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Genetic Medicine | Internal Medicine | Michigan Medicine …

As use of genomic technologies continue to increase in research and clinical settings, the Division of Genetic Medicine serves a key role in bringing together basic, clinical, and translational expertise in genomic medicine, with multidisciplinary faculty comprised of MDs, PhD scientists, and genetic counselors. Demand for expertise in genetics continues to increase, and the Division of Genetic Medicine is committed to advancing scientific discovery and clinical care of patients.

In addition to our Medical Genetics Clinic, genetics services are available through several other Michigan Medicine clinics and programs, including the Breast and Ovarian Cancer Risk Evaluation Program, Cancer GeneticsClinic,Inherited Cardiomyopathies and Arrhythmias Program,Neurogenetics Clinic, Pediatric Genetics Clinic, and Prenatal Evaluation Clinic.

Our faculty are focused on various research areas including cancer genetics, inherited hematologic disorders, neural stem cells,the mechanisms and regulation of DNA repair processes in mammalian cells, predictive genetic testing,understanding the mechanisms controlled by Hox genes, birth defects, bleeding and thrombotic disorders, and human limb malformations.

Division of Genetic Medicinefaculty are actively engaged in the education, teaching, and mentorship of clinicians, and clinical and basic scientists, including undergraduate and graduate students, medical students, residents, and fellows from various subspecialties.

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Genomics and Medicine | NHGRI

It has often been estimated that it takes, on average, 17years to translate a novel research finding into routine clinical practice. This time lag is due to a combination of factors, including the need to validate research findings, the fact that clinical trials are complex and take time to conduct and then analyze, and because disseminating information and educating healthcare workers about a new advance is not an overnight process.

Once sufficient evidence has been generated to demonstrate a benefit to patients, or "clinical utility," professional societies and clinical standards groups will use that evidence to determine whether to incorporate the new test into clinical practice guidelines. This determination will also factor in any potential ethical and legal issues, as well economic factors such as cost-benefit ratios.

The NHGRIGenomic Medicine Working Group(GMWG) has been gathering expert stakeholders in a series of genomic medicine meetingsto discuss issues surrounding the adoption of genomic medicine. Particularly, the GMWG draws expertise from researchers at the cutting edge of this new medical toolset, with the aim of better informing future translational research at NHGRI. Additionally the working group provides guidance to theNational Advisory Council on Human Genome Research (NACHGR)and NHGRI in other areas of genomic medicine implementation, such as outlining infrastructural needs for adoption of genomic medicine, identifying related efforts for future collaborations, and reviewing progress overall in genomic medicine implementation.

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Genomics and Medicine | NHGRI

Q&A:Transforming genetic medicine as the medical standard of care (Includes interview) – Digital Journal

With rare diseases, 72 percent out of the 7000 known are genetic, and 70 percent of those start in childhood. The lack of scientific knowledge and the quality of information often delay diagnosis or lead to misdiagnosed cases, losing precious time that can be vital to find treatment before it's too late.This situation is changing with the advent of genetic medicine. an example is Emedgene's artificial intelligence software, which is the worlds first completely automated genetic interpretation platform using machine learning algorithms.Digital Journal spoke with Einat Metzer, CEO and Co-Founder of Emedgene to talk about the new genetic interpretation software.Digital Journal: How are rare diseases classified?Einat Metzer: Rare diseases defined by the number of people affected. In the U.S., any disease that affects fewer than 200,000 people is defined as rare, in Europe, its any disease affecting fewer than 1 in 2000 people.There are around 6000 known rare diseases, and that number is growing. Whats interesting to know, is that although they are each individually rare, collectively they impact over 300 million people. Those patients have a very difficult time receiving a diagnosis for their disease, and typically go through a diagnostic odyssey lasting on average 5-7 years. Its also worth noting that most rare diseases have a genetic basis, and appear in early childhood. DJ: Is sufficient funding and research invested into rare diseases? What are the factors that influence this?Metzer: There are two challenging aspects to rare diseases, the first is the identification of a rare disease, because obviously, physicians arent familiar with every disease affecting only tens or hundreds of patients worldwide. The second difficult aspect is developing treatments for diseases impacting small numbers of patients. The good news is countries and healthcare systems are increasingly recognizing the need to cover genetic testing for the identification of rare diseases. As of today, over 50% of the US population has insurance coverage for next generation sequencing. However, even insurance coverage for the tests does not entirely solve the problem. Sequencing a patients DNA is easily done, but understanding what variants in a patients genome mean is still quite challenging. Every patient has millions of harmless genetic variants, and only one disease-causing mutation. As a result, geneticists can spend hours manually reviewing hundreds of variants and looking for evidence for the disease in databases and the literature. There are fewer than 5,000 geneticists worldwide available to interpret patients genetic data, resulting in an interpretation bottleneck. Even as more patients become eligible for genetic testing, the workforce capable of diagnosing them is not growing fast enough. We estimate the worldwide capacity of interpretation is capped at roughly 2.4 million tests, less than the predicted rare disease testing volume for 2020. DJ: How can machine learning help?Metzer:Machine learning technologies can reduce the manual labor of interpretation, by offloading both the research and deep analysis tasks from geneticists. Machine learning is a buzzword, widely used, and applied to many types of solutions. Were talking about a unique application of the technology here, where we wont use a single algorithm to solve a single problem. Instead, we need to apply a set of algorithms designed to automate different aspects of the geneticists workflow. On the one hand, the geneticists work is to review thousands of data points for every patients test, and use them to come to a conclusion on the single genetic variant thats causing the disease. We can certainly apply machine learning algorithms to review those data points. But we can go a step further, and collect the data points most likely to impact their decision, and include those in our recommendations. The second labor-intensive task geneticists perform, is looking for the most up-to-date information in databases and the published literature. Thats a task well suited for Natural Language Processing, which can be used to augment existing databases with information curated from the literature. DJ: How does Emedgenes AI software work?Metzer:Emedgenes AI-powered genomic analysis platform tries to do just that, automate the labor-intensive parts of the geneticists workflow, so interpreting a patients genetic test takes less time and effort, and accuracy is not compromised. The goal is to scale the genetic testing interpretation in healthcare systems, so they can offer personalized care to a broader population. Our AI consists of dozens of different algorithms, each solving a different problem, all coming together to automate the genetic testing interpretation workflow. The platform is able to automatically identify the disease-causing variant, compile the evidence, and present it to the geneticist on the case for review. The machine learning algorithms utilize a proprietary knowledge graph that continuously incorporates new knowledge. The knowledge graph contains over 85,000 entities and 340,000 connections today, including unique information curated from the literature that has not yet made its way into public databases.DJ: What were the main challenges when developing the software?Access to large high-quality data sets is a major challenge in developing AI solutions in healthcare in general. For our supervised learning algorithms - those that require labeled data for training the algorithm - once we obtained the data, labeling was a challenge as well. The level of education required to annotate healthcare datasets is quite high.Fortunately, there are good solutions to both problems, both from the scientific and AI perspective. DJ: Are there any case studies you can share, to show the benefits of the approach?Metzer:Weve studied the accuracy of our interpretation algorithms with Baylor Genetics. In the 180-case study, our AI successfully identified the disease-causing mutation in 96% of the cases. Another of our customers, Greenwood Genetic Center, was able to reduce time spent per case by 75%, which was translated directly into shorter turn around times for patients waiting for a genetic diagnosis.

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Q&A:Transforming genetic medicine as the medical standard of care (Includes interview) - Digital Journal

Scientists Discover That a Squid Can Edit Its Own Genetic Code – Futurism

Tentacle Hack

The next generation of genetic medicine may be inspired by a bizarre genetic trick that a small squid species uses to edit its own genome on the fly.

The longfin inshore squid can edit the RNA inside its nerve cells, Wired reports, meaning that it can drastically alter the behavior of its biological machinery as needed perhaps to help the animal rapidly adapt to new environments. Its a bizarre discovery, and one that could potentially lead to better genetic treatments for humans.

Researchers from the Marine Biological Laboratory found that the squid alters the RNA within its axons instead of the DNA within its nuclei, according to research published Monday in the journal Nucleic Acids Research. Thus far, its the only animal known to do so.

RNA editing is a hell of a lot safer than DNA editing, lead researcher Joshua Rosenthal told Wired. If you make a mistake, the RNA just turns over and goes away.

Because it happens outside the nucleus, RNA editing would be an improvement over modern genetic treatments, Wired reports. To gene-hack a patient with CRISPR, the new genetic information needs to breach not only a cells membrane but also the membrane of that cells nucleus to reach its DNA.

But it will be some time before medical doctors start to use the longfin inshore squids weird gene-hacks on people. For now, researchers still arent even sure why, exactly, the squid alters its genes.

READ MORE: Squids Gene-Editing Superpowers May Unlock Human Cures [Wired]

More on gene-hacking: George Church Told us Why Hes Listing Superhuman Gene Hacks

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Scientists Discover That a Squid Can Edit Its Own Genetic Code - Futurism

Patients with Severe Forms of Coronavirus Disease Could Offer Clues to Treatment – Howard Hughes Medical Institute

A new international project aims to enroll 500 COVID-19 patients to search for genetic mutations that make some people more vulnerable to severe infection.

HHMI scientists are joining many of their colleagues worldwide in working to combat the new coronavirus.Theyre developing diagnostic testing, understanding the viruss basic biology, modeling the epidemiology, and developing potential therapies or vaccines. Over the next several weeks, we will be sharing stories of some of this work.

Hundreds of clinicians worldwide are banding together in an effort to study some types ofseverecases of the new coronavirus disease.

The project, led by Howard Hughes Medical Institute (HHMI) Investigator Jean-Laurent Casanova at The Rockefeller University, seeks to identify genetic errors that make some younger patients especially vulnerable to the virus that causes COVID-19, the infectious respiratory illness also known as coronavirus disease 2019.

Casanova aims to enroll 500 patients internationally who meet three broad criteria: theyre less than 50 years old, have been diagnosed with COVID-19 and admitted to an intensive care unit, and have no serious underlying illnesses, such as diabetes, heart disease, or lung disease.

By studying these patients' DNA, scientists may pinpoint genetic mutations that make some people more susceptible to infection. Such information could one day help doctors identify people who are most at risk of developing severe coronavirus disease, says Casanova, a pediatrician at Rockefeller. It could also offer clues for scientists searching for new therapeutics. For example, if patients cells arent making enough of a particular molecule, doctors may be able to offer a supplement as treatment.

Were going to try to find the genetic basis of severe coronavirus infection in young people.

Jean-Laurent Casanova, HHMI Investigator at The Rockefeller University

That day may still be years away. This is not a short-term effort, Casanova says. Some scientists have hypothesized that COVID-19 might be a seasonal illness, with infections ebbing in the spring and summer, and then returning in the fall. But Casanovas team is optimistic. They have already begun enrolling patients and have started sequencing their exomes spelling out all of the DNA letters in every gene in a persons genome. Were going to try to find the genetic basis of severe coronavirus infection in young people.

Late last year, when the first coronavirus infections began cropping up in China, Casanova started reaching out to his colleagues there. Though the most severe cases seemed to concentrate among older adults and those with other conditions, Casanova was interested in the outliers kids and young adults hit hard by the illness who didnt have any of the usual risk factors, such as age or underlying illness.

His team kicked off a new project to study these mysterious cases, and in January just weeks after the Wuhan outbreak began enrolling patients. Clinicians mailed patient blood and DNA to his lab, and researchers there and elsewhere began processing samples the first steps needed for scientists to peer into patients genomes. Now, the project is global, and Casanova is collaborating with scientists and healthcare workers from Europe to Africa, Asia, and Oceania.

We will recruit children and adults <50 yo without risk factor admitted to ICU for idiopathic #COVID19. We will test the hypothesis that they carry inborn errors of immunity to this virus. Please refer patients to @casanova_lab and please RT. pic.twitter.com/DXPoFKieEy

Hunting for the genetic underpinnings of severe infectious diseases is nothing new for Casanovas team. What were doing with coronavirus is what my lab has been doing for 25 years with other infections, he says.

They look for weak spots in peoples immune systems small genetic changes that make people more vulnerable to disease. His group has previously searched the genomes of patients infected with viruses, bacteria, fungi, and even parasites. The infection closest to COVID-19 his team has studied is severe influenza pneumonitis, for which theyve discovered three genetic links. Theyve also identified specific genetic errors that can predispose patients with herpes to viral encephalitis. And theyve found that children with mutations in an immunity gene called IFN-gamma are vulnerable to the bacteria that cause tuberculosis. These children make low levels of the IFN-gamma protein, which is critical for fighting off bacterial infections.

Casanovas team has put these findings to use clinically. For example, the researchers have shown that tuberculosis patients with these genetic errors can benefit from treatment with IFN-gamma. Hes hoping to identify problematic genes in patients with severe coronavirus infection that can bring similar clinical gains. These genes could tell scientists which cellular defenses are crucial for warding off COVID-19 and pave the way for understanding whether such defenses are derailed in older adults or patients with an underlying medical condition.

In the US and around the world, severe coronavirus disease seems to hit older patients hardest, though scientists have reported some country-to-country variation. As of March 24, more than 44,000 confirmed and presumptive positive cases have been reported in the US. Fatality has been highest in people over 85 years old, according to a recent report from the Centers for Disease Control and Prevention (CDC). Though young people may be more susceptible than scientists once suspected,the older you are, the higher the likelihood you have a severe form of the disease, Casanova says.

Last week, Rockefeller closed all labs except those working on the coronavirus, and Casanova whittled his team to a skeleton crew of about eight people down from 35 who rotate so there is only one person per room at a time. He and his lab members are following CDC recommendations, and taking protective measures to keep themselves and others safe, including social distancing, washing hands, and disinfecting surfaces. Theyve also taken to Twitter to get the word out about their work. A tweet posted from Casanovas lab last week about recruiting new patients to their study has since been retweeted more than 400 times.

Soon, theyll be testing their genetic theory on a pandemic thats occurring in real time. Im grateful weve been able to start this new project so quickly, he says. God willing, it will be of clinical usein two or three years.

Follow the Casanova lab on Twitter (@casanova_lab) to learn the latest about their work. Doctors interested in enrolling patients in the study can contact Jean-Laurent Casanova at jean-laurent.casanova@rockefeller.edu.

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Patients with Severe Forms of Coronavirus Disease Could Offer Clues to Treatment - Howard Hughes Medical Institute

Precision Medicine, Nanotechnology and the Rise of the Robot Now. Powered by – Now. Powered by Northrop Grumman.

Since then-President Obamas announcement in early 2015, precision medicine has been an even bigger buzzword in medical research. Its one of those terms you hear frequently, but what exactly is it? And what makes it so important for future health care?

Its both, but definitely not average. The term replaces the older description, personalized medicine. Although they mean roughly the same thing, precision medicine is the preferred term for developing treatment and preventive medicine for individuals based on genetic, environmental and lifestyle factors. In translation: instead of a one-size-fits-all approach for an average patient, the precision approach looks at individual variability when mapping out the treatment plan that has the best chance of success. Doctors base the drug choices on the individual patients genetics.

So, apart from maximizing success, what makes precision medicine so important?

Consider cancer, one of the short-term goals outlined in Mr. Obamas 2015 initiative. Characterizing a patients cancer helps clinicians design an effective treatment plan. Tissue profiling reveals cell markers that are useful when choosing chemotherapeutic drugs. For example, breast cancers that overexpress the HER2 receptor respond very well to trastuzumab (Herceptin) treatment, whereas those with abundant estrogen receptors respond better to hormone therapy. This kind of approach can also customize treatment for other conditions.

