Tag Archives: Coronavirus

Biden coronavirus advisers nix national U.S. lockdown

By Doina Chiacu

WASHINGTON (Reuters) – The head of Democratic U.S. President-elect Joe Biden’s coronavirus advisory board said on Friday there was no plan to shut the country down and that the new administration’s approach will be targeted at specific areas.

Dr. Vivek Murthy, a former U.S. surgeon general tapped to lead the board, said doctors have learned a lot about how the virus spreads and what steps to reduce risk are effective.

“We’re not in a place where we’re saying shut the whole country down. We got to be more targeted,” Murthy said in an interview with ABC’s “Good Morning America.”

Another member of Biden’s COVID team, Dr. Michael Osterholm, suggested in a Yahoo Finance interview on Wednesday that the country could cover individual companies’ and local governments’ losses for a four- to six-week lockdown to drive numbers down.

Osterholm clarified in an interview with ABC on Thursday that he did not discuss a lockdown with anyone on the advisory board and he did not think there was a national consensus for it. “Nobody’s going to support it,” he said.

Neither Murthy nor Dr. Celine Gounder, another Biden adviser, who appeared on CNN on Friday, embraced the idea of a national lockdown.

“Right now the way we should be thinking about this is more like a series of restrictions that we dial up or down depending on how bad spread is taking place in a specific region,” Murthy said.

Murthy cited New York City as an example where health officials are targeting COVID interventions “down to the ZIP code.”

In his failed campaign for re-election, Republican President Donald Trump warned without evidence that Biden would seek to lock down the country. The Trump administration pushed hard for the country’s economy to reopen. Coronavirus cases spiked over the summer and are increasing again now around the country.

The current rise has been accompanied by increasing hospitalizations and surges in the rate of COVID-19 tests coming back positive. The onset of winter, with people more likely to congregate indoors, will only worsen those trends, experts say.

Chicago’s mayor, Lori Lightfoot, on Thursday issued a monthlong stay-at-home advisory, and Detroit’s public schools called a halt to in-person instruction as more than a dozen U.S. states reported a doubling of new COVID-19 cases in the last two weeks.

Murthy said the Biden team’s priority will be to stop the spread of the virus and focus on hard-hit populations like nursing homes and prisons. Increasing testing capacity will be key to those efforts.

“We still don’t have adequate testing so that anyone who wants a test can get one and get results quickly,” he said.

(Reporting by Doina Chiacu; editing by Jonathan Oatis)

Fauci not advising Biden, sees no reason to quit Trump now: Reuters interview

By Julie Steenhuysen

CHICAGO (Reuters) – Dr. Anthony Fauci, the top U.S. infectious disease expert, said he has had no contact with President-elect Joe Biden’s coronavirus transition team and sees no reason to quit to join that effort when there is so much to do now to fight the surging pandemic.

“I stay in my lane. I’m not a politician. I do public health things,” he said in an interview on Thursday ahead of next week’s Reuters Total Health conference.

Since January, Fauci has served on President Donald Trump’s White House Coronavirus Task Force, a position that has frequently put him at odds with the president, who has sought to downplay the pandemic and focused instead on opening the economy.

“There’s absolutely no reason and no sense at all for me to stop doing something in the middle of a pandemic that is playing a major role in helping us get out of the pandemic,” Fauci said.

His advice for the president-elect, he said, is “exactly the same” as what he is recommending now – social distancing, avoiding crowds, wearing masks, washing hands. “Public health principles don’t change from one month to another or from one administration to another.”

Fauci has served six administrations and came to prominence fighting the AIDS epidemic in the 1980s under President Ronald Reagan.

His “day job” is developing vaccines and therapeutics as director of the National Institute of Allergy and Infectious Diseases, work that is starting to bear fruit.

On Monday, Pfizer Inc and German partner BioNTech SE announced that their experimental coronavirus vaccine was more than 90% effective – significantly higher than most experts had anticipated.

Moderna Inc, a company developing a similar vaccine with support from the White House’s Operation Warp Speed program, is expected to report results from their late-stage vaccine trial in the next week or so.

Both vaccines use messenger RNA (mRNA) technology, an entirely new rapid vaccine platform that uses synthetic genes to trigger an immune response. Older methods typically use some form of inactivated or killed virus particles.

