9/8/20 - smart, useful, science stuff about COVID-19
I’d thought we’d only need weekly issues of this newsletter for a bit, but some vaccine development activity and coverage of the “bradykinin hypothesis” compelled me to update you today. -Robin
VACCINE:
1) Presumably in response to reports of political pushing for approvals this fall, the chief executive officers (CEOs) of 9 pharmaceutical companies released a pledge (dated 9/8/20) to “uphold the integrity of the scientific process as they work towards potential global regulatory filings and approvals of the first COVID-19 vaccines.” The CEOs — including those for AstraZeneca, BioNTech, GlaxoSmithKline, Johnson & Johnson, Merck, Moderna, and Pfizer — assert they will “only submit for approval or emergency use authorization after demonstrating safety and efficacy through a Phase 3 clinical study that is designed and conducted to meet requirements of expert regulatory authorities such as [the U.S. Food and Drug Administration].” In other words, they don’t plan to cut any corners in their research nor to yield to political pressure. Vaccines for any condition often are not big money-makers for pharmaceutical companies. And vaccine “hesitancy” has grown in recent years in the U.S. In this context, any potential problems that could be linked to a coronavirus vaccine (which completed Phase 3 studies defend against by design) might be bad business for drug-makers, not to mention yet another blow to public confidence in all vaccines and a blow specifically to successful SARS-CoV-2 vaccination campaigns and to bringing a close to the pandemic. For more contextualized commentary on what Ed Silverman describes as a“highly unusual turn of events," see his column at STAT (9/7/20): https://www.statnews.com/pharmalot/2020/09/07/pharma-covid-19-vaccine-drew-a-line/.
2) Meanwhile, the U.S. Food and Drug Administration (FDA) has quickly taken measures to block any political influence over ongoing research to develop vaccines to protect us from SARS-CoV-2, report Anna Edney, Drew Armstrong, and Robert Langreth for Bloomberg (9/8/20). One measure reportedly includes the FDA “sticking by" June guidance that the agency will only consider for approval vaccine candidates that are at least 50% effective. A lot of political coverage follows the story’s opening paragraphs. But lower down, the reporters write, “There is no guarantee the vaccines furthest along in development will be the most effective, or be safe.” And it could take “months more” for Phase 3 findings to be conclusive, the story suggests. Still, the story ends with estimates by drugmakers for how soon they might complete their Phase 3 studies (efficacy and safety experiments in thousands of study subjects) of SARS-CoV-2 vaccine candidates. Moderna reportedly says as soon as Thanksgiving, and Pfizer reportedly has been saying next month. I remain reasonably skeptical: https://www.bloomberg.com/news/articles/2020-09-08/will-a-vaccine-be-politicized-fda-sets-up-safeguards.
PUBLIC HEALTH:
3) Some experts doubt that frequent use of fast, cheap, but less-accurate SARS-CoV-2 tests called antigen tests by people at home, at schools, or in other workplaces could enable control of the U.S. epidemic, reports Katherine J. Wu at The New York Times (9/6/20). There is no antigen test yet approved by the U.S. Food and Drug Administration for widespread use, the story states. And no clear data exists yet to support the benefits of such a plan over simply expanding and improving the current system, which depends heavily on slower, more expensive “PCR” tests, Wu writes. And there are debates about whether antigen tests will catch people at their peak of contagion. “We just don’t have any proof that a negative test result means you’re not infectious,” a University of Southern California clinical microbiologist is quoted as saying in the story. PCR tests likely will remain the standard in hospitals and other health care settings, the story states: https://www.nytimes.com/2020/09/06/health/coronavirus-rapid-test.html.
4) Many reports have raised concerns about the confluence this winter in the northern hemisphere of flu season and the ongoing spread of SARS-CoV-2. A 9/2/20 story by Maryn McKenna for Wired includes some details that I haven’t seen elsewhere. First, if the incidence of flu this winter is high, it could overwhelm a health care system already heavily impacted by the new coronavirus and COVID-19. Labs “have to use the same machinery and supplies to analyze diagnostic tests for both COVID-19 and flu,” McKenna writes. A senior scholar at the Johns Hopkins Center for Health Security elaborates: “Coronavirus and influenza are going to compete for the same ER space, the same hospital beds, the same ICU beds, the same ventilators, the same personal protective equipment, the same staff.” And the same lab testing machinery and supplies, McKenna notes. On top of that, many people who got their flu shots at work or school in past years might not have that opportunity this year. Nonetheless, health officials are pushing hard for people to get the flu shot, which is already available or en route to pharmacies and doctors, the story states. “Preventing flu might make the Covid pandemic more manageable, and preventing coronavirus transmission might reduce the occurrence of flu as well,” McKenna writes, noting of course that COVID-19 and the flu are caused by different viruses and require different treatments. Positive signs: a reduced incidence of flu in South Africa’s summer, as McKenna reports, and more broadly in the Southern Hemisphere, reported Nell Greenfieldboyce for NPR (8/26/20): https://www.wired.com/story/flu-season-and-covid-19-are-about-to-collide-now-what/.