How do doctors know what works?

Omics is shorthand for a suite of biotechnologies devoted to uncovering the secrets of the genome (DNA), the proteome (proteins), the transcriptome (how genes translate into proteins) and more. Essentially, omics researchers study the basic machinery of the cell and how growth, aging, disease and nutrition affect it. These technologies underpin most research into precision medicine. By studying thousands of individuals, researchers build a picture of health, disease and risk.

Cataloging the genomic information from thousands of individuals in large population cohorts, and then matching it up with health, environmental and lifestyle records shows genes associated with specific diseases. In tumors, it shows how sensitive they are to chemotherapy.

Omics technology is advancing very rapidly and generating vast amounts of data. Sequencing a persons genome first took almost 10 years and $3 billion; current next generation sequencing (NGS) instruments will whiz through around 18,000 individuals or more in a year. Proteomics technology is catching up rapidly.

One genome generates around 780 MB of data out of around 30 terabytes of raw NGS data; typical proteome datasets run into many gigabytes in size. Studying thousands of individuals for population studies generates terabytes of data approximately 40, according to one article. And that takes a lot of processing power to analyze for clinically relevant results more than can be done manually, so biomathematicians develop algorithms and other software tools to tease the answers from the digital soup. Bioinformatics for storing and accessing electronic health records is vital for precision medicine research. Furthermore, IT systems such as the Northrop Grumman-supported MedDRA initiative encode health information consistently ensure that data banks can talk to each other, with advances in cybersecurity ensuring patient privacy despite the cross talk.

Yes. Just think of where all that data comes from.

Population studies are as big as they sound; the Million Veteran Program collects biosamples from U.S. veterans, around 400,000 so far. It aims to generate omics data that in conjunction with information on health, lifestyle and environment will translate into clinical practice. Thats a lot of samples to handle, store and analyze.

Furthermore, microelectronics advances mean that omics instruments handle more samples at a faster rate. Next-generation sequencers such as the Illumina HiSeq and the Thermo Fisher Ion Torrent use chip-based and semiconductor technology to decode genomic materials. A simple flash of fluorescence or change in pH zaps DNA base pair information into a digital format much faster than old-school gel-based Sanger sequencing.

In order to exploit the speed of these tools, robotic handling manages everything from sample aliquots for biobank storage, to 384-well plate assay wrangling. Their speed and automation bring faster results with fewer errors.

Robotic or automated workflows are also important for nanotechnology and microfluidics where the miniaturization that reduces instrument footprint and sample volume also precludes manual input. Even though they will benefit from precision medicine, our clumsy fingers and thumbs are not as welcome in the lab as they once were.

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Precision Medicine, Nanotechnology and the Rise of the Robot Now. Powered by - Now. Powered by Northrop Grumman.

Bridging the gap study sequences Asian genomes to diversify genetic databases – University of Virginia The Cavalier Daily

Though the number of human genomes sequenced continues to rise rapidly since the completion of the Human Genome Project a scientific endeavor spanning multiple decades and countries aimed at detailing human DNA in 2003, less than 10 percent of those genomes to date correspond to individuals of Asian descent. The GenomeAsia 100K Project, a non-profit consortium, seeks to change this lack of knowledge surrounding a major portion of the worlds ethnicities. The conglomeration of researchers and private sector executives from around the world from Seoul, South Korea to the University plans to add 100,000 novel genomes from individuals of Asian ethnicity to new open-access databases.

Academic institutions and private sector companies came together in 2016 to launch the GenomeAsia 100K Project. While the research organization MedGenome and Nanyang Technological University in Singapore originally founded the non-profit consortium, representatives from other businesses and schools including Genentech, Macrogen and the University of California, San Francisco have joined the association.

Since genome sequencing can reveal the unique characteristics of each persons genetic material, it can help determine a persons ancestry and the propensity for certain medical conditions. According to GenomeAsia 100K, Asians constitute nearly half of the worlds population, and the distinct ethnicities and communities offer a relatively untapped repository of genetic diversity. The project hopes to provide new insights into inherited diseases as well as those caused by a combination of genetic and environmental factors.

Aakrosh Ratan, assistant professor of public health sciences and researcher for GenomeAsia 100K, explained that in particular, the information the initiative collects may help develop medical treatments based on peoples specific genetic makeup, instead of relying on traditional general treatments that may not target the unique root cause of each patients form of a disease.

The goal of precision medicine is to tailor treatment towards a persons genetic background, and that dream cannot be realized until you have the proper reference databases, Ratan said.

Mutations in humans DNA sequences lead to different copies of the same gene within a person and amongst ethnicities. These different versions of a gene can act as markers of diseases that are inherited or influenced by genetic makeup. For example, the disorder sickle cell anemia is caused by the change of a single point in the DNA sequence. When someone is born with copies of this particular gene from both parents contain the mutation, he or she will suffer from often debilitating pain resulting from red blood cells that cannot effectively transport oxygen.

Ratan explained that genome sequencing can highlight mutations in a persons DNA that may cause illnesses such as sickle cell anemia.

One of the ways we identify the mutations that drive a rare disease is by identifying the mutations and then prioritizing those mutations based on their prevalence in healthy populations, Ratan said. With the medical datasets we have compiled, we can actually improve such analyses for patients of Asian descent.

As of December 2019, the GenomeAsia 100K Project has completed the analysis of 1,739 genomes from 219 populations and 64 countries worldwide. Preliminary findings appeared that same month in the scientific journal Nature. The paper concluded that the sample provided a reasonable framework for sequencing practices and studying the history and health of Asian populations. Ratan and his lab at the University supervised the identification and contributed to the analysis of these genetic variants.

Once the 100,000 genomes have been collected and sequenced, the data will be publicly available as a controlled dataset. As a result, experts investigating topics from heart disease to human evolution can easily access the genome sequences.

One of the real gaps in human genetics studies of disease has been the underrepresentation of non-Europeans, Charles Farber, associate professor of public health sciences, said in an email to The Cavalier Daily. The work of the GenomeAsia 100K Consortium provided critical insight into the extent and nature of genome variation in individuals of Asian ancestry and will be critical in making disease genetic studies more inclusive of all global populations.

Ani Manichaikul, assistant professor of public health sciences in the Center for Public Health Genomics, expressed enthusiasm for the GenomeAsia 100K Project. She claimed that the additional genetic information could augment her research as part of the Multi-Ethnic Study of Atherosclerosis, a cardiovascular disease where fatty deposits accumulate and potentially block arteries. The study currently focuses on Caucasian, African American, Hispanic and Chinese American individuals.

The GenomeAsia project is very useful because there are some instances where particular genetic variants are only observed in particular genetic groups, Manichaikul said. Those markers can be unique to those sequenced through the project, which means we would not have necessarily have observed those particular variants otherwise.

Manichaikul also suggested that expanding existing repositories of hereditary statistics would improve methods of assigning people risk scores for diseases based on their DNA. The National Human Genome Research Institute describes polygenic risk score, which indicates a persons likelihood of certain diseases based on the presence of mutations known to be associated with a given disorder. Companies such as 23andMe have started to provide consumers with this metric, but without a comprehensive database of genomes from different populations, score reliability can decrease.

Since indicators of genetically-linked conditions often appear in certain alleles, or different versions of a gene, knowing whether one has a disease marker can help patients take preventative measures if need be. However, in the absence of comprehensive information on the range of disease markers that appear in different ethnicities, whole populations may lack the potential benefits of this burgeoning healthcare statistic.

The only way we can create risk prediction models that are accurate across populations is if we also have corresponding databases available with individuals that represent that diversity, Manichaikul said.

Following the findings in the preliminary study, GenomeAsia 100K Project collaborators will continue to sequence more genomes of Asian individuals. The hope is that, once researchers have access to the data, insights from 100,000 genomes will drive the development of new therapeutic strategies that will benefit people around the world.

I would like more researchers to have access to this data, Ratan said. This is a resource. Were working to establish these reference datasets, and we would definitely like them to be used.

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Bridging the gap study sequences Asian genomes to diversify genetic databases - University of Virginia The Cavalier Daily

Genomic assays: on the brink of revolutionising human healthcare – Drug Target Review

Detailed knowledge of the human genome can provide us with extensive information about the causes of disease and how patients will respond to treatments. In this article, Pushpanathan Muthuirulan explores the concept of genetic testing and the potential for pharmacogenomic testing to transform healthcare.

Genomic assays offer enormous potential for improving human health. Recent advances in high-throughput genomic assay technologies have enabled development of more rapid and accurate genetic testing methods that can survey the entire human genome and pinpoint the genetic defects associated with diseases. Genomic assays offer deeper insights into disease causation in families and have improved our ability to diagnose and treat genetic disorders by targeting specific genetic subsets. The rapid pace of the discovery of genetic changes associated with disease has enabled researchers to predict the risk of genetic disorders in asymptomatic individuals, offering tremendous potential for unlocking value in precision medicine. Thus, genomic assays are on the cutting edge of medical innovation, offering resources to clinicians and healthcare providers for patient care and driving the future of medicine.

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Genomic assays: on the brink of revolutionising human healthcare - Drug Target Review

PA reactivating retired healthcare providers’ licenses to treat COVID-19 patients – FOX43.com

In preparation for the expected higher need for healthcare providers, the Pennsylvania Department of State took measures this week to aid the coronavirus response.

LANCASTER, Pa.

As the number of COVID-19 cases continues to rise, health systems will likely require more healthcare providers. In preparation for the expected higher need for healthcare providers, the Pennsylvania Department of State took measures this week to aid the coronavirus response.

Certain administrative requirements will be waived for healthcare providers, including allowing physicians who have retired in the last five years to reactivate their medical licenses through the end of the year for free.

Dr. Ed Balaban of Ambler retired from his work as a hematologist and oncologist about a year and a half ago. He now plans to apply to reactivate his license and volunteer to treat COVID-19 patients. Though Balaban remained a trustee-at-large for thePennsylvania Medical Society after his retirement, he never expected to be practicing medicine again so soon.

I think its only right that I help and participate where I can, he said. Physicians, nurses, healthcare providers in general, I think its just part of our genetic makeup.

Pennsylvania had1,127 confirmed COVID-19 cases as of March 25. The number of infected is expected to double every two to three days.

As case counts double you can see that its going to get very high, very fast, Pennsylvania Secretary of Health Dr. Rachel Levine said in avirtual coronavirus update. The concern is that over the next number of weeks we are going to see a surge of new cases, and thus since approximately 10 percent of new cases require hospitalization, see a surge into our healthcare facilities.

The Department of States waiver of certain administrative requirements applies to physicians,nurses and pharmacists.

If the slope continues the way it is, then I suspect that a fair number of us will be needed, Dr. Balaban said.

The relaxed measures also allow current healthcare workers, like a family care nurse practitioner or retail pharmacist, to temporarily leave their usual specialties in order to care for COVID-19 patients, if needed.

So that we can move these people into these places where theres the greatest need, said Betsy Snook, CEO of thePennsylvania State Nurses Association.

Healthcare systems in need of volunteers or additional healthcare providers will reach out to the public through the media and online.

Some of it has already gone out through social media. And then the people can volunteer in that way, Snook said. They can just directly correspond with whoevers asking for the assistance.

The state also announced last week it was waiving licensing requirements for both in-state and out-of-state healthcare providers to treat patients viatelemedicine.

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PA reactivating retired healthcare providers' licenses to treat COVID-19 patients - FOX43.com

How the Pandemic Will End – The Atlantic

Editors Note: The Atlantic is making vital coverage of the coronavirus available to all readers. Find the collection here.

Three months ago, no one knew that SARS-CoV-2 existed. Now the virus has spread to almost every country, infecting at least 446,000 people whom we know about, and many more whom we do not. It has crashed economies and broken health-care systems, filled hospitals and emptied public spaces. It has separated people from their workplaces and their friends. It has disrupted modern society on a scale that most living people have never witnessed. Soon, most everyone in the United States will know someone who has been infected. Like World War II or the 9/11 attacks, this pandemic has already imprinted itself upon the nations psyche.

A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk. In 2018, I wrote a story for The Atlantic arguing that America was not ready for the pandemic that would eventually come. In October, the Johns Hopkins Center for Health Security war-gamed what might happen if a new coronavirus swept the globe. And then one did. Hypotheticals became reality. What if? became Now what?

So, now what? In the late hours of last Wednesday, which now feels like the distant past, I was talking about the pandemic with a pregnant friend who was days away from her due date. We realized that her child might be one of the first of a new cohort who are born into a society profoundly altered by COVID-19. We decided to call them Generation C.

As well see, Gen Cs lives will be shaped by the choices made in the coming weeks, and by the losses we suffer as a result. But first, a brief reckoning. On the Global Health Security Index, a report card that grades every country on its pandemic preparedness, the United States has a score of 83.5the worlds highest. Rich, strong, developed, America is supposed to be the readiest of nations. That illusion has been shattered. Despite months of advance warning as the virus spread in other countries, when America was finally tested by COVID-19, it failed.

Anne Applebaum: The coronavirus called Americas bluff

No matter what, a virus [like SARS-CoV-2] was going to test the resilience of even the most well-equipped health systems, says Nahid Bhadelia, an infectious-diseases physician at the Boston University School of Medicine. More transmissible and fatal than seasonal influenza, the new coronavirus is also stealthier, spreading from one host to another for several days before triggering obvious symptoms. To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those theyve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not.

As my colleagues Alexis Madrigal and Robinson Meyer have reported, the Centers for Disease Control and Prevention developed and distributed a faulty test in February. Independent labs created alternatives, but were mired in bureaucracy from the FDA. In a crucial month when the American caseload shot into the tens of thousands, only hundreds of people were tested. That a biomedical powerhouse like the U.S. should so thoroughly fail to create a very simple diagnostic test was, quite literally, unimaginable. Im not aware of any simulations that I or others have run where we [considered] a failure of testing, says Alexandra Phelan of Georgetown University, who works on legal and policy issues related to infectious diseases.

The testing fiasco was the original sin of Americas pandemic failure, the single flaw that undermined every other countermeasure. If the country could have accurately tracked the spread of the virus, hospitals could have executed their pandemic plans, girding themselves by allocating treatment rooms, ordering extra supplies, tagging in personnel, or assigning specific facilities to deal with COVID-19 cases. None of that happened. Instead, a health-care system that already runs close to full capacity, and that was already challenged by a severe flu season, was suddenly faced with a virus that had been left to spread, untracked, through communities around the country. Overstretched hospitals became overwhelmed. Basic protective equipment, such as masks, gowns, and gloves, began to run out. Beds will soon follow, as will the ventilators that provide oxygen to patients whose lungs are besieged by the virus.

Read: The people ignoring social distancing

With little room to surge during a crisis, Americas health-care system operates on the assumption that unaffected states can help beleaguered ones in an emergency. That ethic works for localized disasters such as hurricanes or wildfires, but not for a pandemic that is now in all 50 states. Cooperation has given way to competition; some worried hospitals have bought out large quantities of supplies, in the way that panicked consumers have bought out toilet paper.

Partly, thats because the White House is a ghost town of scientific expertise. A pandemic-preparedness office that was part of the National Security Council was dissolved in 2018. On January 28, Luciana Borio, who was part of that team, urged the government to act now to prevent an American epidemic, and specifically to work with the private sector to develop fast, easy diagnostic tests. But with the office shuttered, those warnings were published in The Wall Street Journal, rather than spoken into the presidents ear. Instead of springing into action, America sat idle.

