Daily Archives: July 15, 2020

By: Stephen M. Hahn, M.D., Commissioner of Food and Drugs, Patrizia Cavazzoni, M.D., Acting Director, Center for Drug Evaluation and Research, and Peter Marks, M.D., Ph.D., Director, Center for Biologics Evaluation and Research

When the U.S. Food and Drug Administration learned of the novel coronavirus (COVID-19) and its potentially devastating effects, we acted swiftly to set the regulatory stage for drug and biologics manufacturers to develop products to treat this serious disease. To meet this urgent need, the FDA created the Coronavirus Treatment Acceleration Program (CTAP) to enable the FDAs Center for Drug Evaluation and Research (CDER) and Center for Biologics Evaluation and Research (CBER) to leverage cross-agency scientific resources and expertise to bear on COVID-19 therapeutic development and review. Were excited to say that there are now more than 510 drug development programs in planning stages, and as of today, the agency has reviewed more than 230 trials of potential therapies for COVID-19.

While the FDA is part of a whole of government approach to COVID-19, CTAP is a distinct component of this effort focusing specifically on therapeutics, not vaccines or devices. Another major initiative of the U.S. government, Operation Warp Speed (OWS), funds and rapidly develops or co-develops vaccines, therapeutics, and diagnostics, while the FDA, through CTAP, regulates therapeutic development. There is a clear delineation between OWS executive actions and FDA regulatory decision-making.

The FDA recognized that there would be a need for early and frequent discussions between the agency and potential therapeutic product developers. So early on, we set up an email inbox for COVID-19 therapeutic development inquiries, COVID19-productdevelopment@fda.hhs.gov. It helps researchers and developers get directed to the right person on the first try and enables us to track inquiries.

Each inquiry the FDA receives is reviewed by a triage team that is composed of experienced clinical reviewers, other scientific reviewers, policy experts and regulatory project management staff. The team strives to acknowledge receipt within 24 hours. These staff help those with proposals for potential COVID-19 therapeutics identify and add any information necessary to ensure that the proposal is complete enough for productive discussion. Then, the team sends the proposal with a brief synopsis to the right organizational unit within the FDA for review by disease area experts.

Teams of experienced clinical reviewers and regulatory affairs experts in CDER and CBER provide outreach and regulatory advice to less experienced inquirers. Preliminary, partially-formed inquiries go to them before they are assigned to product review teams to determine next steps for engaging with the FDA, including what regulatory submission is appropriate, what to include in that submission, and how to submit it.

Once individual inquiries develop into proposals, our discussions with sponsors can then meet several key milestones:

We will continue to report the number of active drug development programs, studies underway, EUAs and approvals at our CTAP program dashboard monthly.

Behind the scenes of CTAP, office leaders within CDER and CBER align our efforts across therapeutic areas, scientific disciplines, and organizational units. Clinical, operations and policy supervisors meet regularly to discuss staffing support, trial design, endpoint selection, and consistency of practice and expectations for COVID-19 submissions. Clinical and biostatistical experts meet regularly to share information, advance our scientific understanding and develop consistent approaches. Senior leadership stay actively engaged on key drug and biologic development and review issues.

When CTAP started, we achieved extraordinary turnaround times for certain significant inquiries and proposals, to get key studies going rapidly. For therapeutic development programs with strong rationales and evidence, we continue to dramatically exceed standard timelines. We have found that a complete pre-IND submission is the key to expediting comprehensive pre-IND advice, more rapid review of the subsequent IND and more rapid clinical trial initiation.

While we have shortened our timelines, our regulatory review and decision-making processes have not changed. Interactions with review teams follow our usual stable, predictable, and flexible process. We give all researchers and developers our best advice, apply our legal and regulatory standards, and make decisions on the basis of the science and the data.

Safe and effective COVID-19 therapeutics and other medical products are a very high priority at the FDA. We understand the impact of this public health emergency and approach our role in facilitating the development and availability of important medical products with the strongest sense of urgency.

