For weeks now, I have been finding this note all over the Fox News web site:
Whoops! We couldn't access this Tweet.
The note appears in stories reproducing the Tweets of various political persons.
Tuesday, March 31, 2020
Monday, March 30, 2020
2 drugs viewed as promising in Covid-19 fight
Why do Covid-19 patients die? Their immune systems overreact to the virus with a "cytokine storm" that inflames their lungs so badly that respiration ceases.
So health experts are hopeful that a drug that counters cytokine storms and promotes healthy immune responses will greatly reduce the need for respirators and improve Covid-19 survival rates. A second drug used to treat severe asthma is also being eyed as a means of reducing build-ups of suffocating mucus.
In 2014, Scripps Research Institute reported that certain strains of influenza would kick off these "storms" -- overproductions of immune cells and their activating compounds, or cytokines -- and drastically heighten likelihood of death. "The resulting lung inflammation and fluid buildup can lead to respiratory distress and can be contaminated by a secondary bacterial pneumonia -- often enhancing the mortality in patients," the institute said.
The same syndrome is felling many hospitalized Covid-19 patients, according to Dr. Marc Siegel, a media consultant who writes about pandemics.
Siegel said that a drug used for HIV/AIDS called leronlimab and another used for severe asthma known as NAC both showed promise. Siegel added that hydroxochloroquine, which has received emergency Food and Drug Administration approval for Covid-19, has had a number of good reports, but that medics suspect it may be better used as a preventive or to curb the virus in low-symptom people. It has been reported that health care workers are being issued hydroxochloroquine as a preventive.
Britain's Daily Mail broke the leronlimab story.
https://www.dailymail.co.uk/health/article-8161973/Two-COVID-29-patients-taken-ventilators-days-experimental-treatment.html
In a New York City area hospital, seven patients with severe Covid-19 were treated with leronlimab, according to a Vancouver, Wash., biotech company. Two were taken off respirators and removed from intensive care, with four others showing substantial improvement, according to the company, CytoDyn Inc. The first four patients to receive the drug got better within three days, with their immune systems showing improvement, the firm said.
Tests showed that after three days of therapy "the immune profile in these patients approached normal levels and the levels of cytokines involved in the cytokine storm were much improved,” the company said.
Jacob Lalezari, M.D., a CytoDyn executive, commented, “These preliminary results give hope that leronlimab may help hospitalized patients with Covid-19 recover from the pulmonary inflammation that drives mortality and the need for ventilators."
The immune control drug might also be used in concert with NAC -- or n-acetylcystine. NAC has been studied for severe asthma because it breaks up mucus, which is believed to be a factor in severe attacks. It is hoped that NAC will reduce the mucus buildup that accompanies Covid-19 pneumonia, Siegel said.
Heparin, an anticoagulant, is also being used in Covid-19 patients to counter inflammation, it has been reported.
The Daily Mail account of the NAC-heparin treatment:
https://www.dailymail.co.uk/health/article-8167849/Doctor-claims-combination-drugs-prevent-coronavirus-patients-needing-ventilators.html
Siegel spoke on Tucker Carlson Tonight
So health experts are hopeful that a drug that counters cytokine storms and promotes healthy immune responses will greatly reduce the need for respirators and improve Covid-19 survival rates. A second drug used to treat severe asthma is also being eyed as a means of reducing build-ups of suffocating mucus.
In 2014, Scripps Research Institute reported that certain strains of influenza would kick off these "storms" -- overproductions of immune cells and their activating compounds, or cytokines -- and drastically heighten likelihood of death. "The resulting lung inflammation and fluid buildup can lead to respiratory distress and can be contaminated by a secondary bacterial pneumonia -- often enhancing the mortality in patients," the institute said.
The same syndrome is felling many hospitalized Covid-19 patients, according to Dr. Marc Siegel, a media consultant who writes about pandemics.
Siegel said that a drug used for HIV/AIDS called leronlimab and another used for severe asthma known as NAC both showed promise. Siegel added that hydroxochloroquine, which has received emergency Food and Drug Administration approval for Covid-19, has had a number of good reports, but that medics suspect it may be better used as a preventive or to curb the virus in low-symptom people. It has been reported that health care workers are being issued hydroxochloroquine as a preventive.
Britain's Daily Mail broke the leronlimab story.
https://www.dailymail.co.uk/health/article-8161973/Two-COVID-29-patients-taken-ventilators-days-experimental-treatment.html
In a New York City area hospital, seven patients with severe Covid-19 were treated with leronlimab, according to a Vancouver, Wash., biotech company. Two were taken off respirators and removed from intensive care, with four others showing substantial improvement, according to the company, CytoDyn Inc. The first four patients to receive the drug got better within three days, with their immune systems showing improvement, the firm said.
Tests showed that after three days of therapy "the immune profile in these patients approached normal levels and the levels of cytokines involved in the cytokine storm were much improved,” the company said.
Jacob Lalezari, M.D., a CytoDyn executive, commented, “These preliminary results give hope that leronlimab may help hospitalized patients with Covid-19 recover from the pulmonary inflammation that drives mortality and the need for ventilators."
The immune control drug might also be used in concert with NAC -- or n-acetylcystine. NAC has been studied for severe asthma because it breaks up mucus, which is believed to be a factor in severe attacks. It is hoped that NAC will reduce the mucus buildup that accompanies Covid-19 pneumonia, Siegel said.
Heparin, an anticoagulant, is also being used in Covid-19 patients to counter inflammation, it has been reported.
The Daily Mail account of the NAC-heparin treatment:
https://www.dailymail.co.uk/health/article-8167849/Doctor-claims-combination-drugs-prevent-coronavirus-patients-needing-ventilators.html
Siegel spoke on Tucker Carlson Tonight
Flu killed 7% of those hospitalized last season
But Covid-19 is far more deadly, experts believe
The percentage of U.S. patients killed by flu versus those hospitalized during the last influenza season was a sobering 7%, according to figures provided by the Centers for Disease Control. Because in a few cases people may have died of flu without reaching a hospital, that figure is inexact, though not misleading.
The number of people who contracted influenza was put at 35.5 million, though comparing that with projected Covid-19 numbers is a dicey proposition.
A CDC web page says:
A basic issue however is the stealth technique used by the Covid-19 virus to quietly infect a population and then to suddenly overwhelm hospitals -- a situation which tends to push up the mortality rate as medics strain to keep up.
The flu death toll contrasts with between 100,000 and 200,000 deaths in a best-case scenario, or 2.2 million in a worst-case scenario.
Dr. Deborah Birx, White House coronavirus response coordinator, said today that she is "very worried about every city in the United States," adding, "I think everyone understands now that you can go from five to 50 to 500 to 5000 cases very quickly."
Birx said, "I think in some of the metro areas we were late in getting people to follow the 15-day guidelines."
Birx said the projections by Dr. Anthony Fauci that U.S. deaths could range from 1.6 million to 2.2 million deaths is a worst-case scenario if the country did "nothing" to contain the outbreak, but said even "if we do things almost perfectly," she still predicts up to 200,000 U.S. deaths.
Fauci had said that Covid-19 was about ten times as lethal as flu. The ratio of flu deaths over Fauci's lower estimate shows that Covid-19 is about 12 times more lethal than flu. His higher number would make Covid-19 17 times more lethal than flu, though flu's mortality is held down by widespread use of yearly vaccines. At present, no vaccine exists for Covid-19.
The number of people who contracted influenza was put at 35.5 million, though comparing that with projected Covid-19 numbers is a dicey proposition.
A CDC web page says:
CDC estimates that the burden of illness during the 2018–2019 season included an estimated 35.5 million people getting sick with influenza, 16.5 million people going to a health care provider for their illness, 490,600 hospitalizations, and 34,200 deaths from influenza (Table 1). The number of influenza-associated illnesses that occurred last season was similar to the estimated number of influenza-associated illnesses during the 2012–2013 influenza season when an estimated 34 million people had symptomatic influenza illness.There are no figures available online that give the total number of U.S. hospital admissions for Covid-19 that would reveal a deaths/admissions rate.
A basic issue however is the stealth technique used by the Covid-19 virus to quietly infect a population and then to suddenly overwhelm hospitals -- a situation which tends to push up the mortality rate as medics strain to keep up.
The flu death toll contrasts with between 100,000 and 200,000 deaths in a best-case scenario, or 2.2 million in a worst-case scenario.
Dr. Deborah Birx, White House coronavirus response coordinator, said today that she is "very worried about every city in the United States," adding, "I think everyone understands now that you can go from five to 50 to 500 to 5000 cases very quickly."
Birx said, "I think in some of the metro areas we were late in getting people to follow the 15-day guidelines."
Birx said the projections by Dr. Anthony Fauci that U.S. deaths could range from 1.6 million to 2.2 million deaths is a worst-case scenario if the country did "nothing" to contain the outbreak, but said even "if we do things almost perfectly," she still predicts up to 200,000 U.S. deaths.
Fauci had said that Covid-19 was about ten times as lethal as flu. The ratio of flu deaths over Fauci's lower estimate shows that Covid-19 is about 12 times more lethal than flu. His higher number would make Covid-19 17 times more lethal than flu, though flu's mortality is held down by widespread use of yearly vaccines. At present, no vaccine exists for Covid-19.
Sunday, March 29, 2020
Trump pandemic plan wins very guarded support
Two Johns Hopkins University experts yesterday backed an approach to curbing the Covid-19 epidemic that has been outlined in a White House plan sent to the nation's governors without in any way endorsing President Trump's public statements.
Last week, Trump sent governors a letter outlining a plan to use Big Data methods to rope off contagious individuals in areas that had not flared into hot zones, though the press has not followed up on that letter.
Trump backs Big Data method, eased social distancing
https://invisiblepaul.blogspot.com/2020/03/trump-favors-targeting-of-hot-spots.html
Dr. Thomas Inglesby and Dr. Amesh Adalja said that once massive testing is up and running, and other actions are taken, public health authorities will be able to use traditional track and trace methods to curb contagion in areas that have not become hot zones. Neither expert would commit to a target date as to when the virus would be brought under control. The two university experts appeared to disagree on the necessity of continuing draconian shutdowns.
But Adalia, an infectious disease expert, said that with an experimental vaccine in its initial trial and with experimental antiviral drugs coming into play, there is a good chance of getting ahead of the virus. He said that, because the virus will not strike everywhere simultaneously, many areas still have time to prepare by deploying widespread testing and track and trace methods of isolating and treating infected persons.
Adalia saw a "false alternative" in a "Wuhan-style lockdown" versus an out-of-control virus. Even so, he said, the United States had lost its chance of clamping a lid on the virus because Congress had let public health funding erode, meaning insufficient testing available at a critical time period. The doctor also said the virus had very likely been infecting people in China back in November with light cases, before much was known, which were then brought to America.
Adalia also pointed out that U.S. testing was mishandled because people with mild symptoms were not being tested, meaning they were unwittingly spreading the virus. On the other hand, because of a shortage of test kits, officials initially limited tests to those with severe symptoms.
"So it's going to not be simultaneous," Adalja said. "So you may be spared in the first part of this wave of maybe later on you may get more, more cases. And it's important that you prepare in that time. And you set up processes to be able to detect these cases, isolate them and prepare your hospitals while you have time in some of the smaller cities."
"We're going to see cases in every city and every location around the country. This is a community-spreading respiratory virus and it's going to reach all the corners of this country," Adalja said yesterday. "That being said, it doesn't mean that every city is going to have a New York City-style outbreak."
"We're going to see this kind of cascade across the country at a stuttered approach with certain kinds of cities having a peak there and other cities having to go, getting over their peak."
Inglesby, director of the university's health security center, said that once sufficient testing is in place and medical workers and hospitals have the gear they need and once case numbers begin to fall in certain regions, then trace and track methods can be used and social distancing can be eased. But he was cautious about the timing of any easing of social distancing.
Inglesby said that testing is in good shape and "when we have masks available for all of our doctors and nurses who are putting their lives at risk to take care of sick patients," when hospitals are geared up and when public health system are poised to track down individual infections "like they do in Asia," then "we might experiment" with eased social distancing.
But, Inglesby cautioned that America is "still at the beginning" of the virus crisis. He said that much remains unknown, which makes it "hard to predict" a date for eased restrictions but that he anticipates that the United States could have a better grasp of the situation in another two weeks.
