On Plugged In …
COVID-19…
and the growing urgency …
to develop a safe …
and effective vaccine.
(Dr. Anthony Fauci)
“The assumption we’re making, which I think is reasonable is that we will know by the end of this calendar year whether we have a safe and effective vaccine.”
Dr. Anthony Fauci …
on the challenges …
of finding a cure …
and treating those …
already infected …
with coronavirus.
America’s spike …
in COVID infections.
Is it the beginning …
of a second wave …
or more of the first?
(Dr. Michael Osterholm)
“This is just one constant of a forest fire looking for human wood to burn.”
Experts explain …
the impact on children …
the continued need …
for more and better testing …
and what happens …
when a vaccine …
is approved.
On Plugged in –
Challenges in a Pandemic
(Greta Van Susteren)
Hello and welcome to Plugged In.
I’m Greta Van Susteren, reporting from my home in Washington DC.
Whether you live in cities or in rural communities “you are not immune or protected” from coronavirus.
That’s the latest assessment from Dr. Deborah Birx, the White House coronavirus response coordinator.
She says the United States is in a new phase of the COVID pandemic as it is "extraordinarily widespread" beyond America’s cities.
Worldwide, in July alone, 8-million new cases of COVID-19 were recorded.
That is nearly half as many as recorded in the pandemic’s first six months.
Now with more than 18 million cases around the world the US still has the most confirmed cases, more than 4 and a half million.
Brazil is closing in on 3-million people infected.
And India has nearly 2 million cases.
Then - Russia…South Africa and Mexico.
Under normal circumstances developing a vaccine for any disease is difficult and measured.
Amid a pandemic a challenge is to move fast but assure the public a vaccine is safe.
VOA’s Steve Baragona updates us now on the status of several vaccines entering the final stage of clinical trials.
(Worldwide Vaccine Trials by Steve Baragona)
Tests got underway at 120 sites worldwide on a vaccine developed by drug firms BioNTech, Pfizer and China's Fosun Pharma. Another 89 sites in the United States are hosting tests on Moderna's vaccine.
They’re the last set of clinical trials before approval. Frank Eder leads the study at a Moderna site in New York.
((Frank Eder, Meridian Clinical Research))
"And once we get past this trial, we can move into the general public and actually mass producing and having this given to the population."
((NARRATOR))
Before that happens, though, these trials will gauge how well the vaccines work and how safe they are.
Though new techniques helped get these shots ready in record time, officials say all the normal safety checks are in place. The tests that just started are a key part of that, says Vanderbilt University infectious disease doctor William Schaffner.
((William Schaffner, Vanderbilt University))
"These are new technology vaccines against a new virus in humans. We need to be very careful about that and look at vaccine safety very carefully. That information comes out of the large -- we call them 'phase three' trials. Those are the ones that are currently underway."
((NARRATOR))
Those phase 3 trials involve tens of thousands of patients, to look for less common side effects. Scientists hope for results by the end of the year.
Another vaccine in phase 3 comes from Oxford University and drug firm AstraZeneca.
Like the Moderna and BioNTech vaccines, the Oxford shot triggered immune responses in early tests. But that's not enough, says Oxford's project lead Sarah Gilbert.
((Sarah Gilbert, University of Oxford))
"We don't know how strong that immune response needs to be. So we can't say just by looking at immune responses whether this is going to protect people or not, and the only way we're going to find out is by doing the large phase three trials."
((NARRATOR))
Even before those trials produce results, the British government has given companies millions of dollars -- and the U.S. government, billions -- to manufacture the vaccines. That way some doses will be ready right away if results are positive.
Sandy Douglas is with the Oxford team.
((Sandy Douglas, University of Oxford))
"The vaccine may be available for people in some high-risk groups in the UK by the end of the year, but it won't be made available to everybody immediately. It's likely to be given to the people who have the most to benefit from it, the most to gain from it, earliest, and then gradually introduced for other people."
((NARRATOR))
U.S. health officials also are discussing who will get the limited supply of first doses, likely beginning with health care workers.
Two Chinese companies have vaccines in phase 3 testing in the United Arab Emirates and Brazil.
At least 17 other vaccines are in earlier clinical tests around the world. Experts say more is better, because different vaccines may work best for different groups of people.
STEVE BARAGONA, VOA NEWS.
(Greta)
A research scientist from Britain’s University of Warwick participated in phase two of the Oxford vaccine trial.
