Fewer than half of Americans plan to go to sports events, concerts, movies and amusement parks when they reopen to the public until there is a proven coronavirus vaccine, according to a Reuters/Ipsos opinion poll released on Tuesday.
That includes those who have attended such events in the past, an ominous sign for the sports and entertainment industries hoping to return to the spotlight after being shut down by the pandemic.
Only about four in 10 who follow sports avidly and go to arts and entertainment venues and amusement parks said they would do so again if they reopened before a vaccine was available, the poll found.
Another four in 10 said they were willing to wait, even if it takes more than a year to develop a vaccine.
The rest said they either dont know what to do or may never attend those events again.
Just because people say we can go back, until people feel fully safe they arent going to go back, said Victor Matheson, a specialist in sports economics at the College of the Holy Cross in Massachusetts.
We go to games for entertainment and youre not going to be very entertained if youre not worrying about who the next player to bat is and instead worrying about that person who just coughed two rows down.
The United States leads the world with almost 1 million coronavirus infections and more than 56,000 deaths as of late Monday.
While as many as 100 potential vaccines are in development around the world, scientists are projecting that bringing one to market could take 18 months.
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SUMMARY: Yes, we'll waste billions and risk lives in a fast search for a coronavirus vaccine but it's worth it. More corroboration for the Biden sexual-assault allegation. College presidents are right: Colleges need to open in the fall. Open the parks and beaches! Stop judging people who go outside! Biden to announce a "committee" to evaluate VP candidates? Come on!
A lab technician working on samples from people to be tested for the new coronavirus at "Fire Eye" laboratory in Wuhan in China's central Hubei Province. Getty
Insider's Bill Bostock reports that the world's largest vaccine maker is going to manufacture 40 million doses of a COVID-19 vaccine candidate this summer, even though the vaccine hasn't been tested yet, might not be safe, or might not work. That's great news.
This is just one of what promise to be many apparently wasteful and risky attempts to create a vaccine most of which will fail. Other pharma and biotech firms like Johnson & Johnson and Moderna are similarly ramping up vaccine manufacturing, before they know if the shots will work.
Bill Gates has proposed spending billions of dollars to build multiple vaccine-manufacturing plants to scale up production of seven different untested vaccines, though only one is likely to be effective. The Coalition for Epidemic Preparedness Innovations (CEPI) is going to spend $2 billion to accelerate production of several vaccine candidates, most of which will likely go to waste.
Others propose to risk human lives to speed up vaccine testing. Some leading scientists want to launch "human challenge" trials for coronavirus vaccines. In these trials, volunteers would be given experimental vaccines or a placebo and then deliberately exposed to the coronavirus.
This would massively accelerate knowledge about whether the vaccine works, because we wouldn't have to wait months to see if the test subjects contract the disease in the normal course of life. But some of the volunteer subjects would also fall ill especially if it's a placebo trial and given how terrible COVID-19 is, some would likely die. This is also especially worrying in the current context because we have no effective treatment to help those who do get sick.
Wasting money and potentially harming people obviously aren't good. But, right now, the risks are worth it. That's because our enemy is time.
The normal processes of pharmaceutical research manufacturing only when you know a drug works, and only testing in the safest ways make sense in normal situations. But every day we don't have a vaccine, thousands die, billions of dollars in economic activity are lost, and human welfare declines. Our future selves become poorer and sicker.
So there is literally almost nothing we shouldn't try to get us a vaccine quicker, even if that means building factories that make vaccines that don't work and conducting potentially deadly trials on volunteers. DP
We now have more corroboration of the sexual-assault allegation against then-Sen. Biden in 1993.
Rich McHugh writes in Insider that a neighbor of Tara Reade, the former Biden staffer who recently filed a criminal complaint accusing him of assaulting her in a hallway, has come forward to corroborate her story.
The neighbor, Lynda LaCasse, says Reade told her about the alleged incident in 1995 or 1996, a few years after Reade says it occurred. LaCasse said Reade shared with her many of the same details that Reade has recently alleged.
LaCasse says Reade did not ask her to come forward now. She adds that she is a Democrat and plans to vote for Biden. She says she came forward because she believes it was the right thing to do.
A second corroborator, Lorraine Sanchez, was a colleague of Reade's in a California state senator's office after she left Washington DC. Sanchez says Reade told her that her former boss in Washington had harassed her. Sanchez did not recall whether Reade went into detail.
Biden's campaign has said Reade's allegation is false. Biden himself has not commented on it. He's going to have to.
Read Rich McHugh's latest report here.
The Purdue marching band. Chris T Pehlivan / Shutterstock.com
Crowded parties, football stadiums, dorms, lecture halls colleges are paradise for a zealous coronavirus, which is why they all shut down, and fast, in March. But most universities and colleges can't afford to stay closed for long. They carry huge faculty and staff costs, and own expensive physical plants.
Colleges also depend on tuition to pay their bills. And most can't simply transition to remote learning, because students won't stand for it. They're paying for the college experience, for working together in labs and studios, living together in dorms.
So it's expected and encouraging that we're now seeing a rush of college presidents pushing bold ideas about how to reopen in the fall, even without a coronavirus vaccine or treatment.
In an inspiring letter, president Mitch Daniels said Purdue University is "determined not to surrender helplessly to those [COVID-19] difficulties but to tackle and manage them aggressively and creatively." Daniels argues that the virus is not an intolerable risk for the young. He proposes to test everyone in August, reopen campus for those under 35 years old, segregate those older than 35 or at particular risk from the general population, and track and contact trace the infected.
Will it work? Who knows? But it's heartening to see this kind of practical problem-solving from one of the world's greatest engineering schools. We're not going to learn how to live with the virus without some creative, even unorthodox thinking, and it makes sense to use universities which are the front lines of American research, after all as laboratories.
