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UK to roll out Oxford/AstraZeneca vaccine in January: reports – POLITICO



The United Kingdom is expected to approve the coronavirus vaccine developed by the University of Oxford and drugmaker AstraZeneca within days, local papers reported.

Ministers are drawing up plans to start vaccinating the public with the Oxford/AstraZeneca jab from January 4, the Sunday Telegraph reported, adding that “mass vaccination centres at sports stadiums and conference venues” could launch as soon as the second week of January.

The Oxford/AstraZeneca vaccine still needs the approval of the U.K. regulator, the Medicines and Healthcare Products Regulatory Agency (MHRA). The Sunday Times, citing unnamed government officials, reported that the MHRA is expected to give the green light before Thursday, while the Telegraph said the vaccine will be approved on December 28 or 29.

Responding to the reports, a U.K. Health Department spokeswoman told Reuters: “We must now give the MHRA the time to carry out its important work and we must wait for its advice.”

According to the Telegraph, the government wants 2 million people to receive either the Oxford jab or the BioNTech/Pfizer vaccine — which is already being administered in the U.K. — within two weeks.

The government’s efforts to step up its vaccination campaign come as the country struggles to contain a highly transmissible new strain of the virus. AstraZeneca CEO Pascal Soriot told the Sunday Times that while “we think the vaccine should remain effective” against the new strain, “we can’t be sure, so we’re going to test that.”

This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.





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Trump Lawyer Jenna Ellis Tests Positive For COVID-19: Reports



Jenna Ellis, a lawyer for President Donald Trump, has reportedly tested positive for COVID-19 after attending a White House Christmas party for senior staff last week. 

Ellis was a guest of Trump trade adviser Peter Navarro and was photographed not wearing a mask, according to reporting by Axios later confirmed by ABC News.

She has been working to overturn the results of the presidential election, saying Monday that she believes she is “doing the right thing for God and my country.”

The holiday party now has the potential to become yet another superspreader event hosted by the Trump administration, following a Rose Garden ceremony in late September that has been linked to at least eight cases. Other gatherings, including a debate preparation session and an election night watch party, were also linked to several new cases.

An extraordinary number of high-level officials and advisers in Trump’s orbit have come down with the virus in recent months, including the president, his wife, and at least two of his children. Since the start of the crisis, Trump has consistently downplayed the threat of the virus and the necessity of wearing masks in public spaces, a trend that continued even after he was hospitalized for coronavirus symptoms that included difficulty breathing.

On Sunday, Trump tweeted that Rudy Giuliani, who has been leading efforts to challenge the results of the presidential election in key states, had also tested posted for COVID-19.





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Health

Pfizer’s coronavirus vaccine is more than 90 percent effective in first analysis, company reports



“I would say it’s a historical moment. Something like this has never happened before. First of all, the world was faced with such a terrible situation, the pandemic, and being able in such a short time to go through what usually takes many years,” Kathrin Jansen, head of vaccine research and development at Pfizer, said in an interview. “Hearing that at the interim analysis we are over 90 percent effective — it was almost stunning to hear.”

In Pfizer’s 44,000-person trial, there have so far been 94 cases of covid-19, the illness caused by the coronavirus, in people who were not previously infected. Fewer than nine of those cases were among people who received two shots of the vaccine, a strong signal of efficacy. The data is not yet published or peer-reviewed.

The rapid surge of coronavirus infections in the cooler months, while devastating for the country, means the trial is rushing toward completion faster than company executives anticipated. With more people being exposed to the virus amid the surge, testing the vaccine becomes easier — and faster.

The race for a vaccine had become inextricably tied to election-year politics, and for months, outside experts had worried that Pfizer’s vaccine might be an “October surprise” pushed prematurely through the regulatory process. In the end, the data arrived nearly a week after the election, and shortly after the race was called for President-elect Joe Biden.

President Trump, who had called Pfizer chief executive Albert Bourla to ask about the vaccine and previously accused regulators of a “political hit job” for slowing down a vaccine, celebrated the news. “STOCK MARKET UP BIG, VACCINE COMING SOON. REPORT 90% EFFECTIVE. SUCH GREAT NEWS!” Trump tweeted Monday morning.

The data committee noted no serious safety concerns. Jansen said the side-effect profile of the vaccine was similar to what was reported in an earlier study. That included pain at the injection site and fatigue, chills and fever — which occurred more frequently in younger trial participants than in adults over age 65.

Pfizer and BioNTech said they plan to submit an application for emergency authorization from the Food and Drug Administration after the third week of November, when they will have two months of safety follow-up data on half of the participants in their trial, along with data on their manufacturing process. The trial will continue until it reaches its endpoint of 164 cases of covid-19, which Jansen said could take a few weeks.

