China’s new strategy to tame second-wave virus outbreaks

A recent coronavirus outbreak in Beijing sowed fears of a second wave of infections in China, but officials appear to have beat back the disease with a new targeted strategy.

Authorities did not repeat the drastic nationwide shutdown seen when the virus first spread from Wuhan earlier this year.

Instead, they sealed off a limited number of residences and focused on mass testing, eventually screening more than half of the capital’s 21 million people.

This approach seems to have paid off, with reported cases falling to single digits each day by early July and zero in the past three days.

Here is a look at how China brought the new outbreak under control:

How did the outbreak begin?

China went to great lengths to protect its capital at the height of the pandemic, redirecting incoming flights to other cities and requiring visitors to undergo quarantine and virus tests.

But by early June, with just a handful of active cases across the country, Beijing had relaxed many of its restrictions and locals were no longer made to wear masks outdoors.

The emergence of a new patient on June 11 shocked the city.

Most of the 335 subsequent cases were traced to the sprawling Xinfadi wholesale market in southern Beijing, which was swiftly closed.

Thousands of people were placed under quarantine and 11 million people were tested for the virus.

The city banned outbound travel by residents living in at-risk areas and required others to show negative COVID-19 test results in order to leave.

Authorities are still investigating the cause of the outbreak, but early tests found traces of the virus on a cutting board at Xinfadi used to process imported salmon.

How has China’s handling of the pandemic evolved?

After the virus first began to spread from Wuhan, China imposed a strict lockdown of the city and surrounding Hubei province in January that confined nearly 60 million people to their homes.

But in last month’s outbreak, Beijing used what city authorities called “precise control” to lock down residential areas one neighbourhood at a time.

All food and beverage workers across the city were required to take virus tests and some bars were ordered to shut.

Most malls and restaurants in parts of the city where no cases had been detected were allowed to remain open, however.

The city focused on tracing and rapidly isolating everyone who had potentially been exposed to the virus.

Volunteers went door to door across the city, asking residents if they had been in contact with people who may have been exposed to the virus.

The tracking took on a dystopian tone at times.

Some residents were ordered to take virus tests after authorities used security camera footage of their car licence plates to determine that they had been near the market.

For that reason and others, Beijing is unlikely to serve as a model for other countries dealing with their own second-wave outbreaks.

“Nobody has the resources, capabilities, determination and financial ability, and of course social capital, to do this except China,” Leong Hoe Nam, an infectious disease specialist at Singapore’s Mount Elizabeth Novena Hospital, told AFP.

Is this the ‘new normal’?

China’s economy was hit hard by the lockdowns brought in to curb the initial spread of the virus.

That has made the country’s communist government wary of one-size-fits-all shutdowns like the ones it imposed earlier this year.

“The country is unlikely to revert to old ways unless there is a more serious outbreak,” IHS Markit senior economist Yating Xu told AFP.

Even at the peak of the latest outbreak, Beijing officials avoided closing the city‘s tourist sites and hotels.

https://medicalxpress.com/news/2020-07-china-strategy-second-wave-virus-outbreaks.html

Health center chain Oak Street Health files for a $100 million IPO

Oak Street Health, which operates health centers that provide primary care for Medicare patients in the Midwest, filed on Friday with the SEC to raise up to $100 million in an initial public offering.

The company employs 260 primary care provider and 54 health centers, in 13 markets across 8 states, which provided care for approximately 85,000 patients as of March 31, 2020.

The Chicago, IL-based company was founded in 2012 and booked $641 million in revenue for the 12 months ended March 31, 2020. It plans to list on the NYSE under the symbol OSH. Oak Street Health filed confidentially on September 20, 2019. J.P. Morgan, Goldman Sachs, Morgan Stanley, William Blair and Piper Sandler are the joint bookrunners on the deal. No pricing terms were disclosed.

Relevant Profile: OSH

https://www.renaissancecapital.com/IPO-Center/News/69430/Health-center-chain-Oak-Street-Health-files-for-a-$100-million-IPO

Covid-19 Hits Cruise-Ship Crews Hard

Cruise-ship workers suffered from more confirmed cases of Covid-19 than passengers, according to newly released government data, suggesting that a slow, arduous process for repatriating idled crew members increased their exposure to the contagious virus.

