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.
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.
We are academic scientists who manage vaccine research programs. In fact, Dr. Bridle received COVID-19-focused funding to develop a novel vaccine platform. Although many of us are working hard towards 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.
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 control of COVID-19.
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.
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.
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.
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.
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.
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.
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.
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The Biomedical Advanced Research and Development Authority (BARDA) and Snapdragon Chemistry are teaming up to develop a continuous manufacturing platform to produce a specific raw material for COVID-19 vaccines.
They are developing ribonucleotide triphosphates (NTPs), a critical raw material for COVID-19 vaccines that use messenger RNA technology. The project includes a scalable, continuous manufacturing process for the purification of NTPs.
Messenger RNA (mRNA) is present in all living cells and carries instructions from the DNA of one cell to another. Right now, one of the COVID-19 vaccines being developed with federal funding use mRNA technology and rely on NTPs.
With a small footprint and low capital cost, multiple identical platforms can be deployed to vaccine manufacturing facilities in the United States. This provides a more reliable way of producing the NTP component of some COVID-19 vaccines.
This project is one component of BARDAs rapidly expanding COVID-19 medical countermeasure portfolio.
Snapdragon Chemistry, based in Waltham, Mass., is a chemical technology company focused on the design and development of manufacturing processes for chemicals and pharmaceuticals.
As part of the governments Operation Warp Speed initiative, BARDA is working to remove any barriers to vaccine production and provide the services and expertise private sector partners need to accelerate development and manufacturing.
Then came the novel coronavirus, which began in China and has inflicted its worst damage in the US. Each government has pointed fingers at the other to deflect criticism of its own COVID failings.
How might the pandemic, and its aftermath, alter the rivalry between the world's two largest economies?
China's COVID initiative In some ways, coronavirus has boosted China's international image. Its success in containing the virus, the relative COVID chaos in the US and Europe, and China's willingness to help struggling governments, even in Europe, with critical medical supplies and cash, has allowed Beijing to claim a crisis leadership role that once fell to Washington. Meanwhile, China's economic growth looks to be less affected by the pandemic, as the IMF predicts Chinese GDP will continue to expand this year, even while America's contracts.
Continuing US advantages China's rise doesn't imply a post-COVID US decline. In fact, though COVID has wreaked political and economic havoc in the United States, and government dysfunction is a large and growing problem, the US has lasting advantages that gives it staying power as a central international actor.
The US has long been the world's number one food exporter, and game-changing innovations in energy production have made the US the world's top oil producer. In addition, dollar dominance won't last forever, but today's governments still need greenbacks, allowing the US to continue borrowing as no other country can.
But the biggest post-COVID US advantage is the current dominance of its tech companies. That's why technology is the arena where the post-COVID US-China rivalry will become most intense.
The tech battlefield Today, 11 of the world's 13 largest internet companies are US-based, and the US produces more of the tech startups that will drive innovation in the AI and other cutting-edge technologies that will soon dominate global economic development. COVID enhances those US advantages, because contact tracing, immunity passports, and remote work, enabled by new technologies that US companies have a jump on, are now more important.
Chinese companies, with priority backing from their government, are working in all these same areas and will continue to make progress, and China's government is going all in to make China a technology superpower over the next decade.
Which country will assume the lead in the race for 5G? Will one country gain an insurmountable advantage that allows its regulators to write the rules that govern these technologies? That will be the US-China battleground where the stakes are highest.
The election wildcard The outcome of the US elections in November will also mark a turning point in US-China relations. On the one hand, no matter who wins, Washington and Beijing will remain on a collision course: opposition to some of China's trade practices and the ways it uses data to limit individual freedom are rare issues on which Democrats and Republicans agree. And the US public's distrust of China is at its highest level since polling on the issue began 15 years ago.
If President Trump wins re-election, he's likely to continue the current aggressive unilateral US approach on trade and intellectual property questions. But a President Biden would likely be much more inclined to coordinate pressure on China with likeminded traditional allies in Europe and Asia. That's why Chinese officials may have more to fear from Biden's alliance-building than from Trump's more impulsive go-it-alone approach. If so, a Biden win might ease the tone of the rivalry in the near-term, but broaden and deepen its substance over time.