Vaccine development typically takes many years, even decades. But the coronavirus vaccines have been a rare success story in the response to the virus, able to move forward because of a flourishing of new vaccine technologies, a backbone of prior work on emerging pathogens and a mentality that rarely exists in the world of vaccine development — of governments and companies willing to devote nearly unlimited resources to make sure that a vaccine succeeds.

Outside experts said crucial details of the data need to be examined: How did the vaccine perform in high-risk populations, such as elderly people? Were the cases of disease mostly mild, or did the vaccine also prevent severe disease? Will the effectiveness hold up at this high level as the trial moves toward completion? How long will protection last? What do detailed safety data show?

Paul A. Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said the data look encouraging. The trial’s faster-than-expected progress to 94 cases, he said, was “the upside of having a virus that’s out of control.”

David Benkeser, a biostatistician at Emory University Rollins School of Public Health, said in an email that he was still digesting the news.

“It looks to be an incredibly promising result,” Benkeser wrote, noting that the two biggest questions are how long the effect lasts and how well the vaccine works to prevent severe cases of covid-19. “Both will still require more data to get a definitive answer, but for now, I think this is really good news.”

Regulators had set a far lower bar for the minimum performance of a vaccine, requiring it be at least 50 percent effective. The FDA has also set forth a requirement for five severe cases of the disease in the placebo group, but Jansen said that to preserve the integrity of the trial, Pfizer’s scientists remain blind to the details of the cases at this time.

The vaccine requires two doses, given three weeks apart. Pfizer and BioNTech are working around-the-clock to scale up production, in hopes of having 50 million doses — enough for 25 million people to receive both shots — by the end of the year, and 1.3 billion doses in 2021.

The vaccine uses a new technology never before deployed in an approved medical product. Each injection contains lipid nanoparticles — fat bubbles — that surround a strip of genetic material called messenger RNA. The genetic material carries the blueprint for the distinctive spiky protein that studs the coronavirus surface. After being injected into a person’s arm, the fat capsule delivers its payload to the body’s cells, and the messenger RNA instructs those cells to build the spike protein, effectively teaching the immune system how to recognize and block the coronavirus.

The same approach is being used by Moderna, a biotechnology company that expects to report early results this month for another leading vaccine candidate.

Pfizer, unlike its competitors, did not join Operation Warp Speed, the government initiative designed to erase the financial risk of vaccine and therapeutics development by providing funding to companies and helping coordinate the trials. Instead, Pfizer plowed $2 billion of its own money into the project and then struck a $1.95 billion contract with the U.S. government to provide 100 million doses, contingent on the vaccine being effective.

Its trial initially had a more aggressive design than other late-stage studies in the United States, allowing earlier and more frequent peeks at the data. That raised concern from outside scientists that the company might seek authorization of its vaccine when there were only 32 cases among participants.

The FDA shared those concerns, according to Jansen, and urged the company to wait to do its first data look until there were more cases. Pfizer scientists were initially concerned it would take too long to reach that milestone, particularly as it appeared the pandemic might be coming under control in late summer, thus depriving the study of potentially infected participants. But Pfizer scientists amended their protocol to wait to look at the data until they reached 62 cases as the virus began to surge, and they completed that paperwork last week.

“We saw that huge upswing, we realized that maybe we should listen and come back to the suggestion of the FDA to have more cases,” Jansen said. “It just shows you the enormous uptick right now of the pandemic, that certainly it took us by surprise — how quickly it really went.”

Once the independent data committee met Sunday, there were 94 cases in the trial — meaning the study is more than halfway done.

This is a developing story. It will be updated.



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Entertaiment

Prince William Tested Positive for COVID-19 in April: Reports


Prince William tested positive for COVID-19 in April, BBC News and other British media reported on Sunday, Nov. 1, citing Kensington Palace sources.

The 38-year-old Duke of Cambridge, the third in line to the U.K. throne, kept his diagnosis secret, unlike his father, Prince Charles, who had announced his own positive COVID-19 test in March, the reports said.

When reached by NBC News on Sunday night, Kensington Palace would not confirm or deny the reports about William.

In recent months, he and wife Kate Middleton have been social distancing at their family home Anmer Hall in Norfolk, England.

In late March, weeks after the start of the coronavirus pandemic, Charles revealed that he had tested positive for COVID-19 and had mild symptoms. The 71-year-old has since recovered.

U.K. Prime Minister Boris Johnson, 56, was diagnosed with the coronavirus around the same time and spent a week in the hospital, including time in the ICU.



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Health

Trump Loyalists Tried to Influence C.D.C. Virus Reports


Colleges around the country have run into a host of problems as they have tried to reopen. At the University of North Carolina at Chapel Hill last month, a major outbreak forced classes to move online after a single week, and North Carolina State also went to remote learning when clusters appeared soon after the campus opened.

At least a third of people affiliated with Michigan State who tested positive recently attended social gatherings, a third of them associated with a fraternity or sorority, according to the health department for Ingham County, which encompasses the university’s campus in East Lansing.

