Amina Mohammed addressed ministers from UN Member States, and representatives from international institutions, during a virtual meeting on Tuesday to solidify a menu of policy options for post-pandemic recovery and beyond, which will be presented to world leaders later this month.
Although the crisis has affected everyone, Ms. Mohammed said the consequences will be worse for the worlds most vulnerable citizens.
Between 70 to 100 million people could be pushed into extreme poverty; an additional 265 million people could face acute food shortages by the end of this year, and an estimated 400 million jobs have been lost: disproportionately, of course, affecting women, she said.
Moreover, some 1.6 billion learners have had their studies disrupted and may never return to school, she continued, adding finding immediate and lasting solutions is our responsibility.
The meeting on Financing for Development in the Era of COVID-19 and Beyond was the initiative of the UN Secretary-General and the Prime Ministers of Jamaica and Canada, launched in May.
The aim is to present what the organizers described as a single ambitious menu of policy options to address recovery in the short term, but also to mobilize the resources needed to achieve the Sustainable Development Goals (SDGs) by 2030, and to create a resilient global financial system over the long term.
As Chrystia Freeland, Canadas Deputy Prime Minister and Minister for Finance, pointed out, this crisis has hit women and young people particularly hard and our response must take that into account.
Over the past three months, ministers formed six discussion groups to address issues critical for economic survival and recovery, with the imperative of building back better.
The challenge is immense. Globally, there have been more than 27 million cases of COVID-19, and nearly 892,000 deaths, according to the World Health Organization (WHO).
The UN further estimates that the worlds gross domestic product will suffer a nearly five per cent drop this year, while foreign direct investment and remittances are set to decrease by40 per cent and20 per cent, respectively.
With lockdown measures continuing, borders closed, debt skyrocketing and fiscal resources plunging, the pandemic is pushing us towards the worst recession in decades, possibly even a depression, with terrible consequences for the most vulnerable, said Ms. Mohammed.
The head of the International Monetary Fund (IMF) reported that although some advanced economies are doing somewhat less bad at the moment due to strong policy response by their finance authorities and Central Banks, most emerging markets are still in trouble, including those which rely on tourism revenues or that have high debt levels.
IMF Managing Director Kristalina Georgieva emphasized the need for greater social investment as an important lesson from the pandemic.
We need to recognize that this crisis is telling us we have to build resilience for the future by investing in education and digital capacity everywhere, in human capital, the health systems, the social protection systems in countries, by making sure that the other crises in front of us, like the climate crisis, are well-integrated, she said. And last, but technically not least, by preventing inequalities and poverty raising their ugly heads again.
The discussions sought to further refine policy that will be presented toHeads of State and Government at a UN meeting on 29 September.
For Nigel Clarke, Jamaicas Minister of Finance and the Public Service, the event wasan opportunity to act with dispatch" and "to scale up measures that have already been implemented".
Noting that the world is yet to show the unity and solidarity required for a global response to a crisis unparalleled in recent history, Ms. Mohammed urged Finance Ministers to take action amid the current uncertainties.
I hope you will join us in seizing this initiative to consolidate a menu of options to support your work for the immediate economic relief people need, a peoples vaccine for COVID-19, and to tackle the deep injustices, inequalities and governance challenges while we stand ready together to rethink a global financial system that works for these unprecedented times, she said.
MADISON (WKOW) -- Wisconsin health officials reported 15 new deaths to COVID-19 and 55 hospitalizations since yesterday.
(CLICK HERE FOR THE FULL DHS DASHBOARD)
The Department of Health Services reported 8,871 new test results since yesterday, of which 857or 9.7 percentcame back positive, according to new numbers released today.
The remaining tests returned negative results. However, a negative test only means the person tested did not have the disease at the time. They could still contract COVID-19.
Measuring the percentage of new cases returned in tests each day helps differentiate if increases in cases are due to greater spread or more testing, according to DHS.
The seven-day average of the new positive case percentage is at 11.3, an all-time high.
(App users, see the daily reports and charts HERE.)
The seven-day average of reported positive daily cases is 886, up from 696 a week ago.
DHS reported 15 new deaths, keeping the total at 1,183 people (1.4 percent of positive cases) killed by the disease.
The state reported 8,014 new negative test results.
Of all positive cases reported since the pandemic began, 73,964 or 88.8 percent, are considered recovered.
The state reported 55 new hospitalizations. Wisconsin hospitals are currently treating 298 patients with COVID-19. Of those, 88 are in intensive care units.
DHS now has a county-level dashboard to assess the COVID-19 activity levelin counties and Healthcare Emergency Readiness Coalition regions that measure what DHS calls the burden in each county.View the dashboard HERE.
The Wisconsin Department of Health Services updates the statistics each dayon its website around 2 p.m.
(Our entire coronavirus coverage is available here.)
The new strain of the coronavirus causes the disease COVID-19. Symptoms include cough, fever and shortness of breath. A full list of symptoms is available onthe Centers for Disease Control website.
In severe cases, pneumonia can develop. Those most at risk include the elderly, people with heart or lung disease as well as anyone at greater risk of infection.
For most, the virus is mild, presenting similarly to a common cold or the flu.
Anyone who thinks they may have the disease should call ahead to a hospital or clinic before going in for a diagnosis. Doing so gives the staff time to take the proper precautions so the virus does not spread.
Those needing emergency medical services should continue to use 911.
(County by county results are available here).
COVID-19 cases rise at Miami while remaining low at the University of Cincinnati WKRC TV Cincinnati
Research
The worlds preeminent scientists say a theory from the Broad Institutes Alina Chan is too wild to be believed. But when the theory is about the possibility of COVID being man-made, is this science or censorship?
Illustration by Benjamen Purvis
In January, as she watched the news about a novel virus spreading out of control in China, Alina Chan braced for a shutdown. The molecular biologist at the Broad Institute of Harvard and MIT started stockpiling medicine and supplies. By the time March rolled around and a quarantine seemed imminent, shed bought hundreds of dollars worth of fillets from her favorite fishmonger in Cambridge and packed them into her freezer. Then she began to ramp down her projects in the lab, isolating her experimental cells from their cultures and freezing them in small tubes.
As prepared as she was for the shutdown, though, she found herself unprepared for the frustration of being frozen out of work. She paced the walls of her tiny apartment feeling bored and useless. Chan has been a puzzle demon since childhood, which was precisely what she loved about her workthe chance to solve fiendishly difficult problems about how viruses operate and how, through gene therapy, they could be repurposed to help cure devastating genetic diseases. Staring out her window at the eerily quiet streets of her Inman Square neighborhood, she groaned at the thought that it could be months before she was at it again. Her mind wandered back to 2003, when she was a teenager growing up in Singapore and the first SARS virus, a close relative of this coronavirus, appeared in Asia. It hadnt been anything like this. That one had been relatively easy to corral. How had this virus come out of nowhere and shut down the planet? Why was it so different? she asked herself.
Then it hit her: The worlds greatest puzzle was staring her in the face. Stuck at home, all she had to work with was her brain and her laptop. Maybe they were enough. Chan fired up the kettle for the first of what would become hundreds of cups of tea, stacked four boxes on her kitchen counter to raise her laptop to the proper height, pulled back her long dark hair, and began reading all of the scientific literature she could find on the coronavirus.
It wasnt long before she came across an article about the remarkable stability of the virus, whose genome had barely changed from the earliest human cases, despite trillions of replications. This perplexed Chan. Like many emerging infectious diseases, COVID-19 was thought to be zoonoticit originated in animals, then somehow found its way into people. At the time, the Chinese government and most scientists insisted the jump had happened at Wuhans seafood market, but that didnt make sense to Chan. If the virus had leapt from animals to humans in the market, it should have immediately started evolving to life inside its new human hosts. But it hadnt.
On a hunch, she decided to look at the literature on the 2003 SARS virus, which had jumped from civets to people. Bingo. A few papers mentioned its rapid evolution in its first months of existence. Chan felt the familiar surge of puzzle endorphins. The new virus really wasnt behaving like it should. Chan knew that delving further into this puzzle would require some deep genetic analysis, and she knew just the person for the task. She opened Google Chat and fired off a message to Shing Hei Zhan. He was an old friend from her days at the University of British Columbia and, more important, he was a computational god.
Do you want to partner on a very unusual paper? she wrote.
Sure, he replied.
One thing Chan noticed about the original SARS was that the virus in the first human cases was subtly differenta few dozen letters of genetic codefrom the one in the civets. That meant it had immediately morphed. She asked Zhan to pull up the genomes for the coronaviruses that had been found on surfaces in the Wuhan seafood market. Were they at all different from the earliest documented cases in humans?
Zhan ran the analysis. Nope, they were 100 percent the same. Definitely from humans, not animals. The seafood-market theory, which Chinese health officials and the World Health Organization espoused in the early days of the pandemic, was wrong. Chans puzzle detectors pulsed again. Shing, she messaged Zhan, this paper is going to be insane.
