City of Sioux Falls working on its own COVID-19 peak model – KELOLAND.com

Alain Mrieux, founder of BioMrieux.

Latest update: April 2, 2020, at 7:14 pm ET.

Businesses around the world are shifting into overdrive to help battle the coronavirus, providing everything from rubber gloves and ventilators to diagnostic tools and, hopefully soon, vaccines. While the pandemic continues to wreak havoc, large corporations and small businesses are developing creative solutions to halt the spread of the virus.

Just as automakers famously shifted to make tanks and planes during World War II, todays global giants LVMH, Ford and GE to name a few are retooling their production lines to help make everything from hand sanitizers to respirators. On the medical front, there are more than three dozen COVID-19 vaccines under development, a smart move considering that two out of every three vaccines for infectious diseases fail, according to a study by the Massachusetts Institute of Technology.

Forbes will continue to update this list of private companies and how they are stepping up to fight the COVID-19 pandemic:

Testing:

Abbott Laboratories: Abbott Park, Illinois healthcare firm obtained emergency FDA authorization for its 5-minute coronavirus testing kit on March 27, with plans to start manufacturing 50,000 kits a day.

Alphabet: Through its healthcare arm Verily, Googles parent company launched a website where users can find nearby testing sites in four California counties.

Jeff Bezos.

Amazon: Jeff Bezos retail behemoth invested $20 million in the Amazon Web Services Diagnostic Initiative, which aims to speed up delivery of COVID-19 tests to the market.

BioMrieux: French biotech company, founded by billionaire Alain Mrieux,received emergency FDA approval for its subsidiarys new testing kit, which cuts testing times for the virus down to 45 minutes.

Carbon: California-based 3D printing unicorn backed by Russian tech investor Yuri Milner will soon be distributing testing swabs and face shields to hospitals in the Bay Area.

Cellex: North Carolina biopharma firms antibody-based test for COVID-19 received emergency approval from the FDA.

Cepheid: Sunnyvale, California molecular diagnostics company gained emergency FDA authorization for its new 45-minute COVID-19 testing kit.

Copan Diagnostics: Family-owned company located at the heart of Italys hard-hit Lombardy region makes diagnostic swabs for testing, airlifting 500,000 swabs to the U.S.

DiaSorin: Italian biotech company owned by billionaire Gustavo Denegri obtained emergency authorization from the FDA for its new 60-minute testing kit for COVID-19.

Ipsum Diagnostics: Sandy Springs, Georgia diagnostic company gained emergency FDA authorization for its COVID-19 testing kit.

Mammoth Biosciences: South San Francisco-based biotech startup, founded by three 30 Under 30 alums, prototyped a rapid test by using the gene-editing tool Crispr to detect the disease.

Mesa Biotech: San Diego biotech business obtained FDA approval for its new 30-minute testing kit for COVID-19.

Puritan Medical Products: Maine-based diagnostic maker, one of the worlds largest makers of diagnostic swabs along with Italys Copan Diagnostics, is reportedly increasing production to make one million COVID-19 testing swabs a week.

QIAGEN: Hilden, Germany-based molecular diagnostics firm received emergency approval from the FDA for its new COVID-19 testing kit.

Siemens Healthineers: The German conglomerates healthcare unit received FDA clearance for its blood gas analyzer, which helps doctors monitor the conditions of critical COVID-19 patients in ICUs; the firm is also applying for emergency FDA and WHO approval for its rapid testing kit.

Treatments:

AbbVie: North Chicago-based, publicly traded pharma firm is collaborating with authorities in the EU, the U.S. and China on experimental use of its HIV drug lopinavir/ritonavir to treat COVID-19.

AIM Immunotech: Florida-based pharmaceutical company announced on March 9 it would begin experimental testing of its chronic fatigue syndrome drug rintatolimod as a treatment for COVID-19 in Japan, at the National Institute of Infectious Diseases and the University of Tokyo.

Algernon Pharmaceuticals: Vancouver-based pharmaceutical firm is requesting FDA approval to begin trials of its chronic cough medication ifenprodil as a treatment for COVID-19.

AlloVir: Houston-based cell and gene therapy company is collaborating with Baylor College of Medicine to discover and develop T-cell therapies to fight COVID-19.

Apeiron Biologics: Vienna-based biotech firm announced it would begin a trial of its immunotherapy treatment on 200 COVID-19 patients in Austria, Germany and Denmark.

Ascletis: Hangzhou, China pharmaceutical company announced results of clinical trials of its antiviral drug danoprevir on COVID-19 patients in China; the small-scale study found that danoprevir combined with ritonavir is safe and well tolerated in all patients.

Bioxytran: Boston-based biotech outfit is developing a viral inhibitor to treat COVID-19.

Celltrion: South Korean healthcare firm is developing an antiviral treatment for COVID-19 as well as rapid self-testing kits that would provide results within fifteen to twenty minutes.

Celularity: New Jersey-based therapeutics startup obtained FDA clearance to begin trials of a potential stem cell treatment against COVID-19.

Cocrystal Pharma: Bothell, Washington pharma outfit is developing antivirals to treat COVID-19 using patents it recently acquired from the Kansas State University Research Foundation.

CytoDyn: Vancouver, Washington biotech firm announced preliminary results from three days of testing its antiviral drug leronlimab on COVID-19 patients in New York; the company stated in a press release that test results from the first four patients suggests immunological benefit within three days following treatment with leronlimab.

Eli Lilly: Indianapolis pharma company is partnering with Vancouver-based biotech outfit AbCellera to develop antibody-based treatments for COVID-19.

Emergent BioSolutions: Maryland drugmaker is developing treatments derived from the antibodies found in the blood of people who tested positive for the disease.

EUSA Pharma: British pharmaceutical firm initiated trials of its siltuximab antibody treatment on COVID-19 patients at the Papa Giovanni XXIII hospital in Bergamo, Italy; the company released initial data on April 1 showing that one third of patients experienced clinical improvement with reduced need for oxygen support and a further 43% saw their disease stabilise.

Fujifilm Toyama Chemical: Tokyo-based conglomerates flu drug favipiravir has shown promising results in early clinical trials on COVID-19 patients in China, and the company is investing $83 million in its biological manufacturing capabilities.

Gilead: The Californian biotech giant initiated clinical trials in March for its antiviral drug remdesivir on patients in the U.S.

Harbour BioMed: Cambridge, Massachusetts biomedical firm announced a collaboration with New Yorks Mount Sinai Health System to develop new human antibodies to treat COVID-19.

I-Mab Biopharma: Shanghai-based biopharma outfit announced it would begin clinical trials of its TJM2 antibody treatment on COVID-19 patients in the United States, with plans to expand to other countries affected by the pandemic.

ImmunoPrecise: Canadian life sciences company is teaming up with New York-based AI startup EVQLV Inc on researching antibody-based therapies and a vaccine for COVID-19.

Innovation Pharmaceuticals: Wakefield, Massachusetts biopharma firm is researching the use of its drug brilacidin part of a category of investigational new drugs called defensin mimetics, which could have antimicrobial effects as both a treatment and a vaccine for COVID-19, in separate efforts with a major U.S. university and with the Department of Health and Human Services.

ISR Immune System Regulation: Swedish immunotherapy firms subsidiary, ISR HBV, is conducting toxicological studies to determine whether its Immunolid ISR50 treatment could be used against COVID-19.

Kamada: Israeli pharmaceutical company is working on an antibody-based treatment for COVID-19 using the blood plasma of patients who recovered from the disease.

Mateon Therapeutics: Californian biopharma firm is testing a number of antiviral drugs as potential treatments for COVID-19 and is preparing to submit an application to the FDA in order to begin clinical trials on patients.

Merck KGaA: Darmstadt, Germany-based pharma multinational donated a supply of its multiple sclerosis drug interferon beta-1a to the French National Institute of Health and Medical Research in Paris for clinical trials on COVID-19 patients. The companys North American life sciences arm, MilliporeSigma, is supplying several vaccine efforts with reagents and other essential raw products for vaccine development.

Mesoblast: Australian medical firm is working with authorities in the U.S., Australia, China and Europe to evaluate the use of its remestemcel-L drug to treat COVID-19.

Mylan: Pennsylvania-based pharmaceutical firm restarted production of hydroxychloroquine, a drug used to fight lupus, malaria and arthritis, at its West Virginia factory; the drug is being tested as a treatment for COVID-19 in human trials in New York.

Pluristem Therapeutics: Haifa, Israel-based medical company is developing a cell-based therapy to treat COVID-19, announcing on March 30 it had dosed three Israeli patients under a compassionate use program, with plans to enroll more.

Leonard Schleifer.