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Good morning,
Throughout the coronavirus crisis, many Republicans have remained skeptical about the threat of Covid-19. But as the disease moves from urban Democratic strongholds such as New York into some of the rural and exurban areas that voted for Donald Trump, research suggests those partisan attitudes to the pandemic may be shifting.
Coronavirus cases are climbing in Arizona, Florida, South Carolina and Arkansas. In Texas, hospitalisations for Covid-19 are up 42% since Memorial Day. In Oklahoma, health officials have expressed concern that a Trump campaign rally in Tulsa this weekend could contribute to the spread of the disease in a city that has experienced a recent rise in cases.
The president, however, sees mass rallies as his best chance of changing the narrative and putting him back on track for re-election, reports David Smith:
A Trump rally with a cheering crowd eschewing face masks, and a packed convention crowning him as the Republican nominee, could be used to draw a striking contrast in optics with the mask-wearing, basement-bound Biden, selling the incumbent as a happy warrior.
China has won the battle over world opinion in a survey that found just three out of 53 countries believed the US has handled the coronavirus better than its superpower rival.
But Beijing is back on lockdown after dozens of new cases were linked to two seafood markets in the Chinese capital.
After weeks of protests sparked by the police killing of George Floyd in Minneapolis, a fresh tragedy in Atlanta on Friday has further fuelled the Black Lives Matter movement. Rayshard Brooks, a 27-year-old black man, was shot in the back by a police officer, after what began as a friendly encounter. His death has now been ruled a homicide by the Fulton county medical examiners office.
Leading Democrats said on Sunday that Brookss killing underlines the need for significant change in US law enforcement. This did not call for lethal force, said the House majority whip, James Clyburn. And I dont know whats in the culture that would make this guy do that. It has got to be the culture. Its got to be the system.
The shooting puts a spotlight on two VP contenders, Atlanta mayor, Keisha Lance Bottoms, and former Georgia gubernatorial candidate Stacey Abrams, both touted as potential running mates for Joe Biden. Bottoms said the footage of Brookss death broke her heart.
Beyonc has called for justice for Breonna Taylor. in an open letter to the attorney general of Kentucky, Knowles complained no arrests had been made in the case of the 26-year-old African American EMT shot dead in her home by police.
Trump interrupted his own 74th birthday, spent in seclusion at his New Jersey golf club on Sunday, to tweet that Seattle has been taken over by the radical left. The president appeared to be referring to the Capitol Hill Autonomous Zone established by demonstrators in the citys Capitol Hill neighborhood, where police vacated a precinct amid the protests.
Meanwhile, there was outrage over distressing footage of police macing a seven-year-old boy during a peaceful protest in Seattle on 30 May. Evan Hreha, the 34-year-old who captured the incident on camera, has since been arrested and spent two days in jail, for what some consider police retribution over the video going viral.
US prosecutors say Julian Assange risked American lives by releasing hundreds of thousands of US intelligence documents. But their indictment against the Wikileaks founder does not include perhaps his most shocking revelation: the video entitled Collateral Murder, which depicted an Apache helicopter gunning down a group of Iraqi civilians in Baghdad in July 2007. Its omission has raised accusations that the US is trying to avoid having its war crimes exposed in public.
Angela Davis on George Floyd: Theyre now finally getting it
The veteran civil rights campaigner Angela Davis has witnessed and participated in decades of protest and campaigning for racial justice. This time, things might be different, she tells Lanre Bakare but while the immensity of this response is new, the struggles are not new.
The trans kids helped by a pioneering project
While the debate goes on over whether trans children ought to be allowed to transition, or even to express their gender, their families often need guidance on how to parent them. New Yorks Gender and Family Project is the largest independent program for transgender youth and families in the US. Katelyn Burns reports.
How coronavirus shook a neglected neighborhood
New Yorks coincidentally-named Corona neighbourhood has been hard hit by Covid-19, with economic and health consequences that will likely shake the community for years to come. Amanda Holpuch explains how race, poverty and inequality left this corner of Queens vulnerable.
The GOP is feigning a fainting fit over calls to defund the police. And yet, argues David Sirota, they gladly slash budgets for those charged with policing the worlds most dangerous and powerful criminals.
Apparently, were expected to be horrified by proposals to reduce funding for the militarized police forces that are violently attacking peaceful protesters but were supposed to obediently accept the defunding of the police forces responsible for protecting the population from the wealthy and powerful.
