The urgent search for a vaccine to protect against COVID-19 is well underway, with a number of experimental gene-based vaccines in various stages of development by biotech companies and academic scientists worldwide. Yale pathologist John Jack Rose believes a proven vaccine platform he pioneered decades ago using a livestock virus called vesicular stomatitis virus (VSV) could produce better immunity than other candidates, and be scaled up quickly to meet global demand.
The VSV platform was used to develop the Ebola vaccine that received FDA approval in December 2019 and has since been effectively administered to more than 235,000 people, including over 60,000 health care and frontline workers.
Rose, professor emeritus of pathology and senior research scientist at Yale, and a small team of researchers that includes pathology chair Dr. Chen Liu and Craig Wilen, assistant professor of laboratory medicine and of immunobiology, are now working around the clock to develop a VSV-based COVID-19 vaccine and begin animal testing.
It is so critical that we provide at least an alternative approach for a vaccine, said Liu, who enlisted Rose in the challenge and set up his own lab alongside Roses to share in the work. There are DNA or protein-based vaccines for COVID-19 in trials, but, in my opinion, the viral vector [a vaccine using a live virus] would be more robust in generating immunity.
To make a vaccine using the VSV platform, scientists insert a protein from the virus they are trying to protect against such as Ebola or SARS CoV-2, the virus strain that causes COVID-19 into the livestock virus. The livestock virus is well suited for safely passing genetic material into cells and stimulating an immune response, Rose said. It is genetically stable, does not cause illness in humans, and generates a very strong antibody and T-cell response.
And a livestock virus can be reproduced much more easily than messenger RNA and DNA vaccines.
It would be easy to scale up production of a VSV vaccine for SARS CoV-2. We could get to millions of vaccine doses easily.
John Jack Rose
It would be easy to scale up production of a VSV vaccine for SARS CoV-2, said Rose. We could get to millions of vaccine doses easily.
Wilens lab is growing the live SARS CoV-2 virus strain, necessary for testing the new vaccines effectiveness.
Hes also making synthetic versions of the virus spike protein that will be inserted into the livestock virus. In high-resolution electron micrographs of the SARS CoV-2 virus, the spike proteins appear as protrusions emerging from the central mass like so many sucker feet. Its these proteins that allow the virus to bind to human cells and cause infection.
Because SARS CoV-2 is so contagious and potentially lethal, the Yale scientists wear complete protective gear including respirators and work in an isolated, negative-pressure room.
The coronavirus is similar in terms of virology to the norovirus, Wilens focus before the pandemic hit, he said. We were the first lab at Yale to culture the virus. Were working to pop out the normal VSV protein called G and swap it with the coronavirus protein.
Wilen said he and two postdoctoral students have taken over additional lab space in order to practice social distancing while they work.
The scientists have reason to hope that their VSV-based COVID-19 vaccine will work. Beyond its successful use in protecting against Ebola, the VSV platform has been used to develop other vaccine candidates that have shown promise in animal models for protecting against avian flu, HIV, and SARS CoV-1. The latter virus spread across 26 countries in 2013 and led to over 8,000 cases and 774 deaths.
SARS CoV-2 is a stealth version of SARS, Rose said. The original SARS made people very sick much faster and it was easier to trace contacts.
In his work creating the original SARS vaccine, Rose was able to successfully insert the spike protein into the VSV virus and engineer protection against SARS in mice. Because that virus was easier to contain than the slow-to-emerge SARS CoV-2, the work ended before the vaccine reached human trials.
But he learned important lessons about how the novel coronavirus operates. For one, its hard to generate immunity against it.
Even with the live virus, SARS CoV-1 didnt get a strong immune response [in mice], Rose said. It was protective, but low. It suggests we need a robust vector system.
Preliminary data shows that inserting SARS CoV-2 into the VSV platform will work to generate that protective immune response, Rose said.
Said Liu: This has a really good chance.
Researchers at the University of Montana and two Missoula-based biotech companies with ties to venture capitalist Mike Goguen are engaged in separate efforts to develop a COVID-19 vaccine and gain authorization for a mass-scalable viral test.
Inimmune, a private company involved in UMs vaccine work and founded by nationally reputed vaccine scientists, is also gearing up to test an intranasal spray that researchers say has proven in animal testing to protect against other diseases and could offer protection against coronavirus. That testing will be conducted at the Rocky Mountain Laboratories in Hamilton.
Additionally, the biotech firm FYR Diagnostics is seeking emergency-use authorization from the U.S. Food and Drug Administration for a viral-detection test that it developed and which it believes could offer a viable solution to mass testing in Montana and elsewhere. Two Bear Capital, the Montana-based venture capital firm that Goguen launched in 2019, has provided FYR with seed funding and additional investments.
Goguen said this week that Two Bear Capital is also in venture capital funding discussions with Inimmune.
Inimmunes co-founder and CEO is Dr. Jay Evans, director of UMs Center for Translational Medicineand a research professor in biological sciences who is also the principal investigator on the universitys research team that was recently awarded $2.5 million from the National Institutes of Health (NIH) to identify and advance a COVID-19 vaccine candidate.
Evans and two other scientists founded Inimmune in 2016 after their employer, the pharmaceutical giant GlaxoSmithKline, closed its research and development center in Hamilton, leaving a stable of respected vaccine researchers out of a job. The founders established a partnership with UM and launched Inimmune in conjunction with the formation of the colleges Center for Translational Medicine to maintain and expand scientific research in Montana.
Evans said the relationship between the company and university is a mutually beneficial public-private partnership that bolsters research, funding and commercialization opportunities. The center alone has brought the university nearly $70 million in vaccine research funding since 2016.
The research center boasts unique expertise in adjuvants, which are the components added to vaccines to improve the immune response, and novel delivery systems to ensure vaccines are safely and efficiently delivered to the right cells.