Regeneron Pharmaceuticals: Westchester, New York biotech outfit, run by billionaires Leonard Schleifer and George Yancopoulos, is conducting clinical trials of its rheumatoid arthritis drug sarilumab, developed with French firm Sanofi, on patients in New York.

Roche: Swiss pharma titan, part-owned by billionaire Maja Oeri, is testing its arthritis drug tocilizumab to treat patients in China and received FDA approval to begin U.S. trials.

Roivant Sciences: Swiss pharma company is working with U.S. authorities to begin trials of its antibody treatment, gimsilumab, on COVID-19 patients.

Takeda: Japanese medical firm is working on hyperimmune therapy using blood plasma from previously infected patients.

Vir Biotechnology: The San Francisco-based firm is collaborating with Biogen and Chinese medical firm WuXi Biologics to manufacture antibodies that could treat the virus.

Vaccines:

AJ Vaccines: Danish vaccine developer is working on a COVID-19 vaccine that could hit the market in 2021.

Altimmune: The company is developing a novel intranasal vaccine for the coronavirus, making it one of three firms based in Gaithersburg, Maryland along with Emergent Biosolutions and Novavax thats working on treatments and vaccines for COVID-19.

Arcturus Therapeutics: San Diego-based vaccine maker is developing a COVID-19 vaccine with researchers at the Duke-National University of Singapore medical school in Singapore.

Biocad: Russian drug developer is researching a COVID-19 vaccine, with animal trials scheduled for late April.

Thomas and Andreas Struengmann.

BioNTech: German biotech firm backed by billionaire twins Thomas and Andreas Struengmann is working to develop a coronavirus vaccine in partnership with Pfizer and Fosun Pharma, chaired by billionaire Guo Guangchang.

CanSino Biologics: Tianjin, China-based pharma company isstarting clinical trials for its COVID-19 vaccine, using the vaccine technology deployed to develop the Ebola vaccine.

Codagenix: Melville, New York biotech firm is teaming up with the Serum Institute of India to develop a live-attenuated COVID-19 vaccine, which uses a live but weakened form of the virus.

Dietmar Hopp.

CureVac: German firm, funded by billionaire Dietmar Hopp and the Bill and Melinda Gates Foundation, received $87 million from the European Commission to scale up development of its coronavirus vaccine.

Dyadic: Jupiter, Florida company is collaborating with the Israel Institute for Biological Research on both treatment and a vaccine against COVID-19, using the firms gene expression platform.

Dynavax: Emeryville, California vaccine maker is working with the Coalition for Epidemic Preparedness Innovations (CEPI) and the University of Queensland to develop a COVID-19 vaccine.

EpiVax: Providence-based immunology firm is working with the University of Georgia and Miramar, Florida biotech outfit Generex on separate COVID-19 vaccine efforts.

ExpreS2ion: Danish biotech company received a grant of nearly $1 million from the European Union to develop a vaccine for COVID-19.

GeoVax: Atlanta-based medical company is collaborating with Wuhan-based BioVax to jointly produce a COVID-19 vaccine.

GlaxoSmithKline: British pharma titan is partnering with CEPI and Chengdu, China-based Clover Pharmaceuticals to use its pandemic vaccine adjuvant platform which boosts the immune response in patients receiving a shot to speed up development of COVID-19 vaccines.

Greffex: Houston-based genetic engineering firm is preparing to begin animal trials for its COVID-19 vaccine.

Heat Biologics: North Carolina biopharma company is developing a COVID-19 vaccine with the University of Miami.

iBio: Newark, Delaware biotech upstart is collaborating with Beijing-based CC-Pharming on the rapid development of a COVID-19 vaccine.

Inovio: Plymouth Meeting, Pennsylvania biotech business received $11.9 million in funding from the Department of Defense to rapidly produce a DNA vaccine for COVID-19 with drugmaker Ology Bioservices.

Johnson & Johnson: The companys pharma unit, Janssen, will start manufacturing its vaccine developed with the Department of Health and Human Services this month, with human trials set to begin by September and a public rollout hoped for early 2021. The company and the federal government are investing more than $1 billion in the vaccine effort.

Medicago: Quebec City-based biotech company received more than $7 million from the Canadian and Quebec governments to fund development of its COVID-19 vaccine.

Moderna: Massachusetts biotech company was the first tobegin human trials of its vaccine on March 16 in Seattle and could deploy it to health workers for emergency use by the fall.

Novavax: Maryland-based vaccine maker received $4 million in funding from CEPI to accelerate development of its vaccine candidates, with clinical trials expected in the late spring.

Sanofi: French medical firm is working with the federal government and Massachusetts-based Translate Bio to expedite its coronavirus vaccine, using technology previously used to develop one for SARS.

Sorrento Therapeutics: San Diego-based biotech firm is teaming up with Cambridge, MA gene therapy company SmartPharm Therapeutics to develop a gene-encoded COVID-19 vaccine; its also working with Chinese drugmaker Mabpharm on a fusion protein treatment for the disease.

Takis Biotech: Italian startup with just 25 employees is developing a vaccine with Stony Brook-based Applied DNA Sciences, with plans to begin human trials before the end of the year.

Themis Bioscience: Austrian biotech firm is part of a group, with the Institut Pasteur and the University of Pittsburgh, which received $4.9 million in initial funding from CEPI to build a COVID-19 vaccine modeled on the vaccine for measles.

Tonix Pharmaceuticals: New York-based pharma outfit is researching a potential COVID-19 vaccine based on the virus that causes horsepox.

Vaxart: San Francisco vaccine manufacturer Vaxart is working with Emergent Biosolutions to develop and manufacture an oral vaccine that can be taken as a tablet.

Vaxil: Israeli biotech startup began preclinical trials for its COVID-19 vaccine candidate.

Zydus Cadila: Indian pharma company announced it would fast-track development of a COVID-19 vaccine in February.

Protective Equipment And Sanitizer:

Anheuser-Busch InBev: The worlds largest beer company is making more than one million bottles of hand sanitizer from surplus alcohol at its breweries around the world.

Giorgio Armani.

Armani: Billionaire Giorgio Armanis luxury fashion brand converted all production at its Italian factories to manufacture single-use medical overalls on March 26.

Bacardi: The Bermuda-based spirits giant converted production at nine production facilities in Mexico, France, England, Italy, Scotland, Puerto Rico and the continental U.S. to make hand sanitizer.

BrewDog: Independent beermaker is making hand sanitizer at its distillery in Scotland.

Bulgari: The Italian luxury jeweler is manufacturing hand sanitizer with its fragrances partner, ICR, with plans to make hundreds of thousands of bottles by May.

Sandro Veronesi.

Calzedonia Group: Italian retail clothing group, owned by billionaire Sandro Veronesi, converted production at several plants in Italy and Croatia to manufacture masks and medical gowns, with initial production of 10,000 masks a day.

Cantabria Labs: Spanish health products and cosmetics firm converted production at one of its factories to make hand sanitizer.

Consomed: Tunisian mask and medical equipment maker put all of its workers, more than 70% of which are reportedly women, on quarantine inside the companys Kairouan factory to maximize production of protective gear.

The extremely secluded resort island of Wakaya, Fiji, has confirmed at least five cases of COVID-19. Torsten Blackwood/AFP via Getty Images hide caption

The extremely secluded resort island of Wakaya, Fiji, has confirmed at least five cases of COVID-19.

As COVID-19 cases in the remote Pacific climb, it turns out that even natural isolation is no match against this pandemic.

The novel coronavirus has been confirmed in Papua New Guinea, Fiji as well as in the French territories of French Polynesia and New Caledonia. The U.S. territory of Guam has had one death from the disease and 51 confirmed cases of infection, believed to be the highest total of the small Pacific island jurisdictions.

In an effort to keep to the virus at bay, the authorities have put a range of policies into place from Palau to Tahiti, including travel restrictions, school closings, lockdowns and states of emergency.

Tonga, which currently has no confirmed cases, has banned public gatherings and foreign nationals. Tongan Prime Minister Pohiva Tu'i'onetoa said on March 23 that COVID-19 is an imminent threat and "requires a significant and coordinated response."

These countries are trying to turn what are typically their weaknesses isolation and remoteness into strengths, says Jonathan Pryke, director of the Pacific Islands Program at the Lowy Institute, an Australia-based think tank.

"Because the health systems are so fragile, so stretched, they just would not be able to cope with a major outbreak," he tells NPR.

Yet in throwing up these barriers, Pacific island nations are also expected to decimate their economies in the process as they are all highly dependent on the outside world. Whether it's tourism, foreign aid, imports or immigration all of these things are going to be highly curtailed, Pryke says.

Tourism brings billions of dollars into the region and is the chief driver of job creation.