“At that point, I think we could begin to look for the conditions that might make it safe to begin to lower our social distancing, but not until then.
Inglesby disagreed with Trump’s suggestion that certain parts of the country that have not been hit as hard should begin resuming normal life soon. Later, Trump said that virus casualties were expected to peak in two weeks, meaning that it would be necessary to extend social distancing guidelines to the end of the month.
“At this point we are seeing numbers go up around the country pretty consistently — there isn’t really any place in the country where we are seeing numbers go down. And we wouldn’t expect to have had enough time for social distancing to change the numbers. So I don’t think we have had nearly enough time for these measures to take full effect.”
The President, who is surrounded by noted medical advisers, has said that in some areas people would be able to return to work as long as they take social distancing precautions and remain vigilant about hygiene. Asked about whether the White House experts' idea could be effective, Inglesby pointed to Italy as evidence for why he thought it would not work.
"I don’t think so," he said. "I think we’ve seen in Italy, for example, which is a number of weeks ahead of the United States in terms of its epidemic, that even with very serious, very aggressive social distancing measures where people have been kept at home, schools have been closed, everyone is recommended not to leave their homes, that this disease has continued to spread and is causing a national crisis.”
Inglesby did say that when the situation sufficiently improves, some parts of the country could reopen sooner than others.
In a related matter, after Trump declined yesterday to impose a martial-law style quarantine on the New York City metro region, the governors of Florida and Texas issued orders that people coming in by road or otherwise into their states from the hot zones be checked by police and required to self-quarantine.
In addition, New York Gov. Andrew Cuomo, threatened to sue a fellow Democrat, Rhode Island Gov. Gina Raimondo for requiring state troopers to halt cars with New York plates and ordering occupants to self-quarantine. Raimondo responded today by requiring troopers to issue her self-quarantine order to anyone entering the state in a vehicle with any out-of-state plate.
The Johns Hopkins experts were interviewed by Fox News reporters.
Last week, Trump sent governors a letter outlining a plan to use Big Data methods to rope off contagious individuals in areas that had not flared into hot zones, though the press has not followed up on that letter.
Trump backs Big Data method, eased social distancing
https://invisiblepaul.blogspot.com/2020/03/trump-favors-targeting-of-hot-spots.html
Dr. Thomas Inglesby and Dr. Amesh Adalja said that once massive testing is up and running, and other actions are taken, public health authorities will be able to use traditional track and trace methods to curb contagion in areas that have not become hot zones. Neither expert would commit to a target date as to when the virus would be brought under control. The two university experts appeared to disagree on the necessity of continuing draconian shutdowns.
But Adalia, an infectious disease expert, said that with an experimental vaccine in its initial trial and with experimental antiviral drugs coming into play, there is a good chance of getting ahead of the virus. He said that, because the virus will not strike everywhere simultaneously, many areas still have time to prepare by deploying widespread testing and track and trace methods of isolating and treating infected persons.
Adalia saw a "false alternative" in a "Wuhan-style lockdown" versus an out-of-control virus. Even so, he said, the United States had lost its chance of clamping a lid on the virus because Congress had let public health funding erode, meaning insufficient testing available at a critical time period. The doctor also said the virus had very likely been infecting people in China back in November with light cases, before much was known, which were then brought to America.
Adalia also pointed out that U.S. testing was mishandled because people with mild symptoms were not being tested, meaning they were unwittingly spreading the virus. On the other hand, because of a shortage of test kits, officials initially limited tests to those with severe symptoms.
"So it's going to not be simultaneous," Adalja said. "So you may be spared in the first part of this wave of maybe later on you may get more, more cases. And it's important that you prepare in that time. And you set up processes to be able to detect these cases, isolate them and prepare your hospitals while you have time in some of the smaller cities."
"We're going to see cases in every city and every location around the country. This is a community-spreading respiratory virus and it's going to reach all the corners of this country," Adalja said yesterday. "That being said, it doesn't mean that every city is going to have a New York City-style outbreak."
"We're going to see this kind of cascade across the country at a stuttered approach with certain kinds of cities having a peak there and other cities having to go, getting over their peak."
Inglesby, director of the university's health security center, said that once sufficient testing is in place and medical workers and hospitals have the gear they need and once case numbers begin to fall in certain regions, then trace and track methods can be used and social distancing can be eased. But he was cautious about the timing of any easing of social distancing.
Inglesby said that testing is in good shape and "when we have masks available for all of our doctors and nurses who are putting their lives at risk to take care of sick patients," when hospitals are geared up and when public health system are poised to track down individual infections "like they do in Asia," then "we might experiment" with eased social distancing.
But, Inglesby cautioned that America is "still at the beginning" of the virus crisis. He said that much remains unknown, which makes it "hard to predict" a date for eased restrictions but that he anticipates that the United States could have a better grasp of the situation in another two weeks.
“At that point, I think we could begin to look for the conditions that might make it safe to begin to lower our social distancing, but not until then.
Inglesby disagreed with Trump’s suggestion that certain parts of the country that have not been hit as hard should begin resuming normal life soon. Later, Trump said that virus casualties were expected to peak in two weeks, meaning that it would be necessary to extend social distancing guidelines to the end of the month.
“At this point we are seeing numbers go up around the country pretty consistently — there isn’t really any place in the country where we are seeing numbers go down. And we wouldn’t expect to have had enough time for social distancing to change the numbers. So I don’t think we have had nearly enough time for these measures to take full effect.”
The President, who is surrounded by noted medical advisers, has said that in some areas people would be able to return to work as long as they take social distancing precautions and remain vigilant about hygiene. Asked about whether the White House experts' idea could be effective, Inglesby pointed to Italy as evidence for why he thought it would not work.
"I don’t think so," he said. "I think we’ve seen in Italy, for example, which is a number of weeks ahead of the United States in terms of its epidemic, that even with very serious, very aggressive social distancing measures where people have been kept at home, schools have been closed, everyone is recommended not to leave their homes, that this disease has continued to spread and is causing a national crisis.”
Inglesby did say that when the situation sufficiently improves, some parts of the country could reopen sooner than others.
In a related matter, after Trump declined yesterday to impose a martial-law style quarantine on the New York City metro region, the governors of Florida and Texas issued orders that people coming in by road or otherwise into their states from the hot zones be checked by police and required to self-quarantine.
In addition, New York Gov. Andrew Cuomo, threatened to sue a fellow Democrat, Rhode Island Gov. Gina Raimondo for requiring state troopers to halt cars with New York plates and ordering occupants to self-quarantine. Raimondo responded today by requiring troopers to issue her self-quarantine order to anyone entering the state in a vehicle with any out-of-state plate.
The Johns Hopkins experts were interviewed by Fox News reporters.
Saturday, March 28, 2020
White House doc: No city will be spared
A White House expert on communicable diseases told America last night to brace for the spread of Covid-19 into every city in the nation.
Though she would not answer a newswoman's question as to how many infections were likely to sweep the country, Dr. Deborah L. Birx emphasized, "We don't think any city will be spared from this virus."
Birx, whose background includes work in the global war on AIDS, said the Covid-19 virus is far more communicable than are the viruses for influenza, for other coronaviruses or for the deadly SARS virus that broke out in 2003. She said that once the Covid-19 virus reaches a city, it can fan out silently from person to person for a while before people begin sickening and showing up at hospitals.
"You may think it's not there, but it probably is," said the White House Coronavirus Response Coordinator.
That is why complacency is dangerous. She urged Americans to follow the guidelines issued by the White House, and in particular to be aware that a major route of transmission is from a surface to a hand to a face. That is why much hand-washing and avoidance of touching the face is so important, Birx said.
Birx's comments seemed to imply that the White House has quietly scuttled the notion of slowing the contagion within 15 days. Monday is the end of that period.
Asked about America's infection numbers topping those of every other nation, Birx pointed out that the United States is the third most populous nation on the planet, suggesting that comparison with Italy's numbers was imprecise because of the population difference. As for China, with the world's largest population, she said officials don't really know what the true figures are for the Communist-controlled nation. She conceded that India's numbers are, so far, low as that nation enforces rigorous social distancing. India is the world's second most populous country.
Birx also finessed questions about President Trump's decision yesterday not to impose a mandatory quarantine on New York and parts of New Jersey and Connecticut. New York State Gov. Andrew Cuomo opposed the idea, which had become an issue when governors of other states, such as Rhode Island and Florida, made an issue of New Yorkers fleeing the hot zone and potentially unwittingly bringing the infection with them.
But, a federal quarantine would have been tantamount to federal marshal law, as Cuomo pointed out, and was seen as politically unfeasible. Instead, a U.S. Centers for Disease Control travel advisory was issued urging everyone in the hot zone, except essential workers, to drastically curtail domestic travel.
The White House guidelines say:
Though she would not answer a newswoman's question as to how many infections were likely to sweep the country, Dr. Deborah L. Birx emphasized, "We don't think any city will be spared from this virus."
Birx, whose background includes work in the global war on AIDS, said the Covid-19 virus is far more communicable than are the viruses for influenza, for other coronaviruses or for the deadly SARS virus that broke out in 2003. She said that once the Covid-19 virus reaches a city, it can fan out silently from person to person for a while before people begin sickening and showing up at hospitals.
"You may think it's not there, but it probably is," said the White House Coronavirus Response Coordinator.
That is why complacency is dangerous. She urged Americans to follow the guidelines issued by the White House, and in particular to be aware that a major route of transmission is from a surface to a hand to a face. That is why much hand-washing and avoidance of touching the face is so important, Birx said.
Birx's comments seemed to imply that the White House has quietly scuttled the notion of slowing the contagion within 15 days. Monday is the end of that period.
Asked about America's infection numbers topping those of every other nation, Birx pointed out that the United States is the third most populous nation on the planet, suggesting that comparison with Italy's numbers was imprecise because of the population difference. As for China, with the world's largest population, she said officials don't really know what the true figures are for the Communist-controlled nation. She conceded that India's numbers are, so far, low as that nation enforces rigorous social distancing. India is the world's second most populous country.
Birx also finessed questions about President Trump's decision yesterday not to impose a mandatory quarantine on New York and parts of New Jersey and Connecticut. New York State Gov. Andrew Cuomo opposed the idea, which had become an issue when governors of other states, such as Rhode Island and Florida, made an issue of New Yorkers fleeing the hot zone and potentially unwittingly bringing the infection with them.
But, a federal quarantine would have been tantamount to federal marshal law, as Cuomo pointed out, and was seen as politically unfeasible. Instead, a U.S. Centers for Disease Control travel advisory was issued urging everyone in the hot zone, except essential workers, to drastically curtail domestic travel.
The White House guidelines say:
¶ Listen to and follow the directions of your state and local authorities.
¶ If you feel sick, stay home. Do not go to work. Contact your medical provider.
¶ If your children are sick, keep them at home. Contact your medical provider.
¶ If someone in your household has tested positive for the Coronavirus, keep the entire household at home.
¶ If you are an older American, stay home and away from other people.
¶ If you are a person with a serious underlying health condition—such as a significant heart or lung problem—stay home and away from other people.
Birx was interviewed on Fox News
Suicide surge stuns mayor
Wonders whether shutdowns are counterproductive
From WATE News
From WATE News
The Knox County Regional Forensic Center examined nine suspected suicides just in the last 48 hours, eight from Knox County, according to Knox County Mayor Glenn Jacobs.
He talked about the spike in suicides during the taping of his weekly Friday Update, which was not available online via Google's Chrome browser as of 9:30 p.m. Saturday.
"We have to determine how we can respond to Covid-19 in a way that keeps our economy intact, keeps people employed and empowers them with a feeling of hope and optimism – not desperation and despair," Jacobs is quoted as saying.
These autopsies amount to roughly 10 percent of last year’s total within Knox County, according to a news release from the mayor. In 2019, the medical examiner performed autopsies for 199 confirmed or suspected suicides from across the region with 83 coming specifically from Knox County, the release said.
“That number is completely shocking," the mayor said.
Jacobs' remarks echo the sentiments of a number of public officials who fear the tough measures will backfire. President Trump has sent a letter to governors outlining a new strategy in which hot zones will be the focus of much attention and intervention with an easing of restrictions elsewhere. Such an approach is said to be possible if widespread testing is used in order to permit authorities to use traditional trace and contact methods used to contain outbreaks.
