Category Archives: Molecular Medicine

Premier League players who have suffered COVID-19 symptoms will undergo additional testing for potential lung and heart problems as part of the return-to-play protocol.

Top-flight teams will discuss on Friday the detailed proposals to allow a phased return to small group sessions and then normal squad training before a proposed June restart.

The new rules include players needing to wear face masks or snoods in training and all footballs to be disinfected.

But before this Training Return Date, all clubs must undertake a risk assessment of every player for potential respiratory and/or cardiac complications associated with COVID-19.

For players who are suspected or confirmed sufferers, the preferred testing will see doctors in PPE carrying out blood tests and ECG (electrocardiogram) scans.

The protocol states: All exercise will be stopped until blood results have returned to normal, which may take weeks or months as ongoing elevated blood results may indicate ongoing inflammation and as such risk of sudden arrhythmic death.

Ian Hall, Professor of Molecular Medicine at Nottingham University, said: Groups of individuals, including footballers, who have had COVID19 will include many who had disease which was very mild, with minimal symptoms, and a small number who had more severe disease, potentially resulting in a hospital admission with viral pneumonia.

In general, disease has been more severe in patients who are elderly and have other medical conditions such as high blood pressure, heart disease or chronic lung disease.

"One would therefore expect most premier league footballers who had COVID19 to have had mild forms of the disease.

"I would predict most footballers will not have long term complications if they have had COVID19, but there may be a small number who have some reduction in physical fitness due to having had more severe disease.

"So monitoring simple indicators such as lung function and cardiac function would make sense.

Premier league footballers obviously require high levels of overall fitness, so even a small reduction in lung or heart function could have significant effects on performance.

All players and staff will have to undergo COVID-19 tests at the Premier League's expense within 48 hours of returning to group sessions at the training ground.

Any positive tests will see individuals isolated for seven days before a re-test.

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Premier League stars with coronavirus symptoms to have lung and heart tests before return - Mirror Online

OXFORD, England & BURLINGTON, Mass.--(BUSINESS WIRE)-- Blue Earth Diagnostics, a Bracco company focused on molecular imaging diagnostics, today announced that its CEO, Dr Jonathan Allis, has been appointed as Chair of the UK Rapid Testing Consortium (UK-RTC) for COVID-19 by the UK Department of Health and Social Care (DHSC). The UK-RTC has been formed to draw upon the expertise and resources of the UKs life sciences industries in a combined effort to design and develop a home use antibody test to determine whether people have developed antibodies (and perhaps, potential immunity) after contracting and recovering from COVID-19. It combines the science of Oxford University with the development and manufacturing skills of four UK diagnostic companies: Abingdon Health in England, BBI Solutions in Wales, Omega Diagnostics in Scotland and CIGA Healthcare in Northern Ireland. In his role as Chair of the UK-RTC, Dr Allis will serve as an independent liaison between the participating diagnostic companies and the government. The part-time engagement is of a limited duration, during which time Dr Allis will retain his responsibilities as CEO of Blue Earth Diagnostics. The UK-RTC Chair is independent of the diagnostic companies involved, and Blue Earth Diagnostics is not otherwise engaged in this initiative.

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Jonathan Allis, CEO of Blue Earth Diagnostics (Photo: Business Wire)

When the DHSC invited me to chair a consortium to develop a COVID-19 antibody test based on new technology developed at Oxford University, and in light of the urgency of the COVID-19 health crisis worldwide, I felt it was my absolute duty to say yes, said Jonathan Allis, D. Phil, CEO of Blue Earth Diagnostics. Testing for the presence of the SARS-CoV-2 virus (antigen testing) and immune response after COVID-19 (antibody testing) is possible in large hospital and public and private labs now, but what we really need is a home test (somewhat similar to a home pregnancy test), which can be used to test the whole population. This would help us understand how much of the population has been exposed to the virus and help determine plans for people getting back to work.

Dr Allis continued, Medical diagnostics are critical to informing proper care and treatment for patients, and I feel honoured that my industry experience in the rapid development of healthcare diagnostics may be of value in this effort.

This is a great story of how our manufacturers in the UK are stepping up to the challenge of COVID-19, and I am hopeful that this product will make an impact in our battle against this terrible disease," said Lord Bethell, Health Minister for Innovation and Testing. This is a big step in the right direction. People want to know if theyve had the disease, with a test they can trust.

Jonathan Allis is the founding CEO of Blue Earth Diagnostics. Prior to this role, Dr Allis was the General Manager for PET at GE Healthcare Life Sciences, and had global responsibility for GE Healthcares PET agent and PET synthesis platforms business. He has previously held positions in R&D, Marketing and Product Development at GE Healthcare, Amersham plc, Siemens Medical Solutions and Oxford Magnet Technology, in the UK, USA and Germany.

