Category: Corona Virus Vaccine

The frenetic search for the miracle that will rid the world of COVID-19 is branching out in a thousand directions, and a large part of the microbial treasure hunt is going on in the Bay Area, where major progress has been made in the 100 days since residents were ordered to shelter in place.

Scientists at universities, laboratories, biotechnology companies and drug manufacturers are combing through blood plasma taken from infected patients for secrets that will help them fight the disease.

The key is likely a super-strength antibody found in some patients. But researchers must first figure out how those antibodies work and how they can be harnessed and used to stop the many health problems associated with COVID-19, particularly acute respiratory distress syndrome, or ARDS, which has killed more people than any other complication connected to the disease.

Other developments showing promise include injections of mesenchymal stem cells, found in bone marrow and umbilical cords, that doctors are studying to battle inflammation caused by ARDS. And a steroid called dexamethasone reduced the number of deaths by halting the overreactive immune responses in seriously ill patients in the United Kingdom.

In all, more than 130 vaccines and 220 treatments are being tested worldwide.

What follows is a list of some of the most promising elixirs, medications and vaccines with ties to the Bay Area:

Monoclonal antibodies / Vir Biotechnology, San Francisco: Scientists at Vir and several institutions, including Stanford and UCSF, are studying monoclonal antibodies, which are clones of coronavirus-fighting antibodies produced by COVID-19 patients.

The idea is to utilize these neutralizing antibodies which bind to the virus crown-like spikes and prevent them from entering and hijacking human cells.

Only about 5% of coronavirus patients have these super-strength antibodies, and those people are believed to be immune to a second attack.

The trick for scientists at Vir is to identify these neutralizing antibodies, harvest, purify and clone them. If they succeed, the resulting monoclones could then be used to inoculate people and it is hoped give them long-term immunity against the coronavirus. The company recently signed a deal with Samsung Biologics, in South Korea, to scale up production of a temporary vaccine in the fall after clinical trials are complete.

Another monoclonal antibody, leronlimab, is being studied in coronavirus clinical trials by its Washington state drugmaker, CytoDyn. The companys chief medical officer is in San Francisco, and the company that does laboratory tests of leronlimab is in San Carlos.

Interferon-lambda / Stanford University: Doctors at Stanford are running a trial to see if interferon-lambda, which is administered by injection, helps patients in the early stages of COVID-19. Interferon-lambda is a manufactured version of a naturally occurring protein that has been used to treat hepatitis. Stanford doctors hope it will boost the immune system response to coronavirus infections.

Dr. Upinder Singh, a Stanford infectious-disease expert, said the trial has enrolled more than 50 patients and is halfway finished. We have noted that patients tolerate the drug very well, she said.

Mesenchymal stem cells / UCSF and UC Davis Medical Center: UCSF Dr. Michael Matthay is leading a study about whether a kind of stem cell found in bone marrow can help patients with ARDS. Matthay hopes that the stem cells can help reduce the inflammation associated with some of ARDS most dire respiratory symptoms, and help patients lungs to recover.

Matthay is aiming to enroll 120 patients in San Francisco, the UC Davis Medical Center in Sacramento and hospitals in a handful of other states. He said the trial, which includes a small number ARDS patients who dont have COVID-19, should have results within a year. So far 17 patients are enrolled in the trial, most of them in San Francisco.

Remdesivir / Gilead Sciences (Foster City): Remdesivir, once conceived as a potential treatment for ebola, was the first drug to show some promise in treating COVID-19 patients. The drug interferes with the process through which the virus replicates itself. A large study led by the federal government generated excitement in late April when officials said hospitalized patients who received remdesivir intravenously recovered faster than those who received a placebo.

A later study looking at dosage showed some benefit for moderately ill COVID-19 patients who received remdesivir for five days, but improvement among those who got it for 10 days was not statistically significant. Gilead, a drug company, recently announced that it will soon launch another clinical trial to see how remdesivir works on 50 pediatric patients, from newborns to teenagers, with moderate to severe COVID-19 symptoms. More than 30 locations in the U.S. and Europe will be involved in the trial, the company said.

Coronavirus crisis: 100 days

Editors note: Its been 100 days since the Bay Area sheltered in place, protecting itself from the coronavirus pandemic. What have we learned in that time? And what does the future hold for the region and its fight against COVID-19? The Chronicle explores the past 100 days and looks to the future in this exclusive report.

Favipiravir / Fujifilm Toyama Chemical (Stanford University): This antiviral drug, developed in 2014 by a subsidiary of the Japanese film company to treat influenza, is undergoing numerous clinical studies worldwide, including a Stanford University trial that began this month. Unlike remdesivir, it can be administered orally, so it can be used to treat patients early in the disease, before hospitalization is necessary.

Stanford epidemiologists want to see if favipiravir, which has shown promising results in other trials, prevents the coronavirus from replicating in human cells, halts the shedding of the virus and reduces the severity of infection. The Stanford study, the only outpatient trial for this drug in the nation, is enrolling 120 people who have been diagnosed with COVID-19 within the past 72 hours. Half of them will get a placebo. People can enroll by emailing treatcovid@stanford.edu.

Colchicine / UCSF (San Francisco and New York): The anti-inflammatory drug commonly used to treat gout flare-ups is being studied in the U.S. by scientists at UCSF and New York University. The drug short-circuits inflammation by decreasing the bodys production of certain proteins, and researchers hope that it will reduce lung complications and prevent deaths from COVID-19. About 6,000 patients are receiving colchicine or a placebo during the clinical trial, dubbed Colcorona, which began in March and is expected to be completed in September.

