Category: Corona Virus

For months, public health experts have been eagerly watching the companies developing spit tests for the coronavirus that could be used at home, producing results in a matter of minutes.

If these rapid saliva tests worked, as many news articles have pointed out, they could greatly expand the number of people getting tested. Some experts have even said they could perform as well as a vaccine in curbing the spread of the coronavirus and paving a path back to normalcy.

But so far, the technology is not panning out as some have hoped.

E25Bio and OraSure, two companies pursuing rapid at-home coronavirus tests, have abandoned efforts to use saliva in their products. Their tests, which detect pieces of coronavirus proteins called antigens, will for now rely on shallow nose swabs instead.

If I was placing a bet which I am, because Im leading an antigen-based testing company I would say its going to be very difficult for antigen-based testing to work on saliva samples, said Bobby Brooke Herrera, an E25Bio founder and its chief executive. The notion that the virus sets up shop in the mouth and produces enough antigen to be picked up by todays technology, he said, is far-fetched.

The two companies pursued saliva (or oral fluids, in the case of OraSure) for months in the hopes of their tests being more comfortable than swabs, some of which go painfully deep into the nose, and less reliant on sputtering supply chains that have caused long delays for laboratory tests.

Theres nothing more convenient than spitting in a tube, said Dr. Valerie Fitzhugh, a pathologist at Rutgers University.

But as they continued to tinker with their tests, researchers at both E25Bio and OraSure found salivas performance to be more lackluster than anticipated, and were forced to pivot.

This was a result of optimization studies, said Stephen Tang, OraSures president and chief executive officer. A saliva antigen test is still theoretically possible, Dr. Tang added. But after comparing the amount of coronavirus antigen found in the nostrils and throat, as well as different parts of the mouth, including the cheeks, gums and tongue, we decided to optimize around the nasal cavity, he said.

Spit also differs vastly among people, and can even change over the course of a single day. Weve all noticed that there is variable performance, said Sarah Jung, scientific director of clinical microbiology at Childrens Hospital Colorado.

Both E25Bio and OraSure plan to seek authorization from the F.D.A. to sell at-home antigen tests using nose swabs instead of spit, a technique similar to the one used by the much-talked-about Abbott antigen test that takes about 15 minutes. The E25Bio test would require people to swab their nose, stir the sample into a chemical soup, apply the mixture to a paper strip and wait up to half an hour for bands to appear. E25Bios test picks up on about 80 percent of the infections that ultrasensitive laboratory tests detect the F.D.A.s bare minimum for a regulatory greenlight. OraSure declined to give any details about its tests methodology or accuracy.

Saliva does seem to be working when used in laboratory tests known as P.C.R., which look for bits of the viruss genetic material, or RNA, rather than antigens. P.C.R. tests detect minute amounts of coronavirus RNA, making them far more sensitive than antigen tests. Research teams at Rutgers and Yale have been granted emergency authorization for these spit P.C.R. tests.

At the University of Illinois, some 10,000 of the institutions in-house P.C.R. tests are performed each day on saliva from students, faculty and staff members roughly 1 percent of the nations daily tests.

Standard P.C.R. tests, however, take hours to run and are subject to shortages of laboratory supplies, such as pipettes and chemicals, often leading to delays in getting results.

Other scientists, like Dr. Zev Williams of Columbia University, are working on variants of rapid saliva tests that, like P.C.R., detect RNA, but dont require expensive laboratory machines.

His teams prototype takes just 45 minutes. It uses an array of portable equipment, including two tissue-box-size heaters.

Thats too bulky and expensive for at-home testing. But he said the test could be deployed in places where crowds gather, like schools, offices and travel hubs, granting safe passage to those who test negative while sending the infected back home.

His team has submitted an application for emergency approval from the F.D.A. In the meantime, theyve partnered with Sorrento Therapeutics, a San Diego-based company, to scale up production.

The Columbia saliva test relies on a technique called LAMP thats generally faster but a bit less accurate than P.C.R. The spit sample is briefly boiled and mixed into a cocktail of chemicals that then gets incubated at 145 degrees Fahrenheit for half an hour. If the tubes contents turn from red to yellow, the test is positive.

The latest data shows the Columbia test performs as well as a laboratory deep-nose swab test more than 96 percent of the time, even when using saliva from sick patients who gave messy samples.

Even if there was food or blood, we took it, Dr. Williams said. That wouldnt fly with most other saliva tests in use, he said, which ban eating, tooth-brushing and even gum chewing in the hour or so before depositing drool.

Another saliva LAMP test is being tested by David OConnor at the University of Wisconsin-Madison. Their technique bears many similarities to the Columbia test, including a color-based readout, but takes slightly longer and involves a couple of extra steps. Early trials of the test on volunteers in Wisconsin have gone well, Dr. OConnor said, and one school district in Illinois is using the test to screen about 1,400 students and teachers on a weekly basis.

