skirted a coronavirus surge with room to spare, after new cases slowed markedly when Abe, who does not have the legal powers to declare a European-style lockdown, called on people to beat the virus by avoiding the three Cs: confined and crowded spaces, and close human contact.
The Abe administration has gained few political dividends for its response; instead, most plaudits have gone to the quiet determination shown by the public, armed with virus-challenging habits formed long before the pandemic.
Masks are a common sight during the winter flu season, and in spring among people with hay fever. The custom of bowing rather than shaking hands or hugging, generally high standards of personal hygiene, and the removal of shoes when entering homes have all been held up as possible explanations for Japans low infection rate.
Experts have pointed to universal healthcare, low obesity rates and expertise in treating pneumonia. More fanciful theories have gained traction the consumption of foods, such as natto, that boost the immune system and, according to an unscientific experiment conducted by a TV network, the relatively low number of airborne droplets generated by spoken Japanese.
I dont think the falling number of infections is due to government policies, said Ryuji Koike, the assistant director of Tokyo Medical and Dental university hospital. I think it looks like Japan is doing well thanks to things that cant be measured, like daily habits and Japanese behaviour.
Personal habits and cultural traits, however, tell only part of the story. While Japan hesitated before imposing restrictions on overseas visitors, it was quick to recognise the dangers of mass gatherings.
Museums, theatres, theme parks and other attractions have been closed for months. Japans professional football league suspended matches three weeks before 150,000 people attended the four-day Cheltenham horse racing festival in Britain.
Rugby and baseball leagues followed suit, delaying the start of their seasons, while sumo authorities decided to hold the recent spring tournament without spectators for the first time in the sports history. Abe was criticised for calling for unnecessary school closures in early March, yet many other countries then did the same.
Rob Fahey, a research associate at the Waseda Institute of Political Economy in Tokyo, believes declaring Japans ability to contain the outbreak a mystery ignores the role of individual and collective action.
Acknowledging this, however, requires looking beyond the usual set of policy actors and recognising that Japans response overall can still have been exemplary even if the performance of its central government left much to be desired, Fahey wrote in the Tokyo Review this week.
Japans incremental exit from the state of emergency continues. Last week, Abe ended the measure in 39 prefectures, adding another three this week. Tokyo and four other prefectures could join them as early as Monday, according to media reports.
But experts are warning against complacency given that the low rates of testing may be distorting the extent of infections a hazard recognised by the governments own expert, Shigeru Omi, who admitted that nobody knows whether the true number of coronavirus cases could be 10 times, 12 times or 20 times more than reported.
As Tokyos backstreet bars and restaurants started filling up again this week with some staying open beyond the 8pm closing time requested by the citys governor Abe sought to balance cautious optimism with a dose of post-pandemic reality.
The weeks ahead would not mark a return to the days before the outbreak, he said, but the beginning of a challenge to create a new normal.
Agence France-Presse contributed to this report
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KING COUNTY -- The first phase of a Covid-19 experimental vaccine trial is showing positive results, and the first injections in people happened here in the greater Seattle area.
Jennifer Haller was the first person to receive the experimental Covid-19 vaccine. She got her first injection March 16.
The only side effect that I had was soreness at the site of injection. I felt really normal. It felt similar to the same experience Ive had in the past with flu shots," she said.
Neal Browning is a network engineer from Bothell. He was also one of the first few to test the experimental vaccine for safety.
I knew it was important for me to step forward and say, 'Im a human being, too.' This affects us all. If I can do this for the greater good, I should do that, said Browning.
The experimental vaccine was developed by Moderna, a biotechnology company in Massachusetts.
After eight weeks of testing the vaccine in 45 people, the company is finding the vaccine is generally safe, well-tolerated and producing antibodies in eight of the candidates so far.
They had produced successful amount of antibodies equal or surpassing what was present in people who had already contracted and gotten over Covid-19, said Browning.
While the vaccine is showing positive results, both Haller and Browning said this potential layer of protection isnt putting their guard down with stay home orders and social distancing still in effect.
I dont suppose I have any special immunity right now. I continue to live my life as I have been, as everybody else is, said Haller. Im continuing to practice social distancing and wearing a face mask when Im out in public.
Taking that risk and possibly infecting my family, its not something Im willing to do, so while I may feel a little safer out there I dont take any more risks than I normally would, said Browning.
Both Haller and Browning received a low dose of the vaccine.
