National Institute of Allergy and Infectious Diseases Director Anthony Fauci said Sunday that it is likely the coronavirus will become a seasonal occurrence.
The infectious diseases expert told CBS’s “Face the Nation” that it’s
likely the virus “will assume a seasonal nature” because it is unlikely
to be contained around the world this year.
“Unless we get this globally under control, there is a very good chance that it’ll assume a seasonal nature,” he said.
“We need to be prepared that since it will be unlikely to be
completely eradicated from the planet that as we get into next season we
may see the beginning of a resurgence,” he added.
The possibility of a resurgence is why the federal government is
working “so hard” to improve its preparedness, including developing a
vaccine and completing clinical trials on therapeutic interventions.
“Hopefully, if in fact we do see that resurgence, we will have
interventions that we did not have in the beginning of the situation
that we’re in right now,” he said.
Fauci also said on the Sunday morning show that it would be “a false statement” to say the U.S. government has the coronavirus pandemic under control.
The infectious disease expert last month warned that the U.S. needs to prepare for the coronavirus to be cyclical.
The U.S. has counted more than 321,000 cases of the coronavirus, leading to at least 9,132 deaths, according to data from Johns Hopkins University. https://thehill.com/homenews/sunday-talk-shows/491239-fauci-says-its-likely-coronavirus-will-be-seasonal
In 2009 the U.S. government launched a program to hunt for unknown
viruses that can cross from animals to humans and cause pandemics. The
project, called PREDICT, was funded by the U.S. Agency for International
Development, and it worked with teams in 31 countries, including China.
It was just one part of an emerging global network for
infectious-disease surveillance.
Despite this network and the efforts of thousands of scientists
working to ward off dangerous new outbreaks, the coronavirus behind
COVID-19 was unidentified when it launched into an unprepared world at
the end of 2019. How did the virus slip by disease detectives looking
for exactly this type of threat?
Experts say that like a fishing net with many holes, the surveillance
network had numerous gaps, with too little money and manpower to be
truly effective. “We’ve been gutting surveillance for too long,” says
Michael Buchmeier, a virologist and associate director of the Center for
Virus Research at the University of California, Irvine. “And by doing
that, we’re creating blind spots in our ability to identify and contain
threats of infectious disease in the world.” Indeed, in September 2019,
just months before the COVID-19 pandemic began, USAID announced it would
end funding for PREDICT. The agency claims it has plans for a successor
effort, but it has not provided any additional details, and many worry
that critical momentum is being lost.
An estimated 600,000 unknown viruses, possibly more, have the ability
to jump from animals to people. To find such “spillover” microbes,
researchers look in disease hotspots where wildlife and humans
intermingle, such as forests that are razed for development or
agriculture or markets that sell bushmeat. Sampling tends to focus on
species with high viral loads, such as bats, rats and monkeys. And
scientists run laboratory tests to find out if newly discovered viruses
can infect human cells. Investigators also try to look at the various
ecological and social drivers that can bring disease-carrying wild
animals and humans together.
Researchers were well aware that coronaviruses, one of which caused
severe acute respiratory syndrome (SARS), could be a recurring threat.
That pathogen, SARS-CoV, first surfaced in China in 2002 and spread to
nearly 30 countries before the outbreak died down the following year. In
2007 researchers from the University of Hong Kong published a paper
stating that the presence of many other SARS-CoV-like viruses in bats
made this type of pathogen a “time bomb.” In southern China there was a
culture of eating exotic animals that could pick up such viruses from
the bats, they noted, and this practice made it easier for them to make
the jump to people. Several other groups of scientists later echoed
their fears, and the virus that causes COVID-19 turned out to be so
similar to the 2002–2003 microbe that it was named SARS-CoV-2.
