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REYKJAVIK, Iceland, April 14, 2020 /PRNewswire/ -- Scientists at deCODE genetics and colleagues from Iceland's Directorate of Health and the National University Hospital today publish online in the New England Journal of Medicine a population-based study of the early spread of the SARS-Cov-2 virus (causing COVID-19 disease) in Iceland. The aim of the study was to provide as comprehensive a view as possible of how the virus spreads in a population, in this case one of 360,000 and implementing early and aggressive testing, tracking and isolation measures to contain the epidemic. The results show that roughly 0.8% of the population at large is infected with several strains or clades of the virus supporting the concern that silent carriers spread the disease. This suggests that while the efforts of the public health system have been effective so far in mitigating the spread to date, more data, including massive population screening, will be key to informing efforts to contain the virus in Iceland in the long run.

The study builds on combined targeted testing and population screening at more than 60,000 tests/million at April 4, the stop date for the data in this study; an additional 4,000 tests/million have been conducted in Iceland every day since that time. Icelandic health authorities began testing those returning from high-risk zones (mainly ski resorts in the Alps) and with likely symptoms in the beginning of February, a month before identifying the first SARS-Cov-2 infection on February 28. As of April 4, this targeted testing had identified 1221 cases from among 9199 symptomatic individuals and their contacts. All confirmed cases were placed in isolation and their contacts traced and put in 14-day home quarantine. To complement this testing and provide a view of the spread of the virus in the general population, on March 13 deCODE began testing volunteers who signed up for free screening. By April 1, 10797 people had been screened in this effort, with 87 (0.8%) testing positive. From April 1 to April 4, an additional 2,283 randomly selected individuals were screened, with 13 (0.6%) testing positive. Analysis of the combined testing data suggests that children and women are, in general, somewhat less susceptible to SARS-Cov-2 infection than men and adults.

"In attempting to carefully map the molecular epidemiology of COVID-19 in Iceland we hope to provide the entire world with data to use in the collective global effort to curb the spread of the disease," said Kari Stefansson, CEO of deCODE genetics and a senior author on the paper.

deCODE sequenced the virus from 643 individuals and drew a family tree of the different haplotypes (strings of sequence variants) found. Analysis of sequence data reveals that the haplotypes of the virus detected in the early targeted testing were almost entirely of the A2 clade originating in Austria and Italy and entering Iceland with people returning from skiing holidays. By contrast, the cases identified in the more recent targeted testing and in deCODE's population screening show that various haplotypes of the A1 clade prevalent in countries such as the UK had become more common, and that there is now a wide and growing variety of haplotypes present in the population.

This suggests that the virus entered Iceland from many countries, including those that were then deemed low-risk. Currently 291 mutations have been found in the country that have not been identified elsewhere. One of the utilities of the sequencing of the virus is that it makes it possible to track the contacts and additional infections coming from confirmed cases. These data, and the fact that the majority of new infections are coming from those already in quarantine, underscores the general efficacy of public health efforts to track and isolate these contacts and further control the spread of the virus.

"To bend the curve of this pandemic as quickly as possible, we need scientifically accurate information on how COVID-19 spreads in communities," said Robert A. Bradway, chairman and chief executive officer at Amgen. "I believe deCODE's swift response to this emergency and the insights they have generated will give give the rest of the world a stronger scientific foundation for public health decisions."

Based in Reykjavik, Iceland, deCODE is a global leader in analyzing and understanding the human genome. Using its unique expertise in human genetics combined with growing expertise in transcriptomics and population proteomics and vast amount of phenotypic data, deCODE has discovered risk factors for dozens of common diseases and provided key insights into their pathogenesis. The purpose of understanding the genetics of disease is to use that information to create new means of diagnosing, treating and preventing disease. deCODE is a wholly-owned subsidiary of Amgen (NASDAQ: AMGN).

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deCODE genetics

thoraa@decode.is

+354 894 1909

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Iceland Provides a Picture of the Early Spread of COVID-19 in a Population With a Cohesive Public Health Response - WFMZ Allentown

More than five million Americans, mostly sixty-five or older, suffer from Alzheimers disease (AD), and that number is expected to triple by 2060, as todays twenty-somethings become seniors. No treatments exist for this devastating disease, and its root causes remain as tangled as the curious brain deformities that German physician Alois Alzheimer first described in 1906.