Knox County officials reported a total of 30 positive local cases on the health department web site Friday.
The mayor held a Twitter dialogue on the potential downside of shutdowns.
He talked about the spike in suicides during the taping of his weekly Friday Update, which was not available online via Google's Chrome browser as of 9:30 p.m. Saturday.
"We have to determine how we can respond to Covid-19 in a way that keeps our economy intact, keeps people employed and empowers them with a feeling of hope and optimism – not desperation and despair," Jacobs is quoted as saying.
These autopsies amount to roughly 10 percent of last year’s total within Knox County, according to a news release from the mayor. In 2019, the medical examiner performed autopsies for 199 confirmed or suspected suicides from across the region with 83 coming specifically from Knox County, the release said.
“That number is completely shocking," the mayor said.
Jacobs' remarks echo the sentiments of a number of public officials who fear the tough measures will backfire. President Trump has sent a letter to governors outlining a new strategy in which hot zones will be the focus of much attention and intervention with an easing of restrictions elsewhere. Such an approach is said to be possible if widespread testing is used in order to permit authorities to use traditional trace and contact methods used to contain outbreaks.
Knox County officials reported a total of 30 positive local cases on the health department web site Friday.
The mayor held a Twitter dialogue on the potential downside of shutdowns.
Glenn Jacobs
@GlennJacobsTN
Questions for @neil_ferguson
How long must a lockdown/shelter-in-place order be in place to be effective? What are the criteria for lifting such an order? If #Covid_19 spreads after the order is lifted, does the process being again?
Glenn Jacobs @GlennJacobsTN
Does your model account for deaths due to the negative impacts of a lockdown/shelter-in-place? Is there any way to determine a cost-benefit in terms of the number of lives and quality of life over the short-, mid-, and long-terms?
Questions for @neil_ferguson
How long must a lockdown/shelter-in-place order be in place to be effective? What are the criteria for lifting such an order? If #Covid_19 spreads after the order is lifted, does the process being again?
Glenn Jacobs @GlennJacobsTN
Does your model account for deaths due to the negative impacts of a lockdown/shelter-in-place? Is there any way to determine a cost-benefit in terms of the number of lives and quality of life over the short-, mid-, and long-terms?
David
@Ted246_
Replying to @GlennJacobsTN
Glenn, I’ve wondered the same thing myself. Boris here has called for 3 weeks lockdown. I don’t think it will go down in that time. Surely, once it’s relaxed rates will continue to rise. I can see lockdown lasting 9-12 months. Is that sustainable? I’m doubtful
Replying to @GlennJacobsTN
Glenn, I’ve wondered the same thing myself. Boris here has called for 3 weeks lockdown. I don’t think it will go down in that time. Surely, once it’s relaxed rates will continue to rise. I can see lockdown lasting 9-12 months. Is that sustainable? I’m doubtful
Joel Kegel
@kegel6784
Replying to @GlennJacobsTN
I’ve been wondering the same thing, not just for where I live, but all over the country. We can’t go on like this too much longer or we will cause another pandemic of starvation and small business closures
Replying to @GlennJacobsTN
I’ve been wondering the same thing, not just for where I live, but all over the country. We can’t go on like this too much longer or we will cause another pandemic of starvation and small business closures
Thursday, March 26, 2020
Trump backs targeting of hotspots,
easing social distancing elsewhere
Big Data permits shift in tactics;Europe readies similar approach
Ramped-up Covid-19 testing will feed a Big Data drive for a laser-focus approach to curtailing the dangerous contagion while hopefully putting much of America back to work, it was disclosed today.
President Trump said in a letter to governors that “the day will soon arrive” when Americans can resume their “normal economic, social, and religious lives.”
Trump said his health team is working on new guidelines that will advise state governors on using "robust surveillance" to inform their decisions on loosening or tightening social distancing restrictions, based on whether counties are at low, medium or high risk for the Covid-19 infection.
Trump's action follows closely on the heels of similar actions by European nations hard hit by the contagion, as disclosed by the World Health Organization. WHO refers to the epidemic control approach as "sentinel testing."
If the current number of U.S. infections were to double every 4 days (a conservative estimate), then in 15 days the current 80,000 cases would have ballooned to some 1 million. As hospitals become overwhelmed, the mortality rate would likely surge as some patients are left untreated. But these trends may be arrested with a vigorous "sentinel system" surveillance method, some experts believe.
Prez thanks governors
In the letter, Trump thanked the governors for “stepping up to help America confront this unprecedented global pandemic.”
Before sending the letter, Trump made peace with Illinois Gov. J.B. Pritzker after a Twitter spat, with Pritzker saying Trump was responsive to the state's needs. Trump had blasted Pritzker for criticizing him when he was trying to help. Pritzker shot back that Trump had been dawdling as the epidemic approached. Another Democrat, New York Gov. Andrew Cuomo has been at pains to avoid criticizing Trump as Cuomo copes with the nation's worst hot zone.
Better data based on more widespread testing that is now kicking into gear will permit health authorities to use a more focused approach, easing the shutdowns and lockdowns that have brought America's economy to a halt, the President said, while cautioning that there remains a "long battle ahead."
The President said his health experts believe that expanded testing capabilities will “enable us to publish criteria, developed in close coordination with the nation’s public health officials and scientists, to help classify counties with respect to continued risks posed by the virus.”
“This will incorporate robust surveillance testing, which allows us to monitor the spread of the virus throughout the country,” Trump wrote. “Under these data-driven criteria, we will suggest guidelines categorizing counties as high-risk, medium-risk, or low-risk.”
He added, “This new information will drive the next phase in our war against the invisible enemy.”
'Slowdown' policy may end Monday
Earlier this month the White House launched a policy called “15 days to slow the spread,” which included social distancing, working from home when possible and avoiding gatherings of more than 10 people in order to curb the contagion. Many governors and mayors have forced non-essential businesses to close during the pandemic.
That 15-day period ends on Monday.
The President has argued that he doesn’t want “to turn the country off” and see a continued economic tailspin. He also said he worries that the country will see “suicides by the thousands” if the panic over the pandemic wrecks the economy.
While every state in the union has positive cases of Covid-19, some states have taken a much worse drubbing than others, in particular New York State with more than 37,000 cases as of Thursday afternoon, although the rate of increase has reportedly slowed dramatically.
States with more than 1,000 positive coronavirus cases include New Jersey, California, Washington, Florida, Michigan, Illinois, Louisiana, Pennsylvania, Texas, Georgia, Massachusetts and Colorado.
New York, California, New Jersey, Connecticut, Illinois and Michigan have issued executive orders that closed non-essential businesses and urged residents to work from home unless they are an essential worker. But even small cities in states not so badly affected are under "safer-at-home" orders, such as Knoxville, Tenn., which has only a handful of cases and no crush reported on emergency rooms at this time.
By Thursday afternoon, the United States had reported more than 75,200 positive cases of Covid-19 and more than 1,000 deaths.
'Encouraging signs' in Europe
In a related development, the World Health Organization’s European office said today that it saw “encouraging signs” in Italy reporting a lowered infection rate, though the UN agency cautioned that it was too soon to say whether the worst had passed.
Also, WHO said, many European countries have implemented or plan to implement changes in testing strategies to focus on severe cases and on hot zones in order to improve the quality of data used by epidemiologists.
A very similar approach has been recommended by Marc Siegel, MD, who has written about epidemics and is a media personality.
Generally, the focused approach means to have health authorities spot people who have the disease, track their contacts and apply medication and quarantines. That is the approach generally used for other contagions, so that society need not grind to a halt. But authorities cannot implement that policy when their data are insufficient. In various locales across the United States, there have been complaints of underreporting of Covid-19 infections and deaths due, in part, to shortage of tests and lab equipment.
“While the situation remains very serious, we are starting to see some encouraging signs,” declared Jan Kluge, WHO's regional director for Europe.
“Italy, which has the highest number of cases in the region, has just seen a slightly lower rate of increase, though it is still too early to say that the pandemic is peaking in that country,” he added.
WHO's European office said that to date more than 220,000 cases of Covid-19 had been reported on the continent, along with 11,987 deaths.
That means that globally, roughly 6 out of every 10 cases and 7 out of 10 deaths have been reported in Europe, with the number of confirmed infections worldwide now topping 400,000.
As the virus has spread across the continent, many European countries have adopted severe measures to curb the outbreak, including shelter-in-place lockdowns, the shuttering of nonessential businesses and the closing of borders, as well as the limiting of public gatherings.
Kluge said it will soon be evident whether these social mobility clampdowns have had an impact on curbing the rate of contagion.
WHO reports that
Elements of this story came from the White House, the World Health Organization, Al Manar TV (Lebanon), Fox News, wire services and other sources.
President Trump said in a letter to governors that “the day will soon arrive” when Americans can resume their “normal economic, social, and religious lives.”
Trump said his health team is working on new guidelines that will advise state governors on using "robust surveillance" to inform their decisions on loosening or tightening social distancing restrictions, based on whether counties are at low, medium or high risk for the Covid-19 infection.
Trump's action follows closely on the heels of similar actions by European nations hard hit by the contagion, as disclosed by the World Health Organization. WHO refers to the epidemic control approach as "sentinel testing."
If the current number of U.S. infections were to double every 4 days (a conservative estimate), then in 15 days the current 80,000 cases would have ballooned to some 1 million. As hospitals become overwhelmed, the mortality rate would likely surge as some patients are left untreated. But these trends may be arrested with a vigorous "sentinel system" surveillance method, some experts believe.
Prez thanks governors
In the letter, Trump thanked the governors for “stepping up to help America confront this unprecedented global pandemic.”
Before sending the letter, Trump made peace with Illinois Gov. J.B. Pritzker after a Twitter spat, with Pritzker saying Trump was responsive to the state's needs. Trump had blasted Pritzker for criticizing him when he was trying to help. Pritzker shot back that Trump had been dawdling as the epidemic approached. Another Democrat, New York Gov. Andrew Cuomo has been at pains to avoid criticizing Trump as Cuomo copes with the nation's worst hot zone.
Better data based on more widespread testing that is now kicking into gear will permit health authorities to use a more focused approach, easing the shutdowns and lockdowns that have brought America's economy to a halt, the President said, while cautioning that there remains a "long battle ahead."
The President said his health experts believe that expanded testing capabilities will “enable us to publish criteria, developed in close coordination with the nation’s public health officials and scientists, to help classify counties with respect to continued risks posed by the virus.”
“This will incorporate robust surveillance testing, which allows us to monitor the spread of the virus throughout the country,” Trump wrote. “Under these data-driven criteria, we will suggest guidelines categorizing counties as high-risk, medium-risk, or low-risk.”
He added, “This new information will drive the next phase in our war against the invisible enemy.”
'Slowdown' policy may end Monday
Earlier this month the White House launched a policy called “15 days to slow the spread,” which included social distancing, working from home when possible and avoiding gatherings of more than 10 people in order to curb the contagion. Many governors and mayors have forced non-essential businesses to close during the pandemic.
That 15-day period ends on Monday.
The President has argued that he doesn’t want “to turn the country off” and see a continued economic tailspin. He also said he worries that the country will see “suicides by the thousands” if the panic over the pandemic wrecks the economy.
While every state in the union has positive cases of Covid-19, some states have taken a much worse drubbing than others, in particular New York State with more than 37,000 cases as of Thursday afternoon, although the rate of increase has reportedly slowed dramatically.
States with more than 1,000 positive coronavirus cases include New Jersey, California, Washington, Florida, Michigan, Illinois, Louisiana, Pennsylvania, Texas, Georgia, Massachusetts and Colorado.
New York, California, New Jersey, Connecticut, Illinois and Michigan have issued executive orders that closed non-essential businesses and urged residents to work from home unless they are an essential worker. But even small cities in states not so badly affected are under "safer-at-home" orders, such as Knoxville, Tenn., which has only a handful of cases and no crush reported on emergency rooms at this time.
By Thursday afternoon, the United States had reported more than 75,200 positive cases of Covid-19 and more than 1,000 deaths.
'Encouraging signs' in Europe
In a related development, the World Health Organization’s European office said today that it saw “encouraging signs” in Italy reporting a lowered infection rate, though the UN agency cautioned that it was too soon to say whether the worst had passed.
Also, WHO said, many European countries have implemented or plan to implement changes in testing strategies to focus on severe cases and on hot zones in order to improve the quality of data used by epidemiologists.
