As the COVID-19 pandemic spreads around the world, researchers and
public health experts are casting about for older vaccines and antiviral
drugs that might be used to treat the disease caused by the novel
coronavirus SARS-CoV-2. The prime examples are malaria drugs chloroquine
and hydroxychloroquine, which the U.S. Food and Drug Administration
(FDA) approved for use under an Emergency Use Authorization (EUA) this weekend, despite criticism of the lack of evidence they work.
Researchers in Australia are turning to another older treatment,
a vaccine once used to prevent tuberculosis (TB) called the bacillus
Calmette-Guerin (BCG), which has been used for about 100 years.
Researchers have been taking a hard look at BCG for some time for other
uses, including as an immunotherapy for early-stage bladder cancer.
And earlier this year, researchers at the National Institutes of Health (NIH) conducted
research with the BCG to see if it could be used to improve TB
immunity. And now, in light of the way the BCG vaccine primes the immune
system, it is being evaluated for COVID-19, which has at least a couple
similarities to TB—they’re both lung infections caused by
microorganisms.
Nigel Curtis, head of infectious diseases research at the Murdoch
Children’s Research Institute in Melbourne, Australia, is running a
study into BCG and COVID-19, which the World Health Organization (WHO)
is encouraging other researchers to collaborate with.
“It can boost the immune system so that it defends better against a
whole range of different infections, a whole range of different viruses
and bacteria in a lot more generalized way,” said Curtis, who is also a
professor of pediatric infectious diseases at the University of
Melbourne and head of the infectious diseases unit at the city’s Royal
Children’s Hospital.
In Curtis’s study, which will run six months, 4,000 healthcare
workers will be vaccinated with BCG with the seasonal influenza vaccine
or the influenza vaccine alone. A placebo vaccine isn’t being used
because the BCG shot usually causes a localized skin reaction that
leaves a scar.
Similar studies are ongoing in The Netherlands and Curtis indicated
he is in talks with possible trial sites in Boston and in other
Australian cities.
BCG is used to immunize about 130 million newborns around the globe
each year. Research in babies in Africa demonstrated that BCG offers
protections against TB and other pediatric infections.
“We need to think of every possible way that we can protect
healthcare workers,” Curtis said. “And there’s going to be a particular
need to reduce the amount of time that our healthcare workers are
absent.”
He also added, “We wouldn’t be doing this if we didn’t think that
this might work. We cannot guarantee that this will work. And of course,
the only way to find out is with our trial.”
The BCG vaccine contains a live, weakened strain of Mycobacterium bovis, which is very similar to the microbe that causes tuberculosis.
Results from the trial, which will begin dosing
on April 6, aren’t likely until September. Meanwhile, researchers
worldwide are testing other drugs to respond to the pandemic, with over
100 ongoing clinical trials.
“I am hopeful that within three months we will have a good idea which
drugs are good and which drugs are bad,” Australian National University
geneticist Gaetan Burgio told the Asia Times. “The field is moving very quickly.”
https://www.biospace.com/article/-can-an-old-tuberculosis-vaccine-work-against-covid-19-/
Wednesday, April 1, 2020
Developing antibodies to ‘neutralize’ novel coronavirus before it invades cells
University of Toronto researcher Sachdev Sidhu and his collaborators
are engineering antibody molecules that can neutralize the novel
coronavirus in the body before it invades cells.
The investigator at the Donnelly Centre for Molecular and Biomolecular Research is part of a team that recently received federal funding support through a second round of emergency COVID-19 funding from the Canadian Institutes for Health Research.
Sidhu already leads a different team that received support in the first round of federal funding. The goal of that project is to design antiviral medicines that block viral replication.
“With our two funded projects, we are working to develop molecules that can target the virus both inside human cells and on the outside to prevent it from getting in,” says Sidhu, who is a professor of molecular genetics in the Faculty of Medicine.
The latest funded project, headed by U of T Professor James Rini of the departments of molecular genetics and biochemistry, aims to produce antibodies that can effectively neutralize the virus before it causes damage. Such antibodies are naturally produced by the body in response to infection, but researchers hope to reduce the duration and severity of the disease by boosting the immune system with injected antibodies. To take one existing example: Neutralizing antibodies are used to treat rabies, which is also caused by a virus.
Rini has previously helped to determine how antibodies bind to and inactivate the SARS virus, the coronavirus that caused the outbreak in Asia more than 15 years ago. Also on the team is Alan Cochrane, a professor in the department of molecular genetics and an HIV virologist with expertise in viral RNA processing.
The antibodies will be engineered to block the so-called S-protein that forms spikes on the virus’s surface. The spikes lock on to a protein called ACE2 on the surface of human cells to gain entry. Coating viral particles with synthetic antibodies should prevent the spikes from binding to ACE2.