Crew members also had more cases of “Covid-like illness” of undetermined cause than passengers, according to the data released Friday to The Wall Street Journal.

Most cruise ships disembarked passengers in March and April, as cruising wound down due to the pandemic. It was difficult for crew members to get off ships due to barriers including closed borders, lengthy quarantine periods and the logistical difficulty of securing the necessary charter and commercial flights.

More than two out of every three Covid-19 infections confirmed through testing, at 69%, involved crew members, according to the data released by the U.S. Centers for Disease Control and Prevention. An even larger percentage of cases of “Covid-like illness” involved ships’ employees, at 71%. Passengers, of course, were far more numerous than crew, early in the pandemic, but they were on ships for shorter periods.

The information provided by the CDC shows that some ships had their last Covid-19 case as recently as June 21, long after the cruise lines stopped taking passengers.

Passengers, who were generally older than crew members, died in greater numbers than crew members, with 21 passenger deaths versus 12 crew deaths, according to the CDC, the agency that looks out for the health of Americans.

The data, which covered 121 vessels, came from cruise-line reports and public health officials’ counts and covered the period from March 1 to June 23, for what the CDC described as ships in the U.S. jurisdiction, though not always in U.S. waters. Some cases of infection on cruise ships, identified when people returned to their home countries, didn’t appear to have been included, according to the Journal’s analysis.

Of those on the CDC’s list, the ships with the most confirmed cases of Covid-19 and Covid-like illness, combined, according to the data, were Disney Cruise Line’s Wonder and four Carnival Corp. ships: the Zaandam, the Grand Princess, the Valor and the Coral Princess. Together, they accounted for more than one-third of the CDC’s total of confirmed and possible cases, at 990 of 2,902.

The five ships with the most confirmed Covid-19 cases were the Wonder, the Grand Princess, the Valor, Royal Caribbean Cruises’ Celebrity Eclipse and Carnival Corp.’s Freedom, according to the data.

The most deaths were tied to the Grand Princess, the Zaandam and the Coral Princess according to the CDC, with a total of 17 passenger deaths and three crew deaths, or 20 out of 33 fatalities overall, the data indicates.

The data excludes hundreds of ships with itineraries outside the U.S., including some with significant Covid-19 outbreaks, such as the Diamond Princess and Ruby Princess, whose problems surfaced in Japan and Australia, respectively.

Roger Frizzell, spokesman for Carnival, said his company has “no argument on the numbers tied to positive test results, but completely disagrees with the concept of ‘suspected cases’ since this is not medically valid or accurate.” He added that equating symptoms of Covid-19 with the illness, itself, is “nothing but pure speculation.”

He added that Carnival, which operates cruise brands including Princess Cruises and Holland America, has repatriated more than 77,000 crew members and therefore the infection rate, if anything, “showcases that our protocol in place on our ships has largely been successful” in preventing even greater spread of the virus.

Disney said it tested all crew members on the Wonder in early May, amounting to nearly 750 people, and that this widespread testing may partly explain the seemingly high number of positive cases on the ship, which the CDC pegged at 227.

Disney said more than half of the Wonder crew who tested positive had no symptoms, so without testing it wouldn’t have known these individuals needed to be isolated to protect other crew members. It said it hasn’t had any new infections on the Wonder since May.

Royal Caribbean declined to comment.

https://www.marketscreener.com/WALT-DISNEY-COMPANY-THE-4842/news/Covid-19-Hits-Cruise-Ship-Crews-Hard-30909861/

Burger Chain Turns Pioneer for New Small-Business Bankruptcy Law

July 11, 2020

Twisted Root Burger was a Texas success story, expanding from one casual restaurant in 2006 to 24 sites including restaurants, bars, a brewery and a theater. Now, the company is moving fast in another direction — into bankruptcy.