For example, Brown University president Christina Paxson acknowledges that reopening colleges will almost certainly require using technology that infringes on civil liberties to vigorously track students and faculty. That seems like an infringement worth a test, and no better place to try it out than in the limited space of a campus.
What Purdue president Daniels doesn't say is that the decision by some schools to reopen will put pressure on other schools, since no college will want to risk losing its students to rivals that have reopened. But not every college will have the resources to test and track in the way Purdue or Brown can, so there will definitely be campus COVID-19 clusters in the fall. DP
Fort Greene Park on April 23, 2020, in the Clinton Hill neighborhood of Brooklyn, New York. Mike Lawrie/Getty Images
As pressure builds for lockdowns to be relaxed or dropped, it's time to get more sophisticated about which measures actually have a big effect on slowing the coronavirus and which don't.
Concentrating our efforts on measures that really matter, while giving us more freedom by relaxing those that don't, will enable us to keep the crucial tactics in place for longer.
So here's a suggestion:
Relax restrictions that encourage or compel people to stay indoors.
The virus spreads primarily by droplets getting from one infected person's nose and mouth to another person's, in sufficient quantities and duration to cause an infection. Sunlight kills the virus quickly, and wind disperses it. Studies suggest that transmission almost exclusively occurs indoors.
As Insider's Anna Medaris Miller explains, experts are confident that being outside is low risk, especially when you are properly distanced. When you're distanced and wearing a mask, in fact, it would take something amounting to a "freak accident" for you to catch the virus or infect someone else outside, even if you passed close by each other.
A new study from China underscores this. It looked at 318 "outbreaks" that involved three or more cases. Not a single one of these infections occurred outdoors. (Most of them occurred within homes, with one family member infecting others. It has another important implication for more sophisticated distancing measures namely, creating isolation and quarantine facilities outside of homes but we'll leave that for another day.)
In a broader look at 7,324 cases, in fact, the researchers found only one case in which infection appears to have occurred outdoors. It involved two people in a village who had a conversation after one of them returned from a visit to Wuhan.
To be clear: It's not impossible to catch or transmit the virus outside. But it's rare. And with minimal precautions some distancing and a mask it should be extremely rare.
Meanwhile, going outside has all sorts of psychological and physiological benefits, including allowing us to feel more free and less trapped. As Anna Medaris Miller posits, even experts who fully support distancing measures believe that these benefits offset the risks. Respected Harvard epidemiologist Marc Lipsitch who generally supports strict distancing measures believes there is a net benefit to keeping open spaces open.
So open the parks!
And go outside! HB
Everyone's eager to know who VP Biden will choose as his running mate.
Instead of just making the decision and then telling us the answer, however, Biden reportedly plans to first announce the selection of a "committee" who will evaluate the candidates.
Yes, the Trump habit of dismissing experts and making impulsive decisions with minimal consideration based on his own "gut instinct" leads to imprecision and mistakes. And, yes, the country is suffering for this.
But announcing a committee to evaluate potential VP candidates is going too far the other way.
Of course Biden should have a team evaluate prospective candidates. But he doesn't need to announce in advance who these people are. He also doesn't need to remind Americans that Democrats have a reputation for being overly bureaucratic in their decision-making. HB
Support is growing around the world for initiatives that involve deliberate infection of healthy young people with the coronavirus to test the effectiveness of experimental vaccines. An organization called 1 Day Sooner has already enlisted more than 3,400 people from 52 countries, who have volunteered to be vaccinated in this controversial approach, also known as human challenge trials (HCT). The initiative is not linked to any companies or research groups that are currently working to develop a vaccine, but it exemplifies the mounting interest in smart ways to find an effective vaccine sooner than predicted.
One reason for the lengthy time frame needed to develop a new vaccine is the standard structure what is typically the last stage of testing: efficacy testing, or phase III trials. Usually, a vaccine is initially developed in a lab.
Then its efficacy is tested in vitro and in animals. After these trials show that the vaccine prevents infection of animals that were exposed to the virus, researchers move to the first clinical stage testing the safety of the vaccine for use in humans. At this stage, it is given to a small group of healthy subjects, and researchers check to see whether there are any negative side effects.
Aftersafety testingis complete, complete, and there are some demonstrated effects on recipients immune systems, comes efficacy testing. Development teams give the vaccine to a large group of volunteers, and a placebo vaccine to control groups. Both are monitored over time to see if there is any difference in the rate of infection or high viral load in those who received the vaccine and the control group.
The advantage of HCT is that by deliberately exposing subjects to the virus, which is not done in standard trials, a clear answer concerning the vaccines efficacy can be obtained more quickly.
In an article published in late March in The Journal of Infectious Diseases, Nir Eyal of Rutgers University, Mark Lipsitch of Harvard University and Peter G. Smith of the School of Hygiene & Tropical Medicine in London, laid out the advantages of HCT. Vaccines are our ticket out of the crisis, says Prof. Eyal. If we have a vaccine a few months sooner, well be able to save millions of people from dying from the coronavirus, other diseases and of famine on a biblical scale (as per the UN).
This isnt the first time that the idea of human challenge testing has been considered by the international scientific community. Edward Jenner, the physician who developed the worlds first vaccine, against smallpox, exposed his gardeners son, eight-year-old James Phipps, to cowpox after he discovered that milkmaids who developed this disease displayed immunity to smallpox. A few weeks later, he exposed the child to smallpox, and saw that the boy did not develop the disease. Based on this experiment, Jenner produced the worlds first vaccine in 1796.
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But even today, when scientists and physicians must follow strict rules of ethics and cannot expose poor children to serious diseases, human challenge testing is being done though mostly for relatively mild illnesses.
In recent years, researchers have been testing the efficacy of a number of flu vaccines versus various strains of the flu virus. In previous decades, the development of vaccines for cholera and malaria also relied in part on human challenge testing. More recently, various groups around the world have conducted human testing trials for vaccines against weakened versions of the viruses that cause dengue fever and typhoid.
