On May 12, Moderna Therapeutics, based in Cambridge, Mass., received fast-track approval from the U.S. Food and Drug Administration (FDA) for its COVID-19 vaccine candidate, mRNA-1273. Days earlier, the FDA gave the company the green light to proceed to Phase 2 testing of the vaccine, which is expected to begin shortly. The company plans to launch the final stage of human testing, Phase 3, this summer, assuming the Phase 2 studies are complete, says Dr. Stephen Hoge, president of Moderna.
Fast-track designation boils down to a more expedited review process by the FDA. In particular, it means the agency can review data on a rolling basis so an entire application for approval isnt held up until the final piece of data is collected and analyzed. Its validation that the FDA believes this is a very credible exercise, says Hoge.
The Phase 2 studies will include around 600 healthy volunteers, half of whom are 18-55 years old and half of whom are over 55 years old. They will be randomly assigned to receive either placebo or one of two doses of Modernas experimental vaccine. Each participant will receive two shotsearly studies suggest two injections might be necessary to jump-start the immune system to generate protection against the COVID-19 virus. All the patients will then be followed for a year as the researchers monitor their immune responses.
Already, Moderna is thinking ahead towards the next steps should its vaccine receive FDA approval. We have not hit major speed bumps or road blocks, so its been good so far, says Hoge of developing and testing the vaccine. But now as the data develops, we need to show that we can manufacture at scale, and were doing all we can to scale up to supply tens of millions of doses by the end of this year.
Modernas vaccine relies on a relatively new technology based on the mRNA of the virus; it involves injecting fragments of the viral genetic material into the body, which then stimulates the bodys immune system to fight the novel coronavirus.
Public health experts anticipate that the COVID-19 virus wont dissipate any time soon, and believe that generating strong and widespread immunity to the virus, with the help of vaccines, will be essential in keeping the disease under control and reopening economies around the world. Currently, there are around eight vaccines being tested in people, using different technologies. Public health experts believe that multiple vaccines may be needed in order to meet global demand to immunize and protect as many people as possible from COVID-19 in coming years.
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The country's top infectious disease expert, Dr. Anthony Fauci, Tuesday warned of suffering, death and deeper economic damage if state and local officials lift stay-at-home orders too quickly. Continuing Coverage: Coronavirus in Wisconsin"In this case, that the idea of having treatments available or a vaccine to facilitate the reentry of students into the fall term would be something that would be a bit of a bridge too far," he said. "Even at the top speed we're going, we don't see a vaccine playing in the ability of individuals to get back to school this term."Universities such as Marquette, UW-Milwaukee and every suburban school district are coming up with plans to reopen or to stay closed.For many families, the new normal for school is students online at their kitchen table."The virtual learning does not replicate what schools, in my opinion, were able to offer in their bricks and mortar schools several months ago, said Mike Thompson of the state Department of Public Instruction. But now with news that a COID-19 vaccine won't be ready by the fall, educators are preparing Plan B. After moving 1,600 classes online, the president of Milwaukee Area Technical College said they're preparing for worst case scenarios."If we do offer anything on campus, it will be with every precaution that we can possibly take ensure their safety and health," MATC President Vicki Martin said. "We're listening to what the experts are saying, Waukesha Schools Superintendent Todd Gray said.Gray is optimistic, but he said he's realistic."I just cant imagine having to go another couple of months into the school year on a virtual basis. I don't think that will happen. I mean, we're prepared for anything, but I think that would be a tremendous hardship on students and parents," Gray said.The state predicts the fall could be a combination of in-person and online."Are we gonna have to look at staggered schedules, having less kids in a classroom? They have to plan. How are we gonna transport kids? There's not a shortage of issues. We're creating a framework, a template of what those issues are and how districts can walk through the planning process," Thompson said. Milwaukee Public Schools is also considering several options, which could include online and in-person.It's ultimately up to the state Department of Health, whether schools reopen or stay closed.Sign up for coronavirus email alerts from WISNGet breaking news alerts with the WISN 12 app.Follow us: Facebook | Twitter | Instagram | YouTube
The country's top infectious disease expert, Dr. Anthony Fauci, Tuesday warned of suffering, death and deeper economic damage if state and local officials lift stay-at-home orders too quickly.
Continuing Coverage: Coronavirus in Wisconsin
"In this case, that the idea of having treatments available or a vaccine to facilitate the reentry of students into the fall term would be something that would be a bit of a bridge too far," he said. "Even at the top speed we're going, we don't see a vaccine playing in the ability of individuals to get back to school this term."
Universities such as Marquette, UW-Milwaukee and every suburban school district are coming up with plans to reopen or to stay closed.
For many families, the new normal for school is students online at their kitchen table.
"The virtual learning does not replicate what schools, in my opinion, were able to offer in their bricks and mortar schools several months ago, said Mike Thompson of the state Department of Public Instruction.
But now with news that a COID-19 vaccine won't be ready by the fall, educators are preparing Plan B.
After moving 1,600 classes online, the president of Milwaukee Area Technical College said they're preparing for worst case scenarios.
"If we do offer anything on campus, it will be with every precaution that we can possibly take ensure their safety and health," MATC President Vicki Martin said.
"We're listening to what the experts are saying, Waukesha Schools Superintendent Todd Gray said.
Gray is optimistic, but he said he's realistic.
"I just cant imagine having to go another couple of months into the school year on a virtual basis. I don't think that will happen. I mean, we're prepared for anything, but I think that would be a tremendous hardship on students and parents," Gray said.
The state predicts the fall could be a combination of in-person and online.
"Are we gonna have to look at staggered schedules, having less kids in a classroom? They have to plan. How are we gonna transport kids? There's not a shortage of issues. We're creating a framework, a template of what those issues are and how districts can walk through the planning process," Thompson said.
Milwaukee Public Schools is also considering several options, which could include online and in-person.
It's ultimately up to the state Department of Health, whether schools reopen or stay closed.