These technologies now are being used for the COVID-19 project to rapidly advance a safe and effective vaccine toward human clinical trials, UM stated.
Evans said the 40 people at UM and additional personnel at Inimmune who are involved in vaccine discovery and development form a powerhouse research team. And hes hoping to recruit 10 more researchers as the university center grows.
Theres a reason that NIH comes to our team when theres a national crisis and they need a vaccine developed quickly with good delivery systems and adjuvants, Evans said in an interview earlier this week.
I dont know of another group in the world that has the capacity we do, he added. When we say that were a world-class vaccine discovery and development team, I dont think thats an overstatement.
The university notes that its research team works on a range of new or improved vaccines for influenza virus, tuberculosis, pertussis, Pseudomonas aeruginosa, Lyme disease, E. coli and opioid addiction. After the NIH contacted the university in February, the researchers shifted their attention to developing a vaccine for SARS-CoV-2, the virus strain that causes COVID-19.
We quickly adjusted lower-priority vaccine projects to focus our efforts on this urgent need, Evans said, adding that researchers have navigated school closures, stay-at-home orders and social distancing to rapidly advance this vaccine and continue working on other essential research projects of critical importance to our community and the nation.
Its not every day you can be involved in an essential vaccine project with global health implications, added Dr. Stephanie Lathrop, a UM immunologist and COVID-19 project leader who has been instrumental in designing studies and coordinating staff schedules during the pandemic. It has been amazing to see the UM community rally behind us in support of our efforts.
Evans said the UM team is currently conducting animal testing on COVID-19 vaccine candidates. Although the university was the sole recipient of the recent NIH award, the vaccine development work involves technology produced by both UM and Inimmune.
The $2.5 million allows us to take the technology that currently exists at the university and Inimmune and apply that technology to identify a coronavirus vaccine candidate, Evans said.
After UMs testing is complete, likely in a couple months, the universitys partner in the research, the Icahn School of Medicine at Mount Sinai in New York City, will conduct further testing, moving it closer to human clinical trials, which will require another infusion of funding.
In theory, in six months, we could be in a position to apply for a larger batch of funding that could take us through Phase 1 clinical trials, Evans said, noting that such additional funding could come from agencies or private sources such as venture capital.
Thats where someone like Mike Goguen could really come into the story, he added, noting that Goguen has been assisting Inimmune in an unofficial capacity by helping navigate the different aspects of how to make a company successful in this environment.
More broadly, Evans said Two Bear Capital has emerged as a critical driver of the biotech sphere in Montana.
What Mike is doing for biotech in Montana is pretty incredible, Evans said. Between Next Frontier Capital and Two Bear, if youre a biotech company in Montana, theyre propping up the whole system.
Inimmune has worked for years, independent of UM, to develop an intranasal spray that can protect against certain diseases such as influenza and RSV. If found to work on COVID-19, Evans said the spray could be administered every couple weeks for prolonged protection.
Theres a strong reason to believe these treatments would be effective with the current coronavirus outbreak, Evans said.
Since launching last year, Goguens venture capital firm has focused much of its attention on biotech companies. One such firm is FYR Diagnostics, a Missoula-based molecular diagnostics company that has been developing a mass-scalable and cost-effective COVID-19 viral infection test.
The FDA has approved two different types of COVID-19 tests: antibody tests that detect an individuals immune response to the virus and viral tests that detect the presence of the SARS-CoV-2 virus itself. FYR Diagnostics product is a rapid virus-detection test called Adaptive Low Resource Testing (ALRT), which the company says is effective at identifying a potentially active and contagious infection, even in asymptomatic individuals, but not effective at identifying those who have recovered from the virus.
We are proud to be doing our part to address the COVID-19 crisis, said FYR Diagnostics CEO Chris Booth, Ph.D.
FYR President Sarjubhai Patel is a research professor at UM. Another company cofounder, Braxton Norwood, Ph.D., grew up in Kalispell and graduated from Flathead High School in 1999.
Officials at FYR Diagnostics say several viral-detection diagnostic tests have been approved by the FDA and are in use across the country, but supply chain and equipment shortages have inhibited their capability on a mass scale.
FYR Diagnostics ALRT test opens this bottleneck through alternative reaction components and technologies that do not require scarce equipment or costly specialized devices, the company states. The ALRT test is designed to be low cost, simple to administer without specialized training, and suitable for use at low-resource testing sites beyond hospitals and clinics. It can produce a yes/no test result in 30-40 minutes.
Patel said emergency-use authorization from the FDA would allow for the tests deployment on a broad scale. Goguen, who is FYR Diagnostics executive chairman, noted that insufficient testing capacity here in Montana and throughout the U.S. is amplifying and prolonging the COVID-19 crisis while putting more lives at risk.
FYRs highest priority is to quickly enable mass COVID-19 testing in our home state, and then expand elsewhere, Goguen said.
Goguen founded Two Bear Capital after previously spending 20 years at one of the worlds leading venture capital firms in Silicon Valley, Sequoia Capital. He said the research and development occurring in the state, from universities to private companies, is a badge of honor for Montanans.
In my opinion, we have a lot to be proud of in Montana to have such important work being done right here in our state because of the expertise of folks at UM and at these companies, Goguen said.
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The federal governments response to the coronaviruspandemic could turn out to be a policy mistake of epic proportions. The successof the current response depends on the development of an effective vaccine inrecord time which allows the country to quickly return to its pre-viruseconomic boom. Should reality fall short, Congress will have created a massiveamount of new federal debt with no plan B.
Policies that provide temporary support to shuttered businesseskeeping their non-working employees on the payroll are tremendously expensive.They will only work if the public-private initiatives underway can engineer aquick reduction in the virus spread that allows the nation to return tobusiness as usual, which is why the success of the governments response hingeson the rapid development of an effective vaccine.