5) An undated, recently published ESPN interactive, bylined by Kyle Bonagura, illustrates its analysis and mapping of anonymized cellphone tracking data for three 2019 U.S. college football games. The maps provide a sense of where fans travel to and disperse to after games and thus the regional concentration of potential SARS-CoV-2 (and other infectious disease) spread resulting from the mixing of people before, during and after big match-ups. The piece includes updates on some of the football conferences’ plans and protocols for the 2020 season. The Big Ten and Pac-12 have postponed their seasons, whereas the SEC (Southeastern Conference) seems to be allowing each school to set its own attendance guidelines. I don’t quite follow NCAA (National Collegiate Athletic Association) football designations but some or all of the NCAA teams drew “more than 47.5 million" attendees last season, the piece states. “Even with fewer teams in action and limited-capacity crowds, the prospect that college football could play a role in spreading the coronavirus is too obvious to ignore,” the story states. Thanks to a reader for alerting me to this piece: https://www.espn.com/espn/feature/story/_/id/29608840/mapping-college-football-crowds-covid-risk.
SCIENCE:
6) In a 9/4/20 story for Nature, Heidi Ledford explores what is currently known about the potential for re-infection with SARS-CoV-2, that is, getting infected with the virus more than once. The story focuses on the two verified cases of re-infection — in one case, the patient’s repeat case was milder and in the other, it was more severe, leaving researchers with little clarity yet on the immune system “memory” acquired from an initial infection. Researchers expect more re-infection cases down the line, the story states, which could clarify the question of long-term immunity and “whether the world can rely on the immune system to end the pandemic,” Ledford writes. Factors affecting the severity of a second illness from SARS-CoV-2 could include the amount and variant of the virus to which you're exposed well as how healthy you are. Researchers currently don’t know if the immune response to a second SARS-CoV-2 infection is improved or worsened by an initial infection, the story states. Re-infection is not a barrier to developing a SARS-CoV-2 vaccine, the story states. It could just mean that some of us need a “booster” shot to maintain antibody levels: https://www.nature.com/articles/d41586-020-02506-y.
7) Four readers have alerted me (thank you, readers) to this 9/1/20 essay by Thomas Smith, co-founder and CEO of Gado Images, for Medium’s Elemental about a hypothesis, called the bradykinin hypothesis, for how the new coronavirus affects us. The result of computational biologists' use of a Oak Ridge National Laboratory in Tennessee supercomputer to analyze combinations of 40,000 SARS-CoV-2 genes, the hypothesis “explains many aspects” of the virus, “including some of its most bizarre symptoms,” Smith writes. “It also suggests 10-plus potential treatments.” The findings were published 7/7/20 in the journal eLife. Bradykinin is a chemical that normally helps to regulate blood pressure, Smith writes, but the virus messes with a system that controls the chemical, resulting in a “bradykinin storm — a massive, runaway buildup of bradykinin in the body.” The researchers say that a bradykinin storm, not a cytokine storm, is responsible for the deadly effects of the virus, including leaky blood vessels that can fill the lungs with fluid and immune cells, Smith writes: https://elemental.medium.com/a-supercomputer-analyzed-covid-19-and-an-interesting-new-theory-has-emerged-31cb8eba9d63.
8) Alakananda Dasgupta was on the trail of bradykinin hypothesis days earlier, covering it in more detail for The Scientist (8/26/20). (Hat tip to Montreal-based freelance science writer Roxanne Khamsi for tweeting Dasgupta’s story.) Dasgupta reports that a small study, published 8/13/20 in the medical journal JAMA and led by an infectious disease specialist at the Radboud University Medical Center in the Netherlands, suggested that COVID-19 patients treated with a drug called icatibant showed improvement and needed less supplemental oxygen. The drug targets the system that controls bradykinin: https://www.the-scientist.com/news-opinion/is-a-bradykinin-storm-brewing-in-covid-19--67876.
9) Roxanne Khamsi also tweeted today (9/8/20) that the latest (9/6/20) episode of the podcast This Week in Virology includes a discussion of the bradykinin hypothesis:
MENTAL HEALTH:
10) Check out “To build emotional strength, expand your brain,” by Kerry Hannon at The New York Times (9/2/20). It basically asserts that learning new material, such as a language or craft, that expands your horizons helps you deal with change and crisis, such as the coronavirus pandemic. Near the end, the piece lists some free or low-cost online class sites and some programs that allow nontraditional students to audit classes or work on projects with enrolled graduate and undergraduate students: https://www.nytimes.com/2020/09/02/health/resilience-learning-building-skills.html
ENTERTAINMENT:
11) Octopus:
12) Great blue heron:
13) Cobaltocalcite:
————
BUY ME A CUP OF TEA: For six months now, your generous support, financial and otherwise, has helped me continue to sort through the barrage of pandemic science news and information to make this newsletter for you. Readers say there is nothing like this newsletter elsewhere. Please consider a monthly Patreon contribution, a PayPal donation (to this email’s address) or a Venmo donation (ask me for details) so I can keep this newsletter going through January 1. Thanks to my supporters!
ABOUT THE PUBLISHING INDUSTRY: A lot of online media content is free during the pandemic, as a public service, but publishing, like many industries, is struggling. If you have the means, please subscribe to or purchase worthy publications.
TAG ME: Please reply to this email (or DM me on Twitter) to send feedback and/or good SARS-CoV-2 or COVID-19 science coverage that you’ve read, written, or produced in English, Spanish, French, etc.
RESOURCES, WEEKLY HIGHLIGHTS AT SCIENTIFIC AMERICAN, ARCHIVE TO 3/11/20
Love/In friendship, Robin