Sidhu and Rini will also engineer antibodies that bind ACE2 to make it inaccessible to the virus. This type of engineered immunity surpasses the capacity of the body’s natural immune system since antibodies that react against self-proteins have been filtered out. If successful, the approach may obviate worries about viral mutations that can render drugs ineffective to new emerging viral strains because the host protein ACE2 does not change over time.
Sidhu’s team has advanced a technology called phage display to rapidly create and select human antibodies with desired biological properties, including blocking the virus’s spike protein. Over the last decade, his team has created hundreds of antibodies with therapeutic potential—some of which are in clinical development through spin-off companies and large pharmaceutical firms.
The group has demonstrated success with both approaches for inhibiting viral entry, having developed neutralizing antibodies that target the Ebola virus as well as antibodies that target the human host receptor of hantavirus or hepatitis C. Moreover, other research has shown that antibodies targeting SARS, a related virus whose genetic material is over 80 percent identical to the one causing COVID-19, can clear infection in cells and mice.
Using phage display, in which tiny bacterial viruses called phages are instructed to create vast libraries of diverse antibodies, the team will select the antibodies that can kill the virus in human cells before testing them on mice and, eventually, patients. Experiments on mice could start within three to six months, Sidhu says.
In addition to creating antibodies tailored to the new virus from scratch, the researchers will also modify existing SARS-blocking antibodies so that they attack COVID-19 and provide an additional route to the development of a therapeutic.
Given the global spread of the virus, it’s possible that it will become endemic and circulate in the population like seasonal flu. And, like the flu, it could mutate into new strains that will evade acquired immunity and the vaccines that are being developed. By generating a panel of different antibodies, the researchers aim to stay one step ahead of the virus.
“Our advances in antibody engineering technologies and access to the complete genomes of the COVID-19 virus and its relatives provides us with an opportunity to create tailored therapeutic antibodies at a scale and speed that was not possible even a few years ago,” says Sidhu.
“Ultimately, we aim to optimize methods to the point where the evolution of new drugs will keep pace with the evolution of the virus itself, providing new and effective drugs in response to new outbreaks.”
https://medicalxpress.com/news/2020-04-antibodies-neutralize-coronavirus-invades-cells.html
The investigator at the Donnelly Centre for Molecular and Biomolecular Research is part of a team that recently received federal funding support through a second round of emergency COVID-19 funding from the Canadian Institutes for Health Research.
Sidhu already leads a different team that received support in the first round of federal funding. The goal of that project is to design antiviral medicines that block viral replication.
“With our two funded projects, we are working to develop molecules that can target the virus both inside human cells and on the outside to prevent it from getting in,” says Sidhu, who is a professor of molecular genetics in the Faculty of Medicine.
The latest funded project, headed by U of T Professor James Rini of the departments of molecular genetics and biochemistry, aims to produce antibodies that can effectively neutralize the virus before it causes damage. Such antibodies are naturally produced by the body in response to infection, but researchers hope to reduce the duration and severity of the disease by boosting the immune system with injected antibodies. To take one existing example: Neutralizing antibodies are used to treat rabies, which is also caused by a virus.
Rini has previously helped to determine how antibodies bind to and inactivate the SARS virus, the coronavirus that caused the outbreak in Asia more than 15 years ago. Also on the team is Alan Cochrane, a professor in the department of molecular genetics and an HIV virologist with expertise in viral RNA processing.
The antibodies will be engineered to block the so-called S-protein that forms spikes on the virus’s surface. The spikes lock on to a protein called ACE2 on the surface of human cells to gain entry. Coating viral particles with synthetic antibodies should prevent the spikes from binding to ACE2.
Sidhu and Rini will also engineer antibodies that bind ACE2 to make it inaccessible to the virus. This type of engineered immunity surpasses the capacity of the body’s natural immune system since antibodies that react against self-proteins have been filtered out. If successful, the approach may obviate worries about viral mutations that can render drugs ineffective to new emerging viral strains because the host protein ACE2 does not change over time.
Sidhu’s team has advanced a technology called phage display to rapidly create and select human antibodies with desired biological properties, including blocking the virus’s spike protein. Over the last decade, his team has created hundreds of antibodies with therapeutic potential—some of which are in clinical development through spin-off companies and large pharmaceutical firms.
The group has demonstrated success with both approaches for inhibiting viral entry, having developed neutralizing antibodies that target the Ebola virus as well as antibodies that target the human host receptor of hantavirus or hepatitis C. Moreover, other research has shown that antibodies targeting SARS, a related virus whose genetic material is over 80 percent identical to the one causing COVID-19, can clear infection in cells and mice.
