Month: September 2020

(Reuters) – A malaria drug taken by U.S. President Donald Trump to prevent COVID-19 did not show any benefit versus placebo in reducing coronavirus infection among healthcare workers, according to clinical trial results published on Wednesday.

The study largely confirms results from a clinical trial in June that showed hydroxychloroquine was ineffective in preventing infection among people exposed to the new coronavirus.

Trump began backing hydroxychloroquine early in the pandemic and told reporters in May he started taking the drug after two White House staffers tested positive for COVID-19. Studies have found the drug to offer little benefit as a treatment.

In the study of 125 participants, four who had taken hydroxychloroquine as a preventative treatment for eight weeks contracted COVID-19, and four on placebo tested positive for the virus.

All eight were either asymptomatic or had mild symptoms that did not require hospitalization, according to the results published in the JAMA Internal Medicine journal.

The research shows that routine use of the drug cannot be recommended among healthcare workers to prevent COVID-19, researchers from the University of Pennsylvania said.

The study authors said it was possible that a trial conducted in a community with higher prevalence of the disease could allow detection of a greater benefit from the drug.

In the latest trial, which was terminated before it could reach its enrollment target of 200 participants, mild side effects such as diarrhea were more common in participants taking the malaria drug compared to placebo.

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The fall and winter months are upon us, and COVID-19 infections are starting to surge across the country. Though a vaccine is expected in the next couple of months, experts have warned that once the immunization is available, it will likely take a year or more for it to actually be effective on a national level. This is why Dr. Anthony Fauci, the nation’s leading infectious disease expert and key member of the White House Coronavirus Task Force routinely urges the importance of abiding by a few recommended prevention strategies he has dubbed his fundamentals. And, during an interview with Wired on Wednesday, he added a new one to the list. Read on, and to get through this pandemic at your healthiest, don’t miss these Sure Signs You’ve Already Had Coronavirus.

The Flu Shot is Ready Now, He Said: Get One

Dr. Fauci made it clear that shutting down the economy was not on his list of things to do in order to get the pandemic under control.

“We’re talking about taking a very prudent, careful approach to reopening the economy by the common five or six things,” he explained. These included “wearing masks uniformly, avoiding crowds, keeping distance, doing things outdoors absolutely much more preferentially than indoors, and washing your hands frequently.”

“It sounds like rather simple things, but they do have a major impact on whether you can get those surges to come down,” he added.

And, due to the impending cold and flu season, he offered another recommendation: getting the flu shot. “We now have enough flu vaccine to vaccinate almost 200 million people,” he pointed out.

“Everybody, six months or older should get a flu shot,” he stated.

“If we do and abide by those public health measures that I just mentioned, we might mitigate well the flu season,” he continued.

RELATED: Dr. Fauci Says You Can Catch COVID This Way After All

Other Countries Have Seen Success with the Flu Shot

Story continues

He used Australia and Argentina, “our colleagues in the Southern hemisphere” as an example of the effectiveness of his recommendations, pointing out that they “had almost a non-existent flu season, the first time in memory that they had such a low flu season,” he said.

“The reason is they abided by the public health measures that I just mentioned. So as we enter the flu season, get your flu shot and please pay attention to those very simple public health recommendations,” he concluded.

As for yourself, to get through this pandemic at your healthiest, get that flu shot and don’t miss these 35 Places You’re Most Likely to Catch COVID.

If you go to see a doctor with flu-like symptoms this flu season, chances are you’re going to get swabbed for two tests: one for the flu, and one for COVID-19. Unlike flu seasons when there isn’t a pandemic, doctors can’t be confident that someone with body aches and a fever has the flu. That’ll change the diagnostic process for both diseases.

“This year, if it looks and smells like flu, it could be flu — or could be COVID-19,” says Richard Webby, an infectious diseases researcher at St. Jude Children’s Research Hospital in Memphis.

Sorting out one from the other is important. The treatment methods may not be that different: someone with a mild case of the flu and someone with a minor case of COVID-19 will both probably be sent home to rest and recover. Knowing someone has COVID-19, though, means they can be told to watch out for signs that the illness is becoming more serious. A COVID-19 diagnosis also triggers public health interventions like contact tracing, so that the virus doesn’t continue to spread.