“It was a home run for the Pfizer product, more than 90% – close to 95% – effective. I have every reason to believe that the Moderna product is going to be similar,” Fauci said.

“It’s an almost identical platform to the Pfizer vaccine, so I would not be surprised at all if it was highly effective,” Fauci added.

The next big question about mRNA technology is safety. Fauci took as a good sign the fact that neither the Pfizer trial, which has enrolled more than 43,000 people so far, nor the Moderna trial, which involves 30,000, had to pause to investigate safety issues.

“That’s really good news,” he said. People in both trials will be followed for two years to make sure there are no long-term side effects. Barring that, “I think that the mRNA platform is here to stay,” he predicted.

In spite of the high bar set by the Pfizer vaccine so far, Fauci said he believes there is still “plenty of room for multiple vaccines, even though there may be a modest degree of difference in total efficacy.”

(Reporting by Julie Steenhuysen, Editing by Peter Henderson and Bill Berkrot)

Sewage testing could protect schools, hospitals from COVID-19 outbreaks

By Allison Martell

TORONTO (Reuters) – Early in the pandemic, a few cities and countries around the world began testing sewage for evidence of the coronavirus, hoping to detect rising infections early.

Now some researchers are fine-tuning that strategy by moving upstream to test waste from single hospitals or other buildings, aiming to quickly pinpoint burgeoning COVID-19 outbreaks and stop them with testing and isolation.

While the virus primarily spreads through droplets expelled from the mouth and nose, it can also be shed via human waste.

Testing sewage is cheaper and less invasive than swabbing hundreds of people, and it could be done more frequently. With the virus again surging across much of the world, schools, hospitals and care homes badly need to catch new cases early.

“What we’re trying to do is identify outbreaks before they happen,” said Francis Hassard, a lecturer at Cranfield University, part of a project that started collecting samples at 20 London secondary schools last month.

Hassard’s UK government-funded team will expand sampling to at least 70 schools. The program is a research project, meant to test the approach, and is not yet a full-fledged surveillance system.

In the Canadian province of Alberta, researchers at the University of Calgary have been gathering samples from three local hospitals, including the site of a recent outbreak in which 12 people died.

The team was still refining their methods when that outbreak began. When they went back to test wastewater, they found the amount of coronavirus genetic material rose 580% as the virus spread, said Kevin Frankowski, executive director of Advancing Canadian Wastewater Assets.

“We saw a very significant change,” said Frankowski. “It was really strong proof that this … approach works.”

The project shares data with Alberta Health Services, which runs the province’s hospitals. If levels spike again, they could respond by testing individuals or taking other steps to mitigate spread, depending on the situation, said Frankowski.

In the United States, professional services company GHD set up wastewater testing at a handful of university residences, and recently started advertising the service to long-term care homes, drawing significant interest, said Peter Capponi, a principal at GHD.

CLOSE TO THE SOURCE

So far, most sewage testing has been done at treatment plants. Dutch authorities publish a national statistic, based on samples from all over the country, and French authorities have cited similar data for months. The state of Ohio monitors water at treatment plants across the state.

However, it can take 24-to-36 hours for waste to arrive at a treatment plant, and heavy rain or industrial effluent can dilute samples.

When viral levels rise at a treatment plant, it is not always obvious what should be done. But when virus material suddenly appears in sewage leaving a single building, the path forward is more clear.

At the University of Arizona, for example, sewage from one residence turned positive on August 25. The next day, the university began testing students. Two tested positive and were isolated, heading off what could have been an outbreak, the school said in a release.

With most of these efforts in early stages, it is not yet clear how well the approach will work at scale.

Not every infected person sheds virus in their waste, and there is some disagreement among researchers on how early in the course of COVID-19 that shedding begins on average.

Human behavior can affect data collection. Do enough children use the bathroom at school to generate good data? The virus does not show up in urine, just solid waste.

There are also logistical issues.

“Buildings have multiple discharge points,” said GHD’s Capponi. “Some of them are not accessible. Some may show up on a design drawing, but were not constructed that way.”

Outside the controlled environment of a treatment plant, sewage is less uniform. Sampling equipment can get clogged with toilet paper and other debris, said Hassard.

And a single “grab” sample might miss the virus. The UK project collects throughout the school day.