Sign up for coronavirus email alerts from WISN
Get breaking news alerts with the WISN 12 app.Follow us: Facebook | Twitter | Instagram | YouTube
RAPPERSWIL, Switzerland, May 12, 2020 /PRNewswire/ -- Neovii Pharmaceuticals AG, the Swiss-based biopharmaceutical company and a member of Israeli-based Neopharm Group, has signed a research and license agreement with Tel Aviv University's (TAU) RAMOT, its technology transfer company, to work in collaboration with a team led byProfessor Jonathan Gershoni of the School of Molecular Cell Biology and Biotechnologyto develop a novel and potentially life-saving COVID-19 vaccine.
The agreement will grant Neovii the exclusive right to develop and commercialize a novel and recently patented platform technology that has been developed by Professor Gershoni for the rapid discovery of epitope-based vaccines. The collaboration is focused on the development of a first-in-class COVID-19 vaccine that targets the Achilles' heel of the virus by reconstructing the coronavirus's Receptor Binding Motif (RBM), a critical structure of its "spike" protein.The "spike" protein itself is the major surface protein that the virus uses to bind to the cellular receptor that acts as the doorway into the human cell. After the spike protein binds to the human cell receptor, the viral membrane fuses with the human cell membrane, allowing the genome of the virus to enter human cells and begin infection.
"We have been working on coronaviruses for the last 15 yearsdeveloping a method of reconstructing and reconstituting the RBM structure of the spike protein in SARS-CoV and subsequently in MERS-CoV," explains Professor Gershoni. "The moment the genome of the new virus was published in early January 2020, we began the process of reconstituting the RBM of SARS-CoV-2, the virus that causes COVID-19, and expect to have a reconstituted RBM of the new virus soon.This is the basis for the new vaccine, which could be ready for use within a year to a year and a half."
"The smaller the target and the focus of the attack, the safer and greater the effectiveness of the vaccine," adds Prof. Gershoni."The virus takes far-reaching measures to hide its RBM from the human immune system, but the best way to 'win the war' is to develop a vaccine that specifically targets the virus's RBM."
Keren Primor Cohen, CEO of Ramot: "We hope that through this collaboration with Neovii, it will be possible to produce an effective vaccine that targets the coronavirus's Achilles' heel and will accelerate the development of a protective vaccine against this global threat."
Jrgen Pohle, Neovii CEO, commented, "The outbreak of the COVID-19 pandemic has demonstrated how fragile and vulnerable our societies are in the face of a pandemic. We are extremely excited about our collaboration with Professor Gershoni and TAU which provides Neovii with a first-in-class platform for the rapid development of promising vaccine candidates towards any future emerging pandemics including COVID-19. Furthermore, the COVID-19 vaccine is highly synergistic to Neovii's core expertise in the development and manufacturing of passive polyclonal antibodies and provides an opportunity to bring a COVID-19 immunotherapy in a rapid manner."
Neovii's long-standing and well-established experience and capabilities in developing, manufacturing and commercializing biopharmaceuticals will support the ambition to have a vaccine ready for use in broader population in an accelerated timeline.
About Neovii
Swiss-based Neovii, a member of Israeli-based Neopharm Group, is an independent, rapidly growing commercial-stage biopharmaceutical company with a patient-focused mission to develop and market novel, life-transforming therapies. Neovii has been dedicated for over three decades to improving the outcomes in transplantation medicine and the treatment options for hemato-oncological as well as immune disorders.
Media Relations Contacts:Rebeca Thomas, Senior Account Director, Jango Communications+44 (0)1344 860612beca@jangocom.com
View original content:http://www.prnewswire.com/news-releases/neovii-to-develop-a-novel-vaccine-for-covid-19-in-an-exclusive-partnership-with-tel-aviv-university-301057606.html
SOURCE Neovii
[singing] Singing: Oh, brother, I want you to keep on marchin. And one of these days, and one of these days, you shall be free. Albany, Ga., became an epicenter for Covid-19 in April. Hundreds of cases were traced to two funeral services, and led to one of the highest death rates in the country. It was like a tornado that nobody prepared for. Our churches werent prepared for it, and before we knew it, people were dropping like flies. Pastor Orson Burton lost members of his congregation in the surge, including his wifes father. I can see the park. You can see the park? But we cant go to the park. No. Its still not safe. No. Because the whole world is sick. Yeah, but were praying that the world gets better, right? On April 20, Gov. Brian Kemp announced small businesses could reopen less than three weeks after enforcing a statewide shutdown. For the Burtons, the restart is too soon. Already reopening opening is like a slap in the face. Weve seen how coronavirus can hit our city, our family, our church and it is not worth it. The harsh reality is, there is no more business as usual. Pastor Burton is now on a mission to prevent a second spike. Hes appealing to people who feel conflicted about returning to work. When the owner of the shop first told me, we can go back, I was excited. But that day, I thought about it in my head like, it dont feel right, you know? Yeah. It wasnt enough time to prepare yourself. Pastor Burton is doing outreach like this just about every day, with door-to-door visits and online sermons. My hope and my prayer is that youre still sheltering in place. And we know that even during this pandemic, God has given us resources. And hes not alone. Set up the emojis. Set up the praises. Make some room in that living room. Church leaders across the city are telling members to stay home through livestream videos and drive-in services. [car horns beeping] The virus has hit black residents here particularly hard. Some 30 black and white church leaders have united to remain closed, a decision they announced in this joint statement. We believe that it is in the best interest of our congregations and community that we not resume meeting at this time. The numbers did not indicate that it was time for our city to open. We knew that we just couldnt jump right back in like it was before and start gathering. No matter if your congregation is small or large black, white, Hispanic doesnt matter, were in the same storm. The pastors efforts have been reinforced by the city mayor, who helped pass a resolution encouraging residents to keep sheltering in place. I was a little concerned because I was thinking the ministers are going to say, we need to be back in church. The overwhelming response was, we are not going to resume worship services in our sanctuary until we have a green light from the medical community. Dr. James Black heads the emergency department at Phoebe Putney Medical Memorial, the only hospital in the Albany region. Its been absolutely essential to have the clergy supporting us. They realized the importance of social distancing. While he has seen a decline in cases, the speed of the initial spread makes him wary of a rush to reopen. It took us no time at all to get to 160 Covid patients in the hospital, so were