Scientists see downsides to top COVID-19 vaccines from Russia, China

By Allison Martell and Julie Steenhuysen

TORONTO/CHICAGO (Reuters) – High-profile COVID-19 vaccines developed in Russia and China share a potential shortcoming: They are based on a common cold virus that many people have been exposed to, potentially limiting their effectiveness, some experts say.

CanSino Biologics’ vaccine, approved for military use in China, is a modified form of adenovirus  type 5, or Ad5. The company is in talks to get emergency approval in several countries before completing large-scale trials, the Wall Street Journal reported last week.

A vaccine developed by Moscow’s Gamaleya Institute, approved in Russia earlier this month despite limited testing, is based on Ad5 and a second less common adenovirus.

“The Ad5 concerns me just because a lot of people have immunity,” said Anna Durbin, a vaccine researcher at Johns Hopkins University. “I’m not sure what their strategy is … maybe it won’t have 70% efficacy. It might have 40% efficacy, and that’s better than nothing, until something else comes along.”

Vaccines are seen as essential to ending the pandemic that has claimed over 845,000 lives worldwide. Gamaleya has said its two-virus approach will address Ad5 immunity issues.

Both developers have years of experience and approved Ebola vaccines based on Ad5. Neither CanSino nor Gamaleya responded to requests for comment.

Researchers have experimented with Ad5-based vaccines against a variety of infections for decades, but none are widely used. They employ harmless viruses as “vectors” to ferry genes from the target virus – in this case the novel coronavirus – into human cells, prompting an immune response to fight the actual virus.

But many people already have antibodies against Ad5, which could cause the immune system to attack the vector instead of responding to the coronavirus, making these vaccines less effective.

Several researchers have chosen alternative adenoviruses or delivery mechanisms. Oxford University and AstraZeneca based their COVID-19 vaccine on a chimpanzee adenovirus, avoiding the Ad5 issue. Johnson & Johnson’s candidate uses Ad26, a comparatively rare strain.

Dr. Zhou Xing, from Canada’s McMaster University, worked with CanSino on its first Ad5-based vaccine, for tuberculosis, in 2011. His team is developing an inhaled Ad5 COVID-19 vaccine, theorizing it could circumvent pre-existing immunity issues.

“The Oxford vaccine candidate has quite an advantage” over the injected CanSino vaccine, he said.

Xing also worries that high doses of the Ad5 vector in the CanSino vaccine could induce fever, fueling vaccine skepticism.

“I think they will get good immunity in people that don’t have antibodies to the vaccine, but a lot of people do,” said Dr. Hildegund Ertl, director of the Wistar Institute Vaccine Center in Philadelphia.

In China and the United States, about 40% of people have high levels of antibodies from prior Ad5 exposure. In Africa, it could be as high as 80%, experts said.

HIV RISK

Some scientists also worry an Ad5-based vaccine could increase chances of contracting HIV.

In a 2004 trial of a Merck & Co Ad5-based HIV vaccine, people with pre-existing immunity became more, not less, susceptible to the virus that causes AIDS.

Researchers, including top U.S. infectious diseases expert Dr. Anthony Fauci, in a 2015 paper, said the side effect was likely unique to HIV vaccines. But they cautioned that HIV incidence should be monitored during and after trials of all Ad5-based vaccines in at-risk populations.

“I would be worried about the use of those vaccines in any country or any population that was at risk of HIV, and I put our country as one of them,” said Dr. Larry Corey, co-leader of the U.S. Coronavirus Vaccine Prevention Network, who was a lead researcher on the Merck trial.

Gamaleya’s vaccine will be administered in two doses: The first based on Ad26, similar to J&J’s candidate, and the second on Ad5.

Alexander Gintsburg, Gamaleya’s director, has said the two-vector approach addresses the immunity issue. Ertl said it might work well enough in individuals who have been exposed to one of the two adenoviruses.