Selinexor / Kaiser Permanente: Kaiser hospitals in San Francisco, Oakland and Sacramento are studying selinexor, an anticancer drug that blocks a key protein in the cellular machinery for DNA processing, as a potential COVID-19 treatment. The drug has both antiviral and anti-inflammatory properties, and its administered orally, according to Kaisers Dr. Jacek Skarbinski. The trial aims to enroll 250 patients with severe symptoms at Kaiser and other hospitals that are participating nationwide.

VXA-COV2-1 / Vaxart, South San Francisco: The biotechnology company Vaxart is testing this drug to see if it is as effective at controlling COVID-19 as trials have shown it to be against influenza. VXA-COV2-1, the only potential vaccine in pill form, uses the genetic code of the coronavirus to trigger a defensive response in mucous membranes. The hope is that the newly fortified membranes will prevent the virus from entering the body.

Its the only vaccine (candidate) that activates the first line of defense, which is the mucosa, said Andrei Floroiu, Vaxarts chief executive, noting that intravenous vaccines kill the virus after it is inside the body. Our vaccine may prevent you from getting infected at all.

The drug was effective against influenza and norovirus in trials and appears to work on laboratory animals, Floroiu said. He expects trials of VXA-COV2-1 on humans to begin later this summer.

VaxiPatch / Verndari (Napa and UC Davis Medical Center): Napa vaccine company Verndari makes a patented adhesive patch that can deliver a vaccine instead of a shot. Now, the company is trying to make a vaccine for COVID-19 that they can administer through that patch. At UC Davis Medical Center in Sacramento, Verndari researchers are developing a potential vaccine that relies on the coronavirus spike-shaped protein. When injected into a person, the substance would ideally train their body to recognize the virus and fight it off without becoming ill.

A spokeswoman told The Chronicle that the companys preclinical tests have shown early, positive data in developing an immune response. Verndari hopes to move into the next phase of testing in the coming weeks and start clinical trials in humans this year.

If the vaccine is proved effective and safe, patients could receive it through the mail, according to company CEO Dr. Daniel Henderson. The patch would leave a temporary mark on the skin that patients could photograph and send to their doctor as proof they have taken the vaccine, Henderson has said.

Peter Fimrite and J.D. Morris are San Francisco Chronicle staff writers. Email: pfimrite@sfchronicle.com, jd.morris@sfchronicle.com Twitter: @pfimrite, @thejdmorris

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Efforts at coronavirus vaccines and treatments abound in the Bay Area - San Francisco Chronicle

As I dilute the coronavirus to infect cultured cells, I hear the reassuring sound of purified air being blown by my respirator into my breathing space. There are three layers of nitrile and protective materials between me and the virus, and every part of my body is wrapped in protective equipment.

Thanks to these precautions and other features of our high containment lab, I'm not nervous about being up close and personal with this dangerous pathogen.

Suiting up like you're on a space mission

When performing a SARS-CoV-2 experiment, my days start by coordinating with a least one of my lab members we always work in pairs inside containment. We outline the experiment step by step, check we have all of the required supplies, confirm and review any procedures and communicate with the facility staff.

First thing on site, we check multiple gauges and monitors to ensure the facility is functioning properly. Then we enter the changeroom, where we remove all of our street clothes, including jewelry and underwear. We don't want to bring any potentially contaminated clothing or items out of containment at the end of the day. "You enter and leave containment as you were at birth" is our saying.

We don scrubs, close-toed laboratory shoes, a full-body disposable suit, shoe covers, multiple pairs of gloves and a surgical gown. Most importantly, we also put on our air-purifying respirators. This device includes a Batman-style utility belt that houses a motor attached to an air filter capable of filtering out any infectious agents in the air. Powered by a battery pack that will last at least six hours, the respirator blows purified air up a tube into a hood that covers my entire head and shoulders. The hood is under positive pressure so no air from the environment can enter my breathing space.

Through the clear plastic face shield I can see that we look like astronauts in space suits. Once fully equipped, we enter the containment facility and proceed to our designated virus culture and animal holding rooms. This whole process has taken between 30 and 45 minutes.

What's inside?

The facility itself is a giant vacuum. All of the air flows from outside into the lab. It exhausts through air filters that remove any stray infectious agents. The facility is designed to accommodate failures. If one filter fails, there's a second one, and all work stops until both are working again.

Within this space our work is divided into rooms where we grow virus in cells in plastic dishes. There are separate spaces where we house animals that we use to evaluate how the virus is transmitted and if our vaccines are working.

When we're done for the day, the materials we used are treated with bleach or stored safely. All waste is sealed in plastic bags and treated in a pressurized, high-heat oven called an autoclave to ensure any remaining virus is dead.

To leave the lab, as we move through various anterooms toward the exit, at every stage we remove a layer of gloves and protective equipment. We also regularly spray our suits and respirators with powerful disinfectants. At the last step, we remove our respirator and scrubs and "shower out" of the facility. Even the wastewater from the shower is boiled for an hour under high pressure to kill any microorganisms.

The only living thing that leaves the facility is the scientist.

Training and oversight

Many of the safety precautions around working in a high containment facility happen long before a researcher steps foot on the site. To gain access to this laboratory, I underwent an extensive FBI and police background check.

I was subject to a medical exam, and my lung capacity was tested. I was vaccinated against influenza. I'm sure when a Covid-19 vaccine becomes available, I'll get that shot as well.