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An Update and Behind the Scenes: FDA's Coronavirus Treatment Acceleration Program - FDA.gov

Good morning.

(This article is part of the California Today newsletter. Sign up here to receive it by email.)

Californians who dont have symptoms of Covid-19 will probably have a harder time getting tested for the coronavirus, according to new, stricter guidelines state officials unveiled on Tuesday.

It is critical we continue to be deliberate and creative about testing, Dr. Mark Ghaly, the states head of health and human services, said in a statement. We must do this so that testing is readily available and affordable to those who need it, especially those communities experiencing the worst impacts.

In a virtual news conference, Dr. Ghaly said California was also exploring opportunities for pooled testing, a strategy that could help identify infections in large groups more quickly.

The shift in testing strategy comes as more states around the country have scrambled to ramp up testing, which has resulted in tighter supply chains and longer turnaround times in California, the nations most populous state.

California has contended with an explosion in cases, prompting Gov. Gavin Newsom on Monday to announce the most sweeping rollback yet of reopening plans.

[Read about which businesses were ordered to close down.]

As of Tuesday, California was averaging 8,334 new cases per day over the past week, compared with 3,041 new cases per day on average just a month ago.

Heres what to know about the changes:

Why are they happening now?

Over the past two weeks, the state reported 107,600 tests per day on average a huge increase over the past couple of months. But the states percentage of tests that have come back positive for the virus has inched upward, as well, to 7.1 percent on average over the past two weeks.

Our testing capacity has increased exponentially, Dr. Ghaly said in the statement. At the same time, new national supply chain challenges and large volumes of specimens sent to commercial laboratories have resulted in growing delays in processing times.

What do the new guidelines say?

Previously, state and local officials had encouraged anyone who wanted to get tested to see if they were eligible, whether or not they had symptoms, as testing capacity ramped up across California and case numbers were less troubling.

Under the new guidelines, Dr. Ghaly said that testing would be much more strategically targeted at people in communities where risks of transmission are higher.

Of course, people who have severe symptoms will be prioritized for tests with quick results so they can get a diagnosis and be treated.

According to the new rules, people who have been hospitalized fall in the Tier 1 priority group, along with people who must be tested as part of investigations into specific outbreaks.

Tier 2 includes everyone else with Covid-19 symptoms, as well as people who live or work in the kinds of facilities where outbreaks have been most severe, such as nursing homes, prisons and homeless shelters. It also includes health care workers who have frequent interactions with the public or with people who may have Covid-19.

Tier 3 includes workers in remaining essential sectors, like grocery stores, logistics, manufacturing and education, if they dont have symptoms.

And then, theres Tier 4, which will be implemented only when the test turnaround time is less than 48 hours, as monitored by the state. Thats when anyone else who doesnt have symptoms, but is worried they may have been infected, can get tested.

How will these new rules help stop the spread of the virus?

While individual actions, like following distancing and mask-wearing rules, are critical for curbing the spread of the virus, increasingly, experts have recognized that many transmissions are taking place because Californians who work in low-wage, high-risk jobs havent been able to stop working.

In a first-of-its-kind analysis, researchers at the University of California, Merced, Community and Labor Center found a connection between high concentrations of low-wage work in certain counties like at farms and in warehouses and the prevalence of Covid-19.

Our findings emphasized the importance of not just regulating business openings, but mitigating Covid spread by innovating health and safety reforms for workers, Ana Padilla, the centers executive director, told me.

One way to do that is to ensure that workers in those communities have access to testing and that workplace outbreaks are transparent. That would mean requiring counties to report test results by industry, the report said.

Although we have guidance and support, we know that testing in those environments is key, Dr. Ghaly said on Tuesday, adding that thats why the new testing strategy involves homing in on workplace outbreaks.

Updated July 15, 2020

Still, he said the state hadnt specifically asked counties to report test results by industry or employer.

[Read more about how the pandemic has put warehouse workers in the Inland Empire in a tough spot.]