A very similar approach has been recommended by Marc Siegel, MD, who has written about epidemics and is a media personality.
Generally, the focused approach means to have health authorities spot people who have the disease, track their contacts and apply medication and quarantines. That is the approach generally used for other contagions, so that society need not grind to a halt. But authorities cannot implement that policy when their data are insufficient. In various locales across the United States, there have been complaints of underreporting of Covid-19 infections and deaths due, in part, to shortage of tests and lab equipment.
“While the situation remains very serious, we are starting to see some encouraging signs,” declared Jan Kluge, WHO's regional director for Europe.
“Italy, which has the highest number of cases in the region, has just seen a slightly lower rate of increase, though it is still too early to say that the pandemic is peaking in that country,” he added.
WHO's European office said that to date more than 220,000 cases of Covid-19 had been reported on the continent, along with 11,987 deaths.
That means that globally, roughly 6 out of every 10 cases and 7 out of 10 deaths have been reported in Europe, with the number of confirmed infections worldwide now topping 400,000.
As the virus has spread across the continent, many European countries have adopted severe measures to curb the outbreak, including shelter-in-place lockdowns, the shuttering of nonessential businesses and the closing of borders, as well as the limiting of public gatherings.
Kluge said it will soon be evident whether these social mobility clampdowns have had an impact on curbing the rate of contagion.
WHO reports that
¶ The number of cases reported in Europe has doubled since last weekEuropean nations believe that targeted virus surveillance -- known as "sentinel surveillance" -- will provide better data on the most efficient ways to break the back of the epidemic. WHO says that:
¶ 61% of the cases and 90% of the deaths have been reported from Italy, Spain and France
¶ 96% of deaths were in persons aged 60 years and older
¶ 87% of infected persons with outcome data available recovered
¶ 10% of reported infections with information available was a health care worker
A sentinel surveillance system is used when high-quality data are needed about a particular disease that cannot be obtained through a passive system.
Selected reporting units, with a high probability of seeing cases of the disease in question, good laboratory facilities and experienced, well-qualified staff, identify and notify on certain diseases.
Whereas most passive surveillance systems receive data from as many health workers or health facilities as possible, a sentinel system deliberately involves only a limited network of carefully selected reporting sites.
For example, a network of large hospitals might be used to collect high-quality data on various diseases and their causative organisms, such as invasive bacterial disease caused by Haemophilus influenzae type b, meningococcus or pneumococcus.
Elements of this story came from the White House, the World Health Organization, Al Manar TV (Lebanon), Fox News, wire services and other sources.
Eyebrows rise over Red claims of no new cases
By Richard Bernstein
RealClearInvestigationsMarch 25, 2020
China’s announcement this month of nearly a week of no new infections in Wuhan, the hard-hit city where the coronavirus pandemic originated, was both hope-inspiring -- and hard to believe.
Medical professionals said the draconian set of policies imposed by the Chinese government – including widespread testing, isolation of all infected people and anyone they came in contact with – are proven methods for limiting contagion. Other countries, South Korea and Taiwan, for example, have followed similar courses, and they have also reported steep declines in new infections, though neither says it has achieved no new local infections, as China claims.
Top photo: A TV image described as empty beds in a Wuhan hospital. A Taiwan network reported that one hospital was under pressure from the central government not to admit patients so it could report no new cases.
“What we don't know is the degree to which they're being transparent and the degree to which they're following up on existing infections,” Don Goldmann, a professor of immunology, infectious diseases, and epidemiology at the Harvard T. H. Chan School of Public Health, said in a phone interview.
Dr. Goldmann said Chinese scientists have been extremely transparent about what they've discovered about the coronavirus so far; they have shared information on the genetics and sequencing of the virus and details of autopsies, clinical care and outcomes, he said. They've also shared fatality rates among different age groups.
“So I'm not sure why they would make this up,” he said, “especially since risking another wave of this would not be in their interests or in the interests of their leadership.”
Still, skepticism about China's no-new-local-infections claim is widespread, including, at least according to the anecdotal evidence, inside China. The doubt is fueled both by China's Communist Party's long history of propaganda and by the obvious benefits of changing the focus from the government’s initial efforts to suppress information about the coronavirus to its supposedly glorious victory over the disease crippling much of the world.
“A propaganda spokesman's job is the turn messy facts into a clean narrative,” Andrew J. Nathan, professor of political science at Columbia University and a leading China expert, said in an email. “China is trying to bury the embarrassment of the Covid-19 cover-up in a happy story of triumph over the virus.
“But it feels like overreaching to say that transmission has completely stopped,” Nathan continued. “It seems that the message is political, not epidemiological.”
A Coca-Cola bottling worker in face mask in Wuhan. State media are trying to show China defeating the coronavirus.
(Xiao Yijiu/Xinhua via AP)
Some reports have chipped away at least at China's most extreme claim of success. On the very days when the national health authority was announcing that there were no new local infections, social media accounts in China were circulating photographs of “urgent notices” put up in residential areas announcing new cases and warning people to stay home.
EBC News, a Taiwan cable news network, broadcast two such photographs dated March 20, which is two days after China reported there were no new local Wuhan infections. One of the notices, after announcing the new cases, read: “Do not go out, or gather, wash your hands, be careful, hold on, hold on, and hold on some more.”
EBC also broadcast video of a hospital in Wuhan that it says was taken on March 19 and provided by a local Wuhan journalist. The video shows a reception area crowded with people, some of them on gurneys with IV drips, and health care workers in full protective gear, white suits, face masks and goggles.
According to the Taiwan commentators, the reporter had accompanied a friend who was seeking care for his sick mother, but the hospital, while allowing patients to stay in the waiting area, was refusing to admit any of them. When the reporter asked the reason, a health worker at the hospital told him the hospital was under pressure from the central government to report no new cases.
Firefighters perform disinfection on the platform of Wuhan Railway Station.
There's no question that since Beijing began implementing strict quarantine measures to fight the virus, the Chinese propaganda machine has been in full gear, praising the Communist Party and its paramount leader, Xi Jinping, for directing an effective response to the epidemic and presenting itself as a model for the rest of the world. The overall message is that, as always, when things get tough, the Communist Party and its leaders, and only they, can be counted on for national salvation.
“From the flood rescue effort in 1998 to the SARS epidemic in 2003 and the earthquake relief work in 2008,” the People's Daily, the party's official organ, said early in March, as China began reporting a drop in new coronavirus infections, “these great struggles one after the other have taught us that the Chinese Communist Party is the backbone of the Chinese people and the Chinese nation.”
In recent days, the Chinese media have gone beyond praise of the country's leaders to depicting a world grateful to China for its leadership in the fight against the disease. It has also been expressing fury at President Trump for calling the disease the “Chinese virus” and it has lent credence to the unfounded conspiracy theory that the virus actually originated not in a market in Wuhan, but in an American military germ warfare lab.
“China selflessly extends helping hand to countries around the world in global battle against Covid-19,” read one recent headline in the English-language People's Daily Online. The article showed pictures of a group of Chinese health care workers at a hospital in Italy giving the thumbs up. Another recent headline: “Foreign Politicians Thank China for Support Amid Epidemic.”
The barrage of good news propaganda has, moreover, been accompanied by what the human rights group Reporters Without Borders is calling China's relentless crackdown on all independent news outlets that might mar the official narrative. This repression originated early in January when Li Wenliang, the doctor who first reported the existence of the virus, was taken into custody by the local Public Security Bureau and only released when he signed a confession admitting to “spreading false rumors.”
Dr. Li soon died of the very disease whose existence was being denied by China's authorities, and his martyrdom forced the authorities to admit that they had behaved incorrectly in his case.
But the effort at information control has continued nonetheless. At least three citizen journalists who put out videos and reports on the dismal, crowded conditions in Wuhan’s hospitals have disappeared. Among them was Fang Bin, a businessman in Wuhan who was able to video-record his own arrest by Chinese police, posing as medical workers at his apartment. Fang was released for a time, but he soon put out a video in which he clearly anticipated his ability to act as an independent source of information in Wuhan wouldn't last long. “I'm afraid,” he said. “Before me there's the virus. And behind me, the legal and administrative apparatus of the Chinese state.”
There have been other apparent arrests, or at least unexplained disappearances, including that of Ren Zhiqiang, a wealthy property developer who circulated an article in which he criticized Xi for his handling of the crisis. Earlier this month, according to Reporters Without Borders, an issue of the magazine Ren Wu was pulled from the newsstands after publishing an interview with a prominent Wuhan doctor criticizing the government for censoring doctors.
Now, with China's recent expulsion of reporters from The New York Times, Washington Post and Wall Street Journal, the country's effort to gain total control of the coronavirus narrative would seem to be almost complete.
China “is in the midst of its most intensive propaganda operation in living memory, in trying to project its success in dealing with the virus,” Peter Tsang, the director of the China Institute at the London University School of Oriental and African Studies, told Hong Kong's South China Morning Post. “There is now an imperative for the statistics to be low, and now we have statistics that serve the political imperative.”
So, what is the true picture? That is not an easy question to answer, but the available evidence would seem to support the conclusion that, while the no-new-infections claim may be more propaganda than literal result, China has, as Dr. Goldmann said, almost certainly succeeded in substantially slowing down the spread of the virus.
Still, several things are missing from the official narrative that might be useful to other countries seeking to reduce the virus’s spread. These include whether the actions taken to track down infected people and force them into total quarantine could be duplicated in democratic countries. Taiwan's EBC television network a couple of weeks ago broadcast video of a street brawl between local residents and police, the residents evidently furious they were unable even to obtain food and shouting, “We've been abandoned.” No images of that sort are likely to be shown on Chinese Central TV.
And then there's the risk mentioned by Dr. Goldmann that a new flare up of the virus would harm the credibility of the authorities. But one commentator on Taiwan television speculated that, if there is a new surge of infections, the propaganda machine will put the blame on the United States and Europe, saying the new infections were the result of their failure to follow the Chinese example.
This and all other original articles created by RealClearInvestigations may be republished for free with attribution. (These terms do not apply to outside articles linked on the site.)
We provide our stories for free but they are expensive to produce. Help us continue to publish distinctive journalism by making a contribution today to RealClearInvestigations.
Support RealClearInvestigations → 
Virologist optimistic on finding effective drugs
Equipment can test thousands of compounds quickly,
program up and running after city's red-tape delays
A Boston University virologist who is launching the testing of a large batch of potentially life-saving drugs against a live sample of the coronavirus is "very optimistic" that an effective treatment will be found "as quickly as possible."
Robert Davey, a virologist, received the green light to begin screening potentially life-saving drug candidates against live Sars-Cov-2, the virus that triggers the Covid-19 disease, the university has announced.
Davey is confident that good news is on the way. “Undeniably, we will identify something that has reasonable potency against the novel coronavirus,” he says. “Getting something with high potency is harder, but that’s where great chemists come into play.”
"We will take drugs that are already out there on the market to test them and see if they are effective, and then we're going to test new chemicals to see if they have any ability," Davey told a newsman. "I'm very optimistic we can find something as quickly as possible."
"We're one of the handful of labs around the country that can screen thousands of drugs to find a treatment for this disease," he added. The research is similar to large-scale drug studies being conducted by Scripps Research.
"We learned how to grow the virus, it’s good to get to know your enemy, and we will start testing on human cells ... as soon as this Friday," he said. "We are very hopeful that things will work."
Asked by a TV reporter whether the anti-malarial drugs touted by President Trump would be included in his research, Davey said they are "in the library that we are testing" but hopes to find a more effective cure.
"They are in the library that we are testing but there could be many others out there that could be even better than them," he said, referring to hydroxychloroquine and the antibiotic azithromycin.
Davey and his team of scientists at Boston University’s National Emerging Infectious Diseases Laboratories (NEIDL), this week started suiting up to conduct research on live samples of the novel coronavirus.
This type of emergency—a fast-spreading virus outbreak—is precisely what the NEIDL, now in its second year of full operation, was made for, a university statement says. NEIDL’s work will involve a number of studies scientists are planning related to Sars-CoV-2, the virus that triggers the disease called Covid-19.
Davey’s team will be pitting tens of thousands of drugs against lab cultures of cells infected with contagions, permitting rapid detection of which drugs are most effective at halting or reducing infection. It should take only a few weeks to earmark the most effective drugs, the university said.
