When will a COVID-19 vaccine be ready? – WKRN News 2

When will a COVID-19 vaccine be ready? – WKRN News 2

Here Are All the Companies Working on COVID-19 Vaccines, Treatments, and Testing – Motley Fool

Here Are All the Companies Working on COVID-19 Vaccines, Treatments, and Testing – Motley Fool

April 10, 2020

Help is on the way.

In the midst of a societal upheaval resulting from the novel coronavirus and the disease that it causes, COVID-19, there are many efforts in progress to find solutions to slow the spread of the disease and treat those who already have it. These efforts include those from governments, nonprofit organizations, and companies both privately held and publicly traded.

To help investors who desire to keep tabs on the publicly traded companies with COVID-19 programs, here are lists of all the companies with market caps of at least $200 million that are developing or have developed COVID-19 vaccines, treatments, and tests.

Image source: Getty Images.

Several companies already had vaccine platforms targeting other coronaviruses such as MERS and SARS. This enabled them to rapidly prototype experimental vaccines for immunizing against the novel coronavirus that causes COVID-19. Following are all of the companies that are actively developing COVID-19 vaccines either on their own or in partnership with another drugmaker.

Data sources: Biotechnology Innovation Organization, company press releases, Yahoo! Finance.

Two of these companies appear to be in the lead right now. In March, Moderna initiated the first clinical testing in humans of an experimental COVID-19 vaccine. The biotech's messenger RNA (mRNA) vaccine was developed in collaboration with the National Institute of Allergy and Infectious Diseases(NIAID). Inovio announced on April 6 that it had begun a phase 1 clinical study of experimental COVID-19 DNA vaccine INO-4800.

Several companies already have approved products on the market that could hold potential in treating patients with COVID-19. Others have experimental drugs that have been included in testing for other viruses that could be effective in targeting novel coronavirus infection. Some are scrambling to develop new therapies for COVID-19. Following are the companies that are developing or testing potential COVID-19 therapies.

Data sources: Biotechnology Innovation Organization, company press releases, Yahoo! Finance.

Three drugs with the potential to treat COVID-19 have received the most public attention. Gilead's remdesivir, which was originally developed to treat the Ebola virus, is in late-stage clinical studies and could be the most promising treatment, according to World Health Organization Assistant Director-General Bruce Aylward. President Trump has spoken frequently about his view that anti-malaria drugschloroquine and hydroxychloroquine, which are marketed by companies including Sanofi, could be effective in treating COVID-19, although health officials have stressed that the efficacy of the drugs in treating COVID-19 remains unproven at this point.

The most pressing immediate need in the battle against COVID-19 is for diagnostic tests to determine if individuals are infected by the novel coronavirus. Companies both large and small quickly developed such tests, with several receiving emergency use authorization (EUA) from the U.S. Food and Drug Administration (FDA) to be marketed commercially. Other companies have helped by providing COVID-19 testing services. Here are the companies engaged in activities related to testing for COVID-19.

Market Cap

Data sources: Biotechnology Innovation Organization, EvaluateMedTech, company press releases, Yahoo! Finance.

Roche and Thermo Fisher Scientific have committed to producing millions of COVID-19 tests. Abbott Labs recently launched the fastest COVID-19 test so far. Its test, which runs on the company's widely used ID NOW molecular diagnostics platform,can deliver positive results within five minutes and negative results within 13 minutes.

Investors looking to buy shares of companies with COVID-19 programs should first determine how much risk they're willing to take. Several of the companies are relatively small. The odds of failure, especially with experimental COVID-19 vaccines and treatments, are relatively high.

It's also important to evaluate each stock's prospects beyond the companies' COVID-19 efforts. If you would be interested in buying a given stock even if it wasn't developing a COVID-19 vaccine, treatment, or test, that should put the stock much higher on your list.


Read more here: Here Are All the Companies Working on COVID-19 Vaccines, Treatments, and Testing - Motley Fool
COVID-19 Vaccine: Here’s what you need to know about the second vaccine candidate to start human trials – Firstpost

COVID-19 Vaccine: Here’s what you need to know about the second vaccine candidate to start human trials – Firstpost

April 10, 2020

In an encouraging development, a second COVID-19 vaccine has entered Phase 1 trials in the US. Headed by the pharmaceutical company Inovio, the trial began on Monday and will include 40 healthy adult volunteers.

The first vaccine candidate by the pharmaceutical company Moderna began human trials mid-March in Seattle and has given two-thirds of participants the first of two jabs.

Representational image. Reuters.

The Inovio vaccine, dubbed INO-4800, will be given in two doses, four weeks apart. The trials will be conducted at the Centre for Pharmaceutical Research in Kansas City. If the first phase, which tests mainly for safety and adverse reactions, goes well, Inovio said it would develop a million doses by the end of the year to begin further investigations.

While this is breakneck speed as far as vaccine development is concerned, it will still be at least a year to 18 months before a viable candidate will be accessible to the public.

Preclinical trials involving animal models have shown that the vaccine was able to trigger strong immune responses. Previously, Inovio had conducted a phase 1 trial of a vaccine on MERS (a closely related cousin of COVID-19) which also showed strong immune responses.

This is a DNA vaccine - a small section of the virus is loaded onto synthetic DNA, which encodes proteins similar to those produced by the virus. The hope is that this will trigger an antibody response and help the host maintain immunity against the virus.

Unlike other vaccines, INO-4800 will be injected skin deep rather than muscle deep, and a tiny electric buzz will be administered since this triggers deeper penetration of the vaccine.

The project is funded partly by the Bill and Melinda Gates Foundation, and efforts are in place to hold clinical trials in China as well.

Novavax, a biotech company based in Maryland USA, has also shown encouraging signs in preclinical trials and expects to initiate the first phase of human trials by mid-May in Australia. Johnson and Johnson, which has partnered with and received $500 million from the US Department of Health, also said it would start human trials by September.

More imminently, the University of Pittsburgh and Baylor College of Medicine in Houston are awaiting government approval so that they can start clinical trials as well.

For more information, read our article onCOVID-19 prevention and care tips for parents with young children.

Health articles in Firstpost are written by myUpchar.com, Indias first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.

Updated Date: Apr 09, 2020 16:44:34 IST

Tags : Coronavirus, Coronavirus Treatments, COVID-19, COVID-19 Vaccines, Human Trials, Inovio, Moderna, NewsTracker, Novavox


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UT Health Science Center conducting COVID-19 vaccine, test, and treatment research – KLTV

UT Health Science Center conducting COVID-19 vaccine, test, and treatment research – KLTV

April 10, 2020

COVID-19 is a new pathogen, so less is known about the lung injury, although early reports suggest that the lung injury it causes is similar. LTI-03 can be administered through inhalation and will soon be tested in models of COVID-19 to see if it can prevent early lung inflammation and scarring that typically occurs in patients with severe COVID-19 lung infection. Should this research yield successful outcomes, the LTI-03 could rapidly be made available for clinical trial testing, and if successful, provide novel treatment for patients afflicted with severe COVID-19 lung injury.


