Heres what were talking about this week on the GeekWire Podcast.
It was another tumultuous week in Seattle, the epicenter of the coronavirus crisis, with restaurants and bars ordered closed, large gatherings banned, and the number of COVID-19 cases and deaths continuing to climb. We recap the weeks news, check in with gig economy workers, and hear what Bill Gates has to say.
Among the weeks events: A worker at a tech company in Seattle became the first person injected with a possible COVID-19 vaccine; Amazon says it wants to hire 100,000 workers to deal with demand, the city and state brace for a possible shelter-in-place order, and much more.
Listen above, subscribe in any podcast app, and keep reading for highlights.
Follow our live blog for up-to-date news: Coronavirus Live Updates: The latest COVID-19 developments in Seattle and the world of tech
More from the podcast: Its a tough time to be a worker in the gig economy. We interviewed gig workers who expressed fear, desperation and uncertainty.
And dont believe that story about Bill Gates trying to woo Tom Brady to play in Tampa. But do believe what Gates has been saying for years about preparing for a pandemic.
With GeekWires Todd Bishop, Taylor Soper and Monica Nickelsburg. Our podcast producer is Curt Milton. Our theme music is by Daniel L.K. Caldwell.
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NewsHealthProfessor Beate Kampmann said the situation looks positive for finding a vaccine, but it will be a long process
Friday, 20th March 2020, 7:45 pm
Questions over when a coronavirus vaccine will be ready are at the forefront of most people's minds, as the Covid-19 outbreak continues to spread across the world.
A usable vaccine will not likely be ready for at least a year if not 18 months, an expert confirmed, as the process is likely to be lengthy in order to ensure it is both safe and effective against the virus.
Beate Kampmann, a Professor of Paediatric Infection & Immunity, made the comments following news on Thursday that a US trial began testing on humans.
"This is a completely new virus and there's no new vaccine ready to go because we've not made one for this particular virus before," she said. But because we have seen other viruses within the same coronavirus family such as SARS (Severe acute respiratory syndrome coronavirus) and MERS (Middle East respiratory syndrome-related coronavirus) - which were seen in the past decade vaccine developers can capitalise on some of the previous knowledge when developing a vaccine.
Positive signs
On the whole, the situation looks positive, she explained, as there are at least 35 companies and initiatives currently looking to develop a Covid-19 vaccine - meaning it is very likely there will be at least one option.
Prof Kampmann, also the director of the Vaccine Centre at London School of Hygiene and Tropical Medicine, explained that the US vaccine trial was the one furthest along currently but that it was quite unusual in that it had skipped the stage of testing in animals first.
Usually trials begin with testing on animals, but because this vaccine was likely deemed safe enough, it progressed from the lab to testing on humans straightaway. Unfortunately this does not necessarily mean it is closer to being used as there is still a series of stages before it reaches this point.
Stages of vaccine development
For any vaccine the first stage is called the pre-clinical stage, and is the development in a lab and testing on animals once something looks promising.
The next is known as clinical development, and means that the vaccine is administered initially to healthy adults - notably not people who have contracted the illness you're hoping the vaccine will work against. The reason for this, she explained, is that even if the vaccine was effective against the disease, if it leads to patients feeling extremely sick or experiencing horrible symptoms as a side-effect, no one will want to take it.
"This takes around 20 to 30 people," Prof Kampmann said. "Once the vaccine has passed this stage, also known as the safety gate, the next step is working out whether the vaccine will actually induce the antibody or immune response you predict will likely be the type that protects you against the real virus."
This is called stage two and involves a larger group of people and apart from safety also testing their blood samples. In this part of the trial, which takes several months to acquire all the results, patients' blood is tested before the vaccination and after the vaccination, including at various doses, to see how the body responds and pick the best dose.