Typically, Davey’s team handles some of the world’s most lethal diseases, like Ebola or Marburg fevers, inside a Biosafety Level 4 (BSL-4) laboratory, which has the highest possible level of biosafety containment used for infectious agents that pose especially high risk to humans. At the NEIDL, Davey and crew members routinely wear biocontainment garb -- often known as "moon suits."
Although some people might find the suits claustrophobic, Davey’s team has become more comfortable working inside the suits than outside. So, even though SARS-Cov-2 requires only a BSL-3 lab—no moon suits needed—Davey and his team will treat it just as they would a far deadlier pathogen like Ebola.
In addition, the moon suits can be used instead of other personal protective gear, which is in short supply all across the country/
It has taken Davey and NEIDL colleagues weeks to prod Boston's public health officials to grant approvals for their life-saving work.
The list of requirements that must be met for work to begin on any new pathogen is daunting and the NEIDL team has been "flying at breakneck pace since January" to get its official letter of approval from the Boston Public Health Commission, the university said.
“To get to this point was a huge effort where many people went out of their way to make it happen,” Davey says. “We did everything by the book to make sure we are working safely.” Davey's lab, will use small and efficient robots to overcome "traditional bottlenecks and inefficiencies of working with live cultures, to help them simultaneously evaluate potential drug compounds on 384 different wells of human lung cells infected with Sars-Cov-2," the university said.
“Compounds stick to, or get in between, virus proteins like a wedge, blocking them from coming together and functioning properly,” Davey says.
Inside the culture plates, the researchers will dose Sars-CoV-2–infected lung cells with a huge variety of compounds, he says. Some concoctions are derived from already-FDA-approved antiviral medications—which would make for an especially quick path toward approval for use in humans infected with Covid-19—and some are completely novel drug candidates designed by chemists working with John Porco, director of BU’s Center for Molecular Discovery (BU-CMD).
The NEIDL is among only a handful of facilities in the United States with both BSL-3 and BSL-4 facilities. And so far, partly because of the shortage of BSL-3 gear, it’s the only site in Boston that has the potential to work on live coronavirus.
“We maintain a chemical collection of thousands of compounds designed for a variety of biological uses,” Porco says. “We’ve given the NEIDL—with which we’ve had a long-standing collaboration to develop antiviral agents—our entire collection to test against the novel coronavirus. We think there will be some interesting drug candidates that emerge from this screen.”
Davey says his team will be watching the infected lung cell cultures closely to see how Sars-CoV-2 responds to each different compound from the Molecular Center. Some compounds are designed to block viruses from entering host cells, and others interfere with a virus’s ability to replicate its genetic material. Still others scramble a virus’s ability to assemble itself and proliferate infection after it’s released from dead host cells.
“Our goal is to find drugs that can reduce viral burden and alleviate the highest levels of infection,” Davey says. “The gold standard would be to find small molecules that halt Covid-19 in its tracks and prevent it from transmitting. To get there, of course, is hard. We have to be careful that these molecules don’t otherwise affect a person’s health or cause unintended side effects.”
In addition, Davey and Porco are collaborating to try to fine-tune promising compounds to increase their effectiveness against Covid-19, without causing side effects, however they can. Porco and his team at BU-CMD also specialize in small molecules called macrocycles—chemical compounds that fit into receptors on the surfaces of viruses like a key fits into a lock, blocking other molecular machinery from gaining entry as long as they stay fitted in place.
“Between basic chemistry and drug discovery efforts and the NEIDL, BU is in a great position to be working on COVID-19,” Porco says.
Federal science agencies are rolling out funding calls for Covid-19-related research. Research is being encouraged by the Centers for Disease Control and Prevention, the National Institutes of Health, the National Science Foundation and the Departments of Defense, Energy and Health and Human Services.
Elements of this story appeared on Fox News.
program up and running after city's red-tape delays
Robert Davey holds vials of the Covid-19 virus, which are carefully packed into the container he is holding. His Boston University lab team is used to wearing full biocontainment suits for work on far deadlier viruses, like Ebola. So although the novel coronavirus can safely be worked on at a Biosafety Level 3 facility, his crew in the highest possible containment setting, the NEIDL Biosafety Level 4 lab.
Photo by Callie Donahue, Boston University
A Boston University virologist who is launching the testing of a large batch of potentially life-saving drugs against a live sample of the coronavirus is "very optimistic" that an effective treatment will be found "as quickly as possible."
Robert Davey, a virologist, received the green light to begin screening potentially life-saving drug candidates against live Sars-Cov-2, the virus that triggers the Covid-19 disease, the university has announced.
Davey is confident that good news is on the way. “Undeniably, we will identify something that has reasonable potency against the novel coronavirus,” he says. “Getting something with high potency is harder, but that’s where great chemists come into play.”
"We will take drugs that are already out there on the market to test them and see if they are effective, and then we're going to test new chemicals to see if they have any ability," Davey told a newsman. "I'm very optimistic we can find something as quickly as possible."
"We're one of the handful of labs around the country that can screen thousands of drugs to find a treatment for this disease," he added. The research is similar to large-scale drug studies being conducted by Scripps Research.
"We learned how to grow the virus, it’s good to get to know your enemy, and we will start testing on human cells ... as soon as this Friday," he said. "We are very hopeful that things will work."
Asked by a TV reporter whether the anti-malarial drugs touted by President Trump would be included in his research, Davey said they are "in the library that we are testing" but hopes to find a more effective cure.
"They are in the library that we are testing but there could be many others out there that could be even better than them," he said, referring to hydroxychloroquine and the antibiotic azithromycin.
Davey and his team of scientists at Boston University’s National Emerging Infectious Diseases Laboratories (NEIDL), this week started suiting up to conduct research on live samples of the novel coronavirus.
This type of emergency—a fast-spreading virus outbreak—is precisely what the NEIDL, now in its second year of full operation, was made for, a university statement says. NEIDL’s work will involve a number of studies scientists are planning related to Sars-CoV-2, the virus that triggers the disease called Covid-19.
Davey’s team will be pitting tens of thousands of drugs against lab cultures of cells infected with contagions, permitting rapid detection of which drugs are most effective at halting or reducing infection. It should take only a few weeks to earmark the most effective drugs, the university said.
Typically, Davey’s team handles some of the world’s most lethal diseases, like Ebola or Marburg fevers, inside a Biosafety Level 4 (BSL-4) laboratory, which has the highest possible level of biosafety containment used for infectious agents that pose especially high risk to humans. At the NEIDL, Davey and crew members routinely wear biocontainment garb -- often known as "moon suits."
Although some people might find the suits claustrophobic, Davey’s team has become more comfortable working inside the suits than outside. So, even though SARS-Cov-2 requires only a BSL-3 lab—no moon suits needed—Davey and his team will treat it just as they would a far deadlier pathogen like Ebola.
In addition, the moon suits can be used instead of other personal protective gear, which is in short supply all across the country/
It has taken Davey and NEIDL colleagues weeks to prod Boston's public health officials to grant approvals for their life-saving work.
The list of requirements that must be met for work to begin on any new pathogen is daunting and the NEIDL team has been "flying at breakneck pace since January" to get its official letter of approval from the Boston Public Health Commission, the university said.
“To get to this point was a huge effort where many people went out of their way to make it happen,” Davey says. “We did everything by the book to make sure we are working safely.” Davey's lab, will use small and efficient robots to overcome "traditional bottlenecks and inefficiencies of working with live cultures, to help them simultaneously evaluate potential drug compounds on 384 different wells of human lung cells infected with Sars-Cov-2," the university said.
“Compounds stick to, or get in between, virus proteins like a wedge, blocking them from coming together and functioning properly,” Davey says.
Inside the culture plates, the researchers will dose Sars-CoV-2–infected lung cells with a huge variety of compounds, he says. Some concoctions are derived from already-FDA-approved antiviral medications—which would make for an especially quick path toward approval for use in humans infected with Covid-19—and some are completely novel drug candidates designed by chemists working with John Porco, director of BU’s Center for Molecular Discovery (BU-CMD).
The NEIDL is among only a handful of facilities in the United States with both BSL-3 and BSL-4 facilities. And so far, partly because of the shortage of BSL-3 gear, it’s the only site in Boston that has the potential to work on live coronavirus.
“We maintain a chemical collection of thousands of compounds designed for a variety of biological uses,” Porco says. “We’ve given the NEIDL—with which we’ve had a long-standing collaboration to develop antiviral agents—our entire collection to test against the novel coronavirus. We think there will be some interesting drug candidates that emerge from this screen.”
Davey says his team will be watching the infected lung cell cultures closely to see how Sars-CoV-2 responds to each different compound from the Molecular Center. Some compounds are designed to block viruses from entering host cells, and others interfere with a virus’s ability to replicate its genetic material. Still others scramble a virus’s ability to assemble itself and proliferate infection after it’s released from dead host cells.
“Our goal is to find drugs that can reduce viral burden and alleviate the highest levels of infection,” Davey says. “The gold standard would be to find small molecules that halt Covid-19 in its tracks and prevent it from transmitting. To get there, of course, is hard. We have to be careful that these molecules don’t otherwise affect a person’s health or cause unintended side effects.”
In addition, Davey and Porco are collaborating to try to fine-tune promising compounds to increase their effectiveness against Covid-19, without causing side effects, however they can. Porco and his team at BU-CMD also specialize in small molecules called macrocycles—chemical compounds that fit into receptors on the surfaces of viruses like a key fits into a lock, blocking other molecular machinery from gaining entry as long as they stay fitted in place.
“Between basic chemistry and drug discovery efforts and the NEIDL, BU is in a great position to be working on COVID-19,” Porco says.
Federal science agencies are rolling out funding calls for Covid-19-related research. Research is being encouraged by the Centers for Disease Control and Prevention, the National Institutes of Health, the National Science Foundation and the Departments of Defense, Energy and Health and Human Services.
Elements of this story appeared on Fox News.
Bright spot seen in Italian trend
New York's infection rate nosedives
The rate of new infections in New York State has taken a sudden plunge after New York Gov. Andrew Cuomo issued an emergency decree imposing social distancing restrictions statewide.
Nicole B. Saphier, MD, a radiologist who has been giving broadcast advice on the Covid-19 epidemic, says that numbers released by health officials show that between Sunday and Tuesday, the rate of infection declined rapidly. On Sunday, the day of Cuomo's freeze-in-place order, the number of people testing positive was doubling every two days. On Monday, the doubling was slowed to an average of 3.4 days and by Tuesday night infections were taking an average of 4.7 days to double.
Saphier said that though the caseload is still accelerating -- as shown by 13 deaths in a 24-hour span at a New York City hospital packed with Covid-19 patients -- "we may be reaching an equilibrium sooner than we think."
Saphier, who works for Memorial Sloan-Kettering cancer centers in New York and New Jersey, called these numbers "very encouraging."
The doctor said the rest of the country is "a few days behind New York," but that if Americans maintain social distancing, the national rate should also begin to plateau. Yet, when a rate of climb slows, the numbers still climb -- as when a decelerating car continues to move forward for a while before reaching a stopping point.
Cuomo said yesterday that new evidence suggests social distancing is slowing down the virus, with the rate of hospitalizations slowing every day this week. But, he said, New Yorkers were "still on our way up the mountain."
Cuomo's "New York State on PAUSE" order limits outdoor activity to the essentials, like grocery shopping and getting medication, and requires New Yorkers to cancel all non-essential gatherings and stay at least six feet away from others when out in public.
Remarkably, the New York figures, which were released last night, dovetail with a calculation by a Nobel laureate, Michael Levitt, that his figures showed that the epidemic would be brought under control much sooner than many experts were thinking.
In a previous prediction, Levitt, a Nobel laureate and Stanford biophysicist, after analyzing Chinese and global Covid-19 numbers, in January correctly calculated that China would get through the worst of its outbreak long before many health experts had predicted. The Los Angeles Times reported yesterday that the numbers convinced him the same would happen in America.
There are now 30,000 cases of coronavirus in New York State, including 17,000 in New York City. Across the state, there have been 285 coronavirus deaths, including at least 192 in New York City.
The current hospitalization rate is 12 percent -- a worrying figure especially given the looming peak of cases which is expected to inundate hospitals in just three weeks, though that forecast may change with the infection slowdown. Three percent of cases require intensive care.