In the coming weeks, as the spring sun chased shadows across her kitchen floor, Chan stood at her counter and pounded out her paper, barely pausing to eat or sleep. It was clear that the first SARS evolved rapidly during its first three months of existence, constantly fine-tuning its ability to infect humans, and settling down only during the later stages of the epidemic. In contrast, the new virus looked a lot more like late-stage SARS. Its almost as if were missing the early phase, Chan marveled to Zhan. Or, as she put it in their paper, as if it was already well adapted for human transmission.
That was a profoundly provocative line. Chan was implying that the virus was already familiar with human physiology when it had its coming-out party in Wuhan in late 2019. If so, there were three possible explanations.
Perhaps it was just staggeringly bad luck: The mutations had all occurred in an earlier host species, and just happened to be the perfect genetic arrangement for an invasion of humanity. But that made no sense. Those mutations would have been disadvantageous in the old host.
Maybe the virus had been circulating undetected in humans for months, working out the kinks, and nobody had noticed. Also unlikely. Chinas health officials would not have missed it, and even if they had, theyd be able to go back now through stored samples to find the trail of earlier versions. And they werent coming up with anything.
That left a third possibility: The missing phase had happened in a lab, where the virus had been trained on human cells. Chan knew this was the third rail of potential explanations. At the time, conspiracy theorists were spinning bioweapon fantasies, and Chan was loath to give them any ammunition. But she also didnt want to play politics by withholding her findings. Chan is in her early thirties, still at the start of her career, and an absolute idealist about the purity of the scientific process. Facts were facts.
Or at least they used to be. Since the start of the pandemic, the Trump administration has been criticized for playing fast and loose with factsdenying, exaggerating, or spinning them to suit the presidents political needs. As a result, many scientists have learned to censor themselves for fear that their words will be misrepresented. Still, Chan thought, if she were to sit on scientific research just to avoid providing ammunition to conspiracy theorists or Trump, would she be any better than them?
Chan knew she had to move forward and make her findings public. In the final draft of her paper, she torpedoed the seafood-market theory, then laid out a case that the virus seemed curiously well adapted to humans. She mentioned all three possible explanations, carefully wording the third to emphasize that if the novel coronavirus did come from a lab, it would have been the result of an accident in the course of legitimate research.
On May 2, Chan uploaded the paper to a site where as-yet-unpublished biology papers known as preprints are shared for open peer review. She tweeted out the news and waited. On May 16, the Daily Mail, a British tabloid, picked up her research. The very next day, Newsweek ran a story with the headline Scientists Shouldnt Rule Out Lab as Source of Coronavirus, New Study Says.
And that, Chan says, is when shit exploded everywhere.
Alina Chan, a molecular biologist at the Broad Institute, says we cant rule out the possibility that the novel coronavirus originated in a labeven though she knows its a politically radioactive thing to say. / Photo by Mona Miri
Chan had come to my attention a week before the Newsweek story was published through her smart and straightforward tweets, which I found refreshing at a time when most scientists were avoiding any serious discussion about the possibility that COVID-19 had escaped from a biolab. Id written a lot about genetic engineering and so-called gain-of-function researchthe fascinating, if scary, line of science in which scientists alter viruses to make them more transmissible or lethal as a way of assessing how close those viruses are to causing pandemics. I also knew that deadly pathogens escape from biolabs with surprising frequency. Most of these accidents end up being harmless, but many researchers have been infected, and people have died as a result.
For years, concerned scientists have warned that this type of pathogen research was going to trigger a pandemic. Foremost among them was Harvard epidemiologist Marc Lipsitch, who founded the Cambridge Working Group in 2014 to lobby against these experiments. In a series of policy papers, op-eds, and scientific forums, he pointed out that accidents involving deadly pathogens occurred more than twice a week in U.S. labs, and estimated that just 10 labs performing gain-of-function research over a 10-year period would run a nearly 20 percent risk of an accidental release. In 2018, he argued that such a release could lead to global spread of a virulent virus, a biosafety incident on a scale never before seen.
Thanks in part to the Cambridge Working Group, the federal government briefly instituted a moratorium on such research. By 2017, however, the ban was lifted and U.S. labs were at it again. Today, in the United States and across the globe, there are dozens of labs conducting experiments on a daily basis with the deadliest known pathogens. One of them is the Wuhan Institute of Virology. For more than a decade, its scientists have been discovering coronaviruses in bats in southern China and bringing them back to their lab in Wuhan. There, they mix genes from different strains of these novel viruses to test their infectivity in human cells and lab animals.
When word spread in January that a novel coronavirus had caused an outbreak in Wuhanwhich is a thousand miles from where the bats that carry this lineage of viruses are naturally foundmany experts were quietly alarmed. There was no proof that the lab was the source of the virus, but the pieces fit.
Despite the evidence, the scientific community quickly dismissed the idea. Peter Daszak, president of EcoHealth Alliance, which has funded the work of the Wuhan Institute of Virology and other labs searching for new viruses, called the notion preposterous, and many other experts echoed that sentiment.
That wasnt necessarily what every scientist thought in private, though. They cant speak directly, one scientist told me confidentially, referring to the virology communitys fear of having their comments sensationalized in todays politically charged environment. Many virologists dont want to be hated by everyone in the field.
There are other potential reasons for the pushback. Theres long been a sense that if the public and politicians really knew about the dangerous pathogen research being conducted in many laboratories, theyd be outraged. Denying the possibility of a catastrophic incident like this, then, could be seen as a form of career preservation. For the substantial subset of virologists who perform gain-of-function research, Richard Ebright, a Rutgers microbiologist and another founding member of the Cambridge Working Group, told me, avoiding restrictions on research funding, avoiding implementation of appropriate biosafety standards, and avoiding implementation of appropriate research oversight are powerful motivators. Antonio Regalado, biomedicine editor of MIT Technology Review, put it more bluntly. If it turned out COVID-19 came from a lab, he tweeted, it would shatter the scientific edifice top to bottom.
Thats a pretty good incentive to simply dismiss the whole hypothesis, but it quickly amounted to a global gaslighting of the mediaand, by proxy, the public. An unhealthy absolutism set in: Either you insisted that any questions about lab involvement were absurd, or you were a tool of the Trump administration and its desperation to blame China for the virus. I was used to social media pundits ignoring inconvenient or politically toxic facts, but Id never expected to see that from some of our best scientists.
Which is why Chan stood out on Twitter, daring to speak truth to power. It is very difficult to do research when one hypothesis has been negatively cast as a conspiracy theory, she wrote. Then she offered some earnest advice to researchers, suggesting that most viral research should be done with neutered viruses that have had their replicating machinery removed in advance, so that even if they escaped confinement, they would be incapable of making copies of themselves. When these precautions are not followed, risk of lab escape is exponentially higher, she explained, adding, I hope the pandemic motivates local ethics and biosafety committees to think carefully about how they can reduce risk. She elaborated on this in another tweet several days later: Id alsopersonallyprefer if high biosafety level labs were not located in the most populous cities on earth.
How Safe Are Bostons Biolabs?
As one of the world centers of biotech, the Hub is peppered with academic and corporate labs doing research on pathogens. Foremost among them is Boston Universitys National Emerging Infectious Diseases Laboratories (NEIDL), the only lab in the city designated as BSL-4 (the highest level of biosafety and the same level as the Wuhan Institute of Virology). It is one of just a dozen or so in the United States equipped to work with live versions of the worlds most dangerous viruses, including Ebola and Marburg. Researchers there began doing so in 2018 after a decade of controversy: Many locals objected to the risks of siting such a facility in the center of a major metropolitan area.
The good news? Before opening, NEIDL undertook one of the most thorough risk assessments in history, learning from the mistakes of other facilities. Even Lynn Klotz, a senior science fellow at the Washington, DCbased Center for Arms Control and Non-Proliferation, who advised local groups that opposed NEIDL, told the medical website Contagion that the lab likely has the best possible security protocols and measures in place.
But the reality, Klotz added, is that most lab accidents are caused by human error, and there is only so much that can be done through good design and protocols to proactively prevent such mistakes. (Or to guard against an intentional release by a disgruntled researcher, as allegedly happened in the anthrax attacks of 2001.) Rutgers molecular biologist Richard Ebright, a longtime critic of potentially dangerous pathogen research, says the risks introduced by NEIDL are not low enough and definitely not worth the negligible benefits.
Still, risk is relative. Klotz has estimated the chance of a pathogen escape from a BSL-4 lab at 0.3 percent per year, and NEIDL is probably significantly safer than the typical BSL-4 lab. And if catching a deadly pathogen is your fear, well, currently you run a good risk of finding one in your own neighborhood. Until that gets cleared up, the citys biolabs are probably among the safer spaces in town.
Chan had started using her Twitter account this intensely only a few days earlier, as a form of outreach for her paper. The social platform has become the way many scientists find out about one anothers work, and studies have shown that attention on Twitter translates to increased citations for a paper in scientific literature. But its a famously raw forum. Many scientists are not prepared for the digital storms that roil the Twitterverse, and they dont handle it well. Chan dreaded it at first, but quickly took to Twitter like a digital native. Having Twitter elevates your work, she says. And I think its really fun to talk to nonscientists about that work.
After reading her tweets, I reviewed her preprint, which I found mind-blowing, and wrote her to say so. She thanked me and joked that she worried it might be career suicide.
It wasnt long before it began to look like she might be right.