Dr Allis is Non-Executive Chairman of Polarean Imaging plc and previously served as Co-Chair of the Society of Nuclear Medicine and Molecular Imagings Industry Value Initiative. He has an undergraduate degree in Physics from the University of Cape Town and a doctorate in Biochemistry from the University of Oxford.

About Blue Earth Diagnostics

Blue Earth Diagnostics is a leading molecular imaging diagnostics company focused on the development and commercialization of novel PET imaging agents to inform clinical management and guide care for cancer patients in areas of unmet medical need. Formed in 2014, Blue Earth Diagnostics is led by recognized experts in the clinical development and commercialization of innovative nuclear medicine products. The companys first approved and commercially available product is Axumin (fluciclovine F 18), a novel molecular imaging agent approved in the United States and European Union for use in PET imaging to detect and localize prostate cancer in men with a diagnosis of biochemical recurrence. Fluciclovine F 18 has a broad range of other potential applications in cancer imaging and Blue Earth Diagnostics is investigating the molecule for other cancers including in neuro-oncology. The company's pipeline includes innovative Prostate Specific Membrane Antigen (PSMA)-targeted radiohybrid ("rh") agents, which are a clinical-stage, investigational class of theranostic compounds, with potential applications in both the imaging and treatment of prostate cancer. Blue Earth Diagnostics is a subsidiary of Bracco Imaging S.p.A., a global leader in diagnostic imaging. For more information, visit: http://www.blueearthdiagnostics.com.

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Blue Earth Diagnostics CEO Jonathan Allis Appointed Chair of UK Rapid Testing Consortium (UK-RTC) for COVID-19 by UK Department of Health and Social...

A team of CU Anschutz researchers, along with scientists at the Cleveland Clinic, the Mayo Clinic, Stanford University and others, have won a grant from the American Heart Association (AHA) to investigate the effects of Covid-19 on the bodys cardiovascular and cerebrovascular systems.

The Covid-19 and Its Cardiovascular Impact Rapid Response Grant received over 750 proposals from institutions around the nation, one of the largest responses the AHA ever had to a single topic request for applications. The association awarded $1.2 million to teams at 12 of those institutions, including CU Anschutz.

Despite extensive evidence of clinically important cardiac involvement in some Covid-19 patients, virtually nothing is known about how the virus is affecting the heart and why patients with a history of heart problems are more at risk, said Michael Bristow, MD, PhD, professor of cardiology and leader of the team from the CU School of Medicine. We dont even know if the virus can directly infect heart muscle cells.

But based on work done in his lab over the last 15 years, Bristow and his team know that the receptor the Covid-19 virus binds to is increased in abnormal heart muscle and other mechanisms may be responsible for patients with histories of heart problems being more susceptible to the cardiac effects of Covid.

In this study of Covid-19 patients with evidence of cardiac involvement with catheters, well be taking samples of the heart muscle, measuring the amount as well as the cell-localization of the virus, Bristow said. Well then investigate how the virus is altering the hearts histologic and molecular makeup. Hopefully, these findings will set the stage for more specific treatment of cardiac involvement in COVID-19 disease.

The other team members include: Natasha Altman, MD, Cardiology; John Messenger, MD, Cardiology; Edward Gill, MD, Cardiology; Thomas Campbell, MD, Infectious Diseases and Amber Berning, MD, Pathology.

The Cleveland Clinic will serve as the initiatives COVID-19 Coordinating Center. A team from this center will collect results from the research projects and coordinate the dissemination of all study findings.

Several of these studies focus on disparity and underserved populations and many with pre-existing conditions and thats critical because were seeing these people coming in sicker and getting sicker faster from the complications of COVID-19 and we need to understand whats causing that and how we can help them, said American Heart Association president Robert A. Harrington, M.D., FAHA, Arthur L. Bloomfield Professor of Medicine and chair of the department of medicine at Stanford University.

The research projects are considered fast-tracked to report results as quickly as possible to address the COVID-19 crisis. Research will get underway as early as June 1, with findings expected in less than six to nine months for most of the studies. Several researchers aim to have actionable outcomes before a new anticipated wave of COVID-19 strikes in the winter.

Link:
CU Anschutz Researchers Win Grant to Study Covid-19 Effects on Heart - CU Anschutz Today

Biotech executive, Julia Berretta, Ph.D., is named Chief Executive Officer

Genespire, a biotechnology company focused on the development of transformative gene therapies for patients affected by genetic diseases, announced today the successful close of a 16M Series A financing from Sofinnova Partners, a leading European life sciences venture capital firm based in Paris, London and Milan. The company also announced the appointment of Julia Berretta, Ph.D., as Chief Executive Officer and member of the Board of Directors. Graziano Seghezzi, Managing Partner at Sofinnova Partners, and Lucia Faccio, Ph.D., Partner at Sofinnova Partners, will also join the Board.