We often link to sites that limit access for nonsubscribers. We appreciate your reading Times coverage, but we also encourage you to support local news if you can.

The Trump administration abandoned its plan to strip international college students of their visas if they didnt attend at least one class in person. It was a rare and swift reversal in response to fierce opposition. [The New York Times]

Most of the nations big school districts including in Los Angeles and San Diego arent ready to reopen, because the test positivity rates in the communities where theyre located are much too high. And reassuring examples of schools reopening abroad dont apply here. [The New York Times]

Bankruptcy forced Stockton to defund its Police Department, making it an inadvertent laboratory for pushes to reduce the roles of law enforcement officers in keeping communities safe. [The Los Angeles Times]

If you missed it, heres what Stocktons mayor had to say about calls to defund the police now. [The New York Times]

Transit agencies around the country are struggling. In the Bay Area, there are too many disjointed systems and not enough riders. [Bloomberg CityLab]

Wineries were beginning to settle into a new normal. Then they were told they had to shut down indoor operations.[The San Francisco Chronicle]

He goes by Bruce or Paco or Peter or Pierre or Abraham. He is a peacock. And hes tearing a North Oakland neighborhood apart. [SFGate]

We joke about it: How many years has it been since 2020 started? How many lifetimes?

Theres a sense that were living through a momentous period in history a global pandemic, uprisings over racial justice that have poured into every corner of society and broad recognition that the world is changing rapidly.

So museums and curators are asking us all to help them help future generations understand this time by documenting it. Everything, like protest signs, shopping lists, or snippets of video.

Whatever were taking to be ordinary within this abnormal moment can, in fact, serve as an extraordinary artifact to our childrens children, Tyree Boyd-Pates, an associate curator at the Autry Museum of the American West, told Lesley M.M. Blume, in this article. The Autry is asking for submissions to its Collecting Community History Initiative.

California Today goes live at 6:30 a.m. Pacific time weekdays. Tell us what you want to see: CAtoday@nytimes.com. Were you forwarded this email? Sign up for California Today here and read every edition online here.

Jill Cowan grew up in Orange County, went to school at U.C. Berkeley and has reported all over the state, including the Bay Area, Bakersfield and Los Angeles but she always wants to see more. Follow along here or on Twitter.

California Today is edited by Julie Bloom, who grew up in Los Angeles and graduated from U.C. Berkeley.

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Why You May Not Be Able to Get a Coronavirus Test in California - The New York Times

CHICAGO Chicago could close businesses and go back to Phase 3 if new cases continue to climb, Mayor Lori Lightfoot warned Wednesday morning.

The announcement comes as the citys average number of new cases continues to climb, as does the positivity rate. Young people are driving the uptick in new cases, with people age 18-29 now accounting for 30 percent of coronavirus cases reported in recent weeks in Chicago, officials said.

The Lincoln Park area is the spot thats seen the most increases in cases of people age 18-29.

Lightfoot said people age 18-29 must stop gathering in large groups and start wearing masks in public if the city wants to stay on track.

After that age group, the most new cases have been seen among people 30-39 and 40-49 years old, officials said.

The rise in cases comes as other cities across the country are rolling back their reopenings because theyve faced more significant surges in new cases.

Yes, our metrics are tracking better than the rest of the country, but that doesnt mean that we can ever let our guard down, Lightfoot said. It means our precautions are working and that we need to continue to be diligent.

The city is now seeing an average of 192 new cases per day. That number has been slowly climbing for weeks and its now worryingly close to 200, the number at which Chicago goes back to being considered a city with a high incidence of coronavirus.

And Dr. Allison Arwady, commissioner of the Chicago Department of Public Health, said she expects new cases to keep climbing.

When we get back above 200 were back in a high incidence state, and for me that means we are back in a caution state, Arwady said during Wednesdays press conference. At another point, she added, I think there is wishful thinking happening that COVID is over.

It is not over.