Speaking her mind, it turns outeven in the face of censurewas nothing new for Chan, who is Canadian but was raised in Singapore, one of the more repressive regimes on earth. Her parents, both computer science professionals, encouraged free thinking and earnest inquiry in their daughter, but the local school system did not. Instead, it was a pressure-cooker of a system that rewarded students for falling in line, and moved quickly to silence rebels.
That was a bad fit for Chan. You have to bow to teachers, she says. Sometimes teachers from other classes would show up and ask me to bow to them. And I would say, No, youre not my teacher. Back then they believed in corporal punishment. A teacher could just take a big stick and beat you in front of the class. I got whacked so many times.
Still, Chan rebelled in small ways, skipping school and hanging out at the arcade. She also lost interest in her studies. I just really didnt like school. And I didnt like all the extracurriculars they pack you with in Singapore, she says. That changed when a teacher recruited her for math Olympiads, in which teams of students compete to solve devilishly hard arithmetic puzzles. I really loved it, she says. You just sit in a room and think about problems.
Chan might well have pursued a career in math, but then she came up against teams from China in Olympiad competitions. They would just wipe everyone else off the board, she says. They were machines. Theyd been trained in math since they could walk. Theyd hit the buzzer before you could even comprehend the question. I thought, Im not going to survive in this field.
Chan decided to pursue biology instead, studying at the University of British Columbia. I liked viruses from the time I was a teen, she says. I remember the first time I learned about HIV. I thought it was a puzzle and a challenge. That instinct took her to Harvard Medical School as a postdoc, where the puzzle became how to build virus-like biomolecules to accomplish tasks inside cells, and then to Ben Devermans lab at the Broad Institute. When I see an interesting question, I want to spend 100 percent of my time working on it, she says. I get really fixated on answering scientific questions.
Deverman, for his part, says he wasnt actively looking to expand his team when Chan came along, but when opportunities to hire extraordinary people fall in my lap, he takes them. Alina brings a ton of value to the lab, he explains, adding that she has an ability to pivot between different topics and cut to the chase. Nowhere was that more on display than with her coronavirus work, which Deverman was able to closely observe. In fact, Chan ran so many ideas past him that he eventually became a coauthor. She is insightful, determined, and has the rare ability to explain complex scientific findings to other scientists and to the public, he says.
Those skills would prove highly useful when word got out about her coronavirus paper.
If Chan had spent a lifetime learning how to pursue scientific questions, she spent most of the shutdown learning what happens when the answers you come up with are politically radioactive. After the Newsweek story ran, conservative-leaning publications seized on her paper as conclusive evidence that the virus had come from a lab. Everyone focused on the one line, Chan laments. The tabloids just zoomed in on it. Meanwhile, conspiracists took it as hard evidence of their wild theories that there had been an intentional leak.
Chan spent several exhausting days putting out online fires with the many people who had misconstrued her findings. I was so naive, she tells me with a quick, self-deprecating laugh. I just thought, Shouldnt the world be thinking about this fairly? I really have to kick myself now.
Even more troubling, though, were the reactions from other scientists. As soon as her paper got picked up by the media, luminaries in the field sought to censure her. Jonathan Eisen, a well-known professor at UC Davis, criticized the study in Newsweek and on his influential Twitter account, writing, Personally, I do not find the analysis in this new paper remotely convincing. In a long thread, he argued that comparing the new virus to SARS was not enough to show that it was preadapted to humans. He wanted to see comparisons to the initial leap of other viruses from animals to humans.
Moments later, Daszak piled on. The NIH had recently cut its grant to his organization, EcoHealth Alliance, after the Trump administration learned that some of it had gone to fund the Wuhan Institute of Virologys work. Daszak was working hard to get it restored and trying to stamp out any suggestion of a lab connection. He didnt hold back on Chan. This is sloppy research, he tweeted, calling it a poorly designed phylogenetic study with too many inferences and not enough data, riding on a wave of conspiracy to drive a higher impact. Peppering his tweets with exclamation points, he attacked the wording of the paper, arguing that one experiment it cited was impossible, and told Chan she didnt understand her own data. Afterward, a Daszak supporter followed up his thread with a GIF of a mike drop.
It was an old and familiar dynamic: threatened silverback male attempts to bully a junior female member of the tribe. As a postdoc, Chan was in a vulnerable position. The world of science is still a bit medieval in its power structure, with a handful of institutions and individuals deciding who gets published, who gets positions, who gets grants. Theres little room for rebels.
What happened next was neither old nor familiar: Chan didnt back down. Sorry to disrupt mike drop, she tweeted, providing a link to a paper in the prestigious journal Nature that does that exact experiment you thought was impossible. Politely but firmly, she justified each point Daszak had attacked, showing him his mistakes. In the end, Daszak was reduced to arguing that she had used the word isolate incorrectly. In a coup de grce, Chan pointed out that actually the word had come from online data provided by GenBank, the NIHs genetic sequence database. She offered to change it to whatever made sense. At that point, Daszak stopped replying. He insists, however, that Chan is overinterpreting her findings.
With Eisen, Chan readily agreed to test her hypothesis by finding other examples of viruses infecting new hosts. Within days, a perfect opportunity came along when news broke that the coronavirus had jumped from humans to minks at European fur farms. Sure enough, the mink version began to rapidly mutate. You actually see the rapid evolution happening, Chan said. Just in the first few weeks, the changes are quite drastic.
Chan also pointed out to Eisen that the whole goal of a website such as bioRxiv (pronounced bioarchive)where she posted the paperis to elicit feedback that will make papers better before publication. Good point, he replied. Eventually he conceded that there was a lot of interesting analysis in the paper and agreed to work with Chan on the next draft.
The Twitter duels with her powerful colleagues didnt rattle Chan. I thought Jonathan was very reasonable, she says. I really appreciated his expertise, even if he disagreed with me. I like that kind of feedback. It helped to make our paper better.
With Daszak, Chan is more circumspect. Some people have trouble keeping their emotions in check, she says. Whenever I saw his comments, Id just think, Is there something I can learn here? Is there something hes right about that I should be fixing? Ultimately, she decided, there was not.
By late May, both journalists and armchair detectives interested in the mystery of the coronavirus were discovering Chan as a kind of Holmes to our Watson. She crunched information at twice our speed, zeroing in on small details wed overlooked, and became a go-to for anyone looking for spin-free explications of the latest science on COVID-19. It was thrilling to see her reasoning in real time, a reminder of why Ive always loved science, with its pursuit of patterns that sometimes leads to exciting revelations. The website CNET featured her in a story about a league of scientists-turned-detectives who were using genetic sequencing technologies to uncover COVID-19s origins. After it came out, Chan added scientist-turned-detective to her Twitter bio.
Shes lived up to her new nom de tweet. As the search for the source of the virus continued, several scientific teams published papers identifying a closely related coronavirus in pangolinsanteater-like animals that are heavily trafficked in Asia for their meat and scales. The number of different studies made it seem as though this virus was ubiquitous in pangolins. Many scientists eagerly embraced the notion that the animals might have been the intermediate hosts that had passed the novel coronavirus to humans. It fit their preexisting theories about wet markets, and it would have meant no lab had been involved.
As Chan read the pangolin papers, she grew suspicious. The first one was by a team that had analyzed a group of the animals intercepted by anti-smuggling authorities in southern China. They found the closely related virus in a few of them, and published the genomes for that virus. Some of the other papers, though, were strangely ambiguous about where their data was coming from, or how their genomes had been constructed. Had they really taken samples from actual pangolins?
Once again, Chan messaged Shing Hei Zhan. Shing, somethings weird here, she wrote. Zhan pulled up the raw data from the papers and compared the genomes they had published. Individual copies of a virus coming from different animals should have small differences, just as individuals of a species have genetic differences. Yet the genomes in all of the pangolin papers were perfect matchesthe authors were all simply using the first groups data set. Far from being ubiquitous, the virus had been found only in a few pangolins who were held together, and it was unclear where they had caught it. The animals might have even caught it from their own smuggler.
Remarkably, one group of authors in Nature even appeared to use the same genetic sequences from the other paper as if it were confirmation of their own discovery. These sequences appear to be from the same virus (Pangolin-CoV) that we identified in the present study.
Chan called them out on Twitter: Of course its the same Pangolin-CoV, you used the same dataset! For context, she later added, Imagine if clinical trials were playing fast and loose with their patient data; renaming patients, throwing them into different datasets without clarification, possibly even describing the same patient multiple times across different studies unintentionally.
She and Zhan posted a new preprint on bioRxiv dismantling the pangolin papers. Confirmation came in June when the results of a study of hundreds of pangolins in the wildlife trade were announced: Not a single pangolin had any sign of a coronavirus. Chan took a victory lap on Twitter: Supports our hypothesis all this time. The pangolin theory collapsed.
Chan then turned her Holmesian powers on bigger game: Daszak and the Wuhan Institute of Virology. Daszak had been pleading his case everywhere from 60 Minutes to the New York Times and has been successful in rallying sympathy to his cause, even getting 77 Nobel laureates to sign a letter calling for the NIH to restore EcoHealth Alliances funding.
