Solving COVID
July 29, 2020

Some of the largest slums in Mumbai, India, may be nearing herd coronavirus immunity, a new serological survey found, Bloomberg reports.

The study tested 6,936 people across three suburbs in Mumbai — Dahisar, Chembur, and Matunga — and discovered that 57 percent of the subjects had coronavirus antibodies, a figure far higher than the 21 percent found in New York City in April and 14 percent in Stockholm, Sweden, in May. Per Bloomberg, epidemiologists generally believe a population must reach infection levels of 60 percent to achieve herd immunity, so the study indicates the neighborhoods are pretty much there. The survey appears to go hand-in-hand with a steep decline in cases in the slums in recent weeks, despite India having the world's fastest growth in infections overall.

Social distancing is a challenge in the crowded Mumbai neighborhoods, which seemingly makes them well-suited for the virus' spread, and the study suggests that it did so widely. Fortunately, the population in the slums is young and more likely to avoid severe cases of COVID-19. That, coupled with successful government containment measures that helped catch cases early and ensure high quality care, have kept the fatality low in the slums, even if many infections went undetected, Bloomberg notes.

It's encouraging that some of Mumbai's slums may be closing in on herd immunity without experiencing a high death rate, but the jury is still out on how long immunity lasts. It's also worth noting antibody rates were not nearly as high in other parts of Mumbai, where social distancing is more feasible. Read more at Bloomberg. Tim O'Donnell

11:09 a.m.

Thomas Cueni, the director-general of the International Federation of Pharmaceutical Manufacturers and Associations, said Friday that as many as 10 COVID-19 vaccines could be available by the middle of next year, as long as they are granted approval by regulatory agencies.

Cueni noted that the vaccine developers that have already released info from late-stage trials — Pfizer and BioNTech, Moderna, and the University of Oxford and AstraZeneca — have all showed promising results. Moderna and Pfizer both reported higher than 90 percent efficacy rates, while the Oxford-AstraZeneca trial has sparked some confusion after the accidental discovery that a lower dosing regimen proved more effective than the full one. The trial is being amended, but even the study's lower 62 percent efficacy rate for the full dosing regimen would meet the United States' 50 percent threshold, and the European Union is not setting a minimum efficacy level, so if it passes the regulatory observation the U.K. government is moving forward with, it will likely be gearing up for global deployment.

Beyond that trio, Cueni suggested Johnson & Johnson, Novavax, Sanofi Pasteur, GSK, and Merck, have a good chance of following suit in the coming months. "But all of them need to be submitted by rigorous scientific scrutiny by the regulators," he said. Read more at Reuters. Tim O'Donnell

November 25, 2020

The Food and Drug Administration on Wednesday approved a "new generation" COVID-19 antibody test which is designed to tell how well people are protected against subsequent infection.

Most antibody tests are able to determine whether a person has contracted the virus or not, and some can estimate the level of neutralizing antibodies someone has, CNBC notes. But the newly-authorized COVID-SeroKlir developed by Kantaro BioSciences measures specific levels.

The catch is that scientists aren't sure if high levels of antibody guarantee COVID-19 immunity, so the test won't necessarily serve as proof that someone is protected against re-infection just yet. What it will do, however, is allow researchers to gain a better understanding about the correlation between antibody levels and immunity, which will come in handy both for people who have been exposed to the virus already and for vaccine development.

"It's going to broadly enable studies of immunity and the relationship between immunity and the level of antibodies that an individual has," said Erik Lium, the commercial innovation officer for the Mount Sinai Health System, which joined up with diagnostic startup Renalytix to form Kantaro. Read more at CNBC. Tim O'Donnell

November 25, 2020

The U.S. plans to send 6.4 million doses of Pfizer's COVID-19 vaccine across the U.S. within 24 hours of the vaccine getting emergency use authorization from the Food and Drug Administration, officials said Tuesday. The goal is to distribute 40 million doses of vaccines from Pfizer and Moderna by the end of the year, enough to vaccinate 20 million people. States were informed of their allocations on Friday, and they will probably be advised to inoculate front-line health care workers first, said Gen. Gustave Perna, the logistics chief of the U.S. vaccination effort.

