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Sunday, April 5, 2020

Honeywell pressures suppliers to cut prices 30%

Honeywell (NYSE:HON) is asking some of its suppliers for 30% price cuts, extended payment terms and other concessions, Barron’s reports, citing a letter that says the request mirrors demands it is getting from its customers due to the economic impact of the coronavirus.
“Customers have come to us for support to balance the impacts across their supply chain,” according to the letter, which was signed by Honeywell’s chief procurement officer. “In turn, we are asking our supply chain partners for similar support.”
Honeywell reportedly is seeking 30% across-the-board price cuts, 60 additional days to pay its suppliers, 2% rebates on future order volume growth, holding of Honeywell inventory by its suppliers and immediate resolution of outstanding claims against the company.
The concessions Honeywell and others are seeking from suppliers are another kind of financing that the S&P Global rating firm has called a “sleeping risk” on the books of U.S. businesses.
https://seekingalpha.com/news/3558445-honeywell-pressures-suppliers-to-cut-prices-30-barrons

Gilead ramps up remdesivir production ahead of approvals

Gilead Sciences (NASDAQ:GILD) has been working with regulatory authorities to start additional expanded access programs for remdesivir, its investigational medicine for COVID-19, Chairman and CEO Daniel O’Day wrote on the company’s website.
Such programs allow hospitals or physicians to apply for emergency use of the treatment for multiple severely ill patients at a time.
Even though the medicine isn’t yet approved for use by any regulatory authorities, Gilead is taking the step of of expanding production to increase supply.
“As a result we have reduced the end-to-end manufacturing timeline from approximately one year, to around six months,” O’Day wrote.
Its existing supply, including finished product and investigational medicine in final stages of production, amounts to 1.5M individual doses, which could equate to more than 140,000 treatment courses for patients.
Gilead is providing all of its existing supply at no cost to treat patients with the most severe symptoms of COVID-19.
Sets a goal of producing more than 500,000 treatment courses by October and more than 1M treatment courses by the end of the year.
Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, has recommended that in order to be prepared for COVID-19 becoming a seasonal occurrence, drug manufacturers should take the risk to ramp up production of therapeutics before phase 2 trials begin.
https://seekingalpha.com/news/3558442-gilead-ramps-up-remdesivir-production-ahead-of-approvals

Saturday, April 4, 2020

Massachusetts governor launches effort to trace coronavirus cases in state

Massachusetts Gov. Charlie Baker (R) announced Friday the state government is establishing a COVID-19 community tracing collaborative with a nonprofit that will begin operating at the end of the month.
Baker said the effort will be a “targeted” approach as the state seeks to blunt the effects of the coronavirus, which has already infected more than 10,000 people in Massachusetts and killed nearly 200 in the state.
“There is tracing happening now, but this program that we’re talking about launching today is a much more robust, targeted approach that we hope can be highly effective at slowing the spread of this highly infectious disease,” Baker said at a news conference. “It’s going to be a big part of our ongoing effort to manage and fight our way through COVID-19.”
Baker said Massachusetts is the first state in the country to create such a tracking program, which will be staffed by roughly 1,000 people who will contact patients to check on their recent activities and confirm they have not spread the highly infectious illness.
“The call center will get contact information for as many people as possible that they have come in contact with and potentially exposed,” Baker said. “People will be contacted and informed so that they can stay healthy, isolate when appropriate and prevent further spread.”
Partners In Health, the Boston-based nonprofit that is teaming up with the state government, has done public health interventions during previous crises such as Ebola and will oversee hiring, training and supervision for the virtual call center.
Joia Mukherjee, the group’s chief medical officer, said the effort will help people “isolate themselves” if they appear at risk and will reach out to people who may have contracted the virus but appear asymptomatic.
“We believe that people want to know if they have been in contact with this disease,” she said.
https://thehill.com/homenews/state-watch/491144-massachusetts-governor-launches-effort-to-trace-coronavirus-cases-in