In several long and detailed tweetorials, Chan began to cast a cloud of suspicion on the WIVs work. She pointed out that scientists there had discovered a virus that is more than 96 percent identical to the COVID-19 coronavirus in 2013 in a mineshaft soon after three miners working there had died from a COVID-like illness. The WIV didnt share these findings until 2020, even though the goal of such work, Chan pointed out, was supposedly to identify viruses with the potential to cause human illnesses and warn the world about them.
Even though that virus had killed three miners, Daszak said it wasnt considered a priority to study at the time. We were looking for SARS-related virus, and this one was 20 percent different. We thought it was interesting, but not high risk. So we didnt do anything about it and put it in the freezer, he told a reporter from Wired. It was only in 2020, he maintained, that they started looking into it once they realized its similarity to COVID-19. But Chan pointed to an online database showing that the WIV had been genetically sequencing the mine virus in 2017 and 2018, analyzing it in a way they had done in the past with other viruses in preparation for running experiments with them. Diplomatic yet deadpan, she wrote, I think Daszak was misinformed.
For good measure, almost in passing, Chan pointed out a detail no one else had noticed: COVID-19 contains an uncommon genetic sequence that has been used by genetic engineers in the past to insert genes into coronaviruses without leaving a trace, and it falls at the exact point that would allow experimenters to swap out different genetic parts to change the infectivity. That same sequence can occur naturally in a coronavirus, so this was not irrefutable proof of an unnatural origin, Chan explained, only an observation. Still, it was enough for one Twitter user to muse, If capital punishment were as painful as what Alina Chan is doing to Daszak/WIV regarding their story, it would be illegal.
Daszak says that indeed he had been misinformed and was unaware that that virus found in the mine shaft had been sequenced before 2020. He also says that a great lab, with great scientists, is now being picked apart to search for suspicious behavior to support a preconceived theory. If you believe, deep down, something fishy went on, then what you do is you go through all the evidence and you try to look for things that support that belief, he says, adding, That is not how you find the truth.
Many of the points in Chans tweetorials had also been made by others, but she was the first reputable scientist to put it all together. That same week, Londons Sunday Times and the BBC ran stories following the same trail of breadcrumbs that Chan had laid out to suggest that there had been a coverup at the WIV. The story soon circulated around the world. In the meantime, the WIV has steadfastly denied any viral leak. Lab director Yanyi Wang went on Chinese television and described such charges as pure fabrication, and went on to explain that the bat coronavirus from 2013 was so different than COVID that it could not have evolved into it this quickly and that the lab only sequenced it and didnt obtain a live virus from it.
To this day, there is no definitive evidence as to whether the virus occurred naturally or had its origins in a lab, but the hypothesis that the Wuhan facility was the source is increasingly mainstream and the science behind it can no longer be ignored. And Chan is largely to thank for that.
In late spring, Chan walked through the tall glass doors of the Broad Institute for the first time in months. As she made her way across the gleaming marble foyer, her sneaker squeaks echoed in the silence. It was like the zombie apocalypse version of the Broad; all the bright lights but none of the people. It felt all the weirder that she was wearing her gym clothes to work.
A few days earlier, the Broad had begun letting researchers back into their labs to restart their projects. All computer work still needed to be done remotely, but bench scientists such as Chan could pop in just long enough to move along their cell cultures, provided they got tested for the virus every four days.
In her lab, Chan donned her white lab coat and took inventory, throwing out months of expired reagents and ordering new materials. Then she rescued a few samples from the freezer, took her seat at one of the tissue-culture hoodsstainless steel, air-controlled cabinets in which cell engineers do their workand began reviving some of her old experiments.
She had mixed emotions about being back. It felt good to free her gene-therapy projects from their stasis, and she was even more excited about the new project she and Deverman were working on: an online tool that allows vaccine developers to track changes in the viruss genome by time, location, and other characteristics. It came out of my personal frustration at not being able to get answers fast, she says.
On the other hand, she missed being all-consumed by her detective work. I wanted to stop after the pangolin preprint, she says, but this mystery keeps drawing me back in. So while she waits for her cell cultures to grow, shes been sleuthing on the sideonly this time she has more company: Increasingly, scientists have been quietly contacting her to share their own theories and papers about COVID-19s origins, forming something of a growing underground resistance. Theres a lot of curiosity, she says. People are starting to think more deeply about it. And they have to, she says, if we are going to prevent future outbreaks: Its really important to find out where this came from so it doesnt happen again.
That is what keeps Chan up at nightthe possibility of new outbreaks in humans from the same source. If the virus emerged naturally from a bat cave, there could well be other strains in existence ready to spill over. If they are closely related, whatever vaccines we develop might work on them, too. But that might not be the case with manipulated viruses from a laboratory. Someone could have been sampling viruses from different caves for a decade and just playing mix-and-match in the lab, and those viruses could be so different from one another that none of our vaccines will work on them, she says. Either way, We need to find where this came from, and close it down.
Whatever important information she finds, we can be sure Chan will share it with the world. Far from being shaken by the controversy her paper stirred, she is more committed than ever to holding a line that could all too easily be overrun. Scientists shouldnt be censoring themselves, she says. Were obliged to put all the data out there. We shouldnt be deciding that its better if the public doesnt know about this or that. If we start doing that, we lose credibility, and eventually we lose the publics trust. And thats not good for science. In fact, it would cause an epidemic of doubt, and that wouldnt be good for any of us.
A reminder: We are holding a DealBook Debrief call on Thursday as part of The Timess special project for the 50th anniversary of the seminal Milton Friedman essay that changed the course of capitalism. Joining us are special guests Leo Strine Jr., the former Delaware chief justice, and Joey Zwillinger, the C.E.O. of the shoe company Allbirds. R.S.V.P. here for the call tomorrow at 11 a.m. Eastern.
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The conventional wisdom is that a coronavirus vaccine will be widely available by next summer, if not earlier. But AstraZenecas move to halt testing of its treatment calls that into question and puts into doubt how quickly the global economy can recover from the pandemic.
AstraZeneca is investigating a serious suspected adverse reaction in a volunteer in a late-stage U.K. trial. It isnt clear whether the illness is linked to the companys vaccine, or for how long the drug maker will keep its trial on hold. The AstraZeneca vaccine, which is being developed with Oxford University, is reportedly under consideration by the Trump administration for fast-track approval.
To be clear, this isnt necessarily a bad thing. Medical experts say the point of late-stage clinical trials is to uncover potential side effects by giving thousands of people a treatment under controlled conditions. The perspective we need to keep in mind, said Dr. Faheem Younus, the chief of infectious diseases at the University of Maryland Upper Chesapeake Health, is this one potential case of a serious side effect versus the tens of thousands of Covid-19 patients currently hospitalized in the U.S.
AstraZeneca was one of nine pharmaceutical companies to sign a public pledge not to submit their coronavirus vaccines for authorization until the treatments have been cleared in clinical trials.
Still, the move raises several issues about life without a vaccine:
Coronavirus infections appear to be leveling off in the U.S., but at a persistently high level, and experts fear a flare-up in the fall. That could lead to more government-imposed social restrictions, something that countries like Britain are reintroducing amid a resurgence in cases.
Treatments for coronavirus infections, such as remdesivir and antibody drugs, will assume more importance. But theyre also subject to the same questions of safety, efficacy and availability as vaccine candidates.
Widespread coronavirus testing at airports, schools, workplaces, restaurants and more will become even more critical to restoring the publics confidence. But the capacity to manufacture and use virus tests, particularly in the U.S., is limited. How quickly can that be ramped up?
What path will the economic comeback take if a vaccine doesnt come for a long time? Inequality created by a K-shaped recovery, in which circumstances for wealthy people who can afford to isolate are improving and those for everyone else are not, could worsen.
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Todays DealBook Briefing was written by Andrew Ross Sorkin in Connecticut, Lauren Hirsch in New York, and Michael J. de la Merced and Jason Karaian in London.
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The $16.2 billion deal between LVMH and Tiffany, agreed in November but recently delayed by the pandemic, looks even less certain today. LVMH said it could not complete the deal, and Tiffany has filed a lawsuit to force LVMH to go ahead with it.
There has been concern for months that LVMH would seek to renegotiate the deal, in light of the stress the pandemic has put on the jewelry business. LVMH said in a statement that it wouldnt do the deal as it stands, citing a request from the French government to delay the acquisition beyond Jan. 6 because of the threat of U.S. tariffs on French goods.
Tiffany claims that LVMH is in breach of its contract. It rejects the idea that LVMH can avoid the deal by claiming that Tiffany has undergone a material adverse effect that would have breached its merger obligations. Its lawsuit, filed in Delaware, also says that LVMH cannot avoid completing the deal because it is in some way inconsistent with its patriotic duties as a French corporation.
DealBook hears that Tiffany decided to sue LVMH over frustration that 10 months after the deal, it had not yet filed for deal approval in the European Union.
Markets tumbled again, with tech leading the way down. Another sharp sell-off in tech stocks yesterday led to the Nasdaqs falling over 4 percent reaching correction territory and the S&P 500 slipping nearly 3 percent. Tesla shed a quarter of its value, in part because it wasnt included in the S&P 500 index (more on that below). Futures are currently looking up, though, suggesting an end to the three-day slide.