Derek Thompson: America is acting like a failed state

Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert Ive spoken with had feared. Much worse, said Ron Klain, who coordinated the U.S. response to the West African Ebola outbreak in 2014. Beyond any expectations we had, said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. As an American, Im horrified, said Seth Berkley, who heads Gavi, the Vaccine Alliance. The U.S. may end up with the worst outbreak in the industrialized world.

Having fallen behind, it will be difficultbut not impossiblefor the United States to catch up. To an extent, the near-term future is set because COVID-19 is a slow and long illness. People who were infected several days ago will only start showing symptoms now, even if they isolated themselves in the meantime. Some of those people will enter intensive-care units in early April. As of last weekend, the nation had 17,000 confirmed cases, but the actual number was probably somewhere between 60,000 and 245,000. Numbers are now starting to rise exponentially: As of Wednesday morning, the official case count was 54,000, and the actual case count is unknown. Health-care workers are already seeing worrying signs: dwindling equipment, growing numbers of patients, and doctors and nurses who are themselves becoming infected.

Italy and Spain offer grim warnings about the future. Hospitals are out of room, supplies, and staff. Unable to treat or save everyone, doctors have been forced into the unthinkable: rationing care to patients who are most likely to survive, while letting others die. The U.S. has fewer hospital beds per capita than Italy. A study released by a team at Imperial College London concluded that if the pandemic is left unchecked, those beds will all be full by late April. By the end of June, for every available critical-care bed, there will be roughly 15 COVID-19 patients in need of one. By the end of the summer, the pandemic will have directly killed 2.2 million Americans, notwithstanding those who will indirectly die as hospitals are unable to care for the usual slew of heart attacks, strokes, and car accidents. This is the worst-case scenario. To avert it, four things need to happenand quickly.

Read: All the presidents lies about the coronavirus

The first and most important is to rapidly produce masks, gloves, and other personal protective equipment. If health-care workers cant stay healthy, the rest of the response will collapse. In some places, stockpiles are already so low that doctors are reusing masks between patients, calling for donations from the public, or sewing their own homemade alternatives. These shortages are happening because medical supplies are made-to-order and depend on byzantine international supply chains that are currently straining and snapping. Hubei province in China, the epicenter of the pandemic, was also a manufacturing center of medical masks.

In the U.S., the Strategic National Stockpilea national larder of medical equipmentis already being deployed, especially to the hardest-hit states. The stockpile is not inexhaustible, but it can buy some time. Donald Trump could use that time to invoke the Defense Production Act, launching a wartime effort in which American manufacturers switch to making medical equipment. But after invoking the act last Wednesday, Trump has failed to actually use it, reportedly due to lobbying from the U.S. Chamber of Commerce and heads of major corporations.

Some manufacturers are already rising to the challenge, but their efforts are piecemeal and unevenly distributed. One day, well wake up to a story of doctors in City X who are operating with bandanas, and a closet in City Y with masks piled into it, says Ali Khan, the dean of public health at the University of Nebraska Medical Center. A massive logistics and supply-chain operation [is] now needed across the country, says Thomas Inglesby of Johns Hopkins Bloomberg School of Public Health. That cant be managed by small and inexperienced teams scattered throughout the White House. The solution, he says, is to tag in the Defense Logistics Agencya 26,000-person group that prepares the U.S. military for overseas operations and that has assisted in past public-health crises, including the 2014 Ebola outbreak.

This agency can also coordinate the second pressing need: a massive rollout of COVID-19 tests. Those tests have been slow to arrive because of five separate shortages: of masks to protect people administering the tests; of nasopharyngeal swabs for collecting viral samples; of extraction kits for pulling the viruss genetic material out of the samples; of chemical reagents that are part of those kits; and of trained people who can give the tests. Many of these shortages are, again, due to strained supply chains. The U.S. relies on three manufacturers for extraction reagents, providing redundancy in case any of them failsbut all of them failed in the face of unprecedented global demand. Meanwhile, Lombardy, Italy, the hardest-hit place in Europe, houses one of the largest manufacturers of nasopharyngeal swabs.

Read: Why the coronavirus has been so successful

Some shortages are being addressed. The FDA is now moving quickly to approve tests developed by private labs. At least one can deliver results in less than an hour, potentially allowing doctors to know if the patient in front of them has COVID-19. The country is adding capacity on a daily basis, says Kelly Wroblewski of the Association of Public Health Laboratories.

On March 6, Trump said that anyone who wants a test can get a test. That was (and still is) untrue, and his own officials were quick to correct him. Regardless, anxious people still flooded into hospitals, seeking tests that did not exist. People wanted to be tested even if they werent symptomatic, or if they sat next to someone with a cough, says Saskia Popescu of George Mason University, who works to prepare hospitals for pandemics. Others just had colds, but doctors still had to use masks to examine them, burning through their already dwindling supplies. It really stressed the health-care system, Popescu says. Even now, as capacity expands, tests must be used carefully. The first priority, says Marc Lipsitch of Harvard, is to test health-care workers and hospitalized patients, allowing hospitals to quell any ongoing fires. Only later, once the immediate crisis is slowing, should tests be deployed in a more widespread way. This isnt just going to be: Lets get the tests out there! Inglesby says.

These measures will take time, during which the pandemic will either accelerate beyond the capacity of the health system or slow to containable levels. Its courseand the nations fatenow depends on the third need, which is social distancing. Think of it this way: There are now only two groups of Americans. Group A includes everyone involved in the medical response, whether thats treating patients, running tests, or manufacturing supplies. Group B includes everyone else, and their job is to buy Group A more time. Group B must now flatten the curve by physically isolating themselves from other people to cut off chains of transmission. Given the slow fuse of COVID-19, to forestall the future collapse of the health-care system, these seemingly drastic steps must be taken immediately, before they feel proportionate, and they must continue for several weeks.

Juliette Kayyem: The crisis could last 18 months. Be prepared.

Persuading a country to voluntarily stay at home is not easy, and without clear guidelines from the White House, mayors, governors, and business owners have been forced to take their own steps. Some states have banned large gatherings or closed schools and restaurants. At least 21 have now instituted some form of mandatory quarantine, compelling people to stay at home. And yet many citizens continue to crowd into public spaces.

In these moments, when the good of all hinges on the sacrifices of many, clear coordination mattersthe fourth urgent need. The importance of social distancing must be impressed upon a public who must also be reassured and informed. Instead, Trump has repeatedly played down the problem, telling America that we have it very well under control when we do not, and that cases were going to be down to close to zero when they were rising. In some cases, as with his claims about ubiquitous testing, his misleading gaffes have deepened the crisis. He has even touted unproven medications.

Away from the White House press room, Trump has apparently been listening to Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases. Fauci has advised every president since Ronald Reagan on new epidemics, and now sits on the COVID-19 task force that meets with Trump roughly every other day. Hes got his own style, lets leave it at that, Fauci told me, but any kind of recommendation that I have made thus far, the substance of it, he has listened to everything.

Read: Grocery stores are the coronavirus tipping point

But Trump already seems to be wavering. In recent days, he has signaled that he is prepared to backtrack on social-distancing policies in a bid to protect the economy. Pundits and business leaders have used similar rhetoric, arguing that high-risk people, such as the elderly, could be protected while lower-risk people are allowed to go back to work. Such thinking is seductive, but flawed. It overestimates our ability to assess a persons risk, and to somehow wall off the high-risk people from the rest of society. It underestimates how badly the virus can hit low-risk groups, and how thoroughly hospitals will be overwhelmed if even just younger demographics are falling sick.

A recent analysis from the University of Pennsylvania estimated that even if social-distancing measures can reduce infection rates by 95 percent, 960,000 Americans will still need intensive care. There are only about 180,000 ventilators in the U.S. and, more pertinently, only enough respiratory therapists and critical-care staff to safely look after 100,000 ventilated patients. Abandoning social distancing would be foolish. Abandoning it now, when tests and protective equipment are still scarce, would be catastrophic.

Read: Americas hospitals have never experienced anything like this

If Trump stays the course, if Americans adhere to social distancing, if testing can be rolled out, and if enough masks can be produced, there is a chance that the country can still avert the worst predictions about COVID-19, and at least temporarily bring the pandemic under control. No one knows how long that will take, but it wont be quick. It could be anywhere from four to six weeks to up to three months, Fauci said, but I dont have great confidence in that range.

Even a perfect response wont end the pandemic. As long as the virus persists somewhere, theres a chance that one infected traveler will reignite fresh sparks in countries that have already extinguished their fires. This is already happening in China, Singapore, and other Asian countries that briefly seemed to have the virus under control. Under these conditions, there are three possible endgames: one thats very unlikely, one thats very dangerous, and one thats very long.

The first is that every nation manages to simultaneously bring the virus to heel, as with the original SARS in 2003. Given how widespread the coronavirus pandemic is, and how badly many countries are faring, the odds of worldwide synchronous control seem vanishingly small.

The second is that the virus does what past flu pandemics have done: It burns through the world and leaves behind enough immune survivors that it eventually struggles to find viable hosts. This herd immunity scenario would be quick, and thus tempting. But it would also come at a terrible cost: SARS-CoV-2 is more transmissible and fatal than the flu, and it would likely leave behind many millions of corpses and a trail of devastated health systems. The United Kingdom initially seemed to consider this herd-immunity strategy, before backtracking when models revealed the dire consequences. The U.S. now seems to be considering it too.

Read: What will you do if you start coughing?

The third scenario is that the world plays a protracted game of whack-a-mole with the virus, stamping out outbreaks here and there until a vaccine can be produced. This is the best option, but also the longest and most complicated.

It depends, for a start, on making a vaccine. If this were a flu pandemic, that would be easier. The world is experienced at making flu vaccines and does so every year. But there are no existing vaccines for coronavirusesuntil now, these viruses seemed to cause diseases that were mild or rareso researchers must start from scratch. The first steps have been impressively quick. Last Monday, a possible vaccine created by Moderna and the National Institutes of Health went into early clinical testing. That marks a 63-day gap between scientists sequencing the viruss genes for the first time and doctors injecting a vaccine candidate into a persons arm. Its overwhelmingly the world record, Fauci said.

But its also the fastest step among many subsequent slow ones. The initial trial will simply tell researchers if the vaccine seems safe, and if it can actually mobilize the immune system. Researchers will then need to check that it actually prevents infection from SARS-CoV-2. Theyll need to do animal tests and large-scale trials to ensure that the vaccine doesnt cause severe side effects. Theyll need to work out what dose is required, how many shots people need, if the vaccine works in elderly people, and if it requires other chemicals to boost its effectiveness.

Even if it works, they dont have an easy way to manufacture it at a massive scale, said Seth Berkley of Gavi. Thats because Moderna is using a new approach to vaccination. Existing vaccines work by providing the body with inactivated or fragmented viruses, allowing the immune system to prep its defenses ahead of time. By contrast, Modernas vaccine comprises a sliver of SARS-CoV-2s genetic materialits RNA. The idea is that the body can use this sliver to build its own viral fragments, which would then form the basis of the immune systems preparations. This approach works in animals, but is unproven in humans. By contrast, French scientists are trying to modify the existing measles vaccine using fragments of the new coronavirus. The advantage of that is that if we needed hundreds of doses tomorrow, a lot of plants in the world know how to do it, Berkley said. No matter which strategy is faster, Berkley and others estimate that it will take 12 to 18 months to develop a proven vaccine, and then longer still to make it, ship it, and inject it into peoples arms.

Read: COVID-19 vaccines are coming, but theyre not what you think

Its likely, then, that the new coronavirus will be a lingering part of American life for at least a year, if not much longer. If the current round of social-distancing measures works, the pandemic may ebb enough for things to return to a semblance of normalcy. Offices could fill and bars could bustle. Schools could reopen and friends could reunite. But as the status quo returns, so too will the virus. This doesnt mean that society must be on continuous lockdown until 2022. But we need to be prepared to do multiple periods of social distancing, says Stephen Kissler of Harvard.

Much about the coming years, including the frequency, duration, and timing of social upheavals, depends on two properties of the virus, both of which are currently unknown. First: seasonality. Coronaviruses tend to be winter infections that wane or disappear in the summer. That may also be true for SARS-CoV-2, but seasonal variations might not sufficiently slow the virus when it has so many immunologically naive hosts to infect. Much of the world is waiting anxiously to see whatif anythingthe summer does to transmission in the Northern Hemisphere, says Maia Majumder of Harvard Medical School and Boston Childrens Hospital.

Second: duration of immunity. When people are infected by the milder human coronaviruses that cause cold-like symptoms, they remain immune for less than a year. By contrast, the few who were infected by the original SARS virus, which was far more severe, stayed immune for much longer. Assuming that SARS-CoV-2 lies somewhere in the middle, people who recover from their encounters might be protected for a couple of years. To confirm that, scientists will need to develop accurate serological tests, which look for the antibodies that confer immunity. Theyll also need to confirm that such antibodies actually stop people from catching or spreading the virus. If so, immune citizens can return to work, care for the vulnerable, and anchor the economy during bouts of social distancing.

Scientists can use the periods between those bouts to develop antiviral drugsalthough such drugs are rarely panaceas, and come with possible side effects and the risk of resistance. Hospitals can stockpile the necessary supplies. Testing kits can be widely distributed to catch the viruss return as quickly as possible. Theres no reason that the U.S. should let SARS-CoV-2 catch it unawares again, and thus no reason that social-distancing measures need to be deployed as broadly and heavy-handedly as they now must be. As Aaron E. Carroll and Ashish Jha recently wrote, We can keep schools and businesses open as much as possible, closing them quickly when suppression fails, then opening them back up again once the infected are identified and isolated. Instead of playing defense, we could play more offense.

Whether through accumulating herd immunity or the long-awaited arrival of a vaccine, the virus will find spreading explosively more and more difficult. Its unlikely to disappear entirely. The vaccine may need to be updated as the virus changes, and people may need to get revaccinated on a regular basis, as they currently do for the flu. Models suggest that the virus might simmer around the world, triggering epidemics every few years or so. But my hope and expectation is that the severity would decline, and there would be less societal upheaval, Kissler says. In this future, COVID-19 may become like the flu is todaya recurring scourge of winter. Perhaps it will eventually become so mundane that even though a vaccine exists, large swaths of Gen C wont bother getting it, forgetting how dramatically their world was molded by its absence.

The cost of reaching that point, with as few deaths as possible, will be enormous. As my colleague Annie Lowrey wrote, the economy is experiencing a shock more sudden and severe than anyone alive has ever experienced. About one in five people in the United States have lost working hours or jobs. Hotels are empty. Airlines are grounding flights. Restaurants and other small businesses are closing. Inequalities will widen: People with low incomes will be hardest-hit by social-distancing measures, and most likely to have the chronic health conditions that increase their risk of severe infections. Diseases have destabilized cities and societies many times over, but it hasnt happened in this country in a very long time, or to quite the extent that were seeing now, says Elena Conis, a historian of medicine at UC Berkeley. Were far more urban and metropolitan. We have more people traveling great distances and living far from family and work.

After infections begin ebbing, a secondary pandemic of mental-health problems will follow. At a moment of profound dread and uncertainty, people are being cut off from soothing human contact. Hugs, handshakes, and other social rituals are now tinged with danger. People with anxiety or obsessive-compulsive disorder are struggling. Elderly people, who are already excluded from much of public life, are being asked to distance themselves even further, deepening their loneliness. Asian people are suffering racist insults, fueled by a president who insists on labeling the new coronavirus the Chinese virus. Incidents of domestic violence and child abuse are likely to spike as people are forced to stay in unsafe homes. Children, whose bodies are mostly spared by the virus, may endure mental trauma that stays with them into adulthood.