He told VOA he does not know whether he was injected with the COVID vaccine or a placebo.
(Branko Rithman, Vaccine Test Volunteer, University of Warwick)
“I did a blood test after one month and then the next blood test is gonna be after three months, then six months and then a year in which they're testing whether I have antibodies in my bloodstream. Other than that, I am testing myself with the regular PCR swab test every week.
I haven't seen my parents for six months. There's a lot of people who haven't seen their elderly members of family. So anything that could be done to hasten the solution, I think it's everybody's duty to try and contribute.”
(Greta)
Dr. Anthony Fauci, a member of the Coronavirus Task Force, testified in a hearing before Congress that about 250-thousand people in the United States have volunteered for Phase Three trials.
I will talk to Dr. Fauci about vaccine progress in just a few moments.
First, VOA’s Capitol Hill Correspondent Katherine Gypson on the hearing
and the reality check the doctors gave the lawmakers.
(Battling the Virus by Katherine Gypson)
For the first time since June, new cases of COVID-19 fell nationwide compared to the previous week. But with the number of cases still rising in some states, U.S. lawmakers Friday sought answers from the experts leading the Trump administration response.
((Rep. James Clyburn, Democrat))
“Can you help us understand why Europe largely contained the virus, but the United States is seeing a continued rise in new cases?”
((Dr. Anthony Fauci, National Institute of Allergy and Infectious Diseases Director))
“If you look at what happened in Europe, when they shut down or locked down or went to shelter in place, however you want to describe it, they really did it to the tune of about 95 plus percent of the country did that. When you actually look at what we did, even though we shut down, even though it created a great deal of difficulty, we really functionally shut down only about 50%.”
((NARRATOR))
The United States has ramped up testing in the last few weeks, but with the debate over reopening the American economy still a politically sensitive issue, experts warn testing is no substitute for preventative measures.
((Admiral Brett Giroir, Assistant Secretary of Health and Human Services))
“We cannot test our way out of this or any other pandemic. Testing does not replace personal responsibility. It does not substitute for avoiding crowded indoor spaces, or washing hands, or wearing a mask.”
((NARRATOR))
Precautions that many hope will bridge the gap until early next year when officials estimate a vaccine could be ready.
((Dr. Anthony Fauci, National Institute of Allergy and Infectious Diseases Director))
“Ultimately, within a reasonable period of time, the plans now allow for any American who needs a vaccine to get it within the year 2021.”
((NARRATOR))
The White House said Friday that speed is due to the president’s leadership.
((Kayleigh McEnany, White House Press Secretary))
“These critical investments in a coronavirus vaccine are due to the fact that we have a businessman in the White House.”
((NARRATOR))
But congressional Democrats accuse the president and Republicans of failing to deliver needed aid to Americans who are out of work and struggling.
((Nancy Pelosi, Speaker of the House))
“The Republicans said they wanted to take a pause. Well the virus didn't.”
((NARRATOR))
Leaders from both parties failed to strike a deal this week that would have extended additional aid to millions of unemployed Americans.
Katherine Gypson, VOA News, Washington.
(Greta)
I interviewed Dr. Anthony Fauci who testified at that congressional hearing.
He is considered one of the world’s leading authorities on infectious diseases having advised six U.S. presidents on global health issues.
Since 1984 Dr. Fauci has been the director of the U-S National Institute of Allergy and Infectious Diseases.
He is also a member of the White House Coronavirus Task Force.
I asked him how close are we to identifying a safe and effective coronavirus vaccine.
(Greta Interviews Dr. Anthony Fauci)
AF: I think it's important to point out Greta that there are more than one vaccines. I mean there are at least five or six that are being subsidized and supported, directly or indirectly, by the federal government, in the sense of putting in money not only to help in the testing, but also in the production. And in fact, federal government has invested hundreds of millions, if not more than a billion plus, to making vaccine even before it's proven to be effective. So that if it is effective, you save several months. And the only thing you're risking is money, because if it turns out that it's not, you've made a vaccine that wouldn't be used. So right now at the same time as we're testing the vaccine, they're starting to ramp up the production. So the assumption we're making, which I think is reasonable, is that we will know by the end of this calendar year whether we have a safe and effective vaccine. I'm cautiously optimistic that we will, based on the preliminary data that we've seen from the Phase 1 trial. But assuming that we do, by the end of the year the beginning of 2021, as we go into 2021, we should have hundreds of millions of doses as we get into the year. That means that we should have vaccines enough for everyone here.
