For starters, rather than prohibiting children from playing together and eliminating all social risk, Dr. Chiang and the A.A.P. schools-reopening guidelines focus on reducing risk and state that outdoor play is safer than indoor play. Jenkins said her family now socializes with another cautious family. Their summer plans include outdoor playground and beach visits, but not museums.
Some families who initially tried going without sitters and nannies have relented, and public-health experts acknowledge that the strain was significant. Parents and nannies should have honest discussions about their expectations for mask-wearing and distancing. But there is no way for a nanny to socially distance from a young kid shes taking care of, Dr. Chiang said. And there is no evidence that risk of transmission is lower for a younger nanny, she added.
Ultimately, parents have to weigh their threshold for risk when it comes to childrens interactions with others. And that same advice applies to day care, summer camp or school in the fall. Parents should consider the demands of their work, whether any household member is at high risk for severe Covid-19, the status of the outbreak in their community and administrators plans for keeping children and staffers at least in fixed and distanced groups. Also, look for policies requiring children and staffers to be screened for symptoms.
In other words, Dr. Chiang said, if the spread of coronavirus in your community is low, if administrators seem to be taking risk reduction seriously and if parents have to work from home or are essential workers, sending young kids to day care or school may make sense.
The logistics of keeping kids out of school, but still trying to educate them, go far beyond just infectious diseases, Dr. Starke. They go into economics, they go into social structure, and they go into families.
Dr. Chiang has the same decisions to make. When her daughters day care reopened, she spoke with the facilitys director about distancing, disinfection and other coronavirus-related policies. Statistics, family composition, and the age of her daughter also must be considered.
With her being 2 1/2, the risk that shes going to have severe disease from Covid-19 or develop MIS-C is tiny, Dr. Chiang said. We dont have any older family members living with us or in town, so we dont have to consider her getting infected at day care and infecting grandma and grandpa. And the benefits she gets from day care are amazing.
New research suggests that antibodies the immune system makes to fight the new coronavirus may only last a few months in people with mild illness, but that doesnt mean protection also is gone or that it wont be possible to develop an effective vaccine.
Infection with this coronavirus does not necessarily generate lifetime immunity, but antibodies are only part of the story, said Dr. Buddy Creech, an infectious disease specialist at Vanderbilt University. He had no role in the work, published Tuesday in the New England Journal of Medicine.
The immune system remembers how to make fresh antibodies if needed and other parts of it also can mount an attack, he said.
Antibodies are proteins that white blood cells called B cells make to bind to the virus and help eliminate it. The earliest ones are fairly crude but as infection goes on, the immune system becomes trained to focus its attack and to make more precise antibodies.
Dr. Otto Yang and others at the University of California, Los Angeles, measured these more precise antibodies in 30 patients diagnosed with COVID-19 and four housemates presumed to have the disease. Their average age was 43 and most had mild symptoms.
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Researchers found that the antibodies had a half-life of 73 days, which means that half of them would be gone after that much time. It dovetails with a previous report from China also suggesting antibodies quickly fade.
The results call for caution regarding antibody-based immunity passports, herd immunity, and perhaps vaccine durability, the California authors write.
Thats true, Creech said, but other parts of the immune system also help confer protection. Besides churning out antibodies, B cells develop a memory so they know how to do that again if needed.
They would get called into action very quickly when theres a new exposure to the virus. Its as if they lie dormant, just waiting, he said.
Other white blood cells called T cells also are better able to attack the virus the next time they see it, Creech said.
Although circulating antibodies may not last long, what we need to know is if and how people remake antibodies if exposed to the coronavirus again and if they protect against another infection, Alison Criss, an immunologist at the University of Virginia, wrote in an email. We also need to know if there is a protective T cell response that reappears.
Vaccines, which provoke the immune system to make antibodies, might give longer-lasting protection than natural infection because they use purified versions of what stimulates that response, she noted.
Creech agreed.
This shouldnt dissuade us from pursuing a vaccine, he said. Antibodies are only a part of the story.
By: Jeff Shuren, M.D., J.D., Director, Center for Devices and Radiological Health
The U. S. Food and Drug Administration has been proactive and supportive of test development by all comers including laboratories, and large and small commercial manufacturers to speed development and to quickly authorize tests that the science supports. The agency engaged with the lab and commercial manufacturer communities even before any cases of COVID-19 were diagnosed in the U.S., working with over 500 developers since January, and has been working around the clock to authorize over 180 Emergency Use Authorizations (EUAs) for tests, including molecular, serology, antigen, and tests with at-home specimen collection indications.