Hitting and staying above 200 will be a great concern for officials, Arwady said. Lightfoot said they had the press conference so they could warn Chicagoans theyre close to the 200 mark; they hope the warning can keep people from violating social distancing rules and driving up new cases.

If the city does hit more than 200 cases per day, it will not equal an automatic rollback to Phase 3, but officials will look at problem areas, Arwady said. If theyre seeing cases come from bars, theyd consider closing bars, for example.

For you following every day how were doing in Chicago, thats the number I want you to watch, Arwady said. And I want you to help us drive that number down. Its how we move ahead in Chicago and not backwards.

What things are closed or rolled back would depend on how much cases increase and how quickly, but the city could consider a full move back into Phase 3 if Chicago was seeing an average of more than 400 new cases per day, officials said.

An uptick would mean Chicago has no choice but to go back to Phase 3, Lightfoot said. Thatd mean an end to indoor dining, the closing of businesses like theaters and prohibiting people from gathering in groups larger than 10. Thered be restrictions on mobility again, as well, Lightfoot said.

Lightfoot said people must wear masks in public and stop gathering in large groups if they want to prevent a rollback and keep businesses open.

Minimize gathering in large groups. I repeat: The larger the group the higher risk that someone in that group has COVID-19. So minimize gathering in large groups, Lightfoot said. Wear a face covering when you leave your house everywhere not just some of the time, but all of the time. Thats critically important to reduce the spread.

Young people are at less risk for serious adverse effects of COVID-19, but they can happen, Arwady said. A Chicago woman in her 20s who had no significant underlying conditions had to get a double lung transplant last month coronavirus severely damaged her lungs.

You are not immune to COVID-19, Lightfoot said to young people. The reality is actually quite different, and the data proves it. Were seeing these increases across race and ethnicity and all over the city [among young people]. And this should be the proof that you need: If you are in the 18-to-29-year-old cohort, you are catching COVID-19. You are getting sick.

The problem isnt just that youre hurting yourself. The problem isnt just that youre hurting people in your network. Youre hurting the whole city.

Officials also pointed out young people could transmit the virus to older people, who are more at risk from COVID-19. Arwady said shes concerned Chicago could see an increase in cases among elderly people.

Especially if youre in a younger age group, Im not surprised youre out more, Arwady said. Youre at a lower risk, it is true, for these serious outcomes; but, if you have in your close circle people who have underlying conditions or especially people in those older age groups, I need you to be extra careful with those vulnerable folks in your life.

Still, Arwady noted, Chicago has seen fewer deaths in recent weeks. The city is down to an average of four deaths per day from coronavirus, the lowest that number has been since March. The doctor expects there will soon be a day when Chicago sees no deaths from COVID-19.

And hospitalization data looks great, Arwady said, with the numbers of people hospitalized, in the ICU and using a ventilator all declining.

Lightfoot said she wants to avoid shutting down the economy again, but, if we must, we must.

We are dangerously close to going back to a dangerous state of conditions, she said.

BlockClubChicagos coronavirus coverage is free for all readers.BlockClubis an independent, 501(c)(3), journalist-run newsroom.

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Chicago 'Dangerously Close' To Reversing Course On Coronavirus Progress And Going Back To Phase 3, Mayor Warns - Block Club Chicago

UPDATED 4:15 PM One day after Los Angeles County reported a record number of new coronavirus cases, the Los Angeles Public Health Department confirmed that Wednesday saw the highest number of COVID-related hospitalizations reported since the pandemic began. There are currently 2,193 people currently hospitalized with coronavirus. That breaks a record set just two days before.

Public Health Director Barbara Ferrer called new data troubling and startling, before warning a return of a countywide stay-at-home order might be in the offing.

The director announced that the 7-day rolling average of the test positivity rate is up to 9.8 percent. Thats compared to 9 percent earlier this week.

Ferrer said the county had seen 2,758 new cases of COVID-19 reported over the past 24 hours. While not an all-time high, the number was significant enough to prompt the director to say, We are in an alarming place. She followed by saying noting the 7-day average of 2,859 new cases a day is double where it was in June.