History suggests that expectations of a quick vaccine are heavily optimistic. After almost 40 years of research, there is no vaccine for the HIV. Similarly, there are no vaccines for SARS, MERS, or the common cold. It took 10 years to develop a vaccine for the Avian H5N1 virus. Moreover, vaccines do not offer complete protection. According to the CDC, the current seasonal flu vaccine is estimated to be only 45 percent effective.
The probability of death after contracting COVID-19 is unknown but not insubstantial. In Connecticut, 7.6 percent of all confirmed COVID-19 patients have died. Death rates are similarly high in Massachusetts (5.3 percent), Louisiana (6.2 percent), and Minnesota (7.5 percent). Once asymptomatic cases are accounted for, experts expect the average mortality rate to be much lower, perhaps under 1 percent. Still, without an effective vaccine, the overall risks of the coronavirus are material because a person with the coronavirus likely infects on average between two and 2.5 other people. Without an effective vaccine, informed consumers are likely to demand social distancing mitigation once businesses reopen with or without a government social-distance mandate.
If social distancing remains the only practicalmitigant for the foreseeable future, then many businesses will be forced toadapt to remain viable. It is hard to imagine that airlines, cruise ships, masstransit, eat-in restaurants, sporting events, and all other types of activitiesthat rely on large concentrated gatherings of people will be able to resumepre-crisis operations profitably in this new environment. Taxpayers cannotafford to continue to support these businesses payrolls indefinitely. If the probabilityof survival of these types of businesses is remote in a COVID-19 world, it isshortsighted for Congress to be mortgaging Americas future on programs that freezethese potentially obsolete businesses in time, betting on the unlikely possibilitythat they can quickly and profitably be revived. Congresss failure to devote atleast some of these resources to developing a plan B a plan that does notrely on the timely development of a successful vaccine could end up being anexpensive policy mistake.
It is not surprising that funding for programs that maintain the businesses and lifestyles of voters harmed by the virus through no fault of their own garner unanimous political support. Politicians of all stripes favor programs that grease their own reelection chances, especially when the inevitable spending constraints imposed by shortsighted bailout programs are realized in the future.
However, while there is no doubt the economic transitions catalyzed by the COVID-19 pandemic will be painful for many, they are also unlikely to be avoidable. Congress and the executive branch need to rise above narrow self-interest and focus more attention on formulating a plan B with programs designed to transition the economy so it can continue grow and prosper should the world fail to develop an effective coronavirus vaccine.
Hours after Gilead announced that an NIH trial testing their antiviral drug remdesivir in Covid-19 patients had succeeded, NIAID director Anthony Fauci sat on a couch in the Oval Office and gave the world the top-line readout.
The drug induced a 31% improvement on the primary endpoint of time to recovery: 11 days in the drug arm compared to 15 days in the placebo arm, he said, adding that patients taking the drug appeared less likely to die, with an 8% mortality rate in the drug arm compared to 11% in patients given the placebo.
The mortality data were not yet statistically significant, he cautioned but were trending in the right direction. Fauci, surrounded by President Trump, Vice President Mike Pence and several other advisors, said the news was a very optimistic sign in the hunt for treatments to fight the virus.
Although a 31% improvement doesnt seem like a knockout 100%, it is a very important proof of concept, he said. Because what it has proven, is that a drug has blocked this virus.
Fauci said more details would come and that the study would be submitted to a peer-reviewed journal. Trump, who deferred to Fauci in giving the readout, echoed Faucis commentary.
Its a beginning, that means you build on it, Trump said. But its a very positive event.
Shortly after the briefing, the New York Times reported that the FDA was preparing to issue an emergency use authorization for the drugs use in Covid-19. In an email to Endpoints News, the FDA did not confirm or deny the Times report, but a spokesperson said the agency has been engaged in sustained and ongoing discussions with Gilead Sciences regarding making remdesivir available to patients as quickly as possible, as appropriate.
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Pfizer and partner BioNTech are right in the middle of one of the most important vaccine trials in the world right now, but that doesnt mean the Big Pharma is taking its eyes off the inoculation ball elsewhere.
In the same week it announced dosing had been finished in its pandemic mRNA vaccine test, Pfizer also said it had penned a $308 million Lyme disease vaccine R&D pact with French biotech Valneva.
The deal focuses on development of Valnevas Lyme disease vaccine candidate, VLA15, which is currently in phase 2. VLA15 is the only active Lyme disease vaccine program in clinical development today and covers six serotypes that are prevalent in North America and Europe.
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Collectively, around half a million people across the two regions are infected with the bacteria Borrelia, causing in many long-term debilitating disorders if not treated quickly. Its predominately spread to humans by infected Ixodes ticks.
The multivalent protein subunit vaccine targets the outer surface protein A (OspA) of the Borrelia bacteria: OspA is one of the most dominant surface proteins expressed by the bacteria when present in a tick.
VLA15 has demonstrated strong immunogenicity and safety data in preclinical and phase 1 studies, Valneva said, and was given a fast-track label by the FDA back in 2017. Phase 2 enrollment is done, and the French biotech expects to post data from that study in the coming months.
It gets $130 million upfront, $35 million in development milestones and $143 million in early sales milestones, should it gain approval.
Under the nuts and bolts of the deal, Valneva will fund 30% of all development costs through completion of the development program, while Pfizer will pay Valneva tiered royalties starting at 19%. Pfizer will then lead late-stage development and have sole control over selling the vaccine.
RELATED: Valneva looking to buy small, overlooked vaccines from Big Pharma: CEO
Valneva already sells vaccines to protect against cholera and Japanese encephalitis and has R&D programs in chikungunya.