Higher-tech auto-samplers can collect waste over a longer period, but are in increasingly short supply as more testing programs ramp up.

MilliporeSigma, a unit of Germany’s Merck KGaA, makes the Centricon P-70 filter used on some waste samples.

The company has doubled production, a spokeswoman said, after an “unprecedented surge in demand” from governments hoping to test for the virus.

(Reporting by Allison Martell in Toronto; Edilting by Caroline Humer and Bill Berkrot)

Chicagoans told to stay home, Detroit moves school online as COVID-19 cases surge

By Brendan O’Brien and Maria Caspani

CHICAGO (Reuters) – Chicago issued a stay-at-home advisory and Detroit stopped in-person schooling on Thursday to staunch the coronavirus outbreak as more than a dozen states reported a doubling of new COVID-19 cases in the last two weeks.

Officials in the Midwestern cities along with New York, California, Iowa and other states were re-imposing this week restrictions that had been eased in recent months. The moves were driven by surging infection rates and concern that the onset of winter, when people are more likely to gather indoors, will worsen the trends.

Chicago Mayor Lori Lightfoot on Thursday issued a 30-day advisory calling upon residents to stay at home and have no visitors, even during Thanksgiving festivities. The third- largest city in the United States could see 1,000 more COVID-19 deaths by the end of 2020 if residents do not change behaviors to stop the spread of the virus, Lightfoot said.

Lightfoot set a 10-person limit on gatherings, including indoor and outdoor events, and said travelers from out of the state needed to quarantine for 14 days or submit a negative coronavirus test.

“None of us can keep maintaining the status quo in the face of this very stark reality,” the mayor told reporters, noting the average number of cases have gone from 500 to 1,900 per day over the last month and the city’s positivity rate shot up to 15% from 5%.

Illinois has emerged as the pandemic’s new epicenter in the region as well as across the country. In the past two weeks, the state reported about 130,000 cases, the highest in the country and more than hard-hit Texas and California.

A Reuters tally showed coronavirus cases more than doubling in 13 states in the past two weeks.

In Michigan, the Detroit public school system – the state’s largest – said on Thursday it would suspend of in-person education until Jan. 11, with the infection rate in the city rising rapidly. The district will hold all classes online starting Monday.

New York City Mayor Bill de Blasio said on Thursday that the country’s largest school system was preparing for a possible shutdown but closure might still be averted.

“We’re not there yet, and let’s pray we don’t get there,” de Blasio told reporters. De Blasio has said schools will close if the percentage of city residents testing positive, now at a seven-day average of 2.6%, surpasses 3%.

Total COVID-19 cases across the United States hit an all-time daily high for a second day in a row on Wednesday at 142,279 and crossed the 100,000 mark for an eighth consecutive day, Reuters data showed.

The number of people hospitalized with the virus surged to at least 64,939 by late Wednesday, the highest ever for a single day during the pandemic, increasing by more than 41% in the past two weeks. The death toll rose by 1,464 to a total of 241,809.

Vaccine developers have offered some good news this week, with Pfizer and BioNTech trumpeting successful early data from a large-scale clinical trial of a coronavirus vaccine.

Health experts are hopeful that a vaccine might become available in the coming months for the most vulnerable populations and for healthcare providers.

But with a more lengthy timeline for the general public, many are urging strict adherence to well-known virus mitigation measures like wearing a face covering, washing hands and maintaining a safe social distance.

“We hope that by the time you get into the second quarter, end of April, early May, May-June – somewhere around that time, the ordinary citizen should be able to get it,” Dr. Anthony Fauci, a top U.S. health official, told the ABC “Good Morning America” program on Thursday.

“What we need to do is what we’ve been talking about for some time now but really doubling down on it.”

(Reporting by Maria Caspani in New York and Anurag Maan in Bengaluru and Brendan O’Brien in Chicago, additional reporting by Peter Szekely in New York and Doina Chiacu in Washington; Editing by Howard Goller and Cynthia Osterman)

Explainer – Shot in the dark: Early COVID-19 vaccine efficacy explained

By John Miller

ZURICH (Reuters) – This week has seen a flurry of good news from COVID-19 vaccine developers, with Pfizer Inc. and BioNTech SE trumpeting early data indicating their mRNA candidate is more than 90% effective.