Now a team of Tufts researchers from the School of Medicine and the School of Engineering has received a five-year, $5 million grant from the National Institute on Aging, part of the National Institutes of Health, to study the role of different cell types and mutations in AD. They will use a unique bioengineered mini brain that realistically simulates the human brain environment for years.

The work, which builds on years of collaboration among the researchers, will overcome two traditional stumbling blocks to such studies: the limited relevance of animal models and the inability of cell culture systems to reproduce the physiology of the human brain. While age is the biggest risk factor for AD, genetics also plays a role. Scientists have uncovered twenty gene variants that increase the risk of AD, said Giuseppina Tesco, professor of neuroscience and lead investigator on the research, who has devoted her career to studying the disease.

Recent studies show that most of the genes that carry these variants are expressed in glial cells, particularly astrocytes and microglial cells. Once dismissed as onlookers in the brain, glia are now front and center in Alzheimers research said glia expert Philip Haydon, a principal investigator on the project. Haydon, the Annetta and Gustav Grisard Professor of Neuroscience, likens these cells to the pit crew for the flashy race-car-like neurons, supporting top performance by, for example, preventing buildup of protein plaques.

But unlike neurons, human glial cells behave very differently from those of other mammals. What we can learn from mouse models is very limited. It is very important to study these genes in human cells, said Tesco. And we need to do this over time. It may take months to see the effect of genetic variation.

The Tufts team will use cells derived from patients with AD as well as healthy subjects, drawing on advanced stem cell technology that makes it possible to reverse engineer human primary cells into induced pluripotent stem cells, which can then differentiate into neurons, astrocytes, and microglia.

These glia and other brain cells will grow on a unique three-dimensional doughnut-shaped scaffold made of porous silk and collagenwhat the researchers have dubbed a mini brain. Bioengineer David Kaplan, Stern Family Professor and a principal investigator on the grant, and his team have spent six years perfecting the mini brain for research on AD, traumatic brain injury, and brain cancer.

This model allows us to put cells where we want, determine ratios of different cells to use in the system, and control interactions, so we can study electrophysiology, synaptic activity, and other functions as the tissue ages, said Kaplan. That control over the long term supports exploration of age-related questions about disease progression and contributes to reproducibility, a scientific pillar. Past experiments using these mini brains have mimicked structural and functional features and neural activity for up to two years.

In contrast, a two-dimensional culture systemlike the proverbial petri dishwont replicate the complexities of multiple cell types and physiologies. And organoidssimplified organs in miniature now in vogueare subject to cellular death after a few weeks or months.

To complement the in vitro studies with the scaffolds, scientists in Haydons lab will transplant some of the human cells, both mutated and normal, into mice. As they grow, the human glia cells will replace the mouse cells, giving researchers an opportunity to study human brain function. This is the first step towards translational studies, said Haydon.

The grant complements donations from Tufts alumni, parents, friends, and other private individuals who have experienced the pain of Alzheimers disease in their own lives. Donor dollars really got some of our early, exploratory work up and running, said Haydon. Now we are building on that.

The NIH support is a bright spot at a time when COVID-19 has forced Tufts scientists, like their peers around the world, to halt laboratory research, sometimes losing years of work.

Tesco said that while it is difficult to be away from her lab, safety is more important than anything else. Im from Italy, where we have more than 22,000 deaths, she said. Being healthy and having the possibility to continue to do some work, I feel lucky. Well be in the best position possible when were ready to start because well be able to start something completely new and very exciting.

Kim Thurler can be reached at kimberly.thurler@tufts.edu.

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Stem Cells and Silk Make a New Way to Study the Brain - Tufts Now

EDISON, NJ A groundbreaking saliva test for the new coronavirus developed by researchers at Rutgers University's Human Genetics Institute one that uses patients' spit samples instead of a painful nasal swab has just been granted approval from the Food and Drug Administration and will go into use this week in New Jersey.

For the first time anywhere in the United States, the saliva tests will be offered to the general public starting Wednesday at the Edison Motor Vehicle Commission test site on Kilmer Road.

During his press conference on Tuesday, Gov. Phil Murphy suggested that the new testing could be part of the "robust" strategy New Jersey needs to help contain the coronavirus and, hopefully, help the state eventually reopen the economy. Read more: Gov. Murphy: NJ Coronavirus Outbreak Again Has Deadliest Day: 365

Rutgers said the White House's COVID-19 task force is working with the university to make these tests available nationwide.