The FDA will get a recommendation on whether to approve the Pfizer-BioNTech shots after a Dec. 10 vaccine advisory committee meeting, and final say over emergency approval will go to FDA Commissioner Stephen Hahn. "While we cannot predict how long the FDA's review will take, the FDA will review the request as expeditiously as possible, while still doing so in a thorough and science-based manner," Hahn said in a statement. Health and Human Services Secretary Alex Azar predicted approval would come "soon after" the Dec. 10 meeting.

Within two days of FDA approval, an independent advisory board to the Centers for Disease Control and Prevention will meet publicly to finalize recommendations on who should get the first shots. Then it will be up to the governors of each state, Perna said, describing the federal government as the "air traffic controller" of vaccine distribution.

Getting frozen vials of vaccine — Pfizer's needs to be stored -94 degrees Fahrenheit — to hospitals and other distribution centers across the U.S., then tracking that the right people get two doses of the same vaccine weeks apart will be a massive logistical challenge, as The Washington Post explains.

The CDC's Advisory Committee on Immunization Practices says it will recommend that 20 million health care workers and 3 million people in long-term care facilities get first priority, then about 87 million other essential workers, 100 million adults with high-risk medical conditions, and 53 million senior citizens 65 and older. The general public will probably start getting vaccinated in April. Peter Weber

November 24, 2020

Essential workers — including people who work in meat-packing plants, waste management operations, and the transportation sectors, as well as police officers, firefighters, and teachers — are expected to have earlier access to coronavirus vaccines than any group save for health care workers, Stat News reports. That means those workers would move ahead of people 65 and older and those with high-risk medical conditions.

The Advisory Committee on Immunization Practices, the group of experts tasked with making recommendations to the Centers for Disease Control and Prevention on vaccine use, has not yet had a formal vote on the matter, but members expressed support for the proposal, writes Stat.

The intention is reportedly to ensure people of color, who have been disproportionately affected by the pandemic and make up a high percentage of essential workers, are at the front of the priority line, should they choose to get vaccinated.

"These essential workers are out there putting themselves at risk to allow the rest of us to socially distance," said Beth Bell, a global health expert from the University of Washington who is on the ACIP and chairs its COVID-19 work group. "And they come from disadvantaged situations, they come from disadvantaged communities." Read more at Stat News. Tim O'Donnell

November 23, 2020

The coronavirus almost certainly originated in another species before jumping to humans (perhaps infecting a third party species in between), but new research is suggesting that humans could also play the role of vector, National Geographic reports.

A new study led by Harris Lewin, a professor of ecology and evolution at University of California, Davis, found that humans could potentially spread the virus to wild animals, and they probably already have among animals in captivity. For example, Lewin said it's likely lions and tigers that contracted the virus at the Bronx Zoo in New York were infected by human zookeepers.

That could put endangered species — especially close human relatives like the western lowland gorilla, the Sumatran orangutan, chimpanzees, and bonobos — at high risk of a COVID-19 outbreak, especially in places where wild animals are more likely to come into close contact with humans, Lewin told Nat Geo.

Lewin's co-author Klaus-Peter Koepfli singled out Africa's eastern gorilla as another high-risk species because the fewer than 5,000 remaining individuals live in close-knit family groups, making them more vulnerable to their own pandemic.

The good news is there's no evidence the virus is spreading among wild animal populations, and the animals that have been infected in experimental settings have mostly exhibited mild cases. But the risk remains, so Koepfli and Lewin are calling for a focus on preventative methods such as national park staffers getting regularly tested to mitigate the threat. Read more at National Geographic. Tim O'Donnell

November 23, 2020

An interim trial analysis for Oxford-AstraZeneca's COVID-19 vaccine found the candidate's average efficacy to be 70 percent. While considered encouraging, it falls short of the rates shown by Pfizer/BioNTech and Moderna, whose vaccines appear to be more than 90 percent effective.