The companies promise that they will make up to a billion doses. And you have more than one company that's talking about that. Then you have the Chinese who will be making a vaccine. You have the U.K. and the Europeans who have a vaccine. There will be, I think, enough vaccine if everything turns out to be successful to get vaccine not only to the countries that are the classical rich countries, but those who are low and middle income that would not be able to readily have access to a vaccine. That's what we're hoping to do.
GVS: What is the effectiveness that we are hoping to, Obviously we're hoping for a hundred percent, but what is the definition of effective?
AF: Well, you know it's a statistical analysis of proving that it is significantly better than not having the vaccine. We hope that that's going to be at least 50 to 60 percent. It could be more. I think if it's much less, there may be a reluctance to use it, but it really depends upon how much less.
I would be optimistic and hoping that we get something that’s 70 75, 80percent or more. I hope so. If not, I think even a 50 to 60 percent vaccine would be a major contribution, together with public health measures, to contain this virus. I can tell you if there's a vaccine that's available that's safe and effective, I will get the vaccine, predominantly because I think it's important to protect yourselves as best you can. But I would not stop from the public health measures of handwashing if there's still activity in the community, wearing a mask, avoiding crowds. When the level goes so low in the community, then we could start to be thinking about getting more towards what we consider normal.
But right now if you look in this country, with now 60, 50, 60, even as high as 70 thousand new cases a day, that's not normal. We've got to get that way, way down before we approach normal.
GVS: The therapeutic that everyone seems to have the most attention on right now, and I realize we're learning so much every day, but is Remdesivir, which is what I understand is that if you are very sick and you end up in the hospital here in the United States, you will get it from the I.V. and that it is an antiviral, much like Tamiflu is for the flu. Is there any way to Remdesivir can be distributed orally like Tamiflu?
AF: What we're putting a big push on right now is exactly what you're referring to, namely, what do you do early in infection to prevent someone from progressing to serious disease? We have a number of clinical trials that are ongoing with other direct acting antivirals, but importantly with antibodies that are called monoclonal antibodies that are very specific antibodies directed against the virus that you make from the body's natural capability. You clone it and you make it. There are a number of trials, one’s that already started. Two that are going to be starting this week, to give some to early individuals in an outpatient basis, some to individuals a little bit later in the hospital.
But that's a major goal of therapy now is to what do you give to someone to prevent them from progressing, versus waiting until they have advanced disease, when you can give them some drugs that we know work.
GVS: One of the discussions here in the United States since about beginning of March is hydroxychloroquine and whether -- and that's something used all over the world, an anti-malarial and used for a number of years, used for other disorders like I think lupus. Is that now, has that now been concluded as not to be good as a prophylactic and not to be effective if once you get covid-19?
AF: Well, there have been a lot of different observational studies that have come up with conflicting data. But the randomized placebo controlled trials that are the gold standard of whether something actually does work have uniformly shown there's no efficacy of hydroxychloroquine in the treatment of covid-19 disease.
GVS: That's treatment once you get it. Does that include as a prophylactic before you get it?
AF: There have been no studies that have shown its efficacy at any stage. The ones that have shown early potential signal of efficacy have been done in a way that is not a randomized placebo controlled trial, which is the reason why, if you look at all the data, it's pretty uniform. We still keep an open mind to any placebo control randomized trial that would show efficacy or not for hydroxycholoroquine or any drug, we would keep an open mind. But the overwhelming data as it exists now does not show any efficacy.
(Greta)
Coronavirus has killed more than 155-thousand people in the United States. That number is currently more than any other country.
Among those who’ve died is former Republican presidential candidate Herman Cain.
In 2012 the former CEO of the Godfather’s Pizza chain ran unsuccessfully for the Republican party presidential nomination.
Before that he worked at Coca Cola and later at Pillsbury where he turned around the company’s struggling fast food chains.
Cain once served as a director of the U.S. Federal Reserve Bank in Kansas City.
A cancer survivor - Cain was an ardent supporter of President Donald Trump.
(President Donald Trump)
“He was a very special person. I got to know him very well and unfortunately he passed away from a thing called the “China Virus.”
Just a few weeks ago Cain attended President Trump’s campaign rally in Tulsa Oklahoma.
He was photographed mask-less in the crowd. Nine days later he tested positive for COVID-19.
Herman Cain was 74.
(Greta)
All experts say wearing a mask in public will help mitigate the spread of the virus.