A Russian project came out a day later, touting 92% efficacy for the Sputnik V candidate, named after the Soviet-era satellite, based on a smaller data set.

HOW DO MANUFACTURERS ARRIVE AT EFFICACY NUMBERS?

In Pfizer’s case, it waited until 94 volunteers in its late-stage clinical trial of more than 43,500 people – half got the vaccine, the other half got a placebo – tested positive after developing symptoms.

For 90%-plus efficacy, no more than eight people among those who tested positive had received the vaccine, with the rest having received the placebo.

“Roughly speaking, it’s probably around eight to 86 cases in the treated and placebo groups,” David Spiegelhalter, a Cambridge professor of risk and an expert in statistics, told Reuters.

“You don’t need a lot of fancy statistical analysis to show that this is deeply impressive. It just hits you between the eyes.”

In Russia, Sputnik V-developer Gamaleya Institute reached its preliminary 92% efficacy figure based on 20 illnesses in 16,000 volunteers as its late-stage trial progresses. It aims to reach 40,000 people.

Of the 16,000 people, about quarter got the placebo.

“It suggests that there is some effect, but it’s insufficient to estimate the magnitude of it,” Spiegelhalter said.

HOW MANY PEOPLE MUST GET SICK IN BIG VACCINE TRIALS?

Some experts say that, ideally, 150 to 160 people in a trial of tens of thousands of participants must get sick before making a reliable assessment of a vaccine’s efficacy. That’s a bit of a rule of thumb, though, open to interpretation.

“There is no such regulatory standard requiring X number of events for making a reliable decision,” the government-funded Swiss Clinical Trial Organization said. “The amount of (infections) has to be seen in relation to the disease and its risk profile. It’s rather a case-by-case evaluation.”

Typically, regulators strive to have at least 95% certainty that the trial read-out is not the result of random variations with nothing to do with the tested compound.

For trial sponsors there is safety in numbers as a large enough trial can ensure that 95% reliability hurdle is cleared. But the larger the underlying clinical benefit, the fewer trial participants needed to create that clarity.

In Pfizer and BioNTech’s trial, they planned a final analysis when 164 people had become sick, with multiple, pre-planned interim analyses along the way. They skipped an analysis at 32 patients, and once they were ready to release a look at the 62-person mark, 94 had come down sick.

Details from the Russian trial are unclear, without access to its protocol.

HOW DO THESE RESULTS STACK UP TO OTHER DRUGS, OR VACCINES FOR OTHER ILLNESSES?

In normal drug trials, for diseases like terminal cancer, benefits of new medicines may be less apparent, with survival benefits of just a few months sometimes revolutionary for patients at death’s door.

For vaccines, however, marginal protection is inadequate, and the World Health Organization ideally wants to see at least 70% efficacy in trials, while the U.S. Food and Drug Administration wants at least 50%.

The 90% efficacy reported in the Pfizer and Russian trials beats those, and appears to exceed that of typical flu vaccines, which the U.S. Centers for Disease Control and Prevention (CDC) estimate reduce the risk of sickness by 40%-60%.

For other shots, the CDC estimates the efficacy of a two-shot measles vaccine at 97%, and a two-dose chicken pox vaccine at 90%. Two doses of polio vaccine are 90% effective, rising to nearly 100% with a third.

CAN WE EXPECT EFFICACY RATES TO HOLD UP AS TRIALS ADVANCE?

Pfizer acknowledged on Monday that its final vaccine efficacy percentage may vary. Still, Spiegelhalter said the study’s design seems likely to generally hold up, based on the 94 sick participants.

“In this case, the effect is so huge, even if there is a little bit of fallback – if the effects become slightly smaller over time – that is very unlikely to be significant.”

WHAT ABOUT REAL-WORLD EFFICACY, SHOULD THE VACCINES BE APPROVED?

The interim data is promising, since it appears to demonstrate that a vaccine can be effective in preventing COVID-19.

The jump to mass vaccinations, however, presents new hurdles, in particular for an mRNA vaccine like Pfizer and BioNTech’s that must be stored and shipped at minus 70 degrees Celsius (-94°F).

Moreover, the Pfizer-BioNTech vaccine requires two doses, ideally 21 days apart. If people do not stick to the timetable, it may affect the vaccine’s efficacy.

