Tag Archives: Testing

How sewer science could ease testing pressure and track COVID-19

By Kate Kelland

LONDON (Reuters) – The science of sewage surveillance could be deployed in countries across the world to help monitor the spread of national epidemics of COVID-19 while reducing the need for mass testing, scientists say.

Experts in the field – known as wastewater epidemiology – say that as countries begin to ease pandemic lockdown restrictions, searching sewage for signs of the SARS-CoV-2 coronavirus could help them monitor and respond to flare-ups.

Small early studies conducted by scientific teams in The Netherlands, France, Australia and elsewhere have found signs that the COVID-19-causing virus can be detected in sewage.

“Most people know that you emit lots of this virus through respiratory particles in droplets from the lungs, but what’s less well known is that you actually emit more small virus particles in feces,” said Davey Jones, a professor of environmental science at Britain’s Bangor University.

This suggests that on a wider scale, sewage sampling would be able to estimate the approximate number of people infected in a geographic area without having to test every person.

“Every time a person becomes infected with COVID-19, they start shedding virus into the sewer system,” Jones said. “We’re using that (knowledge) and tracking people’s toilet movements.”

The practice has been used to monitor health threats and viral diseases before.

It’s a crucial tool in the global fight to eradicate polio, and scientists in Britain and elsewhere also use it to monitor antibiotic resistance genes from livestock farming.

“Wastewater epidemiology has been part of monitoring of polio infection across the world, so it’s not completely new,” said Alex Corbishley, a veterinary scientist at the Roslin Institute in Edinburgh who is running a three-month pilot project to track SARS-CoV-2 in wastewater in Scotland. “But it’s never really been applied to an outbreak in this way.”

“The idea here is that you could potentially use this as a relatively cheap, but much more importantly, scaleable, way of saying ‘there’s X amount of transmission’ in a community.”

NOT INFECTIOUS

Scientists conducting initial COVID-19 sewage studies in Europe and Australia stress that what they are picking up is not live, infectious virus, but dead particles or fragments of the virus’s genetic material that are not infectious.

In a pilot trial in Queensland, Australia, scientists were able to detect a gene fragment of SARS-CoV-2 in sewage from two wastewater treatment plants.

In the Netherlands, sewage epidemiologists acted ahead of the COVID-19 outbreak there and took samples from seven cities and a major airport in February and March.

While they found no detectable virus three weeks before the first COVID-19 case was detected, by March 5 – barely a week after the first case was confirmed there – they were able to detect virus fragments.

“The detection of the virus in sewage, even when the COVID-19 prevalence is low, indicates that sewage surveillance could be a sensitive tool to monitor the circulation of the virus,” the researchers wrote in a paper posted online on MedRxiv.

Researchers in Paris posted findings in April that showed how sampling wastewater in the city for a month tracked the same curve of the rising and falling epidemic there.

Few countries have the resources or capacity to test each person individually, with most only able to test healthcare workers or people with symptoms severe enough to mean they need hospitalization. This means authorities have only limited information about how widespread the new coronavirus is or whether it is affecting some communities more than others.

“You can use this type of surveillance as a public health tool,” said Andrew Singer, a researcher at the UK Centre for Ecology and Hydrology who is working with Davey and others on pilot coronavirus sewage testing plans in Britain.

“And the utility of this approach is that it’s so cheap and the investment that you make … will reap rewards, not just for (this) coronavirus pandemic,” but for future outbreaks too.

(Editing by Janet Lawrence)

What you need to know about the coronavirus right now

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

Trade deal in doubt?

U.S. President Donald Trump said he opposed renegotiating the “Phase 1” trade deal on Monday after Chinese-run state newspaper The Global Times reported some government advisers in Beijing were urging fresh talks.

Rising U.S.-China tensions over the coronavirus outbreak have cast the trade deal between the two countries, and proposed talks on a Phase 2 deal, into doubt.

The Global Times said that malicious attacks by the United States have ignited a “tsunami of anger” among Chinese trade insiders after China made compromises in the Phase 1 pact.

Dangerous calculation

WHO officials urged “extreme vigilance” on Monday as countries began to exit from lockdowns, stressing that early studies point to lower-than-expected antibody levels against the COVID-19 disease within the general population, meaning that most people remain susceptible.