This pandemic has created a demand for new tests that is unprecedented in both volume and urgency. The FDAs important roles in testing include determining whether the tests developed for use in the U.S. provide sufficiently accurate and reliable results and helping to provide timely access to such tests.
In a public health emergency, getting an accurate test is important not only for the individual patient, but for the public at large. False positive or false negative results can contribute to the spread of COVID-19, so all tests used for COVID-19 should be validated before use. Similarly, timely access to diagnostic tests is also critically important. To best address these dual, and sometimes competing, needs, the FDA has used its EUA authorities. EUAs permit the emergency use of a product, in this case a test, when the FDA determines that certain criteria are met based on the totality of the scientific evidence available. The EUA process made it possible for molecular diagnostic tests to be developed, validated, and offered for clinical use within weeks rather than months or longer.
The FDAs EUA authorities allow the FDA to authorize the emergency use of tests more quickly than full FDA approval or clearance because the evidentiary standard is different. For full approval or clearance, we typically require validation testing using patient samples; however, due to the immediate need and the small number of patient samples available, we utilized our emergency authorities to authorize tests based on data from contrived clinical samples or smaller sets of patient samples. For example, early-on in the emergency, instead of using specimens from individuals infected with SARS-CoV-2, developers could add different amounts of inactivated SARS-CoV-2 RNA to human specimens, such as sputum, to assess how well their test could detect the virus. As a result, validation could be completed rapidly, in some cases in only a few days once inactivated RNA became available. This approach was less likely to accurately characterize test performance so the FDA has taken several actions now that clinical specimens have become more readily available.
Once multiple sources of positive patient samples were available, we asked developers of new tests to validate with these clinical samples. In addition, as part of each EUA for a COVID-19 test, the FDA requires that each test developer and its authorized distributors collect test performance information, including any suspected occurrence of false results, and report to the FDA as a condition of authorization. An additional condition of authorization requires test developers to track adverse events and report them to the agency. These actions have helped generate more robust evidence of test performance to help providers, patients, laboratories, and the government make better informed decisions.
Additionally, these conditions enable the FDA to detect trends and take swift action to prevent harm to patients, especially when device malfunctions may affect many tests across the nation (e.g., in sample collection swabs, or shared test reagents). For example, we were able to quickly alert the public about potential inaccuracies with the Abbott ID Now point-of-care test to diagnose COVID-19 when we began to see a trend in the adverse event reports we received. In some cases, such as tests that used contrived clinical samples for validation, we required developers to conduct post-authorization studies as a condition of their authorization to further evaluate the clinical performance of the test using clinical specimens. This approach gives patients timely access to potentially beneficial and high-volume tests while assuring a more robust understanding of test performance in a real-world setting. The agency monitors all of this information so that we are able to take action when a tests benefits no longer outweigh its risks. Finally, the FDA requires that manufacturers of certain tests provide evidence that their manufacturing processes will deliver consistent results, helping to ensure that accurate tests are produced in every manufacturing lot.
Another step the FDA took to support independent validation for SARS-CoV-2 diagnostic tests was providing developers with a reference panel. Starting with live SARS-CoV-2 virus we obtained, FDA personnel in the Center for Devices and Radiological Health and the Center for Biologics Evaluation and Research worked collaboratively to create a reference panel from a validated inactivated viral stock, and made it available to developers of molecular diagnostic tests. The FDA-supplied reference panels include well-characterized samples of the SARS-CoV-2 virus genetic material (RNA). The FDA panel is available as an independent performance validation step for commercial and laboratory developers of SARS-CoV-2 nucleic acid diagnostic tests who previously validated their authorized tests with contrived samples, or who are currently having difficulty validating their new test. Data from use of the reference panel will provide the FDA with more accurate information on the comparative performance of different tests so that we will have a better understanding of which tests are more sensitive than others. The FDA will make this information available on our website.