Genespire was founded in March 2020 as a spin-off of the San Raffaele-Telethon Institute for Gene Therapy (SR-Tiget), one of the worlds leading cell and gene therapy research institutes spearheaded by gene therapy pioneer Prof. Luigi Naldini. The Company was co-founded by Fondazione Telethon and the San Raffaele Hospital, along with Prof. Naldini and Dr. Alessio Cantore.

The funds will be used to advance Genespires leading-edge platform technologies towards the development of novel gene therapies in two main areas: primary immunodeficiencies and metabolic genetic diseases.

"Our mission has always been to develop breakthrough solutions for genetic diseases," said Prof. Naldini, Genespires co-founder and Director of SR-Tiget. "This financing enables the company to translate our innovative science and early stage programs into clinical development. The appointment of Dr. Berretta as CEO is a major reinforcement of our team."

Sofinnova Partners Dr. Faccio added, "Genespire is an exciting investment with all the key ingredients for success: Outstanding scientists that developed the first ex-vivo gene therapy to market, experienced executives brought in through Sofinnova Partners network and game changing technologies that have the potential to impact the lives of patients with genetic diseases."

"I am thrilled to be joining Genespire and such exceptional scientific founders," said Dr. Berretta. "Genespire was born of decades of experience in the gene therapy field, and is optimally positioned to advance transformative therapies for patients affected by severe inherited diseases."

Dr. Berretta was part of the Executive Committee of Cellectis S.A., a Nasdaq-listed clinical stage gene editing company developing CAR-T cell therapies for cancer, where she led business development as well as strategic planning. She is also an independent Board member of Treefrog Therapeutics, an innovative stem cell company.

About Genespire

Genespire is a biotechnology company focused on the development of transformative gene therapies for patients affected by genetic diseases, particularly primary immunodeficiencies and inherited metabolic diseases. Based in Milan, Italy, Genespire was founded in March 2020 by the gene therapy pioneer Prof. Luigi Naldini, Dr. Alessio Cantore, Fondazione Telethon and Ospedale San Raffaele. It is a spin-off of SR-Tiget, a world leading cell and gene therapy research institute and is backed by Sofinnova Partners. http://www.genespire.com

About Sofinnova Partners

Sofinnova Partners is a leading European venture capital firm specialized in Life Sciences. Based in Paris, France, with offices in London and Milan, the firm brings together a team of 40 professionals from all over Europe, the U.S. and Asia. The firm focuses on paradigm-shifting technologies alongside visionary entrepreneurs. Sofinnova Partners invests across the Life Sciences value chain as a lead or cornerstone investor, from very early-stage opportunities to late-stage/public companies. It has backed nearly 500 companies over more than 48 years, creating market leaders around the globe. Today, Sofinnova Partners has over 2 billion under management.

For more information, please visit: http://www.sofinnovapartners.com

About Fondazione Telethon

Fondazione Telethon is a non-profit organisation created in 1990 as a response to the appeals of a patient association group of stakeholders, who saw scientific research as the only real opportunity to effectively fight genetic diseases. Thanks to the funds raised through the television marathon, along with other initiatives and a network of partners and volunteers, Telethon finances the best scientific research on rare genetic diseases, evaluated and selected by independent internationally renowned experts, with the ultimate objective of making the treatments developed available to everyone who needs them. Throughout its 30 years of activity, Fondazione Telethon has invested more than 528 million in funding more than 2.630 projects to study more than 570 diseases, involving over 1.600 scientists. Fondazione Telethon has made a significant contribution to the worldwide advancement of knowledge regarding rare genetic diseases and of academic research and drug development with a view to developing treatments. For more information, please visit: http://www.telethon.it

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About Ospedale San Raffaele

Ospedale San Raffaele (OSR) is a clinical-research-university hospital established in 1971 to provide international-level specialised care for the most complex and difficult health conditions. OSR is part of Gruppo San Donato, the leading hospital group in Italy. The hospital is a multi-specialty center with over 60 clinical specialties; it is accredited by the Italian National Health System to provide care to both public and private, national and international patients. Research at OSR focuses on integrating basic, translational and clinical activities to provide the most advanced care to our patients. The institute is recognized as a global authority in molecular medicine and gene therapy, and is at the forefront of research in many other fields. Ospedale San Raffaele is a first-class institute which treats many diseases and stands out for the deep interaction between clinical and scientific area. This makes the transfer of scientific results from the laboratories to the patients bed easier. Its mission is to improve knowledge of diseases, identify new therapies and encourage young scientists and doctor to grow professionally. For more information, please visit: http://www.hsr.it

About the San Raffaele-Telethon Institute for Gene Therapy (SR-Tiget)

Based in Milan, Italy, the San Raffaele-Telethon Institute for Gene Therapy (SR-Tiget) is a joint venture between the Ospedale San Raffaele and Fondazione Telethon. SR-Tiget was established in 1995 to perform research on gene transfer and cell transplantation and translate its results into clinical applications of gene and cell therapies for different genetic diseases.

