Despite the pitfalls of drug development, manufacturers of potential coronavirus vaccines are pushing to accelerate the development timeline. Rather than beginning with preliminary studies in animals, companies are conducting the tests concurrently with early human trials which regulators have allowed because of the urgency of the situation.
Manufacturers are also merging clinical trials, which are typically done in three phases, and moving swiftly from one stage to another. Johnson & Johnson will begin testing its vaccine in people next month, in a study that will combine a phase one safety trial and a phase two efficacy trial. The company plans to start the final phase of testing, a phase three trial, by September.
Another vaccine, made by Moderna Therapeutics, is heading into final human trials in July. And a candidate from AstraZeneca and the University of Oxford is hot on its heels. A dozen more candidates are progressing through laboratory tests and early studies in people.
But those trials can only be accelerated so much. Moderna plans to enroll 30,000 people in its phase three studies, Fauci said and signing them all up could take the rest of the year.
Scientists are also now considering sometimes controversial methods, such as vaccinating healthy volunteers and then exposing them to the virus to see whether the vaccine works. That approach, known as a human challenge study, would need to be authorized by the FDA and overseen by an ethics committee.
Human challenge studies are tricky because scientists need to expose volunteers to just the right amount of the virus too much, and the vaccine could fail; too little, and the vaccines effectiveness could be overstated. But this type of study could fill in crucial data gaps if the U.S. outbreak shrinks before the first candidate vaccines enter phase three trials in the fall.
Its on the table. I hope we wont have to use it, said Fauci, noting that the method would not necessarily save time. We are making challenge doses. Were not saying were going to use them.
We're tracking the highest counts of COVID-19 by zip code in the metro area.
ATLANTA Nearly 1,100 new COVID-19 cases were reported in Georgia Friday, sending our numbers up again.
We're tracking cases across the metro and now we're looking at some of the top zip codes where the virus is growing across our largest counties.
Gwinnett County, which is where the virus is growing significantly, had the highest number of COVID-19 cases in the Lawrenceville area with 770.
In Fulton, the top zip code is 30331 with 401 total confirmed cases. That includes the Princeton Lakes and Greenbrier neighborhoods.
Cobb's highest concentration of the virus is in Marietta. There are now 450 cases reported there.
DeKalb's most recent numbers show the area around Brookhaven, Chamblee, and Druid Hills is now reporting 358 cases of coronavirus.
Written by Shiny Varghese | Updated: June 21, 2020 4:29:23 pm The novel coronavirus pandemic and the lockdowns that were put in place across the world to tackle it pose questions about the future of urban living. (Illustration by Suvajit Dey)
Think of a city that has a skin that can inflate and deflate, depending on the number of people it needs to accommodate. A house that can be lifted on a crane and perched on skyscrapers and detached when your work in the city is done. What if a city can hang off an airship and land overnight in a place, with a kit of moveable parts? In the late 1960s, when modernism was making chunky cubes of houses for people to live in and grids for urban layouts, a group of six British architects came together to form Archigram. They began with a single-page magazine that was filled with collages, poems and visuals of utopian possibilities of a city flexible, mobile and adaptable. The group would challenge generations of architects to build, dream and envision possible futures. Though Archigram never built any city and critics called them out for their assumption that the earth had endless resources, many of their ideas seem to have found their way into our everyday, from escalators to monorails.
The novel coronavirus pandemic and the lockdowns that were put in place across the world to tackle it pose questions about the future of urban living. In India, among the images seared into public memory are those of crowds cheering on balconies of towering apartments and private homes, and that of workers streaming out of cities, walking hundreds of kilometres to their homes. Some of us, for whom home remained a safe place, raised the drawbridges, switched on ourWiFi and disconnected from the outside. We created islands for ourselves within our homes, while the migrant worker moved out of his dwelling place.
Today its the pandemic, tomorrow it could be an intense heat wave or a global climate crisis. Confined living will become the way forward, says Thiruvananthapuram-based urban designer and architect Manoj Kumar Kini. A possible future model, he says, lies in the example of Arcosanti. Sometime in the 1970s, Italian architect Paolo Soleri planned a future city that would meld ecology and architecture. In the Arizona desert, he envisioned the utopian metropolis, Arcosanti. Its ribbed vaults allowed ample light and air to filter into spaces, and encouraged a sense of community. One could walk to the office or workshop, compost with ones neighbour or walk out of ones house into the thick of cultural action. While it had its faults, be it the people who lived there or the unadaptability of the structure, it offered a worldview that could change the way we live.
Closer home, Auroville near Puducherry aimed to be a place with a new consciousness, with like-minded people from all over the world making it their home. In the future, urban living could be like something between an apartment and a township like Dwarka in Delhi, where compact living will be the norm, with people choosing to walk, cycle or take public transport, because distance will compress. We will travel less, have a smaller ecological footprint, and have more time with family, says Kini.
Could buildings of the future be about empathy, about an architect who places himself/herself in the role of a future dweller and tests the validity of the ideas through this imaginative exchange of roles and personalities? asks Finnish architect and thinker Juhani Pallasmaa in the book Architecture and Empathy (Peripheral Projects; 2015). Will buildings become a shared resource? Can a university and a corporate office be in the same campus? Can government administration and cultural centres coexist? Maybe it will open up spaces in the city, between building and non-building, where designers and architects will need to intervene to revitalise, renovate, and renew. We will have to get off our Autocads and get our hands dirty. Just the way you now want a hairdresser to come home, people might want an architect to come home and use what they have to build anew, since money and building resources will be hard to come by, says architect Moulshri Joshi of the Delhi-based firm Space Matters.
Until now, we were aware of those who lived on pavements, in slums and chawls and overcrowded small apartments. But we didnt realise there is another lot of people who live in corridors, garages, attics, mezzanines, and lofts in every city, and their numbers are staggering. When the city turns its back on them, where can they go? says architect and habitat professional Kirtee Shah, who lives in Ahmedabad.
For the poor migrant to the city, there is a place called home in the village and a city where he earns his daily bread. For some, the home is a resort but for those who dont have that privilege, the city was their home. It gave them certainty. What does it mean to not have that in a lockdown? There are no easy answers, but we need to think of ideas of care and how we can create those spaces in our cities. How can we create different levels of communities and what will those spaces be? says Mumbai-based architect and urbanist Rupali Gupte.
In a recent letter to Praveen Pardeshi, former municipal commissioner of Mumbai, Shah offered suggestions for handling the slum crisis in the city. From using vacant houses and unsold inventory in housing for migrants and using rooftops of public buildings to create temporary housing stock, Shah pushed for more dignified dwelling units.He recounts his keynote address at the opening of the State of Housing exhibition in Mumbai in 2018. He asked an audience of nearly a 100 people, a majority of them architects, if they had heard of Indira Awaas Yojana. Only a few hands went up. It was one of the worlds biggest social housing projects, which lasted nearly 30 years and built more than 20 million houses, but Indias architects barely intervened. It speaks volumes about the disconnect architects have with society, he says.
While architects design on a computer, the drawings are executed by masons, carpenters and unskilled labourers. They are the ones who convert our dreams into beautiful projects. So I asked, Since most of you visit your sites at least every two weeks, how many of you have seen the conditions in which the workers live? Barely one hand came up, says Shah. We need to rethink and reshape our cities which are inhuman and hostile to the people who build them.In the letter, Shah suggests renegotiating terms with employers so that workers are provided better places to live. [It] could be a rented place in a slum redevelopment colony, in an affordable low-income settlement, in a slum where a family is willing to rent a room, or in a liveable tent on a public building terrace.