Related StoryLos Angeles Mayor Eric Garcetti Warns He Is On Brink Of Issuing A Total Shutdown Order As Coronavirus Hospitalizations, ICU Cases Hit New High

We dont want to see upwards of 3,000 cases a day, she said.

We now see a 3 day average of over 2,000 people hospitalized from COVID-19, more than at any other time since the pandemic began, said Ferrer. Those are the highest rates the region has had since the pandemic began.

There has also been an increase in patients who need ICU and ventilators, said Dr. Christina Ghaly, Director of the Los Angeles County Department of Health Services. She then reported that the effective transmission number is now 1.07. Thats up from 1.01 late last week.

As a result, The number of ICU beds may become inadequate, she warned. Hospitals and local health officials are, according to Ghaly, Working to implement disaster plans. The biggest issue thats constraining ICU beds is staffing, she said, not the beds themselves.

The number of remaining ICU beds was, frustratingly, not given. But Ferrer did reveal that there are currently 2,193 people who are hospitalized with COVID-19.

According to L.A. Mayor Eric Garcetti, on Monday there was a record-high total of 2,103 hospitalizations in the county, with 766 beds left. Monday saw an increase to 565 ICU patients compared with 397 a month ago, Garcetti said then. There were 141 ICU beds remaining in the greater Los Angeles area at that time, according to the Mayor.

These trends are related to actions two weeks ago, said Ferrer, noting the recent Memorial Day holiday. But, after several workplace closings after outbreaks, businesses also need to do better, she indicated.

All workplaces, she said, must deploy essential resources to every worker.

Keeping businesses open is only possible if we can slow the spread, said Ferrer. Business owners and operators, she continued, have a moral corporate responsibility to keep employees healthy.

When asked about a renewed Safer-At-Home order, Ferrer said, We cant take anything off the table. We have to do everything we can to protect the health care system. Do we want to go back to a Safer-At home order? Absolutely not.

The trends, however, seem to have L.A. headed in that direction.

On Monday California Governor Gavin Newsom ordered all counties to close their restaurants, movie theaters, family entertainment centers, wineries, zoos and bars for indoor service. Bars were ordered to close entirely.

Additionally, L.A. and 31 other counties on the states monitoring list must close fitness centers, places of worship, nail and hair salons and indoor malls. Other L.A.-local counties impacted include Santa Barbara, Ventura, San Diego, Orange and virtually every other county in Southern California.

On Tuesday, the Los Angeles County Department of Public Health confirmed record new COVID-19 cases and hospitalizations in a day with 4,244 new cases and 2,103 people currently hospitalized.

That compares with 2,593 new COVID-19 cases on Monday.

Of the 2,103 people hospitalized on Monday, 27 percent of these people are confirmed cases in the ICU and 19 percent are confirmed cases on ventilators. According to L.A. Mayor Eric Garcetti, on Monday there were only 766 hospital beds left for the regions 10 million residents.

That led Garcetti to say that the citys COVID-19 threat meter is on the border of going to red, the highest level, which would mean a complete shutdown in L.A. owing to the pandemic.

The county confirmed 73 new deaths of Covid-19 on Tuesday. This is one of the highest number of new deaths reported in a day and may reflect a lag in the reporting of deaths over the weekend. To put that in perspective, said Ferrrer, 76 deaths is the most weve seen since this pandemic began.

There were 44 new deaths due to coronavirus on Wednesday, with a total of 3,932 total deaths in L.A. County since the pandemic began.

On Wednesday, health officials also announced that the county is expanding its testing footprint by 65 percent over the next few weeks, especially in South Los Angeles. Currently, the region conducts about 100,000 tests a day for a population of 10 million.

New health officer order, effective today prioritizes those who have symptoms, are in high-risk settings. Known close contact. Essential workers. Effective today. Unless you fall into one of those categories, you may not need to be tested.