View source version on businesswire.com: https://www.businesswire.com/news/home/20200429005417/en/

Contacts

Julia BerrettaCEO, Genespire S.r.linfo@genespire.com +39 02 83991300

Bommy LeeHead of Communications, Sofinnova Partnersblee@sofinnovapartners.com +33 (0) 6 47 71 38 11

North AmericaRooneyPartners LLCKate Barrettekbarrette@rooneyco.com +1 212 223 0561

FranceStrategiesImage (S&I)Anne Reinanne.rein@strategiesimage.com +33 6 03 35 92 05

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Genespire Secures 16 Million Series A Financing from Sofinnova Partners to Advance Transformative Gene Therapies - Yahoo Finance

Newswise (New York, NY April 21, 2020) Researchers at Mount Sinai have found that a novel class of genes known as long non-coding RNAs (lncRNAs) expressed in the brain may play a pivotal role in regulating mood and driving sex-specific susceptibility versus resilience to depression. In a study published online, in the journal Neuron on April 17, the team highlighted a specific gene, LINC00473, that is downregulated in the cerebral cortex of women only, shedding light on why depression affects females at twice the rate of men.

Our study provides evidence of an important new family of molecular targets that could help scientists better understand the complex mechanisms leading to depression, particularly in women, says Orna Issler, PhD, a postdoctoral researcher in the Nash Family Department of Neuroscience and The Friedman Brain institute, Icahn School of Medicine at Mount Sinai, and lead author of the study. These findings into the biological basis of depression could promote the development of more effective pharmacotherapies to address a disease thats the leading cause of disability worldwide.

Past research has shown that about 35 percent of the risk for depression in both sexes can be traced to genetic factors, and the remainder to environmental factors, primarily stress exposure. Long non-coding RNAs fall into a third category: epigenetic factors, which are biological processes that lead to changes in gene expression not caused by changes in the genes themselves. While research focusing on the role of lncRNAs in mood and depression is in its infancy, Mount Sinai has pushed the boundaries of the science by showing the robust regulation of this class of molecules linked to depression in a brain-region and sex-specific manner.

Our work suggests that the complex primate brain especially uses lncRNAs to facilitate regulation of higher brain function, including mood, explains Dr. Issler, and that malfunction of these processes can contribute to pathologies like depression and anxiety in a sex-specific manner. Researchers found, for example, that the LINC00473 gene is a female-specific driver of stress resilience that is impaired in female depression. They also learned it is a key regulator of mood in females, in whom it acts on the prefrontal cortex of the brain by regulating gene expression, neurophysiology, and behavior.

To evaluate the contribution of lncRNAs to depression, the Mount Sinai team screened thousands of candidate molecules, and using advanced bioinformatics narrowed the field to LINC00473. Through viral-mediated gene transfer, researchers expressed LINC00473 in adult mouse neurons, and showed that it induced stress resilience solely in female mice. They found that this sex-specific phenotype was accompanied by changes in synaptic function and gene expression selectively in female mice. That discovery, along with studies of human neuron-like cells in culture, led to selection of LINC00473 as the lead candidate. Other genes considered strong candidates are also being actively investigated.

Our study opens the window to a whole new class of molecular targets that could help explain the mechanisms governing depression susceptibility and resilience, particularly in females, says corresponding author Eric J. Nestler, MD, PhD, Nash Family Professor of Neuroscience at Icahn School of Medicine, Director of The Friedman Brain Institute, and Dean for Academic and Scientific Affairs. Long non-coding RNAs could guide us toward better, more effective ways to treat depression and, just as importantly, to diagnose this debilitating condition. Much work remains, but weve provided a very promising roadmap to follow moving forward.

Researchers from the University of Pittsburgh, University of Texas Southwestern Medical Center, and Massachusetts General Hospital contributed to this research.

The study was supported by grants from National Institute of Mental Health (NIMH), Hope for Depression Research Foundation (HDRF) and Brain & Behavior Research Foundation (NARSAD).

About the Mount Sinai Health SystemThe Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai is a national and international source of unrivaled education, translational research and discovery, and collaborative clinical leadership ensuring that we deliver the highest quality carefrom prevention to treatment of the most serious and complex human diseases. The Health System includes more than 7,200 physicians and features a robust and continually expanding network of multispecialty services, including more than 400 ambulatory practice locations throughout the five boroughs of New York City, Westchester, and Long Island. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of the Top 20 Best Hospitals in the country and the Icahn School of Medicine as one of the Top 20 Best Medical Schools in country. Mount Sinai Health System hospitals are consistently ranked regionally by specialty by U.S. News & World Report.