afraid of a second wave. Were just not over it yet. The fact that places are being allowed to reopen is a scary prospect for a lot of us. The shutdown has devastated small business owners throughout southwest Georgia. Dougherty County, where Albany is located, has experienced a 4,500 percent hike in jobless claims since March. Many residents are now forced to decide between safety and their bottom line. At our salon in Albany Ga., we decided that we would go ahead and open up Friday after Governor Kemp said that we could. I am single and totally dependent on myself, and so far, I have not gotten a stimulus check because I am self-employed. I just didnt have a choice anymore. Some feel more conflicted, like Marcus Scott, who manages Masterpiece Barbershop. We will not reopen. I understand people have their financial situation, and what they have to deal with. However, just getting a phone call or hearing that this barber passed away because they went back to work I wouldnt be able to live with that. He has decided to keep his shop closed for now, but with the support of a local pastor. We, as the church, have decided to give each one of these barbers a certain amount of resources. For some of these barbers, this is their only income. Hey, Pastor. Hey, Sister, how are you? Im good. How are you? Pastor Orson Burton has seen the economic strain on his congregation. Now, how are you doing financially? How are you getting paid? Whats going on? Whats good with that? OK Im good at the unemployment. Everything has been falling in place. Be encouraged. Keep pushing forward, and know that were going to continue to stay with you and walk with you. Amen. As more members lose jobs and even return to work, he is doing whatever he can to make sure they move forward with caution. All right, man, God bless you. Yes, sir, thank you. I believe that if we mismanage this moment for the sake of reopening the economy and bringing in money, we can literally set our children and our childrens children back for generations to come. We just dont want to bury anybody else. We dont want to bury any more loved ones. We dont want to bury any more friends because of Covid-19. These are not numbers. These are souls. These are lives being lost. Weve been through so much. This is our time to make certain that the people are represented in rural south Georgia, but also to spread wisdom and information that will save a life.
Engineers work on a potential vaccine for the coronavirus at a Beijing lab. Nicolas Asfouri/AFP via Getty Images hide caption
Engineers work on a potential vaccine for the coronavirus at a Beijing lab.
Most health experts agree that the need for a vaccine to prevent COVID-19 is clear.
"To return to a semblance of previous normality, the development of SARS-CoV-2 vaccines is an absolute necessity" is how a perspective in Science magazine puts it.
So it's hardly surprising that, around the world, anticipation is high. With more than 100 coronavirus vaccines under development, researchers are reasonably confident that at least one will be successful. Skeptics, and there are some, remind us that optimism about an AIDS vaccine was once high, and 40 years later there is no vaccine.
Still, even if experts today are right that a vaccine for COVID-19 will be easier to develop than an AIDS vaccine, estimates for when it will be widely available vary. Here are some of the vaccine-related questions being raised and what we know at this point.
Is the timeline for COVID-19 faster than for previous vaccines?
President Trump has offered perhaps the most optimistic estimate. He said he expects the United States to have a vaccine by the end of 2020.
So far, it does seem as though the vaccine will be developed faster than ever before in vaccine history. It took more than two decades to come up with a successful polio vaccine. Federal health officials suggest a COVID-19 vaccine may be ready in a tenth of that time.
But there are only some things that you can fast-track, and others, not so much. And even though the Food and Drug Administration is going to be evaluating the various stages of testing with great speed in this case, certain standards must be met: First, you have to prove that a vaccine is safe. Then you need to prove that it generates the immune response you want. And then you need to find out if it actually prevents people from getting sick if they're exposed to the virus.
How would researchers know they have developed a vaccine that works?
Vaccine studies present researchers with a conundrum: You want people to be exposed to the disease being targeted because you need to know if your vaccine is working, and yet in another sense you don't want them being exposed because you don't want them to get sick.
The way you know that the vaccine is effective is that you give a vaccine to one group of people and another group gets a sham injection that doesn't contain the vaccine being tested. Then you see if the vaccinated group is protected.
So how are they going to get exposed to, in this case, the novel coronavirus? Well, if there's a lot of virus circulating in the population, that's one way.
Another possibility that people have talked about is intentionally infecting volunteers with the virus and then seeing if a candidate vaccine prevents them from getting sick. That way you know for sure that the volunteer testers have been exposed and can be confident the vaccine works if that person does not get sick. Such studies, known as challenge trials, are ethically fraught, since you are deliberately infecting volunteers with a potentially lethal virus for which there is no cure.
The alternative to challenge trials is to vaccinate enough people so that you can be confident that some fraction of them will be exposed to the virus. The number you need to vaccinate depends on how prevalent the coronavirus is in the area where the vaccine is being tested. You then compare the vaccinated group with another group that received a sham vaccine to look for efficacy.
Once a vaccine has been developed, how does the manufacturing process work?
"The requirement to scale up to the kinds of numbers we're talking about within the short time-frame that we're speaking about would be an extraordinary effort," says Emilio Emini, who has been working on vaccines for decades and now leads the HIV program at the Bill & Melinda Gates Foundation (which is a funder of NPR and of this blog).
Making billions of doses of vaccine is a herculean task.
The tools that you need for manufacturing one vary considerably depending on the kind of vaccine you're making, but in many cases, you need something called a bioreactor a giant tank that allows the organisms that are actually spewing out the vaccine of interest to grow.
Sometimes you could be talking about a 20,000-gallon bioreactor, and you're not going to go down to your local hardware store and pick one of those up. So that's one issue. There's specialty equipment that has to be made.
In addition to the big stuff, there are smaller things to take into consideration, such as medical-grade glass.
"You have to put a product into a sterile vial or syringe, and there's only so much of that glass to go around," says Fred Porter, senior vice president for technical operations at Adrenas Therapeutics. "If we're thinking about billions of doses to be able to deliver vaccines around the world, that becomes a significant bottleneck."
Is making a vaccine available globally important?
Definitely.