But saliva LAMP tests face their own hurdles. Saliva tends to clump and stick, and can be a difficult substance to handle and transfer from tube to tube, said Jennifer Dien Bard, director of the clinical microbiology and virology laboratory at Childrens Hospital Los Angeles, where her team is working to roll out saliva-based testing for coronavirus RNA. And although color-based results are simple, interpreting them can get messy if a rainbow of hues comes out the other end.

To me, Dr. Dien Bard said, something like this might still belong in a lab.

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Rapid Coronavirus Spit Tests Aren't Coming Soon - The New York Times

Wisconsin continued Friday as one of thenation's coronavirus hotspots, with the recent explosion of cases alarming health officials and straining hospitals in the Fox Valley, Green Bayand Wausau areas.

Before Sept. 17, the state had never recorded a day with more than 2,000 new cases. Over the last seven days, however, ithas reported an average of nearly 2,500 new coronavirus cases each day. Those aren't just the highest numbers of the pandemic, they'rethree times higher than a month ago.

What began with outbreaks on Wisconsin's college campuses has now spread rapidly throughout the state.

"We're entering a dangerous time of new cases here in Wisconsin," Veronica Scott-Fulton, chief nursing officer for SSM Health, said Fridayat a news conference in Madison.

The 2,745 new cases and five deaths reported Friday by the state Department of Health Services came asthe Oshkosh and Neenah area grappled with one of the worst outbreaks in the country, according to a New York Times analysis of case counts.

At one point Friday, the Green Bay and Appleton metro areas joined Oshkosh in the top three spots of the nationwide leaderboard for most new cases in the last two weeks, adjusting for population.

Wisconsin also reported 10,850 negative tests Friday. The death toll rose to 1,353.

Track COVID-19 in Wisconsin: See the latest numbers and trends

How to interpret COVID-19 data: What experts say about positive cases, deaths and hospitalizations

As of Fridaythere were 663 patients hospitalized with COVID-19, with 181 of themin an intensive care unit, according to the Wisconsin Hospital Association. On Sept. 1, the number hospitalized was 295, and the number in an ICU was 100.

Health care officials said a number of factors could be at play in the recent spike, but it's likely the result of people not paying attention to basic prevention. It's no secret thatbars and restaurants especiallyin northern and rural parts of the state are often packed, with masks and social distancing often ignored.

Despite the surge, there's a growing effort to strike down Wisconsin Gov. Tony Evers' statewide mask mandate.

Republican legislative leaders went to court Friday to show support for aconservative legal firm's lawsuit againstthe mandate. The move came the same day President Donald Trump, who does not wear face masks regularly, canceled weekend rallies planned for Wisconsin after hetested positive for the coronavirus.

Health officials outside northeast Wisconsinwarned the outbreak could return quickly to former hotspots such as Madison and Milwaukee.

"We are perilously close to a time back in April when we had our highest level of hospitalizations in the city (of Madison), and we do not want to get back to that point," said Nasia Safdar, medical director of infection control at UW Health.

More than 1.4 million people have been tested statewide for the virus. Of the 105,932 Wisconsinites who have tested positive:

Aspirus Health Care again tightenedvisitor restrictions at its hospitals, nursing homes and health care facilities in northern Wisconsin and Michigan's Upper Peninsula.

Visitors will no longer be allowed at Aspirus facilities. There aresome exceptions, such as for end-of-life situations, labor and delivery,surgery patients, patients with specific caregiving needs or pediatric patients. Those using outpatient treatment centers, such as for dialysis and oncology, may also have a support person.

Earlier this week, Aspirus warned that the recent surge in coronavirus cases and patients was straining its facilities. Matthew Heywood, president and CEO of the system, acknowledge that its Wausau hospital has resorted to at-timesputting patients on await list. He stressed that the number of people on the wait listfluctuates, as do wait times, which he said ranged from a couple of hours to 24 hours or longer.

Andrew Mollica and Mark Johnson of the Journal Sentinel staff contributed to this report.

Contact Mary Spicuzzaat (414) 224-2324 ormary.spicuzza@jrn.com. Followheron Twitter at @MSpicuzzaMJS.

Our subscribers make this reporting possible. Please consider supporting local journalism by subscribing to the Journal Sentinel at jsonline.com/deal.

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Wisconsin reports more than 2,700 new coronavirus cases as outbreak continues to rank among nation's worst - Milwaukee Journal Sentinel

The Tennessee Titans' COVID-19 outbreak is not the end of the NFL's 2020 season. It is the beginning of the most important part of it.

This week's developments are shocking only to those who had settled comfortably into the familiar rhythms of football season and forgotten the potentially impossible circumstances under which this one is being played. The NFL knew this was coming -- a week in which the coronavirus infected one of its teams to the point where it had to consider postponing a game. It knows it'll happen again. The NFL isn't in charge of whether and in what order its games get played this season. The virus is. So the league will adjust the best it can, even if the solutions aren't perfect or universally satisfactory.