We recently announced our participation in the COVID-19 Diagnostics Evidence Accelerator, a multi-stakeholder collaborative project to advance the development of diagnostics through the generation of real-world evidence. It is organized by the Reagan-Udall Foundation for the FDA in collaboration with Friends of Cancer Research to allow the community to analyze both diagnostic and clinical data in real time, which has the potential to contribute to the scientific evaluation of diagnostic tools and medical interventions for COVID-19. The Accelerator project will leverage FDA's SHIELD initiative, a multi-stakeholder collaboration to improve the quality, interoperability and portability of laboratory data within and between institutions so that diagnostic information can be drawn from different sources or shared between institutions. SHIELD harmonizes COVID-19 test data referenced in the HHS COVID-19 laboratory data reporting requirements, which can be used to evaluate the real-world performance of SARS-CoV-2 diagnostic tests and antibody tests.
Evidence generated by the Accelerator project is intended to be complementary to other studies that have been conducted or are underway as well as to provide actionable information about the prevalence of SARS-CoV-2 in specific populations and highlight individual risk factors for patients. This helps improve our understanding of the disease, tailor public health interventions and strategies to mitigate risks for individuals and communities and help stop the spread of SARS-CoV-2.
Taken together, these actions will, and already are, providing the clinical, patient and consumer communities with more accurate information about diagnostic test performance and allowing for the rapid availability of new, accurate and reliable tests.
Some drug companies say well have a coronavirus vaccine by the winter. Others say thats an irresponsible prediction. Some promise to forgo profits on a vaccine, but others believe theyre entitled to their monetary due.
Now, lawmakers can force the industry to get its story straight. On Tuesday, executives from five drug companies leading the vaccine race are due at a congressional hearing to talk about their progress in developing a product the entire world desperately needs. Representatives from AstraZeneca, Johnson & Johnson, Merck, Moderna, and Pfizer will appear in front of the House Energy and Commerce Oversight and Investigations Subcommittee.
People weary of the constraints Covid-19 is placing on lives are pinning a lot of hopes on the promises those companies have made, particularly when it comes to when a vaccine might be ready. But there are still looming questions, from who will get a successful vaccine first to how much it might cost.
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Here are six burning questions the panel could pose.
Most of the manufacturers in the hunt for Covid-19 vaccines are making very bold promises about how quickly vaccines will be ready to be deployed and how rapidly theyll be able to produce their vaccines to the kind of scale needed to combat the pandemic. Many are promising tens, even hundreds of millions of doses by early 2021, and some even predict they can scale to the billion-dose range within the next calendar year.
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But in a recent interview with Harvard professor Tsedal Neeley, Merck CEO Ken Frazier warned that these predicted timelines are doing a grave disservice to the public.
For one thing, he said, vaccine development takes time. The fastest vaccine ever developed before now was the mumps vaccine, which took four years.
Cutting corners is a risky business, Frazier suggested: If youre going to use a vaccine in billions of people, you better know what that vaccine does.
Implied in the statement is the risk that any problems that might arise from use of the vaccines would throw fuel on the fire of the anti-vaccine movement, which is already sowing doubts about the safety of these fast-tracked Covid-19 vaccines.
Frazier also warned that giving people the sense a vaccine may be coming soon allows politicians to downplay other tools that can suppress spread of the disease, such as [wearing] the damn masks.
The most pressing question facing the drug industry is how soon it can come up with an effective vaccine. But right behind that is just how much itll cost. And the industry could answer now by committing to a price before a vaccine is approved.
The U.S. government has some leverage for such a demand. With the exception of Pfizer, each of the companies at the table has received substantial federal funding to support its vaccine development. Through the governments Operation Warp Speed project, taxpayers are on the line for more than $3 billion in research support, and the National Institutes of Health is picking up the tab for at least three massive vaccine studies.
So, what does the American public get in exchange? Some manufacturers have promised to sell their vaccines on a not-for-profit basis, at least for the extent of the pandemic. Others have not. Either way, its looking increasingly likely that the novel coronavirus will not simply vanish once the current crisis subsides, meaning there will demand for vaccines for years to come. If thats the case, will companies come to charge whatever the market will bear? Or are they willing to make pricing commitments now?
Since the start of the crisis, news about vaccine trials has made global headlines, moved markets, and seeped into politics. But the process of disseminating that data has been inconsistent. In May, Moderna put out a press release with vague positive language about its early-stage trial, frustrating experts who wanted more. Pfizer chose to upload its data to a preprint server, where scientific papers are posted without peer review, while AstraZeneca is holding out for publication in the Lancet.