Seth Berkley, CEO of an organization called Gavi, the Vaccine Alliance, believes you can't roll out a vaccine one country at a time.
"We're not going to be safe as a world unless everywhere is safe," he says. "So even if we had parts of the world that would have low spread or no spread, if you had large reservoirs of the virus in other places, of course you have a risk of reintroduction."
With more than 100 vaccines in development around the world, is it safe to say the majority of them are never going to become viable candidates?
Yes.
They may not succeed for a variety of reasons. They may not work, or they work but are too hard to manufacture. At this stage of development, many are expected to fail. That's just the nature of vaccine trials.
Is it possible that we don't get just one vaccine but that multiple vaccines are developed that might work even in somewhat different ways?
It seems likely because there are multiple approaches to making vaccines that have advantages and disadvantages. Some are tried and true and have worked for other viral illnesses. Some you can make much faster, but it's unclear that they'll be as effective. Experts such as Emilio Emini believe the parallel development of multiple vaccines is a good thing.
"It's my perspective that this is going to require more than one successful vaccine," he says. "It's going to require at least several, if not more, that are successfully developed in parallel so that the scope of what will be needed can be satisfied."
Will the coronavirus vaccine be like the annual flu vaccine in that it changes every year because the virus changes every year, or will it be more like the measles or the polio vaccine, which is fixed?
Unfortunately, right now the answer is unclear. There is some indication that this virus doesn't change very rapidly, so if you find a vaccine that works against it, it may work in perpetuity. But researchers also don't know how long immunity to this virus lasts, so we may need to get booster shots not a different shot every year but a booster of the same shot to make the vaccine actually work for multiple years.
How hopeful should we be that there will be a vaccine that works and that we can get our hands on by next year?
Several companies, governments and foundations are betting billions of dollars that it will be possible.
Paul Stoffels, chief scientific officer for Johnson & Johnson, says he's optimistic because of his company's recent experience making vaccines for other viral diseases.
"We have done it with Zika, RSV (respiratory syncytial virus), Ebola," he says. "We know what we do. And if we plug a new virus into that system, we are pretty sure we can get to a vaccine."
That said, vaccine people will tell you that every time you start working on a vaccine for a new virus, you don't know what the hurdles will be. There's a lot of work that needs to be done before we know for sure whether those bets will pay off.
For a second straight day, there were fewer than 200 newly confirmed cases of coronavirus in Wisconsin, and Tuesday'supdate included another encouraging number: Fewer than 4% of all tests were positive for the virus.
Following Tuesday's results, Wisconsin had met five of six criteria set by Gov. Tony Evers to begin a phased reopening of the state.
Of more than 4,900 test results announced Tuesday, 193 returned positive, the lowest number of positive tests announced since April 27 and the lowest portion of new tests that were positive 3.9% since the state stopped including repeated tests of the same patients in its daily updateson March 30.
Nine more people had died of COVID-19, however, increasing the state's total to 418.
As of Tuesday morning, 326 patients were hospitalized with COVID-19 in Wisconsin, while 188 inpatients awaited test results, according to the Wisconsin Hospital Association. Of the hospitals' 1,261 ventilators, 325 were in use.
For each category of personal protective equipment tracked by the WHA face shields, goggles, gowns and N95 and paper masksat least 30 hospitals reported that they had less than a week's worth remaining.
Total tests increased again after a brief Mother's Day dip, though the 4,900 new tests werestill far below the reported daily capacity of more than 50 active labs in the state, which verged on 14,000.
A Johns Hopkins University case tracker showed more than 4.2 million cases worldwide by early afternoon, with nearly a third of those coming in the U.S. Deaths in the U.S. accounted for nearly 82,000 of nearly 290,000 globally.
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The state health department's dashboardfor Evers' Badger BounceBack plan showed green lights for downward trajectories in the percent of new tests that have been positive for coronavirus, number of cases with COVID-19 symptoms and cases among health care workers,as well as two measures that reflect hospital readiness.
Still showing as a red light: A statistically significant downward trends in flu-like illnesses. Flu-like illnesseshave trended downward but the number had yet to meet health officials' definition of statistical significance.
Evers announced Monday that retail stores could open their doors to up to five customers at a time, and drive-in theaters could resume operations with some restrictions.
Marquette University poll results released Tuesday showed that a majority of Wisconsin voters 56% were more concerned that the state would be reopened too soon, compared to 40% who worried more that it wouldn't be opened soon enough.
But compared to March,more voters felt Evers' measures were an overreaction 26% in the new poll, compared to 10% in March.
Evers' order has been challenged by Republican legislators in the state Supreme Court.
The state's count of confirmed cases by county stood as follows Tuesday:
Note that the state's totals are frozen once each day, and that some counties may have reported more up-to-date counts.
Contact Matt Piper at (920) 810-7164 or mpiper@gannett.com. Follow him on Twitter at @matthew_piper.
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About 100 children in N.Y. are suspected of having a rare illness tied to the virus.
New York State health officials are investigating about 100 cases of a rare and dangerous inflammatory syndrome that afflicts children and appears to be connected to the coronavirus, Gov. Andrew M. Cuomo said on Tuesday.
More than half of the states pediatric inflammatory syndrome cases 57 percent involved children ages 5 to 14.
Earlier the day, Mayor Bill de Blasio said that 52 cases of the syndrome, which has symptoms that overlap with those of toxic shock or Kawasaki disease, had been reported in New York City, and that 10 potential cases were being evaluated.
The dead included a 5-year-old boy, who died last week in New York City; a 7-year-old boy in Westchester County and an 18-year-old girl on Long Island.
This is a truly disturbing situation, Mr. Cuomo said at his daily news briefing. And I know parents around the state and around the country are very concerned about this, and they should be.
Hospitals across the state should make it a priority to test any children displaying the syndromes symptoms for the coronavirus, the governor said.
Mr. Cuomos announcement came as he reported 195 more virus-related deaths in the state, an increase from Mondays total but the second consecutive day that the toll was under 200.