Many experts expressed skepticism about the Russian vaccine after the government declared its intention to give it to high-risk groups in October without data from large pivotal trials.

“Demonstrating safety and efficacy of a vaccine is very important,” said Dr. Dan Barouch, a Harvard vaccine researcher who helped design J&J’s COVID-19 vaccine. Often, he noted, large-scale trials “do not give the result that is expected or required.”

(Additional reporting by Christine Soares in New York, Kate Kelland in London, Polina Ivanova in Moscow and Roxanne Liu in Beijing; Editing by Caroline Humer and Bill Berkrot)

What you need to know about the coronavirus right now

(Reuters) – Here’s what you need to know about the coronavirus right now:

Global records

India reported 78,512 new novel coronavirus infections on Monday, slightly fewer than its record set the previous day when it posted the biggest, single-day tally of infections of any country in the pandemic. On Sunday, India’s total of 78,761 new cases exceeded the previous record of 77,299 in the United States on July 16, a Reuters tally of official data showed.

Despite the surging case numbers, Prime Minister Narendra Modi has been pushing for a return to normalcy to lessen the economic pain of the pandemic, having earlier imposed strict lockdowns of the country’s 1.3 billion people.

U.S. cases of the novel coronavirus surpassed 6 million on Sunday as many states in the Midwest reported increasing infections, according to a Reuters tally. While the United States has the most recorded infections in the world, it ranks tenth based on cases per capita.

More than eight months into the pandemic, the United States continues to struggle with testing. The number of people tested has fallen in recent weeks. Public health officials believe the United States needs to test more frequently to find asymptomatic coronavirus carriers to slow the spread of the COVID-19 disease.

Mutation found in Indonesia

A more infectious mutation of the new coronavirus has been found in Indonesia, the Jakarta-based Eijkman Institute for Molecular Biology said on Sunday, as the Southeast Asian country’s caseload surges.

The “infectious but milder” D614G mutation of the virus has been found in genome sequencing data from samples collected by the institute, deputy director Herawati Sudoyo told Reuters, adding that more study is required to determine whether that was behind the recent rise in cases.

The strain, which the World Health Organization said was identified in February and has been circulating in Europe and the Americas, has also been found in neighboring Singapore and Malaysia.

Vaccine approval and use underway in China

Sinovac Biotech Ltd’s coronavirus vaccine candidate CoronaVac was approved for emergency use as part of a program in China to vaccinate high-risk groups such as medical staff, a person familiar with the matter said.

China National Biotec Group (CNBG), a unit of state-owned pharmaceutical giant China National Pharmaceutical Group (Sinopharm), also said it had obtained emergency use approval for a coronavirus vaccine candidate in social media platform WeChat last Sunday. CNBG, which has two vaccine candidates in phase 3 clinical trials, did not say which of its vaccines had been cleared for emergency use.

China has been giving experimental coronavirus vaccines to high-risk groups since July, though officially it has given little details on which vaccine candidates have been given to high-risk people under the emergency use program and how many people have been vaccinated.

Lighter traffic in Seoul; masks on in Auckland

Private tuition centers shut for the first time and traffic was lighter in South Korea’s capital on Monday, the first working day of tighter social-distancing rules designed to halt a second wave of coronavirus outbreaks.

The decision came after earlier restrictions on movement failed to prevent a second wave of coronavirus infections from erupting at churches, offices, nursing homes and medical facilities.

Meanwhile in Auckland, schools and businesses reopened on Monday after the lifting of a lockdown in New Zealand’s largest city to contain the resurgence of the coronavirus, but face masks were made mandatory on public transport across the country. Prime Minister Jacinda Ardern said she was confident the new measure would be taken up across New Zealand, adding that “a bit of smiling with the eyes behind the mask” and kindness to Aucklanders in particular, would help get the country through the latest outbreak.