Increased risk
Regulatory standards for HCT vary widely among different countries. In Britain, the authorities are more inclined to permit such testing than those in the U.S. In 2016, a research group at Oxford University used HCT in a trial where subjects who had received an experimental vaccine were exposed to the abdominal typhus bacterium and then sent home (despite a concern that they could infect others).
Regulations for this type of testing are stricter in the United States. A few years ago, the U.S. considered HCT for a vaccine against the Zika virus, but ultimately decided to avoid the risk.
In the current pandemic, there is pressure to change the U.S. approach. Thirty-five members of Congress recently signed a statement calling on the Food and Drug Adminsitration, as well as the Department of Health and Human Services, to approve HCT for vaccine trials for the novel coronavirus citing the article by Eyal and his colleagues. In the past, regulatory authorities saw human challenge trials as an initial filter before moving on to wide-scale testing. But given the intensity of the current medical, economic and social crisis, We think the regulator should deviate from its habits. Eyal told Haaretz.
Opponents of the approach say there are still too many unknowns about how the novel coronavirus works. Human challenge trials require the controlled breeding of the virus and determination of the optimal dosage for exposure. Another problem is that certain vaccines may actually exacerbate the illness rather than prevent the infection. This increases the risk and thus the ethical concerns of deliberately exposing healthy subjects to the virus.
Eyal says HCT also has significant advantages for the subjects. First, the number of participants in a trial is low (between 100 and 200), so it is possible to ensure access to intensive care for them if necessary, which could be vital if the subjects are recruited, as he recommends, from areas where there is a high rate of infection and ICUs are not accepting new patients. Second, the risk of complications due to the vaccine is reduced with HCT, since the subjects are kept in isolation under constant medical supervision, unlike the thousands of participants in ordinary vaccine trials. And third, with HCT, the subjects know there is no risk that they will infect their family members.
People may conclude that they have a high risk of getting infected and so they would rather do it in a supervised way under safe conditions, Eyal says. The Rutgers University researcher adds that, because of the need to first breed the virus in a controlled fashion and to determine the correct dosage, preliminary studies for HCT should already begin and suitable research facilities should be prepared, so if the go-ahead for these trials is given, no time will be wasted.
Some say, however, that the controversial approach is not needed in the current crisis. Myron Levine, an infectious disease specialist from the University of Maryland who has been conducting human challenge trials for other vaccines for over 40 years, told the news website of Science magazine that he believes standard vaccine testing will be much faster than many people think. Because of the high rates of infection occurring in many places, standard trials will be able to draw conclusions about the vaccines efficacy within a similar time frame to that of HCT, he says.
For example, the Chinese company Sinovac Biotech, which began clinical trials of a COVID-19 vaccine last week, announced that it hopes to complete the first two phases of testing by the end of June. If the trials are successful, the company hopes to apply for regulatory approval to conduct the third phase of testing on at-risk populations such as medical personnel, which is an alternative way to accelerate the efficacy testing of the vaccine without seeking volunteers to be deliberately infected.
On the other hand, says Eyal, regular vaccine studies can take a long time, and sometimes they are never completed as with a study of an experimental vaccine for Ebola that was suspended because the epidemic abated in the place where the trial was being conducted. In China the disease is on the decline, and its unclear if there will be enough doctors who are candidates to get the vaccine. In HCT, results are promised within a limited time frame.
The world is racing to find ways to treat and prevent the novel coronavirus.
Both preventing and treating the disease, experts say, are critical to lessening social distancing measure that have been put in place to minimize the spread of the coronavirus.
While we might never get back to the "normal life" we knew before the pandemic, getting out from under lockdown-like conditions will hinge greatly on whether a vaccine can be developed, and if we can get treatments that are effective in treating COVID-19, the disease caused by the novel coronavirus.
Vaccines are used to prepare the body's immune system to fight off infections. They work by giving the body a small taste of what the virus is like so that way it can produce antibodies that fight off an intruding virus, ideally keeping people from falling ill. Some vaccines protect better than others, and they're typically administered across broad populations.
There are vaccines for some infectious diseases, like the flu, smallpox, measles, and chickenpox. But others, like HIV and hepatitis C, don't have vaccines that protect against them. Vaccines that protect against two other deadly outbreaks, MERS and SARS, have yet to be approved after the outbreaks subsided.
There are more than 70 potential coronavirus vaccines in the works, with a number in early human trials. Drugmakers are looking into ways to produce the billions of doses that might be needed to suppress the pandemic.
Read more: There are more than 70 potential coronavirus vaccines in the works. Here are the top efforts to watch, including the 16 vaccines set to be tested in people this year.
FILE - In this March 2020 photo provided by Gilead Sciences, a vial of the investigational drug remdesivir is visually inspected at a Gilead manufacturing site in the United States. Given through an IV, the medication is designed to interfere with an enzyme that reproduces viral genetic material. (Gilead Sciences via AP) Associated Press
Treatments,on the other hand, are meant to do just that: treat COVID-19, helping patients sickened by the virus survive and recover more quickly. Treatments for disease are there to lessen symptoms and ultimately improve the outcomes of a particular disease.
Sometimes, medications can be used preventatively. For instance, patients with high cholesterol might be prescribed a medication called a statin to prevent heart attacks. Some potential coronavirus treatments are being studied to see if they can prevent people from contracting the virus in the first place.
For COVID-19, researchers are testing everything from antimalarial medications to antivirals, to even common heartburn medications in hospitalized patients with the hopes that more patients will survive severe forms of the illness and potentially recover faster. Some are looking at ways to use patients' own bodies to fight the virus with antibody treatments.