The pediatric illness began to appear in the region in recent weeks, and doctors and researchers are still investigating how and why it affects children.
Connecticut reported its first cases of the syndrome on Monday. As of Tuesday, six children in the state were being treated for the ailment, officials said.
Gov. Ned Lamont announced three of the Connecticut cases at a briefing on Monday.
I think right now its a very, very tiny risk of infection, he said. It was not really ever detected in Asia, which, I dont quite know what that implies.
Three other children were being treated for the syndrome at the Connecticut Childrens Medical Center in Hartford, a spokeswoman, Monica Buchanan, said on Tuesday. Two of the three were confirmed to have the illness, Ms. Buchanan said.
As of Monday, health officials in New Jersey said they were investigating eight potential cases of the syndrome.
With New York making steady progress in its battle against the virus and three upstate regions poised to start a gradual reopening by this weekend, Mr. Cuomo on Tuesday reiterated the importance of federal aid as the state charts its recovery.
The number of people hospitalized in New York continued to decrease, Mr. Cuomo said, one of the key metrics that officials are monitoring in assessing whether the outbreaks severity is waning.
The number of new daily hospitalizations has fallen close to where it was on March 19, just before Mr. Cuomo issued executive orders shutting down much of the state.
Were making real progress, theres no doubt, Mr. Cuomo said. But theres also no doubt that its no time to get cocky, no time to get arrogant.
While sounding that warning, Mr. Cuomo urged lawmakers in Washington to give state and local governments whose budgets have been ravaged by the pandemic the financial help they need to rebound.
To get this economy up and running, were going to need an intelligent stimulus bill, Mr. Cuomo said.
New York state needs an estimated $61 billion in federal support to avoid enacting 20 percent cuts to schools, local governments and hospitals, Mr. Cuomo said.
He also said it would be impossible for New York to resume business as normal without the money it needs to develop a sophisticated testing and contact tracing apparatus.
It is unclear whether Congress will give Mr. Cuomo the help he is seeking. Like President Trump, Senator Mitch McConnell, the Republican majority leader, said he last month that he did not support what he has labeled a blue state bailout.
Mr. Cuomo called Mr. McConnells characterization one of the really dumb ideas of all time.
Gov. Philip D. Murphy of New Jersey on Tuesday outlined plans for the testing and contact tracing of the virus that he said would be critical to reopening the states economy.
Still, Mr. Murphy made the case that New Jersey which, with New York, has been at heart of the pandemic in the United States is now more affected by outbreak than other states. New Jersey, he said, had overtaken New York and Connecticut in the rate of new infections and deaths.
There are still thousands in our hospitals, and sadly an untold number more will perish, Mr. Murphy said, while noting that the number of hospitalizations, deaths and new cases had plunged since their mid-April peak.
To continue to beat back the outbreak, New Jersey officials said they planned to test up to 20,000 people a day by the end of May. The state will also deploy hundreds of contact tracers to determine who has had close interactions with a sick person, Mr. Murphy said.
The states goal, the governor said, was to recruit a racially diverse group of tracers who speak various languages and identify closely with the communities where they will work. The job pays around $25 an hour, he said.
The drop in the number of new virus cases means that the state can consider a limited reopening, Mr. Murphy said, but he warned impatient residents about the risk of loosening restrictions too soon. After closing parks and golf courses in early April, the state reopened them on May 2. Mr. Murphy did not say which businesses may be the first to reopen.
Also on Tuesday, Mr. Murphy announced 198 new deaths 139 more than were reported the day before for a total of 9,508. About half of the fatalities involved nursing home residents. The daily report of new deaths in New Jersey may include deaths that occurred weeks ago and were only recently confirmed.
Those numbers dont lie, Mr. Murphy said. We are still the most impacted state in America.
The puzzle of how to revive New York Citys tourist trade is so vexing that city officials are pulling together a group of industry experts and one of the biggest names on Broadway to try to solve it.
On Tuesday, the citys tourism agency, NYC & Company, said it was establishing the Coalition for NYC Hospitality & Tourism Recovery. Among the groups leaders: Lin-Manuel Miranda, the composer, lyricist and actor who created the musical Hamilton.
The coalitions task is to come up with a plan for wooing people back to the city once it starts to emerge from the coronavirus pandemic, a chapter that appears to be months off at least after the Broadway League said on Tuesday that its members were canceling shows through Sept 6.
It is time to consider how we can begin to reopen our doors and safely reconnect with our city and with each other, and with the visitors who will one day again flock to New York, said Charles Flateman, NYC & Companys chairman and executive vice president of the Shubert Organization.
Joining Mr. Flatemen and Mr. Miranda at the groups helm are Ellen Futter, the president of the American Museum of Natural History, which recently announced a number of layoffs; Thelma Golden, the Studio Museum in Harlems director and chief curator; the restaurateur Danny Meyer; and Peter Ward, the president of the New York Hotel & Motel Trades Council.
Before the pandemic struck, NYC & Company was forecasting an 11th straight year of increased tourism. In 2019, the city had more than 66 million visitors who generated about $70 billion of economic activity that supported 400,000 jobs, according to the agencys estimates.
Together, we will create a next act for our city, Mr. Miranda said in a statement.
Mr. de Blasio on Tuesday announced an expansion of coronavirus testing and tracing across New York City, but he warned again that a limited reopening of the city was weeks away at best.
Twelve new testing sites will be set up in the next three weeks in a push to double the public hospital systems testing capacity, the mayor said at his daily news briefing. The city was also training 535 contact tracers, with a goal of having 2,500 in the field by early June.
Still, the city, the pandemics U.S. epicenter, has met just four of the seven criteria required to start to reopen, Mr. Cuomo said on Monday while announcing that three upstate regions had achieved all of the necessary benchmarks.
Mr. de Blasio has said he is closely monitoring three measures in weighing the citys progress toward reopening: the number of new virus infections; the number of infected patients in intensive care units; and the percentage of residents testing positive for the virus.
Clearly, these indicators are not getting us the kind of answers we need to change our restrictions in May, the mayor said. Youve got to have 10 days to two weeks of consistent, downward motion. We havent had that in a sustained way at all.