Dr. Michael Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
He spoke with Plugged In’s Steve Redisch about how coronavirus has gripped the U.S.
(Plugged In Interview - Dr. Michael Osterholm)
MO: This has just been one big hot forest fire. This is a coronavirus pandemic that is not like one we've seen with influenza before. And we may knock it down, put it put it out, you might say in some areas, only to have it be receded with embers from adjoining fires. And that's what's happening right now. This is just one constant forest fire looking for human wood to burn. And wherever we have mitigation strategies that are able to suppress, it we're seeing less activity. Otherwise, this is going full tilt.
SR: Is the virus mutating?
MO: The virus is mutating. But we have to be very careful how we talk about that, so it doesn't give people a sense that, oh my, look what's happening here. Just like you and me. If we looked at pictures of us 30 years ago or 20 years ago, 10 years ago and now we'd say oh, look how he's changed, but it would be the same us. And we know that this virus is changing as it ages, but it's not clear yet that any those changes are functionally different or make the virus do things that it didn't do before, whether it be increased transmission or whether it caused more severe disease. And those are studies that are still ongoing. But I think it’d be very premature to suggest that something's happened to this virus that makes it a more dangerous or less dangerous virus to deal with.
SR: What is the balance between testing and getting this thing under control, how much testing do we have to do? do we have enough tests? and what would you suggest as far as testing is concerned?
MO: Well first of all I've never really understood the issue about doing too much testing in terms of what it means for the epidemic. That would be like saying if you doubled the number of pregnancy tests you could cut down the number of pregnancies by half. You know, I mean, either you're pregnant or you're not OK? Testing more or less isn't going to determine the number of pregnancies in a community.
And so what we're trying to do is find as many people who we can who are infected with the virus, with the idea of hopefully having them, in a sense, isolate themselves so they don't transmit on to others. Meaning don't be out in the public spaces and so forth if you're infected.
At this point, we don't have a national plan for testing and how to use it. We developed a plan at our center, several months ago published at, in one of our viewpoints on our Web site about smart testing. Smart testing is when you test the right person with the right test at the right time for the right result to have the right outcome. And if you don't have all those linked together, it is a wasted test. A test is returned in eight to 10 days is pretty much meaningless. A test that doesn't ever get returned, even if it's done the first day, is pretty much meaningless. A test that doesn't detect whether or not you really are infected in any accuracy, so that therefore you don't know how to judge the test results isn’t necessarily a smart test.
And if you're testing the wrong people, you know, the people who basically just want to be routinely tested because that makes them feel more comfortable, even though they may not be exposing themselves to the virus - aren't the people we should be testing right now. We should be testing those who are clinically ill, who we believe may have the infection or their contacts. We maybe want to test in certain environments like congregate care areas like long term care to make sure we don't get the virus into them. But the idea of just more testing is better isn't the case, but lots of testing is necessary.
SR: Vaccines, what is, how do you see when a vaccine is developed and approved and ready for distribution? How do you see that going as far as being able to get the vaccines out and the making sure that the public understands that how effective the vaccines will be?
MO: Well, as we have said many, many times, a vaccine is just a vaccine. It means nothing until it's a vaccination, till it's actually in your arm. And that is the critical point. And so what we need to do now is start broadcasting loud and clear all the information we have on what's going on with these vaccine trials, with complete transparency so that the public will know every day what's happening, how many people have been vaccinated? What's happening? What kind of reactions are they having? What are the plans for evaluating the data and how it will then be considered in terms of approval process to complete transparency is critical.
Remember there's not just one vaccine in the race here. There's a number of them. And I'd be happy if all of them work so that we could actually have overlapping vaccines that might very well give us quicker protection, meaning that we can vaccinate more people sooner. But at this point, we have to just take a step back and say, you know, we can be hopeful for these vaccines, but hope is not a strategy.
Will we have a vaccine or vaccines by the end of the year? Likely. But the question is, what does that mean, you'll have a vaccine? Will it be rushed in terms of its evaluation such that people lack confidence in it? How long will it protect for, even if it is adequately evaluated and the safety issues around it elucidated? We just don't know that yet.
And so we all recognize the only real light at the end of the tunnel for us with this disease is a safe and effective vaccine for the world, not just for the United States.
(Greta)
Identifying and isolating everyone who comes into contact with an infected person is one of the most time consuming and challenging tasks for health workers.
But in Nigeria, some local leaders are stepping up to the task of helping tracers do their jobs.