Read more: We just got more promising data on Gilead's potential coronavirus drug. Here's everything we know about remdesivir and 14 other leading coronavirus treatments.
On Wednesday, Gilead Sciences, a biotech company that makes remdesivir, one of the experimental treatments being tested in coronavirus patients, said it had succeeded in a crucial study, raising hopes for the drug's use in treating patients.
Treatments, especially for hospitalized patients, are critical to develop to provide more tools for doctors to treat the disease. Ultimately, as social distancing measures lessen, it'll keep hospitals from being overrun with patients who tend to be hospitalized for weeks.
Read more: Here's how 13 top drugmakers are sprinting to develop a coronavirus vaccine or treatment that can halt this pandemic
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Moderna, among the first organizations to start clinical trials on people for a coronavirus vaccine, will be seeking to move to stage 2.
The mRNA-1273 vaccine candidate will be given to a larger cohort of patients in the second quarter of 2020 if authorities approve the next phase of this trial.
Moderna previously said that the vaccine may be prepared for emergency use as soon as this fall.
Well over 70 coronavirus vaccine candidates are in development around the world in partnership with the World Health Organization (WHO), and many of these have attained the first phase of human testing. Vaccines are supposed to be both effective against COVID-19 infections and safe for all those inoculated. Thats why a vaccine cant be hurried to advertise, and why conservative estimates sit at 12 to 18 months. Some of these candidates might be deployed sooner than that, as soon as this autumn, assuming regulators allow emergency use for these drugs.
One of them will be Modernas mRNA vaccine which completed phase 1 of individual trials. The business announced its ready to proceed with the next step, with stage 2 set to include 600 patients. Moderna is among the first vaccine makers to start trials on humans. A few weeks after, the business made positive opinions about the test drug, claiming that mRNA-1273 may be ready for emergency use as soon as this fall.While a commercially available vaccine isnt likely to be accessible for 12 to 18 months, its possible that under emergency usage, a vaccine could be available to some individuals, possibly including health care professionals, even in the autumn of 2020, Modernas CEO Stephan Bancel advised Goldman Sachs.
Moderna on Monday announced it has submitted a new drug application to the US Food and Drug Administration (FDA) to evaluate the vaccine in a broader study if supported by the results from the first study. The Phase 2 study will begin in the second quarter and will comprise 600 healthy adults and elderly adults. Theyll be broken into two cohorts and delegated either a placebo or the vaccine candidate. The participants could receive two mRNA-1273 vaccinations 28 days apart, and they will be observed for 12 months following the second shot. A third stage could start in the autumn of 2020, assuming the first two are successful. Its unclear when the conclusions of the first stage of the trial are going to be revealed. The research is not prepared, but more people have been added to the phase 1 analysis, including cohorts of older adults (ages 56-70) and older adults (ages 71 and over ). Recent reports have revealed that two competing goods, one made in China and one in the united kingdom, have shown positive effects on rhesus macaque monkeys, offering protection against the virus following post-inoculation vulnerability to COVID-19. These drugs are in stage 1 testing.
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As experts across the world race to find a vaccine for the coronavirus, a team at Oxford University say their version is showing early promise. They hope to have it ready by September. As the NBC News series The Search for Solutions continues, Kelly Cobiella reports for TODAY from London.April 29, 2020
As states across the country weigh options for reopening after weeks of stay-at-home orders, antibody tests have emerged as a potential pathway on how and when to do it.
But there are many caveats, as a recent study found that many of the antibody tests available currently provided inaccurate results.
Antibody tests look for signs in the blood that a person has been exposed to the novel coronavirus. Knowing who has been exposed, along with how many people have been, may help to better understand the spread of the virus. This is especially important as studies continue to show that significant percentages of all coronavirus carriers in some studies, up to half show no symptoms at all.
But should you get one? Can you get one? What do they actually tell us? Heres everything you need to know.
When your body is exposed to a foreign pathogen, like a virus that causes illness, your bodys response is to produce antibodies that live in the blood and tissue. These are proteins that bind to and destroy the virus, preventing it from making copies of itself and further spreading the infection.
The antibody test, also called a serology test, looks at whether your body has developed those antibodies; the presence of them most likely means you were exposed to Covid-19, the illness caused by the virus. Some tests, like the one used by the Mount Sinai Health System in New York, can measure the level of antibodies in your system your titer.
But in general, most of the tests being made available across the country detect only whether the antibodies are present, said Dr. Jeffrey Jhang, medical director of clinical laboratories and transfusion services for the Mount Sinai Health System. A direct-to-consumer test announced on Tuesday from Quest Diagnostics more on that below measures only presence or absence.
Antibodies can take generally anywhere from about a week to 14 days to develop, Dr. Jhang said, and the levels of antibodies vary based on time since exposure and a persons immune system. This means that a lack of antibodies does not necessarily mean you were not exposed to the virus.
The test is similar to other blood tests you may have had before: A sample of blood is taken from the patient and is then analyzed to determine the presence of antibodies. Most tests will generally return results within a few days, but that may vary, as some tests can return results in a few hours.
Not necessarily.
The antibody test does not test for immunity to Covid-19. There is no test yet that can tell if you are immune. It is simply too early to know if the presence of antibodies confers immunity, as this is a new virus, meaning weve never seen it before.
But experts generally agree that, based on experiences with other viruses, including SARS, the presence of antibodies most likely does confer some level of protection, though we dont know to what extent or for how long.
The difficult thing is we do not have clinical evidence yet of whether the presence of antibodies actually prevents the individual from getting the disease again, Dr. Jhang said, adding, I think most people believe that the presence of antibodies in most cases would confer some protection given our experience with other viruses.
But we really have to wait to see some evidence of that before we can be confident in being able to say that these antibodies can be protective, he said.
An antibody test is not the same thing as a diagnostic test for Covid-19, and it will not diagnose whether you currently have it.