Senate Republicans plan to vote on their skinny coronavirus aid bill. The move is meant to put pressure on Democrats to compromise on economic stimulus measures. House Democrats have rejected the $500 billion proposal as pathetic, and even some Senate Republicans are likely to oppose it.
JPMorgan Chase said customers and workers had misused federal relief money. The bank said it had found instances of customers misusing Paycheck Protection Program loans, unemployment benefits and other government programs. JPMorgan said it was cooperating with law enforcement.
New York real estate faces its biggest challenge since the financial crisis. Under 10 percent of New Yorks office workers had returned as of last month, and just 54 percent of companies plan to return by July, The Times reports. Businesses have increasingly put off decisions to sign new leases, and some are holding out for steeper discounts than are now on offer.
The first day of school in the U.S. didnt go smoothly. Website crashes and cyberattacks bedeviled many students logging on remotely. A lot of districts are just wildly unprepared for online learning, one expert told The Times. College students attending in-person classes arent faring much better: Tens of thousands have been infected with the coronavirus, and universities are resorting to lockdowns.
Steven Davidoff Solomon, a.k.a. the Deal Professor, is a professor at the U.C. Berkeley School of Law and the faculty co-director at the Berkeley Center for Law, Business and the Economy. Here, he and Panos N. Patatoukas, a professor at Berkeleys Haas School of Business, run the numbers on Tesla and try to make sense of its volatile valuation.
Its been a torrid time for Tesla, which has lost a third of its value over the past week or so. Yesterday alone it erased 21 percent in value, leading another down day for technology stocks. It follows an amazing bull run for tech stocks in general and Tesla in particular.
Is the correction warranted?
Lets look at it through the eyes of Tesla investors. What did they need to believe about its path ahead to have been willing to value Tesla at almost $500 billion in market capitalization at its recent peak?
We can apply traditional valuation techniques to see what would need to happen for this valuation to be justified. In theory, a companys fundamental value is the capital in place plus the expected added value. Value added, the theory goes, should be based on investors expectations about growth and profitability. Using this basic framework, we recasted the Tesla story in terms of fundamental projections over a 10-year horizon.
There are two key aspects: sales growth and profit margins.
If Tesla is going to justify a half-trillion market capitalization, it needs to increase its sales from $24.6 billion in 2019 to approximately $140 billion by 2030. This would require an annualized growth rate of 19 percent, and end up with the company becoming as big as G.M. and Ford are today.
At the same time, Tesla also needs to expand its net profit margin, the money earned for shareholders per dollar of sales. By our calculations, its net margin will need to increase from minus 3.5 percent in 2019 to over 21.5 percent by 2030. That means that by 2030 Teslas margin would converge to what Apples is today. Toyota is among the most profitable big automakers, and its margin in its latest fiscal year was around 7 percent.
Over all, if you were willing to buy Teslas shares at their recent peak, then you should also be willing to believe that over the next decade Tesla will achieve the scale of Ford or G.M. with the margins of Apple. This implies that Tesla would become more than a car company: It would have to become a renewable technology company in which cars are only a small part of its business. Elon Musks moves into solar panels and batteries suggests that he understands this.
Eventually, expectations reflect reality and fundamental valuation drivers come into play. That said, expectations may take a long time to correct themselves if investors arent very focused on fundamentals. Its possible that Tesla and other hot tech stocks will justify their recent highs, but a lot needs to go right in the long term. Perhaps investors are starting to realize this, and revising their expectations.
One of the best-known advisers to companies on ethics and compliance, LRN, will announce today that it is buying a rival to expand internationally. It comes as the New York-based firm capitalizes on companies growing interest in overhauling their corporate cultures at a time of social justice movements.
LRN plans to acquire Interactive Services, a Dublin-based provider of compliance and online learning programs. Interactive Services clients include Biogen, BNP Paribas, Citigroup, FedEx and Hershey. The combined company will count about 40 percent of the Fortune 500 as clients. The terms of the deal were not disclosed.
The deals roots lie in a 2018 investment by Leeds Equity Partners, a capital infusion intended to help LRN increase its share in an estimated $3 billion market for ethics and compliance training.
The sorts of services that LRN provides are in high demand. We are being asked to help companies create powerful codes of conduct that help their people genuinely live company values, said Dov Seidman, LRNs founder and chairman. At DealBooks 2018 summit, Mr. Seidman was named a Groundbreaker for his role in changing the business world. You will be much more effective if you earn the moral authority to lead rather than rely on the formal authority that goes with your title, he said at the time.
Eric Ries is launching the Long-Term Stock Exchange today, nine years after his book The Lean Startup laid the foundations of the concept and made him a mini-celebrity in Silicon Valley.
The big idea: LTSEs pitch is that it makes it easier for companies to manage for you guessed it the long-term instead of obsessing about quarterly targets. The risks of short-term thinking have been called out by the likes of Jamie Dimon and Warren Buffett, and the embrace of stakeholder capitalism has questioned the wisdom of serving shareholders alone.
The exchange says its more than just marketing. Companies that list on the San Francisco-based exchange are required to report on and maintain a series of principles that focus on long-term value creation. This should appeal to institutions like pension funds that tend to take a longer-term view of returns, Mr. Ries said. He dismissed concerns that even companies with the best intentions could find themselves vulnerable to activist investors or takeover threats, forcing them to make short-term, defensive moves. The bullying tactics only work if youre actually afraid, Mr. Ries said.
It doesnt have any companies signed up yet. Today is the starting gun in which LTSE can begin the solicitation process, beginning with companies that have yet to go public. Asana has explored the prospect of listing on LTSE, people familiar with the matter said, as has Airbnb, The Times has reported. I think this is such a seismic change that to get even one company to do it is unbelievable, Mr. Ries said.
One of the companies that lists on LTSE may be the LTSE itself. The company would not consider exploring a sale, but would consider going public on its own exchange, of course.
Deals
Berkshire Hathaway will invest $570 million in the I.P.O. of Snowflake, the cloud database company, in a rare bet by Warren Buffett on enterprise tech. (FT)
G.M. agreed to take an 11 percent stake in the electric truck maker Nikola, valuing the start-up at nearly $19 billion. (NYT)
The merger of the digital ad companies Outbrain and Taboola has fallen apart nearly a year after the deal was announced. (CNBC)
Sard Verbinnen, the public relations firm, agreed to buy Oakhill Communications of Britain to bolster its U.K. practice. (Sard Verbinnen)
Politics and policy
In an unusual move, the Justice Department is seeking to replace President Trumps private counsel in a defamation suit. (NYT)
Britains top government lawyer quit yesterday amid plans to override the countrys Brexit treaty with the E.U. (NYT)
Tech
Uber plans to spend $800 million by 2025 to help drivers switch to electric vehicles, as part of a pledge to make all rides emissions-free by 2040. (Bloomberg)
Apple countersued Epic Games over their App Store dispute, accusing the Fortnite developer of plotting to violate payments rules. (The Verge)
Best of the rest
The reality TV hit Keeping Up With the Kardashians is calling it quits after 20 seasons. (LA Times)
If you received a package of mystery seeds from China in the mail, would you plant them? These Americans did. (Vice)
Is Zoom on the road to genericide? (Quartz)
Correction: In yesterdays newsletter, we should have said that Deval Patrick is a former executive at Bain Capital, not a current one. He resigned last November to pursue a presidential bid; the return to politics is why some think hes in the mix for a top post in a Biden administration.
Wed love your feedback. Please email thoughts and suggestions to dealbook@nytimes.com.
The race to develop a safe and effective COVID-19 vaccine is well under way, setting the stage to bring to market the fastest vaccine in history.
There are dozens of coronavirus vaccines in development, primarily in the preclinical phase when they are tested on animals. In the U.S., there are seven vaccine candidates that have moved into clinical trials with human participants, including three that have moved into the crucial Phase 3 development phase.
The first and second phases of clinical studies are primarily conducted to test for safety, while the third and final stage is used to determine whether vaccines are efficacious and can prevent infection among participants. At that point, the vaccine makers will decide when to pursue an emergency-use authorization from the Food and Drug Administration and/or a full approval. The majority of the vaccines in development have received funding from the U.S. government, either to help support clinical development or pay for manufacturing and distribution of the vaccines as part of the Trump administrations Operation Warp Speed program.
MarketWatch will update this tally as the vaccines move through development.
AstraZeneca AZN, -1.95% AZN, +0.13%, in partnership with the University of Oxford
Year-to-date stock performance: Up 7.8%.
Name: AZD1222.
Type: Vector-based.
Phase 1/2: Data from the Phase 1/2 trial, which is being conducted in the U.K., was published July 20 in the Lancet. It reported neutralizing antibody responses in 91% of 35 patients when using one test and 100% of 35 patients when using a different test.
Phase 3: This trial, which will be held in the U.S., is expected to enroll up to 30,000 participants. (Late-stage studies are also being conducted in Brazil, South Africa and the U.K.) Data are expected by the end of the year. However, trials were halted in early September over concerns about a serious adverse event.
Clinical development and manufacturing funding from the U.S. government: up to $1.2 billion.
