• Pandemics and the U.S. Military: Lessons from 1918

    The novel coronavirus will hit the U.S. military and its allies hard — how hard will depend on a number of variables, some having to do with the virus itself (how and to what extent it mutates, whether it comes back in subsequent waves, etc.) and others having to do with what measures militaries take to protect themselves. Michael Shurkin writes that, fortunately, we have a historical example that could offer some clues on how the virus might affect the military, and the policy choices that at some point today’s military leaders may face. He is referring to the 1918 influenza epidemic — commonly referred to as the Spanish flu.

  • Threats to Democracy Spread with the Virus, We Must Keep Both in Check

    As the coronavirus pandemic has spread, governments have responded predictably to the threat by agitating for increased authority. Melissa Hooper writes that the worst of these, the Hungarian proposal, was easily enacted into law on Tuesday, “setting a terrible precedent for other countries, in the West and around the world.” She adds: “Under the legislation, Hungary’s parliament will be disempowered in favor of rule by executive decree. The parliament now loses the ability to check the power of Viktor Orbán and his executive branch. Since the Fidesz government has hamstrung its court system, already limiting judicial oversight, this would remove the last obstacle to a dictatorial government. This is especially true since expanded executive power will be granted indefinitely: The bill has no sunset clause.”

  • Study Identifies Medications Safe to Use in COVID-19 Treatment

    A recent study has found that there is no evidence for or against the use of non-steroidal anti-inflammatory drugs such as ibuprofen for patients with COVID-19. The study, led by researchers at King’s College London, also found other types of drugs, such as TNF blockers and JAK inhibitors safe to use.
    89 existing studies on other coronavirus strains such as MERS and SARS, as well as the limited literature on COVID-19, were analyzed to find out if certain pain medications, steroids, and other drugs used in people already suffering from diseases should be avoided if they catch COVID-19.
    Kings College notes that there had been some speculation that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen might make things worse for some COVID-19 patients, but the researchers did not find evidence to support this statement. Other types of drugs such as TNF blockers and JAK inhibitors, used to treat arthritis or other forms of inflammation, were also found to be safe to use. Another class of drug known as anti-interleukin-6 agents is being investigated for helping to fight COVID-19, although there is no conclusive proof yet.
    The researchers found that low amounts of prednisolone or tacrolimus therapy may be helpful in treating COVID-19.

  • Antibodies in the Blood of COVID-19 Survivors Know How to Beat Coronavirus – and Researchers Are Already Testing New Treatments that Harness Them

    Amid the chaos of an epidemic, those who survive a disease like COVID-19 carry within their bodies the secrets of an effective immune response. “Virologists like me look to survivors for molecular clues that can provide a blueprint for the design of future treatments or even a vaccine,” Ann Sheehy writes in The Conversationt.
    Researchers are launching trials now that involve the transfusion of blood components from people who have recovered from COVID-19 to those who are sick or at high risk. Called “convalescent-plasma therapy,” this technique can work even without doctors knowing exactly what component of the blood may be beneficial.
    The extraordinary power of this passive immunization has traditionally been challenging to harness, primarily due to the difficulty of obtaining significant amounts of plasma from survivors. “Fast forward to the 21st century, and the passive immunization picture changes considerably, thanks to steady advances in molecular medicine and new technologies that allow scientists to quickly characterize and scale up the production of the protective molecules,” she writes.

  • Bellerophon Starts INOpulse Treatment in Coronavirus Patients

    Bellerophon Therapeutics has treated the first Covid-19 patient with its INOpulse at the University of Miami School of Medicine in the US.
    This comes after the company received emergency expanded access from the U.S. Food and Drug Administration (FDA) for the inhaled nitric oxide system (iNO).
    Clinical Trials Arena reports that NO is a naturally produced molecule that plays a key role in the immune response against pathogens and infections.
    In-vitro studies found that NO blocks the replication of severe acute respiratory syndrome-related coronavirus (SARS-CoV) and improves the survival of infected cells.

  • COVID-19: One in Five over-80s Need Hospitalization and Death Rate 0.66 Percent

    This is one of the conclusions of an analysis of 3,665 cases in mainland China, published in The Lancet Infectious Diseases. Laura Gallagher writes for Imperial College London that it also estimates that the overall death rate, including unconfirmed cases, is 0.66%. The estimated proportion of deaths from both diagnosed cases and from milder, unconfirmed cases is strongly influenced by age. The estimates are slightly lower than others that have been made for the virus, but are still much higher than for previous pandemics such as 2009 pandemic influenza H1N1, which was estimated to be fatal in around 0.02% of cases. The new estimates are based on an analysis of 70,117 laboratory-confirmed and clinically-diagnosed cases in mainland China, combined with 689 positive cases among people evacuated from Wuhan on repatriation flights.

  • Japan's Fujifilm Starts Avigan Trial to Treat Coronavirus

    Japan’s Fujifilm has begun clinical trials to test the effectiveness of its anti-flu drug Avigan in treating patients with the new coronavirus, after reports of promising results in China.
    The Bangkok Times reports that trials in China have suggested Avigan (generic name: favipiravir) could play a role in shortening the recovery time for patients infected with coronavirus.
    The drug will be administered for a maximum of 14 days to coronavirus patients between 20 and 74 years old with mild pneumonia, the spokesman said.
    The study excludes pregnant women due to side effects shown in animal testing, he added.