The order comes one day after Governor Gavin Newsom announced similar guidance on testing.

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Los Angeles County Coronavirus Hospitalizations Break Record For Second Time This Week As Top Health Official Warns New Stay-At-Home Order Not Off The...

He loved to get his family together, Ms. Flores said. And thats what took him.

My familys encounter with the virus started in the last week of June, when my 17-year-old nephew, who mistook his virus symptoms for strep, joined my 66-year-old mother, 69-year-old father, two sisters and a brother-in-law on a medical road trip to Houston, where my mother had scheduled a mammogram.

Hablas espaol? To read more of our stories in Spanish, subscribe to our newsletter El Times.

On their way back to the Valley, they visited relatives in Galveston. After Fathers Day, about a dozen relatives who had met one another during the trip began describing debilitating headaches, body chills, fever and trouble breathing, all classic Covid-19 symptoms.

The Contreras family was in a similar situation. They gathered for their festive pachanga on June 1, dancing to mariachi music, sharing family stories and savoring classic Mexican barbecue.

Because they kept it small, they thought they were doing the right thing, said Ms. Flores, who stayed home because she worried about the virus.

It only took a few days for Mr. Contreras to develop a severe respiratory illness. Two of his sons soon joined him in the hospital with difficulty breathing. Soon uncles, aunts and cousins also fell ill.

Ms. Flores told me that when she heard her grandfathers brain was bleeding, she rushed to the hospital and found him unconscious and connected to several tubes.

Your gera is here, she whispered, using the nickname he had given her as a child, alluding to her light complexion.

See the article here:

I Went Home to Texas to Cover the Virus. Then My Family Got It. - The New York Times

The BDN is making the most crucial coverage of the coronavirus pandemic and its economic impact in Maine free for all readers. Click here for all coronavirus stories. You can join others committed to safeguarding this vital public service by purchasing a subscription or donating directly to the newsroom.

Another 12 cases of the coronavirus have been detected in Maine, health officials said Wednesday.

There have now been 3,578 cases across all of Maines counties since the outbreak began here in March, according to the Maine Center for Disease Control and Prevention. Thats up from 3,566 on Tuesday.

Of those, 3,186 have been confirmed positive, while 392 are likely positive, according to the Maine CDC.

New cases were tallied in Androscoggin (4), Cumberland (4), Oxford (1), Penobscot (1), Waldo (1) and Washington (1) counties. Daily changes in county-level data may vary from new case reports as the Maine CDC continues to investigate cases.

No new deaths were reported Wednesday, leaving the statewide death toll at 114. Nearly all deaths have been in Mainers over age 60.

So far, 373 Mainers have been hospitalized at some point with COVID-19, the illness caused by the coronavirus. Of those, 12 are currently hospitalized, with nine in critical care and four on ventilators.

Meanwhile, 17 more people have recovered from the coronavirus, bringing total recoveries to 3,079. That means there are 385 active and likely cases in the state, down from 390 on Tuesday.

Heres the latest on the coronavirus and its impact on Maine.

International students at the University of Maine are relieved that they no longer will have to leave the country if the university continues to offer only remote learning during the COVID-19 pandemic. Eesha Pendharkar, BDN

The committee charged with recommending urgent measures to stabilize and support Maines economy amid the coronavirus pandemic recommended the state provide $1.1 billion in aid in an initial report to Gov. Janet Mills on Tuesday. Lori Valigra, BDN

Mainers came out, wore masks and stood 6 feet apart on Tuesday to cast their votes in the states primary election. See how the turnout looked amid the coronavirus pandemic in this photo essay. Natalie Williams, BDN

University of Southern Maine director of athletics Al Bean said he and school administrators agonized over the decision to cancel fall semester sports due to the ongoing COVID-19 pandemic. But they felt there was no choice. Larry Mahoney, BDN

As of Wednesday evening, the coronavirus has sickened 3,478,017 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 137,106 deaths, according to Johns Hopkins University of Medicine.