Remember that antibodies take time to develop, so a lack of antibodies may just mean your body hasnt had enough time to develop them postinfection.
As we just learned, knowing your antibody level will help you determine whether youve been exposed to the coronavirus. This does not mean youre immune, and you should still practice all of the safety precautions you have been. But it does mean you may be eligible to donate convalescent plasma, which can potentially help patients still suffering from Covid-19 by allowing them to borrow your antibodies to accelerate their recovery time.
Widespread antibody testing may also give us a clearer picture of the scope of the disease. Results from a random testing of 3,000 people in New York City recently suggested that as many as one in five residents or about 2.7 million people might have encountered the disease without realizing it. When describing the results, Gov. Andrew M. Cuomo said that because the rate of infection might be far higher than initially thought, the death rate of the virus mighty be far lower than we thought.
Once the medical community determines whether antibodies confer immunity which experts say will take at least six months or so to determine well have a better sense of who may be less at risk emerging from lockdown.
Once we understand that the antibodies are protective, then the testing means something," Dr. Jhang said, as it may help figure out who can go back to work and be protected and not spread the disease, or when kids can go back to school, teachers going in to teach.
A study of 14 available antibody tests published last week found that only three delivered consistently reliable results. The study, which has yet to be peer-reviewed, found that only one test never returned a false positive, which is when the test incorrectly confirms the presence of coronavirus antibodies in people who didnt have them. The other two tests with consistently reliable results returned false positives about 1 percent of the time.
Further, these three tests confirmed the presence of antibodies in infected people only 90 percent of the time.
Part of the reason for the inaccuracies, Dr. Jhang said, may be whats called cross-reactivity: This is when a test misidentifies antibodies for a different, but similar, coronavirus.
Florian Krammer of the Icahn School of Medicine at Mount Sinai in New York told The New York Times that false positives werent necessarily an issue when determining how widespread the disease is, as a given tests false-positive rate can be accounted for in estimates. They do, however, matter greatly on an individual level.
You dont want anybody back to work who has a false positive thats the last thing you want to do, Dr. Krammer said.
And the World Health Organization, citing ideas for an immunity passport or risk-free certificate from some countries, last week advised against relying on the tests for policy decisions.
If you think you currently have Covid-19, or have experienced in the last few days symptoms like coughing, fever, loss of taste or smell, or difficulty breathing, you should not get a test. Again, the antibody test is not the same as a diagnostic test for Covid-19.
The test is generally intended for people who either have had a positive test for Covid-19 and have recovered; or who think they were exposed to Covid-19 and no longer have symptoms.
Quest Diagnostics, which on Tuesday announced it is selling a direct-to-consumer antibody test meaning you dont need to first see a physician to take it offered these guidelines for people interested in an antibody test:
Have had a positive test for Covid-19 and it has been at least seven days and you want to know if you have detectable levels of immunoglobulin G, or IgG, antibodies.
Have not experienced new or worsening symptoms of Covid-19 in the past 10 days: loss of smell or taste, shortness of breath or difficulty breathing, feeling weak or lethargic, lightheadedness or dizziness, vomiting or diarrhea, slurred speech and/or seizures.
While getting a test to diagnose Covid-19 is still somewhat difficult, antibody testing seems to be rolling out a little more smoothly. Many organizations nationwide are beginning to offer the test, perhaps most notably Quest, which is offering the test without a physicians referral at the 2,200 patient service centers it operates around the country, the company said.
LabCorp, a competitor of Quest, announced on Monday that, with a physicians referral, patients could get an antibody test at any of its more than 2,000 patient service centers, as well as its 100 locations in Walgreens.
In New York City, the walk-in clinic CityMD said in an email to patients that, as of Tuesday, it would also offer antibody testing that would indicate with high accuracy if you had the virus in the past whether or not you experienced symptoms.
CityMD advises that people wait two to four weeks after the end of symptoms to get the antibody test. For more information about getting tested through CityMD, click here.
Last, you can just ask your doctor about antibody testing, as doctors can refer patients to many locations running the test nationwide. Most insurance providers should cover the test, but check with yours to be sure.
WASHINGTON The White House has ordered intelligence agencies to comb through communications intercepts, human source reporting, satellite imagery and other data to establish whether China and the World Health Organization initially hid what they knew about the emerging coronavirus pandemic, current and former U.S. officials familiar with the matter told NBC News.
A specific "tasking" seeking information about the outbreak's early days was sent last week to the National Security Agency and the Defense Intelligence Agency, which includes the National Center for Medical Intelligence, an official directly familiar with the matter said. The CIA has received similar instructions, according to current and former officials familiar with the matter.
President Donald Trump appeared to refer to the request at his news conference Monday. "We're doing very serious investigations," Trump said. "We are not happy with that whole situation, because we believe it could have been stopped at the source, it could have been stopped quickly, and it wouldn't have spread all over the world."
Full coverage of the coronavirus outbreak
As part of the tasking, intelligence agencies were asked to determine what the WHO knew about two research labs studying coronaviruses in the Chinese city of Wuhan, where the virus was first observed. NBC News has previously reported that the spy agencies have been investigating the possibility that the virus escaped accidentally from one of the labs, although many experts believe that is unlikely.
The move coincides with a public effort by the White House, Secretary of State Mike Pompeo and Trump's political allies to focus attention on China's inability to contain the virus shortly after it emerged. As NBC News previously reported, U.S. intelligence officials have said China initially failed to disclose the seriousness of the outbreak, robbing the rest of the world of information that might have led to earlier containment efforts.
"As the president has said, the United States is thoroughly investigating this matter," White House spokesman Hogan Gidley said. "Understanding the origins of the virus is important to help the world respond to this pandemic but also to inform rapid-response efforts to future infectious disease outbreaks."
The CIA eclined to comment. An official from the Office of the Director of National Intelligence said, "We are not aware of any such tasking from the White House."