That means there are now about 890 people in the state needing intensive care and experts say the city's hospitals are already close to capacity.
'Encouraging signs' in Italy
In a related development, the World Health Organization’s European office said today that it saw “encouraging signs” in Italy reporting a lowered infection rate, though the UN agency cautioned that it was too soon to say whether the worst had passed.
Also, WHO said, many European countries have implemented or plan to implement changes in testing strategies to focus on severe cases and on hot zones in order to improve the quality of data used by epidemiologists.
A very similar approach has been recommended by Marc Siegel, MD, who has written about epidemics and is a media personality.
Generally, the focused approach means to have health authorities spot people who have the disease, track their contacts and apply medication and quarantines. That is the approach generally used for other contagions, so that society need not grind to a halt. But authorities cannot implement that policy when their data are insufficient. In various locales across the United States, there have been complaints of underreporting of Covid-19 infections and deaths due, in part, to shortage of tests and lab equipment.
“While the situation remains very serious, we are starting to see some encouraging signs,” declared Jan Kluge, WHO's regional director for Europe.
“Italy, which has the highest number of cases in the region, has just seen a slightly lower rate of increase, though it is still too early to say that the pandemic is peaking in that country,” he added.
WHO's European office said that to date more than 220,000 cases of Covid-19 had been reported on the continent, along with 11,987 deaths.
That means that globally, roughly 6 out of every 10 cases and 7 out of 10 deaths have been reported in Europe, with the number of confirmed infections worldwide now topping 400,000.
As the virus has spread across the continent, many European countries have adopted severe measures to curb the outbreak, including shelter-in-place lockdowns, the shuttering of nonessential businesses and the closing of borders, as well as the limiting of public gatherings.
Kluge said it will soon be evident whether these social mobility clampdowns have had an impact on curbing the rate of contagion.
WHO reports that
Elements of this story came from Al Manar TV (Lebanon), Fox News, the World Health Organization, and wire services.
Nicole B. Saphier, MD, a radiologist who has been giving broadcast advice on the Covid-19 epidemic, says that numbers released by health officials show that between Sunday and Tuesday, the rate of infection declined rapidly. On Sunday, the day of Cuomo's freeze-in-place order, the number of people testing positive was doubling every two days. On Monday, the doubling was slowed to an average of 3.4 days and by Tuesday night infections were taking an average of 4.7 days to double.
Saphier said that though the caseload is still accelerating -- as shown by 13 deaths in a 24-hour span at a New York City hospital packed with Covid-19 patients -- "we may be reaching an equilibrium sooner than we think."
Saphier, who works for Memorial Sloan-Kettering cancer centers in New York and New Jersey, called these numbers "very encouraging."
The doctor said the rest of the country is "a few days behind New York," but that if Americans maintain social distancing, the national rate should also begin to plateau. Yet, when a rate of climb slows, the numbers still climb -- as when a decelerating car continues to move forward for a while before reaching a stopping point.
Cuomo said yesterday that new evidence suggests social distancing is slowing down the virus, with the rate of hospitalizations slowing every day this week. But, he said, New Yorkers were "still on our way up the mountain."
Cuomo's "New York State on PAUSE" order limits outdoor activity to the essentials, like grocery shopping and getting medication, and requires New Yorkers to cancel all non-essential gatherings and stay at least six feet away from others when out in public.
Remarkably, the New York figures, which were released last night, dovetail with a calculation by a Nobel laureate, Michael Levitt, that his figures showed that the epidemic would be brought under control much sooner than many experts were thinking.
In a previous prediction, Levitt, a Nobel laureate and Stanford biophysicist, after analyzing Chinese and global Covid-19 numbers, in January correctly calculated that China would get through the worst of its outbreak long before many health experts had predicted. The Los Angeles Times reported yesterday that the numbers convinced him the same would happen in America.
There are now 30,000 cases of coronavirus in New York State, including 17,000 in New York City. Across the state, there have been 285 coronavirus deaths, including at least 192 in New York City.
The current hospitalization rate is 12 percent -- a worrying figure especially given the looming peak of cases which is expected to inundate hospitals in just three weeks, though that forecast may change with the infection slowdown. Three percent of cases require intensive care.
That means there are now about 890 people in the state needing intensive care and experts say the city's hospitals are already close to capacity.
'Encouraging signs' in Italy
In a related development, the World Health Organization’s European office said today that it saw “encouraging signs” in Italy reporting a lowered infection rate, though the UN agency cautioned that it was too soon to say whether the worst had passed.
Also, WHO said, many European countries have implemented or plan to implement changes in testing strategies to focus on severe cases and on hot zones in order to improve the quality of data used by epidemiologists.
A very similar approach has been recommended by Marc Siegel, MD, who has written about epidemics and is a media personality.
Generally, the focused approach means to have health authorities spot people who have the disease, track their contacts and apply medication and quarantines. That is the approach generally used for other contagions, so that society need not grind to a halt. But authorities cannot implement that policy when their data are insufficient. In various locales across the United States, there have been complaints of underreporting of Covid-19 infections and deaths due, in part, to shortage of tests and lab equipment.
“While the situation remains very serious, we are starting to see some encouraging signs,” declared Jan Kluge, WHO's regional director for Europe.
“Italy, which has the highest number of cases in the region, has just seen a slightly lower rate of increase, though it is still too early to say that the pandemic is peaking in that country,” he added.
WHO's European office said that to date more than 220,000 cases of Covid-19 had been reported on the continent, along with 11,987 deaths.
That means that globally, roughly 6 out of every 10 cases and 7 out of 10 deaths have been reported in Europe, with the number of confirmed infections worldwide now topping 400,000.
As the virus has spread across the continent, many European countries have adopted severe measures to curb the outbreak, including shelter-in-place lockdowns, the shuttering of nonessential businesses and the closing of borders, as well as the limiting of public gatherings.
Kluge said it will soon be evident whether these social mobility clampdowns have had an impact on curbing the rate of contagion.
WHO reports that
¶ The number of cases reported in Europe has doubled since last weekEuropean nations believe that targeted virus surveillance -- known as "sentinel surveillance" -- will provide better data on the most efficient ways to break the back of the epidemic. WHO says that:
¶ 61% of the cases and 90% of the deaths have been reported from Italy, Spain and France
¶ 96% of deaths were in persons aged 60 years and older
¶ 87% of infected persons with outcome data available recovered
¶ 10% of reported infections with information available was a health care worker
A sentinel surveillance system is used when high-quality data are needed about a particular disease that cannot be obtained through a passive system.
Selected reporting units, with a high probability of seeing cases of the disease in question, good laboratory facilities and experienced, well-qualified staff, identify and notify on certain diseases.
Whereas most passive surveillance systems receive data from as many health workers or health facilities as possible, a sentinel system deliberately involves only a limited network of carefully selected reporting sites.
For example, a network of large hospitals might be used to collect high-quality data on various diseases and their causative organisms, such as invasive bacterial disease caused by Haemophilus influenzae type b, meningococcus or pneumococcus.
Elements of this story came from Al Manar TV (Lebanon), Fox News, the World Health Organization, and wire services.
Wednesday, March 25, 2020
N.Y. hospital blitzed with 13 deaths
A surge of Covid-19 deaths struck a jammed New York City hospital during the past 24 hours.
The city health department reported that during the last 24 hours 13 people died of the viral disease, but that that figure is "consistent with the number of ICU patients being treated there."
The health department added, "Staff are doing everything in our power to save every person who contracts Covid-19, but unfortunately this virus continues to take an especially terrible toll on the elderly and people with preexisting conditions."
ABC News reported,
The health department put the city's Elmhurst area at "the center of this crisis," making it the "number one priority of our public hospital system right now."
The health department declared, "The frontline staff are going above and beyond in this crisis, and we continue surging supplies and personnel to this critical facility to keep pace with the crisis. We are literally increasing the effective capacity of the hospital on a daily basis by sending more doctors, nurses, ventilators and PPE [masks, gowns, gloves and other personal protective equipment] to meet demand."
Health officials urged New Yorkers to stay inside their homes and to avoid going to emergency rooms if their symptoms were mild or moderate.
Previously officials have said vulnerable seniors or people with other serious longterm ailments should contact doctors by phone or online. Because such individuals, when infected, can suddenly deteriorate, they should not be slow to contact doctors, officials have said.
The city health department reported that during the last 24 hours 13 people died of the viral disease, but that that figure is "consistent with the number of ICU patients being treated there."
The health department added, "Staff are doing everything in our power to save every person who contracts Covid-19, but unfortunately this virus continues to take an especially terrible toll on the elderly and people with preexisting conditions."
ABC News reported,
"Apocolyptic" was how one doctor described the scene inside the emergency room at the hospital in densely populated Elmhurst, a neighborhood in the city's most densely populated borough of Queens.A worried Mayor Bill de Blasio said the federal government had sent the city only enough supplies to keep hospitals going over the last 24 hours, but that thousands more ventilators were urgently needed.
"Right now, we're seeing double our average census every day," said Dr. Ben McVane. "We're filling up our ICUs. We have several floors now that are devoted only to Covid-positive patients. So we're finding ourselves getting close to being overwhelmed by patients. Some of these are very sick patients."
Elmhurst has a level one trauma center and is the hospital to which Rikers Island inmates are rushed in the event of an emergency at the city's jail complex.
The health department put the city's Elmhurst area at "the center of this crisis," making it the "number one priority of our public hospital system right now."
The health department declared, "The frontline staff are going above and beyond in this crisis, and we continue surging supplies and personnel to this critical facility to keep pace with the crisis. We are literally increasing the effective capacity of the hospital on a daily basis by sending more doctors, nurses, ventilators and PPE [masks, gowns, gloves and other personal protective equipment] to meet demand."
Health officials urged New Yorkers to stay inside their homes and to avoid going to emergency rooms if their symptoms were mild or moderate.
Previously officials have said vulnerable seniors or people with other serious longterm ailments should contact doctors by phone or online. Because such individuals, when infected, can suddenly deteriorate, they should not be slow to contact doctors, officials have said.
Nobel winner predicts cases
will begin tapering off soon
Vaccine breakthrough held likely after mutation news
A
Nobel laureate biophysicist predicts that the Covid-19 epidemic in America and across the globe will level off much sooner than expected, The Los Angeles Times is reporting.
LA Times report
https://www.latimes.com/science/story/2020-03-22/coronavirus-outbreak-nobel-laureate
The newspaper today reported
“This suggests that the rate of increase in the number of deaths will slow down even more over the next week,” Levitt wrote in a report he sent to friends Feb. 1 that was widely shared on Chinese social media. And soon, he predicted, the number of deaths would be decreasing every day.
Though American statistics are "still noisy," he predicts the social distancing measures will soon bear fruit.
Meanwhile, Marc Siegel, MD, a professor at New York University School of Medicine and media personality, said that new research shows that the Sars-CoV virus, which triggers the disease of Covid-19, is not mutating rapidly, meaning that various vaccines under development have a better chance of working. He noted that one vaccine is already in clinical trials, making him optimistic of an effective prevention measure that could reduce the contagion quite soon.
Earlier yesterday Siegel said that New York City is now "another Wuhan."
Siegel has written two popular books on potential pandemics.
Prodded by a newswoman, Siegel said that Scripps Research had disproved a rumor that the Sars-CoV virus had been genetically engineered in the Wuhan virology lab. It should be noted that there were initial concerns that a military laboratory, some 600 miles from Wuhan, might have been the source of the pathogen. But Chinese medics reported that they thought the virus had escaped the Wuhan virology lab after an accident in which a worker was bitten by a potentially infected bat. Coronaviruses tend to infect bats, it has been reported.
Scripps reports that it is examining a large number of drugs, using a new computerized technique, that might be repurposed to fight Sars-CoV.
Scripps Research report on Covid-19 work
https://www.scripps.edu/news-and-events/press-room/2020/20200318-covid19-scripps-research.html
Conant comments
The Chinese infection curve flattened once officials imposed highly authoritarian measures to keep people indoors. People received food in plastic bags delivered by government trucks.
But no such measure has been imposed on New York City -- "the new Wuhan" -- where people are crammed into small dwellings and get cabin fever rather easily, and where they disregard social distancing appeals with a free and easy attitude.
It may be necessary to patrol the streets with National Guard troops and/or auxiliary police issuing tickets for social distancing lapses.