Thomas Lingelbach, CEO at Valneva, said: This collaboration is extremely exciting as it provides the opportunity for the rapid development and launch of a vaccine that has the potential to address a major unmet medical need. It validates Valnevas strong vaccine R&D capabilities. We believe that Pfizer is the best partner for our Lyme disease vaccine given their outstanding development and commercial capabilities. Our team is thrilled about the prospect of working with such a successful partner.
The biotech has had pharma partners before, though back in 2016 one didnt work out when it gave up on its vaccine against hospital-acquired infection Pseudomonas aeruginosa. The vaccine was positioned to be picked up by GlaxoSmithKline, but weak phase 2/3 data torpedoed both that possibility and Valnevas interest in forging ahead with development.
It will hope to have better luck with Pfizer.
Nanette Cocero, global president of Pfizer Vaccines, added: Lyme disease is the most commonly reported tick-borne illness in the United States and is growing in its prevalence and geographic reach. We look forward to working closely with Valneva to continue advancing the VLA15 program and potentially bring a new solution to patients for this significant unmet need.
As both a research company, and a manufacturer of pediatric and adult vaccines including a vaccine for tick-borne encephalitis in Europe, we believe that Pfizers vaccine heritage, scientific expertise, and global commercial capabilities will help allow the VLA15 program to reach its maximum potential in helping protect children and adults from Lyme disease.
michael barbaro
From The New York Times, Im Michael Barbaro. This is The Daily.
Michigan has been one of the most aggressive states when it comes to taking steps to combat the coronavirus.
Bans on all gatherings outside a single household, travel to in-state vacation homes, and the use of motorboats
Michigans restrictions on its citizens movements have been at the center of a national debate about public health versus economic survival.
Protests in Michigan are growing because the governor, Democrat Gretchen Whitmer, has told us citizens they cant leave the city and stay in their summer homes.
Dont buy paint, dont buy roses, dont buy I mean, shes got all these crazy things.
Today: A conversation with the governor who ordered those restrictions and a demonstrator who is protesting them.
Its Wednesday, April 29.
So I just want to start by asking you to introduce yourself. Your name and where youre talking to us from.
My name is Phillip Campbell and Im coming to you from Jackson County, Michigan, which is about an hour west of Detroit and about an hour away from the capital of Lansing.
And how long have you lived there?
Ive been here in this particular location for five years, but Im a born and raised Michigander my whole life.
And did you say how old you are?
Yeah, 39. Im turning 40 in June. I had a massive party planned. I was inviting everyone I know and now I just dont know whats happening with that, so.
When you say massive, how massive?
I invited 1,000 people so, we were going to be
[LAUGHS]
I have five acres and I was going to rent Port-a-Johns. And we were going to camp. And it was going to be a multi-day bash, you know?
It turns out youre very popular, too.
[LAUGHS] Well, Ive made a lot of friends over the years.
So tell me about what you do for a living.
Im the vice president of a pest and wildlife control company. We are the ones you call if you wake up at 1:00 a.m. and theres a bat flying around your kids bedroom, and you need somebody to go get it. We will climb on your roof and pull down the hornets nest. We will take care of the mice in your basement. Well do this sort of work.
Mm-hm.
We have about 30 employees. Ive been with the company for about 10 years now. I think Im one of the most senior employees there. We started when we were in the basement of the owners house. And now we have a very large industrial building with a depot and a shop. So its been cool to see that grow over the years.
So at this point, how would you describe the company and its success?
I mean, I think were on the threshold of breaking through to the next level of growth. Were grossing about $3 million a year.
Wow.
Just this year were able to for the first time provide health benefits for our employees. So weve been working towards that for a long time, trying to get to where we have the sort of revenue and the growth that we could take on those costs, which are not insignificant, you know? We like to think that were one of the companies or industries that can still offer regular old Joes without a college education a very decent middle class livelihood with insurance benefits, things like that.
Mm-hm.
The majority of technicians are what I would just call blue-collar people, you know? They like to hunt, they fish. They go out on the lake on the weekends and drink beer on their pontoons and listen to music. And just regular old folks, you know?
Mm-hm. And what kind of a living do the people generally make?
I mean, many of the people in our company, they provide for their families. You know, theyre the breadwinner. You know, a new technician like starting might make 35.
Mm-hm.
And then a technician whos been with us for a while and knows what hes doing, he can make in the high 50s or 60s. So with the 30 employees we have, we feed about 100 mouths, with their children and families. So we feel responsible for about 100 peoples well-being.
And what did the first Michigan lockdown, the one ordered by Governor Whitmer what did it mean for your pest control business?
Her order did not exempt us. The text of the order itself, it did not make an exemption for wildlife control, pest control. And we were preparing to shut down. And then I noticed that it said for its definition of essential services, for further clarification, see this document by the Department of Homeland Security. And we found that we were allowed to stay open.
Got it.
But very quickly after that we had to furlough a couple people after that, because even though we were allowed to stay open, our customer base, many of them arent working. So if your customers arent working, theyre not spending money. And it doesnt really matter if youre open if all the people you serve arent working, you know what I mean?
Right. I dont want to pry too much, but if you were bringing in I think you said almost $3 million a year in revenue before this, what did it start to look like once the lockdown was in place and the calls from customers began to taper off?
At first, it was a 50 percent drop.
Wow.
Again, this is for a company that was allowed to stay open.
Right.
And then around this time, the second shutdown order came in, which was the one that everybody started protesting about.
Tell me what you mean.
Yeah, the second shutdown order just ramped down on the first. This was the one that went in and shut particular sections of stores that were still open. So like it said, you cant buy paint products, you cant buy gardening products. Because what was happening is people thinking, OK, I got to stay home, I might as well work on my house, you know? So a lot of those people were going to Home Depot, were going to whatever to get their supplies. And then the governor said, no, you cant get that stuff.