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Trump has shifted from initially praising China's handling of the outbreak to sharply criticizing it as the threat the pandemic poses to the U.S. economy and his re-election prospects has crystallized. Blaming China for America's economic struggles has proven effective for Trump with his political base, and his allies believe it's a message that could resonate in November with voters in the Midwest.
"The president is now running against China as much as anyone," said a person close to the president.
The Trump administration has also accused the WHO of erring in January when it reported no evidence of human-to-human transmission. Trump, alleging that China exercised undue influence over the agency, has suspended U.S. funding of the WHO.
Initially, the WHO used conservative language. In a statement about the disease on Jan. 14 regarding the first case outside China, in Thailand the WHO said, "There is no clear evidence of human-to-human transmission."
The agency soon stopped saying that, and by mid-January it was clear that the virus was spreading well beyond China.
Critics see the White House focus on China and the WHO as an effort to distract attention from the open question of what warnings Trump got in January and February from his own health and intelligence advisers during a time when he was downplaying the severity of the virus.
The Washington Post reported Monday that the intelligence reporting and analysis about the pandemic appeared in the president's daily intelligence brief more than a dozen times, although the newspaper did not specifically describe what information was passed along.
An administration official confirmed to NBC News that the President's Daily Brief, or PDB, included more than a dozen mentions in January and February of U.S. intelligence about the coronavirus in China, as well as Beijing's attempts to cover it up and suppress information about it.
The official played down the significance of the intelligence, saying there was not much more detail in the briefings than what was in the public domain. The official also said the briefings did not include any warning about how widespread and deadly the virus has now become around the globe.
An ODNI official told NBC News that details in the Washington Post story are not true, but declined to say what specifically is disputed, citing the highly classified nature of the PDB.
Asked Tuesday to clarify what intelligence officials were telling him in January and February, the president said, "I would have to check."
"I want to look to the exact dates of warnings," he said.
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NBC News has reported that U.S. intelligence agencies saw early warning signs of a health crisis in Wuhan as far back as November and that the National Center for Medical Intelligence predicted that the coronavirus would cause a global pandemic in February, well before the WHO declared one.
The House and Senate intelligence committees have requested access to all intelligence products produced about the pandemic and are closely examining what has already been turned over to them, officials from both committees have told NBC News.
The committees typically are not granted access to the PDB, the officials said. The congressionally sponsored commission that investigated the terrorist attacks of Sept. 11, 2001, was allowed to review presidential briefs and determined that President George W. Bush was warned in the summer of 2001 that Osama bin Laden was "determined to strike" inside the United States.
Ken Dilanian is a correspondent covering intelligence and national security for the NBC News Investigative Unit.
Courtney Kube is a correspondent covering national security and the military for the NBC News Investigative Unit.
Carol E. Lee is an NBC News correspondent.
Kristen Welker contributed.
Scientists at Oxford University have begun clinical trials of a coronavirus vaccine that has shown promise in rhesus monkeys, according to news reports.
If the vaccine can effectively protect humans against the novel coronavirus, known as SARS-CoV-2,i the first doses could potentially be administered by the autumn, according to a blog post on the official trial's web page.
The vaccine is made up of a weakened version of a common cold virus called an adenovirus that causes infections in chimpanzees. But the virus has been genetically altered to make it "impossible" for the virus to grow in humans, according to a statement. Then, they combined the weakened adenovirus with genes that code for the coronavirus "spike" protein that SARS-CoV-2 uses to infect human cells.
Related: 13 coronavirus myths busted by science
In theory, the vaccine will train the body to recognize and develop an immune response to the spike protein, thereby preventing SARS-CoV-2 virus from entering human cells, according to the statement.
Similar vaccines made from the same backbone, the weakened version of the chimpanzee adenovirus have been given to more than 320 people to date and have been shown to "be safe and well tolerated," aside from temporary side effects such as fever, headache and a sore arm, according to the statement.
The trials began on April 23, and up to 1,102 healthy participants will eventually be recruited in Oxford, Southampton, London and Bristol to take part. Half of the participants will receive the novel vaccine; most of those people will receive one dose of the vaccine, but 10 of those people will receive a second dose a month later. The other half of the participants will receive a "control" vaccine already approved and given routinely to teenagers since 2015 which protects against meningitis and sepsis.
The reason the researchers decided to use this control vaccine and not just a saltwater solution is so that participants won't be able to guess whether they received the actual vaccine. The researchers expect the novel coronavirus vaccine to cause temporary side effects such as sore arm, headache and fever, side effects that are also expected from the control vaccine but that wouldn't be expected from a saltwater solution.
The trial will last up to six months, with an optional visit one year after vaccination. "The best-case scenario is that by the autumn of 2020, we could have an efficacy result from the phase III trial to show that the vaccine protects against the virus, alongside the ability to manufacture large amounts of the vaccine; but these best-case time frames are highly ambitious and subject to change," the researchers wrote in the blog post.
Of course, it's too early to tell whether or not the vaccine will work, but it has shown promise in rhesus monkeys, according to The New York Times. Researchers gave the vaccine to six rhesus macaque monkeys at the National Institutes of Health's Rocky Mountain Laboratory in Montana. Researchers then exposed them to high amounts of the coronavirus, according to the Times. More than 28 days later, all six monkeys were healthy.
Another vaccine, this one made from an inactivated form of the coronavirus, has also shown promise in monkeys in China, according to a previous Live Science report. Researchers in China are now testing that vaccine on humans in clinical trials. More than 70 other vaccines are under development worldwide, according to the World Health Organization.
Originally published on Live Science.
The novel coronavirus has already claimed the lives of more than 58,000 Americans. But experts fear that number could be far higher at this point in the outbreak -- perhaps by tens of thousands -- once the pandemic subsides enough for officials to go back and make a true reckoning of the dead.