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UT Health Science Center conducting COVID-19 vaccine, test, and treatment research - KLTV
iBio Expands COVID-19 Vaccine Collaboration to Include the Infectious Disease Research Institute – Yahoo Finance

iBio Expands COVID-19 Vaccine Collaboration to Include the Infectious Disease Research Institute – Yahoo Finance

April 10, 2020

- The Nonprofit Will Help Lead Pre-Clinical Development and Clinical Trial Oversight -

NEW YORK, April 09, 2020 (GLOBE NEWSWIRE) -- iBio, Inc. (NYSE AMERICAN:IBIO) (iBio or the Company), a biologics contract manufacturing organization and biotechnology innovator, today announced the signing of two Master Services Agreements (the MSAs) and a Memorandum of Understanding (the MoU) with the Infectious Disease Research Institute (IDRI) in support of iBios SARS-CoV-2 Virus-Like Particle (VLP) vaccine development.

Under the MSAs, IDRI will support pre-clinical development and provide clinical trial oversight, while iBio will provide process development and manufacturing services to IDRI, as needed. Additionally, the MoU calls for iBio and IDRI to establish a separate, additional agreement within the next 60 days if the Company opts to include one of IDRIs novel adjuvants in the COVID-19 vaccine development program (IBIO-200). The MSAs and the MoU integrate IDRI into iBios collaboration with the Texas A&M University System to create a strong partnership that brings deep experience and advanced technologies and capabilities to the task of moving IBIO-200 into the clinic.

We are delighted to have IDRI contribute its deep understanding of infectious diseases and vaccine development expertise to the team, said Tom Isett, Co-Chairman & Chief Executive Officer of iBio. We are also looking forward to evaluating the novel adjuvants in IDRIs portfolio that may deliver even greater immunostimulatory effects. A more potent antigen-adjuvant combination would further increase our projected manufacturing capacity for production of a vaccine for COVID-19 disease.

We are excited to be a partner in the development of IBIO-200, said Corey Casper, M.D., MPH, Chief Executive Officer of the IDRI and Clinical Professor of Medicine and Global Health at the University of Washington. Combining iBios VLP antigen with an IDRI adjuvant provides for promising safety and efficacy characteristics, and importantly, the ready ability to scale-up manufacturing to help meet the projected global demand for a suitable vaccine.

About iBio, Inc.

iBio is a global leader in plant-based biologics manufacturing. Its FastPharming System combines vertical farming, automated hydroponics, and glycan engineering technologies to rapidly deliver gram quantities of high-quality monoclonal antibodies, vaccines, bioinks and other proteins. The Companys subsidiary, iBio CDMO LLC, provides FastPharming Contract Development and Manufacturing Services via its 130,000 square foot facility in Bryan, Texas. Originally built in 2010 with funding from the U.S. Defense Advanced Research Projects Agency (DARPA), iBios FastPharming Facility was part of the Blue Angel initiative to establish factories capable of rapid delivery of medical countermeasures in response to a disease pandemic. iBios FastGlycaneering Development Service includes an array of new glycosylation technologies for engineering high-performance recombinant proteins. Additionally, iBio is developing proprietary products which include IBIO-100 for the treatment of fibrotic diseases and IBIO-200, a COVID-19 vaccine. For more information, visit www.ibioinc.com.

About the Infectious Disease Research InstituteAs a nonprofit global health organization, IDRI (Infectious Disease Research Institute) takes a comprehensive approach to combat infectious diseases, combining the high-quality science of a research organization with the product development capabilities of a biotech company to create vaccines and therapeutics. IDRI combines passion for improving human health with the understanding that it is not just what our scientists know about disease, but what we do to change its course that will have the greatest impact. Founded in 1993, IDRI has 55 employees headquartered in Seattle with more than 100 partners/collaborators around the world. For more information, visitwww.idri.org.

About The Texas A&M University System

TAMUS is one of the largest systems of higher education in the nation with a budget of $6.3 billion. The System is a statewide network of 11 universities; a comprehensive health science center; eight state agencies, including the Texas Division of Emergency Management; and the RELLIS Campus. The Texas A&M System educates more than 151,000 students and makes more than 22 million additional educational contacts through service and outreach programs each year. System-wide, research and development expenditures exceeded $1 billion in FY 2019 and helped drive the states economy.

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FORWARD-LOOKING STATEMENTSSTATEMENTS INCLUDED IN THIS NEWS RELEASE RELATED TO IBIO, INC. MAY CONSTITUTE FORWARD-LOOKING STATEMENTS WITHIN THE MEANING OF THE PRIVATE SECURITIES LITIGATION REFORM ACT OF 1995. SUCH STATEMENTS INVOLVE A NUMBER OF RISKS AND UNCERTAINTIES SUCH AS COMPETITIVE FACTORS, TECHNOLOGICAL DEVELOPMENT, MARKET DEMAND, AND THE COMPANY'S ABILITY TO OBTAIN NEW CONTRACTS AND ACCURATELY ESTIMATE NET REVENUES DUE TO VARIABILITY IN SIZE, SCOPE, AND DURATION OF PROJECTS. FURTHER INFORMATION ON POTENTIAL RISK FACTORS THAT COULD AFFECT THE COMPANY'S FINANCIAL RESULTS CAN BE FOUND IN THE COMPANY'S REPORTS FILED WITH THE SECURITIES AND EXCHANGE COMMISSION.

Contacts:

Stephen KilmeriBio, Inc.Investor Relations(646) 274-3580 skilmer@ibioinc.com

The Fearey GroupPublic Relations for IDRIIDRI@feareygroup.com


Originally posted here: iBio Expands COVID-19 Vaccine Collaboration to Include the Infectious Disease Research Institute - Yahoo Finance
Racing for a cure: where are we with COVID-19 vaccines and treatments? – Euronews

Racing for a cure: where are we with COVID-19 vaccines and treatments? – Euronews

April 10, 2020

SARS-Corona virus 2 (SARS-CoV2), cause of COVID-19, is the infection that the whole world is now trying to beat. The respiratory disease has arguably caused the most serious global crisis since World War II, infecting over one million people and causing more than 70,000 deaths.

As the world grapples with the pandemic, the scientific community is on the hunt for effective, scalable treatments, while at the same time developing a safe and tested vaccine.

It usually takes 10 to 15 years to develop a vaccine.

"For Ebola, we did it in five years, I know we can accelerate that," says Seth Berkley, the CEO of the global health partnership GAVI (Global Alliance For Vaccines and Immunization).

Highly unusually, human trials with an experimental COVID-19 vaccine have already begun. Seattle resident Jennifer Haller became the first person to receive one on March 16 2020, at her hometown's Kaiser Permanente Washington Research Institute.