“We’d like to get rid of them both, but the coronavirus is the one we’re really trying to control,” Webby says. “We want to get that person out of circulation as soon as possible.”

Doctors regularly use rapid flu tests in their offices, with results that come back within 15 minutes, says Anthony Baffoe-Bonnie, the infectious disease chief at Carilion Clinic in Virginia. Flu season hasn’t picked up quite yet, so for now, the first step for treating any patient with respiratory symptoms would be to test them for COVID-19. Once flu tests start coming back positive in his area and when flu surveillance systems start reporting that the virus is circulating, he says he’ll start to add on tests for the flu.

There are a handful of tests available that can check for both influenza and COVID-19 at once: health care companies Roche and Cepheid have Food and Drug Administration authorizations for joint tests, and the Centers for Disease Control and Prevention has one available for public health labs. Those are the best approach, Baffoe-Bonnie says. But they may not be available in every area and at every hospital — most places might have to rely on two separate tests.

Right now, the joint tests are genetic tests: they look for fragments of the influenza genetic sequence and fragments of the coronavirus genetic sequence. Those types of tests require more specialized machinery. The standard, outpatient flu test is usually an antigen test, which looks for the proteins that stick out on the outside of the influenza virus. These tests work fast, and can have results back in about 15 minutes, but tend to be less accurate than genetic tests. Both options are also available for COVID-19 tests.

If a joint test isn’t available, getting tested for both flu and COVID-19 could mean a combination of the testing types. Someone might get a rapid flu test for flu, but a slower, gene-based COVID-19 test. A doctor could decide to send out genetic tests for both viruses to a lab, which could have a turn around time of a few days. People might go to a walk-in COVID-19 testing site for a rapid test, and go to a doctor for a flu test if that comes back negative.

Baffoe-Bonnie says his clinic plans to start with genetic tests for the viruses, while having some ability to do faster antigen tests, if necessary, as well.

All this testing could help get patients better treatment — but it could also be very expensive, worries Edward Belongia, director of the Center for Clinical Epidemiology & Population Health at Marshfield Clinic Research Institute in Wisconsin. Under the CARES act, passed in the United States at the start of the pandemic, COVID-19 tests are supposed to be free for patients. “That’s not true for flu,” he says. In March and April, some people sick with what they thought was COVID-19 were charged thousands of dollars for tests for other respiratory viruses, like flu.

“We don’t want people discouraged from coming in and getting tested because they’re worried about the cost of the laboratory tests,” Belongia says.

That’s a particular worry, because increased testing — and all the costs associated with it — might not be confined to this flu season. There’s still a chance that, even after the pandemic passes, the coronavirus could continue to circulate through the population each year. If that happens, some of the adjustments to the way doctors diagnose the flu could be more permanent, Webby says. Influenza won’t be the only culprit for a feverish, achy patient — they’ll have to consider other viruses, too.

“I think that would put pressure on [the] system to change, not just specifically flu, but the whole respiratory virus testing pipeline,” he says.

Timothy Ray Brown, the so-called “Berlin patient” and the first person known to have been cured of HIV infection, has died at age 54.

It was recently revealed that he was terminally ill from a recurrence of leukemia last year. The news of his passing was announced on Facebook by his partner, Tim Hoeffgen, who called Brown his “angel” and said he was surrounded by friends when he died Tuesday afternoon in Palm Springs, California.

“I am truly blessed that we shared a life together but I’m heartbroken that my hero is now gone. Tim was truly the sweetest person in the world,” Hoeffgen wrote. “Tim’s spirit will live on and the love and support from family and friends will help me through this most difficult time.

“Celebrate Tim’s life and always have Hope,” Hoeffgen continued. “You’re my angel now. I love you forever Tim!”

Brown, who was diagnosed with HIV in the 1990s, learned he had leukemia in 2006 while working in Berlin. In 2007 and 2008, he received stem cell transplants from another patient that resulted in both the remission of the leukemia and him testing negative for HIV. He had tested negative for the virus that causes AIDS ever since.

“Timothy proved that HIV can be cured, but that’s not what inspires me about him,” Dr. Steven Deeks, an AIDS specialist at the University of California, San Francisco, told the Associated Press of his noteworthy status. “We took pieces of his gut, we took pieces of his lymph nodes. Every time he was asked to do something, he showed up with amazing grace.”

