Category Archives: Covid-19

Scientists claim to have found more clues about how the new coronavirus could have spread from bats through pangolins and into humans, as India reported its worst single-day rise in new cases, and the number of Covid-19 infections worldwide neared 6 million.

Writing in the journal Covid-19 Science Advances, researchers said an examination of the closest relative of the virus found that it was circulating in bats but lacked the protein needed to bind to human cells. They said this ability could have been acquired from a virus found in pangolins a scaly mammal that is one of the most illegally trafficked animals in the world.

DrElena Giorgi, of Los Alamos national laboratory, one of the studys lead authors, said people had already looked at the pangolin link but scientists were still divided about their role in the evolution of Sars-Cov-2, the virus that causes Covid-19.

In our study, we demonstrated that indeed Sars-Cov-2 has a rich evolutionary history that included a reshuffling of genetic material between bat and pangolin coronavirus before it acquired its ability to jump to humans, she said, adding that close proximity of animals of different species in a wet market setting may increase the potential for cross-species spillover infections.

The study stilldoesnt confirm the pangolin as the animal that passed the virus to humans, but it adds weight to previous studies that have suggested it may have been involved.

However, Prof Edward Holmes, an evolutionary biologist at the University of Sydney, in Australia, said more work on the subject was needed. There is a clear evolutionary gap between Sars-Cov-2 and its closest relatives found to date in bats and pangolins, he said. The only way this gap will be filled is through more wildlife sampling.

The findings came as Donald Trump announced that the United States was severing its ties with the World Health Organization because it had failed to reform.

In a speech at the White House devoted mainly to attacking China for its alleged shortcomings in tackling the initial outbreak of coronavirus, Trump said: We will be today terminating our relationship with theWorld Health Organizationand redirecting those funds to other worldwide and deserving urgent global public health needs.

The US is the biggest funder of the WHO, paying about $450m (365m) in membership dues and voluntary contributions for specific programmes.

Trumps declaration was condemned in the US and around the world, with Australianexperts joining counterparts in the UK and elsewhere in voicing their support for the WHO. Prof Peter Doherty, a Nobel laureate and patron of the Doherty Institute, which is part of global efforts to find a Covid-19 vaccine, said the WHO had the full support of the scientific community.

Deaths in the US have climbed to more than 102,000, with 1,747,000 infections. It is by far the biggest total in the world. On Friday it emerged that one person who attended the controversial pool parties in the Ozarks last weekend had tested positive for the virus.

In Brazil, there was another large rise in deaths. More than 27,000 people have died from the disease and the country has the worlds second highest number of cases, at 465,000.

There were also big surges in reported deaths in Russia, which identifiedmore coronavirus cases in a day than at any time since early April;2,819 more people tested positive on Friday.

Iran also recorded itsbiggest daily increase in deaths 232 in 24 hours bringing the total to 4,374. President Hassan Rouhani nevertheless said mosques were to resume daily prayers throughout the country, despite some areas reporting continuing high levels of infections. He added that physical distancing and other health protocols would be observed in mosques. He did not say when they were due to reopen.

India, meanwhile, reported a record daily jump of 7,964 new infections. With the latest tally, India has now reported 173,763 coronavirus cases and 4,971 deaths, making it the ninth most-affected country, according to Reuters. While the fatality rates in India have been lower than in worse-hit countries, experts fear the peak has not been reached. The latest numbers would appear to confirm that prediction.

Egypt registered 1,289 new cases and 34 deaths, the health ministry said, marking another record of daily increases on both counts despite stricter curfew rules.

Other developments across the world include:

A leading UK government adviser has warned that it is too early to lift lockdown restrictions as planned next month because the number of new infections is still too high. John Edmunds, a professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine, said he wanted the level of new cases to be driven down further before larger gatherings are allowed as the government has said it wants to do. Tory MPs are still being bombarded by constituents with calls for Boris Johnsons top adviser to quit after he appeared to breach lockdown rules.

Restrictions continue to be lifted to some degree across Europe, with thousands flocking to open-air cinemas to see films together for the first time in weeks.

In Australia, where states are expected to move to relax the rules to allow gatherings of more people from Monday, anti-vaccine protesters gathered in several cities to claim that they believed Covid-19 was a scam.

Also in Australia, scientists are examining the sewage waste in a town in Queensland where a 30-year-old man died this week from the virus. Nathan Turner is the youngest victim in the country so far and the case has baffled experts because he had not left the remote town of Blackwater.

The global death toll passed 365,000, according to data compiled byJohns Hopkins University, with the number of cases just short of 6 million. The true number of infections is likely to be much higher, however, given the vast number of unrecorded and asymptomatic cases.

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Global report: new clues about role of pangolins in Covid-19 as US severs ties with WHO - The Guardian

When Noopur Rajes husband fell critically ill with Covid-19 in mid-March, she did not suspect that she too was infected with the virus.

Raje, an oncologist at Massachusetts General Hospital in Boston, had been caring for her sick husband for a week before driving him to an emergency centre with a persistently high fever. But after she herself had a diagnostic PCR test which looks for traces of the Sars-CoV-2 virus DNA in saliva she was astounded to find that the result was positive.

My husband ended up very sick, she says. He was in intensive care for a day, and in hospital for 10 days. But while I was also infected, I had no symptoms at all. I have no idea why we responded so differently.

It took two months for Rajes husband to recover. Repeated tests, done every five days, showed that Raje remained infected for the same length of time, all while remaining completely asymptomatic. In some ways it is unsurprising that the virus persisted in her body for so long, given that it appears her body did not even mount a detectable immune response against the infection.