(Compiled by Karishma Singh; Editing by Jacqueline Wong)

U.S. coronavirus cases top six million as Midwest, schools face outbreaks

By Lisa Shumaker

(Reuters) – U.S. cases of the novel coronavirus surpassed six million on Sunday as many states in the Midwest reported increasing infections, according to a Reuters tally.

Iowa, North Dakota, South Dakota and Minnesota have recently reported record one-day increases in new cases while Montana and Idaho are seeing record numbers of currently hospitalized COVID-19 patients.

Nationally, metrics on new cases, deaths, hospitalizations and the positivity rates of tests are all declining, but there are emerging hotspots in the Midwest.

Many of the new cases in Iowa are in the counties that are home to the University of Iowa and Iowa State University, which are holding some in-person classes. Colleges and universities around the country have seen outbreaks after students returned to campus, forcing some to switch to online-only learning.

New York Governor Andrew Cuomo on Sunday said his state was sending a “SWAT team” to a State University of New York (SUNY) campus in Oneonta in upstate New York to contain a COVID-19 outbreak. Fall classes, which started last week at the college, were suspended for two weeks after more than 100 people tested positive for the virus, about 3% of the total student and faculty population, SUNY Chancellor Jim Malatras said.

“We have had reports of several large parties of our students at Oneonta last week, and unfortunately because of those larger gatherings, there were several students who were symptomatic of COVID,” Malatras said.

Across the Midwest, infections have also risen after an annual motorcycle rally in Sturgis, South Dakota drew more than 365,000 people from across the country from Aug. 7 to 16. The South Dakota health department said 88 cases have been traced to the rally.

More than eight months into the pandemic, the United States continues to struggle with testing. The number of people tested has fallen in recent weeks.

Many health officials and at least 33 states have rejected the new COVID-19 testing guidance issued by the Trump administration last week that said those exposed to the virus and without symptoms may not need testing.

Public health officials believe the United States needs to test more frequently to find asymptomatic COVID-19 carriers to slow the spread of the disease.

While the United States has the most recorded infections in the world, it ranks tenth based on cases per capita, with Brazil, Peru and Chile having higher rates of infection, according to a Reuters tally.

The United States also has the most deaths in the world at nearly 183,000 and ranks 11th for deaths per capita, exceeded by Sweden, Brazil, Italy, Chile, Spain, the United Kingdom, Belgium and Peru.

(Reporting by Lisa Shumaker in Chicago and Maria Caspani in New York; Editing by Daniel Wallis and Paul Simao)

GSK, partner Vir join race to find COVID-19 antibody treatment

(Reuters) – GlaxoSmithKline and partner Vir Biotechnology have started testing their experimental antibody on early-stage COVID-19 patients, entering the race to find a winner in a promising class of antiviral drugs to combat the pandemic.

The British drugmaker said on Monday the long-acting single injection will be tested on recently diagnosed high-risk cases for its ability to prevent hospitalization, typically a life threatening disease stage.

GSK, which in April moved to invest $250 million in Vir and agreed to collaborate on the antibody, is behind some peers in developing the class.

Regeneron, which is working on antibody manufacturing with Roche, expects initial data from ongoing trials of its COVID-19 two-antibody combination in September.

Eli Lilly, working with biotech firm AbCellera, early this month started testing whether their antibody can prevent the infections in nursing homes. A separate trial testing the compound on recently diagnosed COVID patients may yield initial data in September or shortly after.

“We’re coming into the clinic a little bit later and part of that is because we spent some time selecting what we believe will be a best-in-class antibody,” Vir Chief Executive George Scangos told Reuters.

The antibody is designed to not only block the virus from invading cells but also to recruit immune cells to kill already infected cells, which would otherwise replicate the virus.

It also has been altered to stay effective for several months on a single shot and to cling to a part of the virus’s outer spike protein that has shown no tendency to mutate.

After testing the drug on an initial 20 U.S. participants over two weeks for safety, the trial will expand to 1,300 patients globally.