Protection against the mumps, for instance, drops from nearly 90% to 78%, if people don’t get a follow-up shot.

Swiss epidemiologist Marcel Tanner, president of Switzerland’s Academies of Arts and Sciences and one of the government’s top COVID-19 science advisers, expects possible variations in efficacy among older people, whose immune systems wane with time, or those with immune disorders.

“Efficacy says, ‘Does it work?’ Effectiveness says, ‘Can it be applied? Can you carry the efficacy to the people?'” Tanner said. “But no question: 90% efficacy, at that stage, is a pretty good result.”

(Reporting by John Miller in Zurich, Kate Kelland in London, Ankur Banerjee in Bengaluru, Julie Steenhuysen in Chicago and Polina Ivanova in Moscow; Editing by Josephine Mason and Nick Macfie)

Migrant smugglers see boost from U.S. pandemic border policy

By Laura Gottesdiener and Sarah Kinosian

MONTERREY, Mexico (Reuters) – These days, Martin Salgado’s migrant shelter in the city of San Luis Rio Colorado on Mexico’s border with the United States feels more like an hourly hotel. His guests, many of them from Central America, often don’t even bother to spend the night.

Salgado said he has never seen people cycle through as repeatedly as he has in recent months, after the United States began expelling almost all migrants caught on the Mexican border rather than returning them to their homelands. Now, human smugglers often attempt to get migrants back across the border the very same day they are deported, he said.

Previously, Central American migrants apprehended at the border would be processed in the U.S. immigration system and would often be held for weeks, if not months, before being deported back to their home country.

“We never saw this before,” said Salgado, who runs the shelter near Arizona’s western limits founded by his mother in the 1990’s. Some Central Americans who arrive at the shelter after being deported “eat, bathe, and suddenly they disappear.”

U.S. President Donald Trump’s administration in March announced that it would begin to quickly expel nearly all migrants caught at the border under the authority of an existing federal public health act, known as Title 42, saying the move was necessary to prevent coronavirus spreading into the United States.

But the order appears to be having unintended effects.

It’s led to an increase in repeated border crossing attempts, data from U.S. Customs and Border Protection shows. And it’s benefiting the illegal networks that move people from Central America to the United States, according to interviews with more than a dozen migration experts, shelter directors, immigrant advocates and human smugglers.

That is because U.S. authorities are depositing the migrants on the border, rather than returning them home, which allows smugglers to eliminate some of the costs of repeat border crossings, said three smugglers working with transnational networks. The price migrants pay smugglers, which can be $7,000, or double that, often includes two or three attempted border crossings to offset the risks of being intercepted by Mexican or U.S. authorities, according to the three smugglers, as well as migration experts.

Not all migrants travel with smugglers, but even those braving the dangerous journey alone or in small groups often turn to coyotes at the border for the final stretch of the journey. Since they too are now being returned at the Mexican border when caught they now often pay for a second or third try, in another boon for the smuggling networks, said migrant experts and a guide tied to a smuggling network in the Sonora region.

U.S. border officials say the program, which has resulted in migrants being returned in an average of less than two hours, is crucial for protecting U.S. agents, health care workers and the general public from COVID-19 by avoiding the potential spread of coronavirus if migrants were apprehended, processed, and then sent to U.S. detention centers, as per previous policy.

“It would take just a small number of individuals with COVID-19 to infect a large number of detainees and CBP personnel and potentially overwhelm local healthcare systems along the border,” the U.S. Customs and Border Protection (CBP) said in a statement.

Joe Biden clinched the U.S. presidency following the Nov. 3 election, though Trump has not acknowledged defeat and has launched an array of lawsuits to press claims of election fraud for which he has produced no evidence. The president elect has not laid out specific plans about the Title 42 program. A senior advisor to the Biden campaign in August told Reuters that Biden would look to public health officials for guidance on pandemic-related border closures.

“MAKING MORE MONEY”

Seeking safe passage on the perilous trek north, migrants often pay thousands of dollars to smugglers – known as ‘coyotes’ – linked to gangs that control territory in Mexico.

The three men who identified themselves as smugglers from different transnational networks told Reuters they save about $1,000 or more each time U.S. Border Patrol expels one of their Central American clients at the Mexican border rather than returning them back by plane to their home countries.