The chain shut down in March. Some sites reopened in June only to be shut down again as coronavirus cases surged. “I’m not gonna open that restaurant at half the revenue,” said co-founder Jason Boso. “I’m gonna walk away from those restaurants. I’m not gonna set myself up for failure.”

Mr. Boso isn’t giving up though. Instead, his decision to put five of the restaurants into bankruptcy is a strategic move to keep control.

The 47-year-old entrepreneur is one of the early adopters of a new law that makes it far faster, easier and more advantageous for struggling small-business owners to file for chapter 11. He expects to cut his liabilities by $500,000 and continue to operate the five restaurants that filed for bankruptcy.

Bankruptcy lawyers expect a surge in small-business failures in the coming months. The new law, they say, will make many business owners realize that filing for bankruptcy might be a better option than struggling for years to dig out of a financial hole, especially with the outlook so unpredictable.

“It’ll never get back to normal business,” Mr. Boso said.

The new law could force more creditors like suppliers and landlords to the negotiating table sooner. Under the old rules, most struggling small businesses liquidated without invoking bankruptcy, using the cash to pay their creditors, according to a 2008 analysis of credit records by Edward R. Morrison, a Columbia Law School professor.

The new rules give small businesses options that make it easier to file for chapter 11, providing them more leverage to renegotiate leases and debts while continuing to operate, often under the same ownership.

Big companies have long used chapter 11, but the law was too costly and complicated for many small businesses. Congress voted to change that last year when it passed the Small Business Reorganization Act, which was designed in part to preserve jobs. The law took effect in February, and in March the coronavirus stimulus law known as the Cares Act temporarily expanded eligibility to businesses with $7.5 million or less in liabilities.

“It was somewhat prescient,” said Ryan Wagner, a restructuring and bankruptcy attorney with international law firm Greenberg Traurig LLP. “It was passed without the foresight of the pandemic.” The law is the most significant change to the bankruptcy code since 2005.

Since the first full week the law was in effect, overall bankruptcies are down compared with last year, but there has been a recent bounce in small businesses filing under the new rules. Total weekly filings during that period have fallen 32% from 2019, according to a report prepared by the American Bankruptcy Institute on weekly filing statistics.

The reasons are likely federal stimulus and grace periods on rent and other payments, according to Amy Quackenboss, executive director of the American Bankruptcy Institute. “I do think there is going to be a surge, ” Ms. Quackenboss said.

More than 500 companies filed for bankruptcy under the small-business bankruptcy rules since February, according to the American Bankruptcy Institute. June was the top month for filings with 131 cases; many were filed in states hit hard by the pandemic like Florida, Texas, California, New York and Illinois.

Ms. Quackenboss warned that companies worried about their futures should act sooner rather than later so they have the resources to pay the fees that are part of a bankruptcy. “If you are a small business and you’re looking at the cash you have now and that continues to dwindle and you don’t file now you run the risk of not being able to file in a month,” she said.

Mr. Boso runs his sites as separate business entities. He’s planning to put another six of them into bankruptcy depending on how negotiations with landlords proceed. So far, he says, bankruptcy has cost less than expected and allowed him to cut liabilities.

When Twisted Root Burger shut down in March, the business was already carrying debt from its fast expansion. Costs piled up fast. At one restaurant, Mr. Boso said he had fixed monthly costs of $75,000 to $85,000. That is “not counting the food I just bought that went bad and I had to get rid of,” he said. “When it closes down, it goes into $150,000 of debt for that one month.”

Mr. Boso quickly owed nearly $1 million for supplies and other costs. A Paycheck Protection Program loan provided cash but did little to help him plan for the next 18 months. That is when he considered bankruptcy.

Even before he filed for bankruptcy, he was able to wipe out $500,000 in debt by negotiating with suppliers, and he’s trying to get breaks from his landlords. The new bankruptcy law isn’t clear on how leases should be treated so it would likely be up to a judge if Mr. Boso can’t reach deals with his landlords. He hasn’t had to give up equity, but he does expect to lose some of his restaurants and maybe face lawsuits from creditors who won’t make deals.