Read the rest here:

July 15 evening update: The latest on the coronavirus and Maine - Bangor Daily News

A robot introduces itself to patients in Kigali, Rwanda. The robots, used in Rwanda's treatment centers, can screen people for COVID-19 and deliver food and medication, among other tasks. The robots were donated by the United Nations Development Program and the Rwanda Ministry of ICT and Innovation. Cyril Ndegeya/Xinhua News Agency/Getty Images hide caption

In some places in the world right now, getting tested for COVID-19 remains difficult or nearly impossible. In Rwanda, you might just get tested randomly as you're going down the street.

"So whenever someone is driving a vehicle, bicycle, motorcycle or even walking, everyone is asked if you wish to get tested," says Sabin Nsanzimana, director general of the Rwanda Biomedical Center, which is the arm of the ministry of health that's in charge of tackling COVID-19. Health officials in personal protective equipment administer the test. Nsanzimana says the testing is voluntary, although some others say refusal is frowned upon.

The sample collection from a swab up the nose and filling out the contact information paperwork takes about five minutes.

"All these samples are sent that day to the lab," Nsanzimana says. "We have a big lab here in Kigali. We have also six other labs in the other provinces."

Despite being classified by the World Bank as a low-income country, and despite its limited resources, Rwanda has vowed to identify every coronavirus case. Anyone who tests positive is immediately quarantined at a dedicated COVID-19 clinic. Any contacts of that case who are deemed at high risk are also quarantined, either at a clinic or at home, until they can be tested.

Nsanzimana says health workers call or visit every potential contact of someone who tests positive.

"We really believe that doing so is important to make sure we detect and trace where the virus could be," he says.

Comprehensive contact tracing is a task that has overwhelmed countries with far more resources than Rwanda. Rwanda's per capita income is roughly $2,000 per year. Yet all testing and treatment for the virus is provided for free.

It costs the government between $50 and $100 to run a single coronavirus test, Nsanzimana says. In order to test thousands a day, Rwanda has started using a process called "pool testing." Material from 20-25 nasal swabs are all put into one vial and run through the machine. This allows them to test far more samples at once. If they get a positive result, then all the swabs that went into that initial vial are tested individually to pinpoint the person who's infected.

Nsanzimana says Rwanda's experience dealing with other infectious disease outbreaks is helping it now during the pandemic.

The country is using systems and equipment it already had in place to address HIV.

"The main machines we are using for COVID testing are the HIV machines that were (already) there," he says. "We are using the same structure, same people, same infrastructure and laboratory diagnostics, but applying it to COVID testing."

Since recording its first case in mid-March, the country of 12 million has recorded just over 1,200 cases. Ohio has a similar size population and has recently been reporting roughly 1,200 cases a day.

"Rwanda did a few things that are quite smart," says Sema Sgaier, the head of the Surgo Foundation, which has just launched a new data tool to analyze trends around COVID-19 across Africa. "One is they responded really early. They put some of the most stringent lockdowns in place compared to every other African country. In fact, we've been monitoring physical distancing data across the continent and Rwanda fares, I think, second; they've physical distanced the second most across Africa" a conclusion based on mobile phone movement data. South Africa is No. 1.

Rwanda mobilized community health care workers and police and college students to work as contact tracers. It set up national and regional command posts to track cases. It's even using human-size robots in the COVID-19 clinics to take patients' temperatures and deliver supplies.

Tolbert Nyenswah, who ran the Liberian ministry of health's response to Ebola in 2014, gives Rwanda high marks for how it has been handling COVID-19, even if at times it's heavy-handed.

"Rwanda, from all indications, is a success story for Africa," Nyenswah says. The strong leadership from President Paul Kagame, which Nyenswah says can even be authoritarian, has been effective during this crisis. Kagame demands accountability from his health ministry.

Whether the people trust or fear the government, Rwandans listen to their government and have been following the orders regarding masks, washing hands and staying home.

Nyenswah worries that the worst is yet to come in Africa with this pandemic.