Fiji, for example, is the most-visited Pacific island nation, according to the South Pacific Tourism Organization. Last year, tourism made up nearly half of Fiji's gross domestic product, with an all-time high of nearly 900,000 tourists. But most of the visitors come from Australia, New Zealand, the United States and Europe all places now dealing with the new coronavirus pandemic.

The Pacific islands have a combined population of about 2.3 million, according to the World Bank. They don't have the economic firepower to stimulate the economy, Pryke says, so "they're going to need support to just hold these countries together."

Which means letting the outside world in eventually.

But Pryke also holds some optimism for the region:

"Most of the people of the Pacific are not dependent on the government," Pryke says. "They are resilient."

The coronavirus pandemic is a serious health risk, which is why countries around the world are racing to find vaccines and treatments. Nearly 1,000,000 cases of COVID-19 have been confirmed globally, and by the time you read this, the death toll will have surpassed 50,000.

Some potential treatments listed here were previously in clinical testing for other diseases, such as cancer, allowing the trials for COVID-19 to be fast-tracked. Many arent aimed at the coronavirus itself but instead will hopefully reduce some of the severe side effects the disease causes, like hyperinflammation and respiratory distress.

Notably, many of the proposed treatments have gone through U.S. Food and Drug Administration (FDA) approval for other uses or are currently going through that process, meaning the route to getting approved for a clinical trial to study their effects on COVID-19 patients is shorter and faster than it would be for a new drug. Some of these are being utilized under compassionate use rules, meaning they arent part of clinical trials but are being administered to COVID-19 patients in life-threatening situations.

The path from trial to treatment is long and complex. As new treatments and vaccines make their way to new phases, well update this list. For now, weve excluded those in preclinical phases.

Note: These drugs are all in the early stages of testing for efficacy against COVID-19 and taking them without supervision can have tragic consequences. An Arizona man died after reportedly taking a form of chloroquine used to clean fish tanks. Youll see a long list of potential treatments below, but many of them wont progress to wider testing or use, because theyll prove either unsafe or ineffective.

A vaccine would prevent people from getting sick, instead of treatments to alleviate the system or kill the disease once it has already infected you. Often, vaccines either use an inactive (dead) or live attenuated (less potent) version of the pathogen to build up the bodys defenses. By introducing these weakened forms to the immune system, it can start making antibodies without having to battle the virus itself. Once the body has made antibodies once, it has been trained to recognize the pathogen and can start making them again if the actual virus finds its way inside. Immunity from an inactive vaccine may not last as long, while live-attenuated types have implications for immunocompromised people. In addition, such vaccines havent proven effective for some viruses, like HIV.

Currently, there is no approved vaccine for COVID-19. Coronaviruses caused SARS in the early 2000s and MERS in 2012. The two epidemics were contained before vaccines were created, but some work was started for both. Some companies are building on that research to find a vaccine for COVID-19, which is caused by a novel coronavirus. The Coalition for Epidemic Preparedness Innovations, or CEPI, is an organization helping to accelerate vaccine development. About 35 companies and academic institutions are searching for a COVID-19 vaccine; two in phase-1 clinical trials, and over 40 in preclinical development. A few have begun testing in animals, while biotech firm Modernas attempt has started human trials.

Despite how quickly the research is being developed, there are some aspects of the process that cant be sped up, like widespread testing for side-effects and dosing. Even then, there are logistical hurdles to scaling production and distributing vaccines to affected countries. Experts are predicting it will take 18 months for a vaccine to be widely available.

Non-replicating viral vector; Adenovirus Type 5 vector (Ad5-nCoV): Adenoviruses are common viruses that can lead to bronchitis or pneumonia. Theyve been heavily studied as potential vectors for vaccines, to deliver the antigens that stimulate the production of protective antibodies. These viral vectors can also bolster the immune response in ways traditional vaccines do not.

CanSino Biologics is testing a vaccine candidate in healthy adults, the first phase of clinical testing. In 2017, the company, collaborating with the Chinese Academy of Military Medical Sciences Bioengineering Institute, developed an ebola vaccine. The potential COVID-19 vaccine, AD5-nCoV, is based on the same technology. Its a non-replicating viral vector, so it can infect cells but has been rendered incapable of multiplying. Johnson & Johnson is working on a similar type of vaccine, which will be ready for phase one trials in September.

RNA; LNP-encapsulated mRNA (mRNA 1273): The National Institute of Allergy and Infectious Diseases (NIAID) and Modernas potential vaccine builds on research into the MERS virus. Its a messenger RNA or mRNA vaccine, where a bit of the viruss genetic material gets injected into your muscle. The role of mRNA is to carry genetic information from DNA needed to make proteins. The RNA is packaged in lipid nanoparticles (LNPs), to help effectively deliver it. The mRNA would deliver instructions to cells on how to make proteins to fight the virus. No RNA vaccines have even been approved for human use, but this effort is one of several backed by CEPI.

Coronavirus Testing Labs

Monoclonal antibodies (mAb) are used in treatments for cancer and ebola. Made in a laboratory, these molecules work as substitute antibodies, according to the Mayo Clinic, boosting or mimicking the bodys immune system to attack the virus. They can do so in a variety of ways, including flagging cells for destruction and binding to different types of cells. The majority of those being researched for COVID-19 are in the pre-clinical phase, but several are in clinical trials right now.

Actemra (tocilizumab): Small proteins known as cytokines are part of the bodys immune response, released when theres an infection. Inflammation is a side effect, as blood and other fluids flow to the source of infection. A cytokine storm is when an abundance of the proteins cause hyperinflammation, which can lead to serious complications and death. It has been reported in SARS and MERS patients and could be causing some of the more severe symptoms in some people with COVID-19. Interleukins are one group of cytokines. Actemra is a rheumatoid arthritis drug that blocks interleukin-6 (IL-6) to keep it from attacking healthy tissue when the immune system overreacts. It helped several critical COVID-19 patients recover, but a controlled clinical study needs to be performed, according to The Wall Street Journal.

Avastin (bevacizumab): In healthy adults, vascular endothelial growth factor (VEGF) promotes the formation of new blood vessels and is important for healing wounds. Some COVID-19 patients have been shown to have elevated levels of VEGF, possibly due to hypoxia (low blood oxygen) and inflammation. Avastin is a VEGF blocker and has been used to treat several types of cancer for over 15 years. A clinical trial at the Qilu Hospital of Shandong University in Jinan, China will assess its effectiveness at treating shortness of breath.

Gimsilumab: Gimsilumab is a monoclonal antibody that targets a pro-inflammatory cytokine known as a granulocyte-macrophage colony-stimulating factor (GM-CSF). Its presence can elevate the expression of pro-inflammatory cytokines, causing a kind of feedback loop that increases inflammation. GM-CSF has been found in elevated levels of COVID-19 patients admitted to the ICU, according to pharmaceutical company Roivant. It wants to test Gimsilumab as a treatment for acute respiratory distress syndrome (ARDS). The condition is caused by fluid build-up in the lungs air sacs and the breakdown of surfactant, so that lungs cant fully inflate. Targeting GM-CSF represents a promising strategy for curbing lung damage while allowing time for the virus to clear, Dr. Elizabeth Volkmann, founder and co-director of the UCLA Connective Tissue Disease-Related Interstitial Lung Disease Program, said in Roviants press release.

Kevzara (sarilumab): Like Actemra, Kevzara is a rheumatoid arthritis drug that blocks IL-6. Dr. Naimish Patel told The Wall Street Journal why blocking that cytokine could help COVID-19 patients recover: Even though the virus is diminishing, its sending signals to the immune system to keep attacking. Hes head of global development for immunology and inflammation for Sanofi, which makes Kevzara, along with Regeneron.

Leronlimab (PRO 140): CCR5 is a protein on the surface of white blood cells that plays an important role in the way HIV develops in the human body. Leronlimab is a monoclonal antibody being studied as a potential treatment for HIV. It binds to the CCR5 receptor, which inhibits the release of inflammatory cytokines. Biotechnology company CytoDyn modified its clinical trial to evaluate Leronlimabs effect on severe cases of COVID-19.

PD-1 blocking antibody: There are two types of tolerance in your immune system. Central tolerance is the main way it distinguishes your own cells from outside threats, while peripheral tolerance keeps the body from over-reacting when it encounters allergens or microbes. Usually, the protein programmed cell death-1 (PD-1) helps limit T cell activity during infection to reduce inflammation. But if PD-1 binds to another protein, PD-L1, it prevents T cells from attacking cancerous cells. Monoclonal antibodies that block PD-1 are known as immune checkpoints inhibitors (ICIs). Theyve shown success in treating various types of tumors by preventing PD-1 from binding with PD-L1, freeing T cells to target the tumor. Thymosin, meanwhile, targets PD-L1. A clinical trial at Southeast University in China will study the efficacy of PD-1 and thymosin in COVID-19 patients with severe pneumonia caused by lymphocytopenia (low levels of lymphocytes, including T cells).