VOA’s Timothy Obiezu has more from Abuja.
(Nigeria Contact Tracing by Timoothy Obiezu)
Daniel Sila is the town crier in this Abuja village. His job is to disseminate vital information from the village chief to people who live in the community.
In recent months his message has been about COVID-19, and ways to prevent it.
He is also helping health officials with their contact tracing mission.
((Daniel Sila, Community Town Crier)) (in Pidgin English)
"They came in their vehicles. I wore coronavirus protection clothing with them.”
((NARRATOR))
This community was among the first in the Abuja region to record the spread of the coronavirus.
((Danjuma Dogo, Community Secretary))
"The first time was about seven cases, the second was about fourteen. The conclusion when that testing was done, I think it was about 70-something.”
((NARRATOR))
Health officials have responded by conducting extensive testing here. But as the number of cases grew, so did the difficulty of contact tracing.
Village officials like Dogo are helping health workers locate positive cases.
((Danjuma Dogo, Community Secretary))
"They came with the list and we responded quickly by working together with them to fish out those ones affected. I was part of the committee. Because the list was with me, we had to go round, checking who and who is affected.”
((NARRATOR))
Nigeria has so far reported some 41-thousand cases of COVID-19. But the fear and stigma attached to the disease have limited the number of people who show up for testing or report symptoms. Last month the coronavirus task force committee criticized the unwillingness of Nigerians to participate in contact tracing. Until Nigerians respond they said the pandemic cannot be brought under control.
Timothy Obiezu, for VOA News, Abuja.
(Greta)
While voluntary compliance and attitudes about face masks and social distancing are also an issue here in the United States there is a lot about COVID-19 that we are just learning.
Such as why some patients report a wide range of symptoms and others have none.
Or why children may not be as infectious in spreading the virus to others.
More from my conversation with Dr. Anthony Fauci.
(Greta interviews Dr. Anthony Fauci - Part 2)
AF: We know now, and there are more studies that are coming out that children between 10 and 19 transmit to humans to adults as easily as adults transmit to adults. If you're up to 10 years old, a study from Korea said that in fact, it's less likely to transmit to adults. However, a more recent study came out and found out that very young children have anywhere from 10 to 100 times the amount of virus in their nasal pharynx. So we've got to be careful if it's in the nasal pharynx, you can assume that it may be able to transmit. So we're still learning a lot about infection in children and how likely it is for them to transmit to others.
GVS: If you and I both get covid and you get a mild case, I get a severe case, but we both survive it. Who is there, are we going to the same amount of antibodies? or am I going to have a more robust antibodies in my system because I dealt with a bigger problem?
AF: That's a very good question. We don't know definitively to the answer to that, but it is likely that the longer you have virus replicating in you and the higher the concentration, the more of a potent immune response. The only problem with that assumption, Greta, is that there's so much variability in the human species. This polymorphism we call it, that your ability to amount a good response, even though you get seriously ill, may not be as good as my ability to amount immune response, even if I don't. But in general, the more exposure, the more replication you get, the better chance there is to get an immune response.
GVS: Why is there seem to be so many variability in what people get from this one virus?
AF: I've been dealing as you know, Greta you've been interviewing me with it for years, with viruses for decades and decades. I've never seen a virus that has this wide range of difference in its manifestations.
Up to 40, 45 percent of people get no symptoms at all. There are some they get mild symptoms, some get sick enough to be in bed for weeks at a time and get residual effects even after. Some have to go to a hospital. Some get intensive care. Some require ventilation and some die. It is a very, very unusual to see that wide range. We don't know. It may have to do with the level of receptors, there may be genetic distribution. We don't really know the answer to that. We do know though, that there are people, mainly elderly and those with underlying conditions who have serious consequences of infection. But we don't know why if I got infected and I had no symptoms and you got infected and you had to stay in bed for three weeks, we don't have any idea why that's the case.
GVS: If you get infected or I get infected, we have no symptoms. Are we immune from a second round or can we get Corona or can we get it again?
AF: You have some degree of an immune response, but we don't know what the duration of that is. Whenever you recover and clear the virus from your body, that means that your immune system was responsible for that. What we do not know is how long that protection lasts. It could be a matter of several weeks or months. Or it could be much longer. We're doing a prospective study on that right now.
(Greta)
That is all the time we have today.
Many thanks to my guests, Dr. Anthony Fauci and Dr. Michael Osterholm.