Dr Mike Ryan, head of the WHO’s emergencies program warned countries that have “lax measures” in place to be wary of counting on herd immunity to halt the spread of COVID-19, saying: “This is a really dangerous, dangerous calculation.”

Economic boost

Once Australia removes most social distancing restrictions by July, its GDP will rise by $6.5 bln each month, Treasurer Josh Frydenberg was expected to tell lawmakers on Tuesday in a speech updating them on his budget planning.

Britain’s finance minister Rishi Sunak is similarly due to answer questions about the economic response to COVID-19 in parliament on Tuesday afternoon.

There, the focus is how Britain plans to continue the Coronavirus Job Retention Scheme, which is paying employers 80% of the wages of more than 6 million workers who are on temporary leave from businesses affected by the coronavirus. The scheme is due to run until the end of June.

Prime Minister Boris Johnson said on Monday that coronavirus infections had peaked, and that people who could not work from home should return to their workplaces if possible.

Testing 11 million in 10 days

The Chinese city of Wuhan, the epicenter of China’s coronavirus outbreak, plans to conduct nucleic acid testing over a period of 10 days, an internal document seen by Reuters showed and two sources familiar with the situation said, with every district told to submit a detailed testing plan by Tuesday.

The city of 11 million people reported its first cluster of new infections over the weekend after a months-long lockdown was lifted on April 8.

These plans come as the global alarm was sounded on Monday over a potential second wave of coronavirus infections after Germany reported that the reproduction rate of the pathogen had risen above 1.

Canceled Cannes

“It breaks my heart,” said Joseph Morpelli, leading member of the so-called ‘stepladder gang’ of ardent autograph-hunters and amateur paparazzi, as he stood across the street from the venue of the canceled Cannes Festival on Monday.

Usually, a hive of activity, the location where Morpelli and his fellow diehard fans could get a glimpse of celebrities walking down the red carpet is now deserted, as the film festival which was meant to start on Tuesday has been called off.

It was only the third time in its history that the festival has failed to take place. The two previous occasions were the outbreak of World War Two and 1968, when France was roiled by violent protests.

(Compiled by Karishma Singh)

Some White House staff to wear masks after valet tests positive: Trump

WASHINGTON (Reuters) – U.S. President Donald Trump on Friday said certain White House staff members have started wearing face masks, one day after the White House said his personal valet had tested positive for the novel coronavirus.

Trump, asked whether those who serve him food would now cover their faces, told Fox News in an interview that such White House staff would now be covering their faces.

“They’ve already started,” he said on the network’s “Fox and Friends” morning program.

The White House on Thursday said Trump and Vice President Mike Pence tested negative for the virus and were feeling well after the staffer – a U.S. military service member who works at the White House as a valet – came down with the virus. It also said the two leaders would now be tested daily, versus weekly.

Trump has said he would not wear a mask and has not publicly worn a mask to any of his events so far amid the COVID-19 pandemic, but told reporters this week that he tried some on behind the scenes during his visit to a Honeywell face mask factory in Arizona.

He is scheduled to attend a public event at the World War Two memorial later on Friday before meeting with Republican members of Congress at the White House, according to the White House.

The Republican president also told Fox News that he has not yet been tested for antibodies to the novel coronavirus but probably would be soon. Such a test could confirm previous exposure to the virus.

(Reporting by Susan Heavey; additional reporting by Lisa Lambertl editing by Chizu Nomiyama and Jonathan Oatis)

‘Like a science experiment’: A New York family learns the limits of coronavirus tests

By Jonathan Allen

NEW YORK (Reuters) – After a week or so sick in bed in their New York City apartment in March, members of the Johnson-Baruch family were convinced they had been stricken by the novel coronavirus. Subsequent test results left them with more questions than answers.

Tests both for the virus itself and for the antibodies the immune system produces to fight the infection are becoming more widely available, but they are not perfect. The tests can come back with false positives, false negatives or confoundingly ambiguous results. Doctors cannot always offer definitive explanations.

For Maree Johnson-Baruch, her husband, Jason Baruch, and their two teenage daughters, their experience ran the gamut.

They all became sick around the same time with the same symptoms. But each set of tests they subsequently took, whether for antibodies or the virus, came back with conflicting results among family members – some positive some negative. Eventually, after several weeks and additional tests, they were able to confirm that all four had indeed been infected.

