Coronavirus 2019-nCoV vials(Photo: solarseven, Getty Images/iStockphoto)
Navajo Nation officials said Friday they will participate in the Pfizer-BioNTech COVID-19 vaccine trials. Trials will be conducted at various health care centers across the Navajo Nation on a volunteer basis.
The vaccine trials come after theNavajo Nation, which once held the highest COVID-19 infection rate in the country,has seen a decline in its numbers. On Sept. 8, officials reported zero new cases for the first time since the pandemic started.
The total number of COVID-19 cases reported from the Navajo Nation is 9,933 as of Sept. 10.
"Several COVID-19 vaccine clinical trials are making progress across the U.S. and it's important that the Navajo people have an opportunity to participate in a Phase 3 trial," Navajo Nation President Jonathan Nez said in a press release.
"The clinical trials will be done on a patient-volunteer basis, meaning that no one will be forced to participate unless they are fully willing to do so."
The Navajo Nation Human Research Review Board approved the Pfizer-COVID-19 Vaccine Study on Aug.27, according to Jared Touchin, communications director for the Navajo Nation Office of the President and Vice President.
The study will be led by theJohn Hopkins Center for American Indian Health and is the first COVID-19 vaccine study on the Navajo Nation.
"COVID-19 has disproportionately affected tribal communities. In the Southwest, tribal members have experienced some of the highest rates of the COVID-19 disease in the country," said Navajo Department of Health Executive Director Dr. Jill Jim in a press release.
"Supporting national strategies to develop a vaccine addresses health equality to guide local decision making about vaccine selection and vaccine use," she added.
Enrollment for the study will begin in mid-September and participation will include individuals between the ages of 19 to 85who are healthy or have a stable underlying health condition.
Participants will be given two doses of approved vaccine and will be monitored over a two-year period. Eligible participants who join the study must not have had a prior COVID-19 infection.
"This is because people who have recovered from COVID-19 will likely have antibodies," the press release states.
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There are no approvedvaccines against COVID-19, but there many under development. The federal government announced a goal of delivering 300 million doses of a safe, effective vaccine for COVID-19 by January 2021 in a plan called Operation Warp Speed.
For COVID-19 vaccine trials, the FDA has issued guidance that "strongly encourages the enrollment of populations most affected by COVID-19, specifically racial and ethnic minorities," and has encouraged the inclusion of other high-risk groups such as those with underlying diseases in late-stage vaccine trials as well as pregnant women or women of child-bearing age.
The inclusion of these groups can have important implications for understanding how treatment may affect various groups differently since genetics or other factors influence how well a treatment works.
Before signing up for any COVID-19 study, Jason Robert, an Arizona State University bioethicist who focuses on how to practice safe and ethical science, said people should fully understand the risks and shouldn't volunteer for the wrong reasons.
"Scientists are doing this for the good of the whole, not the individual," he said. "It might be our civic duty to participate in these studies, but don't do it because you think you're going to get better."
Navajo people who are interested in participating in the Pfizer COVID-19 Vaccine Study through the John Hopkins Center for American Indian Health can contact site managers in Chinle;Shiprock, New Mexico;and Gallup, New Mexico.
"We have overseen numerous phase 3 clinical trials with an experienced, dedicated staff who have specialized training in research ethics, Good Clinical Practice, HIPAA compliance, specimen collection, and who are able to conduct high-quality studiesthat meet strict FDA requirements," Dr. Laura Hammitt with John Hopkins Center for American Indian health stated in the press release.
The Chinle site can be reached at 928-674-5051, Shiprock at 505-368-4030, and Gallup at 505-722-6372.
The Navajo Nation is hosting a live online town hall meeting on Sept. 21.Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious DiseasesDirectorwill joinNez and Vice President Myron Lizer to discuss the COVID-19 response efforts and trial vaccines.
Republic bioscience reporter Amanda Morris contributed to this report.