When they both took an antibody test earlier this month, Rajes husband showed a high level of antibodies to the virus, while Raje appeared to have no response at all, something she found hard to comprehend.

Its mind-blowing, she says. Some people are able to be colonised with the virus and not be symptomatic, while others end up with pretty severe illness. I think its something to do with differences in immune regulation, but we still havent figured out exactly how this is happening.

Epidemiological studies are now revealing that the number of individuals who carry and can pass on the infection, yet remain completely asymptomatic, is larger than originally thought. Scientists believe these people have contributed to the spread of the virus in care homes, and they are central in the debate regarding face mask policies, as health officials attempt to avoid new waves of infections while societies reopen.

You dont need to be coughing to transmit a respiratory infection: talking, singing, even blowing a vuvuzela

But the realisation that asymptomatic people can spread an infection is not completely surprising. For starters, there is the famous early 20th century case of Typhoid Mary, a cook who infected 53 people in various households in the US with typhoid fever despite displaying no symptoms herself. In fact, all bacterial, viral and parasitic infections ranging from malaria to HIV have a certain proportion of asymptomatic carriers. Research has even shown that at any one time, all of us are infected with between eight and 12 viruses, without showing any symptoms.

From the microbes perspective, this makes perfect evolutionary sense. For any virus or bacteria, making people infectious but not ill is an excellent way to spread and persist in populations, says Rein Houben, an infectious diseases researcher at the London School of Hygiene and Tropical medicine.

However, when Covid-19 was identified at the start of the year, many public health officials both in the UK and around the world failed to account for the threat posed by asymptomatic transmission. This is largely because they were working on models based on influenza, where some estimates suggest that only 5% of people infected are asymptomatic. As a result, the large scale diagnostic testing regimes required to pick up asymptomatic Covid-19 cases were not in place until too late.

I warned on 24 January to consider asymptomatic cases as a transmission vehicle for Covid-19, but this was ignored at the time, says Bill Keevil, professor of environmental healthcare at the University of Southampton. Since then, many countries have reported asymptomatic cases, never showing obvious symptoms, but shedding virus.

The first identified case of asymptomatic transmission of Covid-19 occurred in early January, when a traveller from Wuhan passed on the virus to five family members in different parts of the city of Anyang. After testing positive, she then remained asymptomatic for the entire 21-day follow-up period.

While scientists still dont know whether asymptomatic people are as contagious as those who display symptoms, there are still many ways in which they can pass on Covid-19. We know that you dont need to be coughing to transmit a respiratory infection like Sars-CoV-2, says Houben. Talking, singing, even blowing instruments like a vuvuzela in the past all of those have been shown to transmit respiratory viruses in some way.

Since January, the race has been on to try and identify just how many asymptomatic cases are out there, with varying findings. One study in the Italian town of Vo reported that 43% of the towns cases of Covid-19 were asymptomatic, while initial reports from the US Centers for Disease Control and Prevention investigation into the spread of Covid-19 on the Theodore Roosevelt aircraft carrier in March, suggest that as many as 58% of cases were asymptomatic. Some 48% of the 1,046 cases of Covid-19 on the Charles de Gaulle aircraft carrier proved to be asymptomatic while, of the 712 people who tested positive for Covid-19 on the Diamond Princess cruise ship, 46% had no symptoms.

Almost all evidence seems to point to a proportion of asymptomatic infections of around 40%, with a wide range, says Houben. The proportion is also highly variable with age. Nearly all infected children seem to remain asymptomatic, whereas the reverse seems to hold for the elderly.

Houben points out that, because most asymptomatic people have no idea they are infected, they are unlikely to be self-isolating, and studies have shown this has contributed to the rampant spread of the virus in facilities such as homeless shelters and care homes. He says this means there is a need for regular diagnostic testing of almost all people in such closed environments, including prisons and psychiatric facilities.

When it comes to controlling Covid-19, this really shows that we cannot rely on self-isolation of symptomatic cases only, he says. Going forwards we need trace and test approaches to account for individuals who are not reporting any symptoms.

Since February, the country that has arguably had the greatest success in suppressing asymptomatic spread of Covid-19 is South Korea. Armed with a rigorous contact tracing and diagnostic testing regime, which involved dozens of drive-through testing centres across major cities enabling tests to be carried out at a rate of one every 10 minutes, they put specific policies in place to offset the threat of asymptomatic carriers from the moment the virus began to spread out of control in Daegu.

Once identified, all asymptomatic people are asked to self quarantine in their house until they test negative, with health service officials checking on them twice daily, and monitoring their symptoms, says Eunha Shim, an epidemiologist at Soongsil University in Seoul.

As Korea attempts to prevent a second wave of infections while reopening schools and allowing people to return to offices, preventing asymptomatic spread is one of their main priorities. This is being done by a mass public health campaign advocating the wearing of masks at all times outside the home. In Seoul, it is not possible to access the subway without a mask.

Many scientists are increasingly calling for this policy to be officially introduced in the UK, especially as more and more people resume commuting in the coming months. Keevil says: There is a strong case to be made for the public wearing appropriate face covers in confined areas such as stations, trains, metro carriages and buses, where it is extremely difficult to maintain the two-metre gap, considered essential to allow respiratory droplets from infected people to fall down before making contact with other people.