Read: The kids arent all right

After the pandemic, people who recover from COVID-19 might be shunned and stigmatized, as were survivors of Ebola, SARS, and HIV. Health-care workers will take time to heal: One to two years after SARS hit Toronto, people who dealt with the outbreak were still less productive and more likely to be experiencing burnout and post-traumatic stress. People who went through long bouts of quarantine will carry the scars of their experience. My colleagues in Wuhan note that some people there now refuse to leave their homes and have developed agoraphobia, says Steven Taylor of the University of British Columbia, who wrote The Psychology of Pandemics.

But there is also the potential for a much better world after we get through this trauma, says Richard Danzig of the Center for a New American Security. Already, communities are finding new ways of coming together, even as they must stay apart. Attitudes to health may also change for the better. The rise of HIV and AIDS completely changed sexual behavior among young people who were coming into sexual maturity at the height of the epidemic, Conis says. The use of condoms became normalized. Testing for STDs became mainstream. Similarly, washing your hands for 20 seconds, a habit that has historically been hard to enshrine even in hospitals, may be one of those behaviors that we become so accustomed to in the course of this outbreak that we dont think about them, Conis adds.

Pandemics can also catalyze social change. People, businesses, and institutions have been remarkably quick to adopt or call for practices that they might once have dragged their heels on, including working from home, conference-calling to accommodate people with disabilities, proper sick leave, and flexible child-care arrangements. This is the first time in my lifetime that Ive heard someone say, Oh, if youre sick, stay home, says Adia Benton, an anthropologist at Northwestern University. Perhaps the nation will learn that preparedness isnt just about masks, vaccines, and tests, but also about fair labor policies and a stable and equal health-care system. Perhaps it will appreciate that health-care workers and public-health specialists compose Americas social immune system, and that this system has been suppressed.

Aspects of Americas identity may need rethinking after COVID-19. Many of the countrys values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs. Having internalized years of anti-terrorism messaging following 9/11, Americans resolved to not live in fear. But SARS-CoV-2 has no interest in their terror, only their cells.

Years of isolationist rhetoric had consequences too. Citizens who saw China as a distant, different place, where bats are edible and authoritarianism is acceptable, failed to consider that they would be next or that they wouldnt be ready. (Chinas response to this crisis had its own problems, but thats for another time.) People believed the rhetoric that containment would work, says Wendy Parmet, who studies law and public health at Northeastern University. We keep them out, and well be okay. When you have a body politic that buys into these ideas of isolationism and ethnonationalism, youre especially vulnerable when a pandemic hits.

Graeme Wood: The Chinese virus is a test. Dont fail it.

Veterans of past epidemics have long warned that American society is trapped in a cycle of panic and neglect. After every crisisanthrax, SARS, flu, Ebolaattention is paid and investments are made. But after short periods of peacetime, memories fade and budgets dwindle. This trend transcends red and blue administrations. When a new normal sets in, the abnormal once again becomes unimaginable. But there is reason to think that COVID-19 might be a disaster that leads to more radical and lasting change.

The other major epidemics of recent decades either barely affected the U.S. (SARS, MERS, Ebola), were milder than expected (H1N1 flu in 2009), or were mostly limited to specific groups of people (Zika, HIV). The COVID-19 pandemic, by contrast, is affecting everyone directly, changing the nature of their everyday life. That distinguishes it not only from other diseases, but also from the other systemic challenges of our time. When an administration prevaricates on climate change, the effects wont be felt for years, and even then will be hard to parse. Its different when a president says that everyone can get a test, and one day later, everyone cannot. Pandemics are democratizing experiences. People whose privilege and power would normally shield them from a crisis are facing quarantines, testing positive, and losing loved ones. Senators are falling sick. The consequences of defunding public-health agencies, losing expertise, and stretching hospitals are no longer manifesting as angry opinion pieces, but as faltering lungs.

After 9/11, the world focused on counterterrorism. After COVID-19, attention may shift to public health. Expect to see a spike in funding for virology and vaccinology, a surge in students applying to public-health programs, and more domestic production of medical supplies. Expect pandemics to top the agenda at the United Nations General Assembly. Anthony Fauci is now a household name. Regular people who think easily about what a policewoman or firefighter does finally get what an epidemiologist does, says Monica Schoch-Spana, a medical anthropologist at the Johns Hopkins Center for Health Security.

Such changes, in themselves, might protect the world from the next inevitable disease. The countries that had lived through SARS had a public consciousness about this that allowed them to leap into action, said Ron Klain, the former Ebola czar. The most commonly uttered sentence in America at the moment is, Ive never seen something like this before. That wasnt a sentence anyone in Hong Kong uttered. For the U.S., and for the world, its abundantly, viscerally clear what a pandemic can do.

The lessons that America draws from this experience are hard to predict, especially at a time when online algorithms and partisan broadcasters only serve news that aligns with their audiences preconceptions. Such dynamics will be pivotal in the coming months, says Ilan Goldenberg, a foreign-policy expert at the Center for a New American Security. The transitions after World War II or 9/11 were not about a bunch of new ideas, he says. The ideas are out there, but the debates will be more acute over the next few months because of the fluidity of the moment and willingness of the American public to accept big, massive changes.

One could easily conceive of a world in which most of the nation believes that America defeated COVID-19. Despite his many lapses, Trumps approval rating has surged. Imagine that he succeeds in diverting blame for the crisis to China, casting it as the villain and America as the resilient hero. During the second term of his presidency, the U.S. turns further inward and pulls out of NATO and other international alliances, builds actual and figurative walls, and disinvests in other nations. As Gen C grows up, foreign plagues replace communists and terrorists as the new generational threat.

One could also envisage a future in which America learns a different lesson. A communal spirit, ironically born through social distancing, causes people to turn outward, to neighbors both foreign and domestic. The election of November 2020 becomes a repudiation of America first politics. The nation pivots, as it did after World War II, from isolationism to international cooperation. Buoyed by steady investments and an influx of the brightest minds, the health-care workforce surges. Gen C kids write school essays about growing up to be epidemiologists. Public health becomes the centerpiece of foreign policy. The U.S. leads a new global partnership focused on solving challenges like pandemics and climate change.

In 2030, SARS-CoV-3 emerges from nowhere, and is brought to heel within a month.

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How the Pandemic Will End - The Atlantic

You can’t kill coronavirus. That’s OK. – Mashable

Some viruses look like moon landers.

Called phages, they hijack bacteria by landing on the hapless cells and injecting them with a ream of genetic material. Then, the phages use the commandeered cells to multiply.

Similar to the new coronavirus, these phages are excellent parasites. They can be aggressive, dogged, and seem to act with purpose. Yet, many microbiologists who know viruses best say it's a stretch to call any virus truly alive. And so, they can't be killed only disarmed, like pulling the plug on an appliance.

But today, with a rapidly spreading viral pandemic that's stirring serious unease in American emergency rooms, it doesn't really matter if a virus meets biologists' definitions of dead or alive. Whatever these entities are, they're powerful.

"It's more of a philosophical question," said Ryan Relich, a medical microbiologist at Indiana University's School of Medicine, of whether viruses are alive or not.

"What's more important is that they're winning," he said.

Today, the coronavirus isn't just winning. It's dominating us. It's closed our arenas. Shut down our bars. Emptied California beaches. The increasingly austere governor of New York is now demanding ventilators from the federal government. Our best, and most critical, defense until a vaccine is developed in a year at the earliest is social distancing: We're avoiding infected persons and hiding from the microbes themselves, which are basically genes surrounded by a shell.

Viruses, like coronavirus, have become globally dominant because they evolved to become master replicators. But they can't multiply alone, so they take over other cells and exploit this cellular machinery to multiply. It's exquisite parasitism. A single coronavirus-infected cell can manufacture millions of coronaviruses.

"Parasitism is an old, venerated way of making a living," said Siobain Duffy, who researches the evolution of viruses at Rutgers University.

A colorized image of a cell (brown) from a patient infected with coronavirus (pink).

Yet, unlike parasites such as intestinal worms, viruses are almost completely dependent upon the cells they hijack. "Viruses don't actually do anything on their own," explained Relich.

They don't breathe. They don't eat. They don't make energy. They appear mindless, floating around with the possibility of landing on a cell. "They don't get up and go to work every day," said Relich. "I dont consider them to be living. But hey, maybe you want to consider them to be alive so that its easier to personify them or rationalize things in a more palatable way."

So, microbiologists can make a good argument that viruses don't have the same hallmarks of living as do amoebas, elephants, and emus.

But maybe viruses are alive just in another sense of alive. After all, life has been evolving on Earth for some 3.8 billion years, noted Duffy. There are all kinds of curious things out there that might blur the boundary between alive and not alive. For example, there are viruses with longer genomes than bacteria (which we all agree are alive), and viruses that make some bacteria better at things, like photosynthesis. Our human DNA is embedded with some viral genetic material, too, noted Relich.

"Life continues to astound us."

"People want a clear dividing line between life and non-life," said Duffy. But that line might be blurrier than we think, she added.

The quandary of whether a virus can ever be killed, then, is a bottomless philosophical hole that may never have a certain answer. But it's safe to say, at least, that there are effective ways "to inactivate viruses or otherwise render them kaput," said Relich.

Chemicals like bleach and rubbing alcohols can massively damage the exterior wrappings of viruses, which for some include a fatty membrane envelope, making viruses useless. Thorough hand washing destroys these viral shells, too. Though there are no proven antiviral medications for coronavirus (and there may not be for many months), these types of drugs are designed to disrupt a virus' activity. For instance, the HIV drug Enfuvirtide blocks the virus from even attaching to human cells. Other drugs stop viruses from replicating, once they've already slipped inside a cell.

There's another very certain thing about viruses. Humanity has a ton to learn about them. There are countless species, and they're everywhere. "There are more viruses in this world than there are cells," said Duffy. But only 6,828 virus species have been formally named by scientists. Meanwhile, there could be millions more species out there. Finding and understanding theses microscopic entities could reveal much more about their nature, and "lives."

"We need more research, we need more researchers, we need more funding for research," said Relich.

Only in 1977 did humanity discover the third domain of life, a massive, ancient group of organisms called archaea (the other two domains are bacteria and eukaryotes which include humans.) What might the great diversity of viruses in this domain, still being discovered, tell us?

"Life continues to astound us," said Duffy. Indeed.

For now, we're focused on the minority of viruses that can threaten our ability to breathe, like the new coronavirus which can result in the serious respiratory disease COVID-19. And for good reason.

"It's to our own advantage to know our enemies as well as possible," said Relich.

Even if they can't be killed.

"Whether or not theyre alive, viruses influence life," said Duffy.

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You can't kill coronavirus. That's OK. - Mashable

10 Groundbreaking Medical Discoveries Made in NYC – Untapped New York – Untapped New York

In a time when New Yorks hospitals and research institutions are under significant pressure to treat sick patients and discover new vaccines and solutions to the coronavirus crisis, it is worth applauding the groundbreaking medical discoveries made in New York City that changed modern medicine forever. From detecting cervical cancer to identifying cystic fibrosis to showing that DNA serves as genetic material, New York City has paved the way for future research which saves the lives of thousands of people yearly.

Perhaps the vaccine for coronavirus will be discovered here. Multiple drug trials are underway in New York, the hardest hit state including using antibody injections and combinations of existing drugs, tests to identify those with antibodies, andwork is ongoing on a serological drug. Special thanks to the New York Academy of Medicine for their help with this article!

Former tuberculosis pavilion in Seaview Hospital

Seaview Hospital was once the largest tuberculosis sanatorium in the country, now listed on the U.S. National Register of Historic Places and is also a U.S. Historic District and New York City landmark. Opened in 1913, the hospital was designed by Raymond F. Allmiral reflecting the latest in thought about the treatment of tuberculosis, including light, cross-ventilation, access to the outdoors, and thought towards medical operational efficiency. At the time, fresh air, rest and a nutritious diet were the only prescribed treatments. At its opening,The New York Timesdeclared Seaview the largest and finest hospital ever built for the care and treatment of those who suffer from tuberculosis in any form.

Sea View hospital was the site of the first clinical trials for hydrazides treatments, which ultimately led to the discovery of the cure of the disease in 1957. The tuberculosis hospital gradually ceased operations in the late 1950s after the cure was discovered, and currently functions as a long term care facility.

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10 Groundbreaking Medical Discoveries Made in NYC - Untapped New York - Untapped New York

Coronavirus vaccine: when will it be ready? – The Guardian

Even at their most effective and draconian containment strategies have only slowed the spread of the respiratory disease Covid-19. With the World Health Organization finally declaring a pandemic, all eyes have turned to the prospect of a vaccine, because only a vaccine can prevent people from getting sick.

About 35 companies and academic institutions are racing to create such a vaccine, at least four of which already have candidates they have been testing in animals. The first of these produced by Boston-based biotech firm Moderna will enter human trials imminently.

This unprecedented speed is thanks in large part to early Chinese efforts to sequence the genetic material of Sars-CoV-2, the virus that causes Covid-19. China shared that sequence in early January, allowing research groups around the world to grow the live virus and study how it invades human cells and makes people sick.

But there is another reason for the head start. Though nobody could have predicted that the next infectious disease to threaten the globe would be caused by a coronavirus flu is generally considered to pose the greatest pandemic risk vaccinologists had hedged their bets by working on prototype pathogens. The speed with which we have [produced these candidates] builds very much on the investment in understanding how to develop vaccines for other coronaviruses, says Richard Hatchett, CEO of the Oslo-based nonprofit the Coalition for Epidemic Preparedness Innovations (Cepi), which is leading efforts to finance and coordinate Covid-19 vaccine development.

Coronaviruses have caused two other recent epidemics severe acute respiratory syndrome (Sars) in China in 2002-04, and Middle East respiratory syndrome (Mers), which started in Saudi Arabia in 2012. In both cases, work began on vaccines that were later shelved when the outbreaks were contained. One company, Maryland-based Novavax, has now repurposed those vaccines for Sars-CoV-2, and says it has several candidates ready to enter human trials this spring. Moderna, meanwhile, built on earlier work on the Mers virus conducted at the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland.

Sars-CoV-2 shares between 80% and 90% of its genetic material with the virus that caused Sars hence its name. Both consist of a strip of ribonucleic acid (RNA) inside a spherical protein capsule that is covered in spikes. The spikes lock on to receptors on the surface of cells lining the human lung the same type of receptor in both cases allowing the virus to break into the cell. Once inside, it hijacks the cells reproductive machinery to produce more copies of itself, before breaking out of the cell again and killing it in the process.

All vaccines work according to the same basic principle. They present part or all of the pathogen to the human immune system, usually in the form of an injection and at a low dose, to prompt the system to produce antibodies to the pathogen. Antibodies are a kind of immune memory which, having been elicited once, can be quickly mobilised again if the person is exposed to the virus in its natural form.

Traditionally, immunisation has been achieved using live, weakened forms of the virus, or part or whole of the virus once it has been inactivated by heat or chemicals. These methods have drawbacks. The live form can continue to evolve in the host, for example, potentially recapturing some of its virulence and making the recipient sick, while higher or repeat doses of the inactivated virus are required to achieve the necessary degree of protection. Some of the Covid-19 vaccine projects are using these tried-and-tested approaches, but others are using newer technology. One more recent strategy the one that Novavax is using, for example constructs a recombinant vaccine. This involves extracting the genetic code for the protein spike on the surface of Sars-CoV-2, which is the part of the virus most likely to provoke an immune reaction in humans, and pasting it into the genome of a bacterium or yeast forcing these microorganisms to churn out large quantities of the protein. Other approaches, even newer, bypass the protein and build vaccines from the genetic instruction itself. This is the case for Moderna and another Boston company, CureVac, both of which are building Covid-19 vaccines out of messenger RNA.