With Connecticut nearing the May 20 date that officials have set for starting a gradual reopening, Gov. Ned Lamont said on Tuesday that the state continued to make steady progress in stemming the coronavirus outbreak.
Mr. Lamont, speaking at a daily news briefing, reported 33 new virus deaths, eight fewer than on Monday. The virus has now been linked to 3,041 deaths in Connecticut.
Hopefully the fatalities continue to go down, Mr. Lamont said.
The governor also said the total number of patients hospitalized with the virus had fallen to 1,189 from 1,212. He reported 568 new confirmed virus cases, which he suggested was in line with an increase in testing.
Mr. Lamonts briefing came several hours after he said he was replacing the states public health commissioner, Renee Coleman-Mitchell, who had been in the job about a year. She had not been at his daily briefings in recent weeks.
The governor did not discuss his reasons for making the change, saying only that he had appointed the states social services commissioner, Deidre Gifford, to fill the post for the time being.
Ms. Coleman-Mitchells service over the last year has been a great deal of help, particularly in the face of the global Covid-19 pandemic that has brought disruption to many throughout the world, Mr. Lamont said in a statement.
In a statement issued by a lawyer, Ms. Coleman-Mitchell said she had been told by members of the governors staff that the move was not related to job performance.
I am proud of the work of the Department of Public Health during this time of unprecedented turmoil and threat to the public health, she added.
The coronavirus outbreak has brought much of life in New York to a halt and there is no clear end in sight. But there are also moments that offer a sliver of strength, hope, humor or some other type of relief: a joke from a stranger on line at the supermarket; a favor from a friend down the block; a great meal ordered from a restaurant we want to survive; trivia night via Zoom with the bar down the street.
Wed like to hear about your moments, the ones that are helping you through these dark times. A reporter or editor may contact you. Your information will not be published without your consent.
Reporting was contributed by Andrea Salcedo, Maria Cramer, Michael Gold, Patrick McGeehan, Jesse McKinley and Azi Paybarah.
The coronavirus pandemic has impacted cities across the country with varying force. New York City has been hardest hit, and its no secret that the Big Apple is going to be one of the places that will have the most challenging time bouncing back from the coronavirus pandemic, no matter when things subside. But which cities will have the best coronavirus recovery? And which other cities will struggle? Moodys Analytics has issued a report that examines the potential to recover from coronavirus among the top 100 metro areas in the USand while some of the results are to be expected, some are more surprising.
The most dynamic recoveries may well bypass traditional powerhouses and take place instead in areas that either were or were poised to lead the way in 2020 before everything changed, writes Adam Kamins, senior regional economist at Moodys Analytics and the author of the report.
Moodys grouped the 10 cities best positioned to recover quickly from the coronavirus pandemic and the 10 cities with the worst chance of recovering from the coronavirus pandemic. Note that they are sorted alphabetically in order to avoid assigning false precision to our calculations, Kamins told Forbes Women.
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A new list has ranked the cities that are best positioned to recover from coronavirusand the worst ... [+] cities.
Best Cities for a Coronavirus Recovery
Among the 10 best cities are small college towns, which are particularly well-poised for a recovery. Durham, North Carolina and Madison, Wisconsin could enjoy a surge in growth in the years to come, says Kamins.
Fast-growing tech hubs in the West and South will also lead in the post-coronavirus era. Silicon Valley is nobodys idea of an up-and-coming area. But there is a notable contrast between the San Jose metro area, with its sprawling tech campuses, and tightly packed San Francisco, says Kamins, who notes that Raleigh, North Carolina could also prove to be more attractive in a new, post-COVID-19 world.
Cities that were fast-growing pre-coronavirus will continue their rise. Denver and Salt Lake City are well-positioned to retake their crown as two of the fastest-rising metro areas in the US, says Kamins.
While Washington DC is one of the more densely populated metro areas in the nation, its highly educated workforce and even its architecture will pay off. Its longstanding height limit on buildings [will help] leave it in better shape than the rest of the region, says Kamins.
Other cities on the top 10 best list include Boise City, Idaho; Durham, North Carolina; Provo, Utah; and Tucson, Arizona. Read on forthe full list of best cities for recovery.
New York City is going to be one of the worst cities to recover from coronavirus.
Worst Cities for a Coronavirus Recovery
A significant number of cities in the Northeast made it to the bottom of the list. The region of the country that I think is worse off is going to be the Northeast, says Kamns. You've got New York, Philadelphia, New Haventhree of the 10. It is a highly educated area, but so many large urban centers have an outsize share of residents living in big cities. That may be difficult to sustain, especially in the short term.
And despite the fact that New York City has a large, skilled workforce, there are factors that will hold it back. Riding the subway, dining in crowded restaurants and attending Broadway shows may be viewed as inherently risky for some time, consistent with the city's status asthe single-most economically exposed metro area, writes Kamins.
Honolulu made it onto the worst list, Kamins says, because of its exposure to tourism.
Kamins says he was surprised by some of the cities on the worst list, including McAllen, Texas and Stockton, California. McAllen is more densely populated than most areas with [a lot of] poverty and low degrees of educational attainment. And inland California is much worse off economically than coastal California. Plus, a place like Stockton is a little bit more compressed. There's not as much space there. So there's a bit more risk, says Kamins. We think that in the aftermath of COVID-19 or even while the pandemic is still going on over the next couple of years, potentially, if there's no vaccine, that these are areas that might be less attractive.
Other places on the list of 10 worst cities to recover include Detroit, Los Angeles, Miami and Tampa, Florida. Read on forthe full list of worst cities for recovery.
The Data
In analyzing the cities, Moodys Analytics looked at population density and plotted it against two measures of workforce quality, both using educational attainment. In the first comparison, Moodys used data to compare population density against the share of jobs that require either a college or graduate degree. Those economies that can provide high-paying jobs to would-be city residents are especially well positioned, writes Kamins.