The argument is that face covers may not protect the wearer, but might significantly reduce transmission of virus particles to adjacent people in the closed environment. If there is any benefit to be gained, then everyone should wear a mask, which is why some countries are fining people who do not wear a mask and preventing them travelling.

Some have argued that masks may pose a risk of harm to the wearer because of their potential to become an infectious surface, but Keevil says this can be avoided through proper cleaning.

There would need to be policies such as, when arriving at work, place the mask immediately in a plastic bag and wash your hands, he says. And then, when returning home, carefully take off the mask and place it immediately in a washing machine for a 60C wash and wash your hands.

It remains to be seen whether the UK government endorses this as an official recommendation, but a recent study across Barts NHS Trust hospitals in London has illustrated how regular testing and social distancing combined with use of facial protection in this case PPE can prevent asymptomatic spread of the virus. Researchers James Moon and Charlotte Manisty said they found that the rate of asymptomatic infection among hospital staff fell from 7% to 1% between the end of March and early May.

For Raje, understanding why asymptomatic patients like her respond the way they do to the virus, will have some critical implications for all of us over the coming months, for example in determining whether vaccines turn out to be effective.

The big question I have after my experience, is whether a vaccine will really work in all people, she says. The vaccination approach is to create an immune response, which then protects you. But if asymptomatic people are not producing a normal antibody response to the virus, what does that mean? Because its these people who are the vectors and the carriers of this virus, I think we cant get away from social distancing until we have some of these answers out there.

Excerpt from:

Could nearly half of those with Covid-19 have no idea they are infected? - The Guardian

If youre sick and dont have supplies, see if a friend can pick them up for you, or if a grocery store or bodega will deliver. (Tip well!) Either way, avoid contact: Whether its a friend or a delivery person, have the bag left outside your door, and dont open the door until the delivery person is gone.

Over-the-counter drugs may not be enough. In particular, the coughing and nausea caused by Covid-19 can be severe enough to warrant prescription medication.

For my husband and me, benzonatate (for the cough) and promethazine (for the nausea) were lifesavers. Some colleagues were prescribed codeine-based cough medicine or Zofran. If you feel you might need them, ask your doctor about medications sooner rather than later. Dont wait until youre doubled over coughing or cant keep anything down.

If you dont have a primary care doctor, some urgent care clinics offer virtual appointments, and some pharmacies offer prescription delivery.

Dry air can exacerbate some symptoms such as coughing and chest tightness. If you have a humidifier, use it. If not, a hot shower works.

Several readers reported that they felt better when they lay on their stomach. A woman in Britain whose partner was sick for several weeks told me that a particular breathing exercise helped him:

You take a deep breath, hold it for 5 seconds and release. Do that 5 times, then on the 6th time on the release, cough hard. Do that cycle twice, then lie on your front and take slightly deeper breaths for 10 minutes. Try to do it a couple of times a day.

In some cases, your doctor may also prescribe an albuterol inhaler to reduce your cough and ease your breathing.

As soon as you get sick, start a detailed log. Every time you take your temperature do it several times a day, at consistent times log it. Every time you take a pill, log it. Every time you eat or drink, log it. If one symptom resolves or a new one develops, log it.

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How to Recover From Covid-19 at Home - The New York Times

New research has poured cold water on the theory that the Covid-19 outbreak in Washington state the countrys first was triggered by the very first confirmed case of the infection in the country. Instead, it suggests the person who ignited the first chain of sustained transmission in the United States probably returned to the country in mid-February, a month later.

The work adds to evidence that the United States missed opportunities to stop the SARS-CoV-2 virus from taking root in this country and that those opportunities persisted for longer than has been recognized up until now.

Our finding that the virus associated with the first known transmission network in the U.S. did not enter the country until mid-February is sobering, since it demonstrates that the window of opportunity to block sustained transmission of the virus stretched all the way until that point, the authors wrote in the paper. The paper has been posted to a preprint server, meaning it has not yet been peer-reviewed or published in a journal.

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The research was led by Michael Worobey, a professor of evolutionary biology at the University of Arizona.

Using available genetic sequence data, Worobey and his co-authors modeled how SARS-CoV-2 viruses would have evolved if the original case, known in the medical literature as WA1 (short for Washington state patient 1), had been the source of the states outbreak. They ran the model 1,000 times, comparing the genetic sequences of 300 randomly selected simulated cases to those retrieved from 300 actual patients. The results didnt jibe.

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In all likelihood this didnt start with WA1, Worobey told STAT in an interview. It started with some unidentified person who arrived in Washington state at some later point. And we dont know from where.

Worobey said the sequence data suggest the infection may have been brought to the country by someone returning from China, or from a nearby Asian country, or even from Asia via British Columbia, Canada.

Trevor Bedford, a computational biologist at the Fred Hutchinson Cancer Research Center in Seattle, drew the initial line between the first Washington state case a man who returned to the state from Wuhan on Jan. 15 and the states first reported case in someone who had not traveled outside the country. That person, a high school student who had been tested negative for influenza, was recognized as a Covid-19 case at the end of February.

Analysis of the genetic sequences of the viruses that infected these two people looked close enough that Bedford concluded SARS-CoV-2 had been spreading undetected in the Seattle area for about six weeks.

But in a series of tweets he posted on Sunday, Bedford said he now concludes that theory was not correct.

Based on data thats emerged in the intervening months, I no longer believe that a direct WA1 introduction is a likely hypothesis for the origin of the Washington State outbreak, he tweeted.

Others agree.

Im convinced by the Worobey study, Kristian Andersen of Scripps Research, an expert on viral genomes, told STAT.