She was one of a group of volunteers that were involved in testing on humans just weeks into the fast-spreading epidemic.

This experimental vaccine, officially named mRNA-1273, was developed by the National Institutes of Health and Massachusetts-based biotechnology company Moderna Inc. Theres no risk of the volunteers becoming infected, because the shots do not contain the coronavirus itself.

The World Health Organization says there are over 40 potential vaccines. There are reportedly as many as one hundred undergoing development, although only a handful are as yet being clinically tested.

A promising way of combating COVID-19 appears to be with a vaccine that manipulates a part of the virus known as RNA.

"The RNA molecule carries all the coronavirus' genetic information," explains Marie-Paule Kieny, Director of Research at the French Public Health organisation INSERM. "The RNA can be synthesised on a large scale in the laboratory. This is why it's being used in this first vaccine, for which there are clinical trials underway.

"Other vaccines are based on viral DNA, or on other viruses which have been weakened, which don't produce disease and in which we can include the genetic information of the COVID virus."

There are over thirty companies and academic institutions worldwide trying different approaches to find the silver bullet that will beat COVID-19.

In Germany, the biopharmaceutical company Curevac is using the so-called messenger molecule - mRNA - in a vaccine that it believes will be ready for clinical tests in June.

As Curevac spokesperson Thorsten Schller explains:

We use the mRNA to instruct the body to produce its own vaccine, so we only put information into the body. It's a totally new approach in medicine.

Curevac made the front pages when it was reported that US President Donald Trump had offered the company one billion dollars to secure the vaccine exclusively for the United States. But Schller insists the company never received any such offer from the White House or any other US institution:

"Our aim is to develop a vaccine for all people, all over the world. Then the health practitioners have to decide how to distribute such a vaccine.

Ursula von der Leyen, President of the European Commission, has since offered CureVac 80 million euros in research funding to help develop a vaccine.

While the world waits for a vaccine, potentially millions of patients will need treatment. Researchers and doctors have started to test sometimes controversial combinations of existing drugs to treat those infected, but so far there is no cure.

In France, Marseille's University Hospital Institute has offered to test and treat people exhibiting COVID-19-like symptoms. Didier Raoult, head of the institute's infectious diseases department believes that a cheap and easily produced malaria drug can treat COVID-19. Raoult announced promising results on a small sample of patients in late February using Chloroquine and its related compound Hydroxy Chloroquine.

But Marie-Paule Kieny is one of many in the scientific community that are sceptical:

"I know that there's been a lot of talk, in France and elsewhere, about claims by certain researchers who say that this drug works, that this drug will save the world. But unfortunately, for the moment, the proof that this hydroxychloroquine medication is effective is extremely weak, or even non-existent.

Across the border in Italy, doctors at Milans San Raffaele Hospital are using the same combination of drugs suggested by Professor Raoult.

Fabio Ciceri, San Raffaele's Deputy Director explains there are no nationally-approved protocols and each hospital can choose its strategy:

"AIFA, the Italian Medicines Agency, has instructed us on a reasoned use of the drugs. So the drugs we are using are existing drugs, repurposed to be used against the coronavirus, based on laboratory results that demonstrate their potential to be effective".

Unheeded warnings

It's felt by some that the current pandemic could have been avoided, or at least very much better prepared for.

After all, there have been previous coronavirus outbreaks, beginning with SARS in 2003.

In 2015, the software developer and philanthropist Bill Gates gave a Ted Talk in which, three years after the MERS outbreak, he warned that the world was not ready for a future pandemic.

If anything kills over 10 million people in the next few decades its most likely to be a highly infectious virus, rather than a war. Not missiles, but microbes.

"Part of the reason for this is that while we have invested a huge amount in nuclear deterrents, we have actually invested very little in the system to stop an epidemic. We are not ready for the next epidemic.

The warnings of Gates and others went largely unheeded. Some prominent epidemiologists blame a system more focused on commercial opportunities than public health needs.

Stuart Blume, Professor of Science and Technology at the University of Amsterdam agrees that despite the attention the issue has received globally, practical organisation and preparation was definitely lacking:

"All the countries for the last 10 years have been busy with epidemic preparedness scenarios. But they're still all over the place (in terms of) trying to find what to do.

Ildefonso Hernndez Aguado, Professor of Preventive Medicine and Public Health, at Alicante's Miguel Hernndez University says the worldwide financial crisis which began in 2008 influenced this lack of preparedness:

Previously, drills were carried out with a certain frequency to get ready for these events. This came to a halt because of the post-crisis years of austerity.

"Budget cuts were requested and money was saved in sectors that were thought to be inessential. Whats happening could have been foreseen, but policies and decision-making went the other way.


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Racing for a cure: where are we with COVID-19 vaccines and treatments? - Euronews
How the development of a coronavirus vaccine could impact the NBA and its fans beyond this season – Yahoo Sports

How the development of a coronavirus vaccine could impact the NBA and its fans beyond this season – Yahoo Sports

April 10, 2020

There has been much discussion during the coronavirus pandemic about when and how professional sports can return, but one thing has become increasingly clear: The likelihood of packing arenas with tens of thousands of fans any time in the near future, if at all this year, is fast approaching near-zero percent.

According to ESPNs Adrian Wojnarowski, NBA executives and many in sports believe not only that leagues cannot open their doors until there is widespread availability of rapid-response testing, but that those doors will not be opened to fans until the development of a similarly accessible COVID-19 vaccine.

Economically, it may bankrupt them not to play, but in the end I dont think its going to be their decision, Wojnarowski told Scott Van Pelt on SportsCenter on Thursday night. This pandemic is going to decide.

This only reinforces the stark contrast between the NBA and NFL responses to the pandemic.

NFL commissioner Roger Goodell has instructed his charges to virtually conduct business as usual in silence, and the league is planning to start the 2020 season on schedule with fans filling stadiums as early as the Aug. 6 Hall of Fame Game and no contingencies currently in place. Conversely, NBA commissioner Adam Silver has conceded that this season could be lost entirely and next season impacted as well, all as the league office considers alternatives, such as finishing its 2020 campaign without fans at a single site.

Granted, the NBA was in the midst of its season when the coronavirus began to spread across the United States, and the NFL will be the last of the major American sports leagues needing to make firm decisions about its 2020 season. But the thought of fans packing stands seems so far from a possibility right now.

NBA commissioner Adam Silver is considering alternatives that include resuming play without fans. (Stacy Revere/Getty Images)

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and a member of the White House Coronavirus Task Force, has maintained his projection that the development of a vaccine will likely take between 12 and 18 months due to a lengthy trial phase. Oddly enough, Fauci addressed this issue during an Instagram Live Q&A with Golden State Warriors superstar Stephen Curry late last month.