“These cases are clusters,” Linda Vail, a county health officer, said in an interview on Saturday evening. “Here, there and everywhere. We have a serious, serious spike in cases all tied to a particular demographic. This is an urgent situation.”

The university, which has an enrollment of about 50,000, announced in mid-August that classes would be remote and asked most students who would have lived on campus to stay home. However, around 35,000 students with off-campus leases returned to East Lansing before the semester began on Sept. 2, said Emily Gerkin Guerrant, a university spokeswoman, and 2,800 students — including athletes, international students or students without stable housing — were allowed to stay in the dorms.

Under the recommended quarantine, students should leave their residences only for in-person classes, or to get food or medicine, Ms. Vail said. Though the quarantine is a recommendation, she said it may be changed to an order for large houses, where groups of more than 10 students live together.

Elsewhere in the state, several students at the University of Michigan recently took to TikTok to voice outrage about campus health policies, including the jury-rigged housing the university has used to quarantine those who test positive. They expressed support for continuing strikes by graduate students, some of whom are instructors and have demanded the right to work remotely, increased testing transparency and other virus protections.

There have been 367 confirmed cases since March, according to the school’s database, and 19 cases since students returned in late August for a mixture of in-person and remote learning.





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Health

Trump officials seek greater control over CDC reports on coronavirus



The emails, first reported late Friday by Politico, describe the CDC documents, widely known as the MMWR, as being “hit pieces on the administration.” Caputo confirmed the authenticity of the emails.

The emails echo the sentiments from an earlier attack by Alexander, reported in The Washington Post in July, about an MMWR on the potential risk of the coronavirus to pregnant women. In that email, Alexander also accused the CDC of undermining the president. The emails are the latest evidence of how the nation’s top public health agency is coming under intense pressure from Trump and his allies, who are playing down the dangers of the pandemic ahead of the Nov. 3 presidential election.

“Most often, the MMWRs are [issued] for purely scientific reasons,” Caputo said Saturday. “But in an election year, and in the time of covid-19, it’s no longer unanimously scientific. There’s political content.”

Caputo said his conclusions are based on reviews by Alexander, an assistant professor at McMaster University in Canada and a specialist in health research methods. Caputo hired him this spring to advise on the science of the pandemic.

Despite the changes to the MMWRs sought by HHS, the requests were “infrequently” accepted by the CDC, Caputo said.

Alexander “gets into productive discussions with the scientists who are open to criticism. They’re free to reject them,” Caputo said. “I think most of his criticisms are rejected.”

He added: “Science is disagreements. It must be difficult for [CDC] to be criticized by an Oxford-educated scientist who has been published in peer-reviewed journals 67 times.”

A former administration official with direct knowledge of the communications from HHS said a request that all reports be stopped until Alexander could review them in their entirety was rejected. On other requests, the CDC “put its head down” and did not comply and “continued to get in trouble over and over again” for doing so, the former official said. The person spoke on the condition of anonymity to share sensitive deliberations.

MMWRs are written by career experts for scientists and public health specialists and are considered among the most authoritative public health reports because they provide evidence-based information on a range of health topics. The reports are independent scientific publications that undergo rigorous vetting, often with multiple drafts to check data and methodology. The reports are closely held; few individuals at the CDC have access until just before publication.

The CDC editorial staff that produces the MMWRs typically sends one-paragraph summaries to HHS and other CDC officials a few days before publication.

“Whenever they come out with that list, there’s concern across [HHS] that some of the scholarship has been tainted by politics,” Caputo said. “That’s my opinion.”

Over the course of the pandemic, top officials including Deborah Birx, the White House coronavirus task force response coordinator, and HHS Secretary Alex Azar have wanted to have a “more complete picture” of the CDC’s activity, according to an HHS official who spoke on the condition of anonymity to share internal deliberations. The MMWRs were the main focus, the official said.

“The future of the agency depends on its ability to disseminate science-based data and recommendations that are science-based,” the official said. “Putting a political lens on everything that we say is very concerning,” the official added. The CDC is not going to do that, the official said. There is no intention or attempt to undermine the president in the publication of CDC reports, the official said, referring to accusations by Alexander as “a paranoid assumption that is not based on anything.”

The CDC declined to comment Saturday.

One CDC report that drew particular scrutiny was on hydroxychloroquine. The MMWR urged clinicians to follow long-accepted prescribing guidelines for the malaria drug. Trump favored the drug as a coronavirus treatment despite scant evidence. The CDC was concerned the drug was potentially being misused to treat covid-19, the illness caused by the virus, and affecting supplies of the medication to treat conditions such as rheumatoid arthritis and lupus.

“Current data on treatment and pre- or postexposure prophylaxis for COVID-19 indicate that the potential benefits of these drugs do not appear to outweigh their risks,” the report said.

The report had been delayed for weeks, according to a former administration official with direct knowledge of the efforts.