Samuel Scarpino, an assistant professor at Northeastern Universitys Network Science Institute, said Worobeys paper confirms what a lot of what we were starting to suspect from the epidemiological data, that there were some early introductions in the West Coast that did not spark sustained transmission.

Worobey and his co-authors estimated that the infection that started the Seattle area outbreak arrived in the country around Feb. 13, shortly after President Trumps ban on travel from China went into effect on Feb. 2. Thousands of Americans in the country fled back to the United States in the days after the ban was announced.

Worobey said the work isnt merely an effort to set the historical record straight. If WA1 sparked the Seattle outbreak, there was really little more that could have been done to prevent it. The patient had recognized he was probably ill and alerted his physician to the risk. Public health authorities mapped his travel and contacted his contacts, isolating him and quarantining the people hed been in contact with.

When the first case of local transmission was linked back to WA1, it appeared that the efforts to contain his infection hadnt been adequate. But in fact, they probably were, Worobey said.

Conclusions that the Seattle area was already six weeks into an epidemic by the end of February, rather than two or three, and the notion that stringent efforts to prevent spread had failed in the WA1 case, may have influenced decision-making about how to respond to the outbreak, including whether such measures were worth the effort, he and his co-authors wrote.

Scarpino said the research supports the idea that contact tracing and isolation can work. Everything is sort of lining up in the direction that if were serious about it, we can control this thing, he said. Were just not being serious about it.

Worobeys group also disputed a claim, published earlier this month, that a more transmissible lineage of SARS-CoV-2 viruses has emerged, arguing the increased geographic spread of viruses with that mutation pattern has more to do with timing than with increased infectiousness.

Viruses with these mutations spread from Hubei province to Italy and from there to New York City and began to spread locally undetected for a time. This viral lineage appears to have been amplified because of luck, not high fitness, they wrote.

Correction: The headline on an earlier version of this story misstated a key finding of the new research that the coronavirus took off in the U.S. later than previously thought.

Link:

New research rewrites history of when Covid-19 took off in the US - STAT

Memorial Day weekend at Robert Moses State Park on Fire Island, N.Y. As the pandemic continues, Harvard's Dr. Ashish Jha says, mask wearing, social distancing and robust strategies of testing and contact tracing will be even more important. Jeenah Moon/Bloomberg via Getty Images hide caption

Memorial Day weekend at Robert Moses State Park on Fire Island, N.Y. As the pandemic continues, Harvard's Dr. Ashish Jha says, mask wearing, social distancing and robust strategies of testing and contact tracing will be even more important.

The bleak milestone the U.S. is about to hit 100,000 deaths from COVID-19 is far above the number of deaths seen from the pandemic in any other country.

So far, the impact of the coronavirus has been felt unevenly, striking certain cities and regions and particular segments of society much harder than others.

To get a sense of how that may change, and where in the course of the epidemic the U.S. is right now, NPR's Morning Edition host David Greene spoke Tuesday with Dr. Ashish Jha, director of the Harvard Global Health Institute and professor of health policy at the Harvard T.H. Chan School of Public Health.

Their conversation has been edited for length and clarity.

As you look at this number looming now, what are you reflecting on?

Well, a couple of things. First of all, it is a solemn moment to reflect on the idea that about 100,000 Americans have died mostly just in the last two months. The speed with which this has happened is really devastating. Of course, we've had very little opportunity to mourn all those losses because most of us have been shut down. And I've been thinking about where we go into the future and fall and reminding myself and others that we're early in this outbreak. We're not anywhere near done.

The U.S. ... has had more deaths than any country in the world. Do you think that the country is absorbing the significance of these numbers?

I think for a majority of Americans, this doesn't quite feel real because the deaths have been concentrated in [a] few places. Obviously, New York has been hit very hard, and some other places like Seattle, Chicago some of the big cities. And so people who don't live in those areas may not be absorbing it.

But the nature of this pandemic is that it starts and kind of accelerates in big cities, but then it moves out into the suburbs and into the rural areas. So, by the time we're done with this, I think every American will have felt it much more up close and personal. That's what I worry about that it shouldn't have to take that for people to really understand how tragic this is and how calamitous in many ways this is.

Q: We're coming out of Memorial Day weekend, and we saw many regulations relaxed in many parts of the country. As you were watching that, what are you predicting in terms of what we could see by the end of summer?

If you look at all of the models out there and most models have been relatively accurate a few of them have been too optimistic. But then, if you sort of look at the models of models the ones that really sort of combine it all and put it together and make projections the projections are that we're probably going to see 70,000 to 100,000 deaths between now and the end of the summer.

While the pace will slow down, because we are doing some amount of social distancing and testing is ramping up we're going to, unfortunately, see a lot more sickness and, unfortunately, a lot more deaths in the upcoming months.

Q: There's been talk of a seasonal aspect to this. Whatever happens over the summer, do we face even more deaths as we head later in the year?

Yes. I'm hoping that the models of the summer of an additional 70,000 to 100,000 deaths are too pessimistic. And they may be, because we may get a seasonal benefit because of the summer: People are outside more.

But the flip side of the seasonal benefit of the summer is what will almost surely be a pretty tough fall and winter with a surge of cases a wave that might be bigger than the wave we just went through. And we've got to prepare for that, because we can't be caught flat-footed the way we were this time around.

Q: What can we do to prepare? We're seeing so many states relax restrictions right now. Is it a matter of potentially putting those restrictions back in place where they need to be? Or are there other things we could be doing?