The reason why it is predicted that a Covid-19 vaccine will only be available in over a years time is that even if one of the many candidates is successful in the early clinical phase and rushes to the next stage stage after a series of good results, it may fail a later stage and will not go further. This is why the timeframe to develop a vaccine can take so long as when one fail the process often starts again, and why several trials at early stages are a good thing right now.
"Lets say that there are several candidates that have gone to phase two as they've introduced the antibody response you wanted," Prof Kampmann said. "Now we need to test whether that vaccine actually prevents you from getting the disease because at the moment you've only been giving it to be people who don't have the disease.
"We call this an efficacy trial and that needs to enrol a large numbers of people to show that the vaccine can actually prevent the disease."
She explained that for this stage, a few thousand people are usually needed. Often a country where the outbreak is an issue is picked so that you can see the impacts of the vaccine effectively on the number of cases. If it gets to this stage and succeeds then we have a viable vaccine.
'Several options'
With so many trials underway, what happens if more than one vaccine works?
"If several look good, a decision might have to be made on which is going forward," she explained. "Issues such how easy it is to make the vaccine for millions of people and its availability and costs are considerations when choosing between more than one."
If there is an effective vaccine but maybe not for the whole world, decisions have to be made who should get it first - like health care workers for example as they are the most exposed to people with the illness and people who are likely to have particularly bad disease.
The other concern is where, and how consistently, the vaccine will be administered.
With coronavirus, even if we have a population that is mostly immune to it when the epidemic eventually dies down, there will always be newborns and people who did not get exposed, all of whom are not immune - meaning the vaccine would have to be given all the time, just like with measles or flu vaccine.
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COVID-19 is caused by a new strain of coronavirus, which means no-one has any immunity when they are first exposed to it.
"With flus they're all derived from very similar types of viruses, whereas this is a new virus where everyone is naive to [it]," said evolutionary biologist Jemma Geoghegan of the University of Otago, who studies the emergence and evolution of viruses.
This means when it comes to cures for COVID-19, while scientists can draw on what we know about other viruses, in many ways they're starting from scratch.
Viral infections are often harder to cure than bacterial infections because you can't treat them with antibiotics, although antiviral medications are available for some infections.
Treatments might be used to alleviate the symptoms of your infection while your immune system is fighting the virus.
Conversely, vaccines are designed to prevent people getting infected in the first place.
They do this by imitating the infection, so that the body's immune system knows how to fight that particular infection and protect you against getting it in the future.
Here's what we know about how our bodies deal with COVID-19, and what's in the pipeline to cure it so far.
Australian researchers have found that our immune systems respond to this coronavirus in the same way as to influenza.
The immune cells that emerge in the blood before patients recover from COVID-19, are the same cells we see in people before they recover from the flu.
Researchers at the Peter Doherty Institute for Infection and Immunity were able to work this out by looking at multiple blood samples from one of Australia's first patients diagnosed with COVID-19.
Importantly, the research published in Nature Medicine is "the first paper that shows the body can give immunity and fight back and recover", researcher Carolien van de Sandt said.
Based on their experience with influenza patients, it also allowed the researchers to accurately predict how long the patient would take to recover from COVID-19.
But it's still too early to tell whether contracting coronavirus once would give you immunity to prevent you catching it again.
However the research could also help in the development of a vaccine and other treatments to tackle COVID-19.
Early signs are promising, after Australian researchers this week revealed they are ready to begin clinical trials of a potential treatment for COVID-19 using two existing drugs.
The drugs in question are an older HIV drug and an anti-malaria drug called chloroquine, which is rarely used now as the malaria pathogen has become resistant to it.
"There's certainly positive signals either this HIV drug or this anti-malaria drug actually work really well against COVID-19," David Paterson, director of the Centre for Clinical Research at the University of Queensland, told The Project.
"We know that in the test tube and in the patients that have been studied so far they've been able to recover and there's no more evidence of virus in [their] system," Professor Patterson said.
The next step for this research is to compare the HIV, the malaria drug, and a combination of the two, to see what treatment is most effective.