But equity concerns aren't as worrisome as existential ones, which is why this week has to be a wake-up call -- a reminder to those who might have forgotten what's going on in the wider world that there's no way to shield the ever-insular NFL from it. As smoothly as training camp and the first few weeks of the season went, this is no time to relax, and that time isn't coming soon.

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"Our job simply isn't done. It's to remain vigilant," NFL Players Association executive director DeMaurice Smith said in an interview Thursday on CNN. "But I'm happy with what's been done, I'm happy with the protocols that have been in place, and we'll find out exactly what happened."

Far more important than the rescheduling of the Week 4 game between the Titans and Pittsburgh Steelers is that the NFL and the NFLPA stay on top of the outbreak in Tennessee. The league issued a memo Thursday reminding teams, "There is one simple rule to remember: act as if every person you come into contact with has a COVID infection and take appropriate protocols." The memo establishes new rules for teams, such as the Titans, that have outbreaks, or the Minnesota Vikings, who come into contact with teams that have outbreaks. These include increased testing, mask and glove requirements during practice and virtual-only meetings among other things.

The league continues to test Titans players and personnel daily, isolate those who test positive -- six players and seven personnel members tested positive this week -- and trace their close contacts to try to monitor and prevent further spread. It continues to test the players and personnel of the Vikings, who played the Titans on Sunday. So far no one has tested positive in Minnesota, and if that continues for another day or two, the league can start to feel confident the coronavirus wasn't transmitted from team to team during a game.

But the NFL and the NFLPA have to find out how the virus got into the Titans' building. They have to make sure everyone else in the league knows what they find out. They have to take some sort of disciplinary action if -- if! -- they find out it was the result of someone's negligence. And while they're at it, they might want to do something about the Las Vegas Raiders.

The Raiders are under league investigation for letting an unauthorized individual into their locker room after a game. Coach Jon Gruden was fined $100,000 and the team $250,000 for Gruden's insufficient use of the league-mandated face covering on the sideline during a game. (Four other coaches and teams have been fined, as well, for the same violations.) And then this week, video surfaced of Raiders players attending an indoor charity event and mingling and posing for pictures with guests while not wearing masks.

Gruden and quarterback Derek Carr can give all the news conferences they want about how they've "done a good job" and they "weren't trying to be careless and reckless," but actions speak louder than words. The Raiders' actions are not those of a team taking this thing seriously, and the fact that they're flying under the radar is not a good thing for the NFL's chances of getting a full season played.

What Carr, Jason Witten, Darren Waller and the other Raiders who were at that event did was incredibly stupid. The coronavirus protocols negotiated between the NFL and the NFLPA permit the team (but not the league) to fine them for it. What makes their actions even dumber is that those same protocols allow their team, should they contract COVID-19 as a result of attending a prohibited event (this one violated state and local regulations, and the country club that hosted it has been fined by the state), to classify their illness as a non-football injury. If a player is on the non-football injury list, his team doesn't have to pay him.

Hopefully, it doesn't come to that. Hopefully, the chickens of the Raiders' careless stupidity don't come home to roost. But until we've seen five to seven days of negative tests in Vegas, we have to count this week's Buffalo Bills-Raiders game as potentially in peril along with Vikings-Houston Texans. If a Titans player transmitted the virus to a Vikings player during last week's game, or if an unmasked guest at Waller's charity event transmitted it to an unmasked Raider, then we could be looking at three postponed games this week instead of just the one.

"I don't want to say it is what it is, but that is why the plan was put in place to have guys, to be prepared and why so many people ... are being diligent and not going out and being reckless and being careful," Steelers quarterback Ben Roethlisberger said Wednesday. "I'm homeschooling my kids. We're not having guests over at the house. You have to do those things if you want to play the games on Sunday."

Everything you need this week: Full schedule | Standings Depth charts for every team Transactions | Injuries Football Power Index rankings More NFL coverage

This is the point the NFL has been trying to drive home -- and get its coaches to drive home -- for the past couple of months. This whole thing is a powder keg. I heard Carr stand up there and say, "We had a few moments where we slipped up," and all that tells me is that the guy either doesn't get it or doesn't care. One moment in which you slip up is enough to let the virus in. Major League Baseball found this out during a Miami Marlins outbreak in August that infected 18 players and threw the schedules of several teams into chaos for weeks.

There are people in our society who don't buy any of this -- who think the virus is a hoax or overblown. So it stands to reason that there are going to be people in the NFL who think the same way. There are surely players and coaches and front-office people who roll their eyes at the protocols and the constant reminders that they have to follow them. And no matter how seriously anyone is taking the virus, everybody wishes they could snap their fingers and just get back to normal. But the NFL's position, built on a mountain of advice from the medical community, is that it can't. The league has worked hard to make sure its players, coaches and other personnel act in a way that respects that position. Coaches who don't wear masks during games will continue to be fined, and this week, the league has told them they also could end up suspended or docked draft picks if the fines don't work. If that doesn't get their attention, it's hard to imagine what will.