“It’s great for us,” said Antonio, a Salvadoran smuggler who is part of a network that he said charges migrants $14,000 a head for three runs at getting from Central America to the United States.

Antonio, like the others involved in the smuggling trade that Reuters interviewed, declined to give his last name.

He said his network spends at least $800 per migrant paying off drug cartels for the right to transit through their turf, then there are additional costs such as food, shelter, transportation, and occasional bribes to Mexican authorities.

In the past, when Central American migrants were caught by U.S. Border Patrol and sent home, his network would have to pick up that tab again on migrants’ second or third attempts.

Mexico’s immigration agency in August vowed to “eradicate the collusion between public servants and human smugglers” as it ousted hundreds of officials for work-related offenses.

Pablo, a Guatemalan who ferries migrants across Guatemala’s border into Mexico, estimated that the network he works for saves at least $1,300 for every Central American who is returned at the U.S. border rather than sent back to their homeland.

“We’re making more money because we don’t have to pay the mafia again in Mexico,” he said. “So, there’s an advantage.”

REPEATED ATTEMPTS

Migration numbers are returning to pre-pandemic levels, following steep declines this spring after Central American countries slammed their borders shut in an effort to halt the spread of coronavirus. The U.S. Customs and Border Protection agency said it conducted nearly 55,000 expulsions and apprehensions of migrants at the southwest border in September. That is more than triple the figure for April and is slightly higher than the 40,507 a year earlier, according to CBP data.

And, apprehensions and expulsions continued to climb in October, said a U.S. official with knowledge of the numbers.

Still, migration numbers for the 12-month period ended in September were down from the previous year. The Title 42 order does not change deportation policy for Mexicans, who made up about two thirds of people expelled by the United States during August and September, according to the CBP. Hondurans, Guatemalans, and Salvadorans account for the next three largest groups.

Meanwhile, the number of repeated attempts has sharply increased, indicating that fewer people are migrating than last year but more of those who are trying to cross the border multiple times.

Between April and September, the proportion of people caught crossing the border more than once surged to 37%, up from 7% for the 12-month period ended in September 2019, according to the CBP.

The president of the Border Patrol union in Laredo Texas, border agent Hector Garza, said the Title 42 order was helping limit the exposure of the border workforce to COVID-19 and avoid overwhelming local hospitals in communities in Texas, which are already experiencing a surge of coronavirus cases.

“But with any benefit there is a downside, and in this case, we’re seeing people coming back and forth, trying to cross multiple times within a 24-hour period,” he told Reuters.

In the border city of Ciudad Juarez on Oct. 31, across from the Texas city of El Paso, Cuban Alexander Garcia stood by the port of entry to the United States. Garcia, who identified himself as a doctor, said he had just been deported after his sixth attempt at crossing the border without authorization.

“They’re returning us in less than three hours!” exclaimed García. “We cross, and they just grab us and push us back into Juarez.”

U.S. Border Patrol Chief Rodney Scott, during a news conference last month, said the pandemic had reduced the ability and willingness of authorities to prosecute because detaining people potentially involved additional risk of spreading COVID-19 in the United States.

“IT MOTIVATES YOU”

About 125 miles east of Salgado’s shelter, Jesus, a guide linked to a local smuggling network, and his Guatemalan girlfriend, Yolanda, have been biding their time in a chilly trailer serving as a migrant stash house along the Mexican border.

They said nearby clashes between rival gangs have delayed Yolanda’s departure across the Sonoran desert into the United States.

But Jesus said he’s heartened by the new U.S. policy – and so are the town’s smugglers that he’s worked for over the years.

“It’s better because if people get caught, they come right back,” he said. “So it’s like, we’re still in business.”

Yolanda was also encouraged when, upon reaching the border, she found out that if she was caught, she would only be sent to Mexico, rather than likely being deported back home.

“It motivates you,” she said, explaining that she left Guatemala after she was forced to close her clothing shop when pandemic restrictions crippled the economy.

She racked up debts, fell behind on her mortgage, and lost her home, she said, joining a small but growing number of Central Americans fleeing the economic crisis triggered by pandemic-related restrictions across the region.