The comfort of home for migrants is also the sense of security that comes from the physical and figurative boundaries in a village. Numerous migrants testified to the urgent need of going home, even if it meant starvation or death. Homes in villages have their own layering. The epidermis that holds you in. You have the aangans (courtyards), and within that the public threshold, and then within them bigger rooms, and then your own room, your clothes, your body. Here, the epidermis of life has always existed, which is not affected by the commodities of the world. With it comes immunity, when your food and shelter is homegrown, says Bengaluru-based architect Varun Thautam, who conducts workshops on handmade buildings. Today, in cities, we dont know who grows our food or where our water comes from. But staying local is the only way forward, he argues. Case in point: the lockdown proved that the kirana shop and the immediate neighbourhood was equipped to handle most of our needs.
It is in a crisis that our true belonging to a place is revealed. We want to return to our villages because our heart is at home, says Chennai-based architect-academic Durganand Balsavar. He speaks of what he learnt from his experiences of working with Sri Lankan civil war refugees and those displaced by the 2004 tsunami in Nagapattinam, Tamil Nadu. Many of the Sri Lankan women, for instance, were skilled at weaving mats. Balsavar, with his team at Artes-Human Settlements Development Collaborative, encouraged them to use these as partitions for their new homes. That should be the way forward for families returning to their villages, too, during the lockdown. None of them want anything free, they are glad to engage their skills in a productive manner. That is what we should be doing, respecting dignity and pride in their work, he says.
Home is about identity and self-definition, an expression of belonging. While our cities privilege privacy and gated elements and also disconnection from the larger masses, in our villages networks are cyclical and form the basis of life. The city and its lack of interdependency is what causes alienation. Pratik Dhanmer of Design Jatra, a rural research and architectural firm in Dahanu, Maharashtra, speaks of how the layout of houses in villages enhance interaction, where verandahs face each other and children are secure playing on the streets.
Balsavar recounts what he noticed in Nagapattinam soon after the tsunami. Several families had abandoned their newly-built concrete-box shelters. These fine engineered solutions for living put the kitchens at the back of the house. The original homes had the kitchens in the front, which enabled women to talk among themselves, keep an eye on their children playing on the street, not to mention the excellent cross-ventilation they afforded. However, in the new homes, the kitchen was pushed to the back of the house, which meant the women worked in isolation, their front doors were shut and the streets empty. The idea of a rural home has many layers, which architects, sociologists and engineers can learn from, says Balsavar.
While we rejoiced in employing our city balconies as a stage for approval, with all the bells and whistles, it has rarely become a site for interaction all these years. Its the park view we seek and not the sense of community. In fact, in many homes, balconies are seen as obstacles in the way of carpet area. Delhi-based architect Gautam Bhatia has planned a design where the community is not compromised. In cities where we privilege privacy, what are the possible combinations which allow for the public and the private to come together? Over the last couple of decades, life has been going into lockdown by itself. Within homes, too, entertainment was becoming private and recreation was getting isolated. So, the idea of an apartment that shares community values yet allows you to keep your privacy is the aim.
These would be about 800-1,000 sq. ft houses, varying from one-two bedrooms. The remaining spaces are given over to the community, with meeting rooms and games areas. The idea is to force you out of your confinement. You pay much less for private space and get more shared space. You will be forced to go out into verandahs. Unlike high-end apartments that are self-contained, where there is no sense of sharing, he says. There is the need to change by-laws in our cities to accommodate more public spaces and integrate all classes to live side by side. The future, Bhatia says, is in smaller homes and rental housing.
The coronavirus has exposed the artificial and abnormal in society, argues Delhi-based Shuddhabrata Sengupta of Raqs Media Collective, which is curating the Yokohama Triennale 2020. There is an enormous amount of resources spent to ensure that our society is not democratic. Delhi, for instance, is a lot about gated communities and large resources are used to keep people out. We are living in a highly artificially maintained dystopia. Architects and urban designers can show a new way and plan how our cities can be for the next 100 years. But I dont see them coming together to demand a commitment to urban housing from any regime. Ultimately, it will not be about big projects but keeping life cycles intact, which our vernacular societies have always done, where life is not a straight line and relationships are important, says Thautam.
Maybe, our cities ought to be like Ersilia, from Italo Calvinos novel Invisible Cities (1972), where relationships nurture life, and its inhabitants stretch strings from the corners of their houses across the city to mark connections, be it for trade or fellowship. So that, even when walls come crumbling down and homes cease to exist, the labyrinth of taut strings will continue to exist.
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Stphane Bancel, CEO of Moderna Therapeutics
Source: Moderna Therapeutics
Recent history suggests a new vaccine entering human clinical trials has about a 1-in-3 chance of getting FDA approval. Stephane Bancel, chief executive ofModerna, pegs the chances of his company's novel coronavirus vaccine at closer to 80% to 90%.
"We know our platform," Bancel said in a recent interview. "It works on MERS, Zika and CMV and so on. When you have the right sequence ... you will get neutralizing antibodies."
Moderna, the apparent front-runner in the Covid-19 vaccine race, has shown its vaccine elicits those neutralizing antibodies (so-called because they stop the virus from being able to infect cells) in early human studies but in just eight people so far.
Still, Bancel's expectations are high. The company has announced plans to start a 30,000-person efficacy trial in July, the first planned in the U.S. It's enrolled more than half of its mid-stage study of 600 people already. All before the complete data from the first stage of the trials has been fully reported, and as the company just posted results of the vaccine's testing in mice. (They showed "promising signs of efficacy," William Blair analysts wrote, "albeit in mice.")
So how did a 10-year-old company with no products yet on the market leapfrog industry giants like Johnson & Johnson and Merck in one of the greatest medical races in history?Moderna was No. 1 on CNBC's Disruptor 50 list in 2015, and five years later it's still disrupting.
If you ask Bancel, there are precisely five reasons.
First, the technology: messenger RNA. It's a way to deliver genetic instructions to the body's cells to make proteins. For the SARS-CoV-2 vaccine, called mRNA-1273, the instructions encode for the virus' spike protein (the protrusions that give the coronavirus family its name, meaning "crown"). Once the body's cells read the instructions and make the protein, the goal is that the immune system will mount a response that would be protective if the vaccinee encounters the virus in the wild.
It's an elegant idea, and it's also very speedy. Moderna delivered the first doses of vaccine to its partners at the National Institute of Allergy and Infectious Diseases in just 42 days.
We know our platform. It works on MERS, Zika and CMV and so on. When you have the right sequence ... you will get neutralizing antibodies.
Stephane Bancel
CEO, Moderna
Bancel's second reason: This is the tenth vaccine Moderna has brought into human clinical trials. The company's most advanced, before the unprecedented timeline set by its Covid-19 program, is a vaccine against CMV, or cytomegalovirus.
Third: Moderna's previous work on MERS, or Middle East Respiratory Syndrome, caused by a virus in the same coronavirus family as SARS-CoV-2. While that vaccine didn't enter human trials, it was a previous collaboration with the National Institutes of Health that Bancel credits for creating the foundation that enabled the early partnership on Covid-19.