GSK said initial results could be available by the end of the year, complete results during the first quarter of 2021, and early access to patients could be on the cards before June.

GSK’s more prominent role so far in combating the pandemic has been in providing adjuvants, efficacy boosters that play a vital role in many vaccines.

The global effort to develop a vaccine against the virus, which has so far claimed more than 800,000 lives globally, has seen recent launches of late-stage trials, but work on treatments has also gone into overdrive.

While one approach has been to quell a dangerous overreaction of the immune system, known as cytokine storm, another has been to block the virus from invading cells with antibodies.

Antibodies, part of the body’s adaptive immune system, are normally made by white blood cells in response to a foreign substance in the body.

But pharma companies, also including AstraZeneca and Molecular Partners, are working on manufactured monoclonal antibodies, made in bioreactors from living cells, for a more targeted attack on the virus.

Using plasma from recovered COVID-19 patients, which contains a range of antibodies, is a similar approach but it may be fraught with more complex logistics and less consistent quality than manufactured antibodies.

In future studies, GSK and Vir plan to run more trials on their antibody’s ability to prevent the infection and treat patients that are already in hospital care. Later this year, they plan to start a trial of a second antibody from the collaboration.

(Reporting by Ludwig Burger; editing by David Evans)

Indoor dining to resume in New Jersey this week, governor says

(Reuters) – New Jersey restaurants may open their indoor dining areas to patrons later this week for the first time since the state shut down most of its commerce when the coronavirus pandemic erupted in March, Governor Phil Murphy said on Monday.

The number of diners must be limited to 25% of the restaurant’s capacity and tables must be spaced in accordance with social-distancing rules when indoor dining resumes on Friday, Murphy said.

“Reopening responsibly will help us restore one of our state’s key industries while continuing to make progress against #COVID19,” Murphy wrote on Twitter.

The governor is expected to elaborate later on Monday on the coronavirus status in the state, which has moved incrementally in reopening its economy since May.

New Jersey, the country’s most densely populated state, was among the hardest hit in the months when the coronavirus first spread to the United States. It still has the second-most COVID-19 deaths of any state, with nearly 16,000, and is eighth among total cases with more than 193,000, according to a Reuters tally.

But the state has had much better control of the pandemic in the past several weeks, with a transmission rate that has largely been below 1%.

Across the rest of the country, total coronavirus cases topped 6 million on Sunday as many states in the Midwest reported increasing infections, according to a Reuters tally.

Although the national metrics on new cases, deaths, hospitalizations and positivity rates of tests have been declining, new hot spots have emerged in the Midwest.

Iowa, North Dakota, South Dakota and Minnesota recently reported record one-day increases in new cases, while Montana and Idaho are seeing record numbers of currently hospitalized COVID-19 patients.

(Reporting by Maria Caspani and Peter Szekely; Editing by Chizu Nomiyama and Peter Cooney)

COVID-19 can wipe out health care progress in short order: WHO

By Emma Farge

GENEVA (Reuters) – More than 90% of countries have seen ordinary health services disrupted by the COVID-19 pandemic, with major gains in medical care attained over decades vulnerable to being wiped out in a short period, a World Health Organization survey showed.

The Geneva-based body has frequently warned about other life-saving programs being impacted by the pandemic and has sent countries mitigation advice, but the survey yielded the first WHO data so far on the scale of disruptions.

“The impact of the COVID-19 pandemic on essential health services is a source of great concern,” said a report on the study released on Monday. “Major health gains achieved over the past two decades can be wiped out in a short period of time…”

The survey includes responses from between May and July from more than 100 countries. Among the most affected services were routine immunizations (70%), family planning (68%) and cancer diagnosis and treatment (55%), while emergency services were disturbed in almost a quarter of responding countries.

The Eastern Mediterranean Region, which includes Afghanistan, Syria and Yemen, was most affected followed by the African and Southeast Asian regions, it showed. The Americas was not part of the survey.