So, yes, the NFL and the NFLPA will conduct their inquiry into what happened in Tennessee. If the result of that inquiry is the discovery of a hole in the testing and tracing protocols, they'll work to patch it. Does that mean testing on game-day mornings, currently the only day of the week on which the NFL is not testing? It could. Does it mean the next time a coach's test comes back positive on a Saturday morning, as Titans outside linebackers coach Shane Bowen's did last week, that his close contacts can't get on the plane, either? Got to at least consider it. The situation is without precedent, which means the COVID-19 protocols must be malleable.

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Adam Schefter reports that there were two more positive tests from the Titans, including one player, which led to the NFL postponing Tennessee's game against Pittsburgh.

But as reliable and effective as the protocols have been at identifying cases and limiting spread, there's no way to get them to 100% effective. There will be more cases. There will be more outbreaks, facility closures, game postponements. It is inevitable. The key to pulling off this NFL season is the behavior of the people on the ground. The ability of players, coaches and team personnel to make the personal sacrifices necessary to keep the virus away as much as possible. And if players and coaches are starting to let their guard down, the NFL has to loudly, publicly and strenuously make sure they get it back up.

We won't know whether the NFL can complete this season until it has. The external challenges are and will remain significant. They might prove impossible to overcome. But failure to stamp out internal challenges will only make things more difficult. This week has been a reminder that those exist, and that they must be kept to a minimum if this football season is to succeed.

Continued here:

The NFL is taking the coronavirus seriously. Are the teams? Why the Titans' COVID-19 outbreak was a wake-up call - ESPN

Marine One, the presidential helicopter, arrives at the South Lawn of the White House on Friday to transport President Trump to Walter Reed National Military Medical Center. The White House says Trump will spend a few days at the military hospital after contracting COVID-19.

(Win McNamee / Getty Images)

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Historic photos of President Trump being transported to Walter Reed for coronavirus treatment - Los Angeles Times

As students return to college campuses, the surrounding communities are seeing an increase in coronavirus infections. Michael Conroy/AP hide caption

As students return to college campuses, the surrounding communities are seeing an increase in coronavirus infections.

Young adults are driving coronavirus infections in the U.S. and are likely spreading the virus to older, more vulnerable populations, according to a recent report from the Centers for Disease Control and Prevention.

Early in the COVID-19 pandemic, older adults were more likely to get infected, but when researchers analyzed cases from June to August, they found that people in their 20s accounted for the largest share of confirmed cases compared to other age groups. And public health experts say this is a worrying trend.

"This group is going to continue to transmit a lot of virus," says Mike Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

The CDC report confirmed what many public health experts have long warned: Infections in young adults lead to infections in older people who are much more likely to be hospitalized and die from COVID-19 than people in their 20s and 30s.

In Southern states over the summer, rising infections among young adults preceded increases in COVID-19 by four to 15 days among people over the age of 60.

"They are mobile, they have contact with those who are older, and we're going to see that spillover occur more and more as we get into the fall," Osterholm says.

The spread among young adults is partly a reflection of how states reopened at the end of the spring, says Dr. Kirsten Bibbins-Domingo, chair of the department of epidemiology and biostatistics at the University of California, San Francisco.

"We asked older people to stay at home because they were more at risk, and we opened the economies and asked younger people to go out and work," Bibbins-Domingo says. "We also know it was summertime, people wanted to be out and socializing again," she adds.

Young people are more likely to hang out in groups, go to bars and restaurants behavior that keeps this virus circulating.

U.S. cases dropped off significantly at the end of the summer, but many communities with colleges and universities are now seeing a rebound in infections as students return to campus.

North Dakota has the highest rate of new cases per capita in the country, with many cases concentrated around colleges and universities.

And last week, Wisconsin Gov. Tony Evers declared a public health emergency because of "near-exponential growth" of cases, much of it linked to a steep rise in 18- to 24-year-olds getting infected.

"We were heading in a good direction, but that changed in early September," says Katarina Grande, who oversees the data team at the public health department for the city of Madison, Wis., and Dane County, Wis.

Cases in her county more than tripled during the first half of this month, compared to the end of August. Most of those new infections are tied to the University of Wisconsin-Madison. Grande says her agency is now tracking an increase in cases in the broader community, which could be an early sign that the campus outbreak is seeding new infections throughout the area.

In California, people under 35 years old made up half of all new cases by late July, says George Lemp, an infectious disease epidemiologist and former director of the University of California's HIV/AIDS Research Program.

"That did decline somewhat over time, but still remains fairly high," Lemp says.

Lemp, who has tracked this trend for months, says infections were already popping up around universities in the summer because students were in session or living near campus.

The question plaguing campuses and college towns is what to do about it.

"We know it's not effective to yell at college students and tell them what their behavior should look like, the decisions to gather and have parties," says Grande. "But that's the population that we're seeing transmission occur in."