Fourth and fifth: Moderna has its own manufacturing plant, in Norwood, Massachusetts, which is "fully digital," employing machines to avoid human error, and "fully integrated," Bancel explained, "meaning we make our critical raw material. We make the mRNA; we formulate it in the lipids."
"If we had had contract manufacturers," he said, "we might still be in preclinical as we speak." (Preclinical is the stage before human trials.)
Perhaps a sixth reason is Bancel himself, and his talent for establishing relationships with the right people.
Two years ago that meant an outreach to Dr. Anthony Fauci and his team at NIAID, which led to the nation's infectious diseases agency and the company working together on a vaccine for MERS, which sickened almost 2,500 people in outbreaks since September 2012and killed about a third of them.
Last fall, Bancel said, the groups agreed to do a trial run of a new outbreak scenario, planned for the second quarter of 2020. But before they could, they were faced with the real thing. Chinese researchers posted the sequence of SARS-CoV-2 online Jan. 11. Two days later Moderna and the NIAID had agreed on the design of their vaccine.
That mRNA-1273 is now approaching a 30,000-person phase 3 trial, six months after it was created, is unheard of. And it's not the only one: An AstraZeneca/Oxford University vaccine is expected to start a similar study in August, while J&J pegs September for its start date for a large efficacy trial.
NIAID's Fauci calls the goal of having a vaccine ready to deploy by the end of the year "aspirational, but it's certainly doable."
Still, there are many questions to be answered. The vaccines have to be proved safe and they have to work.
Bancel joins Fauci in pledging that risks being taken are only business risks, not safety ones.
"Neither us nor NIAID nor FDA was willing to take a safety risk," Bancel said. "What we've taken is business risk, and we've taken a lot of business risk."
Moderna started making the doses for phase 2 trials even as participants were getting the first doses in phase 1, he said.
To be sure, Moderna's financial risk was blunted somewhat by an award from the Biomedical Advanced Research and Development Authority, or BARDA, of $483 million. But the company indicated it would need more funding to finish the job (and drew criticism for a stock offering to raise more funds that was timed after a 20% spike in its share price following the preliminary phase 1 data release).
Any business risk Moderna's been willing to take has been because it's a pandemic, Bancel said, but also because the vaccine "has a high chance of working."
He couches his prediction of an 80% to 90% probability of success to the likelihood the vaccine will have efficacy of above 50% meaning it can reduce the risk of disease by half.
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"At the public health level, a vaccine with 50% [efficacy] will slow down drastically infections," Bancel said. He said he'd need more data to assess the probability of the vaccine showing 90% efficacy.
Meanwhile, as the vaccine moves through clinical testing, Moderna is preparing for the prospect of its first product receiving regulatory approval, hiring Amgen's former chief financial officer David Meline and former Amgen communications head Ray Jordan, and seeking a head of commercial and legal policy to guide the Covid-19 vaccine to market.
It's also signed a deal with manufacturer Lonza to make 500 million to 1 billion doses of the vaccine each year. But don't count out Moderna's Norwood manufacturing facility, which Bancel still wants to show off but only with the proper precautions.
"Once you get the Moderna vaccine," he told me, "you have an open invitation."
Since the onset of the coronavirus outbreak, a vaccine has been widely regarded as the best path toward reopening society and returning to normalcy. Scientists have worked around-the-clock to develop a vaccine even entering late-stage human studies at record speed for the disease that has killed more than 430,000 people worldwide.
Yet, despite these Herculean efforts, scientists say a one-time cure-all is unlikely. Data on close cousins of the COVID-19 virus, including seasonal coronaviruses that cause the common cold, suggests the COVID-19 vaccine probably won't offer lifelong protection -- although more research is needed to understand how well and for how long a potential vaccine could work.
It's a problem significant enough to worry Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, who has been excited at the chance of developing a vaccine, but hesitant to predict how long it might work.
"When you look at the history of coronaviruses, the common coronaviruses that cause the common cold, the reports in the literature are that the durability of immunity that is protective ranges from three to six months to almost always less than a year," Dr. Fauci said in an interview with JAMA Editor Howard Bauchner.
"That's not a lot of durability and protection," Fauci said.
And although it's too soon to say how long a COVID-19 vaccine might protect you, an executive at AstraZeneca, one of the companies working to develop an effective vaccine, told a radio station that he thinks his vaccine might only offer protection for one year.
This means that if we get a safe and effective COVID-19 vaccine, it might not offer lifelong protection. Vaccine experts told ABC News it's still too early to know for sure.
A health worker process for COVID-19 antibodies after getting the blood from the patient at the the Diagnostic and Wellness Center, May 5, 2020, in Torrance, Calif.
As scientists race to answer some of these questions, the United States government is forging ahead with Operation Warp Speed, an ambitious plan to have enough doses of a safe and effective vaccine to be able to vaccinate the majority of Americans by 2021.
"We cannot promise 100% chance of success," a senior government official told reporters earlier this week. "What we can tell Americans is that we've taken every possible step to maximize the probability of success and shorten the timelines to getting safe, effective vaccines and therapeutics."
One way to gauge the durability of an eventual vaccine could be to look at people who have already been infected with and survived COVID-19. But even though some people with COVID-19 have demonstrated an immune response to the disease and recovered, the longevity of response is still unknown, since scientists and doctors have known about the virus for less than six months.
Still, early studies have found that the immune response to SARS-CoV-2, the virus that causes COVID-19, is probably similar to SARS-CoV and MERS-CoV. And we know from SARS and MERS that immunity can last a few years, but antibody protection tends to wane about a year post-infection. This means that even people who have recovered from COVID-19 could get it again in the future.
Nevertheless, a COVID-19 vaccine could induce long-lasting immunity even if the infection does not, said Dr. Paul Goepfert, director of the University of Alabama at Birmingham Vaccine Research Clinic.
"Because vaccines are much more focused in their immune response, it could be that you could develop an antibody to the part of the virus that is more long-lasting," Dr. Goepfert said.
It may come down to the structure and biology of this particular virus. SARS-CoV-2, the virus that causes COVID-19, is covered in tiny spikes called surface proteins. Experts say that the virus is unlikely to mutate in a meaningful way, meaning the vaccines that are being developed now are likely to work in the future.
Different vaccine developers are taking different approaches to create a COVID-19 vaccine. Some groups, such as Oxford and its partner AstraZeneca, are using a traditional approach of using the virus itself but neutering it so that it doesn't make people sick.
Others, such as Moderna and Pfizer, are hoping that by coaxing the body to create this protein, they might be able to trick the immune system into mounting an effective response against future infection. They're hopeful that their approach will allow them to be more agile should the virus mutate in the future.
Aside from durability, not all vaccines have complete protection, for example, the annual flu shot ranges in effectiveness and works better for children than for the rest of the population. In 2019, it was less than 50% effective in preventing the flu, but there were still major benefits.
"A 60% effective COVID vaccine would still decrease the number of infections, the number of deaths and the number of people who become severely ill," Goepfert said.
"Obviously, a vaccine that works 100% of the time would be ideal, but that is not realistic," said Dr. John Mascola, director of the National Institutes of Health Vaccine Research Center.
It's possible that, like the flu vaccine, an eventual coronavirus vaccine might also work better for certain groups, although right now experts say it's too soon to tell.
Should scientists develop a safe and effective vaccine -- and they are cautiously optimistic that they will -- it would be the safest approach to achieving herd immunity. Epidemiologists estimate that about 60% to 80% of the U.S. population would have to recover from COVID-19 or have the antibodies from a vaccine to stop the virus from spreading widely.