There are two things that I would say. First of all, people can't be locked down for the rest of this pandemic. I understand that people need to get out, and being outside is a good thing. But we have to maintain a certain amount of social distancing. I think mask wearing is really important.

The only other tool we have in our toolbox is a really robust testing, tracing, isolation program. You know, if you think about how it is that South Korea and Germany have been able to do much, much better? They have had a really aggressive testing, tracing, isolation program. We know that works. It allows us to kind of have more of our lives back without the number of deaths that we've suffered. So I really think that still remains and should remain one of our priority areas.

Q: The federal government's new strategic testing plan calls on states to take a lot of the responsibility for testing. ... Do you see that as the best approach?

I think this is a real missed opportunity and very unfortunate in many ways, because while states have a critical role to play, testing capacity and testing supply chains are national and international.

We don't want 50 states competing. We want a federal strategy that helps states. And I'm worried that we're just not getting that from the federal government.

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Nearing 100000 COVID-19 Deaths, U.S. Is Still 'Early In This Outbreak' - NPR

The answer, though fanciful, illustrates just how hard it can be to understand exponential growth and doubling, two pieces of math that explain the spread of viruses like Covid-19.

Because by the time you made the 42nd fold, your stack of paper would reach the moon. It's not just a handy fact for trivia night: It shows how exponential growth can result in numbers that are nearly incomprehensible.

"Math concepts are really hard," she said. "It's not a surprise that the general public has a hard time grasping these."

And now, with a pandemic dominating global headlines, Covid-19 is putting Americans' knowledge to the test.

Classroom educators and education activists have said they're concerned by some aspects of the public response to the virus, including angry reactions to the guidelines designed by epidemiologists to keep America safe.

"If people understood how an outbreak could take off so quickly, and it does get back to this concept of exponential growth, they might be more careful about how they go about their day," Wasserman said.

Quiz time

Learning to think like a scientist

While the basics of viral spread, infection and other scientific ideas can help decode stories about Covid-19, many science educators say there's a broader perspective required when it comes to understanding what's happening in the world.

"It's impossible to teach students about everything," said Blake Touchet, who teaches biology at North Vermillion High School and Abbeville High School in Louisiana.

There's simply too much to know, he said. And the frontiers of scientific knowledge are always changing as theories get updated and revised. Instead, Touchet teaches his students to think like scientists.

"It's important that they understand how the process of science works, so that they can continue growing and learning even when they're out of school," he said.

One skill that Touchet emphasizes in his high school classes is called source evaluation, which can be applied to news articles, podcasts or even a study from a scientific journal.

"Analyzing and evaluating it to see if it has bias, or whether it's containing accurate information or whether it's reliable," he said.

In teaching students about the process of science, Touchet also emphasizes the significance of scientific consensus, which can bring clarity to contentious topics.

"There was a study that was published showing that 97% of scientists agree with anthropogenic climate change that humans are causing climate change," he said, offering an example of a clear scientific consensus.

In the news, Touchet said the situation is sometimes represented as an unresolved debate, despite the fact that most experts actually agree on the facts.

"That was a really good visualization of what we're thinking about when we're looking at scientific consensus," Touchet said. "We're not talking about people who are agreeing or disagreeing with each other. We're talking about data."

It's an idea that Touchet said is directly applicable to understanding news about Covid-19, especially when a lone scientist goes on television to tout a so-called cure with little support in the broader community.

America's education gap

Those skills of evaluating scientific ideas are more essential than ever, but Americans' grasp of science varies widely.

Where you went to school matters, too.

Students in some areas have few opportunities to engage with science outside of school, Reid said. She called these places "science deserts," and while the NCSE works in many rural areas, Reid explained that some urban students also lack access to learning opportunities.

Where science meet politics, that information gap feeds a dangerous division.

"Teacher education programs should anticipate, and equip future teachers to deal with, the politicization of science," the report found.

And while the challenges of understanding math and science are not limited to the United States, Americans' competencies in these subjects often fall far behind other developed countries.

In the most recent figures from the Programme for International Student Assessment, students from the United States ranked 37th in math among participating education systems. We did a bit better in science, coming in at 18th place.

Learning more about science at any age

Just because Americans lack some basic information about science doesn't mean they're not interested.

"The term 'anti-science' is thrown around a lot, and I don't think it captures the situation very well," Reid said.

"There are certain areas of science where there's a lot of misinformation pumped into the system, and people accept that information because it's coming from people they trust. But I don't think that makes them anti-science."

In fact, some of the same polls that revealed gaps in Americans' understanding of science spoke to their desire to learn more. A 2016 National Science Board study found that 95% of Americans were interested in new medical discoveries, and 84% were interested in scientific discoveries.

If you're one of the Americans who wants to learn more, there are plenty of free resources for brushing up on your understanding of science.

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Confused by the science behind Covid-19? You're not alone - CNN

Moderna Therapeutics, a biotech company based in Cambridge, Mass., has shipped the first batches of its COVID-19 vaccine. The vaccine was created just 42 days after the genetic sequence of the COVID_19 virus, called SARS-CoV-2, was released by Chinese researchers in mid-January. The first vials were sent to the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH) in Bethesda, MD, which will ready the vaccine for human testing as early as April.

NIH scientists also began testing an antiviral drug called remdesivir that had been developed for Ebola, on a patient infected with SARS-CoV-2. The trial is the first to test a drug for treating COVID-19, and will be led by a team at the University of Nebraska Medical Center. The first patient to volunteer for the ground-breaking study is a passenger who was brought back to the US after testing positive for the disease aboard the Diamond Princess. Others diagnosed with COVID-19 who have been hospitalized will also be part of the study.