Using phage display, in which tiny bacterial viruses called phages are instructed to create vast libraries of diverse antibodies, the team will select the antibodies that can kill the virus in human cells before testing them on mice and, eventually, patients. Experiments on mice could start within three to six months, Sidhu says.
In addition to creating antibodies tailored to the new virus from scratch, the researchers will also modify existing SARS-blocking antibodies so that they attack COVID-19 and provide an additional route to the development of a therapeutic.
Given the global spread of the virus, it’s possible that it will become endemic and circulate in the population like seasonal flu. And, like the flu, it could mutate into new strains that will evade acquired immunity and the vaccines that are being developed. By generating a panel of different antibodies, the researchers aim to stay one step ahead of the virus.
“Our advances in antibody engineering technologies and access to the complete genomes of the COVID-19 virus and its relatives provides us with an opportunity to create tailored therapeutic antibodies at a scale and speed that was not possible even a few years ago,” says Sidhu.
“Ultimately, we aim to optimize methods to the point where the evolution of new drugs will keep pace with the evolution of the virus itself, providing new and effective drugs in response to new outbreaks.”
https://medicalxpress.com/news/2020-04-antibodies-neutralize-coronavirus-invades-cells.html
Should you bring mom home from assisted living during the pandemic?
Dr. Alison Webb took her 81-year-old father out of assisted living, to live.
Coleen Hubbard took her 85-year-old mother out of independent living, to die.
With the coronavirus moving through facilities that house older adults, families across the country are wondering “Should I bring Mom or Dad home?”
It’s a reasonable question. Most retirement complexes and long-term care facilities are excluding visitors. Older adults are asked to stay in their rooms and are alone for most of the day. Family members might call, but that doesn’t fill the time. Their friends in the facility are also sequestered.
In a matter of weeks, conditions have deteriorated in many of these centers.
At assisted living sites, staff shortages are developing as aides become sick or stay home with children whose schools have closed.
Nursing homes, where seniors go for rehabilitation after a hospital stay or live long term if they’re seriously ill and frail, are being hard hit by the coronavirus. They’re potential petri dishes for infection.
Still, older adults in these settings are being fed and offered other types of assistance. My neighbor’s 80-something parents are at a continuing care community outside Denver. It has started a concierge service for residents who need to order groceries and fill prescriptions. At rehab centers, physical, occupational and speech therapists offer valuable services.
But would be Mom or Dad fare better, even with all due social distancing, in the family home?
Of course, care there would fall squarely on the family’s shoulders, as would the responsibility for buying groceries, cooking, administering medication, doing the laundry and ensuring the environment is free from potential contamination.
Home health care services could lend a hand. But they may not be easy to get because of growing demand, shortages of personal protective equipment and staffing issues.
Another concern in bringing someone home: Some facilities are telling residents that if they leave, even temporarily, they can’t return. That happened to a family in western New York, according to Roxanne Sorensen, a geriatric care manager with Elder Care Solutions of WNY.
When this family took their elderly parents out of an assisted living facility for a brief “stay-with-us” respite, they were told the parents had been discharged and had to be placed on a waiting list before they could return.
Sorensen has a client in her early 70s who’s in rehabilitation at a nursing home after emergency surgery for a life-threatening infection. The facility is on lockdown and her client is feeling trapped and desperate. She wants to go home, but she’s still weak and needs a lot more therapy.
“I’ve told her, stay here, get stronger and when you go home you won’t end up in the hospital or with disabilities that could put you back in a nursing home for the rest of your life,” Sorensen said.
Those in nursing care who have cognitive impairments may become disoriented or agitated if a family moves them from an environment that feels familiar, said Dr. Thomas Cornwell, executive chairman of the Home Centered Care Institute. Some have behavioral issues that can’t be managed at home.
Families with children need to think carefully about bringing an older parent home, especially if he or she has underlying chronic illnesses such as heart, lung or kidney disease, Cornwell said. “Kids, generally, even in the past few weeks, have been exposed to hundreds of others (at school),” he said. “They tend to be vectors of infection.”
Ultimately, every family must weigh and balance the risks. Can they give an older parent enough attention? Do they have the emotional and physical stamina to take this on? What does the parent want? Will the pangs of displacement and disrupted routines be offset by the pleasures of being around adult children and grandchildren?
Dr. Alison Webb, a retired physician, is a single mom raising a 3-year-old and a 7-year-old. Her father, Bob Webb, 81, has mild dementia and had been hospitalized for depression before she asked him to leave assisted living and move into her Seattle home.