The reality is that a coronavirus vaccine may provide relatively short protection, said Dr. Beth Kirkpatrick, chair of the University of Vermont's Department of Microbiology and Molecular Genetics.
Researchers may have to consider booster shots or revaccination if people's antibodies fall below the amount associated with protection -- a count that is still unknown. Only time will tell, and long-term observation of patients after vaccination will determine how durable the vaccine really is.
"We will have to follow those people for quite a long period of time to be able to know how long it's going to last for, because if it starts fading away, it won't be until a year or two years or three years that we'll start seeing the infections pop up in people that got vaccinated," Kirkpatrick said.
The average times of the fastest sprinters in the 100-metre dash are in the ballpark of 10 seconds. So, what would you think if someone promised to run the race in one second?
It typically takes a minimum of 10 years for a vaccine to complete the three consecutive phases of the clinical research pipeline. This is because of the scope and length of the experiments, the need to critically assess the results at each stage and the mountains of paperwork that are involved.
READ MORE: WHO says its hoping for a vaccine this year
What are the chances that this can be reduced to 12 months? Indeed, it has been implied that this process can be accelerated to warp speed.
We contend that a safe and effective vaccine against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), which is the causative agent of coronavirus disease COVID-19, most likely cannot be made available to the public in time to make a substantial difference to the natural outcome of this pandemic. People often cling to hope even when prospects of success are low. However, this can have negative consequences if that hope is not realized.
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We are academic scientists who manage vaccine research programs. In fact, one of us Byram Bridle, received COVID-19-focused funding to develop a novel vaccine platform.
Although many of us are working hard toward developing vaccines against SARS-CoV-2, we worry that some in the scientific community have offered too much hope for this to be accomplished in a timely fashion. Sometimes these promises are used by politicians and governments to inform public policies. As a result, the integrity of the scientific community is now in the limelight and, arguably, at risk.
Vaccines are an effective way for a population to achieve what is known as herd immunity. This is the concept that the pandemic will end once approximately 60-70 per cent of people become immune to SARS-CoV-2. An alternative is to let SARS-CoV-2 run its natural course until herd immunity is achieved. With physical distancing, some epidemiologists argue this could take two years, during which time a vaccine could be developed.
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However, vaccinating at the tail end of a pandemic when disease incidence is very low and declining may be of little utility, hence the race to develop a vaccine for COVID-19. If one is not in widespread use within the first half of 2021, it will probably be too late to have a meaningful impact on the control of COVID-19.
[ Sign up for our Health IQ newsletter for the latest coronavirus updates ]
Educators often rely on past performance to predict the future performance of students. In this respect, how was the performance of the scientific community in the wake of the original SARS-CoV, or Middle East respiratory syndrome (MERS)-CoV? The fact is, no vaccine against a coronavirus has successfully navigated the rigours of clinical testing, despite having up to 17 years to do so.
The same applies to other dangerous respiratory pathogens, such as respiratory syncytial virus. Whether enough has been learned from these past experiences to get the design of COVID-19 vaccines right remains to be seen, and still does not negate the need for a rigorous testing process that will take time.
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One concern is that some vaccines can protect against disease (that is, the outcome of an infection) but not against infection (the ability of the virus to get into the body). In this scenario, vaccinated individuals could potentially become asymptomatic carriers of SARS-CoV-2, thereby spreading COVID-19. For this and many other reasons, a cautious approach must be taken to developing COVID-19 vaccines.
READ MORE: What we know and dont know about asymptomatic coronavirus transmission
What about the fact that there are front-runner vaccines already in human clinical trials?
First, many of the vaccine technologies that can most readily make it to the front of the line are not necessarily the best quality. The easiest way to make a vaccine is to inactivate the pathogen or use pieces of it, and mix them with an adjuvant, which tells the immune system that the pathogen is dangerous and worth responding to.
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However, an inactivated virus or its components do not behave like the live virus, so the immune system sometimes responds to these vaccines in a way that is ineffective or sometimes even dangerous. For example, no vaccine based on the genetic material, known as ribonucleic acid or RNA, from a virus like SARS-CoV-2 has ever been approved. Further, some vaccines developed against the original SARS-CoV, after the epidemic was over, exacerbated the disease in mice.
READ MORE: As rich nations prepare for coronavirus vaccine, others could be left behind, experts say
A vaccine for COVID-19 does not have to be the best one, but it does need to be good enough to accelerate a populations progression to herd immunity. As experienced peer reviewers, we have some concerns about the rigour of some of the science surrounding COVID-19 vaccines.
Some vaccines are fast-tracking through the regulatory system before studies are completed and with minimal details of experimental results being released. Executives of a big pharmaceutical company whose vaccine is among those closest to the finish line recently sold their stocks after releasing positive results that were superficial, partial and that included three of eight healthy young volunteers experiencing severe adverse events.
Events like this are causing the public to become skeptical. A promising vaccine should have solid data to back it up. Those touting vaccines against COVID-19 that are in clinical trials should be asked to provide comprehensive details and results of their study. This enables objective and rigorous evaluations by the broader scientific community. A lack of complete transparency would be cause for concern.
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Assuming a vaccine succeeds in human trials, it then needs to be manufactured in massive quantities at an affordable price, undergo quality control testing and be distributed worldwide. Even if by some miracle this spectrum could be bridged at warp speed, one then needs to wonder if up to 70 per cent of individuals can be effectively vaccinated.
Uptake of a vaccine could be compromised by anti-vaxxers, as well as by perceptions that warp-speed manoeuvring might be the result of cutting too many corners and compromising safety. Then there are those who simply do not respond as well to vaccines, which includes the elderly who are in the greatest need of protection.
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Considering what we now know about SARS-CoV-2 vaccines, we need to take a more cautious approach and one could question if any of the vaccines that are now in pre-clinical testing can possibly help with the current pandemic. We sincerely hope that our pessimism about vaccines currently in clinical trials being ready in time is soundly proven wrong.
Even if a vaccine doesnt get developed in time, not all is lost.
The array of vaccines being engineered will help with outbreaks beyond COVID-19. They can be vetted by scientists and the best technologies and associated research teams could be shortlisted to be called upon for future outbreaks.
Although clinical research likely cannot be shortened to 12 months while maintaining integrity of the science, the current attempt to do so will build new and reasonable efficiencies into health regulatory policies. This will facilitate getting a wide variety of future health solutions to patients faster, but not at warp speed.
Byram W. Bridle, Associate Professor of Viral Immunology, Department of Pathobiology, University of Guelph and Shayan Sharif, Professor of Immunology and Associate Dean, Research and Graduate Studies, University of Guelph
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This article is republished from The Conversation under a Creative Commons license. Read the original article.
FARMINGDALE, N.Y.,June 18, 2020/PRNewswire/ Codagenix, Inc., a clinical-stage biotechnology company developing prophylactic vaccines and oncolytic virus therapies, today announced the successful synthesis of a readily-scalable live-attenuated vaccine candidate against COVID-19. The vaccine, CDX-005, is currently undergoing safety and efficacy studies in animals and appears markedly attenuated compared to wild-type SARS-CoV-2, the virus that causes COVID-19, with pre-clinical data expected by early July.