For more information, visithttps://www.mountsinai.orgor find Mount Sinai onFacebook,TwitterandYouTube.

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A Novel Class of Long Non-coding RNAs May Help Explain Increased Susceptibility of Females to Depression - Newswise

XconomyNational

If Peter Marks had a magic wand to perfect the sophisticated process that takes a new vaccine from idea to reality, the US could have a way to prevent some people from COVID-19 infection in nine months to one year.

In the real world, the journey to a vaccine OKd under emergency guidelines is more likely to take 12 to 18 months, said Marks, who runs the FDAs Center for Biologics Evaluation and Research, on a Friday teleconference hosted by the Commonwealth Fund and the Alliance for Health Policy Teleconference for Media and Policymakers.

Marks said factors that will play a role in FDAs issuance of an emergency use authorizationnot an approvalwill include the level of coronavirus circulating, how well the vaccine works, and how safe it appears. Some of the data to back up safety and efficacy claims are likely to come from less traditional sources, such as adaptive trials, or those designed to allow changes along the way in response to early results, and real-world evidence.

Facilitating the development of a vaccine for COVID-19 is an agency priority now and for the foreseeable future since the US will likely see a second wave or even third wave [of infections] if we dont get it right and get it right quickly, he said.

The agency aims to ensure vaccine makers move forward the candidates with the most potential, he said.

What that will really mean from the FDA perspective is working with the various sponsors of the vaccines to most efficiently look at their preclinical data, understand as much as we can about the characteristics of these vaccines, (and) help people develop plans that are most efficient at understanding whether their candidates will get to the level of protection that would really warrant carrying them forward, because, frankly, vaccine candidates that have very low efficacy or not tremendous efficacy, in this particular case, could just distract from capacity for more robust candidates to come forward, he said.

Marks described the careful calculus of ensuring that any vaccine distributed is safe and effective while removing roadblocks to the fastest possible authorization and distribution.

We may not have the long-term data that we normally might like, so we may be putting real-world evidence into practice in this case by vaccinating relatively larger populations of individualsit may be individuals at higher risk for things like thisthen gathering data in the real world, he said.

Choosing which candidates to advance is an especially necessary and high-stakes effort in the face of a pandemic, Marks said.

My unique perspective on this is that its time to really mobilize as best we can in our animal modeling to try and compare things, to the extent that we can, and try and sort things out before we get to humans, knowing its never perfect to make that transition There is an opportunity cost to taking any candidate forward, and so you want to take your best candidates forward because, by definition, they will occupy capacity over one another, he said.

Esther Krofah, who heads the Milken Institutes FasterCures center, said drug companies appear to be operating with a similar timeline in mind, given some recent announcements about plans to ramp up manufacturing of their vaccine candidates in the event they prove safe and efficacious.

In recent weeks Johnson & Johnson (NYSE: JNJ) announced it had selected a lead vaccine candidate to advance against the novel coronavirus, and committed to boosting its manufacturing capacity to be able to make more than one billion doses of such a vaccine. The company anticipates human tests of its candidate to start at the latest by September, and said it expects batches could be ready for use under emergency guidelines in early 2021.

Thats a substantially accelerated timeframe in comparison to the typical vaccine development process, the company noted. Krofah says Milken is tracking 86 active vaccine projects, including six clinical trials; two dozen more are slated to enter the clinic in summer or early fall.

LJ Tan, chief strategy officer at the Immunization Action Coalition, emphasized the speed at which COVID-19 vaccine development is occurring compared to typical timelines for new vaccine innovation.

Tan previously spent about 16 years in leadership roles at the American Medical Association, most recently as director of medicine and public health and as director of infectious disease, immunology, and molecular medicine for more than a decade.

Traditional vaccine development, through all its phases, can take 10, 15, sometimes 20 years, and can cost at least $800 million dollars or even more, Tan said. When you build in all the costs to build the manufacturing facility, the equipment, the quality control that goes into this, the figure can go way over $1 billion to bring a vaccine from development all the way through to market.

Moderna (NASDAQ: MRNA), whose vaccine candidate was the first to start human testing in the US, said Thursday that it anticipated the start of a Phase 2 study this quarter, if safety data from the National Institutes of Health-led Phase 1 trial supports continuation. The Cambridge, MA-based biotech also announced that the US Biomedical Advanced Research and Development Authority (BARDA) had agreed to award it up to $483 million to fund the vaccines development through FDA review and ramp up its manufacturing to allow it to be produced at scale this year.

The company said it plans to add as many as 150 new employees by 2021.

