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A vaccine for COVID-19 could be ready as soon as September, according to a professor from Oxford University. Sarah Gilbert is a professor of vaccinology and says that she is "80% confident" a COVID-19 vaccine being developed by her team will work.
Other Human trials will start within the next fortnightHer team at Oxford is part of a global effort to find a vaccine for coronavirus which has killed more than 100,000 people around the world, according to Johns Hopkins University..
Professor Gilbert has said that human trials are set to take place within the next fortnight, and that she has been working seven days a week to get a vaccine rushed through.
Other Professor Sarah Gilbert believes a vaccine could be ready by September. Pic: University of OxfordShe told The Times newspaper: "I think there's a high chance that it will work based on other things that we have done with this type of vaccine.
"It's not just a hunch and as every week goes by we have more data to look at. I would go for 80%, that's my personal view."
She added that having something ready by the autumn is "just about possible if everything goes perfectly", but warned that "nobody can promise it's going to work".
The lockdown in the UK could make it more difficult to test the vaccine, as human contact is low, so researchers will have to conduct trials somewhere with a higher rate of transmission, to get a quicker result.
In pictures: Coronavirus outbreak (Photos)
Earlier in the week, researchers at Southampton University said they had discovered that the virus has "low shielding", meaning a vaccine could be easier to develop.
The UK is at the forefront of vaccine funding, and pumped 210m into an international fund last month - the biggest contribution at the time for a vaccine.
The government has also said that it would be willing to buy millions of doses, should trials prove successful.
However, despite the optimism from Oxford, other vaccine developers have said it could be up to a year before something is ready to distribute.
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Ministers have been under pressure to explain details of the government's exit-strategy from the ongoing lockdown, but scientists say that it is too early to consider removing the widespread restrictions while the number of dead still rises.
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LISBON (Reuters) - An American mother-of-three is a long-time member of anti-vaxxer groups online: a small but vocal global community that believes vaccines are a dangerous con and refuse to immunize themselves or their children.
FILE PHOTO: Demonstrators, including anti-vaccine protestors, stand outside of the U.S. Grant Hotel following U.S. President Donald Trump's arrival in San Diego, California, U.S., September 18, 2019. REUTERS/Tom Brenner/File Photo
But COVID-19 is shaking her views. The woman who would identify herself only as Stephanie, citing a fear of reprisals from committed anti-vaxxers, says she is now 50:50 on taking a vaccine should one be discovered for the respiratory disease caused by the new coronavirus.
Ive definitely thought about it, she told Reuters by phone from the United States, also expressing frustration at what she considers the anti-vax communitys downplaying of the pandemics seriousness. Were all being affected by this virus, schools closing, young people in hospital, and they still say its a hoax.
As the worlds scientists and pharmaceutical companies seek a cure for the coronavirus, other anti-vaxxers are gearing up for a fight against any potential new vaccine.
Refuse, demonstrate, said a Briton on Facebook in response to a post asking people how they would react if a vaccine was made mandatory.
But some virologists say the quest for a vaccine is so widely supported that resistance will be eroded.
The latest national surveys by pollster ORB International for the Vaccine Confidence Project (VCP), which monitors attitudes to immunisation, appear to support this idea.
In France, where a 2018 poll showed one in three people did not view vaccines as safe, just 18% would refuse a coronavirus vaccine now, according to the VCP poll of around 1,000 people on March 18, a day after France locked down.
In Australia, the VCPs figure was also 7%, while Britain, where about 2,000 people were polled, and Austria registered 5% opposition in polls there a week later.
If a vaccine were made available tomorrow, everyone would jump to get it, said Laurent-Henri Vignaud, who co-authored a history of Frances anti-vax movement.
That view was challenged by Mary Holland, vice-chair of American non-profit group Childrens Health Defense, which is critical of vaccination in the United States.
I dont think this virus fundamentally changes peoples deeply held concerns about vaccines, she told Reuters.
Although the term anti-vax is sometimes associated with conspiracy theories, many people are simply concerned about side-effects or industry ethics.
Globally, one person in five does not view vaccines as safe or is unsure, according to a 2018 survey by the Wellcome Trust health fund. reut.rs/2JTb27q
In China, where the COVID-19 disease caused by the novel coronavirus originated, surveys by VCP researchers show safety is an important cause of concern. Several scandals eroded trust, including in 2018 when a unit of Chinas vaccine maker Changsheng Bio-technology Co Ltd was heavily fined for falsifying data for a rabies vaccine. The company said it was deeply sorry for the incident.
Online discussions tracked by Reuters - including closed Facebook pages with more than 200,000 members, Twitter feeds such as the Childrens Health Defense and YouTube videos totalling over 700,000 views - showed considerable mistrust that a rushed vaccine would be improperly tested.