Sylvant (siltuximab): Another monoclonal antibody that blocks the action of IL-6, siltuximab is approved by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) to treat multicentric Castleman disease (MCD). This rare lymph node disease acts similarly to lymphoma, causing an overgrowth of cells. Doctors at Papa Giovanni XXIII Hospital in Italy will observe its effects on patients with COVID-19, in the hopes it will reduce inflammation in those with severe respiratory disorders.

TJM2 (TJ003234): TJM2, like Gimsilumab, is a monoclonal antibody that targets pro-inflammatory cytokine GM-CSF. In November 2019, the FDA approved it for clinical trials to treat rheumatoid arthritis. I-Mab Biopharma, which makes TJM2, is a U.S.- and China-based biopharmaceutical company. It will now explore the mAbs effectiveness in fighting cytokine storming in patients with serious reactions to COVID-19.

There are a variety of antiviral drugs for diseases like hepatitis, the flu, and herpes many of which could potentially be repurposed to fight coronavirus. They work in different ways to stop the replication of viruses. For example, some flu antivirals are neuraminidase inhibitors. Neuraminidases are enzymes that cut acids and proteins on the surface of virus envelopes, releasing the replicated virus to infect new cells. Neuraminidase inhibitors can help reduce the amount of new viruses that are released inside the human body. The hope is that some of these antivirals will also stop the replication of COVID-19 once a patient has contracted it, lessening the duration or severity of the disease.

Arbidol (umifenovir): This broad-spectrum antiviral blocks virus entry into healthy cells by inhibiting membrane fusion. Its not currently approved by either the EMA or FDA, though it is available in Russia and China. A study at the Guangzhou 8th Peoples Hospital in China will observe its effect on patients with COVID-19. Though people are selling Arbidol on eBay in the U.K., the Medicines and Healthcare Regulatory Agency told The New Statesman, Not only are they breaking the law, they are acting with total disregard of your health.

ASC09: HIV requires protease enzymes to reproduce. Protease inhibitors prevent newly replicated viruses from maturing and invading healthy white blood cells. To see if the same disruption works on COVID-19, China-based biotechnology company Ascletis Pharma will test ASC09 in clinical trials.

Azvudine: Azvudine is a nucleoside reverse transcriptase inhibitor (NRTI). HIV uses the enzyme reverse transcriptase in reverse transcription, converting RNA into DNA. Inhibitors block the enzyme, preventing the virus from replicating. The clinical trial for Azvudines efficacy against COVID-19 will take place at the Peoples Hospital in Guangshan County, China.

Favilavir/Favipiravir/T-705/Avigan: Favipiravir is a broad-spectrum antiviral thats been utilized in Japan to treat influenza. Inside cells, it mimics the organic compound purine and eventually becomes included in the viruss RNA strand as it grows. Exactly how Favipiravir inhibits viral RNA synthesis once its incorporated is unclear, but there is some indication it could be used in COVID-19 patients as well. In clinical trials in China, patients who received the medication tested negative for the virus after a median of four days; those who didnt receive it took 11 days to test negative, according to The Guardian.

Ganovo (danoprevir): Ascletis Pharma developed Ganovo as a direct-acting antiviral agent (DAA) to treat hepatitis C. The efficacy of DAAs in general has been called a monumental advance over previous hepatitis C therapies. Ganovo inhibits the viruss protease, which is necessary for its replication. The effectiveness of Ganovo, in combination with another protease inhibitor (ritonavir), will be tested at Chinas Ninth Hospital of Nanchang.

Kaletra/Aluvia (lopinavir/ritonavir): Kaletra is a combination of protease inhibitors ritonavir and lopinavir, used to treat HIV. Earlier this year, The New England Journal of Medicine published the results of a study of 199 patients with severe COVID-19 patients at Jin YinTan Hospital in China. Those that received the lopinavir-ritonavir treatment saw no difference in the mortality rate. Future trials in patients with severe illness may help to confirm or exclude the possibility of a treatment benefit, according to the authors of the study.

Prezcobix (darunavir): Like ASC09, Prezcobix is a protease inhibitor, used to treat HIV, in conjunction with a pharmacokinetic enhancer. Cobicistat is one such drug, which slows the breakdown of Prezcobix, allowing it to stay in the body for longer and at a higher concentration. Johnson & Johnson sent Prezcobix to Chinese health authorities in January to gauge its effectiveness in treating COVID-19. The companys chief scientific officer, Paul Stoffels, told The Wall Street Journal that studying the drugs effects in ill patients could help researchers find a treatment that works.

Remdesivir: This drug has gotten more press than many of the other potential treatments. Its a broad-spectrum antiviral, and has been studied as a treatment for Middle East respiratory syndrome (MERS), a respiratory illness that is caused by the same family of viruses as COVID-19. Gilead, the company that makes Remdesivir, hoped the drug would work against Ebola, but it wasnt nearly as effective as two other drugs at preventing death from the disease. Some experts are hopeful that it will have more luck with COVID-19, and there are several clinical trials underway.

Truvada (emtricitabine and tenofovir): You may have seen commercials for this drug for whats known as PrEP (pre-exposure prophylaxis). When taken properly, it can reduce the risk of HIV infection. Truvada is a combination of two antiretroviral medications: emtricitabine and tenofovir. Both prevent HIV from replicating, and while they work in different ways, each blocks the reverse transcriptase enzyme needed for reproduction. The Sichuan Academy of Medical Sciences and Sichuan Provincial Peoples Hospital are conducting the clinical trial for Truvada against COVID-19.

Xofluza (baloxavir marboxil): Endonuclease is an enzyme that initiates flu virus replication. Polymerase acidic endonuclease inhibitors, like Xofluza, interfere with that replication. Xofluza received FDA approval in 2018 to treat the flu, and now the First Hospital Affiliated of Zhejiang Universitys Medical School wants to research the drug as a treatment option for COVID-19 patients with pneumonia.

Catalog DNA Data Storage

Cellular therapy replaces or repairs damaged cells or tissues and is used in a range of diseases. Many types of cells have been studied for this purpose, including stem, progenitor, and primary cells. Cell therapy is being used and researched for everything from inflammatory bowel disease to cancer. CAR T-cell, for example, is a therapy in which doctors modify a patients T cells to identify and go after cancer cells.

Mesenchymal stem cells: Stem cells can self-renew through cell division and can also differentiate into different types of cells, like bone cells or liver cells. Mesenchymal stem cells (MSCs) are adult stem cells and can be taken from either humans or animals. Pneumonitis, or the inflammation of the walls in the air sacs of the lungs, is one potential side-effect of COVID-19. There has been some research on using MSCs to treat lung damage caused by radiation for cancer treatment. Chinas Institute of Basic Medicine is conducting clinical trials to see the cell therapys effect on COVID-19 patients with pneumonitis.

MultiStem: Biotech company Athersys created MultiStem, a stem cell product made from multipotent adult progenitor cells (MAPCs) derived from bone marrow. MPACs can self-renew and differentiate into several cell types. Acute respiratory distress syndrome (ARDS) is similar to pneumonia; it makes it difficult for the lungs to fully inflate and can lead to serious complications and death. MultiStem already underwent an early-stage clinical trial for treating ARDS, and the results showed the patients had lower mortality rates and were off ventilators more quickly than those who didnt receive the treatment. The company is working with the FDA to fast-track a clinical trial testing for COVID-19, according to WKSU.

RNA therapies are a fairly recent development and are being studied to treat several diseases, including macular degeneration and Zika. The therapies work in a few different ways, either by targeting nucleic acids (DNA or RNA), targeting proteins, or encoding proteins. A therapy might prevent messenger RNA from being translated into protein or it might encode a normal version of a protein instead of a mutated one. Right now, the potential RNA therapies for COVID-19 are all in preclinical phases.

There are a number of other treatments scientists are researching to see if they can help alleviate some of the severe symptoms of COVID-19. They dont necessarily fit into the categories above.

APN01: Scientists have found that during infection, COVID-19s viral trimeric spike protein binds to human receptor angiotensin-converting enzyme 2 (ACE2). One study showed that deactivating ACE2 caused severe lung injury in mice infected with a strain of avian influenza while administering recombinant human ACE2 was effective at lessening the damage. APN01 is a recombinant human angiotensin-converting enzyme 2 (rhACE2) created by Aperion Biologics to treat acute lung injury (ALI), acute respiratory distress syndrome (ARDS), and pulmonary arterial hypertension (PAH). The company began a clinical trial with APN01 on COVID-19 patients in February. A similar trial is underway at the First Affiliated Hospital of Guangzhou Medical University.