While Title 42 has encouraged some people to risk the crossing after being turned back, some human rights organizations say it erodes migrants’ rights because they are being rapidly returned to Mexico before having an opportunity to explain why they fled their countries or to present a case for why they would qualify for asylum under U.S. law.

CBP said in a statement the agency “remains committed to our obligations to provide safe haven to those who claim persecution.”

(Reporting by Laura Gottesdiener in Monterrey, Sarah Kinosian in Caracas, and Lizbeth Diaz in Mexico City; Additional reporting by Jose Luis Gonzalez in Ciudad Juarez; Editing by Dave Graham, Frank Jack Daniel and Cassell Bryan-Low)

U.S. airlines caution on winter challenges as COVID-19 cases rise

(Reuters) – Delta Air Lines and Southwest Airlines on Thursday cautioned that the recent surge in COVID-19 cases may have a negative impact on travel over the winter holidays, a period the sector had hoped would see improved bookings.

The United States on Wednesday reported new COVID-19 infections reached an all-time daily high for a second day in a row and the number of people hospitalized also surged to the highest ever during the pandemic.

“With the U.S. hitting a grim milestone of 10 million positive cases and outbreaks in Europe and other parts of the world, all signs point to a challenging winter ahead,” Delta Chief Executive Ed Bastian said in a memo to employees on Thursday.

Earlier, low-cost carrier Southwest said an improvement in revenues in the past few months was losing steam in recent weeks, prompting caution about December trends.

“While the company expected the election to impact trends, it is unclear whether the softness in booking trends is also a direct result of the recent rise in COVID-19 cases,” Southwest said.

“As such, the company remains cautious in this uncertain revenue environment.”

The COVID-19 pandemic brought travel to a near halt earlier in the year, forcing airlines to scale back operations and seek government aid.

(Reporting by Tracy Rucinski; Editing by Sonya Hepinstall)

Fauci stresses on need for equitable access of COVID-19 vaccines

(Reuters) – U.S. infectious disease expert Anthony Fauci said on Thursday vaccine developers should push to make billions of their COVID-19 vaccines to ensure access to all parts of the world, instead of focusing on the rich countries.

Fauci’s comments come days after Pfizer Inc said its COVID-19 vaccine candidate was more than 90% effective based on initial results from a large-scale trial, securing a lead in the race to develop a safe and effective vaccine for the respiratory illness.

Pfizer has a $1.95 billion contract with the U.S. government to deliver 100 million vaccine doses beginning this year, as well as a deal with the European Union to supply up to 300 million doses.

“Now a number of different companies are talking about the ability to make billions of doses. That’s what we need. We don’t need hundreds of millions for the rich countries,” Fauci said at a webinar conducted by British think tank Chatham House.

“We need billions (of vaccine doses), so whether you live in the darkest part of the developing world, or if you live in London, you should have the same access.”

Experts have also raised doubts about access to the vaccine, especially in the developing countries, as it needs to be stored at temperatures of minus 70 degrees Celsius (-94 F) or below, posing infrastructure challenges.

“Certainly it is not going to be pandemic for a lot longer, because I believe the vaccines are going to turn that around,” Fauci said, while adding that there may be a need to re-vaccinate people intermittently, if COVID-19 becomes endemic.

Fauci said efforts were underway in the United States to push for the development of antivirals and other therapies for early intervention during the course of the COVID-19 respiratory illness.

(Reporting by Manojna Maddipatla in Bengaluru; Editing by Shounak Dasgupta)

Moderna could begin analyzing COVID-19 vaccine data within days, says Fauci

By Manas Mishra and Dania Nadeem

(Reuters) – Moderna Inc. could have data from a large trial of its experimental COVID-19 vaccine anywhere between “a couple of days” to “a little more than a week”, the top U.S. infectious disease expert said on Wednesday.

A high degree of effectiveness for the vaccine would make sense as it was “almost identical” to the Pfizer shot, Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said at a conference organized by the Financial Times.

“It may not be 95%, it might be 90%, or 96%, or 89%, but it is going to be up there,” he said.

Hopes of the world soon getting an effective vaccine against the virus that has killed over a million people were raised on Monday after Pfizer Inc. said its COVID-19 vaccine was more than 90% effective based on interim trial results.

Moderna, which uses a technology similar to Pfizer’s, said earlier on Wednesday that its November timeline for initial data was on track.