A working vaccine is key to restoring anything resembling normalcy, and the public is desperate for information on the process. But without standardizing the current system, the public is left to parse press releases, rumors, and, worst of all, Twitter. Can the companies developing vaccines establish a system whereby the world gets clear, timely updates on their progress?
The second a coronavirus vaccine proves to be safe and effective, the entire world is going to be calling its manufacturer. The U.S. has already moved to secure millions of future doses, and the European Union is reportedly negotiating to do the same, but whats the plan for the world at large?
Scaling up manufacturing is a time-consuming process, meaning drug makers will be dealing with a constrained supply in the months following a vaccines approval. Beyond the wealthy nations that are already locking in bids, how can countries in the developing world ensure they get access?
That may seem like a question beyond the scope of a House hearing, but the U.S. has a public health interest in vaccines being widely available. With an economy deeply reliant on global trade and travel the U.S. will be at risk of another Covid-19 outbreak as long as the virus persists anywhere in the world.
Some manufacturers are suggesting that there may be enough data to warrant emergency use authorizations as soon as October. If that happens, vaccines destined for use in potentially billions of people will be deployed after mere months of human testing.
In the U.S., manufacturers are shielded from liability if a vaccine or drug developed in response to a health emergency causes injuries to people who receive it. That protection comes from the Public Readiness and Emergency Preparedness Act of 2005.
If that protection were not in place, would vaccine manufacturers be willing to roll out vaccines on such a slight evidence base? Will they make them available to countries that dont offer similar protection against liability?
The major manufacturers are all making vaccine at-risk, meaning they are already working to produce at commercial scale, even before they determine whether their vaccine candidate actually works. The goal is to have large amounts available for use as soon as the Food and Drug Administration green-lights a vaccine. If some candidates fail to clear the FDAs bar, that product will be destroyed.
But manufacturing vaccines is a notoriously unpredictable enterprise. During the 2009 H1N1 flu pandemic, the start of mass vaccination was delayed by several months because the manufacturers had trouble scaling up production. The doses arrived as the fall wave of the pandemic was subsiding in the U.S. That happened with a vaccine that manufacturers had decades of experience producing. So it wouldnt be surprising if some of the companies have or will hit snags. In fact, it would probably be surprising if all the projects sailed through on the very ambitious timelines that have been laid out.
TheWest Virginia Department of Health and Human Resources (DHHR) reports as of 10:00 a.m., on July 20,2020, there have been 233,490 total confirmatory laboratory results receivedfor COVID-19, with 5,080 total cases and 100 deaths.
In alignment with updated definitions fromthe Centers for Disease Control and Prevention, the dashboard includes probablecases which are individuals that have symptoms and either serologic (antibody)or epidemiologic (e.g., a link to a confirmed case) evidence of disease, but noconfirmatory test.
CASESPER COUNTY (Case confirmed by lab test/Probable case):Barbour (25/0), Berkeley (549/19), Boone(60/0), Braxton (7/0), Brooke (38/1), Cabell (220/7), Calhoun (5/0), Clay(16/0), Fayette (102/0), Gilmer (13/0), Grant (23/1), Greenbrier (80/0),Hampshire (50/0), Hancock (58/4), Hardy (48/1), Harrison (140/1), Jackson(149/0), Jefferson (269/5), Kanawha (524/12), Lewis (24/1), Lincoln (21/0),Logan (46/0), Marion (136/3), Marshall (82/1), Mason (28/0), McDowell (12/0),Mercer (72/0), Mineral (71/2), Mingo (53/2), Monongalia (739/15), Monroe(16/1), Morgan (20/1), Nicholas (20/1), Ohio (178/0), Pendleton (19/1),Pleasants (5/1), Pocahontas (37/1), Preston (90/23), Putnam (115/1), Raleigh(98/3), Randolph (197/2), Ritchie (3/0), Roane (12/0), Summers (2/0), Taylor(29/1), Tucker (7/0), Tyler (10/0), Upshur (31/2), Wayne (151/2), Webster(2/0), Wetzel (41/0), Wirt (6/0), Wood (199/9), Wyoming (8/0).
As case surveillance continues at thelocal health department level, it may reveal that those tested in a certaincounty may not be a resident of that county, or even the state as an individualin question may have crossed the state border to be tested.Such is the case of Boone, Cabell,and Wetzel counties.