  • Pluristem Begins Dosing with Covid-19 Therapy in Israel

    Pluristem Therapeutics has started dosing Covid-19 patients in Israel with PLX cells under a compassionate use programme approved by the country’s health ministry.
    Dosing was performed in three patients at two hospitals. Pluristem intends to recruit more coronavirus patients in the coming days.
    Clinical Trials reports that PLX cells are off-the-shelf allogeneic mesenchymal-like cells with immunomodulatory properties that could trigger the immune system’s natural regulatory T-cells and M2 macrophages.
    This mechanism is expected to block the overactivation of the immune system, which leads to complications.
    It is hoped that the approach will potentially decrease the incidence and\or severity of pneumonia and pneumonitis associated with Covid-19 infection.

  • U.K. Considers Virus-Tracing App to Ease Lockdown

    A coronavirus app which alerts people if they have recently been in contact with someone testing positive for the virus “could play a critical role” in limiting lockdowns, scientists advising the government have said.
    The location-tracking tech would enable a week’s worth of manual detective work to be done in an instant, they say. The academics say no-one should be forced to enroll - at least initially.
    U.K. health chiefs have confirmed they are exploring the idea.
    The study by the team at the University of Oxford’s Big Data Institute and Nuffield Department of Medicine was published in the journal Science.
    Leo Kelion writes for the BBC that the study proposes that an app would record people’s GPS location data as they move about their daily lives. This would be supplemented by users scanning QR (quick response) codes posted to public amenities in places where a GPS signal is inadequate, as well as Bluetooth signals.
    If a person starts feeling ill, it is suggested they use the app to request a home test. And if it comes back positive for Covid-19, then an instant signal would be sent to everyone they had been in close contact with over recent days.

  • Potential Drug Treatment Starts U.K. Trials

    A drug that could help treat coronavirus is to be trialed on a small number of patients in England and Scotland.
    The studies, which have been fast-tracked by the government, will initially involve 15 NHS centers.
    The BBC reports that in the absence of a known treatment for the virus, a handful of experimental drugs are being tested globally.
    The drug, known as remdesivir, is manufactured by the pharmaceutical company Gilead.
    Two studies are to be carried out in the UK - one on patients with moderate symptoms, and one on those who are in a serious condition.
    Trials are already underway in China and the US, with the first results expected in the coming weeks.
    The UK trials will be based in England and Scotland and overseen by Dr. Andrew Ustianowski, a consultant in infectious diseases.

  • Because of Age, Third of U.S. Doctors Prone to Worse COVID-19

    Nearly one in three licensed doctors in the United States is older than 60 years, an age-group particularly vulnerable to adverse outcomes from COVID-19, according to a study published yesterday on the preprint server medRxiv. And New York and California, two hard-hit states, have the most older physicians.
    Mary Van Beusekom, writing in CIDRAP, quotes the study’s authors to say that “The physician workforce is not only at risk of losing time spent in clinical care due to these exposures, but at a personal risk from severe disease that requires hospitalization and is associated with high morbidity and mortality.” The authors noted that 80 percent of deaths in China were in people 60 and older and that, in the United States, nearly half of hospitalizations and intensive care admissions and up to 80 percent of deaths have been in that age-group.

  • Are COVID-19 Models a Sound Basis for Public Policy?

    The justification for stay-home orders, closing of “non-essential” businesses, and so on, as we have often been told, is “flattening the curve.” Sheltering in place won’t prevent the COVID-19 virus from working its way through the population, it will just do so more slowly, thus avoiding unnecessary deaths which would result from overwhelming hospitals, especially ICUs.
    The policies enacted by governments are based on statistical models, and John Hinderaker writes in Powerline that as usual with models, the math is relatively simple. It is the assumptions that are critical. Hinderaker notes, for example, that in the U.K., Imperial College scientist Neil Ferguson notoriously revised his U.K. fatality projection from 500,000 to fewer than 20,000, with most of those being people who would have died this year, anyway. Ferguson said this drastic reassessment was due to the draconian stay-home order promulgated by the British government.
    “I am not calling Ferguson a liar, but I would love to see the assumptions and calculations underlying his about-face,” Hinderaker writes. “Are there really numbers for Case A (500,000 fatalities) and Case B (fewer than 20,000) attributable to curve-flattening that 1) are plausible on their face, and 2) have substantial empirical support? Consider me skeptical.”
    Hinderaker notes that many of the models on which public policy is based do not address measures which may lead to a reduction in infection (for example, imposing travel limits out of New York City; the increasing use of face-masks), or the success of treatments (for example, HCQ).
    “Is curve flattening, via stay-home orders and business closures, really as valuable as certain modelers and many politicians allege?” Hinderaker is not so sure.

  • As Global COVID-19 Total Passes 850,000, Study Shows 1.4% Fatality Rate

    A steady surge of COVID-19 activity on many continents pushed the global pandemic total past 850,000 infections yesterday and sent the number of deaths over 41,000. In research developments, a team from the United Kingdom published a new case-fatality rate estimate of 1.4 percent, based on all available data on deaths in and outside of China, and another group found that illness rates in South Korea trended younger and more female compared with patterns seen in China’s outbreak.

  • COVID-19 Therapeutics Accelerator Awards $20 Million to Fund Clinical Trials

    The COVID-19 Therapeutics Accelerator, a global initiative launched in March by the Bill & Melinda Gates Foundation, Wellcome, and Mastercard, has announced three grants totaling $20 million in support of efforts to identify repurposed drugs and immunotherapies for COVID-19.

  • Coronavirus Measures May Have Already Averted Up to 120,000 Deaths Across Europe

    Strong social distancing measures to slow and suppress the spread of COVID-19 across Europe are estimated to have averted thousands of deaths. According to the research, up to 120,000 deaths may have already been averted in 11 countries, including the U.K., Italy and Spain. However, they add that the estimated proportion of people to have been infected with the virus may only be between 2 percent to 12 percent of the population (2.7 percent in the U.K.).