VCP director Heidi Larson said that was also the main reason for concern around the vaccine against the H1N1 swine flu pandemic in 2009.
A quickly produced swine flu vaccine in 1976 led to about one in 100,000 people developing Guillain-Barre syndrome, a paralyzing immune-system disorder, according to the Center for Disease Control and Prevention (CDC).
Some 115 coronavirus vaccine candidates are being developed by institutes and drugmakers, according to the Coalition for Epidemic Preparedness Innovation, a global alliance financing and coordinating the development of vaccines.
I will not be injected with anything, especially a fast-tracked vaccine, added American Vicki Barneck, 67, who believes a strong immune system is enough to combat the disease.
Holland, of the Childrens Health Defense, said: Some react fine to vaccines, others are paralysed or killed.
However, a 2015 paper by CDC epidemiologists said multiple studies and scientific reviews have found no association between vaccination and deaths except in rare cases.
The VCP is running an 18-month study tracking conversation online about the coronavirus and conducting global polls to measure attitudes towards social distancing, isolation, hand-washing and anticipating a vaccine.
From analysing more than 3 million posts a day between January and mid-March 2020, director Dr Heidi Larson said the vast majority were eager for a treatment, fast.
People are hungry for a vaccine, she said.
In Italy, which has been hit badly by COVID-19, the anti-vax movement has virtually disappeared in the discussion on the coronavirus, according to virologist Dr Roberto Burioni.
For a coronavirus vaccine to be effective, wide uptake and annual vaccination is likely to be required, said George Kassianos, immunisation lead at the Royal College of General Practitioners in London.
There is also the question of how to distribute fast enough to people lining up for the vaccine.
Essential workers will be the priority. Police officers, hospital workers, cleaners. Then at-risk groups, said Douglas L. Hatch, a physician specialised in pandemic preparedness working on the COVID-19 response in San Francisco.
By the time you get to the anti-vaxxers, theyll have trouble getting it even if they wanted to.
(Corrects French poll data in eighth paragraph)
Reporting by Victoria Waldersee; Editing by Andrei Khalip, Andrew Cawthorne and Timothy Heritage
Im confused by all these new words
Seldom have we had to get to grips so quickly with a slew of new terms and abbreviations. Had you told most people last Christmas that soon they would be WFH, they might have considered it a cryptic insult. Most probably had only a vague idea what an epidemiologist did or what a ventilator was, while PPE was (if anything) a soft Oxford degree favoured by politicians, rather than the personal protective equipment now urgently needed in hospitals. Few could have told you the difference between an epidemic (the outbreak and rapid spread of an infectious disease through a population) and a pandemic (an epidemic that occurs over a very wide geographical area, perhaps the whole world).
Even the terminology of the virus itself is challenging: the coronaviruses are a family of pathogens, this particular one (being related to that which caused the Sars outbreak of 2002-3) denoted Sars-CoV-2. Covid-19 is the respiratory syndrome it causes, much as Aids is to HIV. A vaccine confers immunity (probably just for a limited period) to the virus; an antiviral interferes with viral replication in the body to slow or arrest its bad effects. Antibiotics attack bacterial pathogens, not viruses, but may be needed with Covid-19 to treat secondary infections such as pneumonia that take advantage of a compromised immune system. Expect to hear lots in the coming weeks about serological tests, which look for proteins in the blood that signal past infection, even if the virus has long since been cleared from the body. Those tests are under development, and they will provide vital information on how widespread infection has been and whether many (or few) have had Covid-19 without any symptoms at all.
While comparisons with wartime and the blitz spirit are deeply misleading, one analogy holds: the second world war slogan Loose talk can cost lives is apt here too.
What makes the coronavirus so deadly is a combination of two numbers. The reproduction number (denoted R0) is the average number of people an infected individual goes on to infect in the absence of any social distancing or quarantining; the mortality rate is the percentage of infected people who die.
Both depend on the biology of the virus, but neither is fixed. R0 for the coronavirus is about 2.5 to three (compared with 1.3 for common flu), but thats an average it varies from person to person. Reducing person-to-person contacts cuts the effective reproduction number R and the epidemic will decay if it drops below one. The mortality rate, meanwhile, depends on the availability of healthcare for people with the most serious symptoms: it is about 0.4% in Germany, 4.6% in the UK, and more than 10% in Iran.
Symptoms are defined by the NHS as either:
NHS advice is that anyone with symptoms shouldstay at home for at least 7 days.
If you live with other people,they should stay at home for at least 14 days, to avoid spreading the infection outside the home.
After 14 days, anyone you live with who does not have symptoms can return to their normal routine. But, if anyone in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start.Even if it means they're at home for longer than 14 days.
If you live with someone who is 70 or over, has a long-term condition, is pregnant or has a weakened immune system, try to find somewhere else for them to stay for 14 days.