Chloroquine/Hydroxychloroquine: These two antimalarial drugs have been getting a lot of attention, though their efficacy as a treatment for COVID-19 is still unknown. Malaria is caused by a parasite, while COVID-19 is caused by a virus. The reason some researchers are looking at these drugs as potential coronavirus treatments is that chloroquine and other drugs were able to block coronaviruses from infecting cells in laboratory testing. These drugs were researched as possible treatments for MERS during the 2012 outbreak. The mechanism by which these malarial drugs would work against COVID-19 is uncertain, but one hypothesis is they change cells surface acidity, so the virus cant infect them. Or chloroquines might activate the immune system. Chloroquine and hydroxychloroquine have not been appropriately evaluated in controlled studies, not to mention that they have numerous and, in some cases, very deadly side effects, Katherine Seley-Radtke, professor of chemistry and biochemistry at the University of Maryland, wrote at The Conversation. There are a few clinical trials underway looking into their efficacy.

Gilenya (fingolimod): Multiple sclerosis causes the bodys own immune system to attacknerves insulating layer, or myelin. The presence of pro-inflammatory white blood cells in the central nervous system can also damage the myelin sheath. A sphingosine 1-phosphate receptor modulator is believed to keep certain white blood cells (lymphocytes) from leaving the lymph nodes and crossing the blood-brain barrier, where they would further damage nerve cells. Pneumonia is an acute inflammatory response that develops in some people with COVID-19, and the First Affiliated Hospital of Fujian Medical University wants to test this MS drugs effectiveness on reducing its severity.

Jakafi/Jakavi (ruxolitinib): Myelofibrosis is a somewhat rare blood cancer in which fibrous scar tissue replaces spongy bone marrow. Many patients with this and a couple of other types of blood cancer have an acquired mutation in the Janus Kinase 2 gene. It causes bone marrow to produce too many abnormal blood cells. Janus kinase inhibitors, or JAK inhibitors, block the function of these enzymes. Because of their role in cytokine production, JAK inhibitors are also used to treat inflammatory diseases, including rheumatoid arthritis. (Cytokines are a normal part of the bodys response to infection, but an overabundance can lead to hyperinflammation.) Patients with severe reactions to COVID-19 could have an excess of cytokines causing lung inflammation. A clinical trial at Tongji Medical College of Huazhong University of Science and Technology will study the effect of Jakafi and mesenchymal stem cells on COVID-19 patients with pneumonia.

Losartan: Angiotensin is a peptide hormone that constricts blood vessels and raises blood pressure. Angiotensin II receptor antagonists or blockers are prescribed for hypertension because they block the hormone. Losartan is one such drug, and the University of Minnesota is conducting clinical trials to see its effect on lung inflammation in COVID-19 patients.

Methylprednisolone/corticosteroids: Methylprednisolone is a synthetic corticosteroid, which mimics how the bodys hormones work to reduce inflammation. Corticosteroids are used to treat a plethora of conditions, from asthma to lupus to arthritis. Though they were used during severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) outbreaks, the World Health Organization doesnt currently advise the use of corticosteroids for COVID-19, according to a February article from The Lancet. Clinical trials for glucocorticoid therapy are going forward at Peking Union Medical College Hospital and Tongji Hospital.

Novaferon: Interferons are cytokine mediators that alert the immune system when theres a viral infection. Lab-made interferons are used to treat several diseases, including hepatitis B. Exactly how interferons affect the virus is unclear, but its thought to interfere with its life cycle, while also boosting cell-mediated immunity. Novaferon is one man-made interferon used to treat hepatitis B, and the First Affiliated Hospital of Zhejiang University Medical School will study whether its effective against COVID-19.

Rebif (interferon beta-1a): Interferon beta-1a is an interferon used to treat multiple sclerosis. Exactly how Rebif, an interferon made by Merck KGaA, works in MS patients isnt known, but it does lessen inflammation and reduce the bodys immune response that damages the myelin sheath. The French Institut National de la Sant et de la Recherche Mdicale (INSERM) will use Rebif in a clinical trial, to see if it similarly reduces inflammation in COVID-19 patients.

Washed microbiota transplantation: Some people who take antibiotics end up wiping out their colon of the healthy bacteria that help stave off clostridium difficile (C. difficile), which can lead to a serious infection. Fecal microbiota transplantation (FMT) reintroduces healthy bacteria via a donors stool, transferred by colonoscopy or another procedure. The washed microbiota process is a way of purifying the sample beforehand. A clinical trial at the Second Affiliated Hospital of Nanjing Medical University is doing a clinical trial on the procedure to examine its effect on COVID-19 patients with antibiotic-associated diarrhea.

For the latest updates on the novel coronavirus outbreak, visit the World Health Organizations COVID-19 page .

GAINESVILLE, Fla. (WCJB)-- Experts held a COVID-19 Data Science Zoomposium today featuring an employee from the University of Florida.

Biostatistic Assistant Professor Natalie Dean spoke on vaccines and therapeutics.

She says there are over 50 candidates testing their vaccines and predicts it will take around 12 to 18 months before a vaccine for COVID-19 can be used.

One of the challenges is we dont have a animal model, this is an animal that has similar symptoms to humans so we can test the vaccine actually reduces disease and then it goes into these early human trials and then gradually we get a bigger trials that tell whether the vaccine prevents infection to people being exposed, she said.

She says it is very likely the world will still need the vaccine come 2021.

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Social distancing can slow the spread of Covid-19, and new therapeutics could blunt its death toll, but a true return to normalcy is unlikely without a widely-available vaccine.

There are currently at least 47 vaccine programs under way, according to a list kept by the Milken Institute. Below are details on nine of the most notable. Probabilities of success are impossible to gauge, and it will only take one truly successful vaccine to effectively save the world. Here are some to keep an eye on.

Status: Human trials ongoing. First patient dosed on March 16

This is perhaps the most well-known of the Covid-19 vaccine programs. Moderna, a clinical-stage biotech that develops messenger RNA-based vaccines and therapeutics, has already begun dosing patients with its experimental mRNA-based Covid-19 vaccine. Heres an overview of the mRNA-based Covid-19 vaccine programs.

Status: Human trials to begin in April

The German biotech BioNTech is designing another mRNA-based Covid-19 vaccine. It plans to begin clinical trials of the vaccine in April. Outside of China, BioNTech is collaborating on the development of the vaccine with Pfizer. Inside China, the company is working with Fosun Pharma, a Chinese pharmaceutical company.

Status: Human trials to begin in April

Inovios Covid-19 vaccine program drew enormous attention early this year. The company is developing a DNA plasmid vaccine. Inovio says that it plans to start a clinical trial in 30 healthy volunteers in the U.S. next month.

Status: Human trials to begin in late Spring

Novavax, another small biotech that was among the first to announce a Covid-19 vaccine program, is developing a type of recombinant vaccine to prevent Covid-19. In mid-March, it said it had received $4 million to develop the vaccine from the Coalition for Epidemic Preparedness Innovations, a coalition of governments and philanthropies. The company says it expects to begin testing the vaccine in humans in late spring.

Status: Human trials to begin in September

Johnson & Johnson, the worlds largest pharmaceutical company, was one of the first drug developers to announce a Covid-19 vaccine program. On Monday, the company said that the vaccine could be available for emergency use early next year, and that it will start manufacturing it immediately. The company is planning to begin testing the drug in humans by September. It said Monday it planned to make the vaccine available on a not-for-profit basis for emergency pandemic use.

Status: Expects to test in humans by end of 2020

Translate and Sanofi are collaborating on another mRNA-based Covid-19 vaccine, announced late last week. Ron Renaud, Translates CEO, said Friday he hoped to begin testing the vaccine by the end of this year, and hoped for the vaccine to be approved by the second half of next year.

Status: Expects to begin in vitro testing this summer

In addition to its collaboration with Translate, Sanofi is also working on another, previously announced Covid-19 vaccine effort, this one with funding from the Biomedical Advanced Research and Development Authority (BARDA). This program is seeking to develop a recombinant vaccine, as distinct from the mRNA vaccines, and will use Sanofis recombinant DNA platform, which has been used to develop a flu vaccine.

Status: Pre-clinical

Arcturus is working on a Covid-19 vaccine that uses a variation on the messenger RNA approach taken by companies like Moderna and Translate. It is collaborating with the Singapore-based Duke-NUS Medical School, and received a grant for the program from the Singapore Economic Development Board, a government agency.

Status: Pre-clinical

This private German company is also developing an mRNA-based Covid-19 vaccine. Drama has surrounded the company in recent weeks, including allegations that Trump administration officials tried to lure the company to move its research to the U.S., plus shuffles among its top leadership.