U.S. dose promise: 300 million doses.
Dosing: 2 doses.
BioNTech BNTX, +4.16% and Pfizer Inc. PFE, +0.69%
Year-to-date stock performances: BioNTech, up 75%; Pfizer, down 8.3%.
Name: BNT162b2.
Type: mRNA.
Phase 1: The companies published preliminary data on July 1 for BNT162b1 as a preprint. They said then that 24 participants in the study who received two doses of the lower-dose vaccine developed neutralizing antibodies. A second preprint was published on Aug. 28 for BNT162b2 that found this candidate produced similar levels of antibodies but participants reported fewer reactions.
Phase 2/3: This trial is expected to focus on BNT162b2. It is expected to enroll up to 30,000 participants in Argentina, Brazil and the U.S.
Manufacturing funding from the U.S. government: $1.95 billion.
U.S. dose promise: 100 million doses, with option to buy up to 500 million more doses.
Dosing: 2 doses.
Moderna Inc. MRNA, +4.71%
Year-to-date stock performance: Up 187.8%.
Name: mRNA-1273.
Type: mRNA.
Phase 1: Preliminary data were released May 18; more detailed data published July 14 in the New England Journal of Medicine. Modernas vaccine candidate elicited neutralizing antibodies in all 45 participants in this trial, which was conducted in the U.S. in partnership with the National Institute of Allergy and Infectious Diseases.
Phase 2a: This study closed enrollment of 600 participants on July 8. This trial is also focused on the U.S.
Phase 3: This study is expected to complete enrollment of up to 30,000 people some time in September.
R&D funding from BARDA: $955 million.
Supply funding from the U.S. government: Up to $1.525 billion.
U.S. dose promise: 100 million, with option to acquire up 400 million additional doses.
Dosing: 2 doses.
Inovio Pharmaceuticals Inc. INO, +6.92%
Year-to-date stock performance: Up 191.2%.
Name: INO-4800.
Type: DNA.
Phase 1: The company released some preliminary data on June; it has not yet shared the full data but has submitted the results for publication in a peer-reviewed medical journal. The trial is being conducted in the U.S.
Phase 2/3: Inovio said on Sept. 8 that it plans to launch this phase of the study in September, if it is given the go-ahead by the FDA.
U.S. government funding: It received $71 million from the Department of Defense to make and buy the devices that will be used to dispense the companys vaccine if it is authorized or approved.
Johnson & Johnson JNJ, +1.65%
Year-to-date stock performance: Up 1.2%.
Name: Ad26. COV2. S.
Type: Vector-based.
Phase 1/2a: The study began in the second half of July, with a goal of enrolling 1,045 adults in Belgium and the U.S.
Phase 3: It plans to launch this trial in September.
R&D funding from BARDA: $456 million
U.S. government funding for manufacturing and delivery:More than $1 billion (from BARDA and the Department of Defense).
U.S. dose promise: 100 million doses, with option to buy up to 200 million additional doses.
Novavax Inc. NVAX, +6.48%
Year-to-date stock performance: Up 2,167.6%.
Name: NVX-CoV2373.
Type: Protein subunit.
Phase 1: Preliminary data from a trial conducted in Australia were published Sept. 2 in the New England Journal of Medicine.
Phase 1/2: The second phase of the Phase 1/2trial started in August and will be conducted in Australia and the U.S.
Phase 3: TBD.
Clinical development and manufacturing funding from the U.S. government:$1.6 billion.
U.S. dose promise: 100 million doses.
Sanofi SNY, +2.48% SAN, -0.29% , in combination with GlaxoSmithKlines GSK, +2.00% GSK, -0.83% adjuvant technology
Year-to-date stock performance: Up 0.6%.
Name: TBD.
Type: Protein-based.
Phase 1/2 study: The trial was initiated Sept. 3, with a goal of enrolling 440 adults in the U.S. Results are expected in December.
Phase 3: This study is expected to launch by the end of 2020.
Clinical development and manufacturing funding from the U.S. government: Up to $2.1 billion.
U.S. dose promise: Up to 100 million doses, with option to buy up to 500 million doses.
Sources: Company websites, federal data, the World Health Organization, RBC Capital Markets.
Many very sick COVID-19 patients, like some in this Brazilian intensive care unit, have obesity.
By Meredith WadmanSep. 8, 2020 , 6:00 PM
Science's COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.
This spring, after days of flulike symptoms and fever, a man arrived at the emergency room at the University of Vermont Medical Center. He was youngin his late 30sand adored his wife and small children. And he had been healthy, logging endless hours running his own small business, except for one thing: He had severe obesity. Now, he had tested positive for COVID-19 and was increasingly short of breath.
He was admitted directly to the intensive care unit (ICU) and was on a ventilator within hours. Two weeks later, he died.
He was a young, healthy, hardworking guy, recalls MaryEllen Antkowiak, a pulmonary critical care physician who is medical director of the hospitals ICU. His major risk factor for getting this sick was obesity.
Since the pandemic began, dozens of studies have reported that many of the sickest COVID-19 patients have been people with obesity. In recent weeks, that link has come into sharper focus as large new population studies have cemented the association and demonstrated that even people who are merely overweight are at higher risk. For example, in the first metaanalysis of its kind, published on 26 August inObesity Reviews, an international team of researchers pooled data from scores of peer-reviewed papers capturing 399,000 patients. They found that people with obesity who contracted SARS-CoV-2 were 113% more likely than people of healthy weight to land in the hospital, 74% more likely to be admitted to an ICU, and 48% more likely to die.
A constellation of physiological and social factors drives those grim numbers. The biology of obesity includes impaired immunity, chronic inflammation, and blood thats prone to clot, all of which can worsen COVID-19. And because obesity is so stigmatized, people with obesity may avoid medical care.
We didnt understand early on what a major risk factor obesity was. Its not until more recently that weve realized the devastating impact of obesity, particularly in younger people, says Anne Dixon, a physician-scientist who studies obesity and lung disease at the University of Vermont. That may be one reason for the devastating impact of COVID-19 in the United States, where 40% of adults are obese.
People with obesity are more likely than normal-weight people to have other diseases that are independent risk factors for severe COVID-19, including heart disease, lung disease, and diabetes. They are also prone to metabolic syndrome, in which blood sugar levels, fat levels, or both are unhealthy and blood pressure may be high. A recent study from Tulane University of 287 hospitalized COVID-19 patients found that metabolic syndrome itself substantially increased the risks of ICU admission, ventilation, and death.
But on its own, BMI [body mass index] remains a strong independent risk factor for severe COVID-19, according to several studies that adjusted for age, sex, social class, diabetes, and heart conditions, says Naveed Sattar, an expert in cardiometabolic disease at the University of Glasgow. And it seems to be a linear line, straight up.
The impact extends to the 32% of people in the United States who are overweight. The largest descriptive study yet of hospitalized U.S. COVID-19 patients, posted as a preprint last month by Genentech researchers, found that 77% of nearly 17,000 patients hospitalized with COVID-19 were overweight (29%) or obese (48%). (The Centers for Disease Control and Prevention defines overweight as having a BMI of 25 to 29.9 kilograms per square meter, and obesity as a BMI of 30 or greater.)
Another study captured the rate of COVID-19 hospitalizations among more than 334,000 people in England. Published last month in theProceedings of the National Academy of Sciences, it found that although the rate peaked in people with a BMI of 35 or greater, it began to rise as soon as someone tipped into the overweight category. Many people dont realize they creep into that overweight category, says first author Mark Hamer, an exercise physiologist at University College London.
Among 334,000 people in England this spring, the chances of being hospitalized with COVID-19 increased steadily with their body mass index (BMI).
Hamer et al., PNAS, 10.1073/pnas.2011086117
The physical pathologies that render people with obesity vulnerable to severe COVID-19 begin with mechanics: Fat in the abdomen pushes up on the diaphragm, causing that large muscle, which lies below the chest cavity, to impinge on the lungs and restrict airflow. This reduced lung volume leads to collapse of airways in the lower lobes of the lungs, where more blood arrives for oxygenation than in the upper lobes. If you are already starting [with] this mismatch, you are going to get worse faster from COVID-19, Dixon says.
Other issues compound these mechanical problems. For starters, the blood of people with obesity has an increased tendency to clotan especially grave risk during an infection that, when severe, independently peppers the small vessels of the lungs with clots. In healthy people, the endothelial cells that line the blood vessels are normally saying to the surrounding blood: Dont clot, says Beverley Hunt, a physician-scientist whos an expert in blood clotting at Guys and St. Thomas hospitals in London. But we think that signaling is being changed by COVID, Hunt says, because the virus injures endothelial cells, which respond to the insult by activating the coagulation system.
Add obesity to the mix, and the clotting risk shoots up. In COVID-19 patients with obesity, Hunt says, Youve got such sticky blood, oh mythe stickiest blood I have ever seen in all my years of practice.
Immunity also weakens in people with obesity, in part because fat cells infiltrate the organs where immune cells are produced and stored, such as the spleen, bone marrow, and thymus, says Catherine Andersen, a nutritional scientist at Fairfield University. We are losing immune tissue in exchange for adipose tissue, making the immune system less effective in either protecting the body from pathogens or responding to a vaccine, she says.