Since COVID-19 cases were first identified in December last year, the virus is thought to have killed nearly 850,000 people, the latest Reuters tally showed.

Researchers think that non-COVID deaths have also increased in some places due partly to health service disruptions, although these may be harder to calculate.

The WHO survey said it was “reasonable to anticipate that even a modest disruption in essential health services could lead to an increase in morbidity and mortality from causes other than COVID-19 in the short to medium and long-term.” Further research was needed.

It also warned that the disruptions could be felt even after the pandemic ends. “The impact may be felt beyond the immediate pandemic as, in trying to catch up on services, countries may find that resources are overwhelmed.”

(Reporting by Emma Farge; Editing by Mark Heinrich)

Locked out by COVID, refugees’ lives on hold

By Edward McAllister

DAKAR (Reuters) – When Michelle Alfaro left her office at the United Nations in Geneva on March 13, her job finding homes for the world’s most vulnerable refugees was under control.

Four days later, the new coronavirus had knocked it into chaos. Governments across the world announced border closures, lockdowns and flight cancellations. The United Nations was forced to suspend the program.

“Everything collapsed that week,” said Alfaro, who manages resettlements for the U.N. refugee agency, UNHCR.

Millions of people have been thrown into limbo by the new coronavirus. Those Alfaro works with had been promised escape from war, violence, conflict or persecution. After submitting to a review process that can take years, and winning a chance to make new lives in countries such as the United States and Canada, thousands suddenly learned – often by phone – their flights would no longer take off.

Ubah Mohamed was one of them. A 23-year-old Somalian, she ran away from her husband after he tried to force her to join the Islamist group al Shabaab, militants who would later kill her father. She was due to fly to the United Kingdom on March 24.

“I didn’t know where I was going,” she said of her five-year ordeal as a refugee. “I was just going. I had no control.”

In the first half of 2020, refugee resettlements fell 69% from 2019 levels to just over 10,000, U.N. data show. The program resumed in June, but at a much slower pace.

The pandemic has hit as attitudes to immigrants have been hardening, loosening another thread in increasingly frayed international efforts to maintain global solidarity.

Nationalism, fear of infection, economic worries and ageing voters’ resistance to change are undermining a long-established post-war consensus that people at risk of persecution, abuse or violence deserve to be sheltered.

The British government this month asked the armed forces to help deal with a rise in the number of boats carrying migrants from France. In Greece, the government has rebuffed thousands of migrants from Turkey this year and stiffened patrols to stop refugees arriving by boat. The European Union has pumped billions of dollars into African states in an attempt to stem the flow of migrants to its southern shores.

The United States rehouses the largest share of refugees in the program, which in recent years has accounted for the majority of U.S. refugee intake. Arrivals under the program have more than halved under President Donald Trump, who came to power in 2017 on an anti-immigration platform and is running for re-election promising more of the same. America accepted one-third of the refugees resettled by the United Nations last year, but is cutting its intake.

The United States stopped taking refugees from March 19 until July 29 because of travel restrictions, a State Department spokesperson told Reuters. As a result, the country resettled fewer than 3,000 people under the U.N. program in the first half of 2020, compared with over 21,000 during the whole of last year, the data show.

Even before COVID-19, the United Nations says it struggled to raise funds and find new homes for the 1.4 million people it estimates need immediate help.

“It has been an especially difficult year for refugees,” said Alfaro, the resettlement officer. “Every single resettlement country we have has been affected – no one is left unscathed.”

NO CONTROL

Mohamed, the 23-year-old Somalian, is stranded 2,000 miles south of Geneva in a refugee camp on a sandy plain outside Niger’s capital Niamey. The mother of two, who shelters in a small tent-like structure in the U.N.’s Hamdallaye camp, was told by UNHCR officials just days before leaving that her flight was off.

“I was so excited to go,” she said in a phone interview with Reuters. “I live in a tent. If I can live in a home in a safe place, I will be satisfied.”