Cepis original portfolio of four funded Covid-19 vaccine projects was heavily skewed towards these more innovative technologies, and last week it announced $4.4m (3.4m) of partnership funding with Novavax and with a University of Oxford vectored vaccine project. Our experience with vaccine development is that you cant anticipate where youre going to stumble, says Hatchett, meaning that diversity is key. And the stage where any approach is most likely to stumble is clinical or human trials, which, for some of the candidates, are about to get under way.

Clinical trials, an essential precursor to regulatory approval, usually take place in three phases. The first, involving a few dozen healthy volunteers, tests the vaccine for safety, monitoring for adverse effects. The second, involving several hundred people, usually in a part of the world affected by the disease, looks at how effective the vaccine is, and the third does the same in several thousand people. But theres a high level of attrition as experimental vaccines pass through these phases. Not all horses that leave the starting gate will finish the race, says Bruce Gellin, who runs the global immunisation programme for the Washington DC-based nonprofit, the Sabin Vaccine Institute.

There are good reasons for that. Either the candidates are unsafe, or theyre ineffective, or both. Screening out duds is essential, which is why clinical trials cant be skipped or hurried. Approval can be accelerated if regulators have approved similar products before. The annual flu vaccine, for example, is the product of a well-honed assembly line in which only one or a few modules have to be updated each year. In contrast, Sars-CoV-2 is a novel pathogen in humans, and many of the technologies being used to build vaccines are relatively untested too. No vaccine made from genetic material RNA or DNA has been approved to date, for example. So the Covid-19 vaccine candidates have to be treated as brand new vaccines, and as Gellin says: While there is a push to do things as fast as possible, its really important not to take shortcuts.

An illustration of that is a vaccine that was produced in the 1960s against respiratory syncytial virus, a common virus that causes cold-like symptoms in children. In clinical trials, this vaccine was found to aggravate those symptoms in infants who went on to catch the virus. A similar effect was observed in animals given an early experimental Sars vaccine. It was later modified to eliminate that problem but, now that it has been repurposed for Sars-CoV-2, it will need to be put through especially stringent safety testing to rule out the risk of enhanced disease.

Its for these reasons that taking a vaccine candidate all the way to regulatory approval typically takes a decade or more, and why President Trump sowed confusion when, at a meeting at the White House on 2 March, he pressed for a vaccine to be ready by the US elections in November an impossible deadline. Like most vaccinologists, I dont think this vaccine will be ready before 18 months, says Annelies Wilder-Smith, professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine. Thats already extremely fast, and it assumes there will be no hitches.

In the meantime, there is another potential problem. As soon as a vaccine is approved, its going to be needed in vast quantities and many of the organisations in the Covid-19 vaccine race simply dont have the necessary production capacity. Vaccine development is already a risky affair, in business terms, because so few candidates get anywhere near the clinic. Production facilities tend to be tailored to specific vaccines, and scaling these up when you dont yet know if your product will succeed is not commercially feasible. Cepi and similar organisations exist to shoulder some of the risk, keeping companies incentivised to develop much-needed vaccines. Cepi plans to invest in developing a Covid-19 vaccine and boosting manufacturing capacity in parallel, and earlier this month it put out a call for $2bn to allow it to do so.

Once a Covid-19 vaccine has been approved, a further set of challenges will present itself. Getting a vaccine thats proven to be safe and effective in humans takes one at best about a third of the way to whats needed for a global immunisation programme, says global health expert Jonathan Quick of Duke University in North Carolina, author of The End of Epidemics (2018). Virus biology and vaccines technology could be the limiting factors, but politics and economics are far more likely to be the barrier to immunisation.

The problem is making sure the vaccine gets to all those who need it. This is a challenge even within countries, and some have worked out guidelines. In the scenario of a flu pandemic, for example, the UK would prioritise vaccinating healthcare and social care workers, along with those considered at highest medical risk including children and pregnant women with the overall goal of keeping sickness and death rates as low as possible. But in a pandemic, countries also have to compete with each other for medicines.

Because pandemics tend to hit hardest those countries that have the most fragile and underfunded healthcare systems, there is an inherent imbalance between need and purchasing power when it comes to vaccines. During the 2009 H1N1 flu pandemic, for example, vaccine supplies were snapped up by nations that could afford them, leaving poorer ones short. But you could also imagine a scenario where, say, India a major supplier of vaccines to the developing world not unreasonably decides to use its vaccine production to protect its own 1.3 billion-strong population first, before exporting any.

Outside of pandemics, the WHO brings governments, charitable foundations and vaccine-makers together to agree an equitable global distribution strategy, and organisations like Gavi, the vaccine alliance, have come up with innovative funding mechanisms to raise money on the markets for ensuring supply to poorer countries. But each pandemic is different, and no country is bound by any arrangement the WHO proposes leaving many unknowns. As Seth Berkley, CEO of Gavi, points out: The question is, what will happen in a situation where youve got national emergencies going on?

This is being debated, but it will be a while before we see how it plays out. The pandemic, says Wilder-Smith, will probably have peaked and declined before a vaccine is available. A vaccine could still save many lives, especially if the virus becomes endemic or perennially circulating like flu and there are further, possibly seasonal, outbreaks. But until then, our best hope is to contain the disease as far as possible. To repeat the sage advice: wash your hands.

This article was amended on 19 March 2020. An earlier version incorrectly stated that the Sabin Vaccine Institute was collaborating with the Coalition for Epidemic Preparedness Innovations (Cepi) on a Covid-19 vaccine.

Link:

Coronavirus vaccine: when will it be ready? - The Guardian

Twelve Women Who Have Shaped The History of the BioHealth Capital Region – BioBuzz

The BioHealth Capital Region (BHCR) and its life science ecosystem have a rich and deep history of pioneering scientific innovation, research, development, and commercialization. The regions history has been written by life science anchor companies, scientific research universities, government research organizations, rich startup culture, and serial entrepreneurs, all of whom have played critical roles in transforming the BHCR into one of the most innovative and productive biocluster in the world.

Contributions to the BHCRs legacy of life science achievement have emerged from all staffing levels, various labs, countless executive teams, numerous entrepreneurs and biohub support organizations. Contributions have arisen from an intricate tapestry of backgrounds and cultures.

Women, in particular, have had a strong hand in shaping the history of the BHCR. In celebration of Womens History Month, were taking a closer look at the achievements of female life science leaders that have laid the groundwork for the next generation of women trailblazers in the BHCR and made the region what it is today.

Dr. Fraser is one of the most influential figures in BHCR history. In 1995, she was the first to map the complete genetic code of a free-living organism while at the Institute for Genomic Research (TIGR) in Rockville, Maryland. It was there that the automation of the DNA sequencing process made the idea of large-scale sequencing efforts tangible. As President and Director of TIGR, Fraser and her team gained worldwide public notoriety for its involvement in the Human Genome Project, which was completed in 2000 with the presentation of a working draft of the fully sequenced human genome.

As a leader, Fraser provided her researchers with the infrastructure to collaborate and apply multi-disciplinary team science and empowered them to think big. She is also most importantly known for how she challenged her team to ask the right questions, which is the root of scientific progress and success.

Her work at TIGR and as part of the Human Genome Project are foundational events in the regions history, as it marked the BHCR as the epicenter of genomic research and helped spark the regions biotech boom. In fact, it was a controversial partnership with TIGR that gave Human Genome Sciences(HGSi) the first opportunity to utilize any sequences emerging from TIGR labs. The mass of genetic information and sequences, especially that associated with diseases, that HGSi acquired catapulted them into biotech history and an important anchor company within the region.

Dr. Fraser is widely viewed as a pioneer and global leader in genomic medicine; she has published approximately 320 scientific publications and edited three books; she is also one of the most widely cited microbiology experts in the world. She founded the Institute for Genome Sciences at the University of Maryland in 1997. The institute currently holds 25 percent of the funding thats been awarded by the Human Microbiome Project and has been referred to as The Big House in genetics.

Dr. Judy Britz is yet another female life science pioneer that put the BHCR on the map. While working as a research scientist at Electro-Nucleonics Inc., Dr. Britz developed one of the first licensed blood screening tests for HIV, and launching a storied career that has spanned approximately 25 years. She is also a serial entrepreneur that has successfully raised $50M in capital and served as the top executive for two highly successful Maryland-located companies.

Dr. Britz was the first woman to lead the states biotech initiative as the first announced Executive Director of the Maryland Biotech Center. The center was launched under the Maryland Department of Commerce to deploy a strategic life science economic development plan under Governor Martin OMalleys $1.3B, 2020 Vision and to be a one-stop-shop and information center to promote and support biotechnology innovation and entrepreneurship in Maryland.

Judy was the first woman to lead Marylands life sciences initiative, bringing industry experience and perspective to the states economic development activities, a focus still maintained under Governor Hogans leadership today, shared Judy Costello, Managing Director, Economic Development BioHealth Innovation, Inc., who served as Deputy Director under Dr. Britz.

Much of the work done by Dr. Britz and her team laid the foundation and seeded the commercialization efforts that have blossomed into the thriving #4 Biotech Hub that we have today.

GeneDx was founded by Dr. Bale and Dr. John Compton in 2000. The company recently celebrated its 20th anniversary. Since its founding, GeneDx has become a global leader in genomics and patient testing. Under her leadership, the Gaithersburg, Maryland company has played an important role in the history of genetic sequencing and the rise of the BHCR as a global biohealth cluster.

GeneDx was the very first company to commercially offer NGS (Next Generation Sequencing) testing in a CLIA (Clinical Laboratory Improvement Amendments) lab and has been at the leading edge of genetic sequencing and testing for two decades. The companys whole exome sequencing program and comprehensive testing capabilities are world-renowned.

Prior to launching GeneDx, Dr. Bale spent 16 years at NIH, the last nine as Head of the Genetic Studies Section in the Laboratory of Skin Biology. She has been a pioneer during her storied career, publishing over 140 papers, chapters and books in the field. Her 35-year career includes deep experience in clinical, cytogenetic, and molecular genetics research.

Prior to being named CEO and Chair of the Board of Sequella in 1999, Dr. Nacy was the Chief Science Officer and an Executive VP at EntreMed, Inc. EntreMed was one of the most influential BHCR companies in the 1990s. EntreMed, MedImmune, Human Genome Sciences and Celera Genomics all played critical roles in creating the globally recognized, top biocluster that the BHCR has become.

After earning her Ph.D. in biology/microbiology from Catholic University, Nacy did her postdoc work at the Walter Reed Army Institute of Research in the Department of Rickettsial Diseases; her postdoc performance earned a full-time position at Walter Reed that started a 17-year career at the institute. After a highly successful run, Nacy left Walter Reed to join EntreMed.

Today, Dr. Nacy leads Rockville, Marylands Sequella, a clinical-stage pharmaceutical company focused on developing better antibiotics to fight drug-resistant bacterial, fungal and parasitic infections. Sequellas pipeline of small molecule infectious disease treatments have the potential to improve the treatment and outcomes for the over 3 billion people worldwide that are impacted by increasingly drug-resistant infectious diseases.

Emmes Corporation is the largest woman-led organization in the BHCR and is headed by Dr. Lindblad, who started her career at Emmes in 1982 as a biostatistician. She has been with Emmes for nearly 40 years, ascending to become VP in 1992, Executive VP in 2006 and ultimately the companys CEO in late summer of 2013.

Dr. Lindblad has published more than 100 publications and presentations has served as a reviewer of grant and contract applications for the National Institutes of Health (NIH) and has chaired or served on Safety and Data Monitoring Committees across multiple disease areas. Emmes is a life science anchor company for the BHCR, employing more than 600 staff globally with its headquarters in Rockville, Maryland.

Under Kings leadership, GlycoMimetics (GMI), an oncology-focused biotech, went public, secured an exclusive global licensing agreement with Pfizer and was instrumental in raising significant amounts of capital for the company. She was also the first woman Chair of Biotechnology Innovation Associations (BIO, 2013-14), where she still plays an active role on BIOs Executive Committee.

A graduate of Dartmouth College and Harvard Business School, King has had a celebrated career in both biopharma and finance. Prior to becoming CEO of GMI, King served as an Executive in Residence for New Enterprise Associates (NEA), one of the leading venture capital firms in the U.S. She has also held the position of Senior Vice President of Novartis-Corporation. King joined Novartis after a remarkable ten year run with Genetic Therapy, Inc. where she was named CEO after helping Genetic Therapy navigate the organization through various growth stages, including the companys sale to Novartis. King was named the Maryland Tech Councils Executive of the Year in 2013, the Top 10 Women in Biotech by FierceBio and has served on multiple boards across her career.

Dr. Connolly has had a pioneering career in the life sciences. She was the very first woman to graduate from Johns Hopkins Universitys Biomedical Engineering Doctoral Program in 1980. She was also a member of the first female undergraduate class entering Stevens Institute of Technology in 1971.

For decades, Dr. Connolly tirelessly worked to build up what is now known as the BHCR. In 1997, shortly before the region gained wider recognition as a biotech hub, she was the first person to be designated the state of Marylands biotechnology representative. Dr. Connollys career has spanned academia, government, and industry, including co-founding a startup and working as the Business Development Director for EntreMed, Inc., an original BHCR anchor company. She is the former Director of Maryland Industrial Partnerships Program (MIPS) and was inducted into the College of Fellows by the American Institute for Medical and Biological Engineering (AIMBE) in 2013.

Dr. Kirschstein played an enormous role in shaping the BHCR as NIH Deputy Director from 1993 to 1999 during the regions early formative years. She also served as Acting Director of NIH in 1993 and from 2000 to 2002. A pathologist by training, she received her medical degree from Tulane University in 1951 and went on to a long, successful career at the Division of Biologics Standards that lasted from 1957 to 1972.

While at the Division of Biologics Standards, Dr. Kirschstein played an important role in testing the safety of viral vaccines and helped select the Sabin polio vaccine for public use. She eventually ascended to Deputy Director of the group in 1972 and was later appointed the Deputy Associate Commissioner for Science at the FDA. In 1974 she became the Director of the National Institute of Medical Sciences at NIH and served in that role for 19 years.

Her awards and accolades are too numerous to list, but one notable honor came in 2000 when she received the Albert B. Sabin Heroes of Science Award from the Americans for Medical Progress Education Foundation.

Lastly, we want to recognize four additional women for their contributions to launching an organization that has impacted thousands of women by promoting careers, leadership, and entrepreneurship for women in the life sciences Women In Bio.

Women In Bio (WIB), one of the most important and influential support organizations for women in the life sciences, was founded in 2002 to help women entrepreneurs and executives in the Baltimore-Washington-Northern Virginia area build successful bioscience-related businesses. WIB started as a BHCR organization but has expanded its footprint to 13 chapters across the U.S. with 225 volunteer leaders and 2,600 members. The non-profit group has created a forum for female life science entrepreneurs and executives based on its core philosophy of women helping women.

WIB founders are Anne Mathias, a local venture capitalist and current Senior Strategist with Vanguard;

Elizabeth Gray, co-founder of Gabriel Pharma and current Partner at Willkie Farr & Gallagher LLP;

Robbie Melton, former Director of Entrepreneurial Innovation at TEDCO and current Director of Kauai County, Hawaiis Office of Economic Development;

and Cynthia W. Hu, COO, and General Counsel at CASI Pharmaceuticals.