Brown said that even though his leukemia returned, he was “still glad” that he had the stem cell treatments, saying they “opened up doors that weren’t there before.”

The International AIDS Society (IAS), an organization of HIV professionals, acknowledged his passing on
their website and on Twitter, saying, “It is with a profoundly heavy heart that the IAS bids farewell to Timothy Ray Brown” and expressing “a great deal of gratitude for opening the door for scientists to explore the concept that a cure for HIV is possible.”

Baltimore blogger Mark King, who writes about HIV, recently visited with Brown and Hoeffgen, who expressed sadness about seeing his partner’s decline.

“The hardest part has been seeing Timothy go downhill,” Hoeffgen told King in a story for the Los Angeles Blade. “He’s a person you can’t help loving. He’s so sweet. The cancer treatments have been rough. Sometimes I wonder if it’s worse than the disease.”

Hoeffgen also told him that researchers had wanted Brown’s body to be “left to science” after his death, but he declined. “I said, ‘thank you, but no. I think he’s done enough,’” Hoeffgen responded.

King also acknowledged Brown’s contribution to AIDS research.

“It is unfathomable what value he has been to the world as a subject of science,” he said. “And yet this is also a human being who is a kind, humble guy who certainly never asked for the spotlight.

“I think the world of him.”

Since March, we’ve all been forced to rethink our handling of personal space. Dictating our distance from other humans is a rule of thumb that defines “close contact”: If you’re within 6 feet of someone for more than 15 minutes, it’s potentially dangerous. This is the rule that federal and state health departments use to determine whom needs to be contacted after someone tests positive for COVID-19, and it’s a rule (especially the 6 feet part) that many Americans are using to determine their risk when going shopping or seeing friends. Restaurant servers adhere to it by not lingering at tables; news anchors adhere to it on TV, their seats carefully spaced out. But as we move indoors in increasing numbers—particularly into classrooms, dormitories, and offices—the underlying assumptions that made 6 feet and 15 minutes a rule to live by are no longer correct. To reflect the risk that comes with gathering indoors, and our evolving understanding of how COVID-19 can be spread, we need to rethink the formula for “close contact.”

The original definition for close contact was basically a good guess.

We’ve been aware for a while that the main way you become infected with SARS-CoV-2 is through inhalation of virus-containing particles; this is why we have physical distancing. Those particles come from the airway of an infected person who coughs, sneezes, sings, yells, or even just speaks and breathes. If you are close enough to breathe those particles as they fall through the air—at the beginning of the pandemic, we thought most particles that conferred risk were relatively large—you stand a chance of becoming infected. For interacting with the general population, where we don’t know who is infected, prevention has centered on minimizing the ways one might be exposed to the virus. These include staying far enough away from one another such that most of the potentially virus-containing particles from one person are either dispersed (this is why the outdoors is considered safer) or fall to the ground before they reach someone nearby (this is the purpose of the 6-foot rule). Disinfecting surfaces where particles may have fallen can be a useful precaution.

For a disease as serious and as infectious as COVID-19, we take additional steps when we identify an infectious case. The cornerstone of pandemic response is isolation, contact tracing, and testing. When this works, it identifies an infected person quickly, through regular testing, then minimizes the number of people who come into contact with them, by isolating the infected person. It proactively identifies other people who had prior contact with the case, through contact tracing; these people are at greatest risk of infection. Who is categorized as having had “close contact” with the infected person is very important: It may affect if they are contacted in the first place, and if they are then counseled to quarantine to avoid further disease spread. In this process of identifying and informing “close contacts,” the finer details matter. Although it is informed by science, there is an art to whether someone qualifies as an instance of close contact. In the process of identifying close contacts, an investigator is likely to talk to many more people than will eventually be deemed “close contacts”—people who came into contact with an infected person only briefly or from a distance. The messaging in all of these discussions must be persuasive, informative, and accurate. That can’t happen if the definition of “close contact” isn’t based on good, up-to-date science.