If you have to stay at home together, try to keep away from each other as much as possible.
After 7 days, if you no longer have a high temperature you can return to your normal routine.
If you still have a high temperature, stay at home until your temperature returns to normal.
If you still have a cough after 7 days, but your temperature is normal, you do not need to continue staying at home. A cough can last for several weeks after the infection has gone.
Staying at home means you should:
You can use your garden, if you have one. You can also leave the house to exercise but stay at least 2 metres away from other people.
If you have symptoms of coronavirus, use theNHS 111 coronavirus serviceto find out what to do.
Source:NHS Englandon 23 March 2020
The bad news is that low testing rates means it is virtually impossible to track the progress of the virus, and can give a false sense of security. The good news is that if more people have the virus than we know, the mortality rate will be lower than the official value. There have been speculations that the extent of infection might be much greater than thought, and that most cases dont even show symptoms. But this idea is hard to reconcile with observations from countries with extensive testing, which seem to indicate that few people get the virus without knowing.
When you see a WhatsApp message about A friend who is an A&E doctor at a leading hospital , dont assume it is reliable, even if it came from your own friend. Dont, even with the best of intentions, tell your other friends about it.
If you want to check the credibility of social media posts, organisations such as FullFact and Snopes audit messages doing the rounds.
Remember also the old quip that the plural of anecdote is not data. We notice anomalies and give them undue emphasis. Some highly unusual cases, among so many infections, are to be expected but this doesnt mean they are true or examples of a common phenomenon.
The news website The Conversation has a handy guide to spotting fake news. Perhaps the most useful of its tips is: If the story appears to claim a much higher level of certainty in its advice and arguments than other stories, this is questionable.
Sorting fact from fiction has become harder in this crisis because even well informed experts arent always united in their advice. Disagreements are normal in science, but are rarely a matter of life and death. It has been as frustrating and unsettling to science reporters as it has to everyone else to find experts at loggerheads over basic concepts such as herd immunity. It is, frankly, still a source of puzzlement why it took a single modelling study from Imperial College London to persuade expert government scientific advisers of what other experts (such as those at the World Health Organization) had been saying all along: that without stringent containment measures, the UK death rate would be catastrophic.
So now even the fine details of the science are being held up to us all for scrutiny. Its unprecedented for a national newspaper to publish a full, simplified version of a scientific paper, as the Observer did with the Imperial study. There will need to be more of this and with luck, it will spread understanding of how scientific results are carefully formulated and circumscribed with caveats, so that experts are seen as well-informed specialists doing their best with the tools and data at hand.
With the stakes this high, experts exploring speculative ideas take on a responsibility they arent used to. A study from epidemiologists at Oxford recently caused a stir when it was reported as claiming that as much as half of the UK population might have already been infected with the coronavirus, mostly without any symptoms. The work was quite reasonably exploring a what if scenario. But the headline in the Financial Times made it sound like an empirical possibility. Researchers will need to be more explicit about what their findings do and do not mean.
All drugs have to pass stringent tests before they are approved for use. In general they are first tested on animals, and then enter clinical trials on humans, of which there are three stages. Phase one, conducted on small numbers of healthy volunteers, checks for safety, looking for toxicity or serious side-effects. Phase two then tests whether the drug actually works in humans with the condition targeted. Finally, phase three trials are conducted on large numbers of people typically hundreds or thousands to see how it will work in the clinic and make sure there are no other complications or failures before making the drug generally available.
Vaccines will have to go through all of these phases, and could, like most candidate drugs, fail at any one of them. While drug-regulation agencies are considering ways to streamline and fast-track the process because of the urgency of the situation, this can only go so far. A coronavirus vaccine would be given to millions of healthy people ultimately, perhaps to most of the worlds population and so its more essential than ever that its safety is checked thoroughly.
Whats more, even when a vaccine gets approved, manufacturing it at such a large scale will be a tremendous challenge only a few pharmaceutical companies worldwide have that capacity. And distribution will present difficulties too, especially to more remote parts of developing countries, or among overcrowded, poorer neighbourhoods in large megacities. If, as is hoped, a vaccine is ready by the middle of 2021, that speed will be remarkable and unprecedented.
It is hoped that some antivirals already developed and tested for other conditions, such as Ebola (remdesivir) or Sars, could work for Covid-19, because they attack similar targets in the virus. In that case some of the testing has essentially already been done, so we would get a head start. There is also broader interest in drug repurposing investigating whether the many drugs that failed for their intended use, but which passed the safety trials, could prove effective for quite different conditions.
In tests on a new drug how safe or effective it is it matters how big the sample is. Drugs dont get approved until they have been tested on hundreds or thousands of people, so outcomes for just a dozen or so are highly preliminary and far from proving efficacy.