In conclusion, we can not fairly capture the true history of life science and the BioHealth Capital Region without giving special recognition to Henrietta Lacks. In 1951 a Johns Hopkins researcher created the first immortal human cell line from cervical cancer cells taken from Lacks. That cell line, known as HeLa, is the oldest and most commonly used human cell line which was essential in developing the polio vaccine and has been used in scientific landmarks such as cloning, gene mapping and in vitro fertilization.

Though she was a black tobacco farmer from southern Virginia, her impact on science and medicine is unquestionable. She never knew that the Doctor took a piece of her tumor that would be used by scientists who had been trying to grow tissues in culture for decades without success. For some reason, that is still unknown, but her cells never died and the first immortal human cell line was born.

Thank you to all of the women who have been so influential in shaping the field of science, the industry of biotechnology and the BioHealth Capital Region.

Steve has over 20 years experience in copywriting, developing brand messaging and creating marketing strategies across a wide range of industries, including the biopharmaceutical, senior living, commercial real estate, IT and renewable energy sectors, among others. He is currently the Principal/Owner of StoryCore, a Frederick, Maryland-based content creation and execution consultancy focused on telling the unique stories of Maryland organizations.

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Twelve Women Who Have Shaped The History of the BioHealth Capital Region - BioBuzz

Alnylam Pharmaceuticals and Gen Sign Distribution Agreement in Turkey for ONPATTRO (patisiran), the First-in-Class Gene-Silencing RNAi Therapeutic -…

Alnylam Pharmaceuticals, Inc. (Nasdaq: ALNY), the leading RNAi therapeutics company, and Gen, a GMP-certified pharmaceutical company specializing in rare diseases, today announced an exclusive Distribution Agreement for ONPATTRO, a first-in-class RNAi therapeutic for the treatment of hATTR amyloidosis in adults with Stage 1 or Stage 2 polyneuropathy.

"Our partnership with Gen enables us to extend access to ONPATTRO to patients suffering from hereditary ATTR (hATTR) amyloidosis with polyneuropathy in Turkey where we currently dont have a presence," said Brendan Martin, Vice President and Acting Head of Canada, Europe, Middle East and Africa, Alnylam Pharmaceuticals. "There are a significant number of patients in Turkey who urgently need new treatment options and we are delighted to partner with Gen to bring ONPATTRO to those in need."

Abidin Glms, CEO of Gen stated: "We are proud of our reputation as one of Turkey's leading specialty pharmaceutical companies and are excited to have partnered with Alnylam. Through collaborations with leading international companies, we aim to bring innovative medicines to patients in Turkey in the fastest and most reliable way possible."

Patients in Turkey were among those who participated in the randomized, double-blind, placebo-controlled, global Phase 3 APOLLO study, the largest-ever study in hATTR amyloidosis patients with polyneuropathy, which led to the approval of ONPATTRO in the U.S. and EU in 2018.

About ONPATTRO (patisiran)

ONPATTRO is an RNAi therapeutic that was approved in the United States and Canada for the treatment of the polyneuropathy of hATTR amyloidosis in adults. ONPATTRO is also approved in the European Union, Switzerland and Brazil for the treatment of hATTR amyloidosis in adults with Stage 1 or Stage 2 polyneuropathy, and in Japan for the treatment of hATTR amyloidosis with polyneuropathy. Based on Nobel Prize-winning science, ONPATTRO is an intravenously administered RNAi therapeutic targeting transthyretin (TTR). It is designed to target and silence TTR messenger RNA, thereby blocking the production of TTR protein before it is made. ONPATTRO blocks the production of TTR in the liver, reducing its accumulation in the bodys tissues in order to halt or slow down the progression of the polyneuropathy associated with the disease. For more information about ONPATTRO, visit ONPATTRO.com.

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Important Safety Information (ISI) for ONPATTRO

Infusion-Related Reactions

Infusion-related reactions (IRRs) have been observed in patients treated with patisiran. In a controlled clinical study, 19% of patisiran-treated patients experienced IRRs, compared to 9% of placebo-treated patients. The most common symptoms of IRRs with patisiran were flushing, back pain, nausea, abdominal pain, dyspnoea, and headache. Hypotension, which may include syncope, has also been reported as a symptom of IRRs.

To reduce the risk of IRRs, patients should receive premedication with a corticosteroid, paracetamol, and antihistamines (H1 and H2 blockers) at least 60 minutes prior to patisiran infusion. Monitor patients during the infusion for signs and symptoms of IRRs. If an IRR occurs, consider slowing or interrupting the infusion and instituting medical management as clinically indicated. If the infusion is interrupted, consider resuming at a slower infusion rate only if symptoms have resolved. In the case of a serious or life-threatening IRR, the infusion should be discontinued and not resumed.

Reduced Serum Vitamin A Levels and Recommended Supplementation

Patisiran treatment leads to a decrease in serum vitamin A levels. Patients receiving patisiran should take oral supplementation of approximately 2500 IU vitamin A per day to reduce the potential risk of ocular toxicity due to vitamin A deficiency. Doses higher than 2500 IU vitamin A per day should not be given to try to achieve normal serum vitamin A levels during treatment with patisiran, as serum levels do not reflect the total vitamin A in the body. Patients should be referred to an ophthalmologist if they develop ocular symptoms suggestive of vitamin A deficiency (e.g. including reduced night vision or night blindness, persistent dry eyes, eye inflammation, corneal inflammation or ulceration, corneal thickening or corneal perforation).

Adverse Reactions

The most common adverse reactions that occurred in patients treated with patisiran were peripheral oedema (30%) and infusion-related reactions (19%).

About RNAi

RNAi (RNA interference) is a natural cellular process of gene silencing that represents one of the most promising and rapidly advancing frontiers in biology and drug development today. Its discovery has been heralded as "a major scientific breakthrough that happens once every decade or so," and was recognized with the award of the 2006 Nobel Prize for Physiology or Medicine. By harnessing the natural biological process of RNAi occurring in our cells, a new class of medicines, known as RNAi therapeutics, is now a reality. Small interfering RNA (siRNA), the molecules that mediate RNAi and comprise Alnylams RNAi therapeutic platform, function upstream of todays medicines by potently silencing messenger RNA (mRNA) the genetic precursors that encode for disease-causing proteins, thus preventing them from being made. This is a revolutionary approach with the potential to transform the care of patients with genetic and other diseases.

About Alnylam

Alnylam (Nasdaq: ALNY) is leading the translation of RNA interference (RNAi) into a whole new class of innovative medicines with the potential to transform the lives of people afflicted with rare genetic, cardio-metabolic, hepatic infectious, and central nervous system (CNS)/ocular diseases. Based on Nobel Prize-winning science, RNAi therapeutics represent a powerful, clinically validated approach for the treatment of a wide range of severe and debilitating diseases. Founded in 2002, Alnylam is delivering on a bold vision to turn scientific possibility into reality, with a robust RNAi therapeutics platform. Alnylams commercial RNAi therapeutic products are ONPATTRO (patisiran), approved in the U.S., EU, Canada, Japan, Brazil and Switzerland, and GIVLAARI (givosiran), approved in the U.S and the EU. Alnylam has a deep pipeline of investigational medicines, including five product candidates that are in late-stage development. Alnylam is executing on its "Alnylam 2020" strategy of building a multi-product, commercial-stage biopharmaceutical company with a sustainable pipeline of RNAi-based medicines to address the needs of patients who have limited or inadequate treatment options. Alnylam is headquartered in Cambridge, MA.

About Gen

Gen is the fastest growing pharmaceutical company in Turkey. Teamed up with its leading international partners and compliant with ethical and scientific principles, Gen supplies products used in treatment of rare diseases and disorders in different branches and aims to bring these products to patients in the easiest, fastest and most reliable way possible while striving to find and bring new treatments to patients with unmet medical needs. With its GMP certificated production facility based in Ankara, Gen exports its products to different countries and has offices in Ankara (HQ), stanbul, zmir, Trabzon, Azerbaijan, Kazakhstan and Russia with 400+ employees. For more information please visit the Gen website.

Alnylam Forward Looking Statements

Various statements in this release concerning future expectations, plans and prospects, including, without limitation, Alnylam's views and plans with respect to the ability to extend patient access to ONPATTRO in Turkey through the announced Distribution Agreement with Gen, and the number of patients in Turkey within the approved indication for ONPATTRO who are in need of new treatment options, Gens views and plans with respect to the speed and reliability with which it is able to bring innovative medicines to patients in Turkey, and Alnylams expectations regarding the continued execution on its "Alnylam 2020" guidance for the advancement and commercialization of RNAi therapeutics, constitute forward-looking statements for the purposes of the safe harbor provisions under The Private Securities Litigation Reform Act of 1995. Actual results and future plans may differ materially from those indicated by these forward-looking statements as a result of various important risks, uncertainties and other factors, including, without limitation: Alnylam's ability to discover and develop novel drug candidates; the pre-clinical and clinical results for its product candidates, which may not be replicated or continue to occur in other subjects or in additional studies or otherwise support further development of product candidates for a specified indication or at all; actions or advice of regulatory agencies, which may affect the design, initiation, timing, continuation and/or progress of clinical trials or result in the need for additional pre-clinical and/or clinical testing; delays, interruptions or failures in the manufacture and supply of its product candidates or its marketed products, including ONPATTRO in Turkey; obtaining, maintaining and protecting intellectual property; intellectual property matters including potential patent litigation relating to its platform, products or product candidates; obtaining regulatory approval for its product candidates, including lumasiran and product candidates developed in collaboration with others, including inclisiran, and maintaining regulatory approval and obtaining pricing, reimbursement and access for its products, including ONPATTRO and GIVLAARI; progress in continuing to establish a commercial and ex-United States infrastructure, including in Europe; successfully launching, marketing and selling its approved products globally, including ONPATTRO and GIVLAARI, and achieve net product revenues for ONPATTRO within its expected range during 2020; potential risks to Alnylams business, activities and prospects as a result of the COVID-19 pandemic, or delays or interruptions resulting therefrom, including without limitation, any risks affecting access to ONPATTRO in Turkey, Alnylams ability to successfully expand the indication for ONPATTRO in the future; competition from others using technology similar to Alnylam's and others developing products for similar uses; Alnylam's ability to manage its growth and operating expenses within the ranges of its expected guidance and achieve a self-sustainable financial profile in the future, obtain additional funding to support its business activities, and establish and maintain strategic business alliances and new business initiatives; Alnylam's dependence on third parties, including Regeneron, for development, manufacture and distribution of certain products, including eye and CNS products, and Ironwood, for assistance with the education about and promotion of GIVLAARI in the U.S.; the outcome of litigation; the risk of government investigations; and unexpected expenditures, as well as those risks more fully discussed in the "Risk Factors" filed with Alnylam's most recent Annual Report on Form 10-K filed with the Securities and Exchange Commission (SEC) and in other filings that Alnylam makes with the SEC. In addition, any forward-looking statements represent Alnylam's views only as of today and should not be relied upon as representing its views as of any subsequent date. Alnylam explicitly disclaims any obligation, except to the extent required by law, to update any forward-looking statements.

View source version on businesswire.com: https://www.businesswire.com/news/home/20200325005133/en/

Contacts

Alnylam Pharmaceuticals, Inc. Christine Regan Lindenboom(Investors and Media)+1-617-682-4340

Fiona McMillan(Media, Europe)+44 1628 244960

Gen Ayhan Yener, MD(Medical Director)+90 554 566 57 40

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Alnylam Pharmaceuticals and Gen Sign Distribution Agreement in Turkey for ONPATTRO (patisiran), the First-in-Class Gene-Silencing RNAi Therapeutic -...

The Harvard Wyss Institute’s response to COVID-19: beating back the coronavirus – P&T Community

BOSTON, March 25, 2020 /PRNewswire/ -- The burgeoning coronavirus (COVID-19) global pandemic has already killed thousands of people worldwide and is threatening the lives of many more. In an effort to limit the virus from spreading, Harvard University was among the first organizations to promote social distancing by requiring all but the most essential personnel to work remotely. However, labs that perform vital COVID-19-related research are permitted to continue their potentially life-saving work and many of these activities are currently ongoing at the Wyss Institute for Biologically Inspired Engineering.

Essentially all medical treatment centers impacted by SARS-CoV2 (CoV2), the SARS-family virus that causes COVID-19, are overstrained or unable to confront the virus, starting from their ability to diagnose the virus' presence in the human body, treat all infected individuals, or prevent its spread among those that have not been infected yet. Therefore, finding better solutions to diagnose, treat, and prevent the disease, is key to combating this menace and bringing this pandemic under control. Equally concerning, there are worldwide shortages on the front lines in hospitals in our region and around the world, including rapidly depleting supplies of personal protective equipment, such as N95 face masks, and nasopharyngeal swabs needed for COVID-19 diagnostic testing. Solving these challenges requires rapid responses and creative solutions.

"With our highly multi-disciplinary and translation-focused organization, we [the Wyss Institute] were able to quickly pivot, and refocus our unique engineering capabilities on much needed diagnostic, therapeutic, and vaccine solutions, and we hope to be part of the solution for many of the innumerable problems the present pandemic poses," said Wyss Institute Founding Director Donald Ingber,M.D., Ph.D., who also is theJudah Folkman Professor of Vascular Biologyat Harvard Medical School and Boston Children's Hospital, and Professor of Bioengineering at the Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS). "We strive to make a major contribution to bringing this crisis under control, and are confident that what we accomplish under duress now will help prevent future epidemics."

Meeting challenges on the front lines of patient care

Many of the Institute's hospital partner institutions and government agencies have reached out to Institute leadership to assist in this rapidly escalating battle against COVID-19. Ingber's team is working closely with collaborators at Beth Israel Deaconess Medical Center(BIDMC), other Harvard-affiliated hospitals, and generous corporate partners to develop potential solutions to the increasing shortage of nasopharyngeal swabs and N95 face masks. Senior Staff Engineers Richard Novak, Ph.D., and Adama Sesay, Ph.D., and Senior Research Scientist Pawan Jolly, Ph.D., are working diligently with our clinical partners to help devise a solution as quickly as possible.

Diagnosing COVID-19 more quickly, easily, and broadly

With COVID-19 rapidly spreading around the planet, the efficient detection of the CoV2 virus is pivotal to isolate infected individuals as early as possible, support them in whatever way possible, and thus prevent the further uncontrolled spread of the disease. Currently, the most-performed tests are detecting snippets of the virus' genetic material, its RNA, by amplifying them with a technique known as "polymerase chain reaction" (PCR) from nasopharyngeal swabs taken from individuals' noses and throats.

The tests, however, have severe limitations that stand in the way of effectively deciding whether people in the wider communities are infected or not. Although PCR-based tests can detect the virus's RNA early on in the disease, test kits are only available for a fraction of people that need to be tested, and they require trained health care workers, specialized laboratory equipment, and significant time to be performed. In addition, health care workers that are carrying out testing are especially prone to being infected by CoV2. To shorten patient-specific and community-wide response times, Wyss Institute researchers are taking different parallel approaches:

Advancing antiviral therapeutics on the fast track

To date there is no antiviral drug that has been proven to reduce the intensity and duration of the infection in more seriously affected patients, or protect vulnerable patients from CoV2 infection. Doctors can merely provide supportive care to their COVID-19 patients by making sure they receive enough oxygen, managing their fever, and generally supporting their immune systems to buy them time to fight the infection themselves. Research groups in academia and industry working at breakneck pace by now have compiled a list of candidate therapeutics and vaccines to could offer some help. However, given the high failure rates of candidate drugs in clinical trials, more efforts are needed to develop effective medicines for a world population that likely will vary with regards to their susceptibility and access to new therapeutic technologies.