Pleasenote that delays may be experienced with the reporting of information from thelocal health department to DHHR.
Please visit thedashboard at www.coronavirus.wv.gov for more detailed information.
Perhaps the most confounding aspect of COVID-19 is the diseases unpredictability.
The coronavirus affects every system of the body, including the respiratory and neurological systems and even the blood. Some patients need ventilators to breathe or have flu-like symptoms for a week or two, while others show no symptoms but shed the virus and unknowingly infect others.
And then there are the long-haulers. They gather by the thousands in online support groups as month after month goes by with little to no signs of getting better.
These patients are a mix of younger and older people whose coughing, chest tightness, shortness of breath and fatigue can last well after they test positive for the coronavirus, according to Dr. Christopher Babiuch of the Cleveland Clinic.
Among them is Dr. Scott Krakower, a 40-year-old psychiatrist from New York who had chills and fever for nearly two weeks in April before testing positive. He closed himself off in a room at home to protect his wife and two young children, but was eventually hospitalized.
His life was essentially saved by Dr. Robert Glatter at New Yorks Lenox Hill Hospital who gave Krakower life-saving steroids that opened his throat. But four months later, he says hes still feeling winded on short walks and has trouble swallowing and talking.
I try to think, 'OK, I'm ready to go back to work and things like that,' Krakower says. And then my friends and my colleagues who are in the medical field, I think just listening to me try to talk to explain why I should even do something, I think that they were like, 'Scott, come on. You can't even basically hold a conversation still at times.'
Krakower says he was quarantined at home for five weeks before going to the hospital. His symptoms started with what he describes as the worst chills of his life, followed by losing his sense of taste and smell about a week later.
Losing those senses was a very unusual and bizarre feeling that Krakower says he will never forget.
All of a sudden, you're eating and you're trying to figure out what the food tastes like, and then you can't decide, he says. And then you realize it doesn't have a taste, so then you eat more ... to see if you could somehow find a flavor to it. But you could still taste like the sweet or the salty, and then after a while of whatever was remaining, just sort of dropped off.
From there, Krakower says his condition rapidly deteriorated. He developed a violent cough that wouldnt stop. Eventually, he started coughing up blood.
It was just horrific, he says. Every night at like six o'clock, I would just dread it, dread it because I would be coughing throughout the day and then the night would come, and then it was almost like a very loud barking cough, finally coughing up blood.
Krakower says the strangest thing about his illness was that he would seemingly start to recover, and then his symptoms would come roaring back worse than before.
I would feel better for a period of like three or four days, almost to the point like I felt like the illness was gone, and then I rapidly deteriorated again, he says. And then out of nowhere, the whole thing spiraled down even more violent than the first time around. It was literally like my throat would start to swell and then I couldn't talk.
His doctors said he was having a cytokine storm to his throat. It got so bad that he couldnt swallow and started to choke on his food. When he lost 15 pounds, thats when his family decided it was time to take him to the hospital.
I think [with] any other illness, you would think that you could walk out the door and go to the E.R. and get treatment, maybe get hospitalized, Krakower says. And this illness, you have to think, 'OK well, what if you do this? What if you infect? What if I walk through and I sneeze the wrong way and then my kids got it?
Dr. Glatter put him on IV steroids, which helped decrease the swelling in his throat, he says. When he was finally discharged from the hospital, he says he felt better for a week before feeling sick again.
I wound up on high dose oral steroids, coughing around the clock again, and there was a fear I was going to go back into the hospital, he says. My oxygen was starting to drop again, and then I just stayed like that. I was so sick for like a good three or four weeks, even after hospital.
Krakower says just talking about his experience is difficult now. He suspects that the virus impacted his nervous system, but he says he tries not to think about that.
When I lost my sense of taste and smell, I didn't realize that my other senses were also dulled until after it came back, he says. So I find it hard to believe that it didn't impact the nervous system to some extent. It was almost like an awakening feeling when it came back.
Karyn Miller-Medzon produced and edited this interview for broadcast with Tinku Ray. Samantha Raphelson adaptedit for the web.
CHICAGO (CBS) Some employees say there is no transparency, no protocol, and no direct information about COVID-19 cases about Chicago Park District facilities.
As CBS 2 Political Investigator Dana Kozlov reported Tuesday evening, employees said at least three parks shut down this month because of positive coronavirus cases, but employees are not being told about it.