A December 2019 report revealed young New Zealanders use the internet as their primary source of sex education, while a third of the countrys most popular porn clips depict non-consensual sexual activity. The governments answer? This web safety ad.
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No measure of COVID-19 has come under more skepticism than the accuracy of the death toll a pandemic statistic key in shaping public opinion and policymaking that been widely scrutinized and even the subject of conspiracy theories.
The scrutiny centers around when should people who have COVID-19 but who also have other life-threatening underlying health issues, such as cancer or kidney disease, be counted in the COVID-19 death tally.
In New York, Gov. Andrew Cuomo on Sunday touched on the matter when he announced his state's lowest daily death toll 23 on Saturday since the early days of the pandemic.
"When the number gets this low, it's basically a question of how people are reporting the cause of death across the nation," Cuomo said. "You have situations where a person dies from multiple causes. You could put down COVID, you could put down cancer, you could put down heart disease. So, at one point, it becomes fairly random, and we're basically at that point."
So far, more than 116,000 COVID-19 deaths have been recorded in the U.S, according to an NBC News counter that tracks state data, and experts are quick to point to the increased likelihood that the total is an undercount.
Meanwhile, the CDC's collection of death data from individual states is hampered by differing state policies while additionally, a hodgepodge of local health officials, including medical examiners, coroners, healthcare providers, funeral homes and health departments are tasked with filling out death certificates and often must make judgment calls in doing so.
The federal government relies on two parallel systems to keep track of COVID-19 deaths. One, run through the National Notifiable Disease Surveillance System, utilizes reports of cases from the states and is able to be more quickly updated. The second, managed via the National Vital Statistics System, relies on death certificate reporting and what is cited by health officials on that document.
The first count is subject to differing state policies on reporting, such as whether a state includes probable deaths in its count, whereas the latter count is part of the decades-long standardized death certificate reporting system throughout the U.S. In that count, there is no distinction between a probable or confirmed case for the purposes of tallying the death total.
The CDC and the Council of State and Territorial Epidemiologists, a group that works with the CDC to offer guidelines on tracking diseases, recommend that states report probable COVID-19 deaths which include deaths where the virus may not have been tested for as part of their total that is plugged into the surveillance system.
But that's not mandatory and, as a result, some states are not reporting probable deaths, as The Washington Post found last week.
"You have this issue with the probables and the confirmed cases," Robert Anderson, who oversees the death certificate reporting system as chief of mortality statistics at the National Center for Health Statistics, told NBC News.
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"We're asking a medical professional, physician, medical examiner, coroner to provide the cause of death information and using the term probable is acceptable," he continued. "If the certifying physician feels that COVID-19 was the probable cause of death, we count it as the cause of death. We trust their medical judgment that they know sufficient about the case to say, 'Yes, in fact this was due to COVID-19.'"
CDC guidance for death certificate reporting says COVID-19 can be listed as the immediate cause of death, the underlying cause of death or a contributing factor, stating that "if COVID19 played a role in the death, this condition should be specified on the death certificate."
Whether COVID-19 played a role in a death can be a subjective determination and comes under the discretion of whoever signs a death certificate. Take Bill Harris, the coroner for Lee County, Alabama, for example. He told NBC News that he's of the belief that "if you have the virus, it is, in some sort or fashion, a contributing factor possibly to your death."
"I mean, my opinion is if they're positive for the virus, it should be on the death certificate," he added.
The presence of the virus itself raises the risk of death from other underlying conditions, and experts said any death involving someone who tested positive for the disease should be included in the COVID-19 death total.
"You have an acute infection (with COVID-19) and you have other co-morbidities and what changed? It's your acute infection that changed," said Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists, adding that for many, COVID-19 is "the tipping point" in a death.
Nate Wardle, press secretary for the Pennsylvania Department of Health, said "there would be very few, if any, cases in the state where COVID-19 would be the cause of death," but rather an underlying cause of death.
Yet it is those determinations that have seen some push back. As The New York Times reported last month, President Donald Trump was questioning whether the death toll had been inflated amid his push to reopen the country, with the publication pointing to conversations about just which deaths were being included.