Reporter Shondiin Silversmith covers Indigenous people and communities in Arizona. Reach her at ssilversmi@arizonarepublic.comand follow her Twitter @DiinSilversmith.
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A Chinese pharmaceutical company has injected hundreds of thousands of people with experimental Covid-19 vaccines, as its Western counterparts warn against administering mass vaccinations before rigorous scientific studies are complete.
China National Biotec Group Co., a subsidiary of state-owned Sinopharm, has given two experimental vaccine candidates to hundreds of thousands of people under an emergency-use condition approved by Beijing in July, the company said this week. Separately, Chinese drugmaker Sinovac Biotech Ltd....
The U.S. reported more than 35,200 new cases of the coronavirus on Thursday, its highest daily tally since Sep. 5, according to data compiled by Johns Hopkins University. The holiday weekend likely impacted the data over the past few days and is only now beginning to stabilize. The seven-day average of daily new cases has fallen to 35,219, down more than 12% compared with a week ago.
Here are today's top headlines:
The following data was compiled by Johns Hopkins University:
I do not believe that the evolution of SARS-CoV-2 is whats driving the viruss continued spread. The coronavirus remains good at propagating itself because most of us still are susceptible to it; we are not immune, and it can still find new hosts to infect relatively easily.
In the same issue of Cell that published the Korber paper, the viral epidemiologist Nathan Grubaugh and colleagues argued that the increase in the frequency of G614 could be explained by chance and the epidemiology of the pandemic.
I agree.
In other words: The next time you compare different outbreaks and start wondering or worrying about the variations, assume first that those variations have to do with conditions on the ground, rather than anything about the virus itself, like a new mutation.
Consider, for example, the wave of SARS-CoV-2 infections that has hit Australia since June. While there has been a major outbreak in the state of Victoria (peaking at around 700 cases per day), the one in the state of New South Wales has been minor so far (with a daily case count usually around 10) yet both have been caused by the same variant of the coronavirus, the one with the D614G mutation.
The precise reasons for these differences are still being investigated, but one may be, simply, that because the outbreak hit Victoria first, the health authorities of New South Wales had more time to prepare.
Mortality rates, too, differ between locations, and in some places the virus may appear to kill more people. But again, these variations probably say less about the virus than about differences in how the disease is being treated, or where the virus has spread mostly among vulnerable populations, like people in nursing homes.
Whats more, even if the D614G mutation does increase the viruss infectivity in humans, that fact probably doesnt have any major implications for our prospects of developing an effective vaccine. The mutation does affect the spike protein, but not the part of it that the neutralizing antibodies of the human immune system target when the body defends itself against infection.
Then, working with a local nonprofit group, the school shifted its strategy. Instead of trying to pole vault its top students into top schools, it tried to focus on getting everyone into a degree program. With a dedicated college-advising office and recent graduates called bridge coaches, the on-time graduation rate is now about 70 percent. In 2019, 75 percent of graduates went directly to college.
We build up our students for four years, to get to the point where theyre confident and comfortable that they belong in college, Robert Schwarz, a vice principal, told The Times. That takes a lot of hand-holding.
Updated Sept. 11, 2020
The latest on how schools are reopening amid the pandemic.
Although the pandemic hit the school and its students hard, Richmond Hill maintained its counseling program. Even as the parents of some students died or lost their jobs, most seniors stayed on track. By early September, despite the pandemic, 70 percent of the graduating class was enrolled in college.
The intensive counseling the bridge coaches provided was the key factor in persuading those students to stick with their plans, said Paul Tough, a contributing writer at The Times Magazine who spent months looking into Richmond Hills strategy.
Now, similar counseling programs are under threat as districts and public college systems face budget cuts. Student support systems like counselors are often the first to go.
When you make those cuts, you inevitably have higher drop out rates, especially for low-income students, Paul said. That feels like the part of the crisis that hasnt happened yet, but everyone can see coming.
Read more: Predominantly white districts are more than three times as likely to be open for some in-person learning, compared with districts that enroll mostly students of color, according to an analysis by The Associated Press and Chalkbeat.