We have started on the development of a vaccine faster than ever in the history of any virus, from the time it was discovered to the time we actually made it and put it into a trial, Fauci told Curry. But when you test the vaccine it takes multiple phases. The first thing you got to do is make sure its safe. We started that a couple of weeks ago. Phase 2 is pretrial to determine if it works. Thats the thing thats going to take an additional eight months or so. So when you add up the three or four months for Phase 1 plus the seven or eight months, you get about a year to a year and a half.

If we really push, we hope that we will know by the time we get into next winter whether or not we have something that works. A vaccine is going to be totally relevant if it cycles into another season, which quite frankly I think its going to do because this virus is very, very transmissible. I cannot imagine its just going to disappear. So vaccines are going to be important the next time around, not for what were dealing with now.

Medical experts abroad have called for relaxed testing regulations to expedite the development of a vaccine by several months, and President Donald Trump has pledged to slash red tape like nobody has ever done it before when it comes to getting very important things to the market medical. Some U.S. health officials have cautioned against fast-tracking a vaccine, citing past cases and unknown side effects.

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Even the earliest possible authorization of a vaccine that has not been fully tested would extend into the projected drop-dead date for the current NBA season and the start of the NFL season. That such a vaccine could be administered widely enough to start filling arenas this summer and fall seems wildly unrealistic.

The NBA and its players association are monitoring the release of rapid-response testing of the coronavirus as a means to resuming this season, according to ESPNs Baxter Holmes. Silver has expressed concern about continued testing if such options are not also widely available to the general public, but the possibility of assessing the health of players in less than 15 minutes at least opens the door to a potential return.

However, should leagues be unwilling to put fans at risk until there is a vaccine, the 12-to-18-month timeline would mean the NBA may have to consider playing the entire 2020-21 campaign inside fan-less venues.

Silver even raised the possibility of limited crowds in his appearance on a Twitter Q&A earlier this week.

Im hoping, at least, that those are short-term issues where we might have to put in effect some sort of social distancing when people first come back to arenas, Silver said. I think a lot of that is specific to this virus and when there might be a vaccine, and if theres an interim period, even when were back to work, where theres not a vaccine yet theres concern about a second wave, what will we need to do?

The answer to that question may be out of Silvers hands entirely. Look no further than UFC president Dana Whites difficulty in trying to host a pay-per-view event scheduled for April 18, despite multiple athletes pulling out of their fights. White moved UFC 249 from Brooklyns Barclays Center to a casino resort on Central California tribal land, where he intended to evade government regulations. Facing public pressure from California politicians, ESPN and its parent company, Disney, urged White to cancel the event. He did.

Likewise, California Gov. Gavin Newsom cautioned against optimism from both Trump and the NFL that football could begin with fans as usual this fall, saying, Im not anticipating that happening in this state.

Ben Rohrbach is a staff writer for Yahoo Sports. Have a tip? Email him at rohrbach_ben@yahoo.com or follow him on Twitter! Follow @brohrbach

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How the development of a coronavirus vaccine could impact the NBA and its fans beyond this season - Yahoo Sports
Why Bluetooth apps are bad at discovering new cases of COVID-19 – The Verge

Why Bluetooth apps are bad at discovering new cases of COVID-19 – The Verge

April 10, 2020

Yesterday, we talked about the things that need to happen before we can begin to slowly re-open our cities: hospital bed supply catches up fully with demand; testing catches up fully with demand; we develop programs for quarantining new cases and informing their contacts that they may have been exposed to the disease; and the number of cases declines for 14 consecutive days.

Today lets zoom in (not Zoom in) on the third point: building systems to enforce quarantine and to trace the contacts of those who get infected. Both are areas where public health officials believe that technology can play a role. But I want to describe why that role might be more limited than you assume and, according to the experts Ive spoken with, much less important than staffing up public health agencies to do the primary work.

First lets talk about quarantine enforcement making sure that people the state has ordered to stay at home are actually doing so. This is an area where technology can play and is playing a huge role. Ive mentioned Taiwans electronic fence in this column a few times already, but heres a quick refresher from Reuters:

The system monitors phone signals to alert police and local officials if those in home quarantine move away from their address or turn off their phones. Jyan said authorities will contact or visit those who trigger an alert within 15 minutes.

The technology here is not particularly complicated. With the cooperation of a telecom company, you can tie a persons phone to a single cellular tower. If the phone pings another tower, or shuts off, the public health authorities contact you. This approach is invasive, somewhat disturbing, and by all accounts quite effective. Its not clear to me how a similar program could be implemented without new legislation giving telecom companies explicit permission to share this kind of data my inbox is full of lawmakers (appropriately!) calling for safeguards and oversight on any such government surveillance. But if the recent stimulus packages are any indication, that also seems like legislation that could be written and passed very quickly.

Note that tech alone doesnt solve the enforcement problem. You also need people calling patients whose phones appear to be moving or have been shut off. You need people doing spot checks to make sure the person under quarantine hasnt simply left their phone at the house and gone to church. And you probably need a place to house quarantined people that is not with their families, which are the most likely places for the coronavirus to spread. Tech is necessary, in other words, but not sufficient.

Now lets talk about what might be the most challenging piece in the entire stack: contact tracing. Public health experts tell me that getting in touch with people who may have been exposed to a known COVID-19 case is one of the most important steps well need to take to contain future outbreaks. But the how of it is complicated. While weve seen a Cambrian explosion of contact tracing apps around the world, it remains unclear how good or effective any of them have been. And as US government officials consider asking big tech companies to consider working on contact tracing solutions and Im told that they have already made inquiries with Facebook thats worth keeping in mind.

To get a sense of how this played out in one country that has done a relatively good job containing the coronavirus outbreak, lets turn to South Korea. Derek Thompson has a good piece on contact tracing in the Atlantic that describes how it has played out there. The country seemingly skipped over traditional contact tracing completely and went straight to putting new coronavirus victims on blast in the new public square other peoples smartphones:

The government uses several sources, such as cellphone-location data, CCTV, and credit-card records, to broadly monitor citizens activity. When somebody tests positive, local governments can send out an alert, a bit like a flood warning, that reportedly includes the individuals last name, sex, age, district of residence, and credit-card history, with a minute-to-minute record of their comings and goings from various local businesses. In some districts, public information includes which rooms of a building the person was in, when they visited a toilet, and whether or not they wore a mask, Mark Zastrow, a reporter for Nature, wrote. Even overnight stays at love motels have been noted.

New cases in South Korea have declined about 90 percent in the past 40 days, an extraordinary achievement. But the amount of information in South Koreas tracing alerts has turned some of its citizens into imperious armchair detectives, who scour the internet in an attempt to identify people who test positive and condemn them online. Choi Young-ae, the chair of South Koreas Human Rights Commission, has said that this harassment has made some Koreans less willing to be tested.