Her journey started in 2015, on a bus to the coastal city of Bosaso, after her father told her the safest thing she could do would be to get away from her husband and leave her children behind.

A man offered her a place on a boat across the Gulf of Aden to Yemen – a common route for Somalians seeking refuge from conflict over the decades. By accepting, she unwittingly entered a network of migrant smugglers that would rob, rape and sell her from Yemen to Sudan to Libya.

Just days into her journey, she said she called her father to let him know where she was. Her step-mother answered the phone and told her the militants had killed him for helping her escape.

In southern Libya, a smuggler raped her repeatedly. She miscarried his child in the spring of 2016. He discarded her and she continued north.

Later that year, at a halfway house for migrants in northern Libya, another smuggler beat her when she told him she did not have enough money for her travel.

Crossing the Sahara Desert from Sudan to Libya in an open-back pick-up truck in 2016, sipping water that tasted of petrol, her mind was flooded with thoughts of her children. She thinks they are with family.

“I don’t know where they are,” she said. “I am a mother, and I cannot be with them. All I can do is cry.”

She married a fellow Somalian refugee in northern Libya in 2017. The smugglers’ network funneled them towards Europe. They were separated just before she boarded an overcrowded dinghy which broke down and drifted on the Mediterranean for days.

There, the Libyan Coast Guard picked her up and handed her over to the U.N. refugee agency and she was reunited with her husband at a migrant detention centre a few days later. The U.N. flew them from Tripoli to Niamey and moved them into the camp in March 2019, where the resettlement assessment began.

“I wanted to forget everything I had been through,” she said.

She said she has not received any information about when she will leave for the United Kingdom. It has suspended resettlements indefinitely because of flight restrictions and limits to its own visa application services during the pandemic, a Home Office spokeswoman told Reuters. It wants to be sure that resuming arrivals does not pose a public health risk.

“We are not in a position to resume arrivals in the immediate short term,” she said.

The United Nations said it does not comment on specific cases.

CAJOLING COUNTRIES

Alfaro’s employer, UNHCR, has been resettling refugees since the 1950’s when it found new homes for 170,000 who escaped the Hungarian Revolution. Over the past 25 years, it says it has helped one million people out of the world’s trouble spots including Syria, Iraq, Sudan and Myanmar. Dozens of countries receive refugees under the program.

The UNHCR identifies those most in need through interviews and refers them to a receiving country, which conducts its own assessments. Another U.N. agency, the International Organization for Migration (IOM), makes the travel arrangements.

When COVID-19 hit, receiving countries evacuated embassy staff, so U.N. officials could no longer reach them to help organize departures or process new referrals. Several countries told the United Nations they were suspending all or part of their refugee intake.

Local officials, confined by lockdowns, have been unavailable to stamp exit visas. House-bound U.N. field staff can’t interview applicants. Officials from receiving countries have been unable to reach applicants for face-to-face interviews because of travel restrictions.

In March, Alfaro’s days disappeared on long conference calls and briefings as she tried to persuade governments to keep their borders open to emergency cases, and to accept online interviews for new referrals.

A few hundred critical cases were resettled during the suspension, Alfaro said; some countries have agreed to video interviews. But others, including the United States, still require them to be conducted in person. The United States has taken in refugees at a far slower pace than pre-COVID levels, the State Department spokesperson said: There are still “few or no flights available” from many of the countries who send them.

Staff at the IOM have been scouring airline booking systems for ways to get emergency cases moving, even during the suspension. Flights would appear and then be cancelled.

In all, the agency cancelled 11,000 plane tickets because of the pandemic, said Rana Jaber, its head of resettlements, who worked with refugees in Iraq from 2015 to 2017.

“I felt like I was in Iraq again,” she said. “My lord, my brains were fried.”

SPACES LOST

Because of the slowdown in interviews, global referrals dropped from 40,000 to 20,000 in the first half of the year, the U.N. data show. This means a backlog of tens of thousands of people is building, and there’s a risk these places will be lost indefinitely.