For the latest updates on COVID-19 - please visit our website at VOANews.com.
And don’t forget to follow me on Twitter @Greta.
Thank you for being Plugged In.
####
COVID-19…
and the growing urgency …
to develop a safe …
and effective vaccine.
(Dr. Anthony Fauci)
“The assumption we’re making, which I think is reasonable is that we will know by the end of this calendar year whether we have a safe and effective vaccine.”
Dr. Anthony Fauci …
on the challenges …
of finding a cure …
and treating those …
already infected …
with coronavirus.
America’s spike …
in COVID infections.
Is it the beginning …
of a second wave …
or more of the first?
(Dr. Michael Osterholm)
“This is just one constant of a forest fire looking for human wood to burn.”
Experts explain …
the impact on children …
the continued need …
for more and better testing …
and what happens …
when a vaccine …
is approved.
On Plugged in –
Challenges in a Pandemic
(Greta Van Susteren)
Hello and welcome to Plugged In.
I’m Greta Van Susteren, reporting from my home in Washington DC.
Whether you live in cities or in rural communities “you are not immune or protected” from coronavirus.
That’s the latest assessment from Dr. Deborah Birx, the White House coronavirus response coordinator.
She says the United States is in a new phase of the COVID pandemic as it is "extraordinarily widespread" beyond America’s cities.
Worldwide, in July alone, 8-million new cases of COVID-19 were recorded.
That is nearly half as many as recorded in the pandemic’s first six months.
Now with more than 18 million cases around the world the US still has the most confirmed cases, more than 4 and a half million.
Brazil is closing in on 3-million people infected.
And India has nearly 2 million cases.
Then - Russia…South Africa and Mexico.
Under normal circumstances developing a vaccine for any disease is difficult and measured.
Amid a pandemic a challenge is to move fast but assure the public a vaccine is safe.
VOA’s Steve Baragona updates us now on the status of several vaccines entering the final stage of clinical trials.
(Worldwide Vaccine Trials by Steve Baragona)
Tests got underway at 120 sites worldwide on a vaccine developed by drug firms BioNTech, Pfizer and China's Fosun Pharma. Another 89 sites in the United States are hosting tests on Moderna's vaccine.
They’re the last set of clinical trials before approval. Frank Eder leads the study at a Moderna site in New York.
((Frank Eder, Meridian Clinical Research))
"And once we get past this trial, we can move into the general public and actually mass producing and having this given to the population."
((NARRATOR))
Before that happens, though, these trials will gauge how well the vaccines work and how safe they are.
Though new techniques helped get these shots ready in record time, officials say all the normal safety checks are in place. The tests that just started are a key part of that, says Vanderbilt University infectious disease doctor William Schaffner.
((William Schaffner, Vanderbilt University))
"These are new technology vaccines against a new virus in humans. We need to be very careful about that and look at vaccine safety very carefully. That information comes out of the large -- we call them 'phase three' trials. Those are the ones that are currently underway."
((NARRATOR))
Those phase 3 trials involve tens of thousands of patients, to look for less common side effects. Scientists hope for results by the end of the year.
Another vaccine in phase 3 comes from Oxford University and drug firm AstraZeneca.
Like the Moderna and BioNTech vaccines, the Oxford shot triggered immune responses in early tests. But that's not enough, says Oxford's project lead Sarah Gilbert.
((Sarah Gilbert, University of Oxford))
"We don't know how strong that immune response needs to be. So we can't say just by looking at immune responses whether this is going to protect people or not, and the only way we're going to find out is by doing the large phase three trials."
((NARRATOR))
Even before those trials produce results, the British government has given companies millions of dollars -- and the U.S. government, billions -- to manufacture the vaccines. That way some doses will be ready right away if results are positive.
Sandy Douglas is with the Oxford team.
((Sandy Douglas, University of Oxford))
"The vaccine may be available for people in some high-risk groups in the UK by the end of the year, but it won't be made available to everybody immediately. It's likely to be given to the people who have the most to benefit from it, the most to gain from it, earliest, and then gradually introduced for other people."
((NARRATOR))
U.S. health officials also are discussing who will get the limited supply of first doses, likely beginning with health care workers.
Two Chinese companies have vaccines in phase 3 testing in the United Arab Emirates and Brazil.
At least 17 other vaccines are in earlier clinical tests around the world. Experts say more is better, because different vaccines may work best for different groups of people.
STEVE BARAGONA, VOA NEWS.