The problem is not only fewer immune cells, but less effective ones, adds Melinda Beck, a co-author of theObesity Reviewsmetaanalysis who studies obesity and immunity at the University of North Carolina, Chapel Hill. Becks studies of how obese mice respond to the influenza virus demonstrated that key immune cells called T cells dont function as well in the obese state, she says. They make fewer molecules that help destroy virus-infected cells, and the corps of memory T-cells left behind after an infection, which is key to neutralizing future attacks by the same virus, is smaller than in healthy weight mice.
Becks work suggests the same thing happens in people: She found that people with obesity vaccinated against flu had twice the risk of catching it as vaccinated, healthy weight people. That means trials of vaccines for SARS-CoV-2 need to include people with obesity, she says, because coronavirus vaccines may be less effective in those people.
Beyond an impaired response to infections, people with obesity also suffer from chronic, low-grade inflammation. Fat cells secrete several inflammation-triggering chemical messengers called cytokines, and more come from immune cells called macrophages that sweep in to clean up dead and dying fat cells. Those effects may compound the runaway cytokine activity that characterizes severe COVID-19. You end up causing a lot of tissue damage, recruiting too many immune cells, destroying healthy bystander cells, says Ilhem Messaoudi, an immunologist who studies host responses to viral infection at the University of California, Irvine. Of the added risk from obesity, she adds: I would say a lot of it is immune-mediated.
The severity of COVID-19 in people with obesity helps explain the pandemics disproportionate toll in some groups. In American Indians and Alaska Natives, for example, poverty, lack of access to healthy food, lack of health insurance, and poor exercise opportunities combine to render rates of obesity remarkably high, says Spero Manson, a Pembina Chippewa who is a medical anthropologist at the University of Colorados School of Public Health. And obesity is connected to all these other [illnesses], such as diabetes and cardiovascular disease, rendering us susceptible to severe COVID-19, Manson says.
In addition, a large body of literature shows that people with obesity may delay seeking medical care due to fear of being stigmatized, increasing their likelihood of severe disease or death. Patients that experience weight stigma are less likely to seek care and less likely to seek follow up because they dont feel welcome in the health care environment, says Fatima Cody Stanford, an obesity medicine physician-scientist at Harvard Medical School and Massachusetts General Hospital.
COVID-19specific research on this question is urgently needed, she adds. We dont know how many people are dying in the community that are never making it in, Stanford says. Maybe that was [due] to their weight or to their race, the two most prevalent forms of stigma in the U.S.
For people with obesity, the extra risk adds a psychological burden, says Patty Nece, vice chair of the Obesity Action Coalition. My anxiety is just totally ramped up, she says, adding that because of stress eating shes recently regained 30 of the 100 pounds she lost before the pandemic. You have the general anxiety of this pandemic and then you layer on top of it: You in particular, you could get really sick.
Data on how to treat COVID-19 patients with obesity are scant. Published evidence supports giving such patients higher doses of anticoagulants, says Scott Kahan, an obesity medicine physician who directs the National Center for Weight and Wellness. But very little is known about whether and how to adjust other treatments such as remdesivir and dexamethasone, partly because patients with obesity are often excluded from clinical trials, he says. He urges that COVID-19 treatment trials include people with high BMIs wherever possible.
People with obesity should take extra care to avoid getting sick, Messaoudi says. If you are a person with obesity, be extra, extra cautious, she says. Wear your mask. Wash your hands. Avoid large gatherings.
In addition, exercising and, separately, losing even a little weight can improve the metabolic health of a person with obesity, and, in doing so, reduce their chances of developing severe COVID-19 if they become infected, says Stephen ORahilly, a physician-scientist who directs the MRC Metabolic Diseases Unit at the University of Cambridge. If youre 300 pounds, even losing a modest amount is likely to have a disproportionate benefit on how well you do with coronavirus infection. You dont have to become a slim Jim to benefit.
Nine pharmaceutical companies issued a joint pledge on Tuesday that they would stand with science and not put forward a vaccine until it had been thoroughly vetted for safety and efficacy.
The companies did not rule out seeking an emergency authorization of their vaccines, but promised that any potential coronavirus vaccine would be decided based on large, high quality clinical trials and that the companies would follow guidance from regulatory agencies like the Food and Drug Administration.
We believe this pledge will help ensure public confidence in the rigorous scientific and regulatory process by which Covid-19 vaccines are evaluated and may ultimately be approved, the companies said.
President Trump has repeatedly claimed in recent weeks that a vaccine could be available before Election Day Nov. 3 heightening fears that his administration is politicizing the race to develop a vaccine and potentially undermining public trust in any vaccine approved.
Well have the vaccine soon, maybe before a special date, the president said on Monday. You know what date Im talking about.
The move was welcomed by some researchers who said that the statement could increase public confidence in a coronavirus vaccine at a time when skepticism was running high. Theres absolutely a desperate need for this vaccine, said Dr. Judith Feinberg, the vice chairwoman for research in medicine at West Virginia University in Morgantown. I love the fact that the nine big vaccine manufacturers today said they would not do anything premature I think theres enormous pressure to do something premature.
Three of the companies that signed the pledge are testing their candidate vaccines in late-stage clinical trials in the United States: Pfizer, Moderna and AstraZeneca.
Pfizer has said repeatedly over the past week that it could apply to the F.D.A. for emergency approval as early as October. On Tuesday, its chief executive, Dr. Albert Bourla, predicted in an interview on the Today show on NBC that the company would have an answer about whether its vaccine worked by the end of October, but acknowledged that did not mean its vaccine would be available to the public by then.
Moderna and AstraZeneca have been less specific, saying only they hope to have a vaccine by the end of the year. Last week, Modernas chief executive said the company was slightly slowing its enrollment in order to include more people from groups that had been most affected by Covid-19.
Pfizer and Moderna are each close to fully enrolling the 30,000 participants in each of their trials, with some analysts predicting they will be finished within the next two weeks. AstraZeneca is further behind in its U.S. trials, having begun enrollment on Aug. 31.
Federal officials have been pushing back against Mr. Trumps enthusiastic predictions. Late last week, Moncef Slaoui, the top scientist on Operation Warp Speed, the federal effort to quickly bring a vaccine to market, warned in an interview with National Public Radio that the chance of successful vaccine results by October was very, very low.
And on Tuesday, Dr. Anthony S. Fauci, the nations top infectious disease expert, said he believed that researchers would know whether the Moderna and Pfizer vaccines were effective by November or December.
In a statement on Tuesday, Dr. Slaoui said the goal of Operation Warp Speed was to ensure that no technical, logistic or financial hurdles hinder vaccine development or deployment without curtailing the critical steps required by sound science and regulatory standards. He added that the pledge reiterates the position of Operation Warp Speed, that this project is driven by science and that any vaccine must meet the gold standard of the Food and Drug Administration.
Drug companies have had to carefully navigate the political landscape. A successful vaccine could help restore the industrys battered image and offer an end to the pandemic. But rushing a vaccine to market that winds up causing serious side effects or simply does not work could do catastrophic damage to their reputations.
In the nine companies statement on Tuesday, they did not mention Mr. Trump, saying only that they have a united commitment to uphold the integrity of the scientific process.
The other six companies that signed the pledge were BioNTech, which is developing the vaccine in partnership with Pfizer, GlaxoSmithKline, Johnson & Johnson, Merck, Novavax and Sanofi.
Illinois health officials Wednesday announced 1,337 new known cases of COVID-19 and 30 additional fatalities, bringing the total number of known infections in Illinois to 253,690 and the statewide death toll to 8,214 since the start of the pandemic.
Meanwhile, the Chicago Public Schools on began the school year Tuesday with remote learning. Most educators were teaching from their homes, although some streamed lessons from their school classrooms.
Many suburban school districts have already resumed classes, with teachers giving lessons remotely from their school classrooms. Some private schools, including the Archdiocese of Chicagos students, already went back to school in person.
Also Tuesday, the city of Chicago added Kentucky to its mandatory quarantine order and removed California and Puerto Rico, officials announced.
Heres whats happening Wednesday with COVID-19 in the Chicago area and Illinois:
9:05 p.m.: No COVID-19 relief package before the election? Top GOP senators make pessimistic predictions.
Top Republican senators made pessimistic predictions Wednesday about securing a bipartisan coronavirus relief package before theNovember election, signaling instead they will just try to pass legislation that would avoid a federal shutdown as lawmakers head home to campaign.
Senate Majority Leader Mitch McConnell, R-Ky., said he was optimistic that Republicans would deliver strong support for the GOPs $500 billion slimmed-downCOVID-19rescue package in a test vote Thursday. But he declined to say whether his majority would be fully on board. Democrats have indicated they will shelve the Republican measure as insufficient, leaving lawmakers at an impasse.
Theres no indication yet that bipartisan talks that crumbled last month will restart. Lawmakers closely tracking recent efforts to strike a deal that could pass before the November election said they saw little reason for hope.
Unless something really broke through, its not going to happen, said Sen. Richard Shelby, R-Ala., chairman of the Senate Appropriations Committee.