The next phase of the experimental vaccine trial will be led by the National Institute of Health, where researchers will determine if a low or medium dose is better suited for a definitive third trial in July.
I was super happy and Ive been kind of on Cloud 9 the whole time, said Browning after learning early results were looking promising.
If everything goes smoothly, Moderna is ambitiously planning to ramp us vaccine production for the end of 2020 or early next year.
Experts in the field said its too soon to really know how effective Modernas experimental vaccine will be. It is one of eight companies worldwide testing Covid-19 vaccines in people.
The global scientific community has joined forces in an unprecedented effort to understand, track, forecast, test for, and find a cure for the current coronavirus pandemic. But in a crisis where every second lost means more loss of lives, solidarity alone isnt enough. Supercomputers are enabling a vastly accelerated pace by which scientists can conduct research and collect and analyze data. Never have they proven their value to society more than during this COVID-19 pandemic.
Supercomputers provide scientists with unique capabilities: they can explore the structure and behavior of the virus at the molecular level, and forecast the spread of the disease and design drugs much faster than would otherwise be possible.
The Texas Advanced Computing Center (TACC) began fielding requests for compute time to assist in the fight against COVID-19 in February 2020. In March, the White House enlisted some of the worlds most powerful supercomputers in the battle against COVID-1 through the COVID-19 High Performance Computing (HPC) Consortium, a public-private partnership providing researchers worldwide with massive computing resources.
As part of this effort, we are working closely with teams to provide priority access to supercomputing resources here and across the world. In the U.S. alone, there are more than 100 projects, involving thousands of researchers, using HPC systems to predict the effects of interventions like stay-at-home orders and school closings; to simulate the molecular behavior of the proteins that make the virus virulent; to understand the genetics of the virus and its mutability; to screen potential drugs and vaccines for efficacy; and to visualize and interactively share data with decision-makers.
At TACC, nearly a third of all computing time has been dedicated to accelerating these efforts the equivalent of 40,000 desktop computers churning non-stop. None of this would be possible without federal funding for high performance computing by the National Science Foundation (NSF) and Department of Energy (DOE), who have made open access to supercomputers part of their mission for more than four decades.
Beyond big machines, supercomputing centers employ some of the brightest minds in computational science, and these individuals are collaborating with teams across the nation to fast-track research.
Among these partnerships is the University of Texas at Austin COVID-19 Modeling Consortium, led by Dr. Lauren Ancel Meyers, which developed one of the leading epidemiological models of how the disease spreads based on virus transmission and real-time cell phone data. The White House and CDC, as well as the national media and public, have used the model to inform their understanding and decision-making.
A team from DOEs Argonne and Brookhaven National Laboratories applied several of the most powerful supercomputers in the world to accelerate an AI-based approach to drug docking. Their effort narrowed 6 billion possible small molecules to the 30 with the best chance of binding to one of the virus proteins and disrupting its function. These are now being tested in labs at the University of Chicago.
The TACC-powered COVID-19 Drug Discovery Consortium is collaborating with Enamine, the worlds largest provider of screening compounds, and Boston University, Texas A&M, and the University of Texas Medical Branch, to identify the 600 most promising, readily available, drug-like molecules (out of 2.6 million) and test them in high-containment laboratories in order to find potential drugs in months rather than years.
New projects are launching daily.
In many of these cases, long-term research collaborations helped speed the projects out of the gate. The UT Austin Modeling Consortiums projections built on a decade of federally-funded R&D on flu pandemic modeling by Meyers team. The DOE researchers adapted AI-based cancer drug discovery methods for SARS-CoV-2. The Drug Discovery Consortium leveraged tools and methods developed over many years to fight bioterrorism. Our ongoing relationships with these teams has made it possible for them to shift their research focus, expand their scope, and reduce limitations as they work towards a common good.
Academic research is frequently the first step in a long process that requires efforts by government agencies, philanthropic organizations, and industry. Basic science helps decision-makers protect the populace, and informs the creation of vaccines and treatments.
Under normal circumstances, this process takes years or decades. However, time is a luxury we simply do not have. The urgency of the challenge we face makes the application of research accelerators like supercomputers even more critical to help flatten the curve and ultimately solve the greatest crisis we as a society have ever faced.
Dan Stanzione is the director of TACC at The University of Texas at Austin.
A version of this op-ed appeared in The Hill.
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COVID-19 Vaccine Trials Are Taking Place Right Now in the USHere's What You Need to Know
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