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Scientists debate coronavirus evolution

Coronavirus transmission map
A graphic generated by Nextstrain shows how different variants of the SARS-CoV-2 coronavirus have spread around the world. Purple streaks show where the virus was transmitted from China, green and yellow-green streaks show transmission from Europe, and red streaks show transmission from the United States. (Nextstrain.org Graphic)

Is the coronavirus behind COVID-19 turning into a more insidious pathogen? Or are such claims overblown?

A fast-moving debate over virus evolution illustrates how not-yet-vetted reports about the course of the coronavirus outbreak can go, um, viral — and how important social media channels have become in the global discussion of the science behind the pandemic.

The nature of SARS-CoV-2, the virus that causes COVID-19, is of such great interest because the disease is so deadly and disruptive: As of today, Johns Hopkins University reports nearly 3.7 million confirmed cases around the world, with a global death toll of more than 250,000. The United States accounts for 1.2 million cases and 71,000 deaths so far, and that toll could double before the worst is over.

Every day, several hundred new studies about SARS-CoV-2 and COVID-19 — most of which haven’t yet gone through the traditional peer-review process — go online, to face scrutiny by researchers and a wide swath of the general public.

One study got more than the usual traction today: The research project, led by scientists at Los Alamos National Laboratory and the University of Sheffield, looked at the way 14 variants of the virus have spread across the world.

The resulting paper was filed to the BioRxiv preprint server last week but has not yet been peer-reviewed. It concluded that one particular variant known as D614G is “of urgent concern.” That variant, a descendant of a form of the virus that started out in China, began spreading in Europe in early February and eventually made the leap to other parts of the world.

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New pandemic projection: 135,000 U.S. deaths

This chart shows the actual and projected daily U.S. death toll for COVID-19 from mid-March to Aug. 4, issued by the Institute for Health Metrics and Evaluation. The pink shaded area represents the uncertainty interval for the projection to the 95% confidence level. (IHME Graphic)

The latest projection from the University of Washington’s Institute for Health Modeling and Evaluation says the coronavirus pandemic will claim nearly 135,000 lives in the U.S. by August, in part because many states are easing their social distancing restrictions.

Other projections also foresee a deadlier spring: A presentation purportedly prepared for the Trump administration and leaked to The New York Times and The Washington Post projects that there’ll be as many as 3,000 deaths per day in the U.S. by June 1, with a sharp increase coming around May 14. That’s significantly higher than the current pace of roughly 1,500 daily deaths, and close to the previous peak rate reported in mid-April.

The White House and the Centers for Disease Control disavowed the slide presentation, which carried the CDC’s logo. The Post quoted one of the researchers providing the data for the presentation, Justin Lasser of the Johns Hopkins Bloomberg School of Public Health, as saying that the modeling work was not complete and that the projection was only one of a range of forecasts.

The Institute for Health Modeling and Evaluation’s projections have been closely watched by the White House and other policymakers — in part because they’ve provided specific albeit variable estimates of total deaths. But the IHME’s projections also have come in for significant criticism from other quarters — in part because the models are based on tracking the course of the pandemic in various regions of the world, rather than the epidemiological characteristics of the virus.

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Remdesivir OK’d for wider use to treat COVID-19

The Food and Drug Administration today authorized emergency use of the experimental antiviral drug remdesivir for treating COVID-19 in the wake of encouraging results from a federally backed clinical trial.

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Bill Gates: We’ll need 7 billion doses of vaccine

Bill Gates has been big on vaccines since before the start of the coronavirus pandemic, but in a new blog posting, the Microsoft co-founder and billionaire philanthropist says the only way to end the pandemic for good is to offer a vaccine to almost all of the planet’s 7 billion inhabitants.

That’s big.

“We’ve never delivered something to every corner of the world before,” Gates notes.

It’s especially big considering that a vaccine hasn’t yet been approved for widespread use, and that it may take as long as a year to 18 months to win approval and start distribution.

Some companies are aiming for a faster pace: Oxford University says its vaccine candidate has shown encouraging results in trials with rhesus macaque monkeys, and if it clears accelerated human trials, a few million doses could be available by September.

Meanwhile, the White House is pressing an initiative called Operation Warp Speed that Anthony Fauci, the director of the National Institute of Allergy and Infectious Disease, could result in hundreds of millions of vaccine doses being manufactured by January.

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Remdesivir wins a vote of COVID-19 confidence

An antiviral drug called remdesivir got a strong vote of confidence today from one of the most prominent figures in the battle against the coronavirus outbreak.

“The data shows that remdesivir has a clear-cut, significant positive effect in diminishing the time to recovery,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters during a White House photo op.