So this was the order that said you cant go out on a lake by yourself in your boat in your private lake, if the boat has a motor. But if it doesnt have a motor, you can go. Things that seemed a lot more arbitrary. The one that said you cant have someone come mow your lawn, even though they pull up in a truck, they drive the lawnmower off, they dont touch you, they dont go into your house. Its just one guy mowing your lawn. You know, things that people started thinking, like, the economys already in freefall, is it really necessary to go this far with it?
From my own experience, if the economy takes a dump and we cant get back to where we were, we have to cut their health insurance or were going to have to lay people off. Were going to take other measures to stay afloat. I dont know what were going to have to do. I dont want to hypothesize. I dont want my employees to listen to this and be like, what did you say is going to happen? I dont know, were going to have do something. We cant just suddenly take a 30 percent to 50 percent decline. Thats huge. What if you got a 50 percent pay cut? It would affect your life.
And so Im thinking about the ripple effect. We take a 30 percent to 50 percent drop. Our employees take a dip. Maybe they cant afford to pay their debts. Maybe they cant afford to pay their own mortgages or whatever. I dont know. I havent assessed the financial situation of each of my employees.
But I guess what I am frustrated about and I dont want to minimize the risk of Covid-19 or the people whove had it but as someone whos worked for 10 years in this business trying to build it up, get it to where it is, Im frustrated with the attitude of some people that we can just shut it off for a while, and then just turn it back on when everythings safe, and just pick up where we left off. Like, no, thats not how business works. Thats certainly not how small business works. If you take a big enough hit, its hard to recover from it, you know?
So Im curious when you first hear about the possibility of a public demonstration, a protest, in Michigan of these lockdown rules?
I saw an event on social media, I think, or I saw people talking about it like, hey, lets go down to Lansing and protest. So the owner and I works been slow, so we said, hey, we got time. Lets drive down to Lansing on Thursday. The way I understood it, we were going to drive by the capitol and honk our horn, basically.
And what was that honked horn going to mean?
The honked horn was going to mean like, we are workers, and we want the freedom for people to be able to work. Please consider opening things back up a little more. The capitol in Lansing, its on a loop, so you drive around in like a circle around the capitol. So I thought that all the traffic would come in, wed kind of loop around and wed honk, and then wed go back home, you know? But they were anticipating a certain amount of people I think 10 times more than they anticipated showed up. So it took us two hours to get to Lansing. We got in Lansing, and then we were just Michael, it was a traffic jam. Thats what it was. It was just a big traf it was like an organized traffic jam.
But what did it feel like to be in that traffic jam? Because its a particular kind of traffic jam with like-minded people there to protest something.
It was really neat. It was nice to not feel so alone, because I was really sick of people on social media telling me Im selfish because I dont want the company I helped build for 10 years to just collapse.
Whos calling you selfish, do you feel like?
Oh, just people on social media, my friends. People in my broader circle. You know, not people Im necessarily close to, but Id say I lost some friends over this, honestly. When the governor shut the economy down, I said this is going to be very hard on businesses and this is going to be very hard on us. And a lot of peoples response seemed to be like, what, do you want people to die or something, you know? And it kind of degenerated into, like, either you want people to die or you hate my business and stuff like that. And I was really glad, because I was starting to feel kind of isolated, to see a solidarity of so many other Michiganders who were similarly frustrated at the situation. Afterwards, when I got home, I saw there was a lot of people with a lot of Trump stuff, and I was kind of thinking, like, no, this isnt political. Dont make it into a political thing because this isnt about the governor happens to be a Democrat or a woman or something. Because I would have gone down there if it was a Republican, you know? It wasnt about her party affiliation. So I was frustrated
What did you make of the flavor of the protest? It seems like you didnt see this yourself in your car, but as youve hinted, there were strong strains of libertarianism and conservatism, and pro-Trump posters, as well as people with guns, as well as some, you know, some more vulgar and extreme sentiments. Some people compared Governor Whitmer to Hitler.
Oh, like Governor Whitler? [LAUGHS] Oh, I dont know, I think thats just juvenile. I mean, I think its pretty juvenile in public discourse when the only thing you go to is compare your opponent to Hitler. I wish it wouldnt have been so much anti-Whitmer, because this isnt about like Governor Whitmer, the person, you know? I wish that it would have been more on point and focused about let me work, you know?
I wonder where you fall in the political spectrum. Did you vote for Trump? Did you vote for Whitmer? And how did your political views apply to this event?
My political views didnt apply to this event really at all. You know, like, I wouldve been there if this was a Republican. I did vote for Trump. I dont particularly think hes doing that great of a job. So Im not a gung-ho Trump supporter. I didnt vote for Whitmer, but I didnt like the guy running against her, either. So.
Youre saying youre not seeing this crisis or the lockdowns through a political lens?
No, no, not at all. Not at all. The little match between President Trump and Governor Whitmer is making it more political. When Trump tweets, Liberate Michigan, when he refers to her as that woman from Michigan, obviously, that sets Governor Whitmer up as a foil against President Trump, which politicizes it. When rumors start coming out that Biden wants to consider her as V.P. material, that politicizes it. I really liked when I was there that it simply seemed like a spontaneous expression of working class frustration.
Phil, I want to tick through what your governor said when she began this process of locking down the state and basically enforcing social distancing. And heres what she said: The only tool we have to fight the virus at this moment and to support our health care system is to give them the opportunity by buying some time.
Yeah.
And she went on to say, Without aggressive measures, more people will get sick, more people will die, and our economy will suffer longer. And in her telling, the disease spreads if people are out there. If people arent out there, the disease doesnt spread. So she is making the case in the beginning that these sacrifices are required to prevent a system overload. What do you think of that?
Well, we were willing to go along with that, because we were all expecting this huge crunch on all our hospitals. We were worried about not enough beds, not enough ventilators. But the fact is the curve is flattened now. We now have hospitals, theyre not overwhelmed anymore. So what were saying is that was all well and good, but now, we can start to open up again because we flattened the curve. Even if infections go back up at this point, as I grant they could if we start being more economically active, it seems highly unlikely, given all the empty hospitals, that were going to get to another crush where we dont have enough beds or something like that.