Experts are urging leaders to take measures right now to preserve data and medical specimens so that science has the chance to determine the precise number of people who succumbed during one of the most severe global pandemics in memory.
Under-counting deaths in this particular epidemic is happening all over, said Dr. Daniel Lopez-Acuna, an epidemiologist and former top World Health Organization (WHO) official, who spent 30 years at the organization. "Its almost inevitable."
Calculating the precise number of COVID-19 deaths is remarkably complicated for a number of reasons. But leading epidemiologists, pathologists, medical examiners, medical history professors and local, state, federal and global health officials told ABC News that more testing is the single most important factor in determining an accurate national death count.
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We need to have the testing available because the big question now with COVID-19 is the denominator -- of anything, said Dr. Alex Williamson of the College of American Pathologists. How many people get it? How many people recover? How many are hospitalized? How many died? We don't know the true denominator. More testing is the most important thing we need to do.
Funeral Director Joe Neufeld inventories the bodies of coronavirus victims bound for burial, in the main chapel of the Gerard J. Neufeld Funeral Home in Queens, New York, April 26, 2020.
Ongoing testing kit shortages in cities and states nationwide means that only clearly symptomatic patients are currently being tested in many places. There also is no uniform national system in the U.S. for investigating deaths, and until two weeks ago, the U.S. was only counting Americans who lab-tested positive, before or after death, for COVID-19.
Left out of the tally are people who died without being tested and those who died at home or some other non-healthcare facilities before they could seek medical care.
It is an extraordinary challenge, said Dr. Sally Aiken, president of the National Association of Medical Examiners (NAME). There just isn't really the infrastructure.
Further undermining an accurate national count are new analyses that suggest the virus was spreading in the U.S. much earlier than previously believed, likely playing a role in more deaths than currently known.
Californias first known COVID-19 death to date was Patricia Cabello Dowd, 57, in Santa Clara County. Dowd died on Feb. 6 of heart complications, which were later determined to have been unleashed by the COVID-19 virus. Dowd's death in which an autopsy obtained by the San Francisco Chronicle listed a heart rupture due to Covid-19 infection came three weeks before the earliest previously identified American coronavirus-related death.
New data on cardiac arrest emergency calls reviewed by ABC News suggests that New York Citys catastrophic outbreak likely began in close-knit neighborhoods in Queens and Brooklyn as far back as mid-February.
Cardiac Arrest and COVID19 Concentration by NYC Zip Code
Finally, as the cardiac arrest data suggested, scientists are contending with an ever-evolving understanding of how COVID-19 attacks the body. Initially, it was believed to primarily attack the lungs, but new research suggests its a danger to nearly every organ.
Experts say that many people like Dowd, who died of a non-respiratory COVID-19 complication early in the outbreak -- before the pandemics impact became apparent -- may never be accurately counted.
The confusion and complications inherent in tracking pandemics have left a weary nation wondering just how high the actual U.S. death count may be and how bad things really are.
Less than 2% of all Americans have been tested for the coronavirus to date, according to White House figures nearly 5.5 million people. It's a figure that experts say is both higher than most nations and far lower per capita than where the U.S. should be at this point.
U.S. Assistant Secretary for Health and White House testing czar Admiral Brett Giroir told George Stephanopoulos on Good Morning America on Tuesday that the Trump administration doesnt concur with a Harvard University study which concluded last week that the U.S. needs to be testing 5 million people a day in June and up to 20 million by July in order to safely re-open the country.
We dont believe those estimates are accurate, nor are they reasonable, Giroir said.
Yet either way, that testing is still mostly focused on the living. Experts told ABC News that an accurate death toll is not only important to later get a better picture of what happened, but if possible, real-time or near real-time death counts can also help public health officials in their battle to contain the virus now.
History: A chilling guide
Researchers retrospectively calculate overall deaths from a pandemic by studying excess deaths year-to-year in a given region. But thats a difficult figure to gauge until a pandemic is over.
Previous studies of other recent virus outbreaks suggest the actual number of COVID-19 deaths to date is very likely dramatically higher than the more than 58,000 deaths currently reported.
A Centers for Disease Control and Prevention (CDC) analysis of the H1N1 swine flu virus outbreak in the U.S. in 2009 and 2010 concluded two years later that the actual tally was likely 15 times higher than the officially recorded figures. A 2013 study by the U.S. National Institutes of Health determined the figure was seven times higher than the official count.
But scientists said that the current coronavirus pandemic is of an entirely different magnitude.
Ive never none of us have ever seen an infection like COVID-19, that literally stopped the world, said Williamson.
While most news organizations rely on the Johns Hopkins University figures, which are pulled directly from state and local government websites and is considered more timely picture of the problem, the National Center for Health Statistics (NCHS), a branch of the CDC, is the primary agency responsible for U.S. health statistics, which are compiled by collecting data on births, deaths and health surveys.
Due to the lack of a uniform U.S. system, the NCHS system lags about two weeks behind in reporting said, Dr. Robert Anderson, chief of mortality statistics.
Daniel Weinberger, an epidemiologist from the Yale School of Public Health, analyzed NCHS death count data to estimate how many COVID-19 deaths may have gone uncounted during the five-week period from March 1 to April 3.
He concluded the official death toll in the U.S., currently closing in on 60,000, is probably a substantial underestimate of the true number by tens of thousands.
An employee of the office of the New York Chief Medical Examiner looks through fencing blocking a view of refrigeration trucks lined up to serve as an expanded morgue in New York, April 3, 2020.
The actual figure, he said, may be in the ballpark of double the reported cases.
Given the still-looming threat to the U.S., researchers are urging municipalities to maintain as much detailed data about COVID-19 records as possible.