(Greta)
A research scientist from Britain’s University of Warwick participated in phase two of the Oxford vaccine trial.
He told VOA he does not know whether he was injected with the COVID vaccine or a placebo.
(Branko Rithman, Vaccine Test Volunteer, University of Warwick)
“I did a blood test after one month and then the next blood test is gonna be after three months, then six months and then a year in which they're testing whether I have antibodies in my bloodstream. Other than that, I am testing myself with the regular PCR swab test every week.
I haven't seen my parents for six months. There's a lot of people who haven't seen their elderly members of family. So anything that could be done to hasten the solution, I think it's everybody's duty to try and contribute.”
(Greta)
Dr. Anthony Fauci, a member of the Coronavirus Task Force, testified in a hearing before Congress that about 250-thousand people in the United States have volunteered for Phase Three trials.
I will talk to Dr. Fauci about vaccine progress in just a few moments.
First, VOA’s Capitol Hill Correspondent Katherine Gypson on the hearing
and the reality check the doctors gave the lawmakers.
(Battling the Virus by Katherine Gypson)
For the first time since June, new cases of COVID-19 fell nationwide compared to the previous week. But with the number of cases still rising in some states, U.S. lawmakers Friday sought answers from the experts leading the Trump administration response.
((Rep. James Clyburn, Democrat))
“Can you help us understand why Europe largely contained the virus, but the United States is seeing a continued rise in new cases?”
((Dr. Anthony Fauci, National Institute of Allergy and Infectious Diseases Director))
“If you look at what happened in Europe, when they shut down or locked down or went to shelter in place, however you want to describe it, they really did it to the tune of about 95 plus percent of the country did that. When you actually look at what we did, even though we shut down, even though it created a great deal of difficulty, we really functionally shut down only about 50%.”
((NARRATOR))
The United States has ramped up testing in the last few weeks, but with the debate over reopening the American economy still a politically sensitive issue, experts warn testing is no substitute for preventative measures.
((Admiral Brett Giroir, Assistant Secretary of Health and Human Services))
“We cannot test our way out of this or any other pandemic. Testing does not replace personal responsibility. It does not substitute for avoiding crowded indoor spaces, or washing hands, or wearing a mask.”
((NARRATOR))
Precautions that many hope will bridge the gap until early next year when officials estimate a vaccine could be ready.
((Dr. Anthony Fauci, National Institute of Allergy and Infectious Diseases Director))
“Ultimately, within a reasonable period of time, the plans now allow for any American who needs a vaccine to get it within the year 2021.”
((NARRATOR))
The White House said Friday that speed is due to the president’s leadership.
((Kayleigh McEnany, White House Press Secretary))
“These critical investments in a coronavirus vaccine are due to the fact that we have a businessman in the White House.”
((NARRATOR))
But congressional Democrats accuse the president and Republicans of failing to deliver needed aid to Americans who are out of work and struggling.
((Nancy Pelosi, Speaker of the House))
“The Republicans said they wanted to take a pause. Well the virus didn't.”
((NARRATOR))
Leaders from both parties failed to strike a deal this week that would have extended additional aid to millions of unemployed Americans.
Katherine Gypson, VOA News, Washington.
(Greta)
I interviewed Dr. Anthony Fauci who testified at that congressional hearing.
He is considered one of the world’s leading authorities on infectious diseases having advised six U.S. presidents on global health issues.
Since 1984 Dr. Fauci has been the director of the U-S National Institute of Allergy and Infectious Diseases.
He is also a member of the White House Coronavirus Task Force.
I asked him how close are we to identifying a safe and effective coronavirus vaccine.
(Greta Interviews Dr. Anthony Fauci)
AF: I think it's important to point out Greta that there are more than one vaccines. I mean there are at least five or six that are being subsidized and supported, directly or indirectly, by the federal government, in the sense of putting in money not only to help in the testing, but also in the production. And in fact, federal government has invested hundreds of millions, if not more than a billion plus, to making vaccine even before it's proven to be effective. So that if it is effective, you save several months. And the only thing you're risking is money, because if it turns out that it's not, you've made a vaccine that wouldn't be used. So right now at the same time as we're testing the vaccine, they're starting to ramp up the production. So the assumption we're making, which I think is reasonable, is that we will know by the end of this calendar year whether we have a safe and effective vaccine. I'm cautiously optimistic that we will, based on the preliminary data that we've seen from the Phase 1 trial. But assuming that we do, by the end of the year the beginning of 2021, as we go into 2021, we should have hundreds of millions of doses as we get into the year. That means that we should have vaccines enough for everyone here.