As more students returned this month, many colleges and universities adopted new measures to prevent the spread of the coronavirus and test students to head off outbreaks.

Public health experts generally agree that shaming young adults is not the best strategy for getting them to follow COVID-19 guidelines.

In the San Francisco Bay area, one local public health department has tapped a group of young adults who are popular on social media to act as COVID-19 "influencers," in hopes of reaching a younger, more receptive audience.

"These young people are our football stars, they are makeup artists, they're on YouTube, they're fashionistas," says Ryyn Schumacher, a program manager at Contra Costa Health Services, which recently launched the new COVID-19 Youth Ambassador Program.

Schumacher says the idea to target this demographic came directly from looking at county data that showed 1 out of every 4 people testing positive was between the ages of 14 and 24.

"We don't spoon-feed the message to our young people," Schumacher says of the social media initiative. "It's up to them to craft their messages. We ask how are you protecting your grandma from COVID? And they may want to talk about their grandma and how she makes the best menudo."

Schumacher says they hope to expand the pilot program and build a relatable outreach campaign that resonates with tens of thousands of young adults.

"It talks about their voice, their story, their brand and the message then becomes a lot more authentic and genuine," Schumacher says.

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As Young Adults Get Infected With Coronavirus, Older Adults At Risk Of COVID-19 : Shots - Health News - NPR

Another Mainer has died as health officials on Tuesday reported 37 new coronavirus cases across the state.

There have now been 5,337 coronavirus cases reported in Maine since the outbreak began here in March, according to the Maine Center for Disease Control and Prevention. Thats up from 5,300 on Monday.

Of those, 4,777 have been confirmed positive, while 560 were classified as probable cases, the Maine CDC reports.

New cases were reported in Androscoggin (7), Cumberland (8), Oxford (1), Sagadahoc (1), Waldo (1) and York (19) counties, state data show.

The seven-day average for new coronavirus cases has fallen to 30.4, down from 34.1 a week ago but up from 23.6 a month ago.

The latest death involved a woman in her 80s from York County, bringing the statewide death toll to 141. It was the first coronavirus-related death reported in Maine in more than a week. Nearly all deaths have been in Mainers over age 60.

So far, 447 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus. Of those, eight people are currently hospitalized, with five in critical care and one on a ventilator.

Meanwhile, 30 more people have recovered from the coronavirus, bringing total recoveries to 4,629. That means there are 567 active confirmed and probable cases in the state, which is down from 561 on Monday.

A majority of the cases 3,095 have been in Mainers under age 50, while more cases have been reported in women than men, according to the Maine CDC.

As of Tuesday, there have been 430,445 negative test results out of 437,878 overall. About 1.5 percent of all tests have come back positive, the most recently available Maine CDC data show.

The coronavirus has hit hardest in Cumberland County, where 2,316 cases have been reported and where the bulk of virus deaths 70 have been concentrated. It is one of four counties the others are Androscoggin, Penobscot and York, with 723, 254 and 1,188 cases, respectively where community transmission has been confirmed, according to the Maine CDC.

There are two criteria for establishing community transmission: at least 10 confirmed cases and that at least 25 percent of those are not connected to either known cases or travel. That second condition has not yet been satisfied in other counties.

Other cases have been reported in Aroostook (43), Franklin (62), Hancock (54), Kennebec (215), Knox (39), Lincoln (42), Oxford (149), Piscataquis (9), Sagadahoc (67), Somerset (86), Waldo (74) and Washington (16) counties.

As of Tuesday afternoon, the coronavirus had sickened 7,168,048 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 205,547 deaths, according to Johns Hopkins University of Medicine.

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Another Mainer dies as 37 new coronavirus cases are reported - Bangor Daily News

About 9% of people nationwide have been infected with the coronavirus, according to a new study led by Stanford School of Medicine investigators.

This is the largest study to date to confirm that we are nowhere near herd immunity, said Julie Parsonnet, MD, professor of medicine and of epidemiology and population health, referring to the point at which alarge part of the population becomes immune to a specific disease. Scientists estimate that 60%-70% of the population must have antibodies to the coronavirus before COVID-19, the disease the virus causes, fades, said Parsonnet, a co-author of the study.

The findings were based on antibody levels from a cross section of patients on dialysis in July.The study also foundsignificantly higher rates of infection among Black and Hispanic people and among people living in densely populated areas.

With this survey, we were able to provide a very rich picture of the first wave of the COVID-19 outbreak in the U.S. that can hopefully help inform strategies to curb the epidemic moving forward by targeting vulnerable populations, said Shuchi Anand, MD, lead author of the study, which was published Sept. 25 inThe Lancet. Glenn Chertow, MD, professor of medicine and chief of the division of nephrology, is the senior author.

The research was conducted by analyzing blood samples from more than 28,000 patients on dialysis across 46 states. The results indicate that population density may be the largest contributing factor to infection rates, Anand said.