Mr. Boso’s restructuring plan anticipates sales down by half in the near future and eventually reaching 75% of their pre-pandemic volume within 12 months, he said. With cases in Texas recently hitting new highs, that could take longer. He also expects each location will have to close at least once every six months to decontaminate if an employee tests positive, he said.

He said small-business owners need to weigh their options, including bankruptcy. “I have a little more experience than a lot of independent restaurants,” Mr. Boso said. “Smaller guys are paying full rents and just hoping they are gonna come out of this.”

https://www.marketscreener.com/news/Burger-Chain-Turns-Pioneer-for-New-Small-Business-Bankruptcy-Law–30909611/?countview=0

China’s CanSino in talks for COVID vaccine Phase III trial overseas

Chinese vaccine developer CanSino Biologics is in talks with Russia, Brazil, Chile and Saudi Arabia to launch a Phase III trial of its experimental COVID-19 vaccine, its co-founder said on Saturday.

China’s success in driving down COVID-19 infections has made it harder to conduct large-scale vaccine trials, and so far only a few countries have agreed to work with it.

“We are contacting and Russia, Brazil, Chile and Saudi Arabia (for the Phase III trial) and it’s still in discussion,” Qiu Dongxu, executive director and co-founder of CanSino, told an anti-viral drug development conference in Suzhou, in eastern China.

He said its Phase III trials were likely to start “pretty soon,” and the company plans to recruit 40,000 participants for the tests.

Its COVID-19 candidate Ad5-nCov became the first in China to move into human testing in March but is running behind other potential vaccines in terms of trial progress. Two experimental vaccines developed by Sinovac Biotech and a unit of China National Pharmaceutical Group (Sinopharm) are already approved for Phase III trials.

Qiu said its Phase II trials involving 508 people have yielded “much better” results than Phase I about the vaccines safety and ability to trigger immune response. He did not disclose specific evidence.

He said its new factory under construction in China will allow it to produce 100-200 million doses of coronavirus vaccines per year by early 2021.

China’s military, whose research unit is co-developing the vaccine candidate, approved its military use last month, while Sinopharm’s two experimental shots are offered to employees at state-owned firms travelling overseas.

Zeng Guang, former chief epidemiologist at Chinese Center for Disease Control and Prevention, told the conference that Chinese construction groups overseas in particular are keen to take experimental vaccines.

He also said discussion should start whether to launch emergency inoculation of experimental vaccines “right now.”

There are no approved vaccines yet for COVID-19, a respiratory disease caused by the new coronavirus, which has killed more than half a million people globally.

https://www.reuters.com/article/us-health-coronavirus-china-vaccine/chinas-cansino-in-talks-for-covid-vaccine-phase-iii-trial-overseas-idUSKCN24C0HS

Orange County Convention Center preps for 1st major event during COVID-19

After 48 conventions canceled for a loss of more than $1 billion amid the ongoing coronavirus pandemic, the Orange County Convention Center is ready for its comeback, with plans to host its first major event next week.

The Amateur Athletic Union 2020 Junior National Volleyball Championship is expected to begin Tuesday and last through Thursday.

“We are really excited to have events in our facility and we are so appreciative of AAU Volleyball and all that they are going to be bringing to our community,” said OCCC Executive Director Mark Tester. “The industry is starting to come back and there is pent up demand.”

According to county leaders, the championship, which was initially scheduled to take place last month, is expected to bring 12,000 athletes and their 5,000 coaches and parents to Orlando.

Convention center officials said they are ready to host the thousands after being one of only two convention centers in the nation to receive Global Biorisk Advisory Council STAR accreditation, recognized for its global standard in cleaning and disinfecting.

“There was 20 different areas that we had to show that we had understood and accomplished and we got to them, so we were very happy with that,” Tester said.

The AAU also posted a list of their protocols online, showing the games will be livestreamed and courts will be separated.

There will also be no spectators allowed in, no international teams, no vendors and no opening ceremonies. There will be health screenings and temperature checks, as well as mask requirements for everyone, except the players during warmups and competition.