Keep up to date with our daily coronavirus newsletter by clicking here.

Remdesivir showed encouraging results among animals infected with two related coronaviruses, one responsible for severe acute respiratory syndrome (SARS) and another for causing Middle East respiratory syndrome (MERS). Volunteers will be randomly assigned to receive either the drug or a placebo intravenously for 10 days, and they will have blood tests and nose and throat swabs taken every two days to track the amount of virus in their bodies. Even if the drug shows some efficacy in keeping blood levels of SARS-CoV-2 from growing, it could help to contain spread of the infection.

Modernas vaccine against COVID-19 was developed in record time because its based on a relatively new genetic method that does not require growing huge amounts of virus. Instead, the vaccine is packed with mRNA, the genetic material that comes from DNA and makes proteins. Moderna loads its vaccine with mRNA that codes for the right coronavirus proteins which then get injected into the body. Immune cells in the lymph nodes can process that mRNA and start making the protein in just the right way for other immune cells to recognize and mark them for destruction.

As Dr. Stephen Hoge, president of Moderna, told TIME earlier this month, mRNA is really like a software molecule in biology. So our vaccine is like the software program to the body, which then goes and makes the [viral] proteins that can generate an immune response. That means that this vaccine method can be scaled up quickly, saving critical time when a new disease like COVID-19 emerges and starts infecting tens of thousands of people.

Please send any tips, leads, and stories to virus@time.com.

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COVID-19 Vaccine Shipped, and Drug Trials Start | Time

In just a few short weeks, weve all made the collective journey from pandemic ignoramuses to budding armchair virologists with a decent grasp of once-arcane terms like personal protective equipment, social distancing and "flatten the curve".

But theres one phrase that might still leave a few justifiably scratching their heads: the R number. The coronavirus has one, and governments around the world are keen to see it shrink as much as possible. But what is it?

R refers to the effective reproduction number and, basically put, its a way of measuring an infectious diseases capacity to spread. The R number signifies the average number of people that one infected person will pass the virus to.

The R number isnt fixed, but can be affected by a range of factors, including not just how infectious a disease is but how it develops over time, how a population behaves, and any immunity already possessed thanks to infection or vaccination. Location is also important: a densely populated city is likely to have a higher R than a sparsely peopled rural area.

Because Sars-CoV-2 to give the novel coronavirus its full honorific is a new pathogen, scientists at the start of the outbreak were scrambling to calculate its R0, or R nought: the viruss transmission among a population that has no immunity. Studies on early cases in China indicated it was between 2 and 2.5; more recent estimates have placed it as high as 6.6.

To put these figure in context, says Wired science editor Matt Reynolds, they're worse than seasonal flu, which has an R0 of 1.3, but miles better than measles, whose R0 is between 12 and 18. The kicker, though, is that for each of those diseases we have a vaccine, and so the effective reproduction number the R is way below 1.

This threshold an R of 1 will become increasingly crucial over the next few months. As the UK government explained in the video that accompanied its press briefing on 30 April, an R figure that is even slightly over 1 can lead quickly to a large number of cases thanks to exponential growth.

Here's how that works. Say a disease has an R of 1.5. This may seem like a manageable figure, but a glance at the figures quickly proves that isn't the case. An R of 1.5 would see 100 people infect 150, who would in turn infect 225, who would infect 338. In three rounds of infection, the number of people with the virus would have more than quadrupled to 438. As worldwide cases now exceed 3.5 million, this helps explain why the novel coronavirus was able to rip so quickly among a global population with no previous immunity.

Image: BBC

Conversely, an R of less than 1 means that the virus will eventually peter out the lower the R, the more quickly this will happen. An R of 0.5 means that 100 people would infect only 50, who would infect 25, who would infect 13. As the number of cases drops and ill people either die or recover, the virus will be brought under control as long as the R can be kept low.

So an R of 1 and above tends towards exponential growth. An R of below 1 tends towards the end of the outbreak. All we need to do is keep the R below 1. Simple, right?

Not so fast. As stated above, the R value is ever-changing. Thanks to lockdown measures, many governments have been able to push R to below 1. In the UK, chief scientific officer Patrick Vallence said that the nations R number is currently thought to be between 0.6 and 0.9, though it varies regionally and in London could be as low as 0.5 to 0.7.

This was only achieved, however, thanks to a heroic, unprecedented series of adjustments which have brought our lives and our economies to a juddering halt and all of this to produce an R of 0.6 to 0.9. This doesnt give us a huge amount of leeway.

Lockdown helped drop Germanys R down to about 0.7 in early April, but researchers at the Robert Koch Institute in Berlin said it had recently increased back to 0.9, before sinking again to 0.75. Even within lockdown, if people start losing patience with restrictions or need to go out to work, R could quickly rise again.

Another difficulty that scientists and policymakers are facing is that its still not entirely clear how much of a role each measure plays. Is shutting schools doing the heavy lifting, or restricting access to shops? How much of a boost could wearing masks provide?

As governments tentatively ease lockdown restrictions around the world, they will be monitoring R very carefully for signs of a sudden jump. If R sneaks above 1 even a fraction, it could trigger a damaging second wave of the virus.

Once R is consistently low and the number of cases is manageable, governments can implement more precise measures to restrict R, such as contact-tracing and location-tracking apps approaches that paid dividends when introduced early on in nations such as South Korea and Singapore.