Codagenix, backed by investors Adjuvant Capital and TopSpin Partners, is collaborating with the Serum Institute ofIndiato develop CDX-005. Although there are more than 140 COVID-19 vaccine candidates currently under development, CDX-005 is one of only a handful of live-attenuated approaches to tackling the current pandemiceven though this framework has led to some of historys most successful vaccines, such as those for measles, smallpox, and rubella. Codagenix is bringing this proven technology into the 21st century with its powerful deoptimization algorithms, allowing the company to engineer vaccine candidates that are structurally identical to naturally circulating SARS-CoV-2 at the amino acid level, yet are unable to efficiently replicate in the vaccine recipient. The goal of this approach is to stimulate a robust immune response that mimics that of the wild-type virus, without leading to clinical illness or further transmission. Codagenix scientists believe that, to the extent natural SARS-CoV-2 infection protects an individual from reinfection for a given period of time, CDX-005 has promising potential to do the same.
Equally important, CDX-005 grows to robust concentrations in cell culture, allowing its production to be scaled rapidly using fairly common vaccine manufacturing equipment to meet the vast, global demand. This is another distinguishing factor relative to the crowded landscape of other COVID-19 vaccines in development, such as those using mRNA, virus-like particles, or adenovirus-vectors, which in many cases may require specialized production infrastructure and/or comparably large quantities of antigen per person to be effective. The anticipated immunogenicity of CDX-005, in contrast, may require only modest quantities of active ingredient per person to be effective, potentially allowing the production of hundreds of millions of doses per year or more from existing vaccine facilities.
Following the successful completion of pre-clinical animal studies, CDX-005 will be manufactured by the Serum Institute and tested in a Phase I clinical trial slated to begin in the fall of 2020. Serum Institute will simultaneously scale manufacturing for large-scale safety and efficacy studies, in addition to preparations necessary to meet global vaccine supply requirements.
There are currently no licensed vaccines available against COVID-19. Until an effective vaccine becomes available, transmission of the virus can be prevented by frequent handwashing, social distancing, and wearing a face covering when in contact with others.
About Codagenix
Codagenix is a clinical-stage synthetic biology company that uses software to recode the genomes of viruses, constructing live-attenuated vaccines or viruses to prevent viral infections or treat solid tumors. Codagenixs recoded vaccine candidates are a perfect antigenic match to the target virus and induce a robust immune response to all viral antigens. For cancer, our nimble platform allows us to turn a virus into a potential oncolytic immuno-oncology therapy. Both programs rely on scalable, low-cost manufacturing. Codagenix Inc. spun out of the laboratory of National Academy of Science Member Eckard Wimmer atStony BrookUniversity in 2012 and is located at the Broad Hollow Bioscience Research Park inFarmingdale, N.Y.Our programs are supported by Adjuvant Capital, TopSpin Partners, Euclidean Capital, and government agencies such as the USDA, NIH/NIAID and the Department of Defense.
For more information, visitwww.codagenix.com.
About Adjuvant Capital
Adjuvant is aNew York andSan Francisco-based life sciences fund built to accelerate the development of new technologies for the worlds most pressing public health challenges. Backed by leading healthcare investors such as Merck, Novartis, and the Bill & Melinda Gates Foundation, Adjuvant draws upon its global network of scientists, public health experts, biopharmaceutical industry veterans, and development finance professionals to identify new investment opportunities. Adjuvant invests in companies developing promising new vaccines, therapeutics, diagnostics, and medical devices for historically overlooked indications such as malaria, cholera, Lassa fever and postpartum hemorrhage, with a commitment to make these interventions accessible to those who need them most in low- and middle-income countries.
For more information, visitwww.adjuvantcapital.com.
About Serum Institute ofIndia
Serum Institute of India Pvt. Ltd. is the worlds largest vaccine manufacturer by number of doses produced and sold globally (more than 1.5 billion doses) which includes Polio vaccine as well as Diphtheria, Tetanus, Pertussis, Hib, BCG, r-Hepatitis B, Measles, Mumps, and Rubella vaccines. It is estimated that about 65% of the children in the world receive at least one vaccine manufactured by Serum Institute. Serum Institute ofIndiawas founded in 1966 by Dr.Cyrus Poonawallawith the aim of manufacturing life-saving immuno-biologicals, which were in shortage in the country and imported at high prices. Thereafter, several life-saving biologicals were manufactured at prices affordable to the common man and in abundance, with the result that the country was made self-sufficient for Tetanus Anti-toxin and Anti-snake Venom serum, followed by DTP (Diphtheria, Tetanus and Pertussis) group of Vaccines and then later on MMR (Measles, Mumps and Rubella) group of vaccines. The Philanthropic philosophy of the company has proliferated to bring down the prices of newer vaccines such as Hepatitis-B vaccine, Combination vaccine etc., so that not onlyIndias, but the entire under-privileged children of the world are protected from birth onwards.
SOURCE Codagenix, Inc.
https://codagenix.com/
Source: https://www.prnewswire.com/news-releases/codagenix-announces-the-synthesis-and-preliminary-safety-of-scalable-live-attenuated-vaccine-candidate-against-covid-19-301079306.html
China temporarily halts some imports of Tyson Foods poultry.
As Beijing struggles to stop a coronavirus outbreak that appears to have started at a vast wholesale food market in the city this month, Chinas customs agency is taking aim at a U.S. company in a politically contentious industry: Tyson Foods.
Chinas General Administration of Customs said on Sunday that effective immediately, it was temporarily suspending poultry imports from a Tyson Foods slaughterhouse that has had coronavirus cases among its workers. Shipments from the slaughterhouse that have already arrived in China will also be seized, the customs agency said in a public notice.
Scientists have said that the coronavirus appears to spread mostly through the air, not contaminated meat. But China has already curbed almost all transmission of the virus within its own borders and is looking to stamp out even low probability risks.
The Chinese agencys notice did not identify the location of the slaughterhouse, providing instead a registration number: P5842. Over the course of this spring, Tyson Foods has disclosed cases among its workers in several U.S. states.
On Friday, the company said that 13 percent of the 3,748 employees at its facilities in northwestern Arkansas had tested positive for the coronavirus. Almost all were asymptomatic. Arkansas is one of 18 U.S. states where daily new cases have been increasing.
Safety limits on food imports from the United States could make it even harder for China to meet its promise to buy more U.S. goods as part of its Phase 1 trade agreement with the Trump administration that was signed in January. But American critics of food processing giants, particularly pork producers, contend that the companies have risked the health of their workers by keeping operations running, in part to supply China.
A person answering the phones at the customs agency on Sunday said that it was closed for the weekend, and Tyson Foods issued no immediate comment.
In his first rally in months, President Trump bragged about his response to the pandemic, despite widespread criticism of his administrations faltering management of the crisis.
Addressing a mostly maskless crowd on Saturday night in a sparsely filled 19,000-seat indoor arena in Tulsa, Okla., Mr. Trump mocked the coronavirus, which has killed 121,000 Americans, and claimed that he wanted to slow down testing.
Heres the bad part, Mr. Trump said, after boasting that the U.S. had tested millions more people than any other country. When you do testing to that extent, you will find more cases. So I said to my people, slow the testing down, please. He also insisted that schools needed to open in the fall.
On Sunday, Peter Navarro, the White House director of trade and manufacturing policy, said in an interview with Jake Tapper on CNNs State of the Union that the presidents comment about slowing testing was tongue in cheek.