The original definition for close contact was basically a good guess, made at the beginning of the pandemic, with the understanding that the virus spread via relatively large particles. Helpfully, our understanding of how the virus makes its way from one person to the next has evolved since. It turns out that large virus-containing particles, the kind that usually don’t travel more than a few feet and don’t linger in the air, aren’t the only particles that an infected person expels as they breathe, talk, and cough. They also emit smaller particles that remain airborne for minutes to hours. (This is what people who say that the virus is “airborne” mean). Outdoors, the smaller particles should be diluted and dispersed. But those smaller particles do not disperse as readily in an indoor environment. Those aerosols are also infectious; we call this route of exposure “airborne transmission.” Defining “close contacts” as just those “within 6 feet for longer than 15 minutes” ignores this important disease transmission pathway. Experts who study airborne viral transmission met in late August at a National Academies of Sciences, Engineering, and Medicine workshop and concluded that airborne transmission of SARS-CoV-2 is playing a role in the spread of the virus. Though the exact extent to which it is causing spread of the virus is still uncertain, we need to take it into account in our infection control strategy.

Currently, “close contact” ignores airborne transmission. Using the current rule, if you (or your child) sat several desks away from another student during a two-hour classroom lecture, no one would need to inform you if that student tested positive for the virus. This is true even if the room is not well ventilated. In fact, in shared spaces where desks, cribs, or mats are placed more than 6 feet apart, the current rule would tell us that the presence of an infected individual would not lead to any of the occupants of the room qualifying as a close contact. This means that other occupants, students, teachers, or caregivers would not, according to federal health guidelines, need to be notified that they had been exposed to an infected individual.

We believe that this failure can lead to unnecessary disease spread. We also believe that strict applications of the “6 feet, 15 minutes” rule is at odds with the expectation parents, students, and teachers have that they should be informed if there is an infection in the classroom. Protracted proximity, under circumstances where ventilation and filtering are substantially reduced relative to being outdoors, should override the fact a person was by-the-measuring-stick distanced from the infected individual. Failing to account for such a commonsense concern of increased risk of airborne transmission in a stuffy room is not just a poor reading of recent science but also bad public health policy. Communication and trust in public health is a cornerstone of disease prevention. Sharing indoor space with a group is inevitably risky. People should have information on how best to protect themselves and others. They also should have the information needed to make personal decisions following a potential exposure—particularly if they are not currently identified as “close contacts” but nonetheless shared a space for an extended period with someone who has tested positive.

A prudent approach moving forward would be to consider all classroom occupants close contacts of one another and, in the event of an infection, recommend quarantine as well as testing of those individuals. The testing data that results could then be used as evidence to refine future classroom quarantine measures, and to develop a formula for close contact that takes into account ventilation, longer exposure periods, and even mask-wearing. At minimum, we recommend that everyone in the classroom with a positive case be notified so that they can be instructed to quarantine or they can decide to quarantine in order to prevent additional community spread of COVID-19. This would be good public health policy. We may never have a magic rule for preventing spread, but an updated evidence-based formula can help us depend less on magic to protect human lives.

For many people around the world, the coronavirus pandemic has been an excuse to learn a homey new skill like knitting or pastry-making.

For Russians, it’s all about the mushrooms.

“I go every other day and can’t get enough. I want more, more, more,” says Svetlana Gladysheva, who has had more time than usual to hunt for fungi in the woods,…

(Reuters) – A malaria drug taken by U.S. President Donald Trump to prevent COVID-19 did not show any benefit versus placebo in reducing coronavirus infection among healthcare workers, according to clinical trial results published on Wednesday.

The study largely confirms results from a clinical trial in June that showed hydroxychloroquine was ineffective in preventing infection among people exposed to the new coronavirus.

Trump began backing hydroxychloroquine early in the pandemic and told reporters in May he started taking the drug after two White House staffers tested positive for COVID-19. Studies have found the drug to offer little benefit as a treatment.

In the study of 125 participants, four who had taken hydroxychloroquine as a preventative treatment for eight weeks contracted COVID-19, and four on placebo tested positive for the virus.

All eight were either asymptomatic or had mild symptoms that did not require hospitalization, according to the results published in the JAMA Internal Medicine journal.

The research shows that routine use of the drug cannot be recommended among healthcare workers to prevent COVID-19, researchers from the University of Pennsylvania said.

The study authors said it was possible that a trial conducted in a community with higher prevalence of the disease could allow detection of a greater benefit from the drug.

In the latest trial, which was terminated before it could reach its enrollment target of 200 participants, mild side effects such as diarrhea were more common in participants taking the malaria drug compared to placebo.