Don't miss local and New Jersey announcements about the coronavirus. Sign up for Patch alerts and daily newsletters.

Middlesex County officials say that, to the best of their knowledge, the Edison location is the first test site in the nation to begin offering coronavirus saliva testing in a drive-thru setting.

To be tested at the Kilmer Road site, people must make an appointment in advance. More information on how to make an appointment and site hours is below. The testing is free.

The Rutgers scientists who invented the coronavirus saliva testing say the benefits are threefold. First, the test is less painful and less invasive than the existing test. Instead of having a swab far into the upper nasal cavity it's been described as excruciating patients now simply provide a spit sample into a test tube, in what the researchers call "spit and seal." Patients can also provide the spit-in-a-test tube sample themselves; they do not need to be taken by a healthcare worker.

Second, test results are much faster. Instead of three to five days, test results are available within 24 to 48 hours, a Middlesex County spokeswoman said. Third, because the saliva tests can be processed more quickly, more people can be tested in one day potentially up to 10,000 per day.

The coronavirus saliva tests were developed at Rutgers' RUCDR Infinite Biologics, led by chief operating officer Andrew Brooks, in partnership with Spectrum Solutions and Accurate Diagnostic Labs (ADL), both privately owned labs.

RUCDR Infinite Biologics is based in Piscataway and says it is the world's largest university-based cell and DNA repository. It is part of the Rutgers' Human Genetics Institute.

The saliva testing method is based on a Nobel Prize-winning laboratory technique that makes millions of copies of the SARS-CoV-2 virus nucleic acid (in this case RNA) in a sample.

As Patch reported, Rutgers unveiled the coronavirus saliva tests April 2. However, because the tests lacked FDA approval, it was only offered to patients and first responders doctors and nurses within the Robert Wood Johnson Barnabas Health network, a Rutgers partner.

However, this past weekend, the FDA granted what's known as "emergency use authorization" to give the saliva tests to the general public. It's the first time the FDA has given such emergency approval, according to a Rutgers news release. The FDA letter that gives emergency approval has been made publicly available, and it can be read it here.

According to the news release, the FDA approved the tests Saturday and, that same day, Brooks said he received a call from the White House's COVID-19 task force offering congratulations and asking how they could expand the saliva testing nationwide.

"The impact of this approval is significant," said Brooks, who also is a professor in the Rutgers genetics department. "It means we no longer have to put health care professionals at risk for infection by performing nasopharyngeal or oropharyngeal collections. We can preserve precious personal protective equipment for use in patient care instead of testing. We can significantly increase the number of people tested each and every day, as self-collection of saliva is more quick and scalable than swab collections. All of this combined will have a tremendous impact on testing in New Jersey and across the United States."

With that approval in hand, the saliva tests is to be rolled out to the Edison MVC test site starting Wednesday. The test tube samples will be analyzed by RUCDR Infinite Biologics at their Piscataway labs.

Two other start-up companies, MicroGen DX and Vault Health, are unveiling what they say are at-home saliva tests for coronavirus; Vault's test is available now on their website. RUCDR Infinite Biologics is also working with Vault to distribute their tests nationwide through telemedicine.

The saliva tests will only be available there Monday, Wednesday and Friday of each week. The Edison test site is at the Kilmer Vehicle Inspection/Driving Testing Center, a COVID-19 drive-thru testing facility on 33 Kilmer Road in Edison.

Brooks also predicted the sheer volume of samples that now can be tested will also help scientists come up with a coronavirus vaccine. The Rutgers RUCDR Infinite Biologics team is working to expand the coronavirus saliva testing nationwide.

The Edison test site was chosen because it is located very close to the Piscataway research labs of RUCDR Infinite Biologics. Middlesex County also already had the existing infrastructure and operational capabilities to introduce the new type of tests.

"We believe our state-of-the-art drive-thru model can set a benchmark for testing that can benefit the state and other counties," said Middlesex County Freeholder Director Ronald Rios. "Middlesex County has built the operations and infrastructure from the ground up to enable us to provide innovative solutions."

To get tested:

The criteria to get tested does not appear to have changed. First, you must be a Middlesex County resident (valid driver's license or state-issued identification is required); make an appointment online or via phone; and have either a valid doctor's prescription or be exhibiting symptoms that include a fever of 100.4 degrees or higher (99.6 degrees for people 65 years and older), respiratory symptoms and/or shortness of breath.