In another instance, a report about the spread of the coronavirus at a Georgia sleep-away camp was also delayed, the former official said. That report, issued July 31, suggested that children of all ages are susceptible to coronavirus infection and may spread it to others — a finding likely to intensify an already fraught discussion about the risks of sending children back to school.

“That report gave them a lot of grief,” the former official said. “But you can’t change facts.” The report likely was delayed, the former official said, to avoid being released around the same time Trump was calling for schools to reopen in person. The changes that were sought were not included, the former official said.

The tone of Alexander’s emails is harsh, this person said, because the CDC ignored his requests. In one email, Alexander wrote to CDC Director Robert Redfield asking that the agency modify two already published reports that Alexander said mistakenly inflated the risks of coronavirus to children and undermined Trump’s push to reopen schools.

“CDC to me appears to be writing hit pieces on the administration,” Alexander wrote in an email. “CDC tried to report as if once kids get together, there will be spread and this will impact school reopening. … Very misleading by CDC and shame on them. Their aim is clear.”

The interference by HHS political appointees in the MMWR process has infuriated career scientists, who have been frustrated for months over the inability to allow scientists to fully share and explain information.



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China tightens tech export controls jeopardizing TikTok deal, reports say


The TikTok app icon sits displayed on a smartphone in front the national flags of China and the U.S. in this arranged photograph in London, U.K., on Monday, Aug. 3, 2020.

Hollie Adams | Bloomberg | Getty Images

An updated export rule from China could jeopardize the sale of TikTok’s  U.S. operations, according to reports published Saturday in The Wall Street Journal and The New York Times

According to the reports, China updated its export control rules to incorporate technology that could include TikTok, a claim later reasserted by commentary published in China’s state-controlled Xinhua news agency on Saturday.

Cui Fan, a professor of international trade in Beijing, told Xinhua that ByteDance would probably have to get approval from the Chinese government and suggested the company may have to suspend negotiations on TikTok’s sale. 

CNBC reported Thursday that TikTok would announce the sale of its U.S., Canadian, Australian and New Zealand operations in the coming days in a deal worth $20 billion to $30 billion. ByteDance is considering offers from multiple companies, including Oracle and a joint bid from Walmart and Microsoft. 

President Donald Trump issued an executive order earlier this month that would ban U.S. transactions with TikTok’s parent company, ByteDance. The company filed a lawsuit against the federal government over the Trump administrations’ efforts to block TikTok on Monday. 

TikTok wasn’t immediately available for comment regarding the reports. 



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Politics

Biden Pick for Vice President Delayed to Second Week of August: Reports


Presumptive Democratic Party presidential nominee former Vice President Joe Biden has reportedly put off choosing his vice presidential nominee until the second week of August–sometime after August 10–according to reports. Biden had initially set a date of around the first of August but told reporters last week he would likely make his decision this coming week. That appears to be put off yet again.

Joe Biden alongside a rejuvenated Kamala Harris. Could this be the ticket?

Biden is taking advantage of the postponement due to the pandemic of the Democrat National Convention in Milwaukee that was originally scheduled for July 13-16 but is now set for August 17-20. Biden has said he would choose a woman to be his running mate, with many in the party urging him to choose a black woman or woman of color.

Among those thought to be top contenders are: Sen. Kamala Harris (D-CA), Sen. Tammy Duckworth (D-IL), Sen. Elizabeth Warren (D-MA), Rep. Karen Bass (D-CA), Rep. Val Demings (D-FL), Atlanta Mayor Keisha Lance Bottoms and former Obama national security advisor and U.N. Ambassador Susan Rice.

Whomever Biden chooses will have a better than most chance of becoming president due to illness, senility or a decision to not seek a second term by the 77-year-old Biden who would be 78 when inaugurated. Biden would be 82 at the end of a first term.

TRENDING: Leftie James Murdoch Resigns from News Corporation, the Parent Company of FOX News Over “Differences in Editorial Content”

Karen Bass emerged this week as a contender. Bass has served in Congress since 2011 and is currently Chair of the Congressional Black Caucus. Before that she was Speaker of the California Assembly and a community organizer. A profile of Bass published this week by the Atlantic to inoculate her on being a young communist, details her history in the 1970s of working with the Venceremos Brigades and her many trips to Castro’s Cuba.

The Trump campaign on Saturday questioned Bass’ suitability and Biden’s judgment:





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Health

Can you get coronavirus twice? Doctors are unsure even as anecdotal reports mount.



As the United States marks its sixth month since the arrival of the coronavirus, Cunningham’s story is among a growing number of reports of people getting covid-19, the disease caused by the novel coronavirus, recovering and then falling sick again — assertions, that if proved, could complicate efforts to make a long-lasting vaccine, or to achieve herd immunity where most of the population has become immune to the virus.