Kevin Olival is a disease ecologist at the EcoHealth Alliance, a New
York City–based nonprofit research group that was part of PREDICT. He
says that EcoHealth researchers and their partners, including a team at
the Wuhan Institute of Virology in China, had identified numerous
SARS-related coronaviruses in bats and were following up with laboratory
experiments on several of them. But, he adds, how and where the
SARS-CoV-2 spillover occurred is not known for certain. There was an
early suspicion that the initial outbreak could have started at the
Huanan Seafood Wholesale Market in Wuhan, which was closed on January 1.
But “we don’t know if the spillover happened outside the market and
then began spreading after it was brought there,” Olival says. It is
also unclear if there was an intermediate animal host between the
disease-carrying bats and humans.
Getting a better grasp on animal-human exchanges is critical to
predicting these spillovers. According to Olival, what is needed is
detailed knowledge of local ecology, maps of species distributions, an
understanding of people’s behavioral interactions with other species and
an awareness of the “cultural and economic drivers of the animal
trade.” If these analyses sound complicated, that is because they are:
Olival says such assessments take a lot of scientists and facilities, as
well as training and money. As a result, they are only being carried
out at a handful of sites around the world. Yet the information they
provide is essential for protecting local communities. High-risk markets
where wildlife is cut up and sold as food can be closed, for instance.
Or people can be alerted when virus-shedding bats are more active around
human food sources, such as fruit trees, so individuals can minimize
their contact with the animals.
Rohit Chitale, an epidemiologist at the Defense Advanced Research
Projects Agency, says the explosion of COVID-19 reflects a global
failure to adequately invest in prevention. “There’s too much emphasis
on treating infectious diseases after the fact,” argues Chitale, who is
program manager of DARPA’s surveillance effort, called Preventing
Emerging Pathogenic Threats (PREEMPT). Early detection efforts, in
contrast, “are very poorly funded,” he says. Olival notes that PREDICT
received approximately $200 million dollars over its decade-long life
span—which is a tiny fraction of the $2 trillion in emergency-relief
spending authorized by Congress as a response to COVID-19 last week.
He says that USAID may launch a new detection-and-prevention program
called Stop Spillovers. An agency spokesperson, when asked to comment,
said a new project should start in August, but gave no details on the
project size or level of financial support. Yet even if a new effort
picks up PREDICT’s work, funding gaps have led to an “unfortunate break
in continuity” and disrupted field work, Olival says. In a late January
letter to USAID, senators Angus King of Maine and Elizabeth Warren of
Massachusetts demanded to know why PREDICT was being shuttered and
expressed concern that even as COVID-19 “threatens public health in the
U.S. and abroad, programs like PREDICT are winding down rather than
winding up.” King and Warren requested answers to their questions by “no
later than February 13,” but as of April 1, the agency had not written
back to them. (The University of California, Davis, which is a PREDICT
partner, said at the end of March that the program got a six-month
emergency extension.)
Thomas Inglesby, who directs the Center for Health Security at the
Johns Hopkins Bloomberg School of Public Health, says that in the
future, these surveillance efforts need to be better integrated with
studies of infected patients in local hospitals. Too many people in
disease hotspots wind up being vaguely diagnosed and treated with
broad-spectrum antibiotics for infections that “may actually be new
types of viral syndromes,” he says. “At the same time that we’re
collecting data from animals, we need more data on what’s really making
people sick.”
Inglesby is optimistic, however, that the next few years will bring
an influx of new resources, because of the devastation unfolding in
front of our eyes today. “We’re going through a seismic experience,” he
says. “Policy makers, scientists and funders will all be talking about
how we can prevent this from ever happening again.”
The University of Washington’s Institute for Health Metrics and
Evaluation has created a model to project future cases of COVID-19 in
the United States.
The study has not yet been peer reviewed and should not be used to guide clinical practice.
Projections are based on the assumption that full social distancing measures will be observed through at least May 2020.
A new model predicts coronavirus deaths will peak in the United States on April 16, though the research is a preprint, meaning
it has not yet been peer reviewed. The peer review process is a vital
part of assessing new medical research and identifies weaknesses in its
assumptions, methods and conclusions.
Full updated results are available here: COVID-19 Projections.