“Initially he resisted. He feared change, and he was concerned that his stuff was going to be left behind and he wouldn’t get it back, ever,” Webb said. Even today, Bob talks about going back home to his apartment.
Webb said a geriatrician on a Facebook group for female physicians convinced her it was safer for her father to leave his assisted living center. “‘You’ll do a lot better here with the grandkids. You can play games. There’s a big yard. You can do some gardening,'” Webb said she told her dad.
There’s another benefit. Because she’s a physician, Webb said, she hopes “I’ll notice if he’s not doing well and take care of it right away.”
Coleen Hubbard’s mother, Delores, whom she described as “really resilient and really stubborn,” had loved living in a one-bedroom apartment in a Denver senior housing complex for the past decade. In October, Delores was diagnosed with endometrial cancer and decided not to have medical treatment.
“Mom had a lot of surgeries and hospitalizations in her life,” Hubbard said. “She was done dealing with the medical community.”
Every time Hubbard suggested her mother move in with her, Delores refused: She wanted to die in her own apartment. But then, a few weeks ago, serious pain set in and Delores asked the Denver Hospice to begin giving her morphine.
“That’s when I realized that we may be close to the end,” Hubbard said. “And I felt an incredible urgent panic that I had to get her out of there. Things were already starting to close (because of the coronavirus). I could not fathom that she might be cut off from me.”
Hubbard prepared a room at home and found a small, tinny metal bell that Delores could ring if she needed help. “We made a lot of jokes about Peter Pan and Tinker Bell,” Hubbard remembered. “When she rang the bell, I’d come in and say, ‘Yes, m’lady, what’s happening?'”
Five days after arriving, Delores passed away. “Grieving right now happens in a space of solitude and silence,” Hubbard wrote in a Facebook post. “Sure, there are texts and phone calls, emails and snail mail, but no embraces, no questionable casseroles delivered by neighbors, no gathering of family and friends to share stories and memories.”
Amid the grief is relief that Delores had what she wanted: a death without medical interventions. “I’m pinching myself that we made that happen,” Hubbard said. “And I’m so glad we brought her home.”
Patricia Scott’s story is unfinished. The 101-year-old was living in a retirement community in Castro Valley, Calif., before her son, Bart Scott, brought her to his house in Santa Rosa, moving her into a spacious in-law apartment.
Asked how she felt about the change, Patricia Scott said, “I’ve never been particularly thrilled with the idea of homogenized residency with a bunch of old farts, of whom I am one.”
Yet, she longs for her two-bedroom apartment: “It’s just that everything is there. I know where crap is. I miss my regular life.”
Bart Scott has four siblings, and they agreed that it was untenable to leave his mother alone during the coronavirus scare. “She is the matriarch of this family,” he said. “There are a lot of people who put a lot of store in her well-being.”
As for potential health threats, Patricia Scott is characteristically sardonic. “I was born in 1918, in the middle of the influenza epidemic,” she said, “and I think there’s a delicious irony that I could very well exit in this one.”
https://medicalxpress.com/news/2020-04-mom-home-pandemic.html
Coleen Hubbard took her 85-year-old mother out of independent living, to die.
With the coronavirus moving through facilities that house older adults, families across the country are wondering “Should I bring Mom or Dad home?”
It’s a reasonable question. Most retirement complexes and long-term care facilities are excluding visitors. Older adults are asked to stay in their rooms and are alone for most of the day. Family members might call, but that doesn’t fill the time. Their friends in the facility are also sequestered.
In a matter of weeks, conditions have deteriorated in many of these centers.
At assisted living sites, staff shortages are developing as aides become sick or stay home with children whose schools have closed.
Nursing homes, where seniors go for rehabilitation after a hospital stay or live long term if they’re seriously ill and frail, are being hard hit by the coronavirus. They’re potential petri dishes for infection.
Still, older adults in these settings are being fed and offered other types of assistance. My neighbor’s 80-something parents are at a continuing care community outside Denver. It has started a concierge service for residents who need to order groceries and fill prescriptions. At rehab centers, physical, occupational and speech therapists offer valuable services.
But would be Mom or Dad fare better, even with all due social distancing, in the family home?
Of course, care there would fall squarely on the family’s shoulders, as would the responsibility for buying groceries, cooking, administering medication, doing the laundry and ensuring the environment is free from potential contamination.
Home health care services could lend a hand. But they may not be easy to get because of growing demand, shortages of personal protective equipment and staffing issues.
Another concern in bringing someone home: Some facilities are telling residents that if they leave, even temporarily, they can’t return. That happened to a family in western New York, according to Roxanne Sorensen, a geriatric care manager with Elder Care Solutions of WNY.