Antibodies are produced by the bodys immune system in response to an infection and can be measured in the blood for months and even years after someone is no longer infected.

Antibody testing is essential for monitoring the pandemic, Parsonnet said. The advantage over swab testing is that it gives you more of a historical view. Its still uncertain how long antibodies remain in the blood of individuals after theyve had COVID-19, but estimates range from at least two months to much longer period of time, she said.

Serology testing, which measures antibody levels in the blood, is commonly used to test for the occurrence of widespread illness, Parsonnet said. Stanford researchers chose to conduct this testing on dialysis patients for multiple reasons, among them the ready availability of leftover blood plasma samples from the large population of these patients who get monthly laboratory blood tests.

Not only is this patient population representative of the U.S. population, but they are one of thefew groups of people who can be repeatedly tested, Anand said. This is a potential strategy for ongoing SARS-CoV-2antibody testing and surveillance.

Since end-stage kidney disease is a Medicare-qualifying condition, these patients dont face many of the financialbarriers to care that limit testing among the general population, Anand said.

Unlike other studies that have aimed to determine the presence of antibodies to SARS-CoV-2, the virus that causes COVID-19, these estimates are unaffected by whether people feel well or unwell, worried or not worried, or have access to testing or not, Chertow said.Testing 28,503 blood samples from patients on dialysis, the researchers found that 2,292 hadantibodies to COVID-19, a prevalence of 8 percent in the sampling population, and 9.3 percent when standardized to the U.S. adult population.

This study also showed a higher prevalence of undiagnosed cases consistent with other studies, Anand said.Other serologic surveys of SARS-CoV-2 antibodies in the United States have been restricted to hotspots or underrepresented high-risk, vulnerable populations, and faced challenges to timely repetition and longitudinal follow-up, limiting their utility for surveillance, the study said.

The Stanford study showed a wide variation in prevalence by neighborhood, ethnicity, income level and population density. Results showed disproportionally high antibody levelsin Hispanic and Black populations (16.3%) compared with the white population (4.8%).And living in densely populated areas translated to a 10-fold higher risk of getting the disease than living in low-density areas.

The study also showed a remarkable variation by state, with early pandemic hotspots showing significantly higher rates than their neighboring states. The study determined that 33.6% of the population of New York had antibodies, whereas that figure was 17.5% in Illinois. In Pennsylvania, it was 6.4%, and in California, it was only 3.8%

There are limitations to relying on the dialysis population as a representative sampling for the nation, such as a higher proportion of those at increased risk of COVID-19 due to comorbidities. On the other hand, these patients are more often unemployed with less exposure to large groups. With repeated testing, these variations will become clearer, Anand said.

This is a practical approach, Anand said. It may not be completely precise, but it is internally consistent. This could greatly help health agencies plan for how best to distribute resources and plan for vaccine distribution.

Other Stanford authors are Maria Montez-Rath, PhD, biostatistician and senior research engineer; biostatistician Jialin Han.

Paul Beyer, CEO of Ascend Clinical, co-conceived the project with Chertow. Other members of the Ascend clinical leadership also contributed to the work, carrying out the rapid and high-throughput testing of plasma.

The study was funded by Ascend Clinical Laboratories. The Stanford researchers were funded by grants from the National Institutes of Health (grants5K23DK101826 and NIDDK K24 DK085446)and by the Stanford Department of Medicine.

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Fewer than 1 in 10 Americans have antibodies to coronavirus, study finds - Stanford Medical Center Report

Remarks by President Trump in an Update on the Nation's Coronavirus Testing Strategy  Whitehouse.gov

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Remarks by President Trump in an Update on the Nation's Coronavirus Testing Strategy - Whitehouse.gov

BARRE, Vermont On the first Friday in June, Jefrey Cameron, 29, left his home around midnight to buy heroin. He had been struggling with addiction for seven years but had seemingly turned a corner, holding down a job that he loved at Basils Pizzeria, driving his teenage sister to the mall to go shopping and sharing a home with his grandmother. But then the coronavirus pandemic hit.

When he returned home that night and tried the product, it was so potent that he fell and hit his head in the bathroom. Mr. Cameron texted a friend soon after, saying that he had messed up and would go to a 12-step meeting with a friend that weekend.

I promise Im good and I cant get in any more trouble tonight, he wrote. Sweet dreams, if you wake up before you hear from me definitely call me. The sooner I get up and into town the better. When Mr. Cameron woke up, he used the rest of the powder largely fentanyl, not heroin, his family would later learn from a small bag with a bunny stamped on it. Less than five hours after he sent the text, his grandmother found him dead.

In the six months since Covid-19 brought the nation to a standstill, the opioid epidemic has taken a sharp turn for the worse. More than 40 states have recorded increases in opioid-related deaths since the pandemic began, according to the American Medical Association. In Arkansas, the use of Narcan, an overdose-reversing drug, has tripled. Jacksonville, Fla., has seen a 40 percent increase in overdose-related calls. In March alone, York County in Pennsylvania recorded three times more overdose deaths than normal.