A rigorous training and testing process made sure I know how to handle agents like SARS-CoV-2 safely, as well as things like what to do during a fire, a bomb threat and even a tornado. Regardless of my over 10 years experience working with viruses, everyone entering the facility is trained from scratch.

Every high containment lab in the U.S. is subject to regular inspections by the US Department of Agriculture, the Centers for Disease Control and Prevention or both. Once open, a facility is reinspected and certified every three years. During the interim, inspectors arrive unannounced to review all aspects of the facility, including maintenance records, inventories of agents and operating procedures. My university also provides oversight.

In addition, there is a myriad of other security features. One of my colleagues once joked that during a zombie apocalypse, the containment lab would be the best place to hide.

Ultimately, all these precautions are in place to help us understand how the SARS-CoV-2 virus is transmitted in animals and determine the optimal vaccine formulation that will prevent transmission. The facility at Penn State, like others throughout the US, was built for this type of research so scientists could quickly and safely respond during a pandemic. With a bit of luck, the work done by dedicated researchers in these facilities will help bring the Covid-19 pandemic to an end, sooner than later.

Troy Sutton is assistant professor of veterinary and biomedical sciences at Pennsylvania State University. Disclosure: Sutton receives funding from Centers of Excellence for Influenza Research (CEIRS), the National Institute of Allergy and Infectious Diseases (NIAID) and The Huck Institutes of Life Sciences at Pennsylvania State University.

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This supersafe labs protects researchers as they race to develop a coronavirus vaccine - CNN

Lockdown is easing. People are returning to work and shops are lifting their shutters. But we dont have a vaccine and were a long way from achieving herd immunity so this new-found freedom is tainted with fear: fear of a second wave of infections.

Indeed, people are already talking about a second wave hitting China and Iran. But the concept of a second wave is flawed and creates dangerous misconceptions about the pandemic.

The idea of a second wave stems from the flawed comparison with the seasonality of the flu virus.

Early in the pandemic, many experts discussed the similarities between SARS-CoV-2 and influenza virus. They are both viruses that cause respiratory infections mostly mild. Influenza is also the cause of most recent previous pandemics. From these similarities, it was tempting to assume that COVID-19 would behave similarly to a flu pandemic. Yet these are very different viruses with very different behaviour.

COVID-19 has a far greater fatality rate compared with the flu, along with a much higher rate of hospitalisations and severe infection. Also, influenza is a seasonal virus. Every year we see cases of the flu begin in early autumn, increase over the winter and then wind down as we approach summer. This repeats yearly, and so if a new strain of flu emerges we would probably have a first wave of infections during winter-spring, then the virus would come back in a second wave in autumn-winter the following year.

The most severe pandemic ever recorded was the so-called Spanish flu pandemic. During this pandemic, the virus infected the northern hemisphere during the spring of 1918, died down some during the summer of 1918 and then came back in greater force in the autumn of 1918. It is tempting to speculate that COVID-19 will decline or disappear during the summer, only to reappear as the weather gets colder. But we dont know if COVID-19 is a seasonal virus.

Emergency hospital during the 1918 flu epidemic, Camp Funston, Kansas.

Image: Otis Historical Archives/Wikimedia Commons

The flu has lower transmission in the summer because the combination of higher humidity, increased UV light and people spending less time inside, close to each other. Some of these factors might also affect COVID-19, but we really dont know to what extent.

Even if seasonal factors affect COVID-19 transmission, the spread of a new virus through a population that has no immunity will overwhelm any influence of seasonal factors. The 2009 swine flu pandemic virus and the 1918 pandemic virus were new viruses that people had no immunity to. As a result, the virus did not go away in the summer, though transmission was somewhat reduced. So we cannot expect that COVID-19 will behave as a seasonal virus and diminish over the summer only to return with a second wave in the autumn.

The first wave hasnt ended

Aside from seasonality, there is another reason the idea of a second wave is flawed. The concept of a second wave implies that it is something inevitable, something intrinsic to how the virus behaves. It goes away for a bit, then comes back with a vengeance. But this idea fails to take into account the importance of ongoing preventative actions and portrays us as helpless and at the whim of this pathogen.

We are not between waves. We have new cases in the UK every day. We are in an ebb and flow of COVID-19 transmission that is continually affected by our precautionary actions.

Letting up on precautions will lead to an increase in cases. This is the new normal and what to expect until we have an effective vaccine with significant population uptake. Until then we have to depend on our actions to keep cases low both now and in autumn.

Cross-sectional model of a coronavirus.

Image: scientificanimations.com/Wikimedia Commons

The concept of a second wave portrays the pandemic as a force of nature that is beyond our control. But we have evidence from many countries that a strong public health system (consisting of widespread testing, contact tracing, isolation and health support) combined with public participation in safe behaviour (wearing face coverings, keeping physical distance, hand washing) is highly effective at minimising COVID-19 transmission.

We are not at the mercy of the virus, now or in the future. This is hopeful news, but it puts the burden of responsibility on all of us. We must keep fighting, but in doing so we should not fear an inevitable second wave.

License and Republishing

World Economic Forum articles may be republished in accordance with our Terms of Use.

Written by

Jeremy Rossman, Honorary Senior Lecturer in Virology and President of Research-Aid Networks, University of Kent

This article is published in collaboration with The Conversation.

The views expressed in this article are those of the author alone and not the World Economic Forum.