Middlesex County residents who have symptoms and would like to be tested should visit Middlesexcountynj.gov/COVID19testing to make an appointment. They will be assigned a time to report to the testing site.

Registrants must bring the completed registration form and proof of residency including, but not limited to: a valid driver's license; state issued identification; or two pieces of mail including utility bills, bank statements, or similar documentation with name and address, to the testing site.

If a resident does not have access to the internet or is having connectivity problems, they are instructed to call 732-745-3100 to make an appointment (from 10 a.m. to 4 p.m.). Appointments will only be made the day prior to a testing day.

If the person is not a Middlesex County resident, does not have a scheduled appointment or does not have symptoms, they will not receive testing.

Residents can visit the Middlesex County website at http://www.middlesexcountynj.gov/COVID-19 or contact 211 for information about the testing site, as well as call the Middlesex County Office of Health Services at 732-745-3100.

Residents who have questions about COVID-19 they can call 211 or the 24-hour public hotline at 800-962-1252 or 800-222-1222, or text NJCOVID to 898-211. They can also text a ZIP code to 898-211 for live text assistance.

Related:

Edison DMV Inspection Center Turned Into Coronavirus Test Site (March 30)

Rutgers Launches Fast-Results Saliva Testing For Coronavirus (April 2)

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NJ Site First In U.S. To Offer Drive-Thru Coronavirus Saliva Test - Patch.com

(Bloomberg Opinion) -- Scientists all over the world are working to understand, contain and cure Covid-19. Heres a quick look at four important advances that made headway this week.

A positive trial for an antiviral drug

Yesterday a rare bit of good news emerged from a clinical trial at the University of Chicago. STATnews reported that the antiviral drug Remdesivir appeared to have some fighting force against Covid-19. The trial included 125 people, 113 of them classified as having a severe case of the virus.

All got the drug; there was no placebo group. Most were released from the hospital less than a week later, and only 2 died an unusually low number given how deadly the disease has been in those who get severely ill. Other trials around the world, if they go this well, should lead to quick FDA approval for the drug, manufactured by Gilead Sciences.

Long before the current Covid-19 pandemic, scientists at the University of North Carolina and Gilead began developing this drug in anticipation of new coronavirus epidemic. Two other deadly outbreaks that occurred this century, SARS and MERS, were both caused by coronaviruses from bats, as with Covid-19.

One of the developers of the drug, Timothy Sheahan of the University of North Carolina, told me in an interview last January that the drug was designed to interfere with enzymes SARS and MERS need to replicate themselves. At the time, his group had just started to see impressive results in animal studies of MERS.

The only human trials before the current outbreak were in Ebola patients in the Democratic Republic of Congo. While it didnt work against Ebola as well as other therapies, it did pass basic safety standards.

The drug has been given sporadically for Covid-19. Anecdotal reports abound of people near death bouncing back after getting the drug. And even this clinical trial has to be viewed with cautious optimism, since it was small, and wasnt compared with a placebo. But more trials are underway around the world including 2,400 participants with severe disease and 1,600 patients whose symptoms are moderate.

New clues to how the virus spread from China

Genetic sleuths are digging deep into the origin and early spread of the Covid-19 virus, tracking small mutations in its genetic material. One surprise is that the virus had already branched into two subtypes by the time it was isolated from the first patient in Wuhan on December 23, and this patient seemed to have the second subtype not the original. Peter Forster, a genetics professor from Cambridge University, has dubbed the original variant A, and the one found in that Wuhan patient variant B. (B carries two mutations not found in A.)

Strain A is more than 96% identical to samples isolated from horseshoe bats, which he believes harbored the virus before it jumped to humans. A molecular clock technique puts that leap between September 18 and December 7, 2019.

Forster said he and his colleagues, who published their work in the Proceedings of the National Academy of Sciences, used a collection of published viral sequences collected in an international database normally used to track influenza. The paper only included the first 160 viral genomes, but his group has now studied more than 1,000.

Looking at data from before January 17, which represents the earliest date people started travelling for Chinese New Year, Forster found that of 44 Wuhan samples, 42 were B and only 2 were A. There were more A strains in the Guangdong Province in southern China.

Some people have speculated that the virus escaped from the Wuhan Institute of Virology, which may have been experimenting on coronaviruses, but Forester says his data point to a jump from bats in Southern China that subsequently spread to Wuhan and other areas. The B strain might have branched off before it reached Wuhan, where the first major outbreak was noticed.