Moodys also looked at CBSAs (core-based statistical areas), a US geographic area defined by the Office of Management and Budget (OMB) that consists of one or more counties (or equivalents) anchored by an urban center of at least 10,000 people plus adjacent counties that are socioeconomically tied to the urban center by commuting. In this case, Moodys used educational attainment and theaverage density across countiesthat was used to calculate regional exposure to COVID-19.
The Impact of Coronavirus on Big Cities
One of the biggest impacts the country might witness, post-coronavirus, is a migration away from living in big cities. The generation that is growing up today could remember the impact of the COVID-19 pandemic on large, densely populated urban areas and be more likely than its predecessors to opt for less densely packed pastures in the decades to come, notes Kamins.
Kamins believes that this will also impact where business is done. Firms will need to follow those workers, writes Kamins. Places that are more spacious, rely more heavily on car travel and provide ample access to single-family housing are likely to emerge as more attractive as a result, especially among those who choose to bypass the highly urbanized Northeast.
Austin, Texas is a city to watch in the post-coronavirus era.
Beyond the Lists
Other urban areas that didnt make the top 10 listbut are places to watchinclude Austin, Texas; Seattle; and Minneapolis. Meanwhile, the draw of suburban areas should not be overlooked, says Kamins. The Silver Spring, Maryland; Montgomery-Bucks-Chester County Pennsylvania; and Cambridge, Massachusetts metro divisions could become appealing alternatives to their neighboring cities in a world in which physical proximity is viewed as inherently risky.
And while they didnt make it into the top 10 list, Omaha and Des Moines could also succeed. Kamins points out that more isolated places in the Midwest will benefit from the fact that they face few land constraints.
Kamins also believes that the coronavirus fallout could damage some of the nations other dynamic economies in the future, including Boston and San Franciscowhich didnt make the 10 worst list, but will also fare poorly in the post-coronavirus era. Each place is resilient enough to eventually find its footing again, but out-migration could pick up in the medium term, writes Kamins.
Here arethe 10 best and 10 worst cities for recovery.Note that Moodys sorted the cities alphabetically in order to avoid assigning false precision to the calculations.
Boise, Idaho will be one of the cities best poised to bounce back from coronavirus.
Top 10: Cities Best-Positioned to Recover From Coronavirus
(Note: These are alphabetically sortednot listed in order)
Boise City, Idaho
Denver, Colorado
Durham, North Carolina
Madison, Wisconsin
Provo, Utah
Raleigh, North Carolina
Salt Lake City, Utah
San Jose, California
Tucson, Arizona
Washington DC
Los Angeles is predicted to be among the worst cities to recover from coronavirus.
Bottom 10: Cities Worst-Positioned to Recover From Coronavirus
(Note: These are alphabetically sortednot listed in order)
Detroit, Michigan
Honolulu, Hawaii
Los Angeles, California
McAllen, Texas
Miami, Florida
New Haven, Connecticut
New York City
Philadelphia, Pennsylvania
Stockton, California
Tampa, Florida
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Medical workers prepare to use a swab to administer a coronavirus test at a drive-through center on March 21 in Jericho, N.Y. Bruce Bennett/Getty Images hide caption
Medical workers prepare to use a swab to administer a coronavirus test at a drive-through center on March 21 in Jericho, N.Y.
The Trump administration says it will now spend billions of dollars to help states make COVID-19 testing more widely available, a move meant to address months-long complaints about test shortages.
But here's the puzzle: Many labs say they have plenty of tests. So what's the disconnect?
Turns out a "test" is not a single device. COVID-19 testing involves several steps, each one requiring different supplies, and there are shortages of different supplies at different times in different places.
But despite warnings about supply shortages by health experts and governors at least as early as February, the federal government took until late April to ramp up domestic production of swabs a universal ingredient in the most common type of COVID-19 test.
The swab test checks for active infections, unlike an antibody test, which involves drawing blood to check whether the body has recovered from the virus.
Step 1 of a swab test is collecting a sample, and the most common way to do that is by swabbing a patient's nose or throat. Sample collection usually involves a swab, a tube and a chemical solution called "viral transport media," which keeps the sample fresh as it travels to a laboratory. There are dozens of types of FDA-approved swab tests, and the swabbing is usually done at hospitals, community health centers or drive-through testing sites.
Step 2 takes place at a lab. There, genetic material is extracted from the sample. That requires a special machine and chemicals called reagents.
Once the genetic material is extracted, Step 3 occurs: A machine checks whether that genetic material contains any of the coronavirus. If it does, the sample has tested positive for COVID-19.
"A test is not simply a one-component test, but is made up of many different components," said Heather Pierce, senior director for science policy and regulatory counsel at the Association of American Medical Colleges. "If any one of those components is missing or has insufficient quantities, the test can't happen."
The COVID-19 testing process has been plagued by missing components, including swabs, reagents and the chemical solution that keeps samples fresh. Some weeks, there are shortages of some but not others, or one location has them and another doesn't.
Take swabs. They are able to work with any approved swab test. The name suggests something as simple as a Q-tip, but they are more specialized. Nasopharyngeal swabs, as they're called, are considered medical devices and must be long and flexible enough to get all the way through the nose to the back of the throat.
At an April 17 press briefing, President Trump said that in the next few weeks, the federal government would be sending millions of swabs to the states, and he added: "Mostly, it's cotton. It's not a big deal."
But Trump was wrong. Cotton can interfere with test results because it contains its own genetic material, so nasopharyngeal swabs are typically made of polyester, nylon, foam or some other synthetic material.
President Trump compares a cotton swab (left) to a swab that could be used in coronavirus testing during a briefing on April 19. Two days prior, Trump erroneously said cotton swabs could be used for coronavirus testing. Patrick Semansky/AP hide caption
President Trump compares a cotton swab (left) to a swab that could be used in coronavirus testing during a briefing on April 19. Two days prior, Trump erroneously said cotton swabs could be used for coronavirus testing.
On April 20, Vice President Pence, speaking publicly about a phased reopening of the economy, said this: "By our best estimates, we have enough testing capacity today for every state in America to go to Phase 1."