“I feel a little bit like a science experiment,” Johnson-Baruch said. “But no one really knows how this virus is behaving.”

Widespread testing is touted by many policymakers and public health experts as a central tool for reopening closed economies and for tamping down any future outbreaks of the virus. But these public health experts have said that the limitations of tests must be factored in, and that there must be time for more research into the degree that antibodies, for example, confer immunity against future infection.

Johnson-Baruch, an actress, began to feel ill shortly after she finished her final performance in the pivotal supporting role of Madame Giry in the Broadway musical “The Phantom of the Opera.” It was a Thursday matinee on March 12, the day New York City began closing non-essential businesses to try to slow the spread of the virus.

Over the weekend she had occasional aches but thought she was just imagining symptoms. By Monday, she had a fever. One by one, her husband and daughters fell sick over the following week. Johnson-Baruch noticed she could not smell the pine-scented disinfectant she was using to clean the family’s apartment.

The family called the New York State Department of Health’s coronavirus hotline. The federal government had botched the rollout of test kits, which then remained scarce – and limited in New York mostly to only those sick enough to require hospitalization. The family followed the advice to recuperate at home and by April everyone felt recovered.

Soon after, Johnson-Baruch read about a new experimental therapy at Manhattan’s Mount Sinai Hospital in which the antibody-rich blood plasma of patients who have recovered from COVID-19, the respiratory disease caused by the virus, is donated to people hospitalized with the illness.

In late April, she and her husband put on face masks and went to the hospital, where healthcare workers decked in protective gear drew blood.

“The strange thing was I tested positive and Jason tested negative,” Johnson-Baruch said.

Such disparities do not surprise Dr. Ania Wajnberg, who oversees Mount Sinai’s antibody testing efforts.

The antibody test developed at Mount Sinai fails to detect antibodies in about 6% of patients who actually have them. The intensity and recentness of the original infection can also affect whether antibodies are detected, Wajnberg said.

“I do think sometimes the results are surprising to people,” Wajnberg said. “And, more than anything, I get tons of questions about what the results mean, and we don’t know exactly what they mean.”

Although antibodies are thought to be likely to provide at least some immunity for some period of time, it remains the subject of study.

“Overall, everyone understands that this is so new and that they are sort of participating in the learning process,” Wajnberg said.

‘WE WERE SURPRISED’

About six weeks after calling the state health department, Johnson-Baruch heard back from an official saying the family could finally get a test for the actual virus that works by looking for distinctive parts of the pathogen’s genetic material, RNA, in a patient’s sample.

“We were well over a month out of our symptoms by that point, so we were surprised to get the call from them sort of out of the blue,” Johnson-Baruch said.

Johnson-Baruch noticed her eldest daughter particularly squirmed when healthcare workers stuck swabs, one by one, deep into the back of their noses.

Once again, the results surprised them. Johnson-Baruch, her husband and their youngest daughter all tested positive. Their eldest daughter tested negative.

What did it mean, the family wondered. Were they still in some sense sick? Could they still infect others?

A health department official who called to relay the results was not much help. “She was quite surprised to hear we were sick six weeks ago,” Johnson-Baruch said.

The tests used by the health department “cannot distinguish between RNA from live or dead virus,” Jonah Bruno, a department spokesman, wrote in an email. “This persistent positive test result can continue long after a person has recovered and does not necessarily indicate that a person continues to be infectious.”

Some 60 different RNA or antibody tests are now available after under emergency use authorization by the U.S. Food and Drug Administration, but the makers of those tests must continue to submit accuracy data to the regulatory agency before final approval is given.

Dr. Danielle Ompad, an epidemiologist at New York University’s School of Global Public Health, said it was challenging to get the general public to accept the limitations of tests.

“People are way more comfortable with ‘yes’ or ‘no’ than ‘maybe,'” Ompad said. “Unfortunately, that’s where the science has us right now: we just don’t know, and it’s much better to say that we don’t know than to try to make predictions without having the data there because that can be detrimental.”

The Johnson-Baruch family members are not quite done with testing. The daughter who had negative virus results has since tested positive for antibodies for the virus after going to a walk-in clinic. Such facilities made testing more widely available this month.

Jason Baruch, a lawyer for Broadway theaters, is also seeking a second antibody test, this time hoping it comes back positive. A positive test would offer some comfort that he may have some level of immunity.