Now refugees are falling victim to COVID-19. In Iraq, Alfaro said the UNHCR is looking after a “significant number” of refugees with urgent medical needs who are unable to be resettled because of travel restrictions. At least two people have died of COVID-19 while awaiting the move.

In Uganda, COVID-19 has spread through slums of the capital Kampala where many who await resettlement are housed in crowded accommodations with no running water or electricity, aid workers said.

The U.N. has resettled about 2,100 refugees since resuming flights – way below the average pace of previous years, said the IOM’s Jaber. Cancellations continue.

“Some are opening up, but not everyone is back online – maybe not until next year,” said Alfaro. “We don’t know how many spaces we’re going to lose.”

There have been bright spots. An Eritrean couple with a young baby were the first refugees to be resettled to Europe since flights were stopped in March, UNHCR said on Twitter on Aug. 14.

Just hours after a vast explosion devastated much of Lebanon’s capital Beirut on Aug. 4, IOM staff were back at work. The ancient city holds hundreds of thousands of refugees who have fled Syria’s civil war.

That night, IOM got 30 of them on a flight out, said IOM’s Jaber. In total, 61 were relocated that week.

“There are challenges still,” she said. “We are back, it is slower, (but) it is working.”

(Reporting By Edward McAllister; Edited by Sara Ledwith)

COVID-19 reinfection detected in U.S. patient; saliva tests endorsed

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.

COVID-19 reinfection seen in U.S. patient

A case of coronavirus reinfection has been documented in a U.S. patient from Reno, Nevada, according to doctors. The 25-year-old man tested positive for the virus in April after showing mild illness and then got sick again in late May, developing more severe COVID-19 symptoms. Doctors and Nevada public health officials said they were able to show through sophisticated testing that the virus associated with each instance of infection represented genetically different strains. Their report, released on Friday, is undergoing peer review by the Lancet medical journal. Last week, three reinfections were reported – one in Hong Kong and two in Europe. Unlike the Nevada case, the second infections in those patients were milder than the first. Reinfection “may represent a rare event,” the Nevada researchers wrote. But, they said, the findings implied that initial exposure to the virus may not result in full immunity for everyone who has been infected by it.

Saliva samples preferable for COVID-19 testing

Letting patients provide saliva samples for COVID-19 tests is easier and safer than swabbing the back of the nose and throat for samples to test, and the results are equally reliable, Yale University researchers said. Writing on Friday in the New England Journal of Medicine, they compared saliva and nasopharyngeal swab samples from 70 U.S. hospitalized COVID-19 patients and 495 asymptomatic healthcare workers, using gold-standard laboratory methods. In both groups, the saliva tests and the nasopharyngeal swab tests showed similar sensitivity for detecting the virus. For healthcare workers, unlike the collection of nasopharyngeal samples, collection of saliva samples by patients does not present a risk of infection and alleviates demands for supplies of swabs and personal protective equipment, the researchers said. In a separate study on Friday in the journal Annals of Internal Medicine, Canadian researchers employed an experimental saliva test kit and found that it might miss some mild or asymptomatic infections. But they agreed with the Yale researchers about the advantages of saliva tests and said they “may be of particular benefit for remote, vulnerable or challenging” patients.

Accuracy of faster COVID-19 tests is unclear

It is hard to know whether so-called point-of-care COVID-19 tests, which provide results in a couple of hours rather than days as some other tests do, are accurate, according to a research review. The authors of the review, published on Wednesday by the Cochrane Library, focused on two types of rapid point-of-care tests: antigen tests, which identify proteins on the virus using disposable devices, and molecular tests, which detect viral genetic material using portable or table-top devices. Altogether, they reviewed 22 studies from around the world that compared point-of-care tests to gold-standard so-called RT-PCR laboratory tests. Three-quarters of the studies did not follow the point-of-care test manufacturers’ instructions, they found. There also was little information about study participants, so it was not possible to tell if the results could be applied to people with no symptoms, mild symptoms or severe symptoms. And studies often were at risk for bias, or did not detail their methods. “The evidence currently is not strong enough and more studies are urgently needed to be able to say if these tests are good enough to be used in practice,” the research team led by Jonathan Deeks of the University of Birmingham in Britain wrote.

