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Federal scientists advocate for pandemic control as infection declines

While coronavirus deaths tend to fluctuate more than cases and hospital admissions, Dr Walensky said the most recent seven-day average was slightly above average earlier in the week. The seven-day average of the newly reported deaths was 2,165 as of Thursday.

“We at the CDC see this as a very concerning course change,” she said, adding, “I want to be clear: the cases, hospital admissions and deaths – all remain very high and the recent change in pandemic must be taken very seriously. “

Dr Walensky said part of the increase could be attributed to newer variants of the coronavirus that spread more efficiently and quickly. The so-called variant B.1.1.7, which first appeared in Britain, now accounts for around 10% of all cases in the United States, up from 1% to 4% a few weeks ago, has she declared.

The ability of the United States to follow variants is much less robust than that of Great Britain. Even so, data collected by the CDC shows that the number of cases with the variant in the country rose from 76 in 12 states as of January 13 to more than 2,100 in 45 states as of Thursday. But actual infections can be much higher due to insufficient surveillance efforts.

“I know people are tired; they want to get back to life, to normal, ”said Dr Walensky. “But we are not there yet.”

Dr Walensky’s loud, vocal warnings made it clear that in the Biden administration, unlike the Trump administration, the CDC director had a powerful voice. Under President Donald J. Trump, the agency has been virtually silenced after one of its senior officials, Dr Nancy Messonnier, told reporters almost exactly a year ago that the coronavirus would cause serious disruption in American life.

At the same time, administration officials have tried to highlight their efforts to pull the country out of the pandemic, including stepping up the national coronavirus vaccination campaign, acquiring new therapies and training the private sector. in the battle.

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Drug prevents coronavirus infection in nursing homes, manufacturer claims

An unusual experiment to keep staff and residents of nursing homes from being infected with the coronavirus has been successful, drugmaker Eli Lilly said Thursday.

A drug containing monoclonal antibodies – virus fighters grown in the lab – has avoided symptomatic infections in residents exposed to the virus, even the most vulnerable frail elderly, according to preliminary results of a study conducted in partnership with the National Institutes of Health.

The researchers found an 80% reduction in infections among residents who received the drug, compared to those who received a placebo, and a 60% reduction among staff, both statistically very powerful results. said Eli Lilly.

The data has not yet been peer reviewed or published. The company plans to present the results at an upcoming medical meeting and publish them in a peer-reviewed journal, but did not say when.

The study included 965 participants in nursing homes: 666 staff and 299 residents. (The company hoped more residents would participate, but it proved difficult to register them; many suffered from dementia and others were concerned about being given an intravenous drug.)

There were four deaths from Covid-19 among study participants. All of them were residents of the nursing homes who received a placebo, not the drug.

The drug, bamlanivimab, already has Emergency Use Clearance from the Food and Drug Administration which allows Eli Lilly to provide it to symptomatic patients at the onset of their infection.

But this study asked if the drug could stop infections before they started. It was an unusual experience: in trucks equipped with mobile laboratories, medical staff traveled to nursing homes as soon as a single infection was detected. Upon arrival, the workers set up temporary infusion centers to administer the drug.

The research ended this weekend with an emergency meeting of the Security and Data Oversight Council, an independent group monitoring the incoming results. The data was strong and compelling enough to put an end to placebos.

Vaccines against covid19>

Answers to your questions about vaccines

While the exact order of vaccinees can vary by state, most will likely prioritize medical workers and residents of long-term care facilities. If you want to understand how this decision is made, this article will help you.

Life will only return to normal when society as a whole is sufficiently protected against the coronavirus. Once countries authorize a vaccine, they will only be able to immunize a few percent of their citizens at most in the first two months. The unvaccinated majority will always remain vulnerable to infection. A growing number of coronavirus vaccines show strong protection against the disease. But it is also possible for people to spread the virus without even knowing they are infected, as they have only mild symptoms, if any. Scientists do not yet know if the vaccines also block the transmission of the coronavirus. So for now, even vaccinated people will have to wear masks, avoid crowds inside, etc. Once enough people are vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society reach this goal, life may start to move closer to something normal by fall 2021.

Yes, but not forever. The two vaccines that will potentially be authorized this month clearly protect people against Covid-19 disease. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. It remains a possibility. We know that people naturally infected with the coronavirus can spread it without experiencing a cough or other symptoms. Researchers will study this question intensely as the vaccines roll out. In the meantime, even vaccinated people will have to consider themselves as possible spreaders.