Pentagon may treat coronavirus patients aboard Navy hospital ship

Defense Secretary Mark Esper is looking at the possibility of treating coronavirus patients aboard the Navy hospital ship docked in New York City, the Pentagon’s top spokesman said Friday.
The 1,000-bed USNS Comfort, which was meant to treat non-COVID-19 patients as a way to take pressure off local hospitals, has treated only a few dozen patients since it docked in the city harbor Monday.
Meanwhile, the USNS Mercy hospital ship docked in Los Angeles has treated even fewer patients.
Spokesman Jonathan Hoffman said switching to also treat COVID-19 infected patients on both ships is “something we’re looking at,” though Pentagon leadership is “very well aware of the risks in doing that.”
“We’ve all seen what happens on some of these ships like the cruise ships … it’s not an environment built for handling infectious diseases en masse,” Hoffman told reporters at the Pentagon.
He later added that such a decision is “not imminent.”
The Pentagon earlier Friday announced that the Comfort had loosened its screening process for patients to get on board after criticism that the ship has been too slow in admitting patients.
Before the changes, ambulances were required to take patients to a hospital first where they were screened for coronavirus and then referred to the ship.
Hoffman said the Pentagon changed the operating process so that ambulances now go directly to the Comfort.
“We expect that will increase the number [of patients],” Hoffman said of the new procedure.
Hoffman also said there have been fewer patients than expected on both ships due to the vessels arriving at their respective cities ahead of need.
Should coronavirus patients be treated on the Comfort, Hoffman said it would be “very difficult” to keep the virus from the infected patients, and the “likelihood of infection of our doctors goes up.”
https://thehill.com/policy/defense/491125-pentagon-may-treat-coronavirus-patients-aboard-navy-hospital-ship