But "testing capacity" does not necessarily mean testing is happening. Remember: Testing involves not just swabbing, but also having a sample analyzed at a lab. And labs may have the machines that analyze samples, but if there aren't enough swabs, those machines may sit idle. In other words, a shortage of swabs may prevent labs from operating at full testing capacity.
So why is there a shortage of something as seemingly simple as swabs?
For one reason, there had been only two major manufacturers of these swabs worldwide Puritan Medical Products in Maine and Copan Diagnostics in Italy. When COVID-19 hit and demand for swabs skyrocketed, the companies became overwhelmed and couldn't keep up.
"I don't think the United States was prepared," said Timothy Templet, Puritan's executive vice president of global sales. "That includes us, Puritan. It includes our customers. And it includes the government ... And now it gets really nerve-wracking to think that we may be in this for another couple years."
Puritan Medical Products employees work in the Guilford, Maine, plant in 2017. On April 29, 2020, the federal government announced Puritan had been awarded a $75.5 million contract to produce more swabs for coronavirus testing. Carl D. Walsh/Portland Press Herald via Getty hide caption
Puritan Medical Products employees work in the Guilford, Maine, plant in 2017. On April 29, 2020, the federal government announced Puritan had been awarded a $75.5 million contract to produce more swabs for coronavirus testing.
The U.S. government could have been amassing swabs in the Strategic National Stockpile, a federal warehouse of medical supplies, but was not.
The government also has the Defense Production Act, a tool the Trump administration used in late March to require General Motors to produce more ventilators for coronavirus patients. But the administration did not act as quickly to use that tool for swab shortages, even though some people were advising that.
"Weeks ago," Washington Gov. Jay Inslee told NPR on April 16, "I spoke to the president and urged him to invoke the Defense Production Act and mobilize the incredible supply chains that the Department of Defense has and to ask them to convert some of their production from other hardware and software to swabs and contact vials and machines that can do analysis. And he did not agree with that assessment, and we lost weeks, frankly."
That was not the first time the federal government had been warned of swab shortages.
On Feb. 12, at a hearing on pandemic preparedness, a group of prominent health experts told a U.S. Senate committee that the country has a testing supply chain problem. On March 16, former FDA commissioner Scott Gottlieb tweeted that "swabs could be a weak link in broadening testing." On March 17, Rhode Island Gov. Gina Raimondo told CNN that "the problem is swabs." During the same time period, there were other public distress calls about supply shortages.
In mid-March, the government acted: It flew shipments of swabs from Italy to the U.S. But that still didn't meet demand, and complaints about shortages were still continuing in mid-April. On April 19, President Trump said he would use the Defense Production Act to increase swab production. On April 29, the government said Puritan Medical Products had been awarded a $75.5 million contract to produce more swabs.
A health care worker seals a coronavirus swab after testing at a coronavirus testing site on April 30 in Wantagh, N.Y. Al Bello/Getty Images hide caption
A health care worker seals a coronavirus swab after testing at a coronavirus testing site on April 30 in Wantagh, N.Y.
Puritan's goal is to produce at least an additional 20 million swabs a month, and it's building a new factory to do that. But it's hard to say whether that's enough to meet demand because it's difficult to get consensus on how much COVID-19 testing the U.S. should be doing, and how many swabs can be produced.
Consider the experience of the American Society for Microbiology, which asked in mid-April to speak with Dr. Deborah Birx's team on the White House coronavirus task force to find out what was being done to address testing supply shortages and discovered that the White House was trying to figure out the same thing.
"Something happened that was very surprising," recalled Dr. Robin Patel, the organization's president. "First of all, Ambassador Birx is a wonderful person and has very good insight into the challenges that are happening ... but what they did is they turned around and they asked the American Society for Microbiology to help with this situation. That's not why we were there. We were there asking for information."
So Patel's group gave the coronavirus task force its feedback.
"We are pleased to be able to help," said Patel, noting that the pandemic is a complicated situation and that everyone needs to work together to solve it. "But we were not there to volunteer to help. That was what was surprising was the ask back to us."
The American Society for Microbiology's experience makes clear that nearly three months into the pandemic, the Trump administration was still struggling to understand the shortage of swabs and other test supplies, and how to fix it.
To help address the shortage, the FDA has approved more types of swabs, and an Ohio company is converting a plant to make swabs. The FDA has also approved a saliva test that does not require a swab.
And this week, the White House said it would send $11 billion to state governments to expand testing and make sure each state has enough testing supplies, although it said it wants to focus on high-risk communities like nursing homes.
So it remains unclear how widespread testing will ever be in the U.S.
NPR's Laura Sullivan, Graham Smith and Tim Mak contributed to this story.
The video featured 20-ish people plotting how to attack a boss. (It was in an area known as "upper black rock spire" in the game.) It was an intricate plan, with all sorts of coordinated moves being worked out and even a guy calculating the group's chances of survival. (It was "32.33, uh, repeating of course" if you were wondering. You weren't.)
The plotting went on for an extended period of time -- right up until one of the players yelled, "Time's up. Let's do this. Leeeeeerrrroy Jenkins!!!!" and sprinted into the room to battle the boss. ("Leroy Jenkins" was his screen name in the game.) They all followed him because, well, what the hell else were they going to do?
The "Leroy Jenkins" video has become the stuff of absolute legend on the internet -- as almost every piece of the video has been transformed into an internet meme of some sort.
What, you are wondering at this point, doesany of that have to do with the coronavirus -- and the way in which governors are reopening their states?
A lot, actually. In fact, "Leroy Jenkins" is the perfect way to understand how we got to a place where 48 of the 50 states will be at least partially reopened by May 17 despite the fact that very few of them have met the federal guidelines for reopening.
Once Leroy -- er, I mean Kemp -- had run through that reopening doorway, the other governors had no choice but to follow.
Because the political pressure to do so -- once Kemp had broken the seal -- became even more intense. And faced with growing protests and economic numbers that hadn't been so bad since the Great Depression, governors rushed to reopen their states, plans, plots and federal guidelines be damned.