Be especially cautious of reports that rely heavily on quotes from drug companies. They are very unlikely to be lying, but institutional press offices have become accustomed to putting a rosy spin on their researchers work and drug companies are under commercial pressures that dont always encourage them to give the full picture. You neednt be cynical, just cautious.
Whether Twitter is a handy, up-to-the-minute source of information, or a hive of misinformation and conspiracy theories, is largely up to you. All the usual caveats about using Twitter beware of strong opinions from pseudonymous tweeters with 15 followers, or of hot takes from media loudmouths with no expertise are multiplied and compounded here. For the problem with the subject of coronavirus on Twitter is that its not just the trolls and attention-seekers who are weighing in. Plenty of serious academics, too, have taken it upon themselves to become epidemiologists and virologists overnight, criticising or praising scientific studies or government policies with all the assurance of seasoned veterans. Often what they say is not ignorant or wild, but merely narrow and lacking context they might be good at interpreting statistics, say, while having no knowledge of viral transmission or mass behaviour. Fear seems to be causing the usual academic caution to be replaced by hubris.
As the site itself says, Anyone can publish on Medium but we dont fact-check every story. Make that your starting point for anything you read there.
This doesnt mean its wrong. But the authoritative-looking stuff you might encounter is probably not coming from experts. One post that went viral, Coronavirus: The Hammer and the Dance, which used an array of charts and statistics to argue for strong containment measures to avoid massive fatalities, was by Tomas Pueyo, a Silicon Valley consultant who works on educational online content and has no epidemiological training. His post was promoted by a content marketing firm and was shared by the likes of Margaret Atwood and Steven Pinker. Whether or not it was accurate in all its details, it sent out a needed wake-up call about the dangers. But other unqualified corona influencers have spread dangerous messages, for example about hoaxes and bogus treatments. Medium has now announced that it will give careful scrutiny to coronavirus-related content to help stem misinformation that could be detrimental to public safety, and will remove any that it deems harmful.
First ask: does this theory confirm the suspicion Ive had all along? About, for instance, 5G? Because if so, double your scepticism and then double it again. We arent so much duped as flattered into buying these theories, and the first defence against confirmation bias is to recognise that no one has natural immunity to it.
The harder ones to avoid are political, because they both speak more directly to our prejudices and are tougher to disprove. Is it obvious that, say, the government is just trying to keep its big-business donors happy at the expense of our own safety? Wed do well to assume in the first instance that leaders and policymakers are not Machiavellian strategists but error-prone muddlers like the rest of us.
Sorting fact from fiction is made harder by the media habits acquired during Brexit the tendency of broadcast journalists and other media reporters to tweet unattributed and unconfirmed rumours. This grave global crisis should prompt some journalists to take a hard look at the ways they have become accustomed to working.
As the COVID-19 pandemic continues, Americans wonder if the illnesses they had earlier this year were actually a result of the novel coronavirus. USA TODAY
The United States has passed Italy to become the country with the most coronavirus deaths.However, as a proportion of the total population in the U.S., virus deaths remain at about one-sixth of those in hard-hit Italy or Spain.
More than 19,700 people in the U.S. have died due to complications from the coronavirus as of Saturday afternoon, accordingto data from theJohns Hopkins University dashboard.Friday, the U.S. saw its highest daily death count yet, at 2,108.
Italy's death toll was at 19,468andSpain,the nation with the third-most fatalities, had 16,353reported deaths.Worldwide, the death count has surpassed 104,000.
Get daily updates in your inbox:Sign up for the Coronavirus Watchnow.
Estimates on how many people will end up dying in the U.S. have fluctuated in recent weeks as new data continues to pour in.
A leading projection model from the University of Washington has forecastabout 60,000 deaths in the country, far less than the 100,000 to 240,000 deaths that were projected in a White House release less than two weeks ago.
"The real data are telling us that it is highly likely that we're having a definite positive effect by this mitigation things that we're doing this physical separation so I believe we are gonna see a downturn in that, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told NBC's "Today" show on April 9.
And it looks more like the 60,000 than the 100,000 to 200,000.
Dr. Deborah Birx of the White House task force said Friday the U.S. is starting to see its curve level off, but she warned that we haven't reached the worstof the epidemic despite the University of Washington's model projecting Friday as the peak of daily deaths.
While Italy is far from out of the woods, the country's daily increasesin new cases havestabilized. On Thursday, April 9, Italyreported 4,204 new cases and 610 deaths, both figures on par with recent days.
Meanwhile, the U.S. reported32,385 new cases and 1,783 on the same day.
Raw totals aren't the best measurement due to the enormous differences in population Italy has about 60 million people, while the U.S. has upwards of 320 million. Butthe flattening of Italy's curve after spikes over the past month may provide an effective model for projecting the virus' future toll in the U.S.