This phase of the trial could be as short as three months, Professor Paterson said, but it would take longer to roll the treatment out in the community, if it did prove effective.
Worldwide, Chinese doctors are completing clinical trials looking at the effectiveness of a combination of two HIV drugs, lopinavir and ritonavir, at treating COVID-19, New Scientist reported.
They are also soon to start testing a drug called remdesivir which was originally developed for Ebola.
Lots of different groups around the world are working on possible COVID-19 vaccines.
"There are now 15 potential vaccine candidates in the pipeline globally using a wide range of technolog[ies]: mRNA, DNA, nanoparticle, synthetic and modified virus-like particles," said microbiologist Ian Henderson of the University of Queensland.
The US National Institutes of Health announced that they have funded phase 1 clinical trials of a potential COVID-19 vaccine, called mRNA-1273, which began this week.
The vaccine was able to be brought to clinical trials so quickly because researchers had already been working on a vaccine to protect against another coronavirus, which causes Middle East respiratory syndrome (MERS).
While results from this first trial may be available within three months, it will still take at least a year and likely longer for a resulting vaccine to be widely available to the public.
Closer to home, last month Queensland researchers were ready to begin testing another potential COVID-19 vaccine on animals, and hope to then start human trials of it by the middle of the year.
But getting to clinical trials, and proving your vaccine is both safe and effective, isn't the only challenge scientists developing these vaccines face.
"The next challenge will be finding enough production capacity globally to produce these competing vaccines, at a scale that millions or even billions of people can be vaccinated," Professor Henderson said.
Which is why we're still hearing it will take at least 12 to 18 months, for a COVID-19 vaccine to be widely available.
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What scientists are working on to find a cure for coronavirus COVID-19 - ABC News
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Seattle volunteers receive world's first experimental COVID-19 vaccine - KOMO News
The first COVID-19 case in the United States was discovered in January. Since then approximately,12,000 tests have been conducted by U.S. public health laboratories. South Korea also announced their first case in January, and theyve conducted nearly250,000 teststo date.
A shortage of testing kits in the U.S. has been well documented, and will eventually be resolved. But patient costs will continue to be front and center. We must prevent high costs from decreasing the availability of testing and treatment. The U.S. Department of Health and Human Services must cover vaccination (once a vaccine is developed and approved), diagnostic testing and treatment without any cost-sharing (i.e. co-payments, co-insurance or deductibles).
As the pandemic explodes across the country, we know that costs are weighing heavily on the minds of many Americans andlegislators.
Americas Health Insurance Plans (AHIP), the chief lobbying organization for private insurers, recently announced that it will work to ensure out-of-pocket costs are not a barrier to people seeking testing for, and treatment of, COVID-19. But this is not enough.
Insurance is complicated and hard to navigate. With complex networks and bills that frequently perplex beneficiaries, many rightlyquestion AHIPs transparency. Meanwhile, President Trump hasnot been clear or accurate: after announcing that insurance companies would waive all co-pays for testing and treatment, the insurance industry pushed back, saying it had not agreed to include treatment.
The recently passed U.S.House bill would make COVID-19 diagnostic testing free for everyone, but it remains to be what will happen with the legislation in the U.S. Senate. A uniform requirement from the federal government is needed to clarify what services are covered, and how expensive they are.
As healthcare providers, we are disheartened that we cannot tell our patients who are literally and figuratively worried sick how much the COVID-19 care they need and deserve will cost.
In the early stages of a local outbreak,Massachusetts-- along with several other states, includingWashingtonandNew York-- issued a bolddirectivefor free diagnostic testing and in some cases treatment. The U.S. government should follow the lead of these states.
A uniform requirement from the federal government is needed to clarify what services are covered, and how expensive they are.