A couple kisses at Duomo Square, Catania, Sicily, as Italy begins a staged end to a nationwide lockdown, 4 May 2020.

Image: Reuters/Antonio Parrinello

There are a number of ways to calculate R, as Wired notes. One is by monitoring hospitalisation and death figures to get a sense of how many people have the virus but the problem with this is that, since the viruss incubation period is so long, it only gives an accurate picture of a few weeks ago. To check transmission rates in a more accurate way, scientists at Imperial College London in the UK have started testing randomised 25,000 groups of the population to see how many are ill.

Its important to note that R isnt the only key measure in assessing the impact of this pathogen, says the BBC. Another crucial yardstick is the number of cases of COVID-19, the disease caused by Sars-CoV-2. If we have a large number of cases and an R of 1 or just below, that still equates to a large number of infections so ideally we need to restrict both R and bring down the number of cases at the same time.

An additional key measure to look out for is the number of ICU beds available in any given country, since this will have a big effect on mortality rate.

Ultimately, the best weapon in the fight to reduce R is a vaccine. But exactly when this will be available or indeed if it will ever happen at all is currently unclear.

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Remdesivir, an experimental antiviral drug made by Gilead Sciences, has been authorized by the Food and Drug Administration for emergency use in treating severely ill COVID-19 patients. Ulrich Perry/POOL/AFP via Getty Images hide caption

Remdesivir, an experimental antiviral drug made by Gilead Sciences, has been authorized by the Food and Drug Administration for emergency use in treating severely ill COVID-19 patients.

Now that the Food and Drug Administration has authorized remdesivir for emergency use in seriously ill COVID-19 patients, the experimental drug is another step closer to full approval. That's when most drugs get price tags.

Gilead Sciences, which makes remdesivir, is donating its initial supply of 1.5 million doses, but the company has signaled it will need to start charging for the drug to make production sustainable. It's unclear when that decision might be made.

"Going forward, we will develop an approach that is guided by the principles of affordability and access," Gilead CEO Daniel O'Day told shareholders during the company's annual meeting Wednesday.

In a quarterly financial filing made the same day, Gilead said its investment in remdesivir this year "could be up to $1 billion or more," much of it for scaling up manufacturing capacity.

The company also acknowledged that it's in the spotlight. "[G]iven that COVID-19 has been designated as a pandemic and represents an urgent public health crisis, we are likely to face significant public attention and scrutiny about any future business models and pricing decisions with respect to remdesivir," Gilead said in the quarterly filing.

How will the company balance its business calculations with the drug's potential value to society?

"Gilead has not yet set a price for remdesivir," company spokeswoman Sonia Choi wrote in an email to NPR. "At this time, we are focused on ensuring access to remdesivir through our donation. Post-donation, we are committed to making remdesivir both accessible and affordable to governments and patients around the world."

Among potential treatments for COVID-19, remdesivir, an intravenous drug that was once studied for Ebola, is one of the furthest along.

"It's hard to imagine a situation in which there will be more public scrutiny," said Michael Carrier, a professor at Rutgers School of Law who specializes in antitrust and pharmaceuticals. "On the one hand, Gilead will try to recover its R&D in an atmosphere in which it is able to potentially make a lot of money. On the other hand, the pressure will be intense not to charge what's viewed as too high a price."

Breaking with its usual practices, the Institute for Clinical and Economic Review, or ICER, an influential nonprofit that analyzes drug pricing, issued an expedited report on remdesivir.

"Under normal circumstances, we would be unlikely to do a report when the evidence is this raw and immature," ICER President Steven Pearson said in an interview with NPR. "But it was quite clear that the world is moving at a much quicker pace."

If the price is based just on the cost of making the drug, then a 10-day course of remdesivir should cost about $10, according to the ICER report. (Gilead said results of a recently completed study suggest a five-day course of treatment may be just as effective.)

But if the drug is priced based on the drug's effectiveness, ICER estimates it should cost around $4,500 assuming the drug is proven to have some benefit on mortality. If it doesn't and the drug only shortens hospital stays, that value-based price goes down to $390.

Results from a federally funded study described by Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, suggested that remdesivir could reduce recovery time by a median of four days 11 days to recovery for patients treated with remdesivir compared with 15 days for those who got a placebo. A potential survival benefit is less clear.

Rutgers' Carrier said he expects Gilead to set the remdesivir price somewhere between the $10 and $4,500 that ICER estimated. The company has already shown that it can respond to public pressure when it asked the FDA to rescind the orphan drug status it won for remdesivir, he pointed out.

"When you see that $10 figure, that sets a benchmark for a figure that is eminently affordable," Carrier said. Ultimately, he said a price more than $1,000 per treatment course would be unpopular.

Gilead "will be watched very carefully," he said, because of its prior history of pricing. He referred to two other Gilead drugs that drew scrutiny over high price tags. The company charged $1,000 per pill for Sovaldi, a cure for hepatitis C. And its HIV drug Truvada can cost $22,000 per year.

But there is such a thing as pricing remdesivir too low, said Craig Garthwaite, who directs the health care program at Northwestern University's Kellogg School of Management.

"We don't think this is the only drug we need," he said, adding that remdesivir doesn't appear to be a "home run" against the coronavirus, based on existing data. "The thing that would worry me the most is that we're somehow telling people that if you take the risky bet to try, and you'll go after a coronavirus cure and you do it, you're not going to get paid."