Write to Josh Nathan-Kazis at josh.nathan-kazis@barrons.com

"Know thy enemy," Sun Tzu advised in The Art of War. That axiom rings true not just for military strategists, but also for your immune system: Your body might "know" the flu, either from a prior infection or a vaccine.

That familiarity makes the flu easier to vanquish than the novel coronavirus sparking the current pandemic.

Beyond a lack of immunity, testing mishaps and unproven treatments make the novel coronavirus pandemic a new and distinct challenge from influenza outbreaks, which researchers have been working to control for decades.

During flu season even a severe one much of the population is already immune. Your immune system might recognise the viral enemy from a previous infection and pump out antibodies to clear the contagion. Or you might have received a flu shot, a dose of dead influenza viruses that trains your body to fend off a live attack.

People with immunity, whether by infection or injection, help keep the greater public relatively safe from the flu, according to Abigail Carlson, an infectious disease specialist at Washington University in St. Louis.

"When the virus infects them, it reaches a dead end," Carlson told Business Insider. "They don't get sick, they don't pass it on. And they stop the virus in its tracks."

This protective process is called herd immunity. While not perfect tens of thousands of Americans die of flu every year herd immunity generally keeps the flu at levels that hospitals can manage. That's not the case for the new coronavirus.

"There's very little to no herd immunity" with SARS-CoV-2, the virus that causes COVID-19, Carlson said. "Even though the virus might not be extremely deadly, there's a larger number of people who can get infected."

Without herd immunity, humans are ideal hosts for the coronavirus, which has raced across the globe in mere months and encountered few dead ends.

"We're at a point now where the health system is under enormous strain," Carlson said. "Masks are limited, ventilators are limited, beds are limited."

As of Thursday afternoon, the US had recorded more than 236,000 COVID-19 cases and at least 5,600 deaths, according to Johns Hopkins University.

A novel coronavirus vaccine to seed herd immunity is likely more than a year away, and developing it is a tall order compared to configuring the annual flu shot, according to Otto Yang, an infectious disease researcher at UCLA.

First, there's no precursor vaccine to work from: Of the seven coronavirus types that infect humans including four that cause the common cold none has a proven vaccine. Researchers are still seeking how best to craft a vaccine against the new coronavirus, whether by using active virus particles, inactivated ones, or synthetic compounds.

Last month marked the first of many clinical trials another reason Yang believes a COVID-19 vaccine will prove more elusive than the flu shot. The FDA doesn't require clinical trials to approve the annual flu vaccine. Although the exact strains the shot targets vary from year to year, the basic biochemistry stays the same and has proven safe.

So while researchers can fast-track the flu shot each year, they must carefully test any new coronavirus vaccine before offering it to the public. And that's likely to be a lengthy process.

A botched rollout of testing for COVID-19 has also left the US less prepared for the disease than for a flu pandemic, Yang said. To find out if a patient has a viral disease like flu or COVID-19, researchers search for the virus' genes in a swab sample from the patient's nose or mouth.

For the flu, that testing process is reliable. Though the virus mutates, most changes affect proteins on its outer surface, which bind to your cells to initiate an infection. Flu tests target more stable genes that encode for proteins inside the virus' shell.

When it comes to flu, "we have PCR tests that test all the strains," Yang said, adding that the same flu testing procedures are used every year. "All that infrastructure for testing was already in place."

In contrast, figuring out which genes to target in a test for the coronavirus "had to be worked out from scratch," Yang said.

The World Health Organisation developed an effective protocol in January but the US decided to develop its own, and then was slow to produce and distribute it. The lack of testing has hindered researchers' understanding of how widely the disease is spreading.

The US has "failed pretty miserably" when it comes to COVID-19 testing, Yang said. Testing rates in countries like South Korea and Italy are more than double those of the US.

(Ruobing Su/Business Insider)

Patients who do test positive for the novel coronavirus have little choice but to ride out the illness. Antiviral medications that help fight the flu appear to be less effective for COVID-19 patients, Yang said.

"There's no proven treatment at this point for SARS-CoV-2." Some doctors are administering anti-malarial drugs to try and combat the coronavirus, but the efficacy of such treatments is still unclear.

The new coronavirus pandemic poses numerous distinct obstacles compared to the flu. Still, Yang and Carlson see room for optimism as we await a vaccine, because so many people though not everyone are taking social distancing seriously.

"You're really seeing people doing their best to stay at home, stay away from others, and bring that curve down in the US," Carlson said. "Those interventions are working if we just give them a chance Things will get better and this pandemic will indeed pass."

This article was originally published by Business Insider.

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A worker cleans an area along the Las Vegas Strip that's now devoid of the usual crowds, with casinos and many other business shuttered. John Locher/AP hide caption

A worker cleans an area along the Las Vegas Strip that's now devoid of the usual crowds, with casinos and many other business shuttered.

Two years ago, science writer Ed Yong wrote an article for The Atlantic in which he warned that a new global pandemic was inevitable and that the world would be unprepared for it when it arrived. Now, with the outbreak of COVID-19, much of what Yong warned about in his reporting has come true.

Yong says scientists are still working to understand how the novel coronavirus travels through air. His latest article for The Atlantic concerns whether or not people beyond health care workers and other front-line personnel should be wearing some sort of mask to help prevent spread of the coronavirus.

Yong notes that there are two ways in which respiratory viruses typically travel through air: as droplets of fluid and as evaporated specks of fluid called "aerosols."

Yong describes aerosols as "far-drifting" and "long-lasting" viral specks. "There is some growing evidence that aerosol transmission what people would traditionally describe as being 'airborne' does apply, to some extent, to the new coronavirus," he says.

He adds that it's not yet clear whether live infectious viral particles remain in the air where infected people have been: "That's the crucial thing to know," he says. "And then really, crucially, are there enough of those viral particles to actually start an infection? We don't know the answer to that yet."

Yong says the experts he has consulted have not come to a consensus regarding whether or not the general population should wear some sort of mask, when in public places. "There is a lot of movement towards recommending widespread mask usage from different countries," he says. "The CDC appears to be considering it. Health experts I've spoken to who were once dismissive about mask use are now edging towards recommending it."

But Yong adds that the short supply of N-95 respirator masks, and even professionally made surgical masks complicates matters.

"We're currently in a situation where masks are already running out in hospital settings and for health care workers, who are the people who need them the most. So any masks any protective equipment should go to health care workers as a matter of priority. And only then should we think about whether the general population should be considering wearing masks."

Looking ahead, Yong says that even if masks, frequent hand-washing and social isolation strategies are effective in slowing the virus' spread, the end to the pandemic is still a long way off: "We are in for this long, protracted game of whack-a-mole with the virus where different places will stamp it out at different times. It will surge back. It will need to be controlled again."

On what we know about how the virus travels through the air and how we're susceptible to inhaling it

There was one study that just shot virus-laden fluids into a rotating cylinder to create a cloud of aerosols. And they found that within that cloud, the virus remained stable for several hours, which suggests that it can at least survive in the air around us. Now, that's a pretty artificial setup. That's probably closer to a medically invasive procedure like intubation, rather than someone just breathing when they're walking down the street or sitting in a room. So it's hard to know what to make of that outside the health care setting.

But there are other studies that suggest that the coronavirus can be released into the air in less dramatic ways. For example, a new [study] released by the University of Nebraska Medical Center looked for traces of the virus' genetic material in the rooms of several patients who had COVID-19 many of whom only had mild symptoms. So they found traces of that genetic material on lots of different surfaces, including hard to reach spots like ventilation grates and the floors beneath beds. That's consistent with the idea that the virus is moving through the air over distances longer than a droplet might land.

What we don't know is whether there are actually live infectious viral particles in the air. The presence of genetic material doesn't indicate that. It's like finding a fingerprint in a crime scene. It means that the culprit was once there, but they might have long gone. So that's the crucial thing to know. ... And, [in each case], are there enough of those viral particles to actually start an infection? We don't know the answer to that yet. And that's a really crucial piece of the puzzle.

On how thinking about masks for the general population might be changing

Confusion is completely understandable, because even among the experts who I've spoken to including people who've studied airborne transmission and its possibility opinion is divided on the role of masks and how much protection they can provide. There's just a mess of data on whether masks worn by the general population will provide protection against respiratory illnesses in general; whether masks prevent you, if you are infected, from infecting other people. I think that's a little clearer, both from the evidence and just through common sense. And that might matter a lot for a disease like COVID-19.

We know that the virus behind it can spread from one person to another before they show symptoms, and that is perhaps the strongest argument for widespread usage of masks. Even if you aren't currently coughing or sneezing or breaking into a fever, you might not know that you have a virus, and wearing a mask might stop you from spreading that virus to someone else.