At the rally, Mr. Trump said the low turnout had resulted from news media reports on local officials health concerns about the indoor rally, and campaign advisers claimed that their supporters had trouble entering the arena because of protesters.
In reality, there were few protests across the city, and black leaders in Tulsa had made calls earlier for people to stay away. TikTok users and fans of Korean pop music groups claimed to have registered potentially hundreds of thousands of tickets for Mr. Trumps campaign rally as a prank.
Concerns that the event could spread the virus were amplified hours before Mr. Trump took the stage, when his campaign acknowledged that six staff members working on the rally had tested positive.
The campaign stressed that all rally attendees were receiving temperature checks before going through security and were then given wristbands, face masks and hand sanitizer.
Yet Trump supporters gathered in Tulsa appeared less worried about the virus and more exuberant over the presidents return to the campaign trail.
If it is Gods will that I get coronavirus, that is the will of the Almighty, said Robert Montanelli, a resident of a Tulsa suburb. I will not live in fear.
With about 100 flights expected to arrive in Spain on Sunday from across Europes free-travel zone the first time international visitors have been allowed into the countrys mainland since a three-month state of emergency was lifted at midnight hundreds of additional health officials were stationed at Spanish airports to help monitor passengers.
The first flights landing in Madrid were from Paris and Milan. Passengers were required to have their temperatures taken, fill out a safety form and undergo a visual check by an airport health official.
Although about 600 additional health officials were dispatched for the efforts, the effectiveness of the safety measures in a country that has experienced one of Europes worst coronavirus outbreaks was a matter of contention in political circles.
The countrys transportation and health ministers both visited Madrids airport on Saturday to check its safety protocol, and Transportation Minister Jos Luis balos told a news conference that it was important to send the message that Madrid was an open but safe city.
But on Sunday, Ignacio Aguado, the deputy head of Madrids regional government, ridiculed the safety checks at Madrids airport, describing them on Twitter as a joke.
After several Major League Baseball teams reported positive coronavirus tests for players and staff members, the Yankees and Mets decided to move their preseason training from Florida, where cases have been spiking, to their home stadiums in New York, Gov. Andrew M. Cuomo said this weekend.
The announcement came soon after M.L.B. temporarily closed all of its spring training facilities, which are in Florida and Arizona, for deep cleanings and asked people to be tested for the virus before returning.
Five teams the Philadelphia Phillies, Los Angeles Angels, San Francisco Giants, Toronto Blue Jays and Houston Astros have confirmed that players, other employees or people connected to them have tested positive or exhibited symptoms of Covid-19.
M.L.B. suspended its spring training on March 12 and indefinitely postponed the start of the regular season. But as the league and its players union recently appeared to make progress in talks over returning to the field with the regular season possibly starting in July some players returned to the training facilities for limited, voluntary workouts.
The Yankees spring training facility is in Tampa, Fla., and the Mets is in Port St. Lucie.
While Florida reported a record number of new cases three days in a row, including 4,049 on Saturday, the number of new cases in New York has tapered off since a peak in April.
Mr. Cuomo said Mets players would begin training this week at Citi Field in Queens. It was unclear when the Yankees would arrive at Yankee Stadium in the Bronx, but the team confirmed that the stadium would become its preseason training site.
Recent reports of new coronavirus cases among athletes have heightened concerns about the resumption of competition. On Friday, just over a week after the PGA Tour restarted, the golfer Nick Watney withdrew from the RBC Heritage tournament in South Carolina after testing positive.
New York City hired 3,000 disease detectives and case monitors for its contact-tracing program, but the effort has gotten off to a troubling start.
The tracers are expected to identify anyone who has come into contact with the hundreds of people in the city who are still testing positive for the coronavirus every day. But the first statistics from the program, which began June 1, indicate that tracers are often failing to find infected people or are unable to get information from them.
Of the 5,347 people whose contacts needed to be traced in the first two weeks of the program, only 35 percent provided information about close contacts, the city said in releasing the first statistics.
In lieu of a vaccine, contact tracing is one of the few tools that public health officials have to fight Covid-19, along with widespread testing and isolation of those exposed to the coronavirus. The stumbles in New Yorks program raise fresh concerns about the difficulties in preventing a second surge of the outbreak in the city, which is to enter a new phase of its reopening on Monday.
China, South Korea and Germany and other countries have set up extensive tracking programs that have helped officials make major strides in reducing outbreaks. But in Britain, the program has struggled to show results with a low-paid, inexperienced work force.
In Massachusetts, which has one of the United States most established tracing programs, health officials said in May that only about 60 percent of infected patients were picking up the phone. In Louisiana, less than half were answering.
More than 3.6 million people tuned in this weekend to watch a live-streamed summer solstice sunset and sunrise at Stonehenge, the prehistoric monument in southwestern England, after the sites annual gathering was canceled because of the pandemic.
The sun might have been elusive, but over 3.6 million of you managed to watch sunset and sunrise with us from Stonehenge, English Heritage, a charity that manages hundreds of English monuments including Stonehenge, said in a tweet on Sunday.
The summer solstice when the Northern Hemisphere takes a maximum tilt toward the sun, bathing in direct sunlight for longer than any other day of the year took place on Saturday, marking the scientific start to summer for half of the world.
Although it remains unclear exactly what kind of events occurred at Stonehenge when it was first erected around 2500 B.C., marking the movements of the sun was important to the farmers, herders and pastoralists who built it, according to English Heritage, and its layout is positioned in relation to the solstices.
Thousands typically gather at the Neolithic monument each year to celebrate the beginning of summer. Some still made their way close to the site on Saturday, according to local news outlets, despite the rain and the coronavirus restrictions that prevented the site from opening to the public.
The pandemic has devastated economies around the globe, shutting businesses and slowing spending. But unlike in the United States, where the jobless rate has soared, workers in Japan have weathered the pandemic with striking success, staying employed in large numbers.
Pro-labor attitudes in Japan, reinforced by strong legal precedents, make it uniquely difficult for Japanese companies, except under severe strain, to fire workers. And a constellation of social and demographic factors, including Japans aging population and shrinking work force, have allowed workers to largely hold on to their jobs and benefits, even as the economy has taken big hits over all.
Output in Japan shrank 2.2 percent in the first three months of the year, pushing the country into a recession. Data from April suggests that conditions will most likely continue to worsen.
Yet the unemployment rate in Japan has ticked up just two-tenths of a percentage point since February, to 2.6 percent. And that has helped Japan largely avoid the sense of anxiety that people in other countries experienced as companies shed employees, leaving millions without benefits in the middle of a public health crisis.
Rest assured, Frances culture minister says: The kiss has not been banished from movies.
As movie and television shoots in the country have slowly resumed after months of lockdown, actors have been working out ways of safely smooching, said the minister, Franck Riester.
Kissing has started again, if I may say so, on movie sets, he told RTL radio on Friday, although he did not refer to any specific films or actors. Some artists got tested, waited a bit and then did that kiss that is so important in cinema.
Last month, the agency that oversees health and hygiene conditions on French film sets issued a guide on how to keep the virus at bay, including measures for scenes that require physical intimacy.
They included adapting or rewriting the action, postponing filming, or asking actors to get tested or regularly take their temperature. Wearing masks was also recommended, camera angles permitting.
The government has created a fund of 50 million euros (about $56 million) to help producers who have to cancel a film shoot for coronavirus-related reasons, but some worry that insurers will balk at the slightest deviation from the guidelines.