Let's hope a good antiviral combo and/or vaccine is deployed rather soon.
The morgues in New York City are reportedly full up.
LA Times report
https://www.latimes.com/science/story/2020-03-22/coronavirus-outbreak-nobel-laureate
The newspaper today reported
Michael Levitt, a Nobel laureate and Stanford biophysicist, began analyzing the number of Covid-19 cases worldwide in January and correctly calculated that China would get through the worst of its coronavirus outbreak long before many health experts had predicted.Levitt noticed that in China on Jan. 31, the country had 46 new deaths due to the novel coronavirus, compared with 42 new deaths the day before. That represents a sudden reduction in the rate of new infections. No longer were cases piling up exponentially.
Now he foresees a similar outcome in the United States and the rest of the world.
While many epidemiologists are warning of months, or even years, of massive social disruption and millions of deaths, Levitt says the data simply don’t support such a dire scenario — especially in areas where reasonable social distancing measures are in place.
“What we need is to control the panic,” he said. In the grand scheme, “we’re going to be fine.”
“This suggests that the rate of increase in the number of deaths will slow down even more over the next week,” Levitt wrote in a report he sent to friends Feb. 1 that was widely shared on Chinese social media. And soon, he predicted, the number of deaths would be decreasing every day.
Though American statistics are "still noisy," he predicts the social distancing measures will soon bear fruit.
Meanwhile, Marc Siegel, MD, a professor at New York University School of Medicine and media personality, said that new research shows that the Sars-CoV virus, which triggers the disease of Covid-19, is not mutating rapidly, meaning that various vaccines under development have a better chance of working. He noted that one vaccine is already in clinical trials, making him optimistic of an effective prevention measure that could reduce the contagion quite soon.
Earlier yesterday Siegel said that New York City is now "another Wuhan."
Siegel has written two popular books on potential pandemics.
Prodded by a newswoman, Siegel said that Scripps Research had disproved a rumor that the Sars-CoV virus had been genetically engineered in the Wuhan virology lab. It should be noted that there were initial concerns that a military laboratory, some 600 miles from Wuhan, might have been the source of the pathogen. But Chinese medics reported that they thought the virus had escaped the Wuhan virology lab after an accident in which a worker was bitten by a potentially infected bat. Coronaviruses tend to infect bats, it has been reported.
Scripps reports that it is examining a large number of drugs, using a new computerized technique, that might be repurposed to fight Sars-CoV.
Scripps Research report on Covid-19 work
https://www.scripps.edu/news-and-events/press-room/2020/20200318-covid19-scripps-research.html
Conant comments
The Chinese infection curve flattened once officials imposed highly authoritarian measures to keep people indoors. People received food in plastic bags delivered by government trucks.
But no such measure has been imposed on New York City -- "the new Wuhan" -- where people are crammed into small dwellings and get cabin fever rather easily, and where they disregard social distancing appeals with a free and easy attitude.
It may be necessary to patrol the streets with National Guard troops and/or auxiliary police issuing tickets for social distancing lapses.
Let's hope a good antiviral combo and/or vaccine is deployed rather soon.
The morgues in New York City are reportedly full up.
Worried about possible infection? Know the signs
Common symptoms are
¶ FeverMuch less common are
¶ Dry cough
¶ Shortness of breath.
¶ Some people get headaches and other body aches and pains, sore throat and fatigue.
¶ Such flu-like symptoms as diarrhea and runny nose.Also,
¶ Sneezing, which does not ordinarily occur among those infected with the Covid-19 virus.
¶ Another important indicator is contact with someone who has tested positive for the virus.
¶ Symptoms for children with the Covid-19 infection may not match the profile for adults. For example, children with the virus are somewhat more likely to have diarrhea.
¶ Although younger people are at less risk than seniors, the risk is not trivial. There have been many reports of people of various ages dying from the disease.
The CDC says get help immediately if you develop the following
Emergency Warning Signs
¶ Trouble breathingThe list above does not cover every possible serious symptom. Please consult your medical provider for any other symptoms that are severe or concerning.
¶ Persistent pain or pressure in the chest
¶ New confusion or inability to arouse
¶ Bluish lips or face
You can answer a self-checker questionnaire found on this CDC page:
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/index.html
Other matters:
Federal information
https://www.usa.gov/coronavirus
White House and CDC info
https://www.coronavirus.gov/
Jobless benefits
Federal volunteer programs
Doctor: New York 'another Wuhan'
Nicole B. Saphier, MD, a radiologist who has been giving broadcast advice on the Covid-19 epidemic, says that a new antibody blood test may work well to alleviate the lockdown mentality sweeping the country.
Saphier, who works for Memorial Sloan-Kettering cancer centers in New York and New Jersey, said that the new test is being checked out by a number of institutions, including her former employer, Mayo Clinic.
Saphier said that the antibody test could relieve pressure in the distribution of nasal swabs used in the current test. The antibody test reveals whether a person is or has been infected by the Sars-CoV virus, which triggers the disease Covid-19. A person's immune system develops antibodies in response to invader viruses and bacteria. These antibodies then tend to stay in the bloodstream in case they need to do battle again.
The antibody test differs from another blood test, an antigen test, which looks for the actual virus, Saphier observed.
Mayo Clinic has announced that it had "significantly expanded its capacity to test clinical samples" for the Sars-CoV-2 virus.
"With new equipment that went online last week, Mayo Clinic Laboratories now has the capacity to process Covid-19 test samples from all Mayo Clinic sites," clinic spokespersons said. "In addition, it has begun processing test samples from its clients across Minnesota, including eight major health systems."
"The capability to test and process clinical samples for the SARS-CoV-2 virus is urgently needed nationwide and we have been working around the clock to make this expansion happen as quickly as possible," William Morice II, head of Mayo Clinic Laboratories, said in a statement. "Our expanded capacity will expedite caring for patients at this critical time, and hopefully will ease the burden being felt at test processing laboratories in Minnesota and a growing number of geographies."
Morice, who holds MD and PhD degrees, is also chief of Mayo Clinic’s Department of Laboratory Medicine and Pathology.
Mayo clinic spokespersons said,
Saphier, who works for Memorial Sloan-Kettering cancer centers in New York and New Jersey, said that the new test is being checked out by a number of institutions, including her former employer, Mayo Clinic.
Saphier said that the antibody test could relieve pressure in the distribution of nasal swabs used in the current test. The antibody test reveals whether a person is or has been infected by the Sars-CoV virus, which triggers the disease Covid-19. A person's immune system develops antibodies in response to invader viruses and bacteria. These antibodies then tend to stay in the bloodstream in case they need to do battle again.
The antibody test differs from another blood test, an antigen test, which looks for the actual virus, Saphier observed.
Marc Siegel, MD, has come out in favor of the antigen test on grounds that mass testing can identify those who are infected versus those who are not. Those who are infected would be cautioned against contact with the immuno-compromised and seniors, he said, warning that mass quarantines tend to make matters worse. Saphier seemed to agree when questioned by a TV interviewer, saying that the antibody test shows promise against the current barrage of shutdown decrees coming from mayors and governors.
Siegel updated his remarks on Wednesday, saying that the New York region has become "another Wuhan" and that expanded testing would permit authorities to permit more flexibility in less distressed areas. But he agreed that people fleeing the area might well be inadvertently spreading the virus across the nation.
The White House has urged self-quarantine for anyone who leaves New York State, but this suggestion relies on voluntary compliance, a somewhat iffy siruation. The Covid-19 virus was spread across the globe by people fleeing Wuhan in order to escape it.
"The capability to test and process clinical samples for the SARS-CoV-2 virus is urgently needed nationwide and we have been working around the clock to make this expansion happen as quickly as possible," William Morice II, head of Mayo Clinic Laboratories, said in a statement. "Our expanded capacity will expedite caring for patients at this critical time, and hopefully will ease the burden being felt at test processing laboratories in Minnesota and a growing number of geographies."
Morice, who holds MD and PhD degrees, is also chief of Mayo Clinic’s Department of Laboratory Medicine and Pathology.
Mayo clinic spokespersons said,
The expanded capacity is made possible by three high-throughput diagnostic processors from Roche Diagnostics, running the Roche cobas® SARS-CoV-2 Test. These instruments are in operation at Mayo Clinic's Superior Drive Support Center in Rochester.With all testing options, Mayo Clinic now can process as many as 4,000 Covid-19 tests daily. Morice says that number likely will grow in coming weeks. "We anticipate that with the ongoing need for Covid-19 testing that we will need to expand our capabilities, and we're prepared to do that."
This test processing capability is in addition to the Covid-19 testing developed by Mayo Clinic's Clinical Virology Laboratory. Announced last week, that test process is available for the Mayo Clinic practice. The Clinical Virology Laboratory, directed by microbiologist Matthew Binnicker, Ph.D., has also increased its capacity as of Wednesday.
A deadly surge on the Colorado plains
Posted Sunday by Daniel J. Wandsneider, a doctor at a hospital on Colorado's eastern plains:
"I’ve been using the same N95 mask since last Wednesday. I’m here until Sunday, maybe longer," Wandsneider said.
Wandsneider says the number of COVID-19 patients rose quickly. "Supplies are starting to run a little bit on the low side and we do see -- in a couple of weeks -- (we) are are not going to have masks or gloves," he said.
About 1/3 of his COVID-19 patients -- some of them in their 30s -- require critical care.
One patient in her 60s died.
"I went from saying, 'She’s doing wonderful' to the next morning saying we had to intubate her. She’s critically ill. Hadn’t quite seen anything like that before," Wandsneider said.
The lack of equipment like ventilators in smaller hospitals is also a concern.
While Wandsneider is committed to his patients, he is also concerned about his family and himself.
"It think’s it’s really only a matter of time. If I come out of this and don’t get the virus, I think it’ll be a miracle," he said.
Wandsneider is wanting to remind people that he’s seeing a lot of people in their 30s with the virus. He’s hoping people heed the stay-at-home orders.
Over 100 hours into my shift, I have first hand experiences with this virus and it’s as bad as you can imagine. For example, a healthy patient day 8 of illness on a few liters of oxygen turns to fulminate respiratory failure on mechanical ventilation within 16 hours. This isn’t another flu. This will infect your friends, parents, grandparents. We’re several weeks behind where we should be in terms of social isolation and healthcare preparedness. It’s the beginning. I wish I had understood the severity of the situation sooner and been a better advocate. I appreciate so many people who are doing their part. There are many who are making this a personal matter, and those are the people who will allow this disease to perpetuate as the 1918 pandemic did for nearly two years. Keep each other accountable and don’t make this personal. Don’t panic, but be prepared to settle in for longer than you think.Denver station KDVR quotes him as saying:
"I’ve been using the same N95 mask since last Wednesday. I’m here until Sunday, maybe longer," Wandsneider said.
Wandsneider says the number of COVID-19 patients rose quickly. "Supplies are starting to run a little bit on the low side and we do see -- in a couple of weeks -- (we) are are not going to have masks or gloves," he said.
About 1/3 of his COVID-19 patients -- some of them in their 30s -- require critical care.
One patient in her 60s died.
"I went from saying, 'She’s doing wonderful' to the next morning saying we had to intubate her. She’s critically ill. Hadn’t quite seen anything like that before," Wandsneider said.
The lack of equipment like ventilators in smaller hospitals is also a concern.
While Wandsneider is committed to his patients, he is also concerned about his family and himself.
"It think’s it’s really only a matter of time. If I come out of this and don’t get the virus, I think it’ll be a miracle," he said.
Wandsneider is wanting to remind people that he’s seeing a lot of people in their 30s with the virus. He’s hoping people heed the stay-at-home orders.
Monday, March 23, 2020
Drug kills virus in test tube, FDA chief reports
Chloroquine available to treat Covid-19
The Food and Drug Administration commissioner indicated yesterday that doctors can use chloroquine or hydroxychloroquine in treating Covid-19 though he said more data are needed to assure that the drugs are effective.
Dr. Stephen Hahn, the FDA chief, spoke with Tucker Carlson of Fox News.
"We do have data from other countries we are looking at, and specifically one trial from France which suggests we might have some benefit for hydroxychloroquine or chloroquine against the Covid-19 disease," Hahn said.
"We also have data from test-tube experiments that it does have activity against the virus," Hahn continued. "That being said, we need more safety and more efficacy data, particularly the efficacy side of this drug, to make a final determination about the effectiveness."