So I want to make sure I understand what youre saying when you talk about where things are in Michigan. The Times has maps about where the virus is in each state. And just pulling this up, Michigan has about 38,000 infections, and theres been about 3,300 deaths.
Yeah, were the third highest state, I think.
So when you talk about your frustrations with the different phases of this lockdown, how do you square it with those numbers?
Well, I square it because my understanding is that the lockdown wasnt supposed to be like, were going to lockdown until this goes away. What we were told was that this lockdown was to distribute those amount of cases over a longer period of time, so that the health system doesnt get overwhelmed. So I look at the total number of deaths and infections and say, OK, this thing is here to stay whether we like it or not. The hospitals do have the ability to take people in. So it seems like to me that the goal has been met. The goal is not to
It sounds like youre saying that if we assume that the measures taken so far have flattened the curve to some degree in Michigan, that youre willing to accept the risks of restarting the economy, even if that means that the curve might go up a little bit. That you think that so far the measures taken have done enough to merit that kind of experimentation with, essentially, taking the risk of reopening.
I think so. And again, Im not saying just a full, like the economy isnt a switch, you just turn it on, everybody comes back out, you know? But I think people who want to work and can work in a way that is maintaining safe protocols, I think they should be able to. Because the thing is, what I would like people to understand is that its not like either we stay home and stay safe, or we all get the coronavirus and die. Its like staying home and nobody working has its own inherent risks and dangers and devastation thats going to come. When I talk about the economy, Im not saying Im worried about the stock market or the financial sector. Im talking about the ability of the average person to provide sustenance for himself and ones family. So we could have negative outcomes because of the shutdown, not because of Covid negative outcomes that dwarf Covid.
Mm-hm. So were now talking on Monday, April 27. And that protest was about two weeks ago.
Yeah.
And Im curious if you think that protest, which was one of the very first protests, had any kind of impact?
Yeah, I think it did. I mean, this is just me kind of blue skying this, but I think it let her see that she only had a limited amount of political capital that she could keep carrying this out indefinitely. She started to say, well let lawn service in again, well let various things start.
She rolled back some of the more, in your mind, problematic restrictions.
Yeah. She rolled back some of the more problematic restrictions and she started talking about an end game, you know? So in that respect, I think it was helpful. I think it got the message across.
We plan to talk to Governor Whitmer and I wonder what you most want to communicate to her about what you think she may not understand, what she might not be getting in this moment?
Well, first, I would say to her, Americans are responsible people. Were creative people. Tell us what social distancing guidelines you think we should be maintaining when were out there, and let us find a way to do it. If you think we need to be six or seven feet apart, if you think we shouldnt have more than six people in a room, give us a safe paradigm of personal behavior and let us work within it. Dont lock us down and say that we cant provide for ourselves. Thats the most basic human right is to provide for your own well-being. Just let us find some way to work.
Well, Phil, thank you very much. We really appreciate your time.
Yeah, thank you. I was very happy to be with you today.
Well be right back.
Hi, there.
Hi.
Governor Whitmer, its Michael Barbaro. How are you?
Im doing all right. How are you doing?
Im doing great. Where are you right now? That looks like it might be home.
Yes. Yes, Im at the governors residence in one of the rooms.
Is that a sign of you that says, The Gov?
Its a beer that was named after me. So yes, thats the poster.
And the beer is called The Gov?
Yep.
Is that any good?
It is pretty good. Its an Indian pale ale.
[LAUGHS] So governor, over the past few weeks, it feels like a lot of people have learned your name. But I sense a lot of Americans, a lot of our listeners dont know all that much about you, and how it is you became the governor of Michigan. So in brief, what is that story?
You know, Im a lifelong Michigander. Ive lived here my whole life. I was brought up in a household with a father who was kind of a Republican, a mother who was kind of a Democrat. I decided to run for governor after spending some time practicing law and teaching, and I did a stint as a prosecutor in my hometown. But I think that part of my nature is when I see a problem, and I dont see the right people there to fix it, I just kind of want to jump in and do it. The tagline of the campaign was fix the damn roads. And it wasnt because it was poll-tested. Its how everyone in the state talks about their frustration with infrastructure that hasnt been attended to properly for a long period of time. And it is the most visceral daily reminder of government thats not getting the fundamentals right.
The coronavirus moved so rapidly across the globe partly because no one had prior immunity to it. Failure to check its spread will result in a catastrophic loss of lives. Yet some politicians, epidemiologists and commentators are advising that the most practical course of action is to manage infections while allowing so-called herd immunity to build.
The concept of herd immunity is typically described in the context of a vaccine. When enough people are vaccinated, a pathogen cannot spread easily through the population. If you are infected with measles but everyone you interact with has been vaccinated, transmission will be stopped in its tracks.
Vaccination levels must stay above a threshold that depends upon the transmissibility of the pathogen. We dont yet know exactly how transmissible the coronavirus is, but say each person infects an average of three others. That would mean nearly two-thirds of the population would need to be immune to confer herd immunity.
In the absence of a vaccine, developing immunity to a disease like Covid-19 requires actually being infected with the coronavirus. For this to work, prior infection has to confer immunity against future infection. While hopeful, scientists are not yet certain that this is the case, nor do they know how long this immunity might last. The virus was discovered only a few months ago.
But even assuming that immunity is long-lasting, a very large number of people must be infected to reach the herd immunity threshold required. Given that current estimates suggest roughly 0.5 percent to 1 percent of all infections are fatal, that means a lot of deaths.
Perhaps most important to understand, the virus doesnt magically disappear when the herd immunity threshold is reached. Thats not when things stop its only when they start to slow down.