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COVID-19: Is it right to talk about a second wave? - World Economic Forum

The latest:

Renewed lockdown measures in a region of Germany where hundreds of coronavirus cases have sprung up at a slaughterhouse and states in the U.S. reporting record new cases provided a stark reminderon Tuesday that the pandemic is far from over.

In the U.S., a number of states reported record daily increaseson Tuesday.

Nevadareported a record 462 new casesamid an uptick of infections that started about two weeks after casinos in Las Vegas reopened; Arizona reported arecord of nearly 3,600 newcasesas the state continued to set records for the number of people hospitalized, in intensive care and on ventilators; Texas Gov.Greg Abbott said hisstate surpassed 5,000 new cases in a single day for the first time; and Mississippi reported a record 611 new cases.

Dr. Anthony Fauci, the government's top infectious disease expert, told a House committee on Tuesday he believes "it will be when and not if" there will be a COVID-19 vaccine and that he remains "cautiously optimistic" that some will be ready at the end of the year

WATCH |Fauci'cautiously optimistic' COVID-19 vaccine will be available by end of 2020:

In Germany, lockdown restrictions are in effect in the North Rhine-Westphalia state after more than 1,550 people tested positive for coronavirus at the Toennies slaughterhouse in Rheda-Wiedenbrueck.

Thousands more workers and family members were put into quarantine to try to halt the outbreak.

On Tuesday, North Rhine-Westphalia Gov. Armin Laschet said people in Guetersloh and parts of a neighbouring county will now face the same restrictions that Germany saw in March and April, including curbs on social gatherings and bar closures.

"The purpose is to calm the situation, to expand testing to establish whether or not the virus has spread beyond the employees of Toennies," Laschet said.

WATCH |German region reinstates lockdown after meat factory virus outbreak:

The governor expressed frustration at the company's handling of the outbreak, saying authorities had to order Toennies to release the names of its employees.

"The readiness to co-operate could have been greater," he said.

Union officials have blamed poor working and living conditions that migrant workers faced under a loosely regulated sub-contractor.

Mexico posted another record one-day increase in confirmed cases 6,288 while 793 more deaths have been reported.

Officials claim the pandemic has stabilized and may have even started a downward trend this week, but they have made that claim several times before.

Mexico has also had an extremely high rate of infections among health care professionals. About 39,000 of the country's confirmed cases are health care workers.There have been 584 deaths among doctors, nurses, technicians and hospital workers.

The World Health Organization says the pandemic is still growing.

"The epidemic is now peaking or moving toward a peak in a number of large countries," said Dr. Michael Ryan, WHO's emergencies chief.

Brazil recorded 39,436 new casesas well as 1,374 new deaths, the country's health ministry said on Tuesday.

The country has the second most COVID-19 cases and deaths in the worldbehind the U.S.

South Africa braced for an anticipated surge of COVID-19 cases by opening a large field hospital with 3,300 beds in a converted car manufacturing plant.

The field hospital has been constructed in the city of East London in the Eastern Cape province, one of the country's centres of the disease. South Africa has now reported a total of 101,590 coronavirus cases, including 1,991 deaths.

India has been recording about 15,000 new infections each day, and some states Tuesday were considering fresh lockdown measures to try to halt the spread of the virus among the country's 1.3 billion people. The government had lifted a nationwide lockdown to restart the ailing economy and give hope to millions of hungry, unemployed day labourers.

India's huge virus caseload is highlighting the country's unequal society, where private hospitals cater to the rich and public hospitals are so overwhelmed that many people fear to enter them.

In Pakistan, the government is determined to buoy the frail economy by opening up the country even if overcrowded hospitals are turning away patients. New cases have also been rising steeply in Mexico, Colombia and Indonesia.

Concerns over the spread of the virus prompted Saudi Arabia's unprecedented decision to limit the number of people performing the hajj pilgrimage this year to only a few thousand. The pilgrimage usually draws up to 2.5 million Muslims from all over the world.

Saudi Arabia has one of the highest infection rates in the Middle East, with more than 161,000 confirmed cases so far, including 1,307 deaths.

Worldwide, more than 9.1 million people have been infected and more than 473,000 have died, according to a tally by Johns Hopkins University.The United States has the most infections and deaths by far in the world, with 2.3 million cases and over 120,000 confirmed virus-related deaths. Experts say the true numbers are much higher because of limited testing and cases in which patients had no symptoms.

WHO Director-General Tedros Adhanom Ghebreyesus said it took more than three months for the world to see onemillion confirmed infections but just eight days to see the most recent onemillion cases.

"The greatest threat we face now is not the virus itself. It's the lack of global solidarity and global leadership," he said.

As of 6p.m.ET on Tuesday, Canada had 101,963 confirmed and presumptive coronavirus cases, with 64,704 of the cases listed asresolved or recovered. A CBC News tally of deaths based on provincial data, regional information and CBC's reporting stood at 8,499.

There are no proven treatments or vaccines for the novel virus, which causes an illness called COVID-19. Health officials say most people who contract the virus will experience mild to moderate illness, but some particularly those with underlying health issues and the elderly are at greater risk of severe illness and death.

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Coronavirus: What's happening around the world on June 23 - CBC.ca

Plano is the nations second most stressed-out city when it comes to worrying about COVID-19, according to a study by Babylon, Inc.

Babylon, a digital health care company, came to that conclusion by analyzing posts on Twitter. The tweets were gathered from May 14 to May 18 and then analyzed using a program that detects stress in text.