And in Colorado last month, Gov. Jared Polis, a Democrat, told "Fox News Sunday" that "the CDC criteria include anybody who has died with COVID-19, but what the people of Colorado and the people of the country want to know is how many people died of COVID-19."
Polis' state recalibrated its death count reporting in May, splitting its total into deaths where the virus is a contributing factor and a slightly longer list of total deaths of those who've had the virus.
Kirk Bol, manager of the Colorado Department of Public Health and Environment's vital statistics program, told NBC News it will be some time before experts know the true number of any over or under counts of COVID-19 deaths. But with time, the numbers are going to continue to be better perfected.
"I do have faith that these numbers are accurate and useful in their form, in terms of driving policy and decision making and people's thoughts and concerns of COVID-19," he said, pointing to the federal vital record system. "There's a lot of rigor and a lot of highly trained and skilled individuals participating in that system."
State health departments across the country noted the difficulty of providing numbers to the public on the fly but said they have confidence in their reporting structures and that the public should have faith in what they're seeing.
"It is difficult trying to report deaths in real time," said Melaney Arnold, public information officer for the Illinois Department of Public Health, adding, "Normally, public health officials investigate and gather additional information before reporting a death. With COVID-19, as IDPH learns more information, the total number of deaths are adjusted."
As Anderson said, the numbers are "not perfect by any stretch, but I think (Americans) should understand there's a good faith effort to produce good numbers."
"Those of us who are part of that federal statistical system, those who do disease surveillance, we don't have a dog in the race with regard to politics," he added.
While the death counts have drifted downward in recent weeks as northeastern states see a reduction of the virus, cases, hospitalizations and positive test rates are on the rise in several states, including Alabama.
When discussing the death count, it's important to remember the human aspect, said Karen Landers, assistant state health officer for the Alabama Department of Public Health, told NBC News.
In Landers' state earlier this month, legendary former Auburn University football coach Pat Dye, 80, was one of those who died with multiple complications in the mix liver and kidney failure weeks after testing positive for COVID-19, according to Harris, who performed Dye's autopsy.
Dye was recently set to rest under a special tree he helped grow 15 feet over the course of six years. The Hall of Fame coach who brought the Auburn program to national prominence had requested a simple burial.
"Every one of these deaths is a person, it's a family, it's a loss to society," Landers said. "So we have to remember when we're looking at numbers, we're also looking at people."
A scientist who was fired from overseeing Floridas Covid-19 database has created her own coronavirus dashboard which she says proves Florida is not ready to reopen.
Dr Rebekah Jones was fired by the Florida department of health in May. She said she was sidelined after she refused to manipulate data regarding the severity of Covid-19, which would have restricted the states plan to reopen its economy.
According to Joness own online database, Floridas Community Coronavirus Dashboard, only one of 67 counties meets state criteria for easing social restrictions.
Joness dashboard also shows a higher number of coronavirus cases than the Florida DoH site, with 83,720 positive cases and 3,022 deaths compared with 75,568 cases and 2,931 deaths.
Jones said the difference was due to a difference in counting technique.
DoH publishes total cases, not positive people, her website says.
Additionally, cases are not currently created for those who receive positive antibody test results, and so DoH excludes them from that total. We show the total number of people who have definitive lab results showing they have or have had Covid-19 regardless of the type of test.
Florida recorded record levels of new coronavirus cases over the weekend, ABC News reported. On Sunday, the state health department reported a second consecutive day of more than 2,000 new cases.
According to data from the Washington Post, in June Florida experienced its highest seven-day average of coronavirus cases since the beginning of the pandemic.
Joness database says Liberty county, in the north-west of the state, does meet criteria for reopening. Other counties do not.
She has said she was fired on 18 May for refusing to manually change data to drum up support for the plan to reopen.
When I went to show them what the report card would say for each county, among other things, they asked me to delete the report card because it showed that no counties, pretty much, were ready for reopening, Jones told NPR.
And they didnt want to draw attention to that.
A spokesperson for Floridas governor, Ron DeSantis, denied that Jones was fired for refusing to manipulate coronavirus data. The state health department said she had exhibited a repeated course of insubordination.
As of Monday morning researchers at Johns Hopkins University in Maryland had recorded about 2.1m coronavirus cases in the US and 115,697 deaths. The actual death toll is believed to be far higher.