When this family took their elderly parents out of an assisted living facility for a brief “stay-with-us” respite, they were told the parents had been discharged and had to be placed on a waiting list before they could return.
Sorensen has a client in her early 70s who’s in rehabilitation at a nursing home after emergency surgery for a life-threatening infection. The facility is on lockdown and her client is feeling trapped and desperate. She wants to go home, but she’s still weak and needs a lot more therapy.
“I’ve told her, stay here, get stronger and when you go home you won’t end up in the hospital or with disabilities that could put you back in a nursing home for the rest of your life,” Sorensen said.
Those in nursing care who have cognitive impairments may become disoriented or agitated if a family moves them from an environment that feels familiar, said Dr. Thomas Cornwell, executive chairman of the Home Centered Care Institute. Some have behavioral issues that can’t be managed at home.
Families with children need to think carefully about bringing an older parent home, especially if he or she has underlying chronic illnesses such as heart, lung or kidney disease, Cornwell said. “Kids, generally, even in the past few weeks, have been exposed to hundreds of others (at school),” he said. “They tend to be vectors of infection.”
Ultimately, every family must weigh and balance the risks. Can they give an older parent enough attention? Do they have the emotional and physical stamina to take this on? What does the parent want? Will the pangs of displacement and disrupted routines be offset by the pleasures of being around adult children and grandchildren?
Dr. Alison Webb, a retired physician, is a single mom raising a 3-year-old and a 7-year-old. Her father, Bob Webb, 81, has mild dementia and had been hospitalized for depression before she asked him to leave assisted living and move into her Seattle home.
“Initially he resisted. He feared change, and he was concerned that his stuff was going to be left behind and he wouldn’t get it back, ever,” Webb said. Even today, Bob talks about going back home to his apartment.
Webb said a geriatrician on a Facebook group for female physicians convinced her it was safer for her father to leave his assisted living center. “‘You’ll do a lot better here with the grandkids. You can play games. There’s a big yard. You can do some gardening,'” Webb said she told her dad.
There’s another benefit. Because she’s a physician, Webb said, she hopes “I’ll notice if he’s not doing well and take care of it right away.”
Coleen Hubbard’s mother, Delores, whom she described as “really resilient and really stubborn,” had loved living in a one-bedroom apartment in a Denver senior housing complex for the past decade. In October, Delores was diagnosed with endometrial cancer and decided not to have medical treatment.
“Mom had a lot of surgeries and hospitalizations in her life,” Hubbard said. “She was done dealing with the medical community.”
Every time Hubbard suggested her mother move in with her, Delores refused: She wanted to die in her own apartment. But then, a few weeks ago, serious pain set in and Delores asked the Denver Hospice to begin giving her morphine.
“That’s when I realized that we may be close to the end,” Hubbard said. “And I felt an incredible urgent panic that I had to get her out of there. Things were already starting to close (because of the coronavirus). I could not fathom that she might be cut off from me.”
Hubbard prepared a room at home and found a small, tinny metal bell that Delores could ring if she needed help. “We made a lot of jokes about Peter Pan and Tinker Bell,” Hubbard remembered. “When she rang the bell, I’d come in and say, ‘Yes, m’lady, what’s happening?'”
Five days after arriving, Delores passed away. “Grieving right now happens in a space of solitude and silence,” Hubbard wrote in a Facebook post. “Sure, there are texts and phone calls, emails and snail mail, but no embraces, no questionable casseroles delivered by neighbors, no gathering of family and friends to share stories and memories.”
Amid the grief is relief that Delores had what she wanted: a death without medical interventions. “I’m pinching myself that we made that happen,” Hubbard said. “And I’m so glad we brought her home.”
Patricia Scott’s story is unfinished. The 101-year-old was living in a retirement community in Castro Valley, Calif., before her son, Bart Scott, brought her to his house in Santa Rosa, moving her into a spacious in-law apartment.
Asked how she felt about the change, Patricia Scott said, “I’ve never been particularly thrilled with the idea of homogenized residency with a bunch of old farts, of whom I am one.”
Yet, she longs for her two-bedroom apartment: “It’s just that everything is there. I know where crap is. I miss my regular life.”
Bart Scott has four siblings, and they agreed that it was untenable to leave his mother alone during the coronavirus scare. “She is the matriarch of this family,” he said. “There are a lot of people who put a lot of store in her well-being.”
As for potential health threats, Patricia Scott is characteristically sardonic. “I was born in 1918, in the middle of the influenza epidemic,” she said, “and I think there’s a delicious irony that I could very well exit in this one.”
https://medicalxpress.com/news/2020-04-mom-home-pandemic.html
Healthy-looking people spread coronavirus, more studies say
More evidence is emerging that coronavirus infections are being
spread by people who have no clear symptoms, complicating efforts to
gain control of the pandemic.