President Donald Trump on Thursday defended comments he made to reporter Bob Woodward in early February in which he acknowledged the coronavirus "goes through air" despite publicly downplaying the threat in public and telling Americans the virus would disappear.
At the time of Trump's private comments to Woodward, it was unclear how the virus spread and scientists were debating whether and to what degree it could spread through the air. Trump, however, insisted on Thursday that it was widely understood that the virus spread through particles in the air before he made his private remarks in a Feb. 7 taped phone call between Woodward and the president.
"This is stuff that everyone knew. There's a report that I have here someplace where China said it was airborne earlier than the statements I made. People knew it was airborne. This was nothing," he said Thursday in a White House press briefing. "When I say it was airborne, everybody knew it was airborne. This was no big thing. Read the reports. China came out with a statement that it was an airborne disease. I heard it was an airborne disease. I assumed it early on."
In response to a question about what report the president was citing, a White House official pointed CNBC to a Jan. 30 report from TIME. The report said Chinese authorities announced on Jan. 7 that they had isolated the virus, which "belongs to the coronavirus family...and spreads via airborne droplets."
A day after Trump's private comments to Woodward, Chinese state media The China Daily reported thatZeng Qun, deputy head of the Shanghai Civil Affairs Bureau, said the virus can spread through aerosol transmission, suggesting the virus was airborne in some situations. But the next day, officials from the Chinese Center for Disease Control and Prevention disputed the earlier report, according to The China Daily, saying that there was no evidence the virus could spread through airborne particles.
Early in the outbreak, scientists stressed how little was known about the virus, which emerged in Wuhan, China, at the end of December. In the nine months since the virus emerged, scientists have learned much about how it spreads and the disease it causes but continue to emphasize that it is a relatively new virus and much remains unclear. The role that airborne transmission of the virus plays in general spread has been among the more contentious questions debated.
The U.S. Centers for Disease Control and Prevention says the virus is primarily spread through respiratory droplets, which an infected person can spread when they talk, cough or sneeze, for example. The CDC adds that these droplets can land on hands and surfaces, where they might survive for some period of time and can potentially infect people. The CDC adds that "short-range" airborne spread of aerosolized particles is a "possibility," but stops short of definitively calling it a confirmed route of transmission.
The question of whether and to what extent these droplets might survive and spread through the air has been debated since early in the outbreak. The first strong scientific study backed by the U.S. government that showed the virus might spread through the air came on March 18.Researchers from the National Institutes of Health, CDC, UCLA and Princeton University examined how long Covid-19 survives in the air as well as on a variety of surfaces and compared it with SARS, the coronavirus that emerged in late 2002 and killed nearly 800 people.
They found that Covid-19 was detectable in aerosols for up to three hours, though it remained unclear whether the trace amounts of the virus found in the air were potent enough to infect someone and replicate. The results suggested "that people may acquire the virus through the air and after touching contaminated objects," Dr.Neeltje van Doremalen, a scientist from NIH and a lead researcher on the study, said in a statement at the time.
The Director-General of the World Health Organization Tedros Adhanom Ghebreyesus had said in a Feb. 11 press conference that "corona is airborne," but he quickly clarified his remarks, saying that he meant the virus can "spread via droplets or respiratory transmission."
It was not until March that the World Health Organization officially acknowledged that the virus-carrying droplets might be spreading through airborne particles in certain environments.
"When you do an aerosol-generating procedure like in a medical care facility, you have the possibility to what we call aerosolize these particles, which means they can stay in the air a little bit longer," Dr. MariaVanKerkhove, head of WHO's emerging diseases and zoonosis unit, said on March 16.
On July 6, a group of 239 scientists from 32 different countries published an open letter calling on the WHO and other health agencies to update their guidance to reflect the threat of airborne transmission of the coronavirus. The scientists said there was emerging evidence that indicated airborne transmission could present a serious risk.