Meanwhile, he says, they find viruses from cluster A in Americans whod travelled from China to the West Coast of the United States between January and early March. Before March 24th, most U.S. cases were A.

B, however, quickly became the dominant type in Wuhan and across China. Another mutation in B led to a strain C, which is nearly absent in China, but is still spreading across Europe. Europe has also shown a lot of sequences from the B cluster. (Whether these mutations affect the behavior or lethality of the virus is yet to be determined, since mutations dont always lead to changes in function.)

Story continues

Forster said the viral genetics show the first case in Italy in late January originated from an early spread in Germany, though Italian health authorities focused only on the patients possible connections to China. Meanwhile the disease is spreading uncontrolled across Italy.

Researchers at NYU and Mount Sinai used similar genetic information gathered later in the outbreak to determine that cases in New York City originated from multiple sources elsewhere in the U.S. and Europe, rather than directly from China, and that there had been local spread in New York for a month or so before it was officially first identified there at the end of February. Their paper is pending publication.

Forster hopes further work in sequencing genomes could help health authorities track new outbreaks without looking in the wrong place. And finding the true origin of the pandemic could help us avoid making the same mistake again.

Antibody studies are looking for more volunteers

Antibody tests have become a hot topic since people jumped to the conclusion that getting a positive test means you cant get or spread Covid-19. While standard tests detect genetic material from the virus itself, antibody tests can detect proteins the body makes to fight the infections.

New York Times tech columnist Kara Swisher wrote this week that she got one, because she knew a guy, but found it a moral dilemma to take a test so many others need.

It would have presented no moral dilemma had the guy been the head of a legitimate research project, because scientists still cant be sure antibodies from a previous infection always protect against a new one. Harvard epidemiologist Marc Lipsitch also warned that too little is yet known about post-infection immunity to assume people cant get re-infected.

Its hard to know what immunity to this virus looks like since its only been in humans since, maybe late 2019, says Harvard immunologist Duane Wesemann, who is collecting samples from volunteers to figure it out. Several other coronaviruses infect humans, causing a subset of common colds. Scientists want to know whether recent infection with these might affect the severity of Covid-19 infections.

The testing itself isnt rocket science, says Wesemann. But understanding the complex relationship between the virus and the human immune system is.

So far only about 6% of volunteers from around the Boston area were positive. Some reported a cold or sore throat in February or March, while others recalled no symptoms at all.

But the sample is still small.

Antibody-rich blood could help protect health care workers

If antibodies do work, and you test positive for them, you may be able to share your protection with several other people. Already, patients whove recovered from documented infections are donating their antibody-rich blood to others.

Doctors in China have treated small groups of patients and reported promising results in the Journal of the American Medical Association and the Proceeding of the National Academy of Sciences. In the United States, some severely ill patients get the same treatment under compassionate use guidelines.

But those are the cases where its least likely to work, says Johns Hopkins immunologist Arturo Casadevall. By then the virus has already done too much damage.

The rule of antibody therapy, he says, is it always works best if used early or prophylactically. Earlier this month, he and his fellow researchers at Johns Hopkins got approval for a clinical trial giving donated antibodies to front-line health care workers to protect them from getting sick.

Casadevall says he started pushing to develop the technology early, before the disease started spreading in the United States. His enthusiasm, he says, is based on his knowledge of medical history. Similar convalescent serum treatments have been used since the early 20th century to prevent or treat measles, mumps, and polio.

Unlike a vaccine, borrowed antibodies from recovered patients would confer only temporary protection starting to fade after a half-life of about 20 days. Still, thats long enough to help health care workers desperate to avoid getting infected.

The big limiting factor now is supply, he says. But that could change with more recovered patients and more antibody testing of people who had been only mildly ill. Donated blood can also be tested for antibodies.

Casadevall is optimistic that the biomedical research community will make quick inroads on this virus between new treatments, new ways to speed up testing, and ways to protect people before a vaccine is close.

While this is the worst pandemic since 1918, and governments in many countries were slow to take precautions, he believes the international biomedical research community is a mighty force. Humanity has never been better prepared.

This column does not necessarily reflect the opinion of Bloomberg LP and its owners.

Faye Flam is a Bloomberg Opinion columnist. She has written for the Economist, the New York Times, the Washington Post, Psychology Today, Science and other publications. She has a degree in geophysics from the California Institute of Technology.

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Any Good News on Coronavirus This Week? Actually, Yes - Yahoo Finance