Italy became theepicenteronce the virus expanded outside of China, and hospitals in the country particularly the northern regions quickly became overrun. The country instituted a nationwide lockdown on March 9 that has been extended through April 13 and is expected to be extended even further.
Birx said Friday thatthe U.S., for the first time, is starting to see its curve level, "like Italy's did about a week ago."
Your coronavirus questions, answered: How can I disinfect a face mask? Should I wear gloves?
Earlier in the week, the same University of Washington model projected about 82,000 deaths, a drop from previous iterations. Changes to the model reflect a massive infusion of new data, said Dr. Christopher Murray, director of the schools Institute for Health Metrics and Evaluation.
On March 31, the White House released estimates that as many as 240,000 Americans may die in the crisis.
And in mid-March, the Centers for Disease Control and Prevention's worst-case-scenario had about 160 million to 210 million Americans infected by December and an estimate that between 200,000 and1.7 million people could die by the end of the year.
When will life return to normal?Expert says US testing is too far behind to know, expects second wave of cases
Speaking to CNN, senior faculty member Dr. Gregory Roth explained that the models are ever-changing.
"The changes in the model are driven by new data and improved methods, particularly around estimating how uncertain the forecasts may be," Roth said."As we receive more data on COVID-19 deaths, we expect our projections to adjust to follow those new trends."
However, the more optimistic projections are based on the assumption that Americans will continue tostay vigilant about social distancing.
It is unequivocally evident that social distancing can, when well implemented and maintained, control the epidemic, leading to declining death rates, Murray told CNN.
Said Roth: "We haven't seen a relaxing of social distancing in any parts of the United States yet. In the future, if social distancing was relaxed, we would be concerned that there would be a rise again in the number of cases."
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The woman was dying. Workers at New Yorks Mt. Sinai Hospital were about to call her husband and break the news that there was nothing left to try. Then Dr. Hooman Poor took a gamble.
With high-stress, high-stakes decisions, doctors around the world are frantically trying to figure out how COVID-19 is killing their patients so they can attempt new ways to fight back. One growing theory: In the sickest of the sick, little blood clots clog the lungs.
Poor couldnt prove it. The tests required would further endanger his staff, who were already at risk of exposure to the novel coronavirus, which causes COVID-19. But the lung specialist saw clues that were screaming blood clots. So Poor pulled out a drug best known for treating strokes, and he held his breath.
I said, What do we actually have to lose? Poor said. Thats when I decided to give not just a blood thinner but a blood-clot buster.
Exactly whats going on with blood clots in at least some COVID-19 patients is a mystery.
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Chinese doctors were first to sound the alarm. In March, Chinese heart specialists advised the American College of Cardiology to watch for clots and said certain blood tests showing a rise in clot risk might signal which patients were in greatest danger. Other reports suggested the clots can show up all over the body. But were they a cause of deterioration or an effect?
Already, many hospitals are attempting preventive doses of blood thinners to keep clots from forming. Theres huge debate over what kind to try, what dose is safe the drugs can cause dangerous bleeding and how soon to start.
In New York, Poor was going a step further with a drug called tissue plasminogen activator, or tPA, which doesnt prevent clots it breaks them up.
Its an example of how, with no vaccine or approved treatment for COVID-19, many overwhelmed doctors are following trails of clues to figure out what to try next.
Poors 55-year-old patient wasnt getting enough oxygen even after doctors rolled her onto her stomach for an extreme ventilation technique called prone positioning. She was in shock. Other organs were failing fast.
Twenty minutes after the injection of tPA, her oxygen levels rose. Poor was elated. But not for long.
She gets better, but then she starts to get worse, he said. Most likely were breaking up the clot, but she is immediately forming the clot again.
So he tried something novel, putting the woman on a low-dose drip of tPA for about 24 hours, together with a blood thinner, in hopes of chipping away at existing clots while blocking new ones.
To Poors dismay, the experimental treatment bought the woman only a few more days of life. A sudden, different complication killed her on Friday.
But last weekend, Poors team tested the new clot-fighting approach in four other severely ill patients. One didnt survive, dying of cardiac arrest from a massive blood clot in his heart.
The rest saw improvement in oxygen levels and shock. As of Friday, three remained on ventilators but were doing better, especially one who had been treated soon after her lungs failed. In a new report, Poor called for urgent study of whether abnormal clotting drives at least some patients deterioration, even as his own hospital updated treatment advice for its sickest cases.
Others are onto the same lead. Specialists at the University of Colorado and Harvard recently published a similar tPA research call and cited three additional cases in which it was tried, as hospitals in Colorado and Massachusetts prepare for a study.