"No country is out of the woods yet," he says. However, he adds that Rwanda is an example to other low-income countries that even with limited resources, this virus can be contained. "So what needs to be done is to follow the (prevention and containment) measures. Political leadership is very, very crucial. Rwanda should continue what it is doing now. And other countries should emulate Rwanda."

Read this article:

Coronavirus Success Story: How Rwanda Is Curbing COVID-19 : Goats and Soda - NPR

With coronavirus spreading faster than ever in the U.S., two new studies are providing more evidence that universal face masking is an effective tool to help slow the spread of the virus. The new research comes just as Walmart, the nations biggest retailer, said it will require all customers to wear a mask.

This week, the director of the Centers for Disease Control and Prevention said that if everyone in America wore a mask, washed hands frequently and practiced social distancing, the spread of the virus would be under control in one to two months.

Cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus particularly when used universally within a community setting, Dr. Robert Redfield said in a statement. All Americans have a responsibility to protect themselves, their families and their communities.

Saskia Popescu, an infectious disease epidemiologist at the University of Arizona, said the plea from the CDC shows the U.S. needs to unite to make a collective effort on masking.

Now is the time for us to work together, and universal masking is one such effort that can make a huge impact, Popescu wrote in an email.

Two new, real-world studies showed how effective face coverings are in slowing coronavirus spread.

In the first, researchers at Massachusetts General Hospital in Boston monitored how wearing a mask affected transmission rates of SARS-CoV-2, the virus that causes COVID-19, among hospital health care workers.

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Researchers tracked the infection rates among staff before and after the mask mandate.

Before masking, the positivity rate of testing was increasing exponentially at a rate of 1.16 percent per day. After masks were required, the positivity rate among health care workers started to slowly decline at rate of 0.49 percent per day.

It's almost a stress test of masking, and it showed that masking is effective in terms of reducing infection from COVID, said Dr. Deepak Bhatt, lead author of the study and a professor at Harvard Medical School and the executive director of interventional cardiovascular programs at Brigham and Womens Hospital.

Bhatt hopes the research will help ease political resistance to wearing a mask.

What we're doing here is bringing out some science," Bhatt said. "This isn't politics. This isn't blaming anyone. This isn't us trying to second guess what's already happened, but rather allow a way hopefully for us all to move forward together and support masking."

A separate report released by the CDC Wednesday found that masks protected against the virus spread in a Springfield, Missouri, hair salon.

Two hair stylists at the salon developed respiratory symptoms but had continued working until they received positive test results for coronavirus.

Between the two stylists, 139 clients had been potentially exposed between the time the stylists developed symptoms to when they received the test results. Both of the stylists and their clients wore face coverings while they were in the salon.

Through contact tracing efforts, local officials found no symptomatic cases reported from exposure to the hair stylists. In addition, 67 of the clients who were exposed were tested and all of them were negative.

This is a beautiful experiment; you couldn't have designed a better one to show that masks work," Dr. Carlos del Rio, an infectious disease specialist and chair of the department of global health at Emory University, told NBC News.

According to Del Rio, one limitation of the study was that not all clients underwent testing, leaving a possibility of asymptomatic infections. Recent CDC estimates say that as many as 40 percent of infections may be asymptomatic.

Ideally you would have liked to test everybody," Del Rio said. "But the reality is, it shows pretty nicely that masks work.

Hair salons remain open in Texas, Arizona, and Florida where cases are surging and ICU bed capacity is dwindling.

Popescu, who resides in Arizona and is seeing the devastating effects of the epidemic in her state, has observed an increase in mask use and attributes this to the recent media attention and mask mandates in many states and communities.

Now is the time for us to rally around public health efforts, help reduce the strain on health care workers and hospitals, and keep ourselves and our loved ones safe, she said.

Akshay Syalis a medical fellow with the NBC News Health and Medical Unit.

Link:

COVID-19 and masks: New evidence shows that cloth face coverings slow coronavirus spread - NBC News