The Pfizer and BioNTech vaccine is given by injection into the arm, like other typical vaccines. The injection will be no different from any you received before. Tens of thousands of people have already received the vaccines and none of them have reported serious health problems. But some of them experienced short-lived discomfort, including aches and pains and flu-like symptoms that usually last for a day. People may need to plan a day off or school after the second shot. While these experiences are not pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and building a powerful response that will provide long-lasting immunity.

No. Moderna and Pfizer vaccines use a genetic molecule to stimulate the immune system. This molecule, known as mRNA, is ultimately destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slip inside. The cell uses mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any given time, each of our cells can contain hundreds of thousands of mRNA molecules, which they produce to make their own proteins. Once these proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules made by our cells can only survive for a few minutes. The mRNA in vaccines is designed to resist the enzymes in the cell for a bit longer, so that the cells can produce additional viral proteins and elicit a stronger immune response. But mRNA can only last a few days at most before being destroyed.

“My jaw dropped when I saw the results chart,” said Dr. Myron Cohen, professor of medicine at the University of North Carolina at Chapel Hill and a senior researcher who helped design and implement study.

Although the study is complete, Dr. Daniel Skovronsky, scientific director of Eli Lilly, said the company will continue to rush to nursing homes in its study network when an outbreak is detected. “Everyone will get the medicine,” he says.

Experts who were not part of the study were enthusiastic, but stressed that they had not yet seen full data. “I only see positive aspects here,” said Dr. Ofer Levy, director of the precision vaccination program at Boston Children’s Hospital. “It’s a victory.”

Dr Kathleen Neuzil, director of the Center for Vaccine Development and Global Health at the University of Maryland, was also encouraged.

“The mortality effect is remarkable,” she said, adding that the drug should be used more widely to prevent and treat Covid-19, “especially in populations such as residents of nursing homes, who have high mortality and may have suboptimal responses to vaccines. “

Vaccines, of course, also protect people from infection with the virus, and nursing home staff and residents were among the first priority groups for vaccines. But supplies are insufficient and many nursing home workers frightened by vaccines have refused to obtain them.

And after vaccination, it can take six weeks for the body to produce enough antibodies for maximum protection, said Dr. Srilatha Edupuganti, a vaccine researcher at Emory University in Atlanta and researcher in the study.

Treatment with monoclonal antibodies, she said, can give almost equivalent protection immediately, although it will not last as long as the protection offered by a vaccine.

Eli Lilly plans to approach FDA about emergency use authorization for use of drug to prevent infections in frail elderly populations, especially those in nursing homes or long-care facilities duration, said Dr Skovronsky.

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The future of the coronavirus? Annoying childhood infection

Other experts have said that this scenario is not only plausible but probable.

“I completely agree with the general intellectual construction of the article,” said Shane Crotty, virologist at the La Jolla Institute of Immunology in San Diego.

If the vaccines stop people from spreading the virus, “then it looks a lot more like the measles scenario, where you immunize everyone, including children, and you don’t really see the virus infecting people anymore,” he said. Dr Crotty.

Vaccines are more plausible to prevent disease – but not necessarily infection and transmission, he added. And that means the coronavirus will continue to circulate.

“The vaccines we have now are unlikely to provide sterilizing immunity,” the type needed to prevent infection, said Jennifer Gommerman, an immunologist at the University of Toronto.

Natural infection with the coronavirus produces a strong immune response in the nose and throat. But with current vaccines, Dr Gommerman said, “You don’t get a natural immune response in the upper respiratory tract, you get an injection in your arm.” This increases the likelihood that infections will still occur, even after vaccination.

Ultimately, Dr Lavine’s model is based on the assumption that the new coronavirus is similar to the common cold coronavirus. But that hypothesis may not hold, warned Marc Lipsitch, an epidemiologist at Harvard TH Chan School of Public Health in Boston.

“Other coronavirus infections may or may not be applicable because we haven’t seen what these coronaviruses can do to an elderly, naive person,” said Dr Lipsitch. (Naive refers to an adult whose immune system has not been exposed to the virus.)

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Nasal Spray Prevents Covid Infection In Ferrets, Study Finds

A nasal spray that blocks the absorption of the SARS-CoV-2 virus completely protected ferrets it was tested on, according to a small study published Thursday by an international team of scientists. The study, which was limited to animals and has not yet been peer reviewed, has been evaluated by several health experts at the request of the New York Times.