A study conducted by researchers in Singapore and published by the U.S. Centers for Disease Control and Prevention Wednesday is the latest to estimate that around 10% of new coronavirus infections may be sparked by people who were infected with the virus but not experiencing symptoms.
In response to recent studies, the CDC changed how it was defining the risk of infection for Americans. The agency’s new guidance, also released Wednesday, targets people who have no symptoms but were exposed to persons with known or suspected infections. It essentially says that anyone may be a considered a carrier, whether they have symptoms or not.
That reinforces the importance of social distancing and other measures designed to stop the spread, experts said.
“You have to really be proactive about reducing contacts between people who seem perfectly healthy,” said Lauren Ancel Meyers, a University of Texas at Austin researcher who has studied coronavirus transmission in different countries.
The new study focused on 243 cases of coronavirus reported in Singapore from mid-January through mid-March, including 157 among people who hadn’t traveled.
Researchers found that so-called pre-symptomatic people triggered infections in seven different clusters of disease, accounting for about 6% of the locally-acquired cases.
An earlier study in Hubei province, China, where the virus was first identified, suggested that more than 10% of transmissions could have occurred before patients spreading the virus ever exhibited symptoms.
Researchers are also looking into the possibility that additional cases are triggered by “asymptomatic” people who are infected but never develop clear-cut symptoms, and “post-symptomatic” people who got sick, appear to be recovered, but may still be contagious.
It remains unclear how many new infections are caused by each type of these potential spreaders, said Meyers, who was not involved in the Singapore study but was part of an earlier one focused on China.
CDC officials say they’ve been researching asymptomatic and pre-symptomatic infections, but the studies are not complete.
In the initial months of the pandemic, health officials based their response on the belief that most of the spread came from people who were sneezing or coughing droplets that contained the virus.
A study conducted by researchers in Singapore and published by the U.S. Centers for Disease Control and Prevention Wednesday is the latest to estimate that around 10% of new coronavirus infections may be sparked by people who were infected with the virus but not experiencing symptoms.
In response to recent studies, the CDC changed how it was defining the risk of infection for Americans. The agency’s new guidance, also released Wednesday, targets people who have no symptoms but were exposed to persons with known or suspected infections. It essentially says that anyone may be a considered a carrier, whether they have symptoms or not.
That reinforces the importance of social distancing and other measures designed to stop the spread, experts said.
“You have to really be proactive about reducing contacts between people who seem perfectly healthy,” said Lauren Ancel Meyers, a University of Texas at Austin researcher who has studied coronavirus transmission in different countries.
The new study focused on 243 cases of coronavirus reported in Singapore from mid-January through mid-March, including 157 among people who hadn’t traveled.
Researchers found that so-called pre-symptomatic people triggered infections in seven different clusters of disease, accounting for about 6% of the locally-acquired cases.
An earlier study in Hubei province, China, where the virus was first identified, suggested that more than 10% of transmissions could have occurred before patients spreading the virus ever exhibited symptoms.
Researchers are also looking into the possibility that additional cases are triggered by “asymptomatic” people who are infected but never develop clear-cut symptoms, and “post-symptomatic” people who got sick, appear to be recovered, but may still be contagious.
It remains unclear how many new infections are caused by each type of these potential spreaders, said Meyers, who was not involved in the Singapore study but was part of an earlier one focused on China.
CDC officials say they’ve been researching asymptomatic and pre-symptomatic infections, but the studies are not complete.
In the initial months of the pandemic, health officials based their response on the belief that most of the spread came from people who were sneezing or coughing droplets that contained the virus.
U.S. starts enhanced measures to disrupt illegal drugs supply: coronavirus briefing
The U.S. is deploying military resources to
prevent drug traffickers from taking advantage of the coronavirus
pandemic for their own gain, President Trump said at the coronavirus
task force briefing.
Defense Secretary Mark Esper said the Department
of Defense is starting enhanced narcotics operations to further disrupt
the flow of illicit drugs into the U.S., including the movement of ships
and surveillance aircraft to Southern Command.
We must “remain vigilant to many other threats” to the country while we’re combating the virus, Esper said.
Update 5:56 PM ET: When asked
about whether China under-reported its cases of COVID-19, National
Security Adviser Robert O’Brien said there’s no way to confirm the
numbers from China.
5:58 PM: “The relationship is
very good” with China and President Xi, Trump said. China’s numbers,
though, seem to be “on the light side,” he said.
6:02 PM: Trump said the U.S. just ordered a lot of hospital gowns from Walmart (NYSE:WMT) and wants Walmart to ship them directly to where they’re needed.