It did not immediately respond to a Reuters request for comment on when it would disclose the data, though the company has said it would publish the data as soon as it is available.

The company would still have to wait for two-month follow up data on safety, which is expected in the second half of this month, before applying for U.S. emergency use authorization.

Earlier in the day, Chief Executive Officer Stephane Bancel said at a Credit Suisse conference the world would have to wait for more data to understand whether the use of a particular vaccine would be more widespread.

There are no vaccines that have gained global approval yet, although a handful, including Moderna’s, are in late-stage studies.

Moderna’s shares were up roughly 7% at $81.25 in afternoon trading.

(Reporting by Manojna Maddipatla, Manas Mishra and Dania Nadeem in Bengaluru; Editing by Saumyadeb Chakrabarty and Sriraj Kalluvila)

Riskier blood thinner used more often in Black patients; psychiatric issues linked to COVID-19

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Use of riskier blood thinner seen in Blacks with COVID-19

A new analysis of the use of blood thinners in hospitalized COVID-19 patients highlights a striking racial disparity that may help further explain why Black patients are hit harder by the disease. The anticoagulant enoxaparin – sold under the brand name Lovenox – which is associated with superior COVID-19 outcomes, is more likely to be given to Caucasian patients. Unfractionated heparin, an alternative drug associated with more complications, is more likely to be given to Black patients, according to data from over 25,000 hospitalized COVID-19 patients in the international Discovery VIRUS registry. Treatment with unfractionated heparin was tied to more kidney injuries, heart injuries, life threatening blood infections, and anemia. Black patients were 28% more likely than Caucasians to receive heparin, the analysis found. Mortality rates were 41% in patients who got unfractionated heparin and 15% in patients administered enoxaparin, researchers reported on Tuesday on medRxiv ahead of peer review. Despite the availability of generic enoxaparin, it still remains more expensive than heparin, said coauthor Venky Soundararajan of nference, a Massachusetts data analytics company. As the study cannot prove causality, Soundararajan’s team calls for rigorous research to elucidate the socioeconomic, racial, or other disparities that underlie their findings.

Recovering COVID-19 patients face mental health risks

Compared to patients recovering from other medical conditions, COVID-19 survivors are at greater risk of developing mental health problems, most commonly anxiety, depression and insomnia, psychiatrists reported on Monday. The estimated incidence of a first psychiatric diagnosis within 90 days was 5.8% among COVID-19 survivors, compared to 2.8% in a comparison group of flu survivors, 3.2% in patients recovering from gallstones, and 2.5% in patients who had suffered fractures. The study, published in The Lancet Psychiatry, included more than 62,000 U.S. COVID-19 patients, about two-thirds of whom had never been diagnosed with a psychiatric illness. Mental health specialists not directly involved with the study said the findings add to growing evidence that COVID-19 can affect the brain and mind, increasing the risk of a range of psychiatric illnesses. “This is likely due to a combination of the psychological stressors associated with this particular pandemic and the physical effects of the illness,” said Michael Bloomfield, a consultant psychiatrist at University College London.

Prone positioning might help more COVID-19 patients

Prone positioning, or lying face down, might be useful for severely ill COVID-19 patients who can still breathe on their own, early data suggest. Lying face down makes it easier for the lungs to deliver oxygen to the blood. The position is often used in COVID-19 patients on mechanical ventilators, but it is not without risks. Until the pandemic, it was not used in patients who were not intubated, even if they had low oxygen levels. In a report on Wednesday in CMAJ, researchers say evidence is emerging that hospitalized COVID-19 patients who are awake and breathing on their own might benefit. Their review of published data found that studies so far have been small, and randomized trials are needed to clarify the benefits and risks in COVID-19 patients, they advise. Earlier this year, Dr. Sanja Jelic of Columbia University Medical Center told Reuters she would not recommend prone positioning at home. “Lay people may not be able to assess accurately whether somebody has altered mental status or is too weak for this maneuver,” she said. “Patients need to have intact mental status and be able to turn themselves in bed without assistance. Being in prone position while confused or lethargic may increase the risk for aspiration and possibly worsen already low oxygen levels.”

(Reporting by Nancy Lapid and Kate Kelland; Editing by Bill Berkrot)