The ongoing COVID-19 pandemic requires rapid action, and the fastest way to combat this challenge is by repurposing existing drugs that are already FDA approved for other medical applications as COVID-19 therapeutics. While clinicians around the world are attempting to do this, the approaches have been haphazard, and there is a great need to attack this problem in a systematic way.

In search of ultimate protection a vaccine

With no vaccine currently available, but several vaccine candidates being explored around the world, Wyss Institute researchers led by Wyss Core Faculty member David Mooney,Ph.D., are developing a material that could make vaccinations more effective. Previously, Mooney's team has developed implantable and injectable cancer vaccinesthat can induce the immune system to attack and destroy cancer cells.

Understanding how COVID-19 develops and how to control it

COVID-19 does not strike equally strong in every individual that it infects. Independent of age, some are prone to become seriously ill, while others show an astonishing level of resilience against the disease. Figuring out the biological basis for these differences could lead to new protective strategies.

On the national level, Walt is a member of a COVID-19 discussion started at the National Academies' newly formed "Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats." The committee is strongly focusing now on the present coronavirus pandemic to find ways to help the federal government consolidate and streamline efforts across the nation but will also work long-term to develop strategies and make recommendations for future health threats.

At the international level, the Wyss Institute functions as a Center of Excellence of the Global Virus Network(GVN), with Ingber as leader and the other Wyss Faculty as key participating members. The GVN is designed to integrate surveillance and response efforts for biothreats, epidemics, and pandemics by integrating efforts of top virus research institutions from around the world.Ingber is also currently working closely with the Defense Advanced Research Projects Agency(DARPA) and Bill & Melinda Gates Foundation, as well as in active discussions with the NIH's National Institute of Allergy and Infectious Diseases(NIAID), Biomedical Advanced Research and Development Authority(BARDA), and Public Health England, as they all try to align and coordinate efforts to meet this monumental health challenge.

"The Wyss Institute and its collaborators are taking exactly the type of comprehensive, integrated approach to addressing this pandemic that is required at local, national, and international levels," said Walt.

PRESS CONTACTS

Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBenjamin Boettner,benjamin.boettner@wyss.harvard.edu, +1917-913-8051

The Wyss Institute for Biologically Inspired Engineering at Harvard University(http://wyss.harvard.edu) uses Nature's design principles to develop bioinspired materials and devices that will transform medicine and create a more sustainable world. Wyss researchers are developing innovative new engineering solutions for healthcare, energy, architecture, robotics, and manufacturing that are translated into commercial products and therapies through collaborations with clinical investigators, corporate alliances, and formation of new startups. The Wyss Institute creates transformative technological breakthroughs by engaging in high risk research, and crosses disciplinary and institutional barriers, working as an alliance that includes Harvard's Schools of Medicine, Engineering, Arts & Sciences and Design, and in partnership with Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Boston Children's Hospital, DanaFarber Cancer Institute, Massachusetts General Hospital, the University of Massachusetts Medical School, Spaulding Rehabilitation Hospital, Boston University, Tufts University, Charit Universittsmedizin Berlin, University of Zurich and Massachusetts Institute of Technology.

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Football: Ryan Day and staff transitioning to work-from-home mode – OSU – The Lantern

Conference calls, FaceTime calls, calls to players and staff, calls to recruits, calls with trainers, calls with families and mornings filled with film study this is what running the Ohio State football program looks like for head coach Ryan Day during the COVID-19 pandemic.

Twice a week, Day holds a conference call with his staff to evaluate each player on academics, strength and conditioning, and football development.

He uses personal calls to direct players on how to stay in shape and continue growing in their football skills.

Day said that one minute he could be watching Tiger King on Netflix or perfecting his chili recipe, but if his phone rings the next minute, he doesnt miss it.

Its always right there, Day said during a teleconference call with media members Wednesday. I cant tell you how many times weve sat down as a family to do something and the phone rings, and then Im off and running.

All of college football holds steady, with spring practice canceled across the country and plans for the future still uncertain. The calls Day is making now will significantly impact how well his team transitions through the COVID-19 quarantine into the 2020 football season.

It is what it is, and its the same for everybody else throughout the country, Day said. Good news for us is, a lot of our young guys played especially in those first 10 games they got a lot of snaps. Some kids got over 200, 250, 300 snaps last year. Quarterback is returning. So I feel like in terms of game readiness that we do have a fairly veteran team.

Under normal circumstances, Ohio State would have held its Pro Day Wednesday and completed its seventh spring practice Thursday.

Instead, the Buckeyes are spread across the country. Most players living in dorms have returned home, with the exception of those who applied for exemptions to stay on campus, Day said. The Woody Hayes Athletic Center is closed to all organized activity.

At this point, guys are just at their house, doing their first week of academics, Day said. All of our stuff has been moved online or virtual.

Constant interaction and communication with players and their families has been second only to personal health for the staff, he added.

Day said the team wants to maintain the structure to which players are accustomed when not under quarantine, in terms of coaching feedback, workouts, academics and meals. Instructions are individually tailored since not all players have home gyms. Some have been sent resistance bands and are running down their hometown streets for conditioning.

We worked really hard to get ourselves in shape and ready for spring practice, Day said. We want to try to maintain that the best we can given the circumstances.

There are specific positional considerations being made, too.

Two Ohio State freshmen, C.J. Stroud and Jack Miller, are both contending for the backup quarterback job behind junior Justin Fields. As early enrollees, spring practice was providing an opportunity for both to learn Ohio States offense and develop chemistry with its wide receivers.

Its unfortunate because spring practice is so important for a young quarterback, Day said. They do have access to our film, and were gonna do the best we can to make sure they have everything they can to study that stuff.

Many players rehabbing injury have been sent instructions by head athletic trainer Shaun Barnhouse and his staff, Day said. Those still in Columbus, Ohio, have been using the Jameson Crane Sports Medicine Institute.

Redshirt sophomore running back Master Teague, for instance, is rehabbing an Achilles injury after having rushed for 789 yards behind J.K. Dobbins this past season. Hell be competing for the 2020 starting role against graduate transfer Trey Sermon from Oklahoma.

Masters a very mature young man. Hes got his priorities straight, Day said. Hes gonna attack this rehab, and hes gonna do the best he can to get back as fast as possible. Hes a little bit of a genetic freak. Were hopeful that with our team and with his hard work and the way his genetics are, well get a speedy recovery here.

Day has also been dealing damage on the recruiting trail from his home office.

The Buckeyes landed four recruits, two of them top 100 prospects, in a three-day span from March 15-17, then added Sermon Sunday.

What allowed those verbal commitments to happen was the foundation laid by the Buckeyes with their prospects throughout the course of the past year, placing them ahead of the curve, Day said.

Day and other staffers have consistently FaceTimed with recruits since the Big Ten banned all on- and off-campus recruiting activities March 13.

I think theres a lot of excitement around the program and what were building on both sides of the ball, Day said. Weve been doing this for a while now with this class. Theres been a lot built up. This is not something we just started a few months ago.

When football does resume, Day said he thinks a structure similar to the NFLs OTAs would be helpful, where teams can recuperate lost spring practice time with additional summer practices and camp days.

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Football: Ryan Day and staff transitioning to work-from-home mode - OSU - The Lantern

How long will we have to wait for a coronavirus vaccine? – Telegraph.co.uk

Disease modelling experts have warned that the shut down imposed on the UK may have to last until a vaccine is available. This isbecause as soon the population comes out of its enforced hibernation the coronavirus will start to spread once more.

The bad news is that that a vaccineis unlikely tobe ready for worldwide use by the beginning of the next year at the earliest.

Covid-19has also mutated into two strains, one which appears to be far more aggressive, scientists have said, in a discovery which could hinder attempts to develop a vaccine.

And health experts have warned that the virus could hit Britain in "multiple waves", and led to fears that some vaccines might not work on mutated strains.

That's the bad news. The good news is that the world has never been more geared up to develop technologies against emerging infectious diseases than it is today.

The rapid genetic sequencing and open publication of the virus by Chinese scientists has been a boon for researchers who have been working against the clock to produce a preventive jab or pill, as well astreatments and diagnostics.

British scientists are competing with dozens of laboratories around the world to be the first to develop a drug. Last week, scientists at Public Health England said that trials of a vaccine could begin within the next month.

Human trials on the vaccine have already startedin the United States - breaking records for the speed with which such trials can get off the ground. Healthy volunteers in Americaare being given the new-generation genetic hack after it bypassed standard animal testing as part of a highly accelerated process.

If proven safe and effective, larger "live situation" trials will be carried out to see whether inoculation works on patients infected withCovid-19. If successful, pharmaceutical industry leaders hope there could be millions of doses ready within 12 to 18 months, but admit its aspirational.

Professor Robin Shattock and his team at the Department of Infectious Disease atImperial College London developed a candidate vaccine within 14 days of getting the sequence from China. They have been testing it on animals since February 10 and hope to move to clinical trials in the summer if they can secure funding.

Other than creating a traditional antibody jab, the Imperial drug works by effectively injecting new genetic code into a muscle, instructing it to make a protein found on the surface of coronavirus, which triggers a protective immune response.

"We have the kind of technology to be able to generate a vaccine with a speed that's never been realised before," said Prof Shattock. "Most vaccines are five years in the discovery phase, and at least one or two years to manufacture and get into trials.

"We may not be the first, but it only requires one group to get there. We're only one party and at some point we might say: 'Somebody else is ahead, we should stop working'. While we want to go the whole way, we're also prepared to stand down."

One crucial advance aiding vaccine research is the development of an organisation called Cepi, set up in response to the lack of scientific progress when Ebola ripped through West Africa in 2014 to 2016.

Cepi's mission is to rapidly respond to epidemics by providing the money to researchers to develop vaccines.

It harnesses the power of so-called "rapid response platforms"which use what its chief executive, Dr Richard Hatchett, describes as a "common backbone"that can be adapted quickly for different pathogens by inserting new genetic or protein sequences.

It is already working on the development of a vaccine against another coronavirus - Middle East respiratory syndrome (Mers) - and in January, Cepi announced that a vaccine for Covid-19 would be ready for testing by the end of May.

But the biggest hurdle for vaccine development is manufacture and distribution at scale.Even the most optimistic pharmaceutical executive would be inclined to suggest the vaccinewould only be ready by the end of this year.

Andit would probably be given to what public health experts call "key populations"first - health workers, vulnerable groups and the contacts of affected patients - before any nationwide mass vaccination programme took place.

But what doctors are pinning their hopes on - more than vaccines - are drugs for other diseasesthat they are repurposing to treat coronavirus patients.

The most promising of these is a drug called remdesivir, a broad-spectrum antiviral treatment developed by drug firm Gilead that began testing earlier this week.

The drug was developed for Ebola and was used to treat the Scottish nurse Pauline Cafferkey when she suffered a relapse 18 months after being cleared of the disease which she contracted while volunteering in Sierra Leone.

Doctors in the United States first used the drug in January on a patient who was not responding to other treatment- within 24 hours, he showed improvements, eventually making a full recovery.

HIV antiviral drugs have also been flagged as potential options, and there are several studies ongoing in China looking at a combination of lopinavir and ritonavir, both of which work to lower the levels of HIV in the bloodstream.

Earlier this month doctors in Thailand claimed that, 48 hours after taking a cocktail of these HIV drugs alongside a flu treatment, a patient tested negative for the coronavirus.

Sir Jeremy Farrar, director of the UK biomedical research charity Wellcome, said using existing drugs makes sense because all the safety and efficacy testing has already been carried out.

But before we can start hailing any miracle cures,proper clinical trials must be conducted.

"Do the drugs work?" Sir Jeremy asks.

"We just don't know, but we won't know unless we look."

The virus has evolved into two major lineages - dubbed L and S types. The older S-type appears to be milder and less infectious, while the L-type which emerged later, spreads quickly and currently accounts for around 70 per cent of cases.

In addition, genetic analysis of a man in the US who tested positive on January 21 also showed it is possible to be infected with both types.

Experts suggest that while Covid-19's mutation makes it more difficult to develop a vaccine, a vaccine is still possible.

Dr Stephen Griffin, of the Leeds Institute of Medical Research and chair of the virus division at the Microbiology Society, said that two of the changes between the S and L lineages were in a crucial protein called a spike, which plays a key role in the infection process and is a target for vaccines.

Dr Griffin said developers would need to test whether their prototype vaccines would still neutralise viruses with the changes, but added that the variations were "fairly limited" and may not be a "huge hurdle."

It is usually the case that when RNA viruses first cross species barriers into humans they arent particularly well adapted to their new host - us! said Dr Griffin.

Thus, they usually undergo some changes allowing them to adapt and become better able to replicate within, and spread from human-to-human.

Virologist Professor Jonathan Ball also warned that mutations could affect vaccine production, but said that the Chinese results needed replication with a larger study.

At the moment we don't have hard evidence that the virus has changes with regards to disease severity or infectivity so we need to be cautious when interpreting these kinds of computer-based studies, interesting as they might be, he added.

New mutations were also discovered in the case of a 61-year-old man from Brazil, although ProfessorDavid Heymann of the London School of Hygiene and Tropical Medicine said a vaccine should still work on the emerging strain.

Nothing has occurred that is major and this virus appears to be stable, he said.

Small mutations are normal, especially with RNA viruses. We look for the parts of the virus that are most sustained.

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Marine medicine: Understanding and treating infection types – National Fisherman

Many fishermen come to believe that they have a natural immunity to infections, but the reality is quite the contrary. Infections have shut down fishing operations across the world, which is why its essential to both understand infection types that cause symptoms as well as what sort of preventative measures can be taken to avoid them entirely. preventions in todays world.

As a baseline for this topic, the definition of an infection is the invasion of an organisms body tissue (man or beast) by disease-causing agents. An agent can be bacteria, viruses, fungus and parasites. Infections can be transmitted in a variety of ways.

Exactly how an infection can spread as well as its effect on the human body depends on the type of infective agent. Some infectious diseases can be passed from one person to another easily while others are harder to transmit. The flu, a cold, measles or a sore throat may be transmitted by a kiss or a simple touch or cough from one person to another. Infectious diseases such as AIDS, herpes and hepatitis are only passed by a closer contact called bloodborne transmission as blood to blood or sexual intercourse.

Some examples of how infections are transmissible, communicable of contagious are:

There are many different root causes of these infections, all of which need to be fully understood in order to determine the best approach for prevention and treatment.

Bacteria Infection

Most of the Earths biomass is made of bacteria, which are single-celled micro-organisms. Bacteria can live in almost any kind of environment which ranges from extreme heat to intense cold. Some can even survive in radioactive waste. Bacteria are also highly adaptable. That can cause problems for people because it often results in resistance to antibiotics.

There are trillions of strains of bacteria and a few of these may cause diseases in humans. Some bacteria are beneficial to human digestion and airways. However, there are also plenty of good bacteria like the digestive bacteria contained in our stomachs.

Some examples of bacteria diseases are:

Bacterial infections can be treated with antibiotics but some strains become resistant and can survive treatment. Antibiotics resistant bacterial infections and or diseases have been an ever-increasing which has become a major a concern to infectious diseases specialists and the CDC (Center for Disease Control).