“No one’s really willing to put themselves on the line and say, ‘Hey, you’re home free, you have antibodies,’ or, ‘You’re still contagious,'” Baruch said. “No one really wants to tell us – definitively – anything.”

(Reporting by Jonathan Allen; Additional reporting by Mike Segar and Aleksandra Michalska; Editing by Ross Colvin and Will Dunham)

Texas back in business? Barely, y’all, as malls, restaurants empty

By Brad Brooks

AUSTIN, Texas (Reuters) – The Domain mall in Austin, Texas, is open for business – unlike most of its 100 upscale shops – as the state entered its first work week of eased pandemic restrictions in the hopes of rekindling the economy.

A dozen or so people were strolling about the sprawling open-air shopping center Monday afternoon, with three seated on the patio of a Tex-Mex restaurant. Only one shopper wore a mask, and the loudest noises were from songbirds perched in the live oak trees along the deserted pedestrian thoroughfares.

“I’ve seen one customer today – they didn’t buy anything,” said Taylor Jund, who was keeping watch over an empty Chaser clothing store. “There’s absolutely no one coming around here.”

While protests across the United States demand state governments allow business to reopen and people to get back to work, the vast majority of Americans balk at relaxing stay-at-home orders too quickly, according to Reuters/Ipsos opinion polling.

Texas, Georgia, and other southern states are leading the way in letting stay at home orders expire and gradually allowing people to go about their business. But the early days of the opening in Texas show that many residents might want to stay home anyway.

“The cases of coronavirus aren’t really going down, so I suspect people aren’t comfortable going to malls or getting back to normal life,” David Tamayo said while sitting on a shaded bench with his girlfriend at The Domain, where he said they came to relax outdoors.

Restaurants, retail stores, and malls in Texas are now allowed to open at 25% capacity in most areas. Stores in rural counties with five or fewer cases can operate at 50%. A second phase is planned for May 18 if infection rates decline.

On Monday, Texas reported that it had 884 deaths from COVID-19 and 32,332 cases total, though it has among the lowest per capita testing rate of any state.

PLEXIGLASS BARRIERS

With temperatures in the 90s, Texans flocked to parks, beaches and rivers over the weekend. Beachgoers packed the shore in the resort town of Galveston, though police said most people seemed to be practicing social distancing.

A large gathering of youth at a lake outside Lubbock, in West Texas, prompted authorities to say on Sunday they were closing the beach there back down.

Still, in most spots in the state – which is larger than France – there has been plenty of room for outdoor recreation and social distancing.

Christy Armstrong, who works for a food distribution company, made the rounds with her restaurant clients across the Houston area on Monday. During a stop at Arnaldo Richards’ Picos Mexican restaurant in central Houston, she saw a handful of customers sitting at a bar, separated from one another by Plexiglas barriers.

“It’s sad to know that this is the first Monday we’ve reopened, and a lot of the places are still very empty,” Armstrong said. “I’m a little shocked it’s so dead out.”

But patience, and even closing down again if there are coronavirus flare-ups, should be foremost on business owners’ minds, said Laura Hoffman, president of Austin’s Chamber of Commerce.

She said the most important thing for businesses was to figure out how to safely reopen and for the Chamber to help them do that, sharing lessons learned at places that have stayed open all along, such as grocery stores.

“We have to look at this pandemic as a long-term condition,” she said. “We must strike the balance between keeping people healthy and reopening.”

(Reporting by Brad Brooks in Austin; Additional reporting by Callaghan O’Hare in Houston; Editing by Bill Tarrant and Gerry Doyle)

U.S. civil rights agency says employers can test workers for COVID-19

By Daniel Wiessner

(Reuters) – The U.S. agency that enforces civil rights laws against disability discrimination said on Thursday that companies can test employees for COVID-19 before permitting them to enter the workplace as long as the tests are accurate and reliable.

The Equal Employment Opportunity Commission (EEOC) last month said employers may take workers’ temperatures without violating the the Americans with Disabilities Act (ADA), but Thursday’s guidance appears to authorize a broader array of testing options.

The commission said mandatory medical testing, which is generally prohibited by the ADA, is allowed if it is “job related and consistent with business necessity.”

Applying that standard, the new guidance allows employers to take steps to determine if employees entering the workplace have COVID-19, the illness caused by the novel coronavirus, because the virus poses a “direct threat” to the health of others.