When a state is chosen under the drop down menu, the infographic
projects how many hospital beds, ICU beds, bed shortage (if any) and
ventilators may be necessary in each state to address patient need.
Local mandates and travel restrictions are reported as well.
So, why release the estimate if it is a preprint? The University of
Washington’s Institute for Health Metrics and Evaluation (IHME) said
colleagues asked them to develop the models at the university’s school
of medicine and soon heard from other hospital systems and state
governments.
“Ultimately, these forecasts were developed to provide hospitals,
health care workers, policymakers, and the public with crucial
information about what demands COVID-19 may place on hospital capacity
and resources, so that they could begin to plan,” the IHME wrote.
The model, published online by IHME, predicts the peak use of
hospital resources, including beds, ICU beds and invasive ventilators,
for COVID-19 patients in each state. The study used data on confirmed
coronavirus deaths from the Word Health Organization (WHO) and local and
national governments as well as data on hospital capacity and
utilization for each of the states.
While peak dates vary from state to state, the IHME forecasts the
national peak for hospital resource use will be on April 15, assuming
that current social distancing measures are observed through May 2020.
The next day, according to the model, will be the peak in deaths for the
nation.
The earliest peak date for hospital resource use is predicted to be
April 8 in New Jersey, while the latest is predicted for May 21 in
Missouri. For COVID-19 deaths, the earliest peak date was March 23 in
Vermont, the day before the state issued its stay at home order, while
the latest is predicted to be May 20, in Virginia, where a stay at home
order was put in place on March 30.
The model also estimates the total number of deaths in each state by
August 4. New York is projected to have the most deaths at 16,261, with
Florida in second at 6,897 deaths.
After a week of daily updates, the IHME wrote in an update
on April 2 that the model has done well in predicting daily deaths. The
model has also been updated as stay at home orders are issued across
the country and new data becomes available. While the initial estimate
for total COVID-19 deaths in the U.S. was 81,114, the IHME estimate has
increased to 93,531. This table was last updated April 2:
British Prime Minister Boris Johnson was admitted to the hospital
Sunday night due to ongoing coronavirus symptoms, a statement from his
office said.
Johnson was hospitalized “on the advice of his doctor” after
experiencing symptoms for more than 10 days after being diagnosed with
COVID-19, according to the statement, which was obtained by the BBC.
“The Prime Minister thanks NHS staff for all of their incredible hard
work and urges the public to continue to follow the Government’s advice
to stay at home, protect the NHS and save lives,” Johnson’s office
added, referring to the U.K.’s National Health Service.
Johnson announced that he had tested positives for the coronavirus
two weeks ago, saying at the time that he would continue to lead his
deputies in the government by video conference.
“Over the last 24 hours I have developed mild symptoms and tested
positive for coronavirus,” Johnson tweeted on March 26. “I am now
self-isolating, but I will continue to lead the government’s response
via video-conference as we fight this virus.”
Johnson is one of the only heads of state to test positive for the virus so far, with Monaco’s Prince Albert another example. According to Johns Hopkins University, the U.K. has confirmed more than 48,000 cases of the virus and nearly 5,000 deaths. https://thehill.com/policy/international/491256-boris-johnson-hospitalized-over-coronavirus-symptoms
A tiger at the Bronx Zoo in New York City has tested positive for the
coronavirus, while several other animals are reportedly being monitored
for similar symptoms.
In a press release,
the Wildlife Conservation Society (WCS), which operates the zoo, said
that the animals were likely infected by an asymptomatic carrier of the
disease. It’s the first known case of the virus being detected in an
animal in the U.S., as well as the first confirmed case in a tiger
anywhere in the world.
“Nadia, a 4-year-old female Malayan tiger at the Bronx Zoo, has
tested positive for COVID-19. She, her sister Azul, two Amur tigers, and
three African lions had developed a dry cough and all are expected to
recover,” the WCS said in a statement.