So far, South Korea appears to be an outlier in this approach. Other countries are opting to build much more targeted interventions, using phones GPS and Bluetooth signals to passively track the proximity between individuals and inform potential contacts after someone gets infected. Singapore, which built an app called TraceTogether that monitors Bluetooth activity, offers perhaps the most likely model for the West, Thompson writes. The country is making TraceTogether available as an open-source project.

To the extent that theyve been written about to date, these passive tracking apps are generally considered in terms of their privacy implications. Who collects the data? Where does it get shared? Can it be linked back to individual patients? How long should that information be stored?

Already, various academics and entrepreneurs are working on passive tracking apps that attempt to solve these issues. At Wired, Andy Greenberg reviews three such efforts, and all of them are absolute Rube Goldberg machines. Heres one of the apps under development:

Covid-Watch uses Bluetooth as a kind of proximity detector. The app constantly pings out Bluetooth signals to nearby phones, looking for others that might be running the app within about two meters, or six and a half feet. If two phones spend 15 minutes in range of each other, the app considers them to have had a contact event. They each generate a unique random number for that event, record the numbers, and transmit them to each other.

If a Covid-Watch user later believes theyre infected with Covid-19, they can ask their health care provider for a unique confirmation code. (Covid-Watch would distribute those confirmation codes only to caregivers, to prevent spammers or faulty self-diagnoses from flooding the system with false positives.) When that confirmation code is entered, the app would upload all the contact event numbers from that phone to a server. The server would then send out those contact event numbers to every phone in the system, where the app would check if any of the codes matched their own log of contact events from the last two weeks. If any of the numbers match, the app alerts the user that they made contact with an infected person, and displays instructions or a video about getting tested or self-quarantining.

All of these efforts seem to skip over the question of whether a Bluetooth-reported contact event is an effective method of contact tracing to begin with. On Thursday I spoke with Dr. Farzad Mostashari, the former national coordinator for health information technology at the Department of Health and Human Services. (Today hes the the CEO of Aledade, which makes management software for physicians.) Mostashari had recently posted a Twitter thread expressing skepticism over Bluetooth-based contact tracing, and I asked him to elaborate.

The first problem he described is getting a meaningful number of people to install the app and make sure its active as everyone makes their way through the world. Most countries have made app installation voluntary, and adoption has been low. In Singapore, Mostashari told me, adoption has been about 12 percent of the population. If the United States had similar adoption, youve now made your big contact-tracing bet on the likelihood that two people passing one another have both installed this app on your phone. The statistical likelihood of this is about 1.44 percent. (It could be higher in areas with greater population density or where the app was more widely installed.)

The second problem is that when these Bluetooth chips do pass in the night, you should expect a large number of false positives.

If I am in the wide open, my Bluetooth and your Bluetooth might ping each other even if youre much more than six feet away, Mostashari said. You could be through the wall from me in an apartment, and it could ping that were having a proximity event. You could be a on a different floor of the building and it could ping. You could be biking by me in the open air and it could ping.

All of this seems really problematic even before you consider asking Apple or Google or Facebook to make a contact tracing app and promote it through their own channels. Weve spent three and a half years having a discussion about the shortcomings of these companies when it comes to protecting our data privacy; putting them in a position to oversee a project as intimate and sensitive as disease infection seems like a bad idea. (My own sense in talking from executives at Google and Facebook in recent days is that they are eager to help with crisis response, and are already doing so in various ways, but basically have no interest in this particular part of the response.)

So that leaves us with two remaining questions: what should Big Tech do, and what should the government do?

Public health experts Ive talked with have been enthusiastic about efforts from Facebook and Google to use aggregated, anonymized data to display movement patterns an important measure of the effectiveness of stay-at-home orders. They like Apples COVID-19 screening tool and Facebooks collaboration with Carnegie Mellon University to encourage users to self-report symptoms to the university, not to Facebook. These projects wont solve the crisis on their own, but theyre good and useful tools for giving public health officials something close to a real-time look at how the disease is spreading through communities. And if there are other tools that they can build particularly ones that rely on aggregated and anonymized data, rather than personally identifiable information I think companies should continue exploring them.

And what about the government? The good news is that our public health infrastructure already has a lot of practice with contact tracing, thanks to our dear old friend the sexually transmitted infection. Come down with HIV, chlamydia, or gonorrhea, and a good county health agency will work with you to contact anyone you may have exposed since becoming infected. (Heres a good piece by Ryan Kost in the San Francisco Chronicle about how the citys experience with HIV/AIDS in the 1980s led it to dramatically beef up its public health infrastructure, which contributed to its admirably quick response to the threat of COVID-19.)

Those same tactics public health investigators making phone calls and working out in the community seem to be the most effective tool we have for contact tracing. And the good news is that savvy public health departments like San Franciscos are already ramping up. Heres James Temple in the MIT Tech Review on what he describes as one of the first such efforts in the country:

The Department of Public Health is supplementing its own staff with city librarians and dozens of researchers, medical students, and others from the University of California, San Francisco. City health workers have already been contact tracing on a small level, but they plan to significantly scale up the effort over the next few weeks. The team includes about 40 people and could rise as high as 150.

The task force will interview every patient who tests positive and provide necessary support to ensure that all are completely isolating themselves, down to helping them find and get to shelter if necessary. They also expect to reach out to between three and five people that patients came into contact with in the preceding days. Theyll alert them they may have been exposed, ask them to limit their contacts, and either encourage them to go in for a test or bring one to them. Those who test positive will trigger additional rounds of interviews and contact tracing.

Experts Ive spoken to say that there are software tools that could help public health workers: a website or app where people affected by COVID-19 can voluntarily upload their contacts, for example, making tracing easier for the health department. But you still need people to contact them.

Tom Frieden, a former director of the Centers for Disease Control and Prevention, told me a story to illustrate this point. Earlier in his career, when he was working on disease prevention with the New York City Department of Health and Mental Hygiene, his team was tracking a young man who suffered from drug-resistant tuberculosis. The man wound up in juvenile detention, but then escaped. He had no cell phone to trace. But Frieden dispatched a team to find him, and eventually succeeded and got him into treatment.

The point was that you cannot design a Bluetooth app that finds this man.

But you can hire people to find him. Frieden says we will need an extraordinary amount of people as many as 300,000, he says. Youre talking about something like a hundred-fold increase in public health capacity, Frieden said. A lot of it can be done by phone banking. But a lot of it involves going out there and knocking on doors.

The good news is that there are a lot of people who are recently out of work and may be considering new career opportunities. It seems like one of the best ways we could spend stimulus money is in helping state and county health programs expand their capacity to hire people for contact tracing.

And we can keep exploring new tech-driven solutions for contact tracing, too. But for now it seems worth saying that theres little evidence that phones are good at contact tracing and a lot of evidence that human beings are. As we prepare to begin re-opening society, the biggest investment we need to make is in people.