"There is significant potential for inhalation exposure to viruses in microscopic respiratory droplets (microdroplets) at short to medium distances (up to several meters, or room scale), and we are advocating for the use of preventive measures to mitigate this route of airborne transmission," the scientists wrote in the paper.
That week, the WHO updated their official guidance to say that "short-range aerosol transmission, particularly in specific indoor locations, such as crowded and inadequately ventilated spaces over a prolonged period of time with infected persons cannot be ruled out." But like the CDC, the United Nations health agency stopped short of confirming that the virus spreads in such a way.
It was five months before that, on Feb. 7, that Trump told Woodward that the coronavirus was spreading widely through the air.
"You just breathe the air and that's how it's passed," he said, according to the tapes of the interview. "And so that's a very tricky one. That's a very delicate one. It's also more deadly than even your strenuous flus."
At around the same time, members of the Trump administration and the White House coronavirus task force told Americans that the general public did not need to buy masks, which appear to help prevent the virus-carrying droplets from spreading. Trump defended his decision to downplay the threat of the virus early in the outbreak.
"The fact is there has to be a calmness," he said Thursday. "You don't want me jumping up and down screaming there's going to be great death."
A court declaration Friday from US Border Patrol Deputy Chief Raul Ortiz revealed the number, which previously hadn't been released to the public.
Since the Trump administration invoked a public health law to implement new restrictions at the border on March 20, the agency has expelled more than 159,000 people, according to Ortiz. That figure, Ortiz says, included 8,800 children who were traveling alone and 7,600 family members.
The declaration was filed as part of the government's appeal of a recent court ruling over a controversial aspect of the coronavirus restrictions: the increasing use of hotels to detain migrant kids rather than licensed and monitored facilities.
But Ortiz and other US officials argue that doing so will put the public at risk, interfere with efforts by the Centers for Disease Control and Prevention to contain Covid-19 and increase the likelihood that US Customs and Border Protection agents and others caring for children in custody could contract coronavirus. They are asking California's 9th Circuit Court of Appeals to block Gee's order.
In his declaration on Friday, Ortiz stated that being forced to stop detaining migrant children in hotels would cause "three significant problems" for the government: crowding and an increased risk of Covid-19 exposure in Border Patrol facilities, an increased risk of Covid-19 exposure in Health and Human Services and Immigration and Customs Enforcement facilities and the straining of an "already overburdened system."
New studies from the U of M College of Science and Engineering analyze how the coronavirus spreads indoors and in human lungs. This information may help businesses and schools control the spread of COVID-19, and help target medicines to virus particles in the lungs.
Using aerosol generation by healthyindividuals to mimic that from asymptomatic COVID-19 patients, mechanical engineering associate professor Jiarong Hong and assistant professor Suo Yang modeled virus transmission through aerosols ejected from an infected person via exhalation or speech. They found that the SARS CoV-2 virus hitches a ride on those aerosols and may land on nearby surfaces or be inhaled by another person.
The researchers numerically modeled how the simulated airborne virus flowed through an elevator, a classroom, and a supermarket and compared how the virus fared with different levels of ventilation and different spacing of room occupants.
They found that good indoor ventilation filters out some virus but may leave more viral particles on surfaces. In a classroom where an asymptomatic teacher talked for 50 minutes, only 10 percent of the aerosols were filtered out; the majority stuck to the walls.
The ventilation forms several circulation zones called vortexes, and the aerosols keep rotating in [them], Yang says. Because they are basically trapped, its very hard for them to reach the vent and actually go out.
The virus-bearing aerosols spread significantly less when the teacher stayed directly under an air vent. This insight could inform how classrooms are arranged and disinfected, and also help places like theaters and concert venues reopen with the proper precautions.
Reaching out
Yang and Hong have been working with the Minnesota Orchestra to measure aerosol concentrations and flow while instruments are played onstage at Orchestra Hall. Eventually, they hope to provide a plan to minimize the COVID-19 risk in Orchestra Hall.