Enlisting tech to fight coronavirus sparks surveillance fears

The portable supercomputers people carry around in their pockets may hold the key to stemming the coronavirus pandemic, some public health experts say.
In places such as South Korea, Singapore and China, governments are relying on phone location data to carry out extremely precise and targeted “contact tracing” for people who test positive for the virus.
Israel’s domestic spy agency, the Shin Bet, tracks people’s cellphone locations, allowing the government to text people who came in contact with a patient who has tested positive. Singapore is taking a similar approach. South Korea is using a mix of location data, digital records and camera footage to track where infected people have been.
In China, a mesh of overlapping systems track people as they move through public transport, taxis, commercial centers, and even specific neighborhoods and buildings, serving to both document where they have been and block potential carriers from moving about and further spreading the disease.
But in the United States, where individual liberty is culturally prized and privacy is enshrined in the Constitution, a tech-based approach faces serious obstacles.
“This is a crisis, and we need to look at everything at our disposal, but we also need to be careful about how we do so,” said Jay Stanley, a privacy expert at the American Civil Liberties Union (ACLU).
“We do have privacy laws that constrain government access to data,” he added.
Gigi Sohn, a distinguished fellow at the Georgetown Law Institute for Technology Law and Policy, put it more bluntly.
“If the government were to take on this kind of surveillance, I think it would be struck down for violating the Fourth Amendment,” she said.
Even abroad, some bristle at the invasiveness of the approach. In South Korea, residents have received text messages detailing the recent whereabouts of people who have tested positive, sometimes to an embarrassing degree, causing an uproar. Israel’s Supreme Court threatened to scrap its system.
Still, some scientists and policymakers say that when it comes to battling a lethal pandemic, technological tracking is a no-brainer, especially when the alternative is economy-killing closures.
“That’s exactly what we need to be doing. Do we want to go into lockdown again?” said Aaron Carroll, a health expert at the Indiana University School of Medicine, who says preventing an endless resurgence of outbreaks will require a combination of widespread testing and contact tracing.
An article published by a group of Oxford scholars in Science, a leading academic journal, suggested that governments would not be able to bring the pandemic under control without some level of technology.
“We conclude that viral spread is too fast to be contained by manual contact tracing, but could be controlled if this process was faster, more efficient and happened at scale,” the authors wrote, noting that a significant portion of the spread occurs before people show symptoms.
“A contact-tracing App which builds a memory of proximity contacts and immediately notifies contacts of positive cases can achieve epidemic control if used by enough people,” they added.
Using technology to contain the virus has found some support on both the right and the left.
A road map from the left-leaning Center for American Progress (CAP) released Friday called for using tech-based contact tracing.
“As a condition of receiving a COVID-19 test in the future, individuals may be required to download the app, which would include their test result,” the plan offered. Others could download it voluntarily to “to see if there are cases in their neighborhood or near their workplace.”
In its own road map released last week, the right-leaning American Enterprise Institute said technology could be used to enforce social isolation.
When asked about the idea on Monday, President Trump seemed to balk.
“So what happens? A siren goes off if you get too close to somebody? That’s pretty severe,” he said.
But he added, “We’re taking a look.”
While there may be benefits to tracking people during the coronavirus pandemic, there are also potential privacy pitfalls, particularly if the federal government is granted emergency powers allowing for more surveillance.
Ashkhen Kazaryan, director of civil liberties at public policy group TechFreedom, compared the current situation to the years after the Sept. 11 attacks, when major surveillance laws were put in place to curb acts of terrorism.
“Unlike with 9/11, we are not at war with a country or a certain group of people. We are at war with the virus,” Kazaryan told The Hill. “The first thing we should require is transparency. There is no need to hide what they are doing.”
Sohn warned of “mission creep” if the federal government is given even limited surveillance powers during the coronavirus crisis.
“The fact of the matter is once you start to expand the government’s powers in this area, it’s very, very hard to limit what they surveil you for,” Sohn emphasized.
Congress is preparing to put a spotlight on the issue next week, when the Senate Commerce Committee plans to hold a paper hearing on the use of big data to fight the spread of the coronavirus. The committee rolled out legislation on consumer privacy last year, but debates involving the impact of coronavirus could put a dent in those efforts.
On Friday, a group of Democratic senators drilled into Apple, sending a letter questioning the company’s recently announced policy that it intended to collect “some information” to improve Apple’s new coronavirus app and website.
“Although, the use of technological innovations and collaboration with the private sector is a necessary component to combating COVID-19, Americans should not have to trade their privacy at the expense of public health needs,” Democratic Sens. Bob Menendez (N.J.), Kamala Harris (Calif.), Cory Booker (N.J.), and Richard Blumenthal (Conn.) wrote.
“A public health crisis is no excuse for data brokers to whitewash and monetize their intrusive, unethical harvesting of our personal data and location information,” Blumenthal said in a statement to The Hill. “We must balance consumers’ privacy interests with the legitimate needs of public health officials and first responders during the coronavirus pandemic.”
Google also took a first step toward making data more accessible to governments on Friday when the company announced it would begin publishing anonymized GPS data for 131 countries and regions showing how people have moved during the pandemic.
Beyond privacy concerns, questions linger as to whether the government will be able to cobble together workable, user-friendly technology that deals with a slew of state and local health systems.
“I think that this is going to be the second greatest challenge, after what our health care workers are dealing with on the front lines every day,” said Adam Conner, vice president of tech policy at CAP.
“This would make the challenge of the ObamaCare website look small by comparison,” he said, recalling the disastrous rollout of the Affordable Care Act exchanges in 2013.
Already, Trump has faced backlash for overpromising on a website that would help people find testing location sights near them. Few testing sites have materialized, and the website so far is focused on just a few counties in California.
The ACLU’s Stanley says the combined risk of failure and privacy breach should raise alarms for proponents of the tech-based health surveillance.
“The worst-case scenario is the government creates a mandatory program that involves using the location tracking of every American, utterly fails on a technological level, swamps the system with false positives, creates enormous mistrust and creates rebellion among the population. Then they keep the system online and use it for other purposes,” he said.
“A government that can’t get enough face masks may not be able to make effective use of this data,” he added.
https://thehill.com/policy/cybersecurity/491134-enlisting-tech-to-fight-coronavirus-sparks-surveillance-fears