Instead, he said he would like to see acceptance of a generous price for remdesivir to send the message to drug companies that the best thing they can do is "dedicate every waking moment to trying to develop that cure, and that if they do that, we will pay them the value they create," he said.

During a Gilead earnings call on April 30, analysts asked executives whether they could expect similar financial returns on remdesivir as they've seen with Gilead's other drugs.

"There is no rulebook out there, other than that we need to be very thoughtful about how we can make sure we provide access of our medicines to patients around the globe," Gilead CEO O'Day said. "And do that in a sustainable way for the company, for ... shareholders, and we acknowledge that."

On May 1, the FDA authorized remdesivir for emergency use, meaning it will be easier to administer to hospitalized patients with severe disease during the pandemic, but the drug is not yet officially approved. The federal government is coordinating distribution of the treatment.

O'Day acknowledged on the recent earnings call that the company "could" charge for remdesivir under an emergency use authorization, but he stressed that Gilead is donating its current supply, which should last through "early summer."

To date, the National Institutes of Health said it has obligated $23 million toward its COVID-19 remdesivir trial. And the U.S. Army Medical Research Institute of Infectious Diseases did some of the early in vitro and animal studies with the medicine prior to the pandemic.

"Taxpayers are often the angel investors in pharmaceutical research and development, yet this is not reflected in the prices they pay," Reps. Lloyd Doggett, D-Texas, and Rosa DeLauro, D-Conn., wrote in an April 30 letter to Health and Human Services Secretary Alex Azar.

Concerned about remdesivir's price, they asked for a full breakdown of taxpayer funds that have gone toward the development of the medicine. "An unaffordable drug is completely ineffective," they wrote in the letter. "The substantial taxpayer investments in COVID-19 pharmaceutical research must be recognized."

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Remdesivir Price Still A Puzzle To Be Solved By Gilead Sciences : Shots - Health News - NPR

As coronavirus disease 2019 (COVID-19) has spread, public health and economic well-being are increasingly in conflict. Governments are prioritizing public health, but the current solutionsocial isolationis costly as commerce remains shut down. Restarting economies could rekindle the pandemic and cause even worse human suffering. Innovation can help societies escape the untenable choice between public and economic health. The world needs effective vaccines, therapies, or other solutions. But how do we achieve these solutions, and achieve them quickly?

Innovation policy can accelerate advances, with high returns. In the United States, COVID-19 has reduced gross domestic product (GDP) by 30%. What if additional investment in research and development (R&D) could bring forward an effective vaccine by just 1 day? If this investment costs less than the daily loss in GDP ($18 billion in the United States alone), it would pay for itself. Even large incremental funding to support R&D will be miniscule in scale compared to the $2.8 trillion the U.S. government is spending to compensate for the economic shutdown.

What principles should guide government innovation policy to battle COVID-19? It is critical to support many independent avenues of research. Outcomes from R&D investments are uncertain. Many avenues will be dead ends, so many different pathseach corresponding to an independent effortshould be pursued. Consider funding 10,000 such efforts. Even if each had only a 0.1% chance of producing an advance in prevention, treatment, or infection control, the probability of at least five such advances would be 97%. By contrast, if efforts crowd into only a few prospects, the odds of collective failure can become overwhelming.

This innovative push must draw widely on talent. Research talent is plentiful, but many laboratories and teams are now shuttered and dispersed by the pandemic. Private investment gravitates toward marketable solutions, but key insights are likely to come from asking why questions (for example, basic research into the pathophysiology of the disease) and not simply from shovel ready drug development projects. Moreover, good ideas often come from unexpected corners. Useful solutions may be discovered outside biomedicine, including through engineering disciplines and information technology.

What would a bold innovation policy agenda look like? In the United States, funding for R&D must be fortified, as recently called for by the Task Force on American Innovation and 17 other organizations. Also, a principal investigator already receiving public funding should be able to receive immediate support to work on COVID-19 with minimal application burden and decisions within 1 week. The National Institutes of Health (NIH) has taken some first steps with emergency procedures to supplement existing grants, but these efforts need to draw on additional labs and talent, and to accelerate review. The marginal investment through the NIH, at $3 billion, appears modest in size, equating to the U.S. GDP loss in just 4 hours. Globally, researchers with relevant expertise are essential workers; they should have access to their labs and additional resources to engage in the COVID-19 battle.

Government support for private sector R&D should be delivered at great speed. A Pandemic R&D Program could deploy loans that are forgivable later, based on actual investment in COVID-19related innovations, thus ensuring that financial constraints do not slow down solutions. More support could come through supplementing the R&D tax credit system, which already exists in the United States and other countries.

In June 1940, the U.S. government created the National Defense Research Committee (NDRC), composed of eminent scientists and innovators in the public and private sectors, with the mandate to achieve innovations related to the war effort. This leadership structure drove the rapid development of numerous technologies, including weapons systems but also antimalarial drugs and penicillin manufacturing. A COVID-19 Defense Research Committee could similarly be empowered to coordinate and fund solutions to the pandemic. This group would track R&D efforts, create a public clearinghouse documenting the avenues pursued, fund innovations and the scaling of successful advances, and streamline bureaucracy. The new vaccine effort, Operation Warp Speed, moves in this direction. But we also need efforts beyond vaccines.

COVID-19 presents the world with a brutal choice between economic and public health. Innovation investments are essential to avoiding that choiceyet tiny in cost compared to current economic losses and other emergency programs. Even the slight acceleration of advances will bring massive benefits.

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Beat COVID-19 through innovation - Science Magazine