* * *

What did I miss? What did I leave out? Im a bit out of my comfort zone here, so if Ive made a mistake in my facts or logic please let me know so I can fix it and share with everyone in our next issue.

Today in news that could affect public perception of the big tech platforms.

Trending up: TikTok pledged $375 million in support of COVID-19 relief efforts. The aid includes $250 million in funds, $100 million in ad credits, and $25 million in ad space for public health information.

Trending up: Facebook is donating another $2 million to mental health resources amid fears that the pandemic will lead to increased depression and related issues.

Trending down: Amazon workers at a fulfillment center in Riverside, California filed a complaint yesterday, asking the state to investigate what they say are dangerous working conditions that pose a threat to public health during the coronavirus pandemic.

How Zoom CEO Eric Yuan built a conferencing app that suddenly became the social network of the pandemic. I never thought that overnight the whole world would be using Zoom, he says. Unfortunately, we did not prepare well, mentally and strategy-wise. (Drake Bennet and Nico Grant / Bloomberg)

Elizabeth Warren sent a letter to Zoom CEO Eric Yuan demanding information about the companys privacy policies, particularly as they relate to children. The letter details a number of Zooms recent security and privacy issues, including the recent Zoombombing harassment attacks. (Russell Brandom / The Verge)

Jeff Bezos made a surprise visit to an Amazon warehouse near Dallas, where employees are working hard to meet a surge in online orders as customers shelter at home. The move comes amid lingering concerns about worker safety at the companys warehouses. (Spencer Soper / Bloomberg)

A manager at an Amazon warehouse in Pennsylvania told staff not to touch shipments from another Amazon facility for 24 hours, since that facility had seen a cluster of COVID-19 cases. The Occupational Safety and Health Administration is opening an investigation into working conditions at the warehouse. (Matt Day, Spencer Soper, and Josh Eidelson / Bloomberg)

Instacart is introducing a pair of new delivery options in an attempt to deal with increased demand due to COVID-19. Fast & Flexible and Order Ahead are both designed to increase the number of available delivery windows, depending on whether customers are willing to be flexible with delivery times or if they want to plan ahead. (Jon Porter / The Verge)

Yelp is cutting 1,000 jobs and furloughing another 1,100 employees amid a massive drop in business. Its the latest company catering to small businesses that has seen much of its customer base decimated amid the COVID-19 outbreak and related shutdowns. (Ina Fried / Axios)

A simulation from researchers in Belgian showing runners and bikers put other people at risk by spreading droplets when they exhale, cough, or sneeze has gone viral. But the findings havent been published in a study (even one thats not peer-reviewed). Its another case of an armchair epidemiologist going viral on Medium with shoddy science. (Jason Koebler / Vice)

Universities are rolling out chatbots and virtual assistants whose speed and tone can simulate text conversation, as students continue to learn remotely. Some can help students navigate issues they might have learned about on a campus visit, like plans for orientation and choosing classes. (Laura Pappano / The New York Times)

Chinese companies are going to extreme lengths to stave off new outbreaks of the novel coronavirus as they reopen for business. Theyre now required to supply employees with face masks and check everyones temperature daily. Its a crucial test of whether a country can keep the infection curve flat after lifting social distancing. (Eva Dou / The Washington Post)

The Unicode Consortium, the group behind emoji releases, announced it wont release new emoji next year. The good news is that the emoji that were announced earlier this year, like the olive, beaver, and plunger, will still be available this fall. (Ashley Carman / The Verge)

Microsoft thinks the coronavirus pandemic will change how we work and learn forever. The company just released a report about remote work habits, noting that demand for Microsoft Teams surged worldwide last month, jumping from 32 million daily active users to 44 million in just a week. (Tom Warren / The Verge)

Webcams have become impossible to find as people stay quarantined at home. Third-party resellers have seized upon the scarcity by marking up webcams at ludicrous prices. (Chris Welch / The Verge)

A surge in internet usage is straining our networks. But its also prompting a wage of updates and upgrades that are making the internet stronger than ever. (Will Douglas Heaven / MIT Technology Review)

The volume of phone calls has surged more than internet use as people want to hear each others voices in the pandemic. Its a trend that has surprised even the biggest telecom providers. (Cecilia Kang / The New York Times)

Total cases in the US: At least 449,260

Total deaths in the US: More than 16,000

Reported cases in California: 19,043

Reported cases in New York: 159,937

Reported cases in New Jersey: 51,027

Reported cases in Michigan: 20,220

Reported cases in Louisiana: 18,283

Data from The New York Times.

The politics of 2020 now look much less ominous for Big Tech. The combination of changing priorities due to the coronavirus pandemic, along with critics like Bernie Sanders and Elizabeth Warren dropping out of the presidential race, mean the techlash has largely faded away. Heres Eric Newcomer at Bloomberg:

Bidens attacks have never provoked the concerns as those from Sanders and Warren. He has deep ties to the tech industry; his former director of communications, Jay Carney, is now Amazons top spokesman. Biden has also repeatedly framed his administration as a continuation of the Obama years, and several former Obama officials have set up shop in Silicon Valley.

While the tech industry rank-and-file mostly donated to the industrys antagonists, its executives seemed most excited about younger moderates Pete Buttigieg and Cory Booker. Biden is a happy consolation prize.

Antitrust regulators in France ordered Google to pay publishers to display snippets of their articles on the companys news service. The regulators gave Google three months to work out a deal with publishers. (Gaspard Sebag / Bloomberg)

Facebook is testing out a new feature called Campus which can only be accessed by college students, according to expert app researcher Jane Manchun Wong. The feature requires a .edu email address. Once youre in, you can fill out a profile with your graduation year, major, minor and dorm if you want to find friends. (Mariella Moon / Engadget)

Facebook is adding a quiet mode that mutes most notifications. This feels like a move from a time when we all cared about how much we were looking at our screens. (Nick Statt / The Verge)

Stuff to occupy you online during the quarantine.

Watch Sheryl Sandberg interview Dr. Julianne Holt-Lunstad, who researches the health impacts of loneliness, about staying emotionally healthy while physically distancing.

Watch a new music video from Thao & The Get Down made entirely on Zoom. The Oakland-based band had to pivot their plans for a live music video shoot due to the coronavirus pandemic. (Dani Deahl / The Verge)

Watch a new Saturday Night Live this weekend. The show is returning with fresh comedy with everyone working remotely.

Send us tips, comments, questions, and your tech solutions for contact tracing: casey@theverge.com and zoe@theverge.com.


Read more here: Why Bluetooth apps are bad at discovering new cases of COVID-19 - The Verge
Will Transmission Of COVID-19 Be Slowed By Summer’s Heat And Humidity? : Goats and Soda – NPR

Will Transmission Of COVID-19 Be Slowed By Summer’s Heat And Humidity? : Goats and Soda – NPR

April 10, 2020

The coronavirus outbreak began during the cold of winter in Wuhan, China. Scientists are asking if heat and humidity in countries like Malaysia (right) and in regions where summer is soon starting could slow transmission. Nicolas Asfouri/AFP via Getty Images; Lim Huey Teng/Reuters hide caption

The coronavirus outbreak began during the cold of winter in Wuhan, China. Scientists are asking if heat and humidity in countries like Malaysia (right) and in regions where summer is soon starting could slow transmission.