Some vaccine candidates are being advanced in multiple geographies. This week Inovio Pharmaceuticals (NASDAQ: INO) announced a $6.9 million award from the Coalition for Epidemic Preparedness to move its vaccine into a Phase 1/2 trial in South Korea. Working with International Vaccine Institute and the Korea National Institute of Health, the trial will parallel Inovios ongoing Phase 1 in the US, which started April 6.

Remember, ultimately, were not talking about just vaccinating a few hundred thousand individuals, were taking about vaccinating a few hundred million people in this country alone and a few billion people globally, so one really would like to try to get it right to the extent they can, obviously working at a very rapid pace, Marks said.

Image: iStock/Nastco

Sarah de Crescenzo is an Xconomy editor based in San Diego. You can reach her at sdecrescenzo@xconomy.com.

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COVID-19 Vax Efforts Aim to Balance Speed, Efficacy in Race to Market - Xconomy

Dr. Seth Corey is Professor, Pediatrics and Molecular Medicine, and on staff in the Departments of Pediatrics, Cancer Biology, and Translational Hematology and Oncology Research at the Cleveland Clinic. He sends along this Facebook post under the heading Day 27+. Slow the spread. I have lightly edited Dr. Coreys post. He writes:

This Wuhan pandemic is Peaking.

Surreal, these times have been, as suggested by the parody of one of Magrittes paintings (at figure at right). If only one could say this is not a pandemic. Magrittes pictures show a distorted reality. Or groups of objects which seemingly have no narrative unity. Magritte forces the viewer to construct his own explanation. There may be multiple truths. Scientific research is not so dissimilar. Lessons are to be learned.

Sometimes the models are right, as we have been informed for the past week at the daily White House press briefings: there is evidence that the new US cases and deaths are peaking at Easter time. Yesterday, there were 33,752 new cases; today 30,003. Yesterday, there were 2035 deaths; today 1830.

A study not yet published from Germany suggests that infection is indeed more widespread and fatality rates lower than expected [see our post Maybe some good news]. Using antibody testing, 15 percent of individuals had been infected with 2 percent having a current SARS-CoV2 infection. The case fatality rate was 0.37 percent whereas that of Germany was 1.98 percent. This is preliminary and should be taken as such.

Ohios numbers are reassuring, and may serve as an example of flattening the peak the purpose was to prepare hospitals for the surge. The model keeps getting flatter and flatter. Hospitalized patients were 1755 yesterday, 1788 today. The hospitals are more than sufficiently prepared. Even New York Citys hospitalization, ICU, and ventilator usage are way under the estimates.

According to the flatter, revised model there should be about 1200 new cases today in Ohio; instead there are 372 cases. Time to revise the model and make it even flatter. This of course means that infections will last longer. Please note 247 deaths include 5 deaths under CDC expanded death definition. Please note that 63 of 6250 cases are defined as CDC expanded case definition. The median age of death in Ohio is 79 yrs (which agrees with Israel and Italy). The deaths in New York follow closely what is observed in Ohio.

Lesson to be learned, especially by New York leaders: the metropolitan NYC (NJ/CT) area needs to be better prepared for the next epidemic. It has the population density, center of international travel, and cultural/economic/ethnic diversity (but so does Houston, which is a minority majority city-but nowhere near the health crisis of New York City with COVID-19).

It is possible that the next pandemic could come from outside New York City, but that would require an extremely more contagious infection (high R0). In addition to comparing COVID-19 to past influenza epidemics, we should restudy the measles outbreaks (measles far more contagious than coronavirus or influenza but there is greater herd immunity due to childhood vaccination).

Lesson to be learned by all: healthcare workers need to be considered high risk. For Ohio, 21 percent of confirmed cases were in healthcare workers.

One needs to ask why the models were so off. One way is for models to be explained more explicitly. What assumptions were used? Where did the data come from? What are the confidence intervals? If models are going to affect 325,000,000 Americans then it is incumbent upon the modelers to provide explicit details so that other scientists can verify or repudiate or revise the models.

Lesson to be learned by all: All models are wrong, but some are useful.

Either one is dead or alive (none of the Schrodingers cat business). Either one is employed or not.Lesson to be learned not soon enough: economic and mental health concerns need to be factored into public health policy. This is not just an infectious disease pandemic.

Keep calm. Wash your hands. Avoid sick people. Avoid physical contact with high risk people. Get rest. Eat well. Keep hydrated. Take zinc. Wear a mask. Support your local businesses. Thank a healthcare worker. Be kind.

I wish a Happy and Healthy Easter to my friends at this surreal time.

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Seth Corey: The pandemic is peaking - Power Line

As scientists race to find specific treatments for COVID-19, the colourless gas nitric oxide has emerged as a candidate.

Nitric oxide works as a signalling molecule in the cardiovascular, nervous and immune systems of animals, and is mostly produced in the inner layer of blood vessels called the endothelium. The compound relaxes muscle cells, which in turn prompts blood vessel walls to widen, boosting blood flow and decreasing blood pressure.