“The AAU is committed to the health and safety of its participants attending next week’s AAU Junior National Volleyball Championships. For this event, several measures have been put in place to promote appropriate social distancing and proper containment mitigation measures,” said a spokesperson with the AAU. “There are four days of competition per team and large areas of distance between courts to allow for larger and wider aisles. There will also be dedicated entrances and exits throughout the building to include a designated check-in location and limited hall access. Pre-screenings and temperature checks will be taken daily at a dedicated location for all attendees and officials. Masks will be required at all times except for players while on the court during warm-up or competition.”

https://www.clickorlando.com/news/local/2020/07/10/orange-county-convention-center-prepares-to-host-first-major-event-during-covid-19-pandemic/

Air Filter that Can Kill Coronavirus

Researchers from the University of Houston, in collaboration with others, have designed a “catch and kill” air filter that can trap the virus responsible for COVID-19, killing it instantly.

Zhifeng Ren, director of the Texas Center for Superconductivity at UH, collaborated with Monzer Hourani, CEO of Medistar, a Houston-based medical real estate development firm, and other researchers to design the filter, which is described in a paper published in Materials Today Physics.

The researchers reported that virus tests at the Galveston National Laboratory found 99.8% of the novel SARS-CoV-2, the virus that causes COVID-19, was killed in a single pass through a filter made from commercially available nickel foam heated to 200 degrees Centigrade, or about 392 degrees Fahrenheit. It also killed 99.9% of the anthrax spores in testing at the national lab, which is run by the University of Texas Medical Branch.

“This filter could be useful in airports and in airplanes, in office buildings, schools and cruise ships to stop the spread of COVID-19,” said Ren, MD Anderson Chair Professor of Physics at UH and co-corresponding author for the paper. “Its ability to help control the spread of the virus could be very useful for society.” Medistar executives are is also proposing a desk-top model, capable of purifying the air in an office worker’s immediate surroundings, he said.

Ren said the Texas Center for Superconductivity at the University of Houston (TcSUH) was approached by Medistar on March 31, as the pandemic was spreading throughout the United States, for help in developing the concept of a virus-trapping air filter.

Luo Yu of the UH Department of Physics and TcSUH along with Dr. Garrett K. Peel of Medistar and Dr. Faisal Cheema at the UH College of Medicine are co-first authors on the paper.

The researchers knew the virus can remain in the air for about three hours, meaning a filter that could remove it quickly was a viable plan. With businesses reopening, controlling the spread in air conditioned spaces was urgent.

And Medistar knew the virus can’t survive temperatures above 70 degrees Centigrade, about 158 degrees Fahrenheit, so the researchers decided to use a heated filter. By making the filter temperature far hotter – about 200 C – they were able to kill the virus almost instantly.

Ren suggested using nickel foam, saying it met several key requirements: It is porous, allowing the flow of air, and electrically conductive, which allowed it to be heated. It is also flexible.

But nickel foam has low resistivity, making it difficult to raise the temperature high enough to quickly kill the virus. The researchers solved that problem by folding the foam, connecting multiple compartments with electrical wires to increase the resistance high enough to raise the temperature as high as 250 degrees C.

By making the filter electrically heated, rather than heating it from an external source, the researchers said they minimized the amount of heat that escaped from the filter, allowing air conditioning to function with minimal strain.

A prototype was built by a local workshop and first tested at Ren’s lab for the relationship between voltage/current and temperature; it then went to the Galveston lab to be tested for its ability to kill the virus. Ren said it satisfies the requirements for conventional heating, ventilation and air conditioning (HVAC) systems.

“This novel biodefense indoor air protection technology offers the first-in-line prevention against environmentally mediated transmission of airborne SARS-CoV-2 and will be on the forefront of technologies available to combat the current pandemic and any future airborne biothreats in indoor environments,”  Cheema said.

Hourani and Peel have called for a phased roll-out of the device, “beginning with high-priority venues, where essential workers are at elevated risk of exposure (particularly schools, hospitals and health care facilities, as well as public transit environs such as airplanes).”

That will both improve safety for frontline workers in essential industries and allow nonessential workers to return to public work spaces, they said.

https://uh.edu/news-events/stories/july-2020/07072020ren-coronavirus-filter.php