He said that, if as a doctor he were hearing a patient ask about the drug, he would want to know that its use was safe for that particular patient before prescribing it. Both chloroquine and hydroxychloroquine have "known safety profiles with the main concerns being cardiotoxicity" with prolonged use in patients with hepatic or renal dysfunction and immunosuppression but have been reportedly well-tolerated in Covid-19 patients, experts report.
But, he said that under Centers for Disease Control guidelines, the drug is "available for that purpose." CDC guidelines on chloroquine were posted within the last two days.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html
According to CDC guidance for clinicians, there are no FDA-approved drugs specifically targeting Covid-19. An array of drugs used for other purposes as well as some experimental drugs are being studied in several hundred clinical trials under way across the globe. The CDC spotlighted the drugs chloroquine and hydroxychloroquine, which are used in the United States for arthritis and other purposes, and the experimental drug remdesivir.
The following information comes from the CDC.
Hydroxychloroquine and Chloroquine
Dr. Stephen Hahn, the FDA chief, spoke with Tucker Carlson of Fox News.
"We do have data from other countries we are looking at, and specifically one trial from France which suggests we might have some benefit for hydroxychloroquine or chloroquine against the Covid-19 disease," Hahn said.
"We also have data from test-tube experiments that it does have activity against the virus," Hahn continued. "That being said, we need more safety and more efficacy data, particularly the efficacy side of this drug, to make a final determination about the effectiveness."
He said that, if as a doctor he were hearing a patient ask about the drug, he would want to know that its use was safe for that particular patient before prescribing it. Both chloroquine and hydroxychloroquine have "known safety profiles with the main concerns being cardiotoxicity" with prolonged use in patients with hepatic or renal dysfunction and immunosuppression but have been reportedly well-tolerated in Covid-19 patients, experts report.
But, he said that under Centers for Disease Control guidelines, the drug is "available for that purpose." CDC guidelines on chloroquine were posted within the last two days.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html
According to CDC guidance for clinicians, there are no FDA-approved drugs specifically targeting Covid-19. An array of drugs used for other purposes as well as some experimental drugs are being studied in several hundred clinical trials under way across the globe. The CDC spotlighted the drugs chloroquine and hydroxychloroquine, which are used in the United States for arthritis and other purposes, and the experimental drug remdesivir.
The following information comes from the CDC.
Hydroxychloroquine and Chloroquine
Hydroxychloroquine and chloroquine are oral prescription drugs that have been used for treatment of malaria and certain inflammatory conditions. Chloroquine has been used for malaria treatment and chemoprophylaxis, and hydroxychloroquine is used for treatment of rheumatoid arthritis, systemic lupus erythematosus and porphyria cutanea tarda.Remdesivir
Both drugs have in-vitro activity against SARS-CoV, SARS-CoV-2, and other coronaviruses, with hydroxychloroquine having relatively higher potency against SARS-CoV-2 . A study in China reported that chloroquine treatment of COVID-19 patients had clinical and virologic benefit versus a comparison group, and chloroquine was added as a recommended antiviral for treatment of COVID-19 in China. Based upon limited in-vitro and anecdotal data, chloroquine or hydroxychloroquine are currently recommended for treatment of hospitalized COVID-19 patients in several countries.
Both chloroquine and hydroxychloroquine have known safety profiles with the main concerns being cardiotoxicity (prolonged QT syndrome) with prolonged use in patients with hepatic or renal dysfunction and immunosuppression but have been reportedly well-tolerated in COVID-19 patients.
Due to higher in-vitro activity against SARS-CoV-2 and its wider availability in the United States compared with chloroquine, hydroxychloroquine has been administered to hospitalized COVID-19 patients on an uncontrolled basis in multiple countries, including in the United States. One small study reported that hydroxychloroquine alone or in combination with azithromycin reduced detection of SARS-CoV-2 RNA in upper respiratory tract specimens compared with a non-randomized control group but did not assess clinical benefit.
Hydroxychloroquine and azithromycin are associated with QT prolongation and caution is advised when considering these drugs in patients with chronic medical conditions (e.g. renal failure, hepatic disease) or who are receiving medications that might interact to cause arrythmias.
Hydroxychloroquine is currently under investigation in clinical trials for pre-exposure or post-exposure prophylaxis of SARS-CoV-2 infection, and treatment of patients with mild, moderate, and severe COVID-19. In the United States, several clinical trials of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection are planned or will be enrolling soon. More information on trials can be found at: https://clinicaltrials.gov/external icon.
There are no currently available data from Randomized Clinical Trials (RCTs) to inform clinical guidance on the use, dosing, or duration of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection. Although optimal dosing and duration of hydroxychloroquine for treatment of COVID-19 are unknown, some U.S. clinicians have reported anecdotally different hydroxychloroquine dosing such as: 400mg BID on day one, then daily for 5 days; 400 mg BID on day one, then 200mg BID for 4 days; 600 mg BID on day one, then 400mg daily on days 2-5.
Remdesivir is an investigational intravenous drug with broad antiviral activity that inhibits viral replication through premature termination of RNA transcription and has in-vitro activity against SARS-CoV-2 and in-vitro and in-vivo activity against related betacoronaviruses.Other Drugs
There are currently four options for obtaining remdesivir for treatment of hospitalized patients with COVID-19 and pneumonia in the United States:
A National Institutes of Health (NIH)-sponsored adaptive double-blinded, placebo-controlled trial of remdesivir versus placebo in COVID-19 patients with pneumonia and hypoxia is enrolling non-pregnant persons aged 18 years and older with oxygen saturation of ≤94% on room air or requiring supplemental oxygen or mechanical ventilation.
https://clinicaltrials.gov/ct2/show/NCT04280705
Exclusion criteria include alanine aminotransaminase or aspartate aminotransaminase levels >5 times the upper limit of normal, stage 4 severe chronic kidney disease or a requirement for dialysis (i.e., estimated glomerular filtration rate (eGFR) <30); Two phase 3 randomized open-label trials of remdesivir (5-days versus 10-days versus standard of care) are open to enrollment in persons aged 18 years and older with COVID-19, radiographic evidence of pneumonia and oxygen saturation of ≤94% on room air (severe disease).
https://clinicaltrials.gov/ct2/show/NCT04292899
or >94% on room air (moderate disease).
https://clinicaltrials.gov/ct2/show/NCT04292730
Exclusion criteria include alanine aminotransaminase or aspartate aminotransaminase levels >5 times the upper limit of normal, participation in another clinical trial of an experimental treatment for COVID-19, requirement for mechanical ventilation, or creatinine clearance <50 mL/min; and Finally, in areas without clinical trials, COVID-19 patients in the United States and other countries have been treated with remdesivir on an uncontrolled compassionate use basis. The manufacturer is currently transitioning the provision of emergency access to remdesivir from individual compassionate use requests to an expanded access program. The expanded access program for the United States is under rapid development. Further information is available at:
https://rdvcu.gilead.com/
Lopinavir-ritonavir did not show promise for treatment of hospitalized COVID-19 patients with pneumonia in a recent clinical trial in China. This trial was underpowered, and lopinavir-ritonavir is under investigation in a World Health Organization study.
Several other drugs are under investigation in clinical trials or are being considered for clinical trials of prophylaxis or treatment of COVID-19 in the United States and worldwide. Information on registered clinical trials for COVID-19 in the United States is available at:
https://clinicaltrials.gov/
EFF warns on abuse of crisis
for unwarranted surveillance
By CINDY COHN
Executive Director,
Electronic Frontier Foundation
The COVID-19 pandemic has now altered our timeline.
Executive Director,
Electronic Frontier Foundation
The COVID-19 pandemic has now altered our timeline.
It has made obvious how important the Internet and digital tools are to our lives and how vital it is that we maintain an open and secure approach to them. But we must be as vigilant as we are thoughtful in our response. From long experience, we know that times of crisis have often led politicians to embrace unnecessary and discriminatory measures that increase surveillance and threaten privacy.
EFF and its members work to ensure that technology supports freedom, justice, and innovation for all the people of the world. Our shared mission—both embracing the positives that emerge during this time and heading off the inevitable negatives—is more important than ever.
Online Creativity Is A Bright Spot In The Darkness
For those of us living under quarantine, shelter in place orders, or just staying home to voluntarily help protect our communities, we now rely on the Internet and digital tools more than ever to share information and advice, create art and memes, listen to our favorite musicians perform “live,” or just to feel less alone. We see how technology is helping us cope, hopefully temporarily, with the loss of in-person contact. Many others are using digital tools and services to organize mutual aid for their neighborhoods and communities in this time of crisis.
Thanks to open access science, scientific and medical teams are able to instantly share their work and build on efforts to track the virus, study its effect on people, and develop vaccines. Others are developing ways to create and repair vital medical equipment using open tools, including reportedly 3D printing. We are coming together online and offline in new and creative ways, and ensuring that security, privacy, and openness are baked into the tools and services we use will only support our efforts.
In some ways, the explosion of open creativity online to keep us connected and sane during these scary times is one of the bright spots in the darkness. But in the United States, it also shows how this crisis disproportionately impacts those of us who are marginalized in our society already—the unsheltered, those who cannot afford or access reliable broadband service to continue school or work, the consultants and retail workers who have little reserves, and all of those falling through our frayed social safety net. Innovation is needed here too—like ensuring that robust broadband access works for everyone, not just the wealthy, and is not dependent on temporary largess of some giant providers.
We Must Be Extra Vigilant In Defending Our Rights In This Moment
We also know that times of great public fear come with great risk. Public fear has driven some of the worst human rights atrocities, and given opportunities for those who would seize power from us and reduce or even erase our hard-won human rights and civil liberties. Already we see efforts to use this public health crisis as an excuse to place irrational blame on our Asian communities and direct even more pressure and discrimination against refugees and immigrants. We already see calls from companies seeking to cash in on this crisis for unchecked face surveillance, social media monitoring, and other efforts far beyond what medicine or epidemiology require.
When fear threatens to undermine our rights and pervert justice, that’s where EFF—and you—come in.
We know that this virus requires us to take steps that would be unthinkable in normal times. Staying inside, limiting public gatherings, and cooperating with medically needed attempts to track the virus are, when approached properly, reasonable and responsible things to do. But we must be sure that measures taken in the name of responding to COVID-19 are, in the language of international human rights law, “necessary and proportionate” to the needs of society in fighting the virus. Above all, we must make sure that these measures end and that the data collected for these purposes is not re-purposed for either governmental or commercial ends.
We Can Take Advantage Of Technology, and Emerge Stronger
As we head further into these difficult times, EFF is standing strong to make sure that we both take advantage of how technology can help us now and, equally importantly, that we emerge from this time with our freedom and democracy as strong, if not stronger, than when we went in. Because we at EFF have a committed membership as our primary support—over half of our annual budget comes from individuals—we can pivot our attention to these issues even as we continue our ongoing fights.
EFF's lawyers are scrutinizing the proposed laws and regulations and corporate privacy moves, especially the growing and concerning raft of corporate/government surveillance efforts. Our technologists are digging into the digital tools we all rely on during this crisis to make sure that your privacy is protected. We’re pushing to lower artificial barriers to information sharing, and working to make sure that access to knowledge is one of the things we keep as we emerge from these times. And more.
We have created an issue page dedicated to our COVID-19 focused work and will continue to highlight our efforts there, as well as publish needed practical information about how to fight COVID-19 phishing attempts and how to show your EFF support as we head into our 30th year of standing strong for your rights.
Right now, when real science is so often under attack, those of us who care about truth, health, and each other need to take seriously the things that science and medicine are telling us about how to keep this virus from spreading. And we also need to be vigilant so that we come out the other side of this crisis with a society we want to live in and hand down to our kids. We can—and must—do both.
Right now, when real science is so often under attack, those of us who care about truth, health, and each other need to take seriously the things that science and medicine are telling us about how to keep this virus from spreading. And we also need to be vigilant so that we come out the other side of this crisis with a society we want to live in and hand down to our kids. We can—and must—do both.
EFF is proven, ready, and strong. With the support of our members, new and old, we’ll be there with you every step of the way.
Subscribe to:
Posts (Atom)
NEWS of the WORLD launched
The Invisible Man is being folded into the new site, NEWS of the WORLD, which has begun operation. Though this Invisible Man site is ce...