Once enough immunity has been built in the population, each person will infect fewer than one other person, so a new epidemic cannot start afresh. But an epidemic that is already underway will continue to spread. If 100,000 people are infectious at the peak and they each infect 0.9 people, thats still 90,000 new infections, and more after that. A runaway train doesnt stop the instant the track begins to slope uphill, and a rapidly spreading virus doesnt stop right when herd immunity is attained.
If the pandemic went uncontrolled in the United States, it could continue for months after herd immunity was reached, infecting many more millions in the process.
By the time the epidemic ended, a very large proportion of the population would have been infected far above our expected herd immunity threshold of around two-thirds. These additional infections are what epidemiologists refer to as overshoot.
Some countries are attempting strategies intended to safely build up population immunity to the coronavirus without a vaccine. Sweden, for instance, is asking older people and those with underlying health issues to self-quarantine but is keeping many schools, restaurants and bars open. Many commentators have suggested that this would also be a good policy for poorer countries like India. But given the fatality rate, there is no way to do this without huge numbers of casualties and indeed, Sweden has already seen far more deaths than its neighbors.
As we see it, now is far too early to throw up our hands and proceed as if a vast majority of the worlds population will inevitably become infected before a vaccine becomes available.
Moreover, we should not be overconfident about our ability to conduct a controlled burn with a pandemic that exploded across the globe in a matter of weeks despite extraordinary efforts to contain it.
Since the early days of the pandemic, we have been using social distancing to flatten its curve. This decreases strain on the health care system. It buys the scientific community time to develop treatments and vaccines, as well as build up capacity for testing and tracing. While this is an extraordinarily difficult virus to manage, countries such as New Zealand and Taiwan have had early success, challenging the narrative that control is impossible. We must learn from their successes.
There would be nothing quick or painless about reaching herd immunity without a vaccine.
Carl T. Bergstrom is a professor of biology at the University of Washington. Natalie Dean is an assistant professor of biostatistics at the University of Florida.
When will it hit and what will it look like? Those are just a few unanswered questions about a possible second wave of COVID-19. USA TODAY
If COVID-19 follows a pattern set by the 1918 Spanish flu, the pandemic is likely to last up to two years and return with a vengeance this fall and winter a second wave worse than the first, according to a study issued fromthe University of Minnesota.
"States, territories and tribal health authorities should plan for the worst-case scenario," warns the report out of the university'sCenter for Infectious Disease Research and Policy, "including no vaccine availability or herd immunity."
"Risk communication messaging from government officials should incorporate the concept that this pandemic will not be over soon and that people need to be prepared for possible periodic resurgences of disease," the authors suggest.
The study team, headed by Dr. Kristine A. Moore, medical director at the University of Minnesota center, includedpandemic experts from Harvard and Tulane universities.
Antibody tests were supposed to help guide reopening plans. They've brought more confusion than clarity amid coronavirus.
In a preface to the report, researchers said they are striving to produce critical and timely information "with straight talk and clarity."
The worst-casescenario with a major resurgence by year's end is one of three laid out in the paper.
A second possibility suggests the outbreak this yearcould be followed by a series of smaller waves into 2021.
And a third scenario, not seen in previous pandemics, would feature a "slow burn" of viral transmission with no clear pattern.
"The virus caught the global community off guard, and its future course is still highly unpredictable," says the report. "There is no crystal ball to tell us what the future holds and what the 'end game' for controlling this pandemic will be."
However, it stresses,a COVID-19 vaccine is not likely to be available until 2021. And, because up to aquarter of those infected may have no symptoms and others spread the disease for days before feeling ill historic influenza pandemics provide the best model.
Second wave: When will it hit, and what will it look like?
Because humans don't have natural immunity and the virus is so easily transmitted, up to 70%of the population may have to develop immunity before COVID-19'sspread diminishes naturally. That means the pandemic length "will likely be 18 to 24 months," and the virus will remain endemic afterward.
The worst-case scenario a more lethal resurgence this fall and winter is based on the Spanish flu outbreak a century ago, when a small wave hit in early 1918, followed by a huge spike that falland a third major wavein early 1919.
Studies suggestsocial distancing measures had workedagainst the 1918 epidemic until they were hastily lifted by some cities, like Denver, in early celebrations. Instead of continuing to flatten the curve, these cities experienced a second spike in cases.
A lot of the confusion, in general, is premised on the misunderstanding that if you control the epidemic once, then youre done, Harvard epidemiologist Marc Lipsitch told the USA TODAY Editorial Board last month. Theres no reason to think that.
The researchers urged government agencies and officialsto gird for resurgencesand develop triggers for re-instituting mitigation measures so health care systems won't once again be overwhelmed.
Contributing: Adrianna Rodriguez, USA TODAY.
Fact Check: Herd immunity would not fully stop the spread of coronavirus
Antibody tests: Theycould be key to reopening the country. Here's how they work.
Read or Share this story: https://www.usatoday.com/story/news/health/2020/05/01/coronavirus-wont-end-2-years-worse-second-wave-study-warns/3064708001/
A facility in Camden, N.J. conducts COVID-19 testing in view of the Benjamin Franklin Bridge. States across the country are working to ramp up their testing capacity. Matt Rourke/AP hide caption
A facility in Camden, N.J. conducts COVID-19 testing in view of the Benjamin Franklin Bridge. States across the country are working to ramp up their testing capacity.
Updated May 11 at 9:44 p.m. ET
Part of a series on coronavirus-related restrictions across the United States.
Jump to a State: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, other states
The first version of this page was originally published on March 12. This is a developing story. We will continue to update as new information becomes available.
NPR's Brakkton Booker, Merrit Kennedy, Vanessa Romo, Colin Dwyer, Laurel Wamsley, Aubri Juhasz and Bobby Allyn contributed to this report.