Marina Fos, an actress, expressed worry on French television last week that insurers would have undo influence over how films are made during the pandemic.
If I want to act well, I need to abandon something, she told France 5. I need to let happen what will happen.
With cases rising in 19 states across the South, West and Midwest in the United States, at least two states announced record-breaking numbers of new cases this weekend while infection levels reached new highs in at least two others.
Florida and South Carolina both had their third straight day breaking single-day records for news cases, while infection levels for Missouri and Nevada soared increases that came as the United States reported more than 30,000 new infections on Friday, its highest total since May 1.
Florida reported 4,049 new cases on Saturday, bringing the states total to about 94,000 cases and more than 3,000 deaths. And South Carolina broke its record with 1,155 new cases.
Strikingly, the new infections have skewed younger, with more people in their 20s and 30s testing positive, Gov. Ron DeSantis of Florida said clusters that may be especially worrying to colleges and universities that plan to bring students back to campus in the fall, when the coronavirus and the flu virus are expected to be circulating simultaneously.
In Florida which has all the makings of the next large epicenter, according to model projections by the PolicyLab at Childrens Hospital of Philadelphia an advisory from the states Department of Health this weekend recommended that people avoid crowds larger than 50 people. It also encouraged social distancing and mask wearing at smaller gatherings.
President Trump is set to deliver his national convention speech on Aug. 27 in Jacksonville, Fla., inside an arena that holds 15,000 people.
Amid the coronavirus outbreak, a resident of a Connecticut nursing home was told that he had less than a week to pack his things and move to a homeless shelter, his lawyer said. In April, Los Angeles police officers found an 88-year-old man with dementia crumpled on a city sidewalk. His nursing home had recently deposited him at an unregulated boardinghouse.
And in New York City, nursing homes tried to discharge at least 27 residents to homeless shelters from February through May, according to data from the citys Department of Homeless Services.
More than any other institution in America, nursing homes have come to symbolize the deadly destruction of the coronavirus. Residents and employees of nursing homes and long-term care facilities represent more than 40 percent of the death toll in the United States.
At the same time, nursing homes across the country have been forcing out older and disabled residents among the people most susceptible to the coronavirus and often shunting them into unsafe facilities, according to 22 watchdogs in 16 states.
Critics suggest that such ousters create room for a class of customers who can generate more revenue: patients with Covid-19. Aside from sheltering older people, nursing homes gain much of their business by caring for patients of all ages and income levels who are recovering from surgery or acute illnesses like strokes.
Because of a change in federal reimbursement rates last fall, Covid-19 patients can bring in at least $600 more a day from Medicare than people with relatively mild health issues, according to nursing home executives and state officials.
Many of the evictions, known as involuntary discharges, appear to violate federal rules, and at least four states have restricted nursing homes from evicting patients during the pandemic. But 26 ombudsmen from 18 states provided figures to The Times: a total of more than 6,400 discharges, many to homeless shelters.
Were dealing with unsafe discharges, whether it be to a homeless shelter or to unlicensed facilities, on a daily basis, said Molly Davies, the Los Angeles ombudsman. And Covid-19 has made this all more urgent.
When its time to invite people over or arrange a play date, would-be hosts face tough conversations with friends, neighbors and family on their standards for avoiding coronavirus infection. Here are some strategies to help.
Reporting was contributed by Anne Barnard, Keith Bradsher, Aurelien Breeden, Benedict Carey, Emily Cochrane, Ben Dooley, Amy Julia Harris, Iliana Magra, Raphael Minder, Aimee Ortiz, Sharon Otterman, Jessica Silver-Greenberg, Liam Stack, Ana Swanson, Hisako Ueno and Mark Walker.
Here are the areas that are starting to reopen
Here are the areas that are starting to reopen
People exercise in workout pods at Inspire South Bay Fitness, a gym in Redondo Beach, California, on Monday, June 15.
Here are the areas that are starting to reopen
Sue Stamp fits a young girl with a new pair of shoes after W.J. French and Son reopened in Southampton, England, on June 15.
Here are the areas that are starting to reopen
Here are the areas that are starting to reopen
Floor supervisor Dumitru Carabasu sanitizes dice at Las Vegas' Excalibur Hotel & Casino on Thursday, June 11. It was reopening for the first time since mid-March.
Here are the areas that are starting to reopen
Nail technicians perform manicures and pedicures at a nail bar in Moscow on June 9. The Russian capital ended a tight lockdown that had been in place since late March.
Here are the areas that are starting to reopen
Commuters wear protective masks as they ride a subway train in New York on June 8.
Here are the areas that are starting to reopen
Parishioners are welcomed back to a Greek Orthodox church in Keilor East, Australia, on June 7. Religious services and gatherings for up to 20 people are now permitted in the state of Victoria.
Here are the areas that are starting to reopen
Visitors ride a roller coaster at the Universal Studios theme park in Orlando after it reopened on June 5.
Here are the areas that are starting to reopen
Customers stand on an escalator inside Le Printemps Haussmann, a department store in Paris, on May 28.
Here are the areas that are starting to reopen
A restorer cleans Michelangelo's David statue on May 27 while preparing for the reopening of the Galleria dell'Accademia in Florence, Italy.
Here are the areas that are starting to reopen
Traders work on the floor of the New York Stock Exchange after it reopened for in-person trading on May 26.
Here are the areas that are starting to reopen
A man dives into an outdoor swimming pool in Rome on May 25.
Here are the areas that are starting to reopen
Visitors take photos from the South Rim of the Grand Canyon shortly after sunrise on May 25. Grand Canyon National Park has partially reopened on weekends.
Here are the areas that are starting to reopen
Students in Abidjan, Ivory Coast, study at the Merlan school of Paillet on May 25.
Here are the areas that are starting to reopen
Tourists enjoy the hot weather at a beach in Bournemouth, England, on May 25.
Here are the areas that are starting to reopen
Visitors look at the work of artist Berlinde De Bruyckere at Fondazione Sandretto Re Rebaudengo, a contemporary art foundation in Turin, Italy, on May 23.
Here are the areas that are starting to reopen
Jasmine Donaldson cleans a movie theater in Auckland, New Zealand, on May 22. Matakana Cinemas reopened May 28 with a reduced capacity to allow for social distancing between seats and in the foyer.
Here are the areas that are starting to reopen
Chinese Communist Party delegates stand for the national anthem at the opening of the National People's Congress on May 22. The annual parliamentary gathering had been postponed.
Here are the areas that are starting to reopen
People visit the ARoS Museum of Art in Aarhus, Denmark, on May 22. The museum opened its doors to the public after being closed for two months.
Here are the areas that are starting to reopen
Surfers take to the water in Lido Beach, New York, on May 21.
Here are the areas that are starting to reopen
People visit the reopened Blaavand Zoo in Denmark on May 21.
Here are the areas that are starting to reopen
People swim at a public pool in Cologne, Germany, on May 21.
Here are the areas that are starting to reopen
Christian Orthodox faithfuls attend a liturgy in Athens, Greece, on May 20.
Here are the areas that are starting to reopen
People visit Florida's Clearwater Beach on May 20. Florida opened its beaches as part of Phase 1 of its reopening.
Here are the areas that are starting to reopen
People walk in Naples, Italy, on May 19.
Here are the areas that are starting to reopen
People enjoy the water as Florida's Palm Beach County reopened some beaches on May 18. Social-distancing rules were still in effect.