Testing struggles emerge as key hurdle to reopening country

The U.S. needs to significantly increase its testing capability for the coronavirus in order to safely start reopening the country, experts say.
If the current approach of telling everyone to stay home is to be lifted, widespread and faster testing will be needed to identify infected people for isolation. Easing stay-at-home orders in the absence of sufficient testing would risk reigniting the outbreak.
Leading estimates have called for between 750,000 and 1 million tests per week. On the surface, the U.S. is getting closer to hitting those numbers, after an extremely slow rollout of tests in the initial weeks of the outbreak.
The country is now conducting more than 100,000 tests a day, according to The COVID Tracking Project.
But with a large backlog of cases, many of those samples are awaiting analysis, with an average of four to five days for several testing methods in use. Getting same-day results is crucial for any effective testing system to help reopen the country, according to experts.
They say blunt social distancing measures need to remain in place until the worst has passed and the number of new cases is declining. At that point, having a system of testing and tracing ready to go will be key.
“We better be careful about declaring victory just because you’ve turned the corner on a curve,” Anthony Fauci, the government’s top infectious disease expert, said Thursday on CNN.  “When we turn the corner and it goes down, we have to have in place the ability to do the kind of containment that’s pristine — namely, you test like crazy, you identify people, you isolate them and you do contact tracing.”
Michael Mina, a professor at Harvard’s T.H. Chan School of Public Health, said improvements in testing would help ease social distancing measures.
“We’re obviously seeing right now that there are other ways to control a virus without testing, but it’s highly detrimental to the economy and to our lifestyles and pulls at the social fabric of society, frankly. So we obviously can’t just keep social distancing,” he said.
But governors across the country are reporting that their states are struggling with testing.
As of Wednesday, the California Department of Public Health said 59,500 test results were pending, compared with results for just 32,944 tests. Gov. Gavin Newsom (D) said it’s an issue affecting other states as well.
“This is a national problem,” Newsom told reporters Thursday. “Just one lab in the United States has over 100-plus thousand backlogged tests. Those large commercial labs are overwhelmed by the demand.”
President Trump, on a call with governors Monday, said he did not think testing was a problem anymore. “I haven’t heard about testing in weeks,” Trump said, according to audio obtained by The New York Times.
Governors pushed back on his remarks.
“Yeah, that’s just not true,” Maryland Gov. Larry Hogan (R) told NPR on Tuesday. “I mean, I know that they’ve taken some steps to create new tests, but they’re not actually produced and distributed out to the states.”
“No state has enough testing,” he added.
Some hard-hit areas have limited testing to people who are hospitalized and front-line health workers. There are also persistent problems with shortages of supplies needed to conduct tests, including reagents, chemicals used to process the tests.
“There are widespread shortages of specimen collection materials, personal protective equipment, test kits and reagents,” said a spokesperson for the American Clinical Laboratory Association. “All of these factors impact the ability of laboratories to push through testing backlogs and steadily increase capacity.”
There are some signs the situation is improving.
Abbott Laboratories announced it had been approved at the end of March for a point-of-care test that can deliver results in as little as five minutes, a development touted by Trump.
Darcy Ross, an Abbott spokeswoman, told The Hill that by the end of Friday, the company will have shipped more than 191,000 of the rapid tests to 21 states.
Experts also point to the importance of a different kind of test, called a serology test, that looks for antibodies in the blood. The analysis can determine if someone has had the virus before, not just whether they have it while being tested. That means the serology test can help identify people who have had the virus but are now immune and who can more fully reenter society.
The Food and Drug Administration approved the first coronavirus serology test on Thursday, from a company called Cellex.
In addition to testing capacity, states will also need enough public health workers to be able to carry out the tracing of infected people and their close contacts.
“We need an army of contact tracers in every community of the U.S.,” Tom Frieden, former head of the Centers for Disease Control and Prevention, said on a call with reporters Wednesday.
Staffing, therefore, could be a problem.
Massachusetts Gov. Charlie Baker (R) is launching one of the country’s most aggressive contact tracing efforts by enlisting more than 1,200 public health college students to help, according to The Boston Globe.
Sen. Chris Murphy (D-Conn.) said Wednesday that he thinks the Trump administration needs to do more to ramp up testing and staffing for contact tracing.
“Other countries taught us we cannot turn the corner on coronavirus [without] a comprehensive system of TESTING, TRACING, and QUARANTINE,” he tweeted. “The Trump Administration has zero plan to stand up that system nationally. That’s frightening and it must change.”
Experts said preparedness needs to be ramped up quickly.
“Once the rate of infections has been slowed by social (really physical) distancing, only a testing scheme far beyond our current capabilities can prevent another surge in infections,” Aaron Carroll, a professor at Indiana University School of Medicine, wrote in The Atlantic on Tuesday. “If we are going to get out of lockdown, we need to radically improve our testing protocols and infrastructure. And we need to do it fast.”
https://thehill.com/policy/healthcare/491128-testing-struggles-emerge-as-key-hurdle-to-reopening-country