For Mr. Cameron, the shutdown of daily life in the spring not only led him back to drugs, but led him to use alone an especially dangerous proposition.

Usually he would use with somebody, especially if its a different dealer or different batch, said his mother, Tara Reil. I dont think he had that person to use with, to have that safety net.

Mr. Cameron lived in East Barre, a tiny town about 20 minutes outside of the state capital, Montpelier. He drove a red Subaru Legacy, had a pet snake named Lucy and was passionate about making food for others. For two days after he died, the pizza shop he worked for closed its doors; now his pictures plaster the windows and customers can buy car decals, T-shirts and bracelets made in his memory.

When Vermont shut down in March, so did Mr. Camerons job, which provided his biggest support network. He was lonely and had money to spare: the $600 per week he received in extra unemployment benefits from the federal government was more than he earned from his job.

Jefrey hated being alone. And the last couple of weeks, he was, said Ms. Reil, who is 47. His grandmother had gone to Atlanta to visit her other children and had delayed flying home for fear of catching Covid-19. In her absence, Mr. Cameron started keeping the television tuned to her favorite channel, blaring Western movies and Bonanza reruns.

He was home alone a lot more, Ms. Reil said. And I think the drug became his friend.

Mr. Cameron had stopped taking Suboxone, a medication that helps suppress the cravings and withdrawal symptoms that plague people addicted to opioids, last fall; it has been found to sharply reduce the risk of dying from an overdose, but he had grown tired of taking it after three years, his mother said.

Opioid addiction has been a scourge in Vermont for more than two decades. When dealers and illegal drug organizations realized they could charge more for narcotics here than they could in nearby cities such as Boston, New York or Montreal, the market was flooded. As the painkillers that many young Vermonters became addicted to in the early 2000s grew harder to get starting about a decade ago, heroin moved in. Then came fentanyl, which is far more potent and has driven up deaths in almost every corner of the country.

Last year, after aggressive efforts to expand access to treatment, Vermont saw its first decrease in opioid-related deaths since 2014; that year, then-Gov. Peter Shumlin devoted his entire State of the State Message to what he called a full-blown heroin crisis gripping Vermont. But Vermont saw 82 opioid overdoses through July of this year, up from 60 during the same period last year.

Nowhere in the state is as hard hit as Windham County, which borders New Hampshire and Massachusetts and typically has the highest yearly number of opioid-related deaths. In the first three months of this year, emergency workers in Brattleboro, the county seat, responded to 10 overdose calls, none of them fatal. But by August they had responded to a total of 53 overdoses, including seven that were fatal.

When this all initiated, it shot up, said Lt. Adam Petlock of the Brattleboro Police Department.

Before the pandemic, Lieutenant Petlock and a trained civilian addiction counselor would bring Narcan and information packets to drug users and homeless people every two weeks through a program called Project CARE. Health and safety concerns prevented them from conducting the wellness checks during the peak of the shutdown, but they recently restarted the program.

While most businesses in the county closed in March, the Brattleboro Retreat, a psychiatric and addiction treatment hospital, remained open. It was able to stockpile hand sanitizer and protective gear, and even created a 22-bed, negative-pressure unit so it could accommodate coronavirus patients in the event of an outbreak.

But in order to be admitted, patients have to test negative for Covid-19 a potentially deadly setback for some who are unable or unwilling to wait several days for results.

Far more common than inpatient addiction care is treatment with three medications that help suppress the cravings and withdrawal symptoms that plague people addicted to opioids. Vermont has gone further than most states in expanding access to medication-assisted treatment, as it is known; at least 8,960 residents about 1.5 percent of the states population were taking one of the three medications, buprenorphine, methadone and naltrexone, during the first quarter of this year.

Once the pandemic began, the federal government tried to make it easier for patients to stay on these medications while doctors offices and clinics were generally closed and people were being asked to stay home. Nik Rowley, 37, has been taking a daily dose of Suboxone a brand name for buprenorphine for about eight years.

Typically, Mr. Rowley has to go see a doctor every two weeks to get 38 doses of Suboxone two per day. What they started doing was emergency exemption doses. So you were getting a months worth of emergency doses, he said.

Mr. Rowley was getting back on his feet after being hospitalized for pneumonia when the pandemic hit. With nowhere else to go, he found housing in a hotel through a state-funded program to keep residents off the streets. The extra supply of medication helped him avoid drugs, but in his hotel room, he relapsed on alcohol. I had a few beers at the hotel because youre stuck in a room all by yourself, he said. You have nothing to do. So all you do is sit there and ruminate and your depression gets worse.

Brattleboro has several hotels that the state helped convert into temporary housing units for homeless and other at-risk people. Groundworks, a year-round housing service in Windham County, typically places 33 people in hotels during the winter months; in the spring, the number swelled to 150.