“Our cats were infected by a person caring for them who was
asymptomatically infected with the virus or before that person developed
symptoms,” the release continued. https://thehill.com/homenews/state-watch/491262-tiger-at-bronx-zoo-tests-positive-for-coronavirus
Defense Secretary Mark Esper
said Sunday that the military will issue guidance on face coverings for
troops after the Centers for Disease Control and Prevention (CDC)
recommended people cover their faces when out in public to stem the
spread of coronavirus.
ABC’s George Stephanopoulos asked Esper on “This Week” whether he expects all service members to follow the new CDC guidelines.
“We will have a directive on that coming out today,” he said, adding “We are going to move toward face coverings.”
The Pentagon chief also said another priority, in addition to the
protection of troops, is to continue to conduct the country’s national
security missions.
“And to do that, we can’t always do six feet distancing whether
you’re in an attack submarine, a bomber, in a tank, so we have to take
other measures,” he said.
“But we ought to provide them all the guidance they need to adjust it
in whatever’s unique to their situation, their circumstance or the
mission set,” he added. President Trumpannounced the new CDC recommendations Friday, repeatedly saying it is “voluntary.”
“You can do it. You don’t have to do it. I’m choosing not to do it, but some people may want to do it, and that’s OK,” he said.
The recommendations are a backtrack from the CDC’s earlier suggestion
that healthy people should not use masks because it would not protect
them from contracting the coronavirus.
But now, the CDC says wearing a face covering can prevent
asymptomatic people from unknowingly spreading the disease, adding that
people should not purchase the surgical masks or N95 respirators needed
by medical professionals. Officials also stressed the recommendation was
to be used in addition to, not instead of, social distancing
guidelines. https://thehill.com/homenews/sunday-talk-shows/491218-pentagon-chief-says-military-moving-toward-face-coverings
Scott Gottlieb and Mark McClellan Co-Author
Efficiently launching medical products to combat the current and
future outbreaks of COVID-19 requires supporting the Food and Drug
Administration’s (FDA) work with manufacturers that have high potential
to develop and deliver needed diagnostics, therapeutics, and
prophylactics, stated former FDA Commissioners Scott Gottlieb, MD and
Mark McClellan, MD, PhD, in a working paper issued today by the Duke-Margolis Center for Health Policy.
The co-authors call for FDA to establish two task forces: one focused
rapid development of point of care (POC) diagnostics; the second
focused on rapid development of effective therapeutics and prophylaxis.
In addition, the commissioners urge the White House to accelerate steps
on a nationwide COVID-19 surveillance partnership to support these
efforts and help target further interventions.
”We need these drugs and testing tools to help patients now. We also
need them for the long term,” said Drs. Gottlieb and McClellan. “With
the isolation and other steps we are taking now, it’s possible that the
epidemic spread of coronavirus will wane in the coming weeks and months.
But it’s also possible that there will be additional waves of viral
spread with the risk of another epidemic in the future.”
To current and future needs, the co-authors contend that the FDA can
support large scale access to different drugs that have shown they may
be effective against the coronavirus in a framework can collect good
information to determine which medicines are working best for patients,
and ultimately merit full FDA approval. “At the same time, we can
advance treatments that can help protect people from becoming infected
with coronavirus in the first place,” said the co-authors.
The white paper details how the FDA could structure the recommended
task forces as well as the goal of each entity. The paper also defines
how establishing a public-private partnership can help to ensure more
comprehensive national surveillance COVID-19 to prevent the current and
possible future waves of infections.
Dr. Gottlieb is a resident fellow at the American Enterprise
Institute and was Commissioner of the Food and Drug Administration from
2017-19. Dr. McClellan, who directs the Duke-Margolis Center for Health
Policy, was Commissioner of the Food and Drug Administration from
2002-04.
Read the paper: https://healthpolicy.duke.edu/sites/default/files/atoms/files/covid-19_tx_working_paper.pdf https://healthpolicy.duke.edu/news/advancing-treatments-save-lives-and-reduce-risk-covid-19