Were taking care of extremely ill patients that are dying in front of us, and we cant get any diagnostic testing, yet still have to make treatment decisions, said Dr. Steven Pugliese, a pulmonologist at the University of Pennsylvania.
Pugliese called Poors tPA report very intriguing and concluded: What these doctors did in these very ill patients who were dying was a judgment call, and it was the right thing to do.
But with the bleeding risk, the strategy has to be studied in carefully chosen patients, Pugliese said, especially with no good way to tell in advance who really has these tiny clots.
Poor first noticed oddities as his ICU filled with patients who just werent responding to care the way doctors expected. They were on breathing machines after developing acute respiratory distress syndrome, or ARDS. Its an inflammatory form of lung failure that, when caused by other infections, stiffens lungs.
At least early on, Poor didnt see that.
It was like Groundhog Day with each patient, he said, referring to the movie in which the same events repeat day after day. They had severe abnormalities in oxygen and carbon dioxide levels, but, shockingly, their lungs were not stiff.
He recalled Italian doctors who spotted the same thing and wrote in an American Thoracic Society journal that COVID-19 was causing atypical ARDS.
Back in Poors hospital, when ventilated patients had improved enough to allow them to wake up a bit, alarms would sound as their blood oxygen levels immediately plummeted.
The residents would yell at me, So and so is desaturating! Poor recalled. Classically in ARDS, we think thats because the lung is collapsing. But it wasnt.
Poor often treats patients for pulmonary embolism, a large clot in the lungs that can quickly kill. The COVID-19 patients didnt look quite like that. Nor were their hearts struggling to pump blood into the lungs.
Then, as he was doing laundry at 2 a.m., Poor remembered a rare disease in which some lung blood vessels abnormally dilate even as others are clogged. If that explains the COVID-19 contradictions, he thought, a clot-buster might help.
I did a case series of five. This does not prove anything, he cautioned. Perhaps it brings light to possibilities where further research can delve into what exactly is going on.
Neergaard writes for the Associated Press.
President Donald Trump speaks during a coronavirus task force briefing at the White Houseon Friday. Seated from left, Director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci, White House coronavirus response coordinator Dr. Deborah Birx, Surgeon General Jerome Adams, and Food and Drug Administration Commissioner Dr. Stephen Hahn. Evan Vucci/AP hide caption
President Donald Trump speaks during a coronavirus task force briefing at the White Houseon Friday. Seated from left, Director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci, White House coronavirus response coordinator Dr. Deborah Birx, Surgeon General Jerome Adams, and Food and Drug Administration Commissioner Dr. Stephen Hahn.
The Trump administration has enlisted some of the biggest corporations in America to help expand the supply of medical equipment needed to fight COVID-19 but many of those supplies aren't going to the cities and hospitals where they're needed most.
Instead, this public-private collaboration means that the marketplace and long-established business ties often shape decisions about who gets life-saving equipment, and who has to wait, NPR found.
While FEMA is doing some of the work, corporate and U.S. officials say the medical supply shortage nationwide is so vast and dire that the federal government can't handle it alone. They say companies are needed because of their expertise and facilities to ramp up shipments fast.
So, late last month, the Trump administration shifted much of the supply effort for the COVID-19 fight to corporations, including McKesson, Cardinal Health and Medline Industries.
This arrangement surprised and dismayed many state governors. When the COVID-19 pandemic exploded in the U.S., they expected the federal government to step in aggressively, buying ventilators, N95 masks and other medical equipment, rushing supplies to growing hotspots like New York City.
"When I was in the federal government, FEMA effectively was the shipping clerk," said New York Gov. Andrew Cuomo, who served in the Clinton administration. "They did the purchasing, they disseminated to the states. That's the simplest system."
Company executives interviewed by NPR say their efforts are already accelerating deliveries and expanding the supply of medical equipment.
"We operate about 50 distribution centers in the United States, and we have about 22 manufacturing facilities," said Jesse Greenberg, a Medline spokesman. "We're doing our very best to step up to this challenge."
The executives say safeguards are in place to prevent firms from price-gouging during the pandemic. Earlier this month, the Justice Department took the extraordinary step of issuing a letter allowing five of the country's biggest medical supply companies to collaborate on the COVID-19 response, sharing information and resources in ways that would normally violate antitrust laws.
"It's totally unique. I do not remember anything like it before," said Eleanor Fox, who studies trade regulation at the New York University law school. "It would probably be an illegal cartel, but for the fact that this is a crisis."
But the majority of medical supplies procured by these companies aren't being handed out through FEMA or distributed on the basis of immediate need. Instead, the equipment is going first to companies' regular customers.
"We have existing contracts," said Medline's Greenberg. He noted that his firm stopped taking new orders from frontline health providers, even those in desperate need, as the pandemic escalated. "The inventory isn't there for Medline to service new customers."