There is precedence for requiring private insurers to cover preventive care (vaccines and screening tests) without cost-sharing. Under the Affordable Care Act (ACA), private insurersmust covervaccines approved by the Centers for Disease Control and Prevention (CDC) without cost-sharing.Diagnostic testing, while not strictly a preventive service, should also fall under the purview of the ACA mandate. Vaccination coverage clearly falls under the current requirement by the ACA. For example, influenza vaccination is covered under this directive.
The eventual COVID-19 vaccine should be treated similarly, and must be added to the CDCs list of covered vaccinations to make this possible.
Vaccinations require herd immunity, a concept in immunology that dictates a critical mass of the society needs to have immunity to prevent community spread of an infectious disease. If the immunization is free at the point of care, Americans willmore readily obtain it.
In the case of a pandemic disease such as COVID-19, diagnosis is preventative care because it encourages better compliance with isolation measures intended to avoid disease spread. Testing could also streamline quarantine and isolation measures if cases are detected earlier.
A federal directive requiring free access to diagnostic tests, treatment and the eventual vaccine will reduce the spread of the virus within communities.
One of the most progressive measures the U.S. government could take, would be waiving all cost-sharing related to COVID-19 care. In the past few years, there has been an increase in high deductible health plans. Many underinsured individuals will facecost-sharing exceeding a thousand dollarsto receive inpatient care.
While no precedent that we are aware of exists, covering all treatment related cost-sharing is morally and financially responsible. Decreasing barriers to care will likely help control community spread and thereby reduce U.S. health system costs overall. Worst-case estimates implyover 20 million Americans could be hospitalized. Unsurprisingly, insurers oppose removing cost-sharing related to COVID-19 treatment. However, it is possible for a compromise to be reached that would waive most elements of cost-sharing such as deductibles for related treatment.
A federal directive requiring free access to diagnostic tests, treatment and the eventual vaccine will reduce the spread of the virus within communities. Federal intervention also provides a regulatory framework to enact faster responses to future public health crises.
Coronavirus is a threat. To thoroughly contain it, we must thoroughly screen for it. And to thoroughly screen for and prevent it, the U.S. government must make allCOVID-19 care free for patients.
Nicole Bustosis a rising fourth-year graduate student at Massachusetts Institute of Technology. Her research examines transmission of respiratory infectious diseases.
Alex Pomerantzis a rising fourth-year medical student at Harvard. He has conducted health care delivery and public health research that has been published locally and nationally.
Aakash Shah M.D. M.B.A. M.Sc.is a practicing emergency room doctor and public health expert who was involved in the care of the first confirmed cases of COVID-19 in New Jersey.
Follow Cognoscenti on Facebook and Twitter.
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The U.S. Should Make COVID-19 Testing, Prevention And Care Free To All - WBUR
On Sunday night, her sons fever spiked, and in the morning he woke with body aches, a sore throat and a bad headache.
The mother, a nurse practitioner in the Birmingham area, told APR on Tuesday that shed spent the morning trying unsuccessfully to get her 10-year-old tested for COVID-19.
She wasnt able to, in part because drive-thru testing at the Church of Highlands Grandview campus closed after hundreds of cars clogged U.S. 280, cutting off access to and from a nearby hospital.
But there are also concerns over a lack of tests and testing supplies in Alabama and across the country, and public health officials cautioned that those without symptoms dont need to be tested, which could overwhelm a system already under strain.
She first called a pediatrician and was told the office couldnt help her.
Theyre seeing patients with fever via telehealth, they will not stop for strep or flu, she said.
She was told to call Urgent Care for Children, which is operating drive-thru COVID-19 testing for people up to 20-years-old, but her son wasnt experiencing a cough at the time, so she was turned down for a test.
She said we have a limited number of tests, which is completely understandable, she said.
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Her son has since developed a cough, so she tried to get him tested at the Church of the Highlands Grandview campus only to find herself stuck in traffic next to others on U.S. 280, who seemed to also be trying to get to the church.