As such, physicians have used it for a range of conditions, and it was first approved for use by the U.S. Food and Drug Administration in 1999.

Warren Zapol, emeritus anesthetist-in-chief at Massachusetts General Hospital and a professor at Harvard Medical School, told Gizmodo nitric oxide is used to treat babies born blue, as well as adults with cardiac surgery, and patients with what is known as acute respiratory distress syndrome, where the oxygen supply to lungs are cut off by bodily fluids. "About a half-million Americans have breathed in NO [nitric oxide]," Zapol told the outlet.

Nitric oxide was also central to the creation of the erectile dysfunction drug Viagra in the 1990s, as the pill's main ingredient sildenafil makes the relaxing effect of nitric oxide in the body more potent and increases blood flow.

Now, Zapol is among scientists exploring whether nitric oxide could be harnessed to help COVID-19 patients. Currently, there are no specific drugs for the disease. He and colleagues at the Massachusetts General Hospital have launched two clinical trials to see if the gas can help patients with mild to moderate COVID-19, and others with severe respiratory distress.

Zapol told Gizmodo his team is also awaiting approval to start a trial to see if dosing healthcare workers with the gas would prevent them from being infected by the new coronavirus

Dr. Lorenzo Berra, critical-care specialist at Massachusetts General Hospital who is leading the trials, told Los Angeles Times he wanted to try the gas on COVID-19 patients after it showed promise during the SARS epidemic.

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Meanwhile, a team of scientists at Tongji Hospital in China have launched a clinical trial to investigate whether sildenafil can help COVID-19 patients.

Ian Hall, professor of molecular medicine at the University of Nottingham who is not involved in the projects, explained to Newsweek: "Nitric oxide works mainly by relaxing the blood vessels which supply blood to the lungs from the heart, and has been used to treat patients with other conditions where the pressure in these blood vessels is too high.

"Some patients with more severe COVID-19 disease have abnormal pressures in these blood vessels (the pulmonary arteries) and hence nitric oxide might help relieve this increased pressure, and hence improve gas exchange in the lung."

It is hoped the treatment would reduce the number of patients who need treatment in an intensive care unit or a ventilator, said Hall.

However, he stressed "whilst there is some anecdotal evidence this may work in patients with COVID19, there has been no formal clinical trial to date."

Hall warned any such experimental treatments could have unwanted side effects.

"Hence I think it is critical that these interventions are studied in a formal clinical trial setting. As such it is encouraging to see that this is exactly the approach being suggested in these studies," he said.

Putting the trials into the wider context of the COVID-19 pandemic, Hall said: "There are a lot of clinical trials which are underway or being planned for patients with COVID-19. Most of these target hospital patients with more severe disease."

"At present we don't know which drugs work, but we will soon get information on this from studies such as RECOVERY in the U.K. which is comparing a range of different agents," Hall said. That trial focuses on a HIV drug and a steroid.

Unapproved anti-viral remdesivir is also being tested as a COVID-19 treatment, as are the antimalarial drugs chloroquine and hydroxychloroquine. Last month the World Health Organization launched a multi-country clinical study of four potential combinations, including remdesivir and chloroquine.

Four months in to the COVID-19 pandemic, 1.3 million cases have been confirmed, almost 76,000 people have died, and over 289,000 have recovered, according to Johns Hopkins University. As shown in the Statista map below, every continent except Antarctica is affected.

Hygiene advice

Medical advice

Mask and glove usage

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What Is Nitric Oxide? How the Gas That Gave Us Viagra Could Help Treat Coronavirus Patients - Newsweek

Most people with coronavirus will recover within about a week of getting symptoms and will not need medical care.

But some people will need to be treated in hospital - as the prime minister was.

Boris Johnson, who is 55, has been discharged from St Thomas' hospital in London after being in intensive care.

He was given oxygen, but didn't need a ventilator machine to help his breathing.

Some people are at higher risk of complications.

This includes people over the age of 70, regardless of whether they have a medical condition or not, and people of any age with underlying health conditions such as heart disease.

There are more than 1.5 million people in the UK who are at the greatest risk of needing hospital treatment if they catch coronavirus.

This includes people with cancer who have been receiving chemotherapy, and they are being asked to stay at home all of the time to shield themselves from the virus.

Coronavirus also appears to disproportionately affect men in their 50s and 60s to a certain degree, although they are not singled out as a high risk group. But it's not that clear-cut. Correlation isn't necessarily cause.

Scientists are unsure.

UK data from intensive care hospital wards shows the average patient who is critically ill is aged 60. Most are men and many have other health conditions that could put them at increased risk, such as heart problems and obesity.

Of the 647 coronavirus-related deaths registered by the Office for National Statistics in England and Wales up to the week ending 27th March, 44 were aged 45-65 - around 7% of the total.