Also today, The New York Times quoted an unnamed administration official as saying that the Food and Drug Administration is likely to clear remdesivir to be employed more widely as a treatment for COVID-19 under the terms of an Emergency Use Authorization.

The FDA acknowledged that it’s “engaged in sustained and ongoing discussions” with remdesivir’s manufacturer, California-based Gilead Sciences, to make the drug available to patients as quickly as possible where appropriate.

Fauci said his optimism is based on a randomized, placebo-controlled trial involving more than 1,000 COVID-19 patients at medical clinics around the world, including four clinics in Washington state.

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Coronavirus modelers raise projected death toll

COVID-19 death projection
A chart created by the University of Washington’s Institute for Health Metrics and Evaluation traces the actual and projected trend line for daily COVID-19 deaths in the United States between March 1 and July 1, as solid and dotted lines respectively. The pink shaded area indicates a wide uncertainty interval for future death rates. (IHME Graphic)

The timeline has slipped to the right and the projected death toll has trended upward in a new projection from the creators of a closely watched computer model for the course of the U.S. coronavirus outbreak.

Tonight’s update from the University of Washington’s Institute for Health Metrics and Evaluation raises the outlook for the cumulative U.S. death toll through Aug. 4 from the 67,641 fatalities projected on April 22 to a new figure of 74,073.

That’s creeping closer to the death toll of 81,114 that IHME laid out in its first projection, way back in late March. Since then, the figures have gone as high as 93,000 and as low as 60,000.

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Social distancing needs to be more stringent

South Lake Union
Amazon’s banana stand in Seattle’s South Lake Union district was an early victim of social distancing policies enacted to counter the coronavirus outbreak. (GeekWire Photo / Kurt Schlosser)

Although many states are starting to relax restrictions on business activity and contacts, Seattle-area epidemiologists say such restrictions will need to be tightened up to reduce the spread of coronavirus much further.

The only alternative to clamping down harder would be to create a robust system of testing and contact tracing, experts at the Bellevue, Wash.-based Institute for Disease Modeling say in their latest report.

Their conclusions are based on an updated analysis of viral transmission patterns in Seattle and the rest of King County. The numbers suggest that the extent of the pandemic in the county is declining very slowly, if at all.

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Researchers revise recommendations for reopening

The projected dates for relaxing social distancing policies has slipped later, on average, since Friday’s projection. Click on the image for a larger version. (Institute for Health Metrics and Evaluation Graphic)

The latest computer projections from the University of Washington’s Institute for Health Metrics and Evaluation deliver a double dose of discouragement about the course of the coronavirus outbreak, especially for those in the institute’s home state.

IHME’s April 22 assessment estimates that conditions could be acceptable for Washington state to loosen its current social distancing restrictions on May 28 — which is 10 days later than the April 17 estimate. Moreover, that assessment assumes that public health officials will have adequate resources for testing patients, conducting contact tracing and isolating those who become infected — which is not assured.

The other discouraging word is that the projected U.S. death toll through Aug. 4 has been raised, from 60,308 on April 17 to 67,641 on April 22. There’s a wide interval of uncertainty to that figure: The institute said it could end up as low as 45,375 or as high as 124,120. (The actual death toll was already nearly beyond that lower bound when IHME made its projection.)

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UW to conduct clinical trial for hydroxychloroquine

The University of Washington School of Medicine is looking for people who have tested positive for COVID-19 to participate in a clinical trial aimed at finding out whether a controversial drug called hydroxychloroquine can keep them from having to be hospitalized.

Word of UW Medicine’s clinical trial comes after reports about a study at Veterans Health Administration medical centers in which COVID-19 patients who took hydroxychloroquine, which is typically used to treat malaria and autoimmune disease, died at higher rates than those who didn’t take the drug.

Today, the Food and Drug Administration warned that hydroxychloroquine carries “known risks” of potentially deadly heart complications — and said the drug should be used in supervised settings such as clinical trials, where the risks can be better studied and mitigated.

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Software tools for COVID-19 research go viral

COVID-19 study connections
This graph charts the connections that link dozens of research studies about coronavirus and related subjects. (Covidgraph.org)

One month after the debut of the COVID-19 Open Research Dataset, or CORD-19, the database of coronavirus-related research papers has doubled in size – and has given rise to more than a dozen software tools to channel the hundreds of studies that are being published every day about the pandemic.

In a roundup published on the ArXiv preprint server this week, researchers from Seattle’s Allen Institute for Artificial Intelligence, Microsoft Research and other partners in the project say CORD-19’s collection has risen from about 28,000 papers to more than 52,000. Every day, several hundred more papers are being published, in peer-reviewed journals and on preprint servers such as BioRxiv and MedRxiv.

CORD-19 aims to make sense of them all, using the Semantic Scholar academic search engine developed by the Allen Institute for AI, also known as AI2.

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