This means a hospital with existing supply contracts with one of these companies before COVID-19 hit might get shipments of masks and gowns even when not facing a surge of sick patients.
Meanwhile, a hospital without that kind of relationship might have to wait, even if its doctors and nurses are at risk because they lack protective equipment.
One high-profile part of this public-private arrangement is known as the Airbridge project. The Trump administration is chartering dozens of cargo flights packed with medical supplies from overseas.
"That gear and those outfits are being handed out as they arrive," said President Trump during his White House briefing on Thursday. "They're going directly to point."
In fact, the masks, gowns and other gear carried on those planes go first to private companies.
Firms partnering on the Airbridge flights tell NPR that under their agreement with the White House and FEMA, roughly half the medical equipment in those deliveries is theirs to sell however they like. The other half will be shipped to COVID-19 hotspots but not necessarily to the worst-hit hospitals. Once again, supplies go to existing customers.
"This product that we're moving is primarily commercial product," said Navy Rear Adm. John Polowczyk, who leads FEMA's procurement task force. "That would enter the commercial system and be distributed through financial business transactions between hospitals and these distributors."
Asked why more supplies aren't being prioritized and distributed based on need rather than market-driven factors, Polowczyk said he didn't want to disrupt existing supply chains. "We're bringing product in, they're filling orders for hospitals and nursing homes, like normal."
But many governors say the situation isn't normal. In many places, nurses, doctors and first responders are still caring for patients without enough protective equipment.
As a result, many states have chosen to work around the Trump administration's public-private supply chain, seeking their own suppliers. Governors say this has led to confusion and chaotic bidding wars with suppliers around the world.
"I have to figure out how to do business with China where I have no natural connection as a state," Cuomo said. "Every state has to scramble to find business connections with China."
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The number of people with COVID-19 in Alaska continued to increase on Saturday with 11 new cases announced by the states health department, bringing the states total to 257.
The updated numbers come at the end of a week in which Alaska saw its sharpest single-day increase in COVID-19 cases (Mondays 22 new positives) and state officials took additional steps to limit the spread of the illness statewide, extending social distancing and travel mandates and closing schools through the end of the school year.
New cases announced Saturday include a Wasilla resident, as well as nine more Anchorage residents and an individual who lives in Craig the first among residents of that Southeast Alaska community. So far, 121 Municipality of Anchorage residents and 10 Matanuska-Susitna Borough residents have tested positive for COVID-19.
The updated numbers also include the eighth COVID-19-related death of an Alaskan, the third announced this week. A 73-year-old woman with underlying health conditions died Friday at Fairbanks Memorial Hospital, according to officials from Foundation Health Partners, which operates the hospital. The death is the second to occur in Interior Alaska.
Two Alaskans have died from COVID-19 while out of state. Most who died were over the age of 60 with underlying health conditions, though an Anchorage woman in her 40s and an Anchor Point man in his 30s are among the fatalities.
The state had received COVID-19 test results for a total of 7,732 Alaska residents through Friday. The state of Alaska does not publish information on the number of tests that are outstanding.
In Anchorage, a person who tested positive for COVID-19 is staying in isolation at the Dempsey Anderson Ice Arena on West Northern Lights Boulevard, said Carolyn Hall, spokeswoman for Mayor Ethan Berkowitz.
The arena, which contains two ice rinks, was recently converted into an isolation and quarantine medical site for people sick with COVID-19 who do not have anywhere else to recover, including people experiencing homelessness. Hall said the city couldnt disclose any information about the person in isolation at the ice arena.
Sixty-three Alaskans have recovered from the illness, according to the state, and a total of 31 have been hospitalized, including three new hospitalizations Friday.
The states case count numbers reflect the number of positive test results between midnight and 11:59 p.m. on the previous day, meaning that cases of COVID-19 reported on Saturday represent the number of people who tested positive for the disease on Friday.
In addition, the state reports cases based on a persons residency. They dont necessarily reflect where a person is at the time of their positive test result or where they became ill.
As case counts rose, state officials extended measures intended to curb the spread of COVID-19 and prevent health care facilities from being overwhelmed.
This week, Gov. Mike Dunleavy said that a previously announced school closure would last through the end of the school year for Alaska.
The state also extended a mandate that orders Alaskans to remain at their place of residence and practice social distancing," which is set to be re-evaluated by April 21. The mandate says that everyone in the state must not participate in public or private gatherings that include non-household members, regardless of the number of people involved.
The mandate includes an exemption for outdoor activities, but asks that Alaskans keep their distance from others while outside.
A mandate that bans all non-essential travel between Alaska communities was also extended and is expected to be re-evaluated by April 21, state officials announced.