6:10 PM: “There’s a narrative”
that the U.S. military would have to shut down to deal with the
coronavirus, Esper said. That’s not going to happen, he said. “We have a
mission to protect the United States and its people.”
6:12 PM: “I think we have 11 companies making ventilators right now,” Trump said.
6:15 PM: The administration is
looking “very seriously” at building two new hospital ships, or possibly
renovating an existing vessel into a hospital ship, Trump said.
In the U.S., there are 206,207 confirmed cases of
COVID-19 and 4,542 deaths,according to Johns Hopkins University ;
globally, there are 921,924 cases of COVID-19 confirmed and 46,252
deaths.
https://seekingalpha.com/news/3557637-u-s-starts-enhanced-measures-to-disrupt-supply-of-illegal-drugs-coronavirus-briefing
AI tool finds 3 coronavirus signs that often lead to a severe case
The novel coronavirus outbreak is far from being under control, with
COVID-19 ravaging several countries at the moment. The US alone has
accounted for nearly 175,000 cases
of the more than 818,000 cases worldwide at the time of this writing.
Italy is topping the casualty list with over 11,500 deaths and a
fatality rate of 11.39%. Social distancing measures and good hygiene
habits should significantly flatten the curve, but the results won’t be
seen for several more weeks. The lower the curve, the less crowded the
hospitals will be. That way, the severe COVID-19 cases will have a
better chance of surviving the disease, which still lacks an effective
treatment or vaccine.
Several such drugs are in testing, with some of them showing promise in limited trials. Plenty of vaccines are in the works as well, with at least two trials already underway. But there might be another untapped resource that could help doctors create therapies that could assist critical COVID-19 patients: Artificial intelligence. A new study shows that AI has been able to highlight three COVID-19 symptoms that are indicative of severe COVID-19 complications. Interestingly enough, it’s not the most common coronavirus symptoms that signal rapid deterioration after infection. If the discovery can be scaled up to more patients, it could potentially save more lives in the months ahead.
You’ve heard it a hundred times before, but COVID-19 has no universal symptoms. If you’re experiencing a fever, coughing and shortness of breath, you might be infected. But first, you have to rule out the flu. Other common symptoms may include throat pain and fatigue. Also, doctors observed that some patients reported a loss of smell and taste, which is the only COVID-19 symptom that really stands out. But many people who contract the virus will not show any symptoms at all, or at worst will simply experience mild discomfort.
According to a new study, only one of these symptoms can be indicative of severe disease, but only when combined with two other signs which require hospitalization. Per AFP, researchers from the US and China used AI to analyze data from 53 coronavirus patients across two hospitals in Wenzhou, China.
The algorithms discovered three changes in the body that precipitate severe illness: Body aches, levels of enzyme alanine aminotransferase (ALT) and hemoglobin levels. ALT is a liver enzyme that’s tested to measure liver function and diagnose liver failure. Hemoglobin testing is part of the standard blood work you get when admitted to the hospital.
The AI figured out these three features were the most accurate at predicting a severe COVID-19 case. The algorithm showed a 70 percent-80 percent accuracy at predicting the risk of acute respiratory disease syndrome (ARDS). ARDS is the COVID-19 complication that fills the lungs with fluid and kills some 50 percent of patients who get it.
Other symptoms, including particular patterns in lung imaging, fever and strong immune responses, were not useful at predicting whether a mild case could worsen to ARDS:
The team is looking to further refine the data and the AI tool might be ready to deploy sometime in April. The full study is available in Computers, Materials & Continua.
https://nypost.com/2020/04/01/ai-tool-finds-3-coronavirus-signs-that-often-lead-to-a-severe-case/
Several such drugs are in testing, with some of them showing promise in limited trials. Plenty of vaccines are in the works as well, with at least two trials already underway. But there might be another untapped resource that could help doctors create therapies that could assist critical COVID-19 patients: Artificial intelligence. A new study shows that AI has been able to highlight three COVID-19 symptoms that are indicative of severe COVID-19 complications. Interestingly enough, it’s not the most common coronavirus symptoms that signal rapid deterioration after infection. If the discovery can be scaled up to more patients, it could potentially save more lives in the months ahead.
You’ve heard it a hundred times before, but COVID-19 has no universal symptoms. If you’re experiencing a fever, coughing and shortness of breath, you might be infected. But first, you have to rule out the flu. Other common symptoms may include throat pain and fatigue. Also, doctors observed that some patients reported a loss of smell and taste, which is the only COVID-19 symptom that really stands out. But many people who contract the virus will not show any symptoms at all, or at worst will simply experience mild discomfort.