According to Babylons analysis, 40.7 percent of tweets from Plano showed high levels of stress. That earned the city the number two ranking in the nation. Stockton, California came in first with 43.7 percent. Forty percent of tweets from Naperville, Illinois indicated high levels of stress, earning it the third spot.

No other Texas cities were in the top 10 and the state did not register in the top ten most stressed states, which was led by Wyoming.

The coronavirus pandemic is undoubtedly causing stress for millions of people across the US, but after analyzing Twitter to tap into local consciousness around the virus, weve found that some states and cities are much more stressed than others, Babylons study states.

Each tweets each contained at least one or more words relating to COVID-19 such as quarantine, corona, virus, COVID, self-isolation, social distancing, pandemic, epidemic, vaccine, mask, PPE (personal protective equipment, ventilator, antibody and antibodies.

The level of stress was determined by a tool called TensiStrength, which was developed by Mike Thelwall, professor of information technology at Wolverhampton University in the United Kingdom. TensiStrength estimates the stress levels in short texts based on the classification of words in the text related to stress, frustration, anxiety, anger and negativity.

The tweets that were analyzed came were from the top five most populated cities for each state in the US, according to Babylon. Also included were the top 100 most populated cities in the country.

The top three stressed-out states, based on their tweets, were Wyoming (40.1 percent), Delaware (38.8) and Mississippi (38.7). Texas was not in the top 10.

In all, more than 2.5 million tweets were collected and 155,177 were included in the final analysis, according to the study.

A city of nearly 300,000, Plano has 684 active cases of COVID-19 and 253 recoveries as of Tuesday afternoon. Ten people in Plano have died from the illness. The citys website has a COVID-19 webpage that frequently updates the number of cases and other related information.

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Study finds Plano is second in the nation for COVID-19 stress - The Dallas Morning News

A new study suggests that as many as 8.7 million Americans came down with coronavirus in March, but more than 80% of them were never diagnosed.A team of researchers looked at the number of people who went to doctors or clinics with influenza-like illnesses that were never diagnosed as coronavirus, influenza or any of the other viruses that usually circulate in winter.There was a giant spike in these cases in March, the researchers reported in the journal Science Translational Medicine."The findings support a scenario where more than 8.7 million new SARS-CoV-2 infections appeared in the U.S. during March and estimate that more than 80% of these cases remained unidentified as the outbreak rapidly spread," Justin Silverman of Penn State University, Alex Washburne of Montana State University and colleagues at Cornell University and elsewhere, wrote.Only 100,000 cases were officially reported during that time period, and the U.S. still reports only 2.3 million cases as of Monday. But there was a shortage of coronavirus testing kits at the time.The team used data collected from each state by the Centers for Disease Control and Prevention for influenza-like illness. The CDC uses this data to track the annual seasonal flu epidemic. It asks doctors to report all cases of people coming in for treatment for fever, cough and other symptoms caused by influenza."We found a clear, anomalous surge in influenza-like illness (ILI) outpatients during the COVID-19 epidemic that correlated with the progression of the epidemic in multiple states across the U.S.," Silverman and colleagues wrote."The surge of non-influenza ILI outpatients was much larger than the number of confirmed cases in each state, providing evidence of large numbers of probable symptomatic COVID-19 cases that remained undetected."These were people who showed up at a doctor's office or clinic with symptoms. Most people with COVID-19 likely never sought treatment of testing for it."The U.S.-wide ILI surge appeared to peak during the week starting on March 15 and subsequently decreased in numerous states the following week; notable exceptions are New York and New Jersey, two of the states that were the hardest hit by the epidemic, which had not started a decline by the week ending March 28," the team wrote.The researchers could not count every single case, so they ran a series of calculations to make sure their data fit in with what's known about state populations and about the annual flu epidemic, as well as with the hard data that was collected from actual testing of coronavirus patients. They also took into account growing evidence that people started avoiding hospitals, clinics and doctor's offices once it was clear there was a pandemic, and after pandemic lockdowns started."If 1/3 of patients infected with SARS-CoV-2 in the U.S. sought care, this ILI surge would have corresponded to more than 8.7 million new SARS-CoV-2 infections across the U.S. during the three-week period from March 8 to March 28, 2020," the researchers wrote.Cases fell after that. "We saw this huge peak that ended on March 22 in most places," Silverman told CNN. Cases have been on the decline since then, he said but the data the team is collecting does not include the past two weeks.The team is now working to try to get closer to real-time surveillance of the pandemic. The data from the CDC comes in about two weeks after people make their doctor visits. They hope their approach called syndromic surveillance could complement data collected from actual testing. "In a dream world, everyone who comes in would have a test. We would be able to get a full scope of the pandemic," Washburne told CNN.

A new study suggests that as many as 8.7 million Americans came down with coronavirus in March, but more than 80% of them were never diagnosed.

A team of researchers looked at the number of people who went to doctors or clinics with influenza-like illnesses that were never diagnosed as coronavirus, influenza or any of the other viruses that usually circulate in winter.

There was a giant spike in these cases in March, the researchers reported in the journal Science Translational Medicine.

"The findings support a scenario where more than 8.7 million new SARS-CoV-2 infections appeared in the U.S. during March and estimate that more than 80% of these cases remained unidentified as the outbreak rapidly spread," Justin Silverman of Penn State University, Alex Washburne of Montana State University and colleagues at Cornell University and elsewhere, wrote.

Only 100,000 cases were officially reported during that time period, and the U.S. still reports only 2.3 million cases as of Monday. But there was a shortage of coronavirus testing kits at the time.