On why touching your mask negates its protection

One of the reasons why some people are still on the fence about recommending widespread mask usage is this idea that people who wear masks and aren't used to them kind of futz around with them. They fidget with the masks, they touch their faces. There's not a huge amount of data on this ... but almost everyone I've spoken to who has experience of actually using the masks properly, whenever they've seen people use them in more casual ways, people almost always get it wrong. They pull the mask over their chin, wipe their faces. They touch the masks constantly. They're always adjusting it. And that carries a risk, and maybe the risk is that you do lure yourself into a false sense of security, thinking you're safe, but in a situation when you're actually increasing the likelihood of infection.

On how American hubris and exceptionalism have contributed to the slow response

[A virus] has no interest in people's terror, only their cells. It just wants hosts to infect and doesn't care whether you're feeling brave or not. And I think that some aspects of America's national character do seem to have made it harder for people to take the necessary measures to slow the spread of the pandemic. And not just this sense of resilience, of being brave in the face of fearful threats, but also the sense of individualism and exceptionalism. This idea that "I have the freedom to do what I want to do," which stops people from just staying indoors and heeding advice about isolating yourselves when it's necessary. And I think that the country's famed exceptionalism the idea that this is the greatest country in the world that, I think, contributed to a delay in the nation's response.

The [U.S.] could have sprung into action ready for this, for the virus to eventually reach it. But if anything, America more or less sat idle. It was sluggish. And I do wonder if that propensity to think of itself as being truly exceptional, that slight hubris, left it more unprepared than it needed to be.

Ed Yong

COVID-19 was taking off in China for at least a month before it first reached U.S. shores. And during that month, not much actually happened [in the U.S.]. A lot of preparedness measures could have been launched. The country could have sprung into action, ready for this, for the virus to eventually reach it. But if anything, America more or less sat idle. It was sluggish. And I do wonder if that propensity to think of itself as being truly exceptional, that slight hubris, left it more unprepared than it needed to be. And I think that even though many people had warned about this for a long time, the underwhelming nature of America's response to this threat has really surprised even people who had been warning, who had been issuing alarms.

There is a thing called the Global Health Security Index, which ranks different countries according to their levels of preparedness for pandemics, according to 140 different criteria, based on regulations from the World Health Organization. And out of all the countries that were assessed, the United States has the highest score 83.5, a solid B. But if you look at how the country has actually reacted to the pandemic, I think we probably get something like an F. This nation that was meant to be the most prepared of all has really flubbed its response, and I think, to a degree, that has shocked even the most alarmed or pessimistic people who I'd spoken to before, in my earlier reporting.

On what happened to the medical supply chain for masks and swabs

The medical system runs on a just-in-time economy, much like the rest of the world, and products are made to order and they depend on these very long international supply chains, many of which have fractured in this pandemic. So, for example, Hubei Province, where the pandemic first took off in China, is also one of the world's leading centers for manufacturing medical masks. So the fact that the pandemic hit that region first and hardest really exacerbated the shortage of medical supplies. There's also now a shortage of the swabs that people used to collect viral samples as the very first step of testing. And one of the companies that leads the manufacture of those swabs is based in northern Italy, which is one of the centers of the pandemic in Europe. ...

It's really bad luck that both of those regions were particularly hit, but you could envisage the same problems for all sorts of other areas. I think this is what happens when you rely on a medical system that depends on these large international chains and that really don't have a lot of capacity to flex and surge in the event of a crisis. And that's especially bad now, because the pandemic has spread so quickly that the entire world is facing down the same problem at the same time and is after the same supplies at the same time which really has stretched many of these supply chains to a breaking point. Everyone is after the same supplies and there aren't enough of those supplies to go around. Everyone is competing with each other instead of cooperating, because the crisis has spread so quickly.

On rolling out a COVID-19 vaccine

The first steps so far have actually been encouragingly quick. A vaccine candidate has already entered early safety trials after a record-breakingly short time from actually identifying and sequencing the genome of this new virus. But the journey from these first trials to actually having a product that you can shoot into people's arms is very long and hard to shortcut. You need to know whether the vaccine is safe, whether it triggers an immune reaction. Then you need to know whether it's actually effective at preventing infections. You need to know what dose to use, how many doses to use, whether it also works in elderly people who are more at risk. All of these steps take time, and if you don't go through them, you might run the risk of creating a product that has really severe side effects or that is rolled out widely but just doesn't work.

So the experts I've spoken to feel that it will probably take between 12 and 18 months to even develop a working vaccine, let alone then to create the manufacturing capacity to create enough doses and then to distribute those doses and to actually inject them into people. This is not going to be a fast process. And until that process is complete, COVID-19 is going to be a part of our lives.

On the different methods being used to develop a vaccine for COVID-19

Most existing vaccines [against other viruses] use a dead or weakened virus or a fragment of that virus. So the idea is, you show that to the immune system, [and] the immune system can prepare defenses ahead of time. [One new vaccine candidate in development against the coronavirus] works in a slightly different way. It uses a piece of the virus' genetic material, its RNA. You inject that up into a person in the hope that that person then can build their own fragments of the virus using the instructions in that genetic material and that those sorts of homegrown fragments can then train the immune system. These RNA vaccines are a new technology. They have the potential to be really important and to be much faster. But the caveat is that no such vaccines have ever been taken to the market before. So we're breaking new ground and there aren't facilities already available that can manufacture such vaccines in the quantities that are needed.

By contrast, other teams are using more traditional approaches. For example, there's one group in France that is trying to repurpose the existing measles vaccine to instead target the new coronavirus. That might take a longer time at the front end. But on the plus side, if that actually works, then the world knows how to make measles vaccines in large quantities. So it's unclear which of ... these solutions will end up being quickest. But it's certainly reassuring that a lot of different options are being tried not just these two, but but many others. And we'll just have to wait and see which gets to the finish line soonest.

On the idea that the spread of the coronavirus might slow down in the summer

So, traditionally, coronaviruses and a lot of other respiratory viruses, like flu, do go away in the summer, and there are many possible reasons for that. Certainly, humidity and heat makes it easier for the cells of our airways to clear out a virus, and some of the immune response to these respiratory viruses appear to be stronger under those climatic conditions.

Now, is this new coronavirus going to behave in the same way? Possibly. Is that going to make a difference with the pandemic? I'm not sure. And the reason for that is that the virus is circulating through a global population that is completely immunologically naive to it. Our immune systems are not ready to deal with something like this. And so the virus has a large proportion of hosts among whom it can easily spread. To hope that the summer is going to downplay those dynamics far enough to contain the pandemic is, I think, wishful thinking. ... We're seeing transmission in places like Australia, which is just coming out of its summer, or Singapore, which is hot and humid in the tropics. And what that tells us is that it's probably wishful thinking to hope for heat and humidity to be the things that contain this virus. They may help, but only if we can slow its spread in other ways, such as through social distancing.

On being prepared for COVID-19 to come back

I think that's very likely. I think most experts would expect some kind of resurgence once current social distancing measures are released. That's sort of in the nature of these viruses. It's definitely likely because the pandemic is now so widespread that unless the entire world simultaneously brings the virus to heel, there are always going to be pockets where outbreaks are still ongoing, and that can seed [and] can reignite sparks of infection in places where outbreaks had already been extinguished. ...

And so we're likely looking at multiple rounds of social distancing, multiple bouts of social upheaval. Now, it's possible if we get our act together and if we do well in this first wave, that those subsequent bouts will be less dramatic and less uprooting than this current period of time has been, and that may well just be because of that uneven spread. So currently the virus is everywhere. It's hitting everywhere ... at more or less the same time. If different places can get it under control, there might be less potential for that sort of explosive worldwide spread. And then, over time, one would hope that surveillance measures would be better. We become better at testing for the virus and working out who's immune to it, at building up the necessary supplies to protect health care workers. All of those measures might mean that we can get a little bit more sophisticated in where social distancing is being rolled out, in the nature of those measures. But I think it's very clear that that is going to be a long game.

Pandemics often expose existing fault lines in societies, and they reveal whom a society cares about and whom it often ignores.

Ed Yong

On how the pandemic has hit society's most vulnerable

Clearly, the economic implications of this are going to be profound. I think, as with many disasters, it's going to hit people in different ways that are magnified by existing inequalities; people from low income groups, people from marginalized groups are going to feel the effects of this far more.

Pandemics often expose existing fault lines in societies, and they reveal whom a society cares about and whom it often ignores. The people who are still having to serve on the front lines of society while everyone else is sheltering indoors, people like grocery store workers, janitors, they are currently risking their lives because many of them don't have a choice. The elderly who have often been marginalized in the fringes of society are now [being asked to] isolate themselves even more, deepening the loneliness that many of them have already felt. People with mental health disorders, people with anxiety and obsessive compulsive disorder who have long been grappling with worries about infection and cleanliness, are now seeing some of their worst nightmares playing out around them and are struggling in a context where they don't have access to their usual support networks or therapists.