According to a new study, only one of these symptoms can be indicative of severe disease, but only when combined with two other signs which require hospitalization. Per AFP, researchers from the US and China used AI to analyze data from 53 coronavirus patients across two hospitals in Wenzhou, China.
The algorithms discovered three changes in the body that precipitate severe illness: Body aches, levels of enzyme alanine aminotransferase (ALT) and hemoglobin levels. ALT is a liver enzyme that’s tested to measure liver function and diagnose liver failure. Hemoglobin testing is part of the standard blood work you get when admitted to the hospital.
The AI figured out these three features were the most accurate at predicting a severe COVID-19 case. The algorithm showed a 70 percent-80 percent accuracy at predicting the risk of acute respiratory disease syndrome (ARDS). ARDS is the COVID-19 complication that fills the lungs with fluid and kills some 50 percent of patients who get it.
Other symptoms, including particular patterns in lung imaging, fever and strong immune responses, were not useful at predicting whether a mild case could worsen to ARDS:
The model highlights that some pieces of clinical data may be underappreciated by clinicians, such as mild increases in ALT and hemoglobin as well as myalgias. Key characteristics predictive of diagnosis, including fever, lymphopenia, chest imaging, were not as predictive of severity. Likewise epidemiologic risks such as age and gender were not as predictive; all ARDS patients in this study were male but most males did not develop ARDS.“It’s been fascinating because a lot of the data points that the machine used to help influence its decisions were different than what a clinician would normally look at,” physician and professor at New York University’s Grossman School of Medicine Megan Coffee told AFP.
The team is looking to further refine the data and the AI tool might be ready to deploy sometime in April. The full study is available in Computers, Materials & Continua.
https://nypost.com/2020/04/01/ai-tool-finds-3-coronavirus-signs-that-often-lead-to-a-severe-case/
NYC map shows total cases testing positive for coronavirus by ZIP code
A new city map showing confirmed coronavirus cases based on patient address by ZIP code suggests the poorest New Yorkers are being hardest hit by the pandemic.
Wealthier parts of the city, including much of Manhattan, waterfront sections of Queens and brownstone Brooklyn, have the fewest number of coronavirus cases, according to the map released by the city Department of Health.
A stark example of the wealth gap is the Rockaway section of Queens. The richest part of the peninsula that incorporates Belle Harbor where homes sell for over $1 million has at least 112 cases while Far Rockaway with its public housing complexes has up to 947 cases.
Data scientist Michael Donnelly, who’s been crunching the city’s coronavirus numbers since the start of the outbreak, noted the new map tracks with earlier MTA turnstile data.
Those maps showed ridership plummeting in Manhattan stations in mid-March, while New Yorkers from the outer reaches of the outer boroughs continued commuting.
“Over time we start to see the effect of the fact that Manhattan and the inner zip codes of Queens and Brooklyn have a lower positive rate because they were able to bend the curve before the outer boroughs,” Donnelly said.
Neighborhoods with fewer than 200 cases — like Park Slope, Brooklyn and Greenwich Village in Manhattan — count many white-collar professionals who can telecommute as residents.
“I think the clear next step there, is if that’s true, then there’s a real socio-economic inequality, inequity in the fact that these ZIP codes, which also tend to skew lower socio-economic, are also going to be the ones who are harder hit by this pandemic,” Donnelly said.
“Broad strokes, those tend to be the wage workers, emergency service workers that are exposing themselves more and more over time,” Donnelly said.
Many front-line workers, from grocery store clerks to EMTs, live in the outer boroughs. Their jobs require them to use the subways while the majority of New Yorkers stay home.
Neighborhoods with high poverty like Mott Haven in The Bronx and East New York in Brooklyn have as many as 947 cases compared to Park Slope and Greenwich Village’s 200 cases.
The map doesn’t always track to income. More exclusive enclaves like Williamsburg, Brooklyn also have up to 947 cases, likely because of a cluster among the area’s Orthodox Jewish population.
On Staten Island, solidly middle class sections like Heartland Village and Annadale are the hardest hit — potentially due to the concentration of first responders who live there.
Another version of the map showing percent of patients testing positive for COVID-19 by zip code was flawed because it was a depiction of which neighborhoods had the most access to testing, not the prevalence of the disease.
The overall impact of COVID-19 on the city remains unknown. Only 96,528 New Yorkers out of a population of 8.6 million have been tested. Of those 44,915 have tested positive.
The maps use slightly outdated data based on 38,936 positive cases.
https://nypost.com/2020/04/01/nyc-map-shows-percentage-of-patients-with-coronavirus-by-zip-code/
Subscribe to:
Posts (Atom)