But before implementing testing, employers should review standards from the U.S. Food and Drug Administration and other authorities about which type of testing is considered safe and accurate, the commission said.

And employers who test workers should still require employees to observe infection control practices, such as social distancing and regular handwashing, to prevent transmission of the coronavirus.

The EEOC announcement comes as some states begin to lift shelter-in-place orders and allow businesses to reopen and their employees to return to work.

(Reporting by Daniel Wiessner in Albany, New York; Editing by Aurora Ellis)

Protests highlight growing U.S. unease over coronavirus lockdowns

By Joseph Ax and Doina Chiacu

NEW YORK/WASHINGTON (Reuters) – The U.S. debate intensified on Monday over when to lift restrictions to control the coronavirus outbreak, with protesters gathering in state capitals to demand an end to lockdowns and officials urging caution until more testing becomes available.

Stay-at-home measures, which experts say are essential to slow the spread of the virus, have ground the economy to a virtual standstill and forced more than 22 million people to apply for unemployment benefits in the past month.

Demonstrations have flared in recent days across the country to demand an end to the lockdowns, with more planned on Monday. Thousands gathered outside the capitol building in Lansing, Michigan, last week to protest against Democratic Governor Gretchen Whitmer.

Tim Walters, who was part of a “Reopen Maryland” protest over the weekend in which hundreds of people drove through the state capital Annapolis, said concerns about the virus must be kept in perspective and weighed against the economic toll of lockdowns.

“There is a lot of frustration about who decides what is essential. And people are hurting,” said Walters, a management consultant for a group he estimated had 20,000 members on Facebook. Walters’ group is not associated with another protest planned in Annapolis on Monday.

In Pennsylvania, where Democratic Governor Tom Wolf has promised to veto a Republican-backed bill that would force him to reopen some businesses, a large protest was expected in the state capital Harrisburg.

“Anyone who has been impacted by this shutdown in a negative way is welcome and we want them to be heard regardless of their party affiliation,” said Stephen LaSpina, an organizer of the protest. He added that protesters would be encouraged to stay in their cars and maintain social distancing.

President Donald Trump, a Republican seeking re-election in November, has said state governors should have the final say but has favored an early end to the lockdowns, and many protesters in the past week have sported pro-Trump signs and campaign gear.

Republican lawmakers in several states have also backed the protests.

Joe Buchert, 48, a retired police officer who lives in Pottstown, Pennsylvania, attended the Harrisburg protest because he thinks the governor has overreached.

“The Democratic governors are just trying to kill the economy to hurt Trump,” said Buchert, who was wearing a red Trump 2020 hat.

In Washington, lawmakers in Congress were near an agreement for extra money to help small businesses hurt by the pandemic, a top Republican lawmaker said. The Trump administration sought to add $250 billion to a small-business loan program established last month as part of a $2.3 trillion coronavirus economic relief plan. That fund already has been exhausted.

Click for a GRAPHIC tracking the novel coronavirus in the U.S.

FEARS OF RESURGENCE

Health experts and lawmakers on the front lines of the battle to curb the pandemic have warned that the country could face a second and even deadlier wave of infections if the lockdowns end prematurely.

The United States has by far the world’s largest number of confirmed coronavirus cases, with more than 753,000 infections and over 40,500 deaths, nearly half of them in the state of New York, according to a Reuters tally.

New York Mayor Bill de Blasio said on Monday it could take weeks if not months before the country’s most populous city reopens due to a lack of widespread testing, even as officials elsewhere began rolling back restrictions on daily life.

De Blasio, whose city is at the U.S. epicenter of the coronavirus crisis, said New York needed to be conducting hundreds of thousands of tests a day and to see hospitalizations decline further before reopening the economy.

“The federal government is not stepping up … I think I might be the first person in history to ask Donald Trump to speak up,” De Blasio told a news conference. Earlier, the mayor told MSNBC the virus could boomerang if testing capacity was not ramped up.

De Blasio’s warning on testing echoed comments by several governors over the weekend disputing Trump’s assertions that there were enough tests for COVID-19, the respiratory disease caused by the novel coronavirus.

Trump’s guidelines to reopen the economy recommend a state record 14 days of declining case numbers before gradually lifting restrictions.

Residents in Florida were allowed to return to some beaches after Governor Ron DeSantis approved the relaxing of some restrictions.