This is part of a series about coronavirus-related restrictions across the United States.
Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont
Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin
South: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virginia, West Virginia
West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming
Before the coronavirus outbreak, Dr. Lindy Fox, a dermatologist in San Francisco, used to see four or five patients a year with chilblains painful red or purple lesions that typically emerge on fingers or toes in the winter.
Over the past few weeks, she has seen dozens.
All of a sudden, we are inundated with toes, said Dr. Fox, who practices at the University of California, San Francisco. Ive got clinics filled with people coming in with new toe lesions. And its not people who had chilblains before theyve never had anything like this.
Its also not the time of year for chilblains, which are caused by inflammation in small blood vessels in reaction to cold or damp conditions. Usually, we see it in the dead of winter, Dr. Fox said.
Dr. Fox is not the only one deluged with cases. In Boston, Dr. Esther Freeman, director of global health dermatology at the Massachusetts General Hospital, said her telemedicine clinic is also completely full of toes. I had to add extra clinical sessions, just to take care of toe consults. People are very concerned.
The lesions are emerging as yet another telltale symptom of infection with the new coronavirus. The most prominent signs are a dry cough and shortness of breath, but the virus has been linked to a string of unusual and diverse effects, like mental confusion and a diminished sense of smell.
Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing. (Covid-19 is the name of the illness caused by the coronavirus.)
Several medical papers from Spain, Belgium and Italy described a surge in complaints about painful lesions on patients toes, Achilles' heels and soles of the feet; whether the patients were infected was not always clear, because they were otherwise healthy and testing was limited.
Most cases have been reported in children, teens and young adults, and some experts say they may reflect a healthy immune response to the virus.
The most important message to the public is not to panic most of the patients we are seeing with these lesions are doing extremely well, Dr. Freeman said.
Theyre having what we call a benign clinical course. Theyre staying home, theyre getting better, the toe lesions are going away.
Scientists are just beginning to study the phenomenon, but so far chilblain-like lesions appear to signal, curiously enough, a mild or even asymptomatic infection. They may also develop several weeks after the acute phase of an infection is over.
Patients who develop swollen toes and red and purple lesions should consult their primary care doctor or a dermatologist to rule out other possible causes. But, experts said, they should not run to the emergency room, where they risk being exposed to the coronavirus or exposing others if they are infected.
The good news is that the chilblain-like lesions usually mean youre going to be fine, Dr. Fox said. Usually its a good sign your body has seen Covid and is making a good immune reaction to it.
Patients who get the painful lesions are often alarmed. They appear most frequently on the toes, often affecting several toes on one or both feet, and the sores can be extremely painful, causing a burning or itching sensation.
At first, the toes look swollen and take on a reddish tint; sometimes a part of the toe is swollen, and individual lesions or bumps can be seen. Over time, the lesions become purple in color.
Hannah Spitzer, 20, a sophomore at Lafayette College who is finishing the academic year remotely at her home in Westchester County, has lesions on all 10 of her toes, so uncomfortable painful during the day, and itchy at night that she cant put anything on her feet, not even socks.
Walking is difficult, and she has trouble sleeping. At first I thought it was my shoes, but it got worse and worse, Ms. Spitzer said. Most of my toes are red, swollen, almost shiny. It looks like frostbite.
She has used hydrocortisone and Benadryl to alleviate the discomfort, and said ice is also helpful. Doctors say the lesions disappear on their own within a few weeks.
Adding to the mystery is that some teens and young adults with the lesions have tested negative for the coronavirus.
Dr. Amy Paller, chair of the department of dermatology at Northwestern University Feinberg School of Medicine, said one possible explanation is that these patients had such a mild disease and that viral replication was limited, making the virus undetectable.
Another possibility, she said, is that the lesions are what is called an epiphenomenon a symptom may accompany a disease without being causally related. For instance, perhaps more people are developing the lesions because they are staying inside and walking around barefoot more than usual.
But she also dismissed that idea as highly unlikely. I dont think thats it I think its a mild inflammatory process manifesting in this way, Dr. Paller said. Its a real phenomenon. We dont really understand it at all.
Ms. Spitzer had a test shortly after developing the lesions, and the result was negative, but she is convinced the toe lesions are a delayed response to an earlier infection that was so mild she barely noticed it.
Most of the patients were teens or young adults, including one 15-year-old who found out he had Covid-19 pneumonia when he went to the emergency room seeking medical attention for his toes.
Another patient was a 91-year-old man who had been hospitalized with the coronavirus three weeks earlier, and had recovered and returned home.
While dermatologists say its not unusual for rashes to appear along with viral infections like measles or chickenpox the toe lesions surprised them.
Other problems like hives have also been linked to the coronavirus, but Covid toes have been the most common and striking skin manifestation.
Patients with viral infections often get a pink bumpy rash called morbilliform, or hives, Dr. Fox said, but added that the toe lesions were unexpected.
No one knows exactly why the new coronavirus might cause chilblain-like lesions. One hypothesis is that they are caused by inflammation, a prominent feature of Covid-19. Inflammation also causes one of the most serious syndromes associated with the coronavirus, acute respiratory distress syndrome.
Other hypotheses are that the lesions are caused by inflammation in the walls of blood vessels, or by small micro clots in the blood. (Clotting has been another feature of the disease.)
The lesions seen in otherwise healthy people appear to be distinct from those that doctors are seeing in some critically ill Covid-19 patients in intensive care, who are prone to developing blood clots.
Some of these clots may be very small and can block the tiny vessels in the extremities, causing rashes on the toes, said Dr. Humberto Choi, a pulmonologist and critical care physician at the Cleveland Clinic.
Some experts now believe Covid toe should be recognized as sufficient grounds for testing, even in the absence of other symptoms.
This should be a criteria for testing, just like loss of smell, and shortness of breath and chest pain, Dr. Fox said.