The team used data collected from each state by the Centers for Disease Control and Prevention for influenza-like illness. The CDC uses this data to track the annual seasonal flu epidemic. It asks doctors to report all cases of people coming in for treatment for fever, cough and other symptoms caused by influenza.

"We found a clear, anomalous surge in influenza-like illness (ILI) outpatients during the COVID-19 epidemic that correlated with the progression of the epidemic in multiple states across the U.S.," Silverman and colleagues wrote.

"The surge of non-influenza ILI outpatients was much larger than the number of confirmed cases in each state, providing evidence of large numbers of probable symptomatic COVID-19 cases that remained undetected."

These were people who showed up at a doctor's office or clinic with symptoms. Most people with COVID-19 likely never sought treatment of testing for it.

"The U.S.-wide ILI surge appeared to peak during the week starting on March 15 and subsequently decreased in numerous states the following week; notable exceptions are New York and New Jersey, two of the states that were the hardest hit by the epidemic, which had not started a decline by the week ending March 28," the team wrote.

The researchers could not count every single case, so they ran a series of calculations to make sure their data fit in with what's known about state populations and about the annual flu epidemic, as well as with the hard data that was collected from actual testing of coronavirus patients. They also took into account growing evidence that people started avoiding hospitals, clinics and doctor's offices once it was clear there was a pandemic, and after pandemic lockdowns started.

"If 1/3 of patients infected with SARS-CoV-2 in the U.S. sought care, this ILI surge would have corresponded to more than 8.7 million new SARS-CoV-2 infections across the U.S. during the three-week period from March 8 to March 28, 2020," the researchers wrote.

Cases fell after that. "We saw this huge peak that ended on March 22 in most places," Silverman told CNN. Cases have been on the decline since then, he said but the data the team is collecting does not include the past two weeks.

The team is now working to try to get closer to real-time surveillance of the pandemic. The data from the CDC comes in about two weeks after people make their doctor visits. They hope their approach called syndromic surveillance could complement data collected from actual testing. "In a dream world, everyone who comes in would have a test. We would be able to get a full scope of the pandemic," Washburne told CNN.

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Study suggests 80% of COVID-19 cases in the US went undetected in March - 4029tv

Despite the pitfalls of drug development, manufacturers of potential coronavirus vaccines are pushing to accelerate the development timeline. Rather than beginning with preliminary studies in animals, companies are conducting the tests concurrently with early human trials which regulators have allowed because of the urgency of the situation.

Manufacturers are also merging clinical trials, which are typically done in three phases, and moving swiftly from one stage to another. Johnson & Johnson will begin testing its vaccine in people next month, in a study that will combine a phase one safety trial and a phase two efficacy trial. The company plans to start the final phase of testing, a phase three trial, by September.

Another vaccine, made by Moderna Therapeutics, is heading into final human trials in July. And a candidate from AstraZeneca and the University of Oxford is hot on its heels. A dozen more candidates are progressing through laboratory tests and early studies in people.

But those trials can only be accelerated so much. Moderna plans to enroll 30,000 people in its phase three studies, Fauci said and signing them all up could take the rest of the year.

Scientists are also now considering sometimes controversial methods, such as vaccinating healthy volunteers and then exposing them to the virus to see whether the vaccine works. That approach, known as a human challenge study, would need to be authorized by the FDA and overseen by an ethics committee.

Human challenge studies are tricky because scientists need to expose volunteers to just the right amount of the virus too much, and the vaccine could fail; too little, and the vaccines effectiveness could be overstated. But this type of study could fill in crucial data gaps if the U.S. outbreak shrinks before the first candidate vaccines enter phase three trials in the fall.

Its on the table. I hope we wont have to use it, said Fauci, noting that the method would not necessarily save time. We are making challenge doses. Were not saying were going to use them.

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White House pressure for a vaccine raises risk the U.S. will approve one that doesnt work - POLITICO

Written by Shiny Varghese | Updated: June 21, 2020 4:29:23 pm The novel coronavirus pandemic and the lockdowns that were put in place across the world to tackle it pose questions about the future of urban living. (Illustration by Suvajit Dey)

Think of a city that has a skin that can inflate and deflate, depending on the number of people it needs to accommodate. A house that can be lifted on a crane and perched on skyscrapers and detached when your work in the city is done. What if a city can hang off an airship and land overnight in a place, with a kit of moveable parts? In the late 1960s, when modernism was making chunky cubes of houses for people to live in and grids for urban layouts, a group of six British architects came together to form Archigram. They began with a single-page magazine that was filled with collages, poems and visuals of utopian possibilities of a city flexible, mobile and adaptable. The group would challenge generations of architects to build, dream and envision possible futures. Though Archigram never built any city and critics called them out for their assumption that the earth had endless resources, many of their ideas seem to have found their way into our everyday, from escalators to monorails.

The novel coronavirus pandemic and the lockdowns that were put in place across the world to tackle it pose questions about the future of urban living. In India, among the images seared into public memory are those of crowds cheering on balconies of towering apartments and private homes, and that of workers streaming out of cities, walking hundreds of kilometres to their homes. Some of us, for whom home remained a safe place, raised the drawbridges, switched on ourWiFi and disconnected from the outside. We created islands for ourselves within our homes, while the migrant worker moved out of his dwelling place.