With patchwork of reporting protocols, a 'pipe dream' to gauge actual death toll
As the pandemic rages across all 50 states and around the globe with no uniform reporting protocol in place, experts said the official death count is hard to even estimate.
One of the difficulties is that every state does things differently, said William Hanage, an epidemiologist at Harvard Universitys T.H. Chan School of Public Health. When I look at the data, Im sitting there thinking, Okay, this is Oklahoma. What kind of modifier am I adding to that to figure out whats going on here? It would be incredibly helpful not to have to do that.
Hes doubtful that a uniform national death count reporting process is possible anytime soon.
Its a bit of pipe dream," he said.
A funeral worker is assisted moving a deceased patient into a van at the Brooklyn Hospital Center on April 27, 2020, in New York.
And that's before taking into account the ways other countries count their own death tolls.
Even now if youre comparing reporting among different countries, youve got to ask, Are they reporting only deaths in hospitals? Only people they are sure had COVID? Which test did they use? What about deaths occurring elsewhere in nursing homes and at home? Are they being counted?
COVID-19-related deaths in non-hospital settings -- largely nursing home deaths and deaths at home -- are also fueling revised death counts in some U.S. regions and nations around the world.
As many as half of the COVID-19 deaths in Europe may have come from nursing homes, Hans Kluge, the WHO's regional European director, said in a press briefing last week. When France added nursing homes to its tally, the nations death count spiked 40%, according to the Wall Street Journal.
While the U.S. is not currently counting nursing home deaths nationally, its estimated that thousands have died from or with COVID-19 complications in these facilities across the U.S. Last week ABC News reported that based on the reporting of 28 states, the death toll in long-term care facilities has already surged past 10,000.
Yet it was also only last week that the CDC began the laborious process of preparing to incorporate nursing home deaths into its overall death count. The agency issued a notification saying it would soon begin requiring that nursing homes report communicable disease deaths promptly to federal authorities. Its unclear when the U.S. will begin including those figures in its national death count.
On April 14, the CDC directed all U.S. states and territories to begin counting suspected as well as lab-confirmed COVID-19 deaths.
Officials in some states have said theyll adhere to the new CDC guidelines, but each state has their own laws, which sometimes takes time, said Janet Hamilton, executive director Council of State and Territorial Epidemiologists (CSTE).
In mid-April, New York City released its first death count to include suspected -- not just lab-confirmed -- cases. That metric accounted for at-home deaths. The revised city figures, which added 3,700 deaths, drove up the nationwide death count by 17%.
Last week, scientists at Yale School of Public Health published a scholarly paper, which has yet to be peer-reviewed, that estimated that the actual death count in New York and New Jersey could be up to three times higher than the official tally of confirmed COVID-19 deaths or deaths that would be expected normally this time of year with respiratory diseases.
Some states, such as Florida and Pennsylvania, might have missed deaths early on and might be under-counting deaths by a substantial degree currently, the Yale scientists concluded. Other states, like Washington, have an accurate estimate of the mortality burden of the pandemic virus due to intense testing," the paper said. "And in states that have been hit hard by the pandemic virus, such as New Jersey and New York, the total excess mortality burden is 2-3 times that ascribed to COVID-19 in official statistics.
The golden question
Many U.S. states remain too overwhelmed by the outbreak or too short on supplies to perform postmortem COVID-19 testing.
Yet experts say localities inclusions of suspected cases in their death counts is vital going forward.
It is critical to include both the probable and the confirmed cases so we have the full picture of the impact, said Hamilton, of CSTE. Failure to do so, she said, would be a failure of our public health system.
Even those areas that can include probable and suspected COVID-19 deaths face challenges due to how little we yet understand about the disease, and how long the dead may carry it.
Post-mortem, we don't know how long the [COVID-19 diagnostic] test is valid for after death, said CAPs Williamson. If a person is not found in their house for five days, does the COVID-19 test still work? We don't really know the answer to that.
There are two main types of death investigations in the U.S.: medical examiner autopsies and hospital-based autopsies.
A worker organizes bodies in the Gerard Neufeld funeral home in Queens on April 22, 2020, in New York.
Medical examiners are the most rigorously trained forensic pathologists in the death investigation field -- but even they do not have uniform national reporting protocols for COVID-19 deaths.
The CDC first introduced a common code to list COVID-19 as a cause of death on U.S. death certificates on March 24, followed by formal guidance on April 3, but the guidance will take time to take root nationwide, experts said.
Beyond a shortage of testing that is forcing hospital officials to prioritize testing of live patients over the deceased, many hospital pathologists remain wary of conducting autopsies during the pandemic because of all that is still unknown about the coronavirus, according to ABC News interviews around the nation.
Even swabbing the nose of a corpse could potentially re-introduce the virus into the air surrounding the body, pathologists said -- urging their colleagues to only conduct such testing in the proper settings.
One pathologist who spoke with ABC News on the condition of anonymity said a recurring theme online among prominent U.S. academic pathologists is that due to a limited, evolving understanding of how the virus spreads, shortages of personal protective equipment and limited autopsy rooms with appropriate precautions in hospitals, many pathologists are scared to do the autopsies for fear of being infected.
Yet postmortem samples and tissue can be preserved until more testing is available.
You can freeze the nasal pharyngeal swabs and test them later, Aiken said. And medical examiners and coroner's draw blood for toxicology. Eventually that blood could be used for antibody testing. So even though the lab tests are limited now, in the long run, they may be able to determine if deaths are COVID-19 related.
The final factor that undermines a complete COVID-19 death count, according to experts, is that many if not most of the people who have died had at least one additional underlying chronic medical condition that contributed to the deaths particularly obesity, diabetes and hypertension.
But which factor actually caused the death?
Thats the golden question: who died with COVID-19, and who died of COVID-19, Williamson concluded. Thats what we still dont know.
ABC News' Josh Margolin and Lee Ferran contributed to this report.