Here are the areas that are starting to reopen
Nuns await a Mass in Rome on May 18. It was the first Mass celebrated by parish priest Marco Gnavi in more than two months.
Here are the areas that are starting to reopen
A worker wears protective gear while cutting a customer's hair at a salon in Nadiad, India, on May 17. India's lockdown was set to remain in place until May 31, but many salons and shops were able to reopen.
Here are the areas that are starting to reopen
Police walk through New York's Hudson River Park with a reminder about social distancing on May 16.
Here are the areas that are starting to reopen
Here are the areas that are starting to reopen
Swimmers pay for sunbeds at the Alimos beach near Athens, Greece, on May 16.
Here are the areas that are starting to reopen
Here are the areas that are starting to reopen
Here are the areas that are starting to reopen
A customer buys eggs at a market in Kunming, China, on May 12.
Here are the areas that are starting to reopen
A woman takes a photo at Disneyland Shanghai after the amusement park reopened in China on May 11. The park had been closed for three and a half months. Visitors are now required to wear masks, have their temperatures taken and practice social distancing.
Here are the areas that are starting to reopen
People eat fries on the boardwalk in Ocean City, Maryland, on May 10.
Here are the areas that are starting to reopen
People exercise on a reopened promenade next to a beach in Barcelona, Spain, on May 9.
Here are the areas that are starting to reopen
Patrons eat at a restaurant in Bangkok, Thailand, on May 9.
Here are the areas that are starting to reopen
Fans cheer during a professional baseball game between the Fubon Guardians and the Uni-President Lions in New Taipei City, Taiwan, on May 8.
Here are the areas that are starting to reopen
Traci Hancock has her hair cut by stylist Jill Cespedes at Shampoo Salon in Fort Worth, Texas, on May 8. Texas Gov. Greg Abbott announced that hair salons, barber shops and tanning salons were allowed to open on Friday.
Here are the areas that are starting to reopen
A long line of cars forms as a KFC drive-thru reopens in Plymouth, England, on May 8.
Here are the areas that are starting to reopen
Sue Conklin, owner of Books Rio V, stocks her shelves in Rio Vista, California, on May 8. It was her first day back at the used bookstore since March 28.
Here are the areas that are starting to reopen
A man receives a haircut at Doug's Barber Shop in Houston on May 8.
Here are the areas that are starting to reopen
Two men wearing face masks play chess in Montevideo, Uruguay, on May 7.
Here are the areas that are starting to reopen
People enjoy a beach that had just reopened in Isle of Palms, South Carolina, on May 6.
Here are the areas that are starting to reopen
People stand on social-distancing markers at a Mercedes-Benz car dealership in Brussels, Belgium, on May 6.
Here are the areas that are starting to reopen
Kelly Watson puts glass in a recycling bin in Springfield, Missouri, on May 6, The Lone Pine Recycling Center had just reopened.
Here are the areas that are starting to reopen
Customers wait to get their nails done at the Nail Tech salon in Yuba City, California, on May 6.
Here are the areas that are starting to reopen
A man wears a protective face mask while visiting the Old Masters Picture Gallery in Dresden, Germany, on May 6. The gallery had been closed for more than six weeks.
Here are the areas that are starting to reopen
Here are the areas that are starting to reopen
People in Athens, Greece, enjoy a sunset May 5 on the Areopagus hill near the Acropolis.
Here are the areas that are starting to reopen
Kayleigh Tansey and Justin Smith watch a movie in Kyle, Texas, on May 4. The EVO Entertainment movie theater reopened after Gov. Greg Abbott lifted a shelter-in-place order and allowed select businesses to open to the public at no more than 25% capacity.
A boy wearing a face mask flies a kite at a park in Beijing. Researchers are studying the response of children to COVID-19. Wang Zhao /AFP via Getty Images hide caption
A boy wearing a face mask flies a kite at a park in Beijing. Researchers are studying the response of children to COVID-19.
Why the coronavirus appears to affect children differently than it affects adults is one of the great mysteries of the current pandemic.
And it's a question that Rosalind Eggo, an assistant professor of mathematical modeling from the London School of Hygiene and Tropical Medicine, and her colleagues have tried to answer.
"What we found was that people under 20 were about half as susceptible to infection as people over 20," Eggo says.
So kids and teens appear far less likely than adults to actually get infected with the virus.
"And then we also found that the probability of showing clinical symptoms ... so getting ill enough that you report the infection... that rose from around 20% in 10- to 19-year-olds, up to around 70% in those over 70," she says.
Eggo's research was published this week in the journal Nature. It uses mathematical models to examine coronavirus data from six countries China, South Korea, Italy, Japan, Singapore and Canada. The results are similar to an April study from the U.S. Centers for Disease Control and Prevention, which found that while kids under age 18 make up 22% of the U.S. population, they've accounted for fewer than 2% of reported cases.
The implications of how SARS-CoV2 plays out in children are huge.
One of the big questions in this pandemic is why countries in Africa haven't been hit harder the disease.
The median age in Africa is 20; while in Europe, it's 43.
If younger people are less susceptible to the disease, does that mean countries with younger citizens may have less intense outbreaks?
"It's something definitely that needs to be further looked into," says Eggo.
She and her colleagues didn't start out investigating the youth mystery. They originally were looking at COVID-19 relative to how flu pandemics spread. But she says this virus is different. "We haven't seen the same patterns. Looking at the global picture if this was like flu, you would ordinarily expect places with more children to have more intense epidemics."
She says transmission among kids needs to be better understood so officials can make plans for appropriate precautions when reopening schools.
And there are other questions. Should kids be allowed to visit their grandparents? Or is it the middle-aged people who pose a greater risk to the elderly?
Indeed, perhaps the most critical unknown: What role do youngsters have in the spread of COVID-19?
Megan Culler Freeman, a virologist and pediatrician at University of Pittsburgh School of Medicine, says kids are major spreaders of many other respiratory diseases.
"The kids are going to day care, they're going to school, especially the younger ones [who] aren't necessarily as polite with their coughs and sneezes," Freeman says. "So it's really easy for those diseases to spread."
Yet that's not what's been reported so far with COVID-19.
Freeman, who studied coronaviruses for her Ph.D,, says children are clearly susceptible to the other known coronaviruses that circulate each year during cold and flu season. Yet something different is happening with this new one.
"We've had a tremendous number of case numbers throughout both the United States and the world. And really a minority of those have been identified in children," she says. "Somewhere between 2 and 5% of all of the [reported] infections are in children under the age of 18, which is kind of amazing."
There are a couple of hypotheses as to why, Freeman says. One is that kids get a milder form of the disease. If they aren't showing symptoms, they may never get tested. And thus those infections aren't counted.
Freeman adds there's also some research showing that the receptors in human cells that the coronavirus latches on to are less developed in younger people.
But both Eggo and Freeman say it's still unclear exactly why children are less at risk to the virus, why so few cases have been detected in kids and whether that trend will continue.
"It does seem that kids are less affected than adults. But I think their role in community spread is still somewhat untested," she says. Around the world from Abuja to Aruba to Arkansas, schools were shut down in the early stages of the outbreaks. "So we don't know how things are going to change if that variable is back in play."
Some countries have started to reopen schools, but that is mainly in places like Hong Kong and New Zealand, where transmission levels are incredibly low.
If schools reopen in places where transmission levels remain high, it may give a clearer picture, Freeman says, of how much transmission is driven by children.