If the spray, which scientists have described as non-toxic and stable, proves effective in humans, it could provide a new way to fight the pandemic. A daily spritz in the nose would act like a vaccine.

“Having something new that works against the coronavirus is exciting,” said Dr. Arturo Casadevall, president of immunology at the Johns Hopkins Bloomberg School of Public Health, who was not involved in the study. “I could imagine that this is part of the arsenal.”

Work has been underway for months by scientists at Columbia University Medical Center in New York, Erasmus Medical Center in the Netherlands, and Cornell University in Ithaca, New York.The study was funded by the National Institutes of Health and Columbia University Medical Center.

The team would need additional funding to continue clinical trials in humans. Dr Anne Moscona, a pediatrician and microbiologist at Columbia and co-author of the study, said they had applied for a patent on the product, and she hoped Columbia University would approach Operation Warp Speed. From the federal government or big pharmaceutical companies looking for new ways to fight the coronavirus.

The spray directly attacks the virus. It contains a lipopeptide, a particle of cholesterol linked to a chain of amino acids, the building blocks of proteins. This particular lipopeptide exactly matches a stretch of amino acids in the spike protein of the virus, which the pathogen uses to attach to a human airway or to a lung cell.

Before a virus can inject its RNA into a cell, the peak must actually decompress, exposing two chains of amino acids, in order to fuse with the cell wall. As the tip moves up to complete the process, the lipopeptide in the spray inserts itself, hooking onto one of the amino acid chains on the tip and preventing the virus from attaching itself.

“It’s like you close a zipper but put another one inside, so the two sides can’t meet,” said Matteo Porotto, a microbiologist at Columbia University and one of the authors of the article.

The work was described in an article published on the bioRxiv preprint server Thursday morning, and has been submitted to the journal Science for peer review.

Dr Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, said the therapy looked “really promising.”

“What I would like to know now is how easy it is to scale production,” he said.

In the study, the spray was administered to six ferrets, which were then divided into pairs and placed in three cages. Also in each cage were two ferrets who had been given a placebo spray and a ferret who had been deliberately infected with SARS-CoV-2 a day or two earlier.

Ferrets are used by scientists who study influenza, SARS, and other respiratory illnesses because they can pick up viruses through the nose just like humans do, although they also become infected through contact with feces. or by scratching and biting.

After 24 hours together, none of the treated ferrets contracted the disease; all of the ferrets in the placebo group did.

“Replication of the virus has been completely blocked,” the authors wrote.

The protective spray attaches to cells in the nose and lungs and lasts for about 24 hours, said Dr Moscona. “If it works well in humans, you could sleep in a bed with an infected person or be with your infected children and still be safe,” she said.

Amino acids come from a part of the spike protein in coronaviruses that rarely mutates. Scientists tested it against four different variants of the virus, including the well-known ‘Wuhan’ and ‘Italian’ strains, as well as the coronaviruses that cause SARS and MERS.

In cell cultures, it protected completely against all strains of the pandemic virus, fairly well against SARS and partially against MERS.

The lipoprotein can be inexpensively produced as a freeze-dried white powder that does not need refrigeration, said Dr Moscona. A doctor or pharmacist can mix the powder with sugar and water to make a nasal spray.

Other labs have designed antibodies and “mini-proteins” that also block the SARS-CoV-2 virus from entering cells, but these are chemically more complex and may need to be stored at cold temperatures.

Dr Moscona and Dr Porotto have been collaborating on similar “fusion inhibitor” peptides for 15 years, they said on a conference call. They developed it against measles, Nipah, parainfluenza and other viruses.

But these products have garnered little commercial interest, Dr Porotto said, because an effective measles vaccine already exists and because the deadly Nipah virus only occasionally appears in distant places like Bangladesh and Malaysia.

Monoclonal antibodies to the novel coronavirus have been shown to prevent infection and treat it, but they are expensive to make, require refrigeration, and must be injected. Australian scientists have tested a nasal spray against Covid-19 in ferrets, but it works by boosting the immune system, not directly targeting the virus.

Because lipopeptides can be shipped as a dry powder, they could be used even in rural areas of poor countries with no refrigeration, Dr Moscona said.

Dr Moscona, a pediatrician who usually works on parainfluenza and other viruses that infect children, said she was most interested in getting the product to poor countries that may never have access to monoclonal antibodies and vaccines. to mRNA that Americans may soon have. But she has little experience in this area, she says.