Today its the pandemic, tomorrow it could be an intense heat wave or a global climate crisis. Confined living will become the way forward, says Thiruvananthapuram-based urban designer and architect Manoj Kumar Kini. A possible future model, he says, lies in the example of Arcosanti. Sometime in the 1970s, Italian architect Paolo Soleri planned a future city that would meld ecology and architecture. In the Arizona desert, he envisioned the utopian metropolis, Arcosanti. Its ribbed vaults allowed ample light and air to filter into spaces, and encouraged a sense of community. One could walk to the office or workshop, compost with ones neighbour or walk out of ones house into the thick of cultural action. While it had its faults, be it the people who lived there or the unadaptability of the structure, it offered a worldview that could change the way we live.

Closer home, Auroville near Puducherry aimed to be a place with a new consciousness, with like-minded people from all over the world making it their home. In the future, urban living could be like something between an apartment and a township like Dwarka in Delhi, where compact living will be the norm, with people choosing to walk, cycle or take public transport, because distance will compress. We will travel less, have a smaller ecological footprint, and have more time with family, says Kini.

Could buildings of the future be about empathy, about an architect who places himself/herself in the role of a future dweller and tests the validity of the ideas through this imaginative exchange of roles and personalities? asks Finnish architect and thinker Juhani Pallasmaa in the book Architecture and Empathy (Peripheral Projects; 2015). Will buildings become a shared resource? Can a university and a corporate office be in the same campus? Can government administration and cultural centres coexist? Maybe it will open up spaces in the city, between building and non-building, where designers and architects will need to intervene to revitalise, renovate, and renew. We will have to get off our Autocads and get our hands dirty. Just the way you now want a hairdresser to come home, people might want an architect to come home and use what they have to build anew, since money and building resources will be hard to come by, says architect Moulshri Joshi of the Delhi-based firm Space Matters.

Until now, we were aware of those who lived on pavements, in slums and chawls and overcrowded small apartments. But we didnt realise there is another lot of people who live in corridors, garages, attics, mezzanines, and lofts in every city, and their numbers are staggering. When the city turns its back on them, where can they go? says architect and habitat professional Kirtee Shah, who lives in Ahmedabad.

For the poor migrant to the city, there is a place called home in the village and a city where he earns his daily bread. For some, the home is a resort but for those who dont have that privilege, the city was their home. It gave them certainty. What does it mean to not have that in a lockdown? There are no easy answers, but we need to think of ideas of care and how we can create those spaces in our cities. How can we create different levels of communities and what will those spaces be? says Mumbai-based architect and urbanist Rupali Gupte.

In a recent letter to Praveen Pardeshi, former municipal commissioner of Mumbai, Shah offered suggestions for handling the slum crisis in the city. From using vacant houses and unsold inventory in housing for migrants and using rooftops of public buildings to create temporary housing stock, Shah pushed for more dignified dwelling units.He recounts his keynote address at the opening of the State of Housing exhibition in Mumbai in 2018. He asked an audience of nearly a 100 people, a majority of them architects, if they had heard of Indira Awaas Yojana. Only a few hands went up. It was one of the worlds biggest social housing projects, which lasted nearly 30 years and built more than 20 million houses, but Indias architects barely intervened. It speaks volumes about the disconnect architects have with society, he says.

While architects design on a computer, the drawings are executed by masons, carpenters and unskilled labourers. They are the ones who convert our dreams into beautiful projects. So I asked, Since most of you visit your sites at least every two weeks, how many of you have seen the conditions in which the workers live? Barely one hand came up, says Shah. We need to rethink and reshape our cities which are inhuman and hostile to the people who build them.In the letter, Shah suggests renegotiating terms with employers so that workers are provided better places to live. [It] could be a rented place in a slum redevelopment colony, in an affordable low-income settlement, in a slum where a family is willing to rent a room, or in a liveable tent on a public building terrace.

The comfort of home for migrants is also the sense of security that comes from the physical and figurative boundaries in a village. Numerous migrants testified to the urgent need of going home, even if it meant starvation or death. Homes in villages have their own layering. The epidermis that holds you in. You have the aangans (courtyards), and within that the public threshold, and then within them bigger rooms, and then your own room, your clothes, your body. Here, the epidermis of life has always existed, which is not affected by the commodities of the world. With it comes immunity, when your food and shelter is homegrown, says Bengaluru-based architect Varun Thautam, who conducts workshops on handmade buildings. Today, in cities, we dont know who grows our food or where our water comes from. But staying local is the only way forward, he argues. Case in point: the lockdown proved that the kirana shop and the immediate neighbourhood was equipped to handle most of our needs.

It is in a crisis that our true belonging to a place is revealed. We want to return to our villages because our heart is at home, says Chennai-based architect-academic Durganand Balsavar. He speaks of what he learnt from his experiences of working with Sri Lankan civil war refugees and those displaced by the 2004 tsunami in Nagapattinam, Tamil Nadu. Many of the Sri Lankan women, for instance, were skilled at weaving mats. Balsavar, with his team at Artes-Human Settlements Development Collaborative, encouraged them to use these as partitions for their new homes. That should be the way forward for families returning to their villages, too, during the lockdown. None of them want anything free, they are glad to engage their skills in a productive manner. That is what we should be doing, respecting dignity and pride in their work, he says.

Home is about identity and self-definition, an expression of belonging. While our cities privilege privacy and gated elements and also disconnection from the larger masses, in our villages networks are cyclical and form the basis of life. The city and its lack of interdependency is what causes alienation. Pratik Dhanmer of Design Jatra, a rural research and architectural firm in Dahanu, Maharashtra, speaks of how the layout of houses in villages enhance interaction, where verandahs face each other and children are secure playing on the streets.