Cases are climbing in Florida and Arizona while in Texas hospitalizations from Covid-19 are up 42% since 25 May.
On Friday the federal governments leading public health expert, Dr Anthony Fauci, said the US might not see a second wave of Covid-19 if you approach it in the proper way.
Fauci said the correct approach involved people continuing to wear masks and maintaining social distancing.
Over the weekend, footage showed people in New York City, Washington and other places gathering without masks, and not practicing social distancing.
The Texas Medical Center says hospitalizations give an objective view of how COVID-19 impacts the healthcare system.
HOUSTON Doctors are concerned about Houston and Harris County's rising rate of hospitalizations of people suffering from COVID-19 in the last three weeks.
Houston Health Authority Doctor David Persse said simply speaking can spread the virus, so wearing a mask is critical.
People who dont yet have symptoms, thats actually when they spread the virus the most. Right in the couple of days before they have symptoms is when theyre most dangerous to the people near them," Dr. Persse said.
He, and doctors at UT Health, say the re-opening of the economy is likely one cause of the increased spread.
They say the percentage of people testing positive for COVID-19 is higher now than it was a few months ago.
Doctors say if you go out in public, the combination of wearing a mask and keep physical distance is the best way to stay safe. While doctors agree that being outside mitigates the spread, it is not a substitute for physical distancing.
Its really human behavior thats driving this," said Dr. Catherine Troisi, an infectious disease expert for UT Health.
Harris County Judge Lina Hidalgo released a new coronavirus "public threat level system," to help residents better understand the status of coronavirus in the area and what actions they need to take to help maintain the spread of the virus.
Dr. Troisi said limiting social circles to a select group of fewer than 10 friends people who you know have all been taking the same precautions is one of the safest ways to get together with friends, adding you are only as safe as the weakest link in your chain of friends.
Make that your household, your pod that you feel safe socializing with those people," Dr. Troisi said.
Dr. Persse said activities such as going out for brunch with people who live outside of your household can be risky.
Those are the exact types of behaviors the virus is going to take advantage of," Dr. Persse said. If youre out in public, you should be wearing a mask. Period.
Since first being recorded late last year in China, the Covid-19 coronavirus has spread around the world, and been declared a pandemic by the World Health Organization. However, differences in testing mean that the number of cases may be understated for some countries.
The number of deaths is a more dependable indicator. The disease has hit certain countries, including Brazil, the UK and the US, with particular cruelty.
Meanwhile in Asia, where the disease began, the spread continues, although in China it seems for now to have passed its peak.
In Europe most countries have closed schools, and many are in lockdown.
Finally, a reminder that most people who contract the disease recover; many may never notice they had it at all.
Due to the unprecedented and ongoing nature of the coronavirus outbreak, this article is being regularly updated to ensure that it reflects the current situation at the date of publication. Any significant corrections made to this or previous versions of the article will continue to be footnoted in line with Guardian editorial policy.
WHO is following upwithChineseauthoritiesabouta clusterof COVID-19casesin Beijing, Peoples Republic ofChina.
Today, officials from the NationalHealth Commissionand BeijingHealth CommissionbriefedWHOs China country office, to share details of preliminary investigations ongoingin Beijing.
As of 13June,41 symptomatic laboratory confirmed cases and 46 laboratory confirmed caseswithout symptomsof COVID-19have been identifiedin Beijing.
The firstidentifiedcasehadsymptom onset on 9 June, and was confirmed on 11 June. Several of the initial cases were identified through six fever clinics in Beijing. Preliminary investigations revealed thatsomeof theinitialsymptomatic caseshad a linkto theXinfadiMarket in Beijing. Preliminary laboratory investigations of throat swabs from humansandenvironmental samplesfromXinfadiMarket identified 45 positive human samples (allwithout symptomsat the time of reporting) and 40 positive environmental samples. One additionalcasewithout symptomswas identified as a close contact of a confirmed case.
All cases are in isolationand under care as needed,and contact tracing is underway. Genetic sequencing of samples isalsounderwayand rapid sharing of these resultsisimportant to understand the origin of the clusterand links between cases.
WHO has offeredsupport andtechnicalassistance,as well as requestedfurther information about the cluster andthe investigations underway and planned.