Doctors emphasize there is no evidence of widespread vulnerability to reinfection and that it is difficult to know what to make of these cases in the absence of detailed lab work, or medical studies documenting reinfections. Some people could be suffering from a reemergence of the same illness from virus that had been lurking somewhere in their body, or they could have been hit with a different virus with similar symptoms. Their positive coronavirus tests could have been false positives — a not-insignificant possibility given accuracy issues with some tests — or picked up dead remnants of virus, as authorities believe happened in hundreds of people who tested positive after recovering in South Korea.

“You can’t extrapolate those anecdotal, first-person observations to the entire population and make sweeping conclusions about how the virus works,” said Angela Rasmussen, a virologist at Columbia University.

There is still not enough evidence or sufficient time since the virus first struck to draw firm conclusions about how people develop immunity to the coronavirus, how long it might last — or what might make it less robust in some individuals than in others.

When the outbreak first hit, many experts including the National Institutes of Health’s Anthony S. Fauci said they hoped protection from reinfection might last at least through the expected second wave in the fall, or into the next year. For severe acute respiratory syndrome, or SARS, and Middle East respiratory syndrome (MERS), the antibodies seem to last for a year or longer. But other coronaviruses, such as the four that cause the common cold, act differently. People seem to be able to get them each season, over and over again.

Daniel Griffin, an infectious-diseases doctor and researcher at Columbia University Medical Center, said that with every virus — including chickenpox, for which antibodies are supposed to last a lifetime — there are cases of people who become sick again after recovering from the initial illness. When it comes to Ebola, American doctor Ian Crozier was declared free of the virus but then doctors found it lurking in his eye. In HIV/AIDS cases, a baby in Mississippi born to an HIV-positive mother was thought to be cured but then the virus reemerged 27 months after therapy was stopped.

So in a world where 14.5 million people have had the coronavirus, a small number with resurgent sickness should not be cause for alarm. “The big question is: Is that a rare situation, or is that going to be the rule?” Griffin said.

Based on what we know about the novel coronavirus, physicians and public health officials say reinfection is certainly a theoretical possibility. But they disagree over whether there is convincing evidence that that is happening and if so, what the implications might be for vaccines.

“No one is yet believing in reinfection since there is no good scientific report on it,” Monica Gandhi, a professor of medicine and associate chief of infectious diseases at the University of California-San Francisco, said. “On the other hand, no one wants to dismiss the possibility.”

Gandhi and others exhort their colleagues to share data and detailed case reports, so the reported cases can be corroborated as reinfections or disproved. .

Conflicting studies

Last week, a British study posted to a preprint server added to the body of evidence that virus-fighting antibodies drop off steeply two to three months after infection — setting off dire news stories asserting that surviving covid-19 would offer little protection against future coronavirus infection and that billions of dollars gushing into the vaccine race might be for naught.

It was quickly followed by another study, also not peer-reviewed, of antibodies in nearly 20,000 New Yorkers with mild or moderate covid-19 symptoms. After retesting 120 of those people three months later, researchers at Mount Sinai Health System found virus-fighting antibodies were largely stable and had even increased in people that started with lower levels right after their infections. The Mount Sinai researchers speculated that the antibody test they used, which has been authorized by the Food and Drug Administration, may have been more sensitive than the ones used in other studies. The researcher who led the British study did not respond to an interview request.

“When you look at other respiratory viruses, you see what we are seeing,” said Ania Wajnberg, an internist at Mount Sinai Health System who led the study. “You expect these antibodies to form, and you don’t expect them to drop off after two weeks. That would be strange. Generally, they take some time to decrease.”

Virologists and immunologists have also been quick to point out that the body’s immune system uses an array of tools to fight infections. Antibodies, a blood protein, have gotten the most attention because they are relatively easy to measure and work in a simple and graspable way — they block viruses from entering cells and rout the infection.

But there are also memory B cells, a type of white blood cell, which create antibodies based on past skirmishes with pathogens. T cells, another type of white blood cell, also play crucial roles — orchestrating the entire immune response, instructing the body to create more antibodies and even actively fighting the virus by killing infected cells.

Scientists are unclear which components of the immune response are most important to fight off the coronavirus. Seeing antibody levels drop off is a concerning sign, but the data is still provisional and conflicting. Even if antibodies decrease, it does not necessarily mean people are just as susceptible if they encounter the virus again.

“Even if you don’t have a very high level of antibodies, you may be able to respond very rapidly to a challenge and nip it in the bud — and that’s because you have memory cells that remember,” said Michel Nussenzweig, head of the laboratory for molecular immunology at Rockefeller University. “You may be able to produce a better response the second time around, a faster response the second time around. So even if you’re exposed to the virus, you may have an aborted infection or something that is very mild.”

In a review of 40 studies published in the Journal of General Virology, British researchers Paul Kellam and Wendy Barclay​ warned that “reinfection of previously mild SARS-CoV-2 cases is a realistic possibility that should be considered in models of a second wave and the post-pandemic era.”