The worst outbreaks of COVID-19 so far have been in colder parts of the Northern Hemisphere during winter or early spring. Will warmer weather slow the transmission?

Could the Southern Hemisphere see outbreaks intensify as that part of the globe moves into winter?

And is it possible that transmission might be naturally interrupted as it is each year for the seasonal flu?

These are some of the key questions about COVID-19 that scientists are trying to answer.

"The seasonality of flu and other respiratory viruses has been known for hundreds of years, if not thousands," says Akiko Iwasaki, a professor of immunobiology at the Yale University School of Medicine. "During the winter months, we tend to have a surge in the cases of respiratory infection, including the influenza viruses."

There are a number of factors that contribute to why the flu arrives in the winter, but Iwasaki says the primary factor is the relative humidity of the air. In winter, the drop in the amount of water vapor in the cold, dry air makes it easier for viruses to become airborne.

This makes what Iwasaki calls the "perfect setting" for respiratory viruses to transmit.

"When you cough or sneeze or even talk, you're generating these droplets that are coming out of your mouth," she says. "And some of them, if you're infected, will contain virus particles. In very arid conditions, those particles lose the water vapor and they become airborne." This allows the virus to persist in the air for a long time, much longer than in summer.

Of course, she's talking about traditional cold and flu viruses that have been studied for years.

The question is whether the new coronavirus will also behave this way.

Iwasaki thinks so.

"This novel coronavirus is a cousin of the coronaviruses that are circulating in humans and just causing the common cold," she says. "So the property of the virus is likely to be similar to the common cold version of the coronavirus. So I would expect that this [new] coronavirus can also stay in the air better at lower relative humidity, meaning the indoor conditions that you find in the winter months." Meaning that it would be more likely to spread in winter.

But for this to happen, there has to be airborne transmission.

The World Health Organization and the U.S. Centers for Disease Control and Prevention in their guidance on SARS-CoV2 downplay airborne spread, saying instead that the primary form of transmission is by "large respiratory droplets."This debate airborne vs. droplets is a crucial divergence in thought when it comes to figuring out if COVID-19 is going to be seasonal. If the primary form of transmission is airborne, then the novel coronavirus could become a seasonal disease. If it mainly spreads through "large respiratory droplets", then seasonality is less likely.

There's evidence pointing toward both possible transmission routes.

The transmission through "large respiratory droplets" works this way. When an infected person sneezes or coughs, virus-laden spittle flies out into the air. The particles, which may even be big enough to see, don't go very far: WHO estimates they travel about 3 feet before dropping onto surfaces directly around the infected person.

According to this model, if a person with COVID-19 is eating at restaurant, they're far more likely to infect someone at their table than someone across the room.

So if the new coronavirus primarily spreads this way on large droplets, seasonality may not matter.

Studies out of Asia have documented this type of spread among people in close contact to one another.

And in 2003, another deadly coronavirus that's closely linked to SARS-CoV 2 the offical name of the current coronavirus severe acute respiratory syndrome is believed to have spread primarily through large droplets.

But researchers in the U.S. have aerosolized the novel coronavirus in laboratory settings mechanically spraying virus into the air so that it floats. They found it can remain in the air for more than an hour. At certain temperatures and humidity levels, they've seen in preliminary results that aerosolized particles can remain suspended in the air even longer than some flu viruses.

WHO agrees that the new coronavirus can be aerosolized, especially during some invasive medical procedures, but the global health body insists this isn't a primary form of transmission.

Iwasaki disagrees.

"I would be quite surprised actually, if this novel coronavirus isn't aerosolized," she says. "Why would it be different from other types of respiratory viruses?"

But other researchers caution against assuming that any new virus, regardless of how it spreads, will follow a seasonal pattern.

"With a new virus coming into the population, everybody is susceptible," says Anice Lowen, an associate professor of microbiology and immunology at Emory University. She notes that no one has had a chance to develop immunity: "Everybody is sort of fair game for an infection [from] that virus. So it makes the virus transmit much more readily, such that it may continue to transmit even when the climactic conditions ... or the season ... is not optimal for transmission."

She says this new coronavirus may well continue to spread straight through the summer here in the U.S..

Lowen points out that when the H1N1 influenza virus emerged in 2009, it didn't start in winter the way the seasonal flu does.

"The 2009 pandemic started in April and May," she says, "well outside the normal seasonality."

Eventually the H1N1 virus did fall into a more traditional seasonal pattern, but it took several years.

Ben Cowling, an epidemiologist at the University of Hong Kong, also says higher temperatures haven't seemed to have stopped the spread of this virus.

"What we've seen in Southeast Asia is that there was heavy seeding of infections [from China] into Thailand, into Malaysia, Indonesia and some other places which are relatively hotter," he says. "And it looks at the moment like spread of infection has been a little bit slower in some of the hotter countries than in the cooler countries. So my interpretation is there's a little bit of seasonal pressure, perhaps reducing transmission by 10 percent, but that's not nearly enough to stop an epidemic from occurring when we have such a high basic transmissibility."

Even in the U.S. Southern states like Florida and Louisiana have been hard-hit along with colder states like New York and Michigan.

But the worst outbreaks so far globally have been in cooler locations. So as the Southern Hemisphere moves into winter, researchers will be watching closely whether transmission of SARS-CoV 2 increases in South America, Africa and Oceana as the temperature drops.


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Will Transmission Of COVID-19 Be Slowed By Summer's Heat And Humidity? : Goats and Soda - NPR
Here’s how projected Covid-19 fatalities compare to other causes of death – STAT

Here’s how projected Covid-19 fatalities compare to other causes of death – STAT

April 10, 2020

The numbers seem catastrophic, overwhelming, beyond a magnitude that the human mind or heart can grasp: What do 60,000 or even 240,000 deaths look like?

Those are roughly the lower and upper limits of projected fatalities in the U.S. from Covid-19 in models that have been informing U.S. policy. Last month, when the lower estimate was 100,000, the White House recommended nationwide countermeasures. Those started with a ban on gatherings and quickly escalated to closing schools and businesses, advising people to wear face masks, and reminding them to stay physically apart. This week, when the lower estimate (from the Institute for Health Metrics and Evaluation) dropped to 60,000, reflecting how well those measures are working, it stoked optimism that the epidemic might soon end with less loss of life.

The lower number, 60,000, is a little more than the capacity of Dodger Stadium in Los Angeles. It is the number of passengers in 180 full jumbo jets. It is more than the number of U.S. combat deaths in the Vietnam War.