Charlie Latham, mayor of Jacksonville Beach, said the beach there was reopened with limited hours, and it went well with no arrests for people violating social distancing rules which barred chairs and blankets.

“We thought that the public was ready to maintain the social distancing standards and to exercise good judgment. And it’s paid off, it’s paid off really well,” Latham told Fox News.

 

(Reporting by Joey Ax, Barbara Goldberg and Jessica Resnick-Ault in New York, Jarrett Renshaw in Harrisburg, Pennsylvania and Nathan Layne in Wilton, Connecticut and Doina Chiacu in Washington; Writing by Paul Simao; Editing by Nick Zieminski and Howard Goller)

U.S. economy will eventually reopen but with big changes: White House’s Kudlow

WASHINGTON (Reuters) – The Trump administration is aiming to reopen the U.S. economy when the nation’s top health experts give the go-ahead, but Americans’ lives will be drastically different, White House economic adviser Larry Kudlow said on Tuesday.

Even when people in the United States return to work and school, they will likely have to stay home when they have signs of sickness, face more widespread and ongoing testing and submit to routine temperature taking, he told Politico in an interview.

“We are aware that things are going to be different,” he said. “That’s going to be a new feature of American life. And I don’t know how quickly that gets up and going, but it’s going to be very, very important because we obviously want to prevent any recurrences.”

It remains unclear when the country, which remains largely shuttered amid the ongoing outbreak that has crushed the economy, will resume more normal operations as a number of states approach their potential peak number of cases amid federal guidelines to isolate until the end of April.

Health officials have called on Americans to brace for a tough week as the death toll rises, but on Tuesday said there were optimistic signs ahead that mitigation efforts were helping to contain the highly contagious and potentially lethal virus.

“It is the health people that are going to drive the medical decisions, here, the medical-related decisions,” Kudlow told Politico, adding that he still believes “that in the next four to eight weeks we will be able to reopen the economy and that the power of the virus will be substantially reduced and we will be able to flatten the curve.”

(Reporting by Susan Heavey and Jeff Mason; Additional reporting by Tim Ahmann; Editing by Chizu Nomiyama and Nick Zieminski)

CVS ramps up drive-through coronavirus testing sites with faster kits

CVS ramps up drive-through coronavirus testing sites with faster kits
By Michael Erman

(Reuters) – CVS Health Corp , called on by the Trump administration last month to help test Americans for infections from the new coronavirus, said it was launching two offsite testing locations with Abbott Laboratories’ faster diagnostic kit and would be able to handle 1,000 tests per day.

Testing for COVID-19, the serious respiratory illness cased by the new coronavirus, has been held back by a lack of test kits and other equipment. While more than 300,000 people in America have tested positive for the new coronavirus, officials believe a shortage of kits has undercounted cases.

Testing, including at drive-through sites like these, is also seen as a key component for U.S. workers and restarting the economy as most states have ordered many non-essential businesses to close.

Executives from Walmart In, Walgreens Boots Alliance Inc  and Target Corp also said in March as part of the government announcement that they would start this testing.

In recent weeks, CVS and Walgreens had said that they each had a pilot site running.

CVS’ two new drive-through COVID-19 testing sites in Georgia and Rhode Island will use the new Abbott tests, which can work in 15 minutes, and that up to four more locations to follow.

“We want to get some experience under our belt with these sites and understand exactly sort of what the volume looks like,” CVS Chief Medical Officer Troy Brennan said in an interview.

Brennan said the company expects to announce a third testing site in a different state on Tuesday and could launch up to three more sites afterward.

Brennan said it was changing the pilot model it had tested – a single-lane drive-through in the parking lot of one of its stores. The new testing sites will be located at Georgia Tech university and the other will be in the parking lot of a casino in Rhode Island.

CVS will supply personnel from its MinuteClinic unit to oversee the testing. The states will provide security and protective equipment.

The testing is currently available at no cost to patients and is being paid for by the federal government, CVS said.

Walgreens said last week on a conference call with analysts that it had a pilot running in Chicago that was doing about 150 tests a day under the direction of the government. Target said in March that because CVS handled the pharmacy operations in its stores, it would partner with them to bring any sites online.

(Reporting by Michael Erman and Caroline Humer; Editing by Nick Zieminski and Alistair Bell)