The stalemate is politically risky for all sides heading into the fall election that will decide not only the presidency, but alsocontrol of Congress.
7:45 p.m.: Half of Chicago households report serious financial problems during the COVID-19 pandemic, NPR-Harvard poll finds
Half of Chicago households, many of them Black and Latino families, reported facing serious financial problems caused by the coronavirus pandemic, according to a poll of more than 3,400 respondents in four major U.S. cities published Wednesday.
The poll was conducted from July 1 through Aug. 3 in New York City, Los Angeles, Houston and Chicago by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.
During the pandemic, many Chicago residents have struggled to pay bills, rent and utilities, as well as afford medical care and child care. Many have also depleted their savings, according to the study.
The poll found 69% of Black households, 63% of Latino households and 59% of households making less than $100,000 annually in Chicago reported serious financial problems.
6:30 p.m. (update): COVID-19 vaccine by Nov. 3? Halted study explains just how unlikely that is.
The suspension of a huge COVID-19 vaccine study over an illness in a single participant shows there will be no compromises on safety in the race to develop the shot, the chief of the National Institutes of Health told Congress on Wednesday.
AstraZeneca has put on hold studies of its vaccine candidate in the U.S. and other countries while it investigates whether a British volunteers illness is a side effect or a coincidence.
This ought to be reassuring, NIH Director Dr. Francis Collins said before a Senate committee. When we say we are going to focus first on safety and make no compromises, here is Exhibit A of how that is happening in practice.
Read more here. Associated Press
4:30 p.m.: Lightfoot says she doesnt expect mass crowds of trick or treating this Halloween
On what should have been an epic year for Halloween lovers, with the annual celebration of costumes and candy falling on a Saturday, it seems the coronavirus will be playing the final trick on those seeking treats in Chicago.
Mayor Lori Lightfoot said the citys looking at how to best celebrate the holiday and doesnt expect it to look like years past. Lightfoot said the city is working on plans to recognize and celebrate Halloween, but in a way thats consistent with the public health guidance.
I dont expect to see mass crowds of trick or treating like we have in years past, she said. Its not safe for the children. Its not safe for the adults.
The announcement isnt a surprise in a city thats discouraged large social gatherings while urging people to be careful about who they come into contact with, though its unclear how the city would enforce trick or treat bans.
3:45 p.m.: CPS clerks must continue to work in person for now, but unfair labor complaint prompted by COVID-19 will be heard
Chicago Public Schools employees who say the risks of COVID-19 make their buildings unsafe must continue to show up for in-person work for now.
Illinois education labor board denied a request from the Chicago Teachers Union for emergency relief for clerks and other school employees whove been asked to work in person but say CPS has not bargained with them in good faith over working conditions.
Despite the outcome of Wednesdays hearing, the board has agreed to advance the case.
1:43 p.m.: United, pilots union reach tentative deal to avoid furloughs
United Airlines and the union representing its pilots have reached an agreement that would spare almost 3,000 pilots from furloughs next month.
1:41 p.m.: Positive COVID-19 test at Hinsdale Central High School
Hinsdale High School District 86 has launched its contract tracing procedure as someone at Hinsdale Central High School has had a positive COVID-19 test.
District officials notified families Wednesday morning about the positive test, but did not say when the person was tested or when the individual was in the school.
Students have been doing remote learning since the start of school last month, so students are not attending classes in person at Hinsdale Central or Hinsdale South high schools.
Students could be at the school campus participating in one of the fall sports, which include girls and boys cross country, girls tennis and girls swimming and diving.
1:04 p.m.: Impact of COVID-19 seen on enrollment numbers at Illinois universities
The number of freshmen and international students are down at many Illinois universities as the impact on the coronavirus on fall enrollment begins to come into view.
At the University of Illinois, the number of undergraduate students enrolled is down about 350 from last years high. The freshman class is also down about 1.8%, and the number of students who chose to defer enrollment was nearly five times higher than in a typical year, officials said.
For more on fall enrollment at UIUC and other Illinois colleges, read more here. Elyssa Cherney
12:24 p.m.: I wanted to always play it down: President Trump admits to downplaying the threat of coronavirus in new Bob Woodward book
President Donald Trump acknowledged to journalist Bob Woodward that he had knowingly played down the coronavirus earlier this year even though he was aware it was deadly and vastly more serious than the seasonal flu.
This is deadly stuff, Trump told Woodward on Feb. 7 in one of a series of interviews he conducted with the president for his upcoming book, Rage.
The Washington Post and CNN were given advance copies of the book and published details Wednesday.
You just breathe the air and thats how its passed, Trump said. And so thats a very tricky one. Thats a very delicate one. Its also more deadly than even your strenuous flu.
That was a vastly different story than what Trump was telling the public.
I wanted to always play it down, Trump told Woodward on March 19. I still like playing it down, because I dont want to create a panic.
12:05 p.m.: 1,337 new known COVID-19 cases, 30 additional deaths reported
Illinois health officials Wednesday announced 1,337 new known cases of COVID-19 and 30 additional fatalities, bringing the total number of known infections in Illinois to 253,690 and the statewide death toll to 8,214 since the start of the pandemic.
11:22 a.m.: NIH: Halted vaccine study shows there will be no compromises on safety
AstraZenecas suspension of final testing of its potential COVID-19 vaccine while it investigates a volunteers illness shows there will be no compromises on safety in developing the shots, the chief of the National Institutes of Health told Congress on Wednesday.
This ought to be reassuring, NIH Director Dr. Francis Collins said before a Senate committee. When we say we are going to focus first on safety and make no compromises, here is Exhibit A of how that is happening in practice.
Late Tuesday, AstraZeneca announced its final-stage studies are on temporary hold while the company looks into whether a test subjects illness is a side effect of the shot or a coincidence. The company gave no details on the illness, but Collins said it involved a spinal problem.
10:22 a.m.: Tamale Guy restaurant reopens today in Chicago as owner remains in ICU
Tamale Guy Chicago reopens today in the Ukrainian Village neighborhood. The namesake restaurant of Claudio Velez was closed for nearly two weeks after he tested positive for COVID-19, just two weeks after a grand opening with 10 block long lines, two hour waits and selling out of thousands of tamales. Prior to the coronavirus mandated closures, Velez was best known for his red cooler full of warm tamales, sold bar to bar on the North Side of the city.
Velez remains hospitalized on a ventilator in ICU with his condition improving. His business partners, longtime chef and friend Pierre Vega and his wife Kristin Vega, will continue operations. All staff tested negative for the coronavirus. They also have cleaned and disinfected the takeout-only restaurant according to CDC guidelines, said Velezs son, Osmar Abad.
A GoFundMe for Velezs medical expenses has raised more than $56,000 to date. Last week Abad said the family planned to close the campaign, but its still open. We will leave the funds there until my dad is able to wake up and make his own decisions, said Abad.
9:24 a.m.: Dr. Anthony Fauci sticks with 2021 prediction for coronavirus vaccine
Dr. Anthony Fauci said hes sticking with his projection that a safe and effective coronavirus vaccine may be ready in early 2021. He said its possible it could be sooner, but unlikely.
The White House adviser on the coronavirus told "CBS This Morning the more likely scenario is that we will know by the end of this calendar year and hopefully well be able to start vaccinations in earnest as we begin early 2021.
Fauci said its routine for late-stage vaccine studies to be put on hold because of side effects. A study by AstraZeneca of a potential coronavirus vaccine was recently paused for safety reasons after an illness from a shot in a recipient in Britain.
7:15 a.m.: JPMorgan Chase says some customers and employees misused PPP, other stimulus programs
JPMorgan Chase said Tuesday that a number of its employees and customers may have abused the Paycheck Protection Program and other coronavirus stimulus programs.
The New York-based bank said it is working with law enforcement in some cases, although in a memo sent to employees it did not state how many employees may have unethically misused the programs, or what exactly they did. The bank declined to comment beyond the memo.
Unfortunately, weve also seen conduct that does not live up to our business and ethical principles and may even be illegal, the memo said.
7 a.m.: Pritzker to attend Springfield memorial service for those who died from COVID-19
After census event in Normal in the morning, Gov. J.B. Pritzker was scheduled to attend a memorial service in Springfield Wednesday evening for people who have died from the coronavirus, according to his office.
Pritzker was scheduled to attend a memorial service at the First Presbyterian Church in Springfield to honor those who have lost their lives to coronavirus and their families, according to his press office. Further details werent immediately released.
6:45 a.m.: Parents, students at Wheaton rally call for in-person learning and the early return of high school sports
Could Illinois be next on the list for an early return of high school sports?
That was an idea behind a large gathering Tuesday night in Wheaton.
Wheaton businessmen Dave Ruggles and Eric Brown helped form a We Stand for the Students rally at Memorial Park. More than 1,000 people showed up for two purposes bringing back fall sports in its regular form as well as in-person learning to schools.
On Sept. 3, Michigan government officials lifted an order restricting organized sports. The Michigan High School Athletic Association then reinstated football and other fall sports.
The next day, the Louisiana High School Athletic Association announced football will resume in that state on Oct. 8. Colorado is considering doing the same for football and other fall sports.
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Here are five stories from Tuesday related to COVID-19.