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And 240,000, of course, is four times any of the above.

But are these large numbers or small numbers? At the beginning of the pandemics spread in the U.S., President Trump dismissed early projections of thousands, even tens of thousands, of U.S. deaths as no worse than the lives lost in an average influenza year. So far this season, flu deaths total 24,000 to 63,000 (data from the Centers for Disease Control and Prevention are estimates with wide uncertainties).

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Whether you think a multiple of up to 10 on top of that is a tragedy or merely unfortunate is a personal call. For what its worth, about 8,000 Americans die every day from, almost overwhelmingly, diseases and other natural causes. Those, of course, havent stopped; Covid-19 deaths are in addition to those (with a caveat noted below).

To make these numbers easier to grasp, we show how 60,000 to 240,000 compares to some of the leading causes of death and to previous pandemics.

One note about methodology: The projected Covid-19 deaths come from models that see the number of cases and deaths plateauing nationally in the next few weeks, as they have already done in Seattle, San Francisco, and other places that were hit first. If stay-at-home orders and other countermeasures keep working, there should be few deaths after July. We therefore treated the 60,000 to 240,000 deaths as occurring over five months, from March to July, as the IHME researchers do, and therefore calculated five months worth of cancer, heart disease, and other deaths. Of course, as Anthony Fauci, a member of the White House Covid-19 task force, told a JAMA webcast this week, the new coronavirus is not going to disappear from the planet, for sure, after July.

But the concentration of deaths is truncated into weeks, said Fauci, director of the National Institute of Allergy and Infectious Diseases. That is what captures our attention and overwhelms hospitals.

Covid-19 is particularly severe in and more likely to kill the elderly and people with existing illnesses, including heart disease. Some people taken by Covid-19 would likely have died from these diseases even in the five-month time frame. We do not try to calculate how many of the Covid-19 deaths substitute for other deaths; that is an important calculation that researchers will be eager to do once the crisis passes.

You may believe a different methodology paints a truer picture of how Covid-19 deaths compare to others. As we said, how to think about deaths is deeply personal.


Originally posted here: Here's how projected Covid-19 fatalities compare to other causes of death - STAT
COVID-19 clinicians wrestle with false negative results – The Verge

COVID-19 clinicians wrestle with false negative results – The Verge

April 10, 2020

As the rate of COVID-19 testing slowly creeps up in the US, public health experts have a new concern that many people with negative test results actually have the virus.

If you have had likely exposures and symptoms suggest Covid-19 infection, you probably have it even if your test is negative, wrote Harlan Krumholz, a professor of medicine at Yale, in The New York Times.

Doctors and clinicians struggle with test accuracy all the time, across all areas of medicine. No test is perfect. Under normal circumstances, though, they understand the factors that contribute to false negative or false positive results from a particular test. They might also have more extensive data on the test that helps them interpret what it says. Not in this case.

Theres a lot of talk saying its a bad test. I think its not that the test is bad, says Catherine Klapperich, director of the Laboratory for Diagnostics and Global Healthcare Technologies at Boston University. Instead, she says, the health care providers and patients dont have the information they need to fully understand their test results.

The bulk of the tests done in the US for COVID-19 use a technique called PCR, which looks for bits of the new coronavirus in a mucus sample taken from a patient. PCR works well, and it will flag a sample as positive even if there are only a few copies of the virus in it.

The problem is that the virus doesnt tend to stay in an easily accessible part of the body. It lurks in the nasopharynx, where the back of the nose meets the top of the throat. To test someone for the new coronavirus, doctors and nurses have to stick a very long swab very deep into their nose. Its not rocket science, but you have to be trained to do it, Klapperich says. Many false negative test results are probably because the swab wasnt done correctly.

Doctors also dont know when in the course of a COVID-19 illness the test works best. The data on the tests false negative rate jumbles together all of the tests that have been done. It hasnt broken out the false negative rates of tests done at different times during the progression of the disease. The false negative rate for tests done right when someone starts feeling sick, for instance, might be different than that same rate for tests done when people are hospitalized.

All tests are wrong sometimes, but clinicians are more comfortable with false results for certain types of tests than they are others. There are variables that affect your tolerance for false negatives and positives, Klapperich says.

On a screening test for HPV, a virus that can lead to cervical cancer, a false positive result is usually less dangerous than a false negative result. Someone with a positive test result will have additional follow-up tests to confirm if they actually have HPV and if they need additional treatment. In that case, if the positive result is incorrect, that can be corrected. If someone tests negative incorrectly, it could delay treatment. The anxiety and unnecessary follow-up tests that can come from a false positive result can cause harm. But for HPV, its not as risky as a false negative.

With the new coronavirus, its the opposite. If someone is told they have COVID-19, theyll be told to quarantine. Theyll be alone, and stressed but safe. If you tell them theyre negative and theyre not, they could infect other people, Klapperich says. As the consequences of this pandemic keep changing, health care workers treating patients with COIVD-19 are constantly reevaluating their tolerances for false positive or false negative testing results, she says.

Doctors have to decide if they can trust a negative test enough to stop wearing protective equipment when treating a hospitalized patient or if the clinical symptoms look enough like COVID-19 that the negative result doesnt matter.

Normally, retesting sick patients could be a straightforward way to compensate for a less-accurate test. For something like a strep test, when a result doesnt match a patients symptoms, a doctor can do a second type of test or a repeat test. Limited testing resources, though, make that much more challenging for COVID-19.

Ideally, if someone tests positive, youll say theyre positive. If theyre negative and have symptoms, they could get another test. We cant do that now, Klapperich says. We dont have luxury of rerunning a test or sending someone for a test thats complementary to get more data.

Instead, doctors and patients have to decide on the fly what to do with a single negative or positive COVID-19 test. When they have more experience with a test, theyre better equipped to make those decisions. Mammograms are good examples, Klapperich says. False positives on those tests, which screen for breast cancer, happen fairly often. People have the experience to say, oh, you have a spot. Clinicians are trained to say that this is usually not a big deal.

The coronavirus test is much newer than mammograms or tests for strep and HPV, and clinicians dont have as much clear data to inform their interpretation of results. Theres an interplay between the test and how well it does, and how people receive the test results, Klapperich says. Do they trust them? Do they trust the guidelines that go along with the test?

Klapperich thinks there will be better information for both patients and providers available soon. Many clinicians are keeping good records and storing patient samples after theyve been tested while carefully noting when in the course of an illness the sample was taken. Soon, she says, theyll be able to figure out how accurate the test is at different points in a case of COVID-19. That should help doctors make more confident recommendations that incorporate both when a test was done and what a patients symptoms are.

The limitation right now is that people doing the testing are focused on patients, she says. When things settle down, and they dont have to focus on patients every minute, theyll do those studies.


See the original post here: COVID-19 clinicians wrestle with false negative results - The Verge