Death rates go up with age in both men and women, but men tend to outstrip women across the ages.

Data from China, where the pandemic began, also suggests men are at greater risk than women, although experts caution there could be factors other than gender, such as smoking habits, that could explain the link.

Prof Ian Hall, Professor of Molecular Medicine, University of Nottingham, said: "I am not convinced this completely explains the increased risk of severe disease in men, so it seems possible there may be some other as yet unidentified factor playing a role."

Men are more likely than women to have heart disease, diabetes and chronic lung disease.

Some have suggested genes and sex hormones might be involved too.

Prof Philip Goulder, an expert in immunology at University of Oxford, said: "It is becoming increasingly recognised that there are substantial differences in the immune system between males and females and that these have significant impact on outcome from a wide range of infectious diseases.

"The immune response throughout life to vaccines and infections is typically more aggressive and more effective in females compared to males."

This could be down to women carrying two copies of the X chromosome, compared to the single X and a Y that men have.

A number of critical immune genes are located on the X chromosome, he says.

Every year, about 600,000 people in the UK die. People with underlying health conditions and the elderly are most at risk, just as they are if they have coronavirus.

Nearly 10% of people aged over 80 will die in the next year, Prof Sir David Spiegelhalter, at the University of Cambridge, points out, and the risk of them dying if infected with coronavirus is almost exactly the same.

Stay as fit and healthy as you can by exercising and eating a balanced diet.

If you smoke, now is a good time to quit.

Men are more likely than women to:

Coronavirus spreads when an infected person coughs or sneezes small droplets - packed with the virus - into the air. These can be breathed in, or cause an infection if you touch a surface they have landed on, then your eyes, nose or mouth.

So, coughing and sneezing into tissues, not touching your face with unwashed hands, and avoiding close contact with infected people are important.

If you have a new, continuous cough or a fever you should stay at home and self-isolate for at least seven days.

If you, or someone you live with, develop symptoms, the entire household needs to isolate for 14 days to monitor for signs of the disease.

The main reason people need hospital treatment is difficulty breathing.

In the UK, the NHS 111 website will guide you through what you need to do.

If you are so breathless that you are unable to speak more than a few words then you will be told to call 999 as this is a medical emergency.

If you become so ill that you've stopped doing all of your usual daily activities then the website will advise speaking to a nurse by dialling NHS 111.

Link:
Coronavirus: What is the risk to men over 50? - BBC News

HAMILTON, Ontario The outbreak of coronavirus around the globe is stretching medical supplies to their limits. Growing demand for advanced medical masks are leaving healthcare workers in desperate situations, but is hi-tech equipment really needed to keep you safe from COVID-19? Researchers now say the most popular type of respirator masks should be saved for medical workers treating patients with severe cases of coronavirus.

According to McMaster University in Canada, a basic, loose-fitting medical mask works just as well for protecting against the spread of COVID-19. Researchers say the popular N95 respirator mask should be used by healthcare workers who carry out tasks like inserting tubes into a patients throat.

There is not convincing evidence that the loose-fitting medical masks are inferior to N95 respirators, Dr. Mark Loeb, a professor of pathology and molecular medicine at McMaster said in a statement. But the N95 respirators are unanimously recommended by national and international guidelines for aerosol generating procedures.

Loeb, an infectious disease doctor, notes that N95 respirators are most needed for those high-risk procedures that see patients coughing up more of the virus into the air around them. The professor sides with the World Health Organization and Canadian Public Health Agency, saying a standard face mask is fine for anyone treating non-emergency coronavirus patients.

Although COVID-19 transmission is not fully understood, its believed to be mainly through respiratory droplets, and the medical masks provide barrier protection for that, and prevent hand to face contact, Loeb explained.

Not all experts are convinced that a regular medical mask is good enough when treating people infected with COVID-19. The McMaster University study notes that both the U.S. Centers for Disease Control and Prevention and the European Centre for Disease and Prevention both urge people to wear the N95, even during routine medical work.

Loeb and others hope the research will convince the public to conserve the shrinking supplies of the tight-fitting respirators.

This evidence to support the relative effectiveness of medical masks compared to N95 respirators in routine care, might help preserve stockpiles of N95 respirators, Jessica Bartoszko, one of the papers authors said.

Loeb and a team of researchers are now expanding their work. They are testing the effectiveness of standard masks versus N95 respirators in several locations where patients with respiratory illnesses are being treated.

This study is critical to ensure were using personal protective equipment correctly during this, and any future infectious disease outbreak, Loeb concluded.

The studys findings are published in the journalInfluenza and Other Respiratory Viruses.

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Popular N95 Masks Only Needed For Workers Treating Extreme Coronavirus Cases, Researchers Say - Study Finds