Balsavar recounts what he noticed in Nagapattinam soon after the tsunami. Several families had abandoned their newly-built concrete-box shelters. These fine engineered solutions for living put the kitchens at the back of the house. The original homes had the kitchens in the front, which enabled women to talk among themselves, keep an eye on their children playing on the street, not to mention the excellent cross-ventilation they afforded. However, in the new homes, the kitchen was pushed to the back of the house, which meant the women worked in isolation, their front doors were shut and the streets empty. The idea of a rural home has many layers, which architects, sociologists and engineers can learn from, says Balsavar.

While we rejoiced in employing our city balconies as a stage for approval, with all the bells and whistles, it has rarely become a site for interaction all these years. Its the park view we seek and not the sense of community. In fact, in many homes, balconies are seen as obstacles in the way of carpet area. Delhi-based architect Gautam Bhatia has planned a design where the community is not compromised. In cities where we privilege privacy, what are the possible combinations which allow for the public and the private to come together? Over the last couple of decades, life has been going into lockdown by itself. Within homes, too, entertainment was becoming private and recreation was getting isolated. So, the idea of an apartment that shares community values yet allows you to keep your privacy is the aim.

These would be about 800-1,000 sq. ft houses, varying from one-two bedrooms. The remaining spaces are given over to the community, with meeting rooms and games areas. The idea is to force you out of your confinement. You pay much less for private space and get more shared space. You will be forced to go out into verandahs. Unlike high-end apartments that are self-contained, where there is no sense of sharing, he says. There is the need to change by-laws in our cities to accommodate more public spaces and integrate all classes to live side by side. The future, Bhatia says, is in smaller homes and rental housing.

The coronavirus has exposed the artificial and abnormal in society, argues Delhi-based Shuddhabrata Sengupta of Raqs Media Collective, which is curating the Yokohama Triennale 2020. There is an enormous amount of resources spent to ensure that our society is not democratic. Delhi, for instance, is a lot about gated communities and large resources are used to keep people out. We are living in a highly artificially maintained dystopia. Architects and urban designers can show a new way and plan how our cities can be for the next 100 years. But I dont see them coming together to demand a commitment to urban housing from any regime. Ultimately, it will not be about big projects but keeping life cycles intact, which our vernacular societies have always done, where life is not a straight line and relationships are important, says Thautam.

Maybe, our cities ought to be like Ersilia, from Italo Calvinos novel Invisible Cities (1972), where relationships nurture life, and its inhabitants stretch strings from the corners of their houses across the city to mark connections, be it for trade or fellowship. So that, even when walls come crumbling down and homes cease to exist, the labyrinth of taut strings will continue to exist.

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How will Covid-19 change our cities? - The Indian Express

We're tracking the highest counts of COVID-19 by zip code in the metro area.

ATLANTA Nearly 1,100 new COVID-19 cases were reported in Georgia Friday, sending our numbers up again.

We're tracking cases across the metro and now we're looking at some of the top zip codes where the virus is growing across our largest counties.

Gwinnett County, which is where the virus is growing significantly, had the highest number of COVID-19 cases in the Lawrenceville area with 770.

In Fulton, the top zip code is 30331 with 401 total confirmed cases. That includes the Princeton Lakes and Greenbrier neighborhoods.

Cobb's highest concentration of the virus is in Marietta. There are now 450 cases reported there.

DeKalb's most recent numbers show the area around Brookhaven, Chamblee, and Druid Hills is now reporting 358 cases of coronavirus.

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Top COVID-19 zip codes in Gwinnett, Fulton, Cobb and DeKalb on June 19, 2020 - 11Alive.com WXIA

Apple CEO Tim Cook delivers the keynote address during a special event on September 10, 2019 in the Steve Jobs Theater on Apple's Cupertino, California campus.

Justin Sullivan | Getty Images

Stocks rolled over to trade lower on Fridayafter Apple said it will again close some stores because of recent spikes in coronavirus cases around the U.S.

Shares of Apple closed down 0.57%.

A total of 11 Apple stores will close in Florida, North Carolina, South Carolina and Arizona starting on Saturday. Customers who have products in those stores for repair will have the weekend to get their devices back, Apple said. All of the stores had been reopened since Apple initially closed them in March.

"Due to current Covid-19 conditions in some of the communities we serve, we are temporarily closing stores in these areas. We take this step with an abundance of caution as we closely monitor the situation and we look forward to having our teams and customers back as soon as possible," an Apple spokesman said in a statement.

Apple previously shut its stores around the world in March in response to the Covid-19 pandemic. Stores began to reopen in recent weeks with safety measures including mandatory masking, temperature checks, curbside pickup in certain regions and service by appointment.

Apple said earlier this week that it planned to reopen stores in New York City and that it was aiming for more than 200 U.S. stores to be open by the end of the week.

The announcement hit stocks across the board as the Dow was up 47 points before the news, and subsequently dropped more than 230 points before recovering slightly. The announcement negatively affected brick-and-mortar retailers in particular.

The full list of Apple stores closing is below:

Florida

- Waterside Shops

- Coconut Point

North Carolina

- Southpark

- Northlake Mall

South Carolina

- Haywood Mall

Arizona

- Chandler Fashion Center

- Scottsdale Fashion Square

- Arrowhead

- SanTan Village

- Scottsdale Quarter

- La Encantada

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Apple will close some stores again in states that are seeing a resurgence of Covid-19 cases - CNBC