The states chief medical officer, Dr. Anne Zink, on Friday encouraged Alaskans to wear face coverings while out in public because new information continues to show that they can be an effective tool to limit the spread of the virus.
As Alaskans approached another weekend hunkering down, with several businesses closed and many people out of work statewide, state officials expressed hope that the efforts to blunt the spread of COVID-19 would help initiate a return to normalcy.
Every day, we get new tools in, Zink said. Every day, we have more resources to be able to address this pandemic and to be able to support Alaskans.
Zink said that she hopes the state can ward off the virus long enough to get a vaccine and protect the states most vulnerable. Zink also highlighted the importance of testing in allowing officials to see early on where the spread of COVID-19 is happening, so it can be contained.
I think that we just see really promising things on the horizon, both for testing and for treatment options, Zink said.
On Friday, Dunleavy said that he would work to look at ways of going about a phased reopening throughout the state, though many aspects of the virus make the timeframe hard to predict.
We are working around the clock to try to figure out the ways to disrupt peoples lives as little as possible, Zink said.
Reporter Paula Dobbyn contributed to this story.
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And then came the coronavirus outbreak.
Stringent instructions were issued, along with dire warnings meant to protect older people, who are most vulnerable to the virus. Elderly persons must absolutely avoid leaving home or receiving guests, the Health Ministry admonished. Minister of Defense Naftali Bennet declared: The most important rule is to protect grandfather and grandmother. Find creative ways of hugging and loving them, from a distance! A public-service announcement on the military radio station said: Save Grandpa and Grandma. Dont go to visit them.
My family was divided. Most of us thought that Dad and his live-in partner should be totally isolated in their home. This led to a series of discussions, sometimes arguments, within the family. All of us had only Dads well-being in mind, but there were disagreements over the right way to ensure it.
The first people who had to stop coming to Dads house were the trainers and therapists, the ones whose daily contact with him had kept him alert and active. Attempts to continue his sessions over video chats didnt work.
Then most of us thought we, too, should stop visiting him. The health authorities were already predicting that within days, hundreds of Israelis would be on respirators, most of them old people, and their number would soon be in the thousands, with only 1,500 such machines available. (Those predictions proved wrong.) One family member made a grim prediction about what would happen if Dad were infected with the virus: It is reasonable to assume that he would have very low priority when they have to decide who to respirate and who dies.
After three weeks, I persuaded the family to allow me a visit. I immediately saw that something was seriously wrong. Dad was drifting away, disconnecting from his surroundings. Should we call a doctor? Just letting a doctor in risked infection, and there was going to be a shortage of respirators. We called one anyway.
The doctor advised us to go immediately to the emergency room. My sisters, Dads partner and I had more arguments, with some saying that hospitals were the worst place to be. We called another doctor, who said the hospital seemed too dangerous. A third doctor told us to call her again in a couple of days.
Over the next few hours I watched Dad slipping away from us. That morning he had responded to questions in a weak voice, but at around 4 p.m. he was hardly opening his eyes, and at 6 not at all. He had become totally detached. His temperature was going up. I felt I was being ripped apart. What do I know? What do I understand about medicine? Perhaps his decline was only temporary, maybe he was having a bad day, as hed had in the past. Or was it a worsening of his Alzheimers or a spread of the cancer? Under any other circumstances, we would have taken him to the E.R. immediately. But if he contracted the coronavirus at the hospital and died as a result, would I be able to look his partner and my sisters in the eye?
For Immediate Release: April 10, 2020
The U.S. Food and Drug Administration issued an emergency use authorization for a blood purification system to treat patients 18 years of age or older with confirmed Coronavirus Disease 2019 (COVID-19) admitted to the intensive care unit (ICU) with confirmed or imminent respiratory failure.
The authorized product works by reducing the amount of cytokines and other inflammatory mediators, i.e., small active proteins in the bloodstream that control a cells immune response by filtering the blood and returning the filtered blood to the patient. The proteins that are removed are typically elevated during infections and can be associated with a cytokine storm that occurs in some COVID-19 patients, leading to severe inflammation, rapidly progressive shock, respiratory failure, organ failure and death.
We continue to work across all sectors to expedite the development of numerous innovative potential preventive and treatment approaches by both facilitating emergency access for patients, to the extent we can, and supporting the evaluation of potential therapies, said FDA Commissioner Stephen M. Hahn, M.D. With todays authorization of a blood purification device, we are expediting the availability of a treatment option for patients in the ICU to help reduce the severity of the disease. Our staff will continue our around the clock review of all medical products to expedite the availability of treatments to help fight this devastating disease.
The FDA issued this emergency use authorization to Terumo BCT Inc. and Marker Therapeutics AG for their Spectra Optia Apheresis System and Depuro D2000 Adsorption Cartridge devices.
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nations food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
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04/10/2020