Still, the Oxford-AstraZeneca candidate has a few key advantages — it can be stored at regular refrigerators temperatures for a long period of time, and it's much cheaper than the other candidates, which means it could be particularly crucial for developing nations and rural communities around the world.

The vaccine costs just $3 to $4 per dose. In comparison, the Pfizer and Moderna candidates cost around $20 and $30, respectively. AstraZeneca has also made a "no-profit" pledge, and the more-established technology used by Oxford means it will be easier to mass produce cheaply, BBC News notes. Read more at BBC and The Financial Times. Tim O'Donnell

November 23, 2020

Oxford University and drugmaker AstraZeneca announced Monday morning that their COVID-19 vaccine candidate had proved to be 70 percent effective in its Phase Three trial of 20,000 volunteers in Britain and Brazil. And Oxford Vaccine Group director Andrew Pollard told BBC Radio 4 Today that the vaccine appeared to be 90 percent effective when people were given a half-dose of the vaccine followed by a full dose.

"We are really pleased with these results," Pollard said. "What we have got is a vaccine that is able to protect against coronavirus disease and, importantly, there were no hospitalizations or severe cases in anyone who had the Oxford vaccine." Sarah Gilbert, the vaccine's architect, said "the announcement today takes us another step closer to the time when we can use vaccines to bring an end to the devastation caused by" the new coronavirus.

Britain has ordered 100 million doses of the Oxford vaccine, and if U.K. regulators approve it for emergency use, the country is ready to roll out an aggressive immunization program. Residents and staff of nursing homes are first on the list of those approved for vaccinations, followed by health care workers and people over 85, then consecutively lower age groups.

"After Pfizer and Modena both produced vaccines delivering 95 percent protection from COVID-19, a figure of 70 percent is relatively disappointing," BBC News reports. "However, anything above 50 percent would have been considered a triumph just a month ago. This vaccine can also be stored at fridge temperature, which means it can be distributed to every corner of the world, unlike the Pfizer/BioNTech and Moderna vaccines, which need to be stored at much colder temperatures." Peter Weber

November 22, 2020

Pfizer's coronavirus vaccine, which was submitted to the Food and Drug Administration for an emergency use authorization this week and could be rolled out by mid-December, must be kept in ultra-cold conditions and will initially be shipped in boxes that hold a minimum of 975 doses. Once a vial is thawed and diluted to make five shots, people receiving the vaccine (early on that is expected to be health-care workers), will then have just six hours to get inoculated, Politico reports. Whatever is left over will then spoil.

While there's great excitement about the vaccine's pending authorization, the concern about wasted shots is very real, "especially early on when it will be practically liquid gold," Douglas Hoey, CEO of the National Pharmacists Association, told Politico.

States are trying to come up with ways to mitigate the risk, but spoiled doses are inevitable. Maryland health officials told the Centers for Disease Control and Prevention that as much as 5 percent of the vaccine the state is allocated could go unused in the initial rollout, especially because rural counties may not be able to use up all 975 doses on their own. To counter, Maryland is considering creating regional clinics where people in high priority groups from different rural communities could come to get vaccinated.

Oregon is considering contracting emergency medical providers to drive around and divy up the vaccine among remote areas, Politico reports. And North Dakota wants to repackage the vaccine into smaller boxes — Pfizer says it's working on a smaller pack size that won't be ready until next year — while also identifying people in the next priority group to get a shot if there are any doses left over.

Regardless, the situation will be tricky, but Moderna's vaccine, which will also soon be up for FDA authorization, is expected to be a bit easier to distribute than Pfizer's. Read more at Politico. Tim O'Donnell

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