One of those parks is Haas Park, at 2402 N. Washtenaw Ave. in Logan Square. It was the latest to shut down.
Employees said the shutdown is because of COVID-19. But youd never know it by walking by or even calling. There is no explanation.
But a longtime Chicago Park District employee, who asked to have their identity hidden for job protection purposes, said Haas Park is not the first one to close because of the virus.
We, as employees, are not being notified. Theres no protocol in place. Its word of mouth that were finding out from each other, said the employee.
A memo now circulating among park district employees mentions the COVID case at Haas by name, then asks staffers to help come clean the park. The employee wondered why there was not a company on standby to do that.
If this happened at a school, you would never just not do anything or ask the school next door come on over and help clean up, the employee said.
Other employees told CBS 2 Columbus Park, at 500 S. Central Ave. in Austin, is now temporarily closed for the same reason. A staffer at Blackhawk Park, at 2318 N. Lavergne Ave. in Belmont Cragin, confirmed that park had been closed for COVID too.
And it does not just impact employees. It could also affect families who use the parks or kids who attend day camps.
You cant go on our website and see a listing of parks closed for cleaning purposes, said the employee. So, you could be a neighbor of that park, and you stopped in yesterday to use the restroom and pick up one of the free lunches that are being offered to the community. And now the park is closed because of the positive COVID test, and you have no way of finding that out.
Staffers have to find out amongst themselves, the employee reiterated.
Because supervisors at locations re helping to inform other supervisors, so that we, at least internally, we can figure stuff out. But its all just hush-hush, the employee said. It just doesnt make sense. I mean, its nobodys fault if COVID happens at a park. however, it is your fault if youre not telling your employees whats going on.
The apparent lack of transparency flies in the face of what Chicago Mayor Lori Lightfoot and public health officials say is key to stopping the COVID-19 spread. The staffer said park district higher-ups need a plan.
Currently, there is no protocol in place for what happens when there is a positive COVID test. Were just kinda flying by the seat of our pants, said the staffer.
Late Tuesday, Chicago Park District Michelle Lemons issued a statement on this issue.
The statement read, In each instance, the district took immediate action and followed proper procedures as outlined by the Chicago Department of Public Health, including notifying staff and parents of any minors involved in programming to ensure the safety of anyone involved.
Lemons statement also said each park was disinfected and cleaned in accordance with health and safety guidelines.
But that is exactly the opposite of what the Park District employee said.
Lemons also confirmed there was a fourth case at a fourth park, which Lemons confirmed. But that park, Kozlov was told, never shut down but had been cleaned.
Former intelligence contractor and whistleblower Reality Winner has reportedly tested positive for COVID-19. Winners sister, Brittany Winner, tweeted her diagnosis earlier today. Winner is currently incarcerated in a federal medical prison in Fort Worth, Texas, where an outbreak has sickened hundreds of inmates and killed at least two.
Winner is seeking compassionate release during the coronavirus pandemic, citing underlying medical conditions. An early petition for release from her imprisonment at FMC Carswell was denied in April. Shortly afterward, Carswell reported its first coronavirus death: Andrea Circle Bear, who died after giving birth on a ventilator. The Fort Worth Star-Telegram reported last week that 130 people had contracted COVID-19 at the prison; the most recent Federal Bureau of Prisons statistics show over 500 cases. An appeal is currently pending.
Winners attorney, Joe Whitley, told Law.coms Daily Report that he hopes the court will take the outbreak into consideration. I hope the BOP is equipped to handle the geometric surge in cases, effectively at all their facilities, but I am concerned that may not be the case. According to Daily Report, Winners sister says she is currently asymptomatic, and one of her cellmates also tested positive.
Prisons have emerged as one of the most dangerous hotspots for Americas coronavirus outbreak. Attorney General William Barr has ordered prisons to prioritize releasing inmates to home confinement, but numerous reports have demonstrated confusion and delays in the process although some high-profile Trump associates, like Paul Manafort and Michael Cohen, have been released.
Winner, who previously worked for the National Security Agency, accepted a plea deal for espionage in 2018 after leaking a report on Russian election interference to The Intercept. She is currently scheduled for release in November 2021.
Readout from the Vice President's Governors Briefing on COVID-19 Response & Best Practices Whitehouse.gov