So a lot of societal dynamics which were already being overlooked and which were already fraying are going to fray even more. I think it's important to be wary of [that unraveling] and to look out for the people who are most going to need help. A pandemic causes a wave of physical suffering, but following that, there is also economic suffering, mental suffering, emotional suffering. We will need to be wary of all of those things when society rebuilds in the wake of this crisis.

On the potential of the pandemic to inspire positive change

I think that this is the time to be imagining what a better world might look like and to start actively working towards it. These periods of great social upheaval carry with them great risk and tragedy, but also great potential. So on a very simple level, after HIV spread throughout the world and the '80s, it led to better awareness of sexual health that led to mainstreaming of condom use, of testing [for sexually transmitted infections]. And perhaps the COVID-19 pandemic will lead to a normalization of health behaviors that have been quite difficult to get people to take up, like regular hand-washing for 20 seconds sometimes a rarity even in hospital settings, let alone in homes. And now all of us well, many of us, hopefully [are] washing our hands on a regular basis every day. Hopefully that will become a normal part of our culture in the future.

I also really hope that a lot of the ethic of cooperation that we're starting to see, of people in communities looking out for each other, coming together at a moment of crisis, will continue through the rest of this long-haul pandemic and beyond. I think we're going to need that if we're going to be better-prepared for what's to come. We need that sense of cooperation between neighbors in a community, between states, in a country and between countries an international community.

Amy Salit and Seth Kelley produced and edited the audio of this interview. Bridget Bentz, Molly Seavy-Nesper and Deborah Franklin adapted it for the Web.

The University of Wisconsin announced the development of a COVID-19 vaccine Thursday, and are offering $1.5 million in grants for COVID-19 research and community aid through the Wisconsin Partnership Program.

An international group of virologists at UW, in collaboration with the vaccine companies FluGen and Bharat Biotech, have begun to develop and test an original vaccine against COVID-19 called CoroFlu.

CEO of Wisconsin Alumni Research Foundation Erik Iverson spoke about the project in the news release.

The partners in this endeavor University of Wisconsin researchers, a biotech startup, and an international vaccine developer are moving forward with a sense of urgency and integrity incumbent upon us as scientists and world citizens, Iverson said.

UW predicts $100 million loss due to COVID-19 pandemicThe University of Wisconsin is expecting a $100 million loss due to the ongoing COVID-19 crisis, according to the Wisconsin Read

M2SR is a flu vaccine that activates an immune response against the flu. Based on this invention by UW virologists and FluGen co-founders Yoshihiro Kawaoka and Gabriele Neumann, M2SR will serve as the foundation for the COVID-19 vaccine, according to the news release.

Explained by the news release, Kawaokas lab will work to insert gene sequences from SARS-CoV-2, the coronavirus that causes the disease COVID-19, into M2SR in hopes the new vaccine will also prompt immunity against the coronavirus.

CoroFlu will also express the influenza virus hemagglutinin protein, which is the major influenza virus antigen, so we should get immune responses to both coronavirus and influenza, Neumann said the news release.

According to the news release, refinement of the vaccine and its testing at UW is expected to take three to six months. Bharat Biotech in Hyderabad, India will then produce the vaccine for clinical trials. Bharat Biotech has commercialized 16 vaccines and has the ability to produce almost 300 million doses of CoroFlu per year.

As a result of the expediency of the research, trials and production, CoroFlu could be tested in human clinical trials by fall 2020, according to the news release.

Also in response to the pandemic, a new Wisconsin Partnership Program funding opportunity hopes to aid researchers and community organizations to combat the present challenges facing Wisconsin from the COVID-19 pandemic, according to a news release from UW School of Medicine and Public Health.

Wisconsin Partnership Program University Relations Specialist Anne Pankratz discussed the expeditious turnaround time and communal relief focus of the COVID-19 Grant Program in an email.

COVID-19 Daily Updates: At least 31 confirmed deaths in Wisconsin, 228 confirmed cases in Dane CountyThe Badger Herald will update this article daily as more COVID-19 information comes out. Thursday, April 2. There are now Read

The grant program was developed to help researchers and community organizations address immediate needs and challenges that the pandemic is creating, Pankratz said. It was designed with a brief turn-around time in mind to help address immediate needs, rather than long-term challenges.

COVID-19 Response Grant Program serves as a rapid response mechanism to lessen the impact of the COVID-19 pandemic through scientific, medical or public health approaches, the grant program page said.

According to the Wisconsin Partnership Program, this funding opportunity supports community projects working to improve and protect the health of the people of Wisconsin, with an emphasis on high-risk populations.

We expect that researchers across the UW campus may apply for funding for projects that have the potential to lessen the impact of COVID-19, by focusing on medical and scientific advances as well as public health initiatives, Pankratz said.

According to the Wisconsin Partnership Program, the grant opportunity will fund up to $1.5 million in total awards. $750,000 will go to support community-led projects and the other $750,000 to support projects led by UW researchers. The grant opportunitys award amounts will range from $25,000 and $150,000, for up to 12 months.

Convalescent plasma

Plasma from those who have recovered from COVID can be used to treat those who have yet to get disease or are early in their disease progression. The plasma contains neutralizing antibodies that can boost a persons immune system to fight the virus. A team of investigators including Ray Goodrich, CSUs executive director of the Infectious Disease Institute and Heather Pidcoke, CSUs chief medical research officer, are collaborating on a project to study the efficacy and potential methods to improve the safety of this repurposed plasma treatment as part of planning for potential clinical trials.

The antibodies in convalescent plasma are specifically made to find the virus and take it out. We are studying pathogen reduction methods that may lower the chance of accidentally giving someone COVID-19 or another infection without meaning to, Pidcoke said. Ultimately we want to protect healthcare workers and other high-risk people from getting sick if they are exposed to the virus that causes COVID-19.

The FDA has already approved a number of individual drugs to treat patients showing symptoms of COVID-19 but use of those drugs in new combinations requires additional approval. CSU researchers have established the use of vero cells to screen cocktails of approved drugs to accelerate the approval process.

CSU researchers have initiated projects with at least six industry partners details to be announced shortly to quickly move these combination drug products toward FDA approval.

A lot of industries are limited with how they can work with the virus, said Rushika Perera, an associate professor of virology who is leading the project to repurpose approved drugs for COVID treatment. They need to partner with CSU to do this research. We have the expertise, labs and physical space.

Vaccines can offer long term protection from COVID-19 and CSU has two vaccine candidates in development.

Solavax repurposes a commercial platform that is currently used to inactivate pathogens in blood transfusions. The strategy uses light and riboflavin to produce an inactivated virus which stimulates a persons immune system to fight the virus.

We are building off of nearly 20 years of experience of using this process to improve the safety of blood transfusion products. That prior knowledge and current experience helps to translate this rapidly into a way to manufacture vaccine products, said Goodrich.

Another vaccine project underway would use a genetically modified form of the common probiotic Lactobacillus acidophilus to avert infection by the novel coronavirus. The concept of this work, led by Gregg Dean, head of CSUs Department of Microbiology, Immunology and Pathology, starts with a microorganism that thrives in the mucous membrane exactly where the new coronavirus attacks the body. The vaccine would interrupt attachment of the virus to host cells at two key junctures, sites that amount to the Achilles heel of the virus, Dean said.

Were fortunate to have such a depth and breadth of expertise in infectious disease here at CSU, he said. Investigators are working on vaccines, on antiviral therapies, on diagnostic strategies, and on how we can inactivate the virus on surfaces. Were trying to tackle this problem from every angle we can.

By Gina Lee

Investing.com-Australia announced a $973 million package for its childcare sector.

Japans government debated an economic packageincluding ECMO machines.

The United States is on target to develop aCOVID-19 vaccine with biotech company Modernawithin 12 to 18 months.

As ofApril 1,thenumber of confirmed cases globally stood at827,419with40,777deaths, according to the World Health Organisation.

Australia

Prime Minister Scott Morrison announced an A$1.6 billion ($973 million) package for the countrys13,000-strongchildcare sector over the next three months.

The services will be rendered free of charge as theywill be paid from taxpayer subsidies.

Japan

The government is mulling the increased production of extracorporealmembranousoxygenation (ECMO) machinesas part of an economic package to combat COVID-19.

The machines will replace a persons breathing to supply oxygen and remove carbon dioxide.

United States

White Househealthadvisor Anthony Fauci announcedovernightthat the first human trialto test a potential COVID-19 vaccine is on target and will be an ultimate game changer.

Biotech company Moderna is working with Fauci and other healthofficialsto develop the vaccine. Human trials started on March 16.

The vaccine is estimated to bedistributedwithin 12 to 18 months, with phase two trials expected to begin in a few months.

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