CDC launches studies to get more precise count of undetected Covid-19 cases

The Centers for Disease Control and Prevention has begun preliminary studies to try to determine how many Americans have already been infected with SARS-CoV-2, the virus that causes Covid-19, an agency official revealed Saturday. On Friday, the agency said nearly 240,000 people in the country have been infected with the virus and nearly 5,500 have died.
Joe Bresee, deputy incident manager for the CDC’s pandemic response, said the agency hopes to flesh out the portion of cases that have evaded detection using three related studies.
The first, which has already begun, will be looking at blood samples from people never diagnosed as a case in some of the nation’s Covid-19 hot spots, to see how widely the virus circulated. Later, a national survey, using samples from different parts of the country, will be conducted. A third will look at special populations — health care workers are a top priority — to see how widely the virus has spread within them. Bresee said the CDC hopes to start the national survey in the summer; he gave no timeline for the health workers study.
“We’re just starting to do testing and we’ll report out on these very quickly,” Bresee said at a media briefing. “We think the serum studies will be very important to understand what the true amount of infection is out in the community.”
These studies — called sero-surveys — involve drawing blood from people never diagnosed as a case to look for antibodies to the virus. They are conducted by taking a representative sample of people in a city, for instance, ensuring people from different age groups are included.
It’s known that many people have mild infections when they contract Covid-19. Data from China and elsewhere suggests about 80% of people confirmed to have the infection have mild or moderate symptoms.
But it is also assumed that figure may in fact be low — that more people may have already encountered and fended off the virus than have been detected. There have been reports, for instance, from the Diamond Princess cruise ship involving people who tested positive who recounted having no symptoms at all. The ship was the first of several cruise ships on which the virus circulated widely; nearly 20% of passengers and crew on the ship eventually tested positive for the virus.
Getting a sense of how many mild and asymptomatic cases there are helps authorities plan for future responses to Covid-19 activity. If it’s known that a high percentage of people in a community were likely infected when the virus moved through during its first wave of infections, the response to a reappearance later might be tailored to protect only high-risk people, for instance.
This work is part of ramped-up coronavirus surveillance at the CDC. The agency has been adapting a number of surveillance systems used to record the toll of seasonal flu in the United States to get a near-real-time picture of SARS-CoV-2’s march across the country.
On Friday, the CDC published the first of what will be a weekly Covid-19 surveillance report, based on the model of its longtime influenza report, FluView. The report is based on data from the last week of March. It showed that in that week, nearly 76,000 Americans had been tested for the infection, with nearly 11,000, or 14.5%, testing positive.
It also showed that pneumonia and influenza deaths, which would normally be falling at this time of year as flu season starts to abate, are increasing. Pneumonia deaths have been rising sharply since the end of February — because of Covid-19.
The new surveillance systems will allow the CDC to add context to the daily reports of Covid-19 cases and deaths, said Lynnette Brammer, head of CDC’s domestic influenza surveillance system and COVIDView, the new weekly report. It will help the agency determine who is contracting the virus and being hospitalized because of Covid-19 infections, and who is dying from the disease.
“We’re starting to see different trends, but it will take us a while to get really comfortable interpreting this data,” Brammer said.
CDC launches studies to get more precise count of undetected Covid-19 cases