New studies add to data on COVID-19 in children

Children are far less likely than adults to get severe cases of COVID-19, British doctors found. At 138 hospitals in Britain, through June, less than 1% of COVID-19 patients were children, and 99% survived. Those who died had serious underlying health conditions. “We can be quite sure that COVID in itself is not causing harm to children on a significant scale,” said Malcolm Semple of the University of Liverpool, co-author of research published on Thursday in BMJ. While children’s risk for severe COVID-19 is low, Black children and obese children experienced higher risks. A separate study published on Monday in the journal JAMA Pediatrics suggests the proportion of U.S. children with asymptomatic COVID-19 may be low. At 28 hospitals, more than 33,000 children were tested during ear, nose and throat appointments or procedures. None were suspected of having the virus. Fewer than 1% were asymptomatically infected. Even without symptoms, infected children can shed virus for weeks, Korean doctors said on Friday in the JAMA Pediatrics.

(Reporting by Nancy Lapid, Kate Kelland and Deena Beasley; Editing by Will Dunham)

Trump willing to sign a $1.3 trillion coronavirus relief bill: Meadows

WASHINGTON (Reuters) – President Donald Trump is willing to sign a $1.3 trillion coronavirus relief bill, a top Trump aide said on Friday, marking a $300 billion increase from an initial $1 trillion offer from the White House and Senate Republicans.

Three weeks to the day after talks on Capitol Hill broke down without a deal on legislation to help Americans suffering from the coronavirus pandemic, White House Chief of Staff Mark Meadows said Trump was “right now willing to sign something at $1.3 trillion.”

But the new White House amount is still $900 billion less than the $2.2 trillion that House of Representatives Speaker Nancy Pelosi has demanded that the Trump administration accept before negotiations can resume.

The $1.3 trillion has been offered in private, Meadows said. Negotiations have involved Pelosi, Meadows, Treasury Secretary Steven Mnuchin and Senate Democratic leader Chuck Schumer.

Meadows and Pelosi spoke by phone for 25 minutes on Thursday without a breakthrough, and afterward the Democrat said the conversation showed that the White House “continues to disregard the needs of the American people.”

Pelosi told reporters that Democrats could not go lower than $2.2 trillion, saying the figure would allow both sides to “meet in the middle.”

(Reporting by Lisa Lambert and David Morgan; editing by Jonathan Oatis)

First U.S. COVID-19 reinfection case identified in Nevada study

By Deena Beasley

(Reuters) – Researchers for the first time have identified someone in the United States who was reinfected with the novel coronavirus, according to a study that has not yet been reviewed by outside experts.

The report, published online, describes a 25-year-old man living in Reno, Nevada, who tested positive for the virus in April after showing mild illness. He got sick again in late May and developed more severe COVID-19, the disease caused by the virus.

Cases of presumed reinfection have cropped up in other parts of the world, but questions have arisen about testing accuracy. Earlier this week, University of Hong Kong researchers reported details of a 33-year-old man who had recovered in April from a severe case of COVID-19 and was diagnosed four months later with a different strain of the virus.

Researchers at the University of Nevada, Reno School of Medicine and the Nevada State Public Health Laboratory said they were able to show through sophisticated testing that the virus associated with each instance of the Reno man’s infection represented genetically different strains.

They emphasized that reinfection with the virus is probably rare, but said the findings imply that initial exposure to the virus may not result in full immunity for everyone.

(Reporting by Deena Beasley; Editing by Dan Grebler)