I saw people enjoying conversation and laughing, and I saw a lot of people smoking cigarettes out of their car windows, she said. Theres no way that all these people meet criteria for testing and Ive got a sick kid in my backseat.
By the time she got up to the intersection, police officers were telling drivers that the testing site was closed.
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They didnt say why at the time, but it was very clear to me, looking at Grandview hospital, that this was really compromising access to the hospital, she said.
Attempts Tuesday to reach the church were unsuccessful, but Al.com reports that the church will move the testing to the churchs Grants Mill Road campus and reopen for testing on Wednesday.
She said theyve left a message with Urgent Care for Children and will try there again on Wednesday since hes developed a cough.
So Im hopeful, but if that doesnt pan out, I have no idea, she said.
As a health care provider herself, the nurse said shed like to see more communication to the public about who needs to be tested and who doesnt.
Try to keep people from panicking, but we need more tests, and we need more testing capacity, she said. Its not just the test, its the people who are going to process those tests.
Thats a concern expressed by Dr. Jeanne Marrazzo, head of infectious diseases at the University of Alabama at Birmingham, who told reporters Monday that the state simply doesnt have the staffing and resources to test as quickly and as widely as is needed.
Marrazzo urged the public to seek a test only if they have symptoms, which are fever, shortness of breath and a cough.
Its a message echoed by other state health officials in recent days who have pleaded for the public to first call the states COVID-19 hotline at 1-888-264-2256 before driving to a testing location.
Sen. Doug Jones, D-Alabama, on Tuesday told reporters that were seeing long lines in the drive-thru test center yet people are still having trouble getting a test.
Ive got a friend who sent me a text just a moment ago, whos been trying to get a test for five days. Now shes got symptoms, shes got a fever, shes got respiratory issues, but she cant get a test, Jones said. And that is in part because so many people are willing to get tests that dont really have any symptoms and arent really sick. Im not criticizing. What Im asking people to do is to hold back if you dont have a fever and respiratory issues.
The nurse said she also worries that if theres a panic, asymptomatic people could flood emergency rooms and primary care offices, which would cut off access to care for people like her son, whose fever had come down some Tuesday afternoon.
Hes probably improving, and I hope that will continue, but again, I dont know. I cant be certain of what it is without testing, she said.
After 3 hours on hold with Urgent Care for Children, the nurse said she was able to get her son an appointment to be tested later on Tuesday.
That took far too much effort for someone who even knows how to navigate the healthcare system. I cant imagine what its like for those uninsured, she said.
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Updated: May 25, 2018:
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The FDA Regulatory Landscape for Covid-19 Treatments and Vaccines - JD Supra
GAITHERSBURG, Md. (WDVM) A global life sciences company headquartered in Montgomery County is making headway when it comes to manufacturing products to stop the spread of the coronavirus.
With local facilities in Gaithersburg, D.C., and Baltimore, Emergent BioSolutions has started the development of products to prevent and treat coronavirus.
We are actively funding the advancement of two different technologies, said Sean Kirk, Executive Vice President of Manufacturing and Technical Operations at Emergent.
In a remote briefing with 6th District Congressman David Trone on Tuesday morning, executives from Emergent broke down the biology behind manufacturing therapeutic medications.
Well begin collecting plasma from citizens who have navigated their way through the infection, so they have antibodies in their blood. We can purify those antibodies to create a treatment for folks who are actively sick, Kirk explained.
Theyre also planning to collect and purify antibodies from horses to create a potential treatment.
Developing these products takes time, and theyre partnering with Maryland-based vaccine developer Novavax to bring a COVID-19 vaccine to market.
The team is in active execution of that project, they have a target of June for their clinical trial, said Senior Vice President and head of Contract Development and Manufacturing Organization Syed T. Husain.
Congressman Trone says he hopes to help the companies through the process as much as he can.
Weve got to get all hands on deck, were all part of one team and thats the American peoples health, he said.
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Montgomery Co. life science companies work together on COVID-19 vaccine - WDVM 25