But what “reinfection” means also needs to be studied. A small study of human volunteers who had a common cold coronavirus squirted up their nose — and then came back for a repeat dose a year later — showed that antibodies in their blood declined and people were able to be reinfected with the virus. But they did not develop colds and were less contagious, shedding virus for shorter periods.

Other infections, such as dengue, however, can be more severe the second time around.

Larry Luchsinger, a principal investigator at the New York Blood Center, said the variability in immune responses among people who have been infected — including the finding that some do not develop antibodies at all — suggests people may fall on a spectrum where some have complete immunity, while others are vulnerable to a second infection.

“We wish that everybody that got covid-19 would be protected in the future, but that probably isn’t a reality,” Luchsinger said. But he argues that it is the degree of sickness that matters.

“If we’re finding people who are at-risk, 65-year-olds, get very sick, come out of the hospital and they’re back in — we have a problem,” Luchsinger said. “If 30- to 40-something people [come down] with flu-like symptoms and their immune response wasn’t strong enough and they get it again, that … is terrible, but … we, from a public health policy point of view, want to reduce mortality.”

Kamran Kadkhoda, medical director of immunopathology at the Cleveland Clinic, said the question of what happens when people are re-exposed to the virus is a critical one. If protection tends to be short-lived, he said, it would make masking and social distancing even more important.

“It would definitely be a predicament for public health, there’s no question about that,” he said. “In the absence of a vaccine, the main thing that we’d have against reinfection are these prevention measures.”

But in an interview, Fauci, the director of the National Institute for Allergy and Infectious Diseases, said short-term immunity is a solvable problem.

“How long it [antibody response] lasts is an important question, but as long as you get it, that’s a good first step,” he said. “We’ll find out and when we find out — and if you need to — we’ll give [you] a boost” with another vaccine.

Robert Glatter, an assistant professor of emergency medicine at Lenox Hill Hospital and Northwell Health, the largest medical system in New York State, said if widespread reinfection is a possibility, people may have to be vaccinated over and over again, leading to logistical and supply challenges.

“We may find ourselves confronted with continued seasonal outbreaks having to provide multiple booster shots throughout the year, to ensure more robust immunity,” he speculated.

Relapse

There is no data on how many U.S. patients report being reinfected. But doctors say they began seeing a trickle of relapsed patients in June and July. Those patients ran the gamut, including both men and women in their 20s to 60s, who are distinct from the “long-haulers” and who had complained of symptoms for months. These were people who had tested positive way back when and seemed to be recovered.

At the University of Pennsylvania, there was the pregnant woman infected in March who was fine for two months and then became so sick during childbirth she had to be put on a ventilator. At Cleveland Clinic, there was a patient with very mild symptoms in February — just a loss of smell and taste — who was well for two months, but then needed to be hospitalized in early May and was confirmed to have the virus again.

And at ProHealth Care in Long Island, there was a man infected at the end of March who was never sick enough to be hospitalized. He showed up again in July, this time very ill.

“He thought he had an immunity shield, so he took care of his son when he got covid,” Griffin said. “Two weeks later, he was in the ER.”

The man, who had a very high antibody response the first time and donated his plasma so it could be used to treat other coronavirus patients, had barely any when doctors recently tested his blood in the hospital. Griffin said that while he finds this case very “compelling” and knows of five similar cases, he cautions that it was premature to draw conclusions about reinfection.

To confirm actual reinfection, scientists say, researchers would need to sequence the genetic code and the virus in a person’s body and find two distinct versions — something no one is known to have done.

“This is one of those things I really don’t want to be true,” Griffin said. “But a lot of us are starting to say, ‘I’m willing to entertain it as a possibility. Let’s keep our eyes out and start watching.’”

Glatter, from Lenox Hill Hospital, said he has been surprised that he is seeing with “relative frequency” patients who had coronavirus infections, cleared the virus for six to eight weeks and who come back with a relapse. Their tests with a nasal swab have come back positive.

In the case of Cunningham, the WNBA player, she said during a preseason news briefing last week that in early March, she suffered headaches and lost her sense of taste and smell for four to five days. At the time, she said, doctors assumed she had covid-19 but did not test her for the coronavirus because her illness was mild, and the kits were not widely available. They asked her to quarantine for 14 days, which she did.

She described spending subsequent weeks, while most of the nation was under stay-at-home orders, on her family’s farm. But she did venture out to the gym — where she fears she caught the virus again.

She tested positive on June 18, and her condition this time was more worrisome — shortness of breath, sore throat, headaches and fatigue — and she was isolated for 32 days.

“I’m not going to lie to you — it was a struggle,” she said. “My breathing was weird.”

Cunningham has recovered, and she is expected to be able to resume playing when the season opens later this month. Reached by phone, her father James Cunningham said he considers her very lucky because she is young and healthy:

“If it happened to me, I would be sick still,” he said.

Magda Jean-Louis contributed to this report.