Viral infections

Viral infections are as numerous and as deadly as bacterial diseases. Viral infections can range from the common cold to Ebola. Unlike bacteria, viruses are made up of only a genetic code that is encapsulated in a shell made up of protein and fat.

Viruses invade a host and attach to the hosts cell. By this process of attachment and release of genetics (commanding seed matter), the virus rapidly replicates and kills the host cells only to go on to infect new cells and repeats the cycle. Since the virus is only genetic material, it may remain dormant and reactivate when conditions demand so.

Some examples of viral infections are:

Antiviral medications can help in some cases as they can either prevent the virus from reproducing or boost the bodys immune system response. Antibiotics are not effective against viruses but most treatments are directed to relieve symptoms while the immune system combats the virus without assistance from drugs and treatments.

Fungal infections

A fungus is a many-celled parasite that can reproduce by spreading spores. Many fungal infections will appear on the topical skin as a persistent rash. Inhaled fungal spores can cause thrush and candidiasis.

Examples of fungal infections are:

Since commercial fishermen work in such harsh environments, the demands of the bodys protective immune system are much greater. A healthy active lifestyle can help keep the immune system strong and able to defend the body against different kinds of infections. Fishermen can stop the spread of communicable diseases with some simple common sense procedures that can be followed on their vessels and onshore.

There is no single way to prevent all infectious diseases. However, the following tips can reduce the risk of transmission:

Given how much they are handling gear and fish, the majority of commercial fishermens on-the-job infections are infections of the fingers and hands. Thats why its especially important to understand what it means to understand these types of infections.

Treating and preventing infections of the fingers and hands

Fish and fish products are often contaminated with infectious bacteria, which explains why fishermen are so prone to infections via the involuntary penetration into soft tissue by fish spines and bones. Bacteria can be easily carried into these open wounds by fish slime, fish intestinal parts and contaminated vessel components. Additionally, the handling of ropes, cables and moving metal parts in the unpredictable environment of the sea adds to the likelihood of bloody injuries that are centered on the hands.

Prevention is always better than treatment. All finger and hand infections are very painful and disabling. Some infections can cause permanent disability, possibly ending a fishermans career. Infections in the hands should always be treated aggressively within the following guidelines:

Knives and fishhooks

Injuries caused by a fishermans working tools such as knives and fishhooks should be treated aggressively and immediately. These instruments can directly inject harmful bacteria deep in the soft tissue.

In order to remove a fishhook with the minimum tissue damage, follow this simple procedure:

The ability to give and receive proper medical attention while at sea is extremely limited. Thats why your medical skills and the supplies you have on hand can make all the difference. Preventing injuries is always the most cost-effective action plan, but that underscores why its essential to get proper training, be prepared, but most importantly, always think safety first.

For additional information concerning the best medical kit for your vessel visit marinemedical.com or email your request to info@marinemedical.com.You can also reach us by calling 800-272-3008.

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Understanding SARS-CoV-2 and the drugs that might lessen its power – The Economist

Mar 12th 2020

THE INTERCONNECTEDNESS of the modern world has been a boon for SARS-CoV-2. Without planes, trains and automobiles the virus would never have got this far, this fast. Just a few months ago it took its first steps into a human host somewhere in or around Wuhan, in the Chinese province of Hubei. As of this week it had caused over 120,000 diagnosed cases of covid-19, from Troms to Buenos Aires, Alberta to Auckland, with most infections continuing to go undiagnosed (see article).

But interconnectedness may be its downfall, too. Scientists around the world are focusing their attention on its genome and the 27 proteins that it is known to produce, seeking to deepen their understanding and find ways to stop it in its tracks. The resulting plethora of activity has resulted in the posting of over 300 papers on MedRXiv, a repository for medical-research work that has not yet been formally peer-reviewed and published, since February 1st, and the depositing of hundreds of genome sequences in public databases. (For more coverage of covid-19 see our coronavirus hub.)

The assault on the vaccine is not just taking place in the lab. As of February 28th Chinas Clinical Trial Registry listed 105 trials of drugs and vaccines intended to combat SARS-CoV-2 either already recruiting patients or proposing to do so. As of March 11th its American equivalent, the National Library of Medicine, listed 84. This might seem premature, considering how recently the virus became known to science; is not drug development notoriously slow? But the reasonably well-understood basic biology of the virus makes it possible to work out which existing drugs have some chance of success, and that provides the basis for at least a little hope.

Even if a drug were only able to reduce mortality or sickness by a modest amount, it could make a great difference to the course of the disease. As Wuhan learned, and parts of Italy are now learning, treating the severely ill in numbers for which no hospitals were designed puts an unbearable burden on health systems. As Jeremy Farrar, the director of the Wellcome Trust, which funds research, puts it: If you had a drug which reduced your time in hospital from 20 days to 15 days, thats huge.

Little noticed by doctors, let alone the public, until the outbreak of SARS (severe acute respiratory syndrome) that began in Guangdong in 2002, the coronavirus family was first recognised by science in the 1960s. Its members got their name because, under the early electron microscopes of the period, their shape seemed reminiscent of a monarchs crown. (It is actually, modern methods show, more like that of an old-fashioned naval mine.) There are now more than 40 recognised members of the family, infecting a range of mammals and birds, including blackbirds, bats and cats. Veterinary virologists know them well because of the diseases they cause in pigs, cattle and poultry.

Virologists who concentrate on human disease used to pay less attention. Although two long-established coronaviruses cause between 15% and 30% of the symptoms referred to as the common cold, they did not cause serious diseases in people. Then, in 2002, the virus now known as SARS-CoV jumped from a horseshoe bat to a person (possibly by way of some intermediary). The subsequent outbreak went on to kill almost 800 people around the world.

Some of the studies which followed that outbreak highlighted the fact that related coronaviruses could easily follow SARS-CoV across the species barrier into humans. Unfortunately, this risk did not lead to the development of specific drugs aimed at such viruses. When SARS-CoV-2similarly named because of its very similar genomeduly arrived, there were no dedicated anti-coronavirus drugs around to meet it.

A SARS-CoV-2 virus particle, known technically as a virion, is about 90 nanometres (billionths of a metre) acrossaround a millionth the volume of the sort of cells it infects in the human lung. It contains four different proteins and a strand of RNAa molecule which, like DNA, can store genetic information as a sequence of chemical letters called nucleotides. In this case, that information includes how to make all the other proteins that the virus needs in order to make copies of itself, but which it does not carry along from cell to cell.

The outer proteins sit athwart a membrane provided by the cell in which the virion was created. This membrane, made of lipids, breaks up when it encounters soap and water, which is why hand-washing is such a valuable barrier to infection.

The most prominent protein, the one which gives the virions their crown- or mine-like appearance by standing proud of the membrane, is called spike. Two other proteins, envelope protein and membrane protein, sit in the membrane between these spikes, providing structural integrity. Inside the membrane a fourth protein, nucleocapsid, acts as a scaffold around which the virus wraps the 29,900nucleotides of RNA which make up its genome.

Though they store their genes in DNA, living cells use RNA for a range of other activities, such as taking the instructions written in the cells genome to the machinery which turns those instructions into proteins. Various sorts of virus, though, store their genes on RNA. Viruses like HIV, which causes AIDS, make DNA copies of their RNA genome once they get into a cell. This allows them to get into the nucleus and stay around for years. Coronaviruses take a simpler approach. Their RNA is formatted to look like the messenger RNA which tells cells what proteins to make. As soon as that RNA gets into the cell, flummoxed protein-making machinery starts reading the viral genes and making the proteins they describe.

First contact between a virion and a cell is made by the spike protein. There is a region on this protein that fits hand-in-glove with ACE2, a protein found on the surface of some human cells, particularly those in the respiratory tract.

ACE2 has a role in controlling blood pressure, and preliminary data from a hospital in Wuhan suggest that high blood pressure increases the risks of someone who has contracted the illness dying of it (so do diabetes and heart disease). Whether this has anything to do with the fact that the viruss entry point is linked to blood-pressure regulation remains to be seen.

Once a virion has attached itself to an ACE2 molecule, it bends a second protein on the exterior of the cell to its will. This is TMPRSS2, a protease. Proteases exist to cleave other proteins asunder, and the virus depends on TMPRSS2 obligingly cutting open the spike protein, exposing a stump called a fusion peptide. This lets the virion into the cell, where it is soon able to open up and release its RNA (see diagram).

Coronaviruses have genomes bigger than those seen in any other RNA virusesabout three times longer than HIVs, twice as long as the influenza viruss, and half as long again as the Ebola viruss. At one end are the genes for the four structural proteins and eight genes for small accessory proteins that seem to inhibit the hosts defences (see diagram). Together these account for just a third of the genome. The rest is the province of a complex gene called replicase. Cells have no interest in making RNA copies of RNA molecules, and so they have no machinery for the task that the virus can hijack. This means the virus has to bring the genes with which to make its own. The replicase gene creates two big polyproteins that cut themselves up into 15, or just possibly 16, short non-structural proteins (NSPs). These make up the machinery for copying and proofreading the genomethough some of them may have other roles, too.

Once the cell is making both structural proteins and RNA, it is time to start churning out new virions. Some of the RNA molecules get wrapped up with copies of the nucleocapsid proteins. They are then provided with bits of membrane which are rich in the three outer proteins. The envelope and membrane proteins play a large role in this assembly process, which takes place in a cellular workshop called the Golgi apparatus. A cell may make between 100 and 1,000 virions in this way, according to Stanley Perlman of the University of Iowa. Most of them are capable of taking over a new celleither nearby or in another bodyand starting the process off again.

Not all the RNA that has been created ends up packed into virions; leftovers escape into wider circulation. The coronavirus tests now in use pick up and amplify SARS-CoV-2-specific RNA sequences found in the sputum of infected patients.

Because a viral genome has no room for free riders, it is a fair bet that all of the proteins that SARS-CoV-2 makes when it gets into a cell are of vital importance. That makes each of them a potential target for drug designers. In the grip of a pandemic, though, the emphasis is on the targets that might be hit by drugs already at hand.

The obvious target is the replicase system. Because uninfected cells do not make RNA copies of RNA molecules, drugs which mess that process up can be lethal to the virus while not necessarily interfering with the normal functioning of the body. Similar thinking led to the first generation of anti-HIV drugs, which targeted the process that the virus uses to transcribe its RNA genome into DNAanother thing that healthy cells just do not do.

Like those first HIV drugs, some of the most promising SARS-CoV-2 treatments are molecules known as nucleotide analogues. They look like the letters of which RNA or DNA sequences are made up; but when a virus tries to use them for that purpose they mess things up in various ways.

The nucleotide-analogue drug that has gained the most attention for fighting SARS-CoV-2 is remdesivir. It was originally developed by Gilead Sciences, an American biotechnology firm, for use against Ebola fever. That work got as far as indicating that the drug was safe in humans, but because antibody therapy proved a better way of treating Ebola, remdesivir was put to one side. Laboratory tests, though, showed that it worked against a range of other RNA-based viruses, including SARS-CoV, and the same tests now show that it can block the replication of SARS-CoV-2, too.

There are now various trials of remdesivirs efficacy in covid-19 patients. Gilead is organising two in Asia that will, together, involve 1,000 infected people. They are expected to yield results in mid- to late-April. Other nucleotide analogues are also under investigation. When they screened seven drugs approved for other purposes for evidence of activity against SARS-CoV-2, a group of researchers at the State Key Laboratory of Virology in Wuhan saw some potential in ribavirin, an antiviral drug used in the treatment of, among other things, hepatitis C, that is already on the list of essential medicines promulgated by the World Health Organisation (WHO).

Nucleotide analogues are not the only antiviral drugs. The second generation of anti-HIV drugs were the protease inhibitors which, used along with the original nucleotide analogues, revolutionised the treatment of the disease. They targeted an enzyme with which HIV cuts big proteins into smaller ones, rather as one of SARS-CoV-2s NSPs cuts its big polyproteins into more little NSPs. Though the two viral enzymes do a similar job, they are not remotely relatedHIV and SARS-CoV-2 have about as much in common as a human and a satsuma. Nevertheless, when Kaletra, a mixture of two protease inhibitors, ritonavir and lopinavir, was tried in SARS patients in 2003 it seemed to offer some benefit.

Another drug which was developed to deal with other RNA-based virusesin particular, influenzais Favipiravir (favilavir). It appears to interfere with one of the NSPs involved in making new RNA. But existing drugs that might have an effect on SARS-CoV-2 are not limited to those originally designed as antivirals. Chloroquine, a drug mostly used against malaria, was shown in the 2000s to have some effect on SARS-CoV; in cell-culture studies it both reduces the viruss ability to get into cells and its ability to reproduce once inside them, possibly by altering the acidity of the Golgi apparatus. Camostat mesylate, which is used in cancer treatment, blocks the action of proteases similar to TMPRSS2, the protein in the cell membrane that activates the spike protein.

Not all drugs need to target the virus. Some could work by helping the immune system. Interferons promote a widespread antiviral reaction in infected cells which includes shutting down protein production and switching on RNA-destroying enzymes, both of which stop viral replication. Studies on the original SARS virus suggested that interferons might be a useful tool for stopping its progress, probably best used in conjunction with other drugs

Conversely, parts of the immune system are too active in covid-19. The virus kills not by destroying cells until none are left, but by overstimulating the immune systems inflammatory response. Part of that response is mediated by a molecule called interleukin-6one of a number of immune-system modulators that biotechnology has targeted because of their roles in autoimmune disease.

Actemra (tocilizumab) is an antibody that targets the interleukin-6 receptors on cell surfaces, gumming them up so that the interleukin-6 can no longer get to them. It was developed for use in rheumatoid arthritis. China has just approved it for use against covid-19. There are anecdotal reports of it being associated with clinical improvements in Italy.

While many trials are under way in China, the decline in the case rate there means that setting up new trials is now difficult. In Italy, where the epidemic is raging, organising trials is a luxury the health system cannot afford. So scientists are dashing to set up protocols for further clinical trials in countries expecting a rush of new cases. Dr Farrar said on March 9th that Britain must have its trials programme agreed within the week.

International trials are also a high priority. Soumya Swaminathan, chief scientist at the WHO, says that it is trying to finalise a master protocol for trials to which many countries could contribute. By pooling patients from around the world, using standardised criteria such as whom to include and how to measure outcomes, it should be possible to create trials of thousands of patients. Working on such a large scale makes it possible to pick up small, but still significant, benefits. Some treatments, for example, might help younger patients but not older ones; since younger patients are less common, such an effect could easily be missed in a small trial.

The caseload of the pandemic is hard to predict, and it might be that even a useful drug is not suitable in all cases. But there are already concerns that, should one of the promising drugs prove to be useful, supplies will not be adequate. To address these, the WHO has had discussions with manufacturers about whether they would be able to produce drugs in large enough quantities. Generic drug makers have assured the organisation that they can scale up to millions of doses of ritonavir and lopinavir while still supplying the HIV-positive patients who rely on the drugs. Gilead, meanwhile, has enough remdesivir to support clinical trials and, thus far, compassionate use. The firm says it is working to make more available as rapidly as possible, even in the absence of evidence that it works safely.

In the lab, SARS-CoV-2 will continue being dissected and mulled over. Details of its tricksiness will be puzzled out, and the best bits of proteins to turn into vaccines argued over. But that is all for tomorrow. For today doctors can only hope that a combination of new understanding and not-so-new drugs will do some good.

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This article appeared in the Briefing section of the print edition under the headline "Anatomy of a killer"

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Understanding SARS-CoV-2 and the drugs that might lessen its power - The Economist


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