The researchers recently joined an international work group of experts led by U of M professor Michael Osterholm, director of the Center for Infectious Disease Research and Policy, to learn how much SARS CoV-2 virus it takes to become infected and provide science-driven policy to mitigate the COVID-19 pandemic.
Read more.
Reaching in
Yang is also modeling aerosols to predict how the coronavirus travels inside the human respiratory system.
The key symptom of COVID-19 is the lung inflammation, he explains. Were trying to understand how the virus aerosol is transported and deposited in the lung. Where is the high concentration zone? Whats the pattern? Does it depend on other conditions?
By creating models of human lungs based on computed tomography (CT)scans from real COVID-19 patients, Yang hopes to inform the design of medical treatments, namely nasal sprays.His team has already begun running test simulations of aerosols in the back of the throat, nasal linings and trachea.
Then, Yang plans to map how medicine particles travel throughout those same systems in order to test the effectiveness of treatments and get the delivered to the right address in the lungs.
Once we optimize these options, we can give that information to the medicine companies, and they can create their products accordingly to most efficiently target the system," he added
Yang works with biomedical engineering professor David Odde, who earlier this year released a model of how the virus functions withinhuman cells. The two will combine their results into a comprehensive recommendation on treatment design.
Learn more about this topic.
Coronavirus latest: US coronavirus cases rise by the most in a week as it happened Financial Times
Each week, we answer "frequently asked questions" about life during the coronavirus crisis. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Weekly Coronavirus Questions."
If you're wondering when it will be safe to date again or how to do it you're not alone.
Via social media and email, NPR readers have sent in questions about dating and relationships in the age of COVID-19. Some of the queries:
"Will I ever be able to impress women with my cooking skills again, or do we need to keep all dates outdoors?"
"Do we need to get tested before masks come off?"
"Are masks during sex really a thing?"
As one of our readers put it, it certainly would be easier if there were a dating app that assesses potential partners by their efforts to keep safe in the pandemic. Until that happens, we consulted with several health and relationships experts to figure out how to navigate intimacy while keeping COVID-19 at bay.
Their main takeaway? Just like before the pandemic, open and honest communication is key.
Having the "COVID talk"
When you first start dating someone new, you usually consider their hobbies, common interests and politics to figure out if you're a good match. Now, says sex and relationships writer Sophie St. Thomas, there's a new level of compatibility added in: you and your partner's approach to COVID-19 safety.
That means asking questions such as: If your job requires you to be around other people, what precautions do you take during and after interactions? Do you live with other people, and if so, how do you track each other's risk of exposure to the virus? Do you go to restaurants and other public spaces?
The experts we interviewed agreed that you should be asking potential partners these queries pretty early on, ideally before meeting in person. The answers help you gain a better sense of how much exposure this person has to other people and to environments that pose a risk of contracting the coronavirus. Basically, you're trying to assess your risk of getting sick if you start a relationship.
And even though it may feel uncomfortable to ask someone you just met about their daily whereabouts and activities, it's essential for everyone's health and well-being, says Dr. Joyce Sanchez, an infectious disease specialist at the Medical College of Wisconsin. You have to keep in mind that exposing yourself to a new partner doesn't just affect you, she adds the impact also extends to the people you live and work with as well as your community at large when you're out and about. Sanchez calls this your "bubble."
That bubble is constantly changing maybe one of your roommates just got back from a visit with family or you've been asked to start going to your workplace a few times a week. Sex educator and writer Gabrielle Alexa Noel says her girlfriend recently got a new roommate, which forced all three to have the "COVID talk" before choosing to share personal space. So you not only have to have great communication with a dating partner but with the people in your bubble, Sanchez says.
"Immediately, if someone is not eager to participate in a conversation like that, that would already give me pause," Noel says.
No matter how awkward or uncomfortable you might feel asking some of the questions, she says, if someone else is also taking their health seriously, that person should be eager to discuss safety and precautions with you as part of the bubble-merging process.