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Several cities seeing jumps in domestic violence reports amid pandemic


In an eastern Pennsylvania town under a local shelter-in-place order, a man who lost his job due to the pandemic shot his girlfriend in the back and then killed himself on Monday. Just before he went into the basement to get his handgun, he became “extremely upset” about coronavirus, the victim, who survived, told police.

“Domestic violence is rooted in power and control, and all of us are feeling a loss of power and control right now,” said Katie Ray-Jones, the CEO of the National Domestic Violence Hotline. “We’re really bracing for a spike post-Covid-19 — that’s when law enforcement and advocates and courts are going to hear the really, really scary stuff going on behind closed doors.”

While police and advocates haven’t seen jumps in domestic violence cases across the board, some hot spots are emerging around the country. Of the 20 large metropolitan police departments that provided data to CNN, nine saw double-digit percentage jumps in domestic violence cases or 911 calls in March, either compared to the previous year or to earlier months in 2020.

Not every department provided standardized numbers — some counted domestic violence-related 911 calls, while others tallied confirmed cases or arrests.

Portland, Oregon had a 27% increase in domestic violence arrests between March 12 and 23, 2020, as compared with the same period in 2019, police said. Boston had a 22% jump in domestic assault and battery reports between March 2019 and March 2020, and Seattle had a 21% increase in reports of domestic violence during the same time period.

But advocates worry that with victims stuck in close proximity with abusers, there are many others who are unable to safely reach out for help.

“I imagine that that is the tip of the iceberg,” said Anne DePrince, a University of Denver psychology professor who studies domestic violence.

How stay-at-home orders impact victims

With more than 96% of Americans living under stay-at-home orders, some cities are seeing significant jumps in domestic violence reports.

Police in Pittsburgh, Charlotte, Oklahoma City, San Antonio and Omaha experienced double-digit percent increases in domestic violence-related calls, comparing March or part of March to 2019 or earlier months in 2020, according to data provided by the departments to CNN. Kansas City reported a similar jump in domestic violence incident reports.

Other cities like St. Louis and Denver registered barely any change in domestic violence calls, while San Diego and Las Vegas saw small declines in calls. New York City, the epicenter of the pandemic, saw a 15% drop in domestic violence complaints from March 2019 to 2020, although an aide to New York Gov. Andrew Cuomo said Friday that the state police had received reports about spikes in cases elsewhere in the state.

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Chicago’s domestic battery 911 calls are up only 3% between March 2019 and 2020, according to data provided by the city — but calls to the Illinois Domestic Violence Hotline have spiked, with the hotline hitting its highest daily call volume in its 20-year history this week, city officials told CNN.

Experts say the varying numbers might have to do with the different timing of when shelter-in-place orders went into effect. And in some cities, calling 911 may be domestic violence victims’ main resource to get help, while other areas have robust networks of nonprofit agencies and hotlines that survivors turn to first.

Some organizations are seeing changes in the times their hotlines are busiest. In the last two weeks of March, a Seattle domestic violence hotline, New Beginnings, saw a 34% drop in typical call volume during the daytime on weekdays, but a 13% jump in calls at night. Susan Segall, the organization’s executive director, said that was likely because victims who typically find time alone during the day now don’t have that opportunity to avoid their abuser, or because they’re now busy taking care of kids.

The national hotline, which typically gets around 1,800 to 2,000 calls, chats and text messages a day, has stayed at a mostly normal pace, Ray-Jones said. But because of isolation, she predicted that there would be a flood of more reports after social distancing measures ease.

“They can’t reach out safely, because their perpetrator is sitting right next to them,” Ray-Jones said.

The group has been receiving an increasing number of calls from survivors who say the pandemic is making their situation worse. One woman was audibly hoarse and said her partner had tried to strangle her, but she was too scared of the virus to go to the hospital, Ray-Jones said.

Another woman calling in to the hotline said her partner had started slowly loading his gun as she got ready to leave for her job, telling her she couldn’t go outside at all. A third said her partner had forced her to keep scrubbing her hands until they were raw.

Rhonda Voss, 63, a domestic violence activist and survivor in North Carolina, said being cooped up at home is a domestic violence victim’s nightmare.

“I know they would be constantly walking on eggshells just trying their best to stay out of the way, to keep the person appeased,” she said. Getting out of the house can be “such a relief” for victims, she said, “and that’s not available that much now.”

Shelters are struggling to help

In some ways, the coronavirus pandemic seems like the worst possible scenario for domestic violence victims. In addition to being cloistered inside with their abuser, job and financial losses can inflame stress. The economic impact can also make it harder for survivors to plan an escape or hold onto their financial independence.

Research suggests an association between natural disasters and increased rates of domestic violence. After Hurricane Harvey flooded Houston in 2017, for example, the city saw an increase in domestic violence reports.
Women are using code words at pharmacies to escape domestic violence during lockdown

Now, the pandemic could have a similar effect — but like a hurricane slamming the entire country at the same time.