Many of the recent lethal overdoses in the town have taken place at those hotels. We immediately saw a skyrocket in the amount of substances that people were using, says Rhianna Kendrick, director of operations for Groundworks.

Nick Luoma, a heroin user who has been living in one of the hotels, said several people who had overdosed during the pandemic had relapsed after it began. I get it like, what are you going to do? said Mr. Luoma, who is 35.

When he got housed at a hotel in late March he was using less than a bag of heroin a day, but his use has gone up. Despite efforts to stop he briefly tried medication-assisted treatment he accidentally overdosed twice in July. I am not honoring some of the parts of myself that have so much potential, Mr. Luoma wrote in a text message that month.

Last night I almost died again, he wrote. I may have to wait 2-3 weeks to get into rehab. Im fortunate to have the folks from Groundworks willing to find ways to help me through this waiting period, but the nagging urge, the beast inside that sits waiting for a moment of weakness could kill me before I am able to get in.

Not all drug-related deaths during the pandemic have been from overdoses. Jessie-Mae DeCosta, 32, died from sepsis, an infection she got from injecting drugs. Covid kind of sealed Jessies fate, said her mother, LaNell DeCosta, 62, of Bristol, Vt.

Ms. DeCosta had struggled with drug use for a decade and was living with her mother, and three cats she had rescued, until the shutdown began. Afraid that she might expose her mother to the virus, she moved into a house with some friends where they all were using drugs. Already in poor health, with abscesses covering much of her body, she started feeling worse than usual in May and assumed she had Covid-19. But past experiences in hospitals, including one long stay when she was treated poorly by doctors and nurses because of her addiction, made her avoid seeking care.

She was petrified, LaNell DeCosta said. Imagine being trapped in an environment where you have nobody on your side, you dont have your mother, you dont have a boyfriend, you dont have any friends. You just have people that you think could be judging you.

Ms. DeCosta, like so many other grieving family members and friends of people who have died during the pandemic, grapples with how to say goodbye to her only daughter. Because of the pandemic, she has put off holding a funeral or memorial service. Its denied me closure, and I think it denied her boyfriend closure, denied her dad closure, denied everyone who loved her, Ms. DeCosta said. Because no one could say or show their last respects to her.

The Reil family decided to wait over a month after Mr. Cameron died to hold a service. On a bright and humid afternoon in July, more than 80 friends and family members came together at St. Sylvesters Catholic Cemetery in Barre to mourn him.

Our hearts break, our heads shake at the injustice of yet another young life extinguished by the disease of addiction, Pastor Rachel Fraumann said after beginning her service with a strong warning for mourners to stay as distant from one another as possible. I dont want to do a bunch of funerals on the heels of this one.

Tara Reil and her four surviving children sat in white folding chairs with masks, tissues and water bottles handy. Two of Mr. Camerons brothers had flown in from out of state, taking leave from their posts in the Marine Corps and Navy.

Six family members spoke, including Mr. Camerons stepfather, Terry Reil. Let Jefs purpose empower you to make a difference in yours or someone elses life, he said, to do good things in this world or just let someone you know, know you care about them.

See more here:

Coronavirus Pandemic Drives Hike in Opioid Deaths - The New York Times

Also, outside a lab, infection depends mainly on breathing in viral particles from an infected person and normal contact doesnt necessarily translate into infection for animals. Ferrets have been shown in the laboratory to be susceptible to infection with the virus, and to spread it to other ferrets.

But scientists at Tufts reported, in a paper that has yet to be peer- reviewed, that in one house with 29 pet ferrets and two humans with Covid not one ferret became infected with the virus.

The 29 ferrets roamed freely in the house, and both human adults were ill enough with Covid to show symptoms, so there was ample opportunity for infection. Kaitlin Sawatzki, a virologist at Tufts University and one of the authors of the ferret paper, said, Isnt that incredible? It was a beautiful natural experiment.

The researchers concluded that there could be genetic barriers to infection that are overcome in a lab with concentrated doses of virus. Minks, which are in the same family as ferrets, appear to be very easily infected, and to get sick from the disease. Researchers have also reported transmission from animals to humans at mink farms in the Netherlands in a paper not yet peer-reviewed. Dr. Sawatzki said the paper showed very strong evidence of multiple, independent mink-to-human transmission events.

The Colorado State researchers advise keeping cats indoors, particularly if a human in a household has become infected, because they could spread it to other cats. Also, if a person with Covid needs to be admitted to a hospital and has pet cats, Dr. Porter suggested, the cats caretakers should know to observe social distancing as they would with a person.

The infected cats that showed immunity, Dr. Bosco-Lauth said, were animals that were infected by contact with other cats, not by pipette. And, she said, the immune response was stronger than in some other laboratory animals, although how long that protection might last is completely unknown.

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Cats Shed More Than Dogs. The Coronavirus, Not Fur. - The New York Times