Dr. Abraar Karan of Harvard Medical School agrees he says you should approach this conversation the same way you would talk about sexually transmitted diseases before being intimate with someone for the first time: It's a matter-of-fact conversation about your health and that of your potential partners.
"Nothing can guarantee you are fully safe, but this is the best way to think about risk reduction," he says.
How should I transition from virtual and outdoor dates to indoor intimacy?
In-person connections are not off the table until the pandemic ends, says Dr. Dolores Albarracn, who teaches medicine and psychology at the University of Illinois at Urbana-Champaign.
Let's say you've met someone you like and have gone on several FaceTime or even picnic dates. But you'd like to take things to the next level and meet up indoors.
Sanchez recommends answering three main questions before making this leap:
Karan says COVID-19 case numbers and community spread within your county or neighborhood are a good benchmark to inform your decision to meet in-person indoors. If transmission rates are high, there's probably a higher risk that someone at a restaurant or cafe could have COVID-19 and potentially transmit the virus to you or your date so you may want to keep things online or outdoors for the time being.
If transmission rates in your community are low, you might feel safer venturing to an indoor location for dinner, Karan says.
Other factors to consider before choosing a date spot: Are all the tables at least 6 feet apart? Does the establishment require servers to wear masks? (More considerations on dining indoors here.)
If you're planning to take your dates into each other's homes and getting intimate, you should both be sure you don't have COVID-19, Albarracn says. She recommends getting tested and waiting to see if the result is negative or quarantining for two weeks without symptoms before close, mask-free proximity.
What about sex?
Speaking of protection, here's a question that probably never made it into Cosmopolitan magazine's dating advice columns: If you aren't willing or able to get tested or complete a two-week quarantine beforehand, are masks necessary during sexual encounters?
Canada's chief public health officer, Dr. Theresa Tham, became the latest among several health officials to suggest that when it comes to getting physical with a partner, people should wear masks and avoid kissing. New York City health officials also encouraged people to engage in positions facing away from one another to avoid the exchange of breathing particles. That's because a primary mode of transmission is mouth-to-mouth, so to speak particles breathed out by someone infected, then inhaled by someone else.
While Sanchez agrees that masks do make sexual activity somewhat safer in that they reduce the exchange of viral particles, she says it's hard to measure effectiveness.
"Unfortunately, the answer is we don't know how much the risk goes down when you wear a mask while having sex," Sanchez says. "Ultimately, you can't have sex 6 feet apart. So it's going to be a high-risk activity whether or not you wear the masks and avoid kissing."
Wouldn't it just be easier to hook up with my ex?
For some people, the pandemic has presented an additional layer of emotional confusion. Several readers wrote in with the conundrum: Is it worth the effort to try and meet someone new and figure out their pandemic philosophy or is it better to rekindle things with a former partner whose judgment on pandemic safety you already trust?
St. Thomas says it's perfectly normal to want to reach out to an ex during this time and check in in a dramatically changing world, it's OK to want to check in on people who have been an important part of your life. But that doesn't always mean it's a good idea to reignite a relationship that previously ended.
"It's so easy to [reach out], especially if you are socially isolated," she says. "[But] if someone is still a pain point for you, if it's something that is still fresh, I would caution against it."
Restarting things with an ex could potentially lead to mixed expectations about the relationship this time around or could negatively affect the progress you've both made since the breakup, St. Thomas says. Instead, she says, rely on your support group. Friends, family and a therapist are all good people to talk to about rekindling an old flame.
Relationships can be helpful
Although dating in the era of COVID-19 does present a series of risks, Karan says we have to assess it similarly to how we assess the risks we take when going to the grocery store or to a testing site. Meaningful emotional connections are still an essential part of everyday life and we should keep the rewards and benefits of dating in mind, just as we do with buying food or seeking medical care.
"I think we should not downplay the importance of human connection because relationships are what help us stay mentally sane through something like this," he says.