During Harvey, “the stressors of being out of work, being at home, losing everything — that spiked our violence,” said Chau Nguyen, the chief public strategies officer for the Houston Area Women’s Center. “You’re going to see it more and more.”

Now, Nguyen’s shelter is full, and they’re struggling to help the people calling. One pregnant woman who the shelter is helping is terrified that she’s going to have to go home after giving birth because she has no place to go, Nguyen said. Another woman who fled from another state had been reaching out to domestic violence shelters around the region and finding none of them had any space.

Neha Gill, the executive director of Apna Ghar, a Chicago domestic violence shelter that focuses on immigrant and refugee communities, said her shelter is also full. They had to cut the capacity of the shelter by two-thirds — from about 30 people to about 10 — in order to maintain safe social distancing policies.

“It’s been frustrating and painful for those of us whose job is to help,” she said.

For now, the Houston and Chicago shelters are both paying out of pocket for hotel rooms for some survivors who desperately need to leave home. Gill said she hoped the city or state would start a program to fund similar efforts.

That has left advocates to get creative. In several cities, courts have started granting temporary restraining orders remotely. Others groups are promoting their texting help line, which might be easier for victims to surreptitiously use even from the same room as their abuser. They’re encouraging family members to stay in close contact with victims suffering abuse.

Staff at DC SAFE, a nonprofit that helps coordinate response to domestic violence cases in Washington, DC, has found that as more of the city has shut down, it’s taken twice as long for them to find resources for survivors like mental health services, food or transportation.

“All the services that would normally happen are really not happening,” said Natalia Marlow-Otero, the group’s executive director. “As barriers increase for survivors and services shrink, they are left in situations where there’s not a lot of options for them.”

Reports of deadly domestic violence cases tied to coronavirus

There have already been several domestic violence fatalities around the country which police have tied to coronavirus.

In Colorado Springs, a woman accused of fatally shooting her husband in their home last month said he had brandished a knife at her, “blaming the coronavirus and stating he was not going to live through it,” according to court documents reported by the Colorado Springs Gazette.
In Wilson Borough, Pennsylvania, a town about 50 miles north of Philadelphia, 38-year-old Roderick Bliss IV shot his longtime girlfriend in the back on Monday before killing himself, detective Dan Pacchioli said in an interview. Bliss had become increasingly upset about coronavirus after losing his construction job due to the pandemic, the victim told officers.

“She was completely shocked that he went off the wall in the way he did that day,” Pacchioli said.

But in the vast majority of domestic violence cases, any connection to the pandemic is less obvious.

Ed Gonzalez, the sheriff of Texas’ Harris County, which includes Houston, said his county has had two domestic violence murders in the last two weeks, including one in which a husband allegedly left his three young children at home with the body of his wife and went to the police to turn himself in.

“It’s not that all of a sudden the virus comes along and people become abusive — it’s already there,” Gonzalez said in an interview. “Many people will not be killed by Covid-19, but instead they’ll die at the hands of an intimate partner.”

Some families are left wondering whether the isolation caused by the pandemic could have played a part in their loved one’s death.

In Mashpee, a Massachusetts town on Cape Cod, 53-year-old Sandra Corfield was killed last week in a suspected domestic beating that took place two days after the state’s shelter-in-place order went into effect. Her boyfriend, Marc Audette, told police that he was “off my meds” and that Corfield had kept saying “I love you” while he was hitting her in the head, according to a police report reviewed by the Cape Cod Times. Audette has pled not guilty to Corfield’s murder.
Corfield was an art teacher at Boston schools who painted murals and taught modeling. She had been with Audette for about a year and had seemed happy with him, her mother, Eleanor Corfield, said in an interview.

Eleanor said she didn’t know whether the pandemic and shelter-in-place order had played any role in her daughter’s death. “It could have tied into it, it could very well have,” she said. “They were together all the time.”

Now, with a large funeral impossible under the stay-at-home order, Eleanor said she was planning to ask for donations to a domestic violence charity in honor of her daughter.

“I would like the word to get out, if it even helps one battered woman,” she said. “I would like them to know it’s okay to reach out for help.”

Resources for victims of domestic violence

National Domestic Violence Hotline Call 1-800-799-7233 or text LOVEIS to 22522

Available 24/7. Can connect callers with local resources and immediate support. Also available through online chat tool.

National Sexual Assault Hotline 1-800-656-4673

Provided by RAINN (Rape, Abuse & Incest National Network). Available 24/7. Also available through online chat tool.

Crisis Text Line Text HOME to 741741

Available 24/7 for victims of abuse and any other type of crisis.

Childhelp National Child Abuse Hotline 1-800-422-4453

Available 24/7 in 170 different languages.

Office on Women’s Health Helpline 1-800-994-9662

A resource provided by the US Department of Health & Human Services.



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