The companies promise that they will make up to a billion doses. And you have more than one company that's talking about that. Then you have the Chinese who will be making a vaccine. You have the U.K. and the Europeans who have a vaccine. There will be, I think, enough vaccine if everything turns out to be successful to get vaccine not only to the countries that are the classical rich countries, but those who are low and middle income that would not be able to readily have access to a vaccine. That's what we're hoping to do.
GVS: What is the effectiveness that we are hoping to, Obviously we're hoping for a hundred percent, but what is the definition of effective?
AF: Well, you know it's a statistical analysis of proving that it is significantly better than not having the vaccine. We hope that that's going to be at least 50 to 60 percent. It could be more. I think if it's much less, there may be a reluctance to use it, but it really depends upon how much less.
I would be optimistic and hoping that we get something that’s 70 75, 80percent or more. I hope so. If not, I think even a 50 to 60 percent vaccine would be a major contribution, together with public health measures, to contain this virus. I can tell you if there's a vaccine that's available that's safe and effective, I will get the vaccine, predominantly because I think it's important to protect yourselves as best you can. But I would not stop from the public health measures of handwashing if there's still activity in the community, wearing a mask, avoiding crowds. When the level goes so low in the community, then we could start to be thinking about getting more towards what we consider normal.
But right now if you look in this country, with now 60, 50, 60, even as high as 70 thousand new cases a day, that's not normal. We've got to get that way, way down before we approach normal.
GVS: The therapeutic that everyone seems to have the most attention on right now, and I realize we're learning so much every day, but is Remdesivir, which is what I understand is that if you are very sick and you end up in the hospital here in the United States, you will get it from the I.V. and that it is an antiviral, much like Tamiflu is for the flu. Is there any way to Remdesivir can be distributed orally like Tamiflu?
AF: What we're putting a big push on right now is exactly what you're referring to, namely, what do you do early in infection to prevent someone from progressing to serious disease? We have a number of clinical trials that are ongoing with other direct acting antivirals, but importantly with antibodies that are called monoclonal antibodies that are very specific antibodies directed against the virus that you make from the body's natural capability. You clone it and you make it. There are a number of trials, one’s that already started. Two that are going to be starting this week, to give some to early individuals in an outpatient basis, some to individuals a little bit later in the hospital.
But that's a major goal of therapy now is to what do you give to someone to prevent them from progressing, versus waiting until they have advanced disease, when you can give them some drugs that we know work.
GVS: One of the discussions here in the United States since about beginning of March is hydroxychloroquine and whether -- and that's something used all over the world, an anti-malarial and used for a number of years, used for other disorders like I think lupus. Is that now, has that now been concluded as not to be good as a prophylactic and not to be effective if once you get covid-19?
AF: Well, there have been a lot of different observational studies that have come up with conflicting data. But the randomized placebo controlled trials that are the gold standard of whether something actually does work have uniformly shown there's no efficacy of hydroxychloroquine in the treatment of covid-19 disease.
GVS: That's treatment once you get it. Does that include as a prophylactic before you get it?
AF: There have been no studies that have shown its efficacy at any stage. The ones that have shown early potential signal of efficacy have been done in a way that is not a randomized placebo controlled trial, which is the reason why, if you look at all the data, it's pretty uniform. We still keep an open mind to any placebo control randomized trial that would show efficacy or not for hydroxycholoroquine or any drug, we would keep an open mind. But the overwhelming data as it exists now does not show any efficacy.
(Greta)
Coronavirus has killed more than 155-thousand people in the United States. That number is currently more than any other country.
Among those who’ve died is former Republican presidential candidate Herman Cain.
In 2012 the former CEO of the Godfather’s Pizza chain ran unsuccessfully for the Republican party presidential nomination.
Before that he worked at Coca Cola and later at Pillsbury where he turned around the company’s struggling fast food chains.
Cain once served as a director of the U.S. Federal Reserve Bank in Kansas City.
A cancer survivor - Cain was an ardent supporter of President Donald Trump.
(President Donald Trump)
“He was a very special person. I got to know him very well and unfortunately he passed away from a thing called the “China Virus.”
Just a few weeks ago Cain attended President Trump’s campaign rally in Tulsa Oklahoma.
He was photographed mask-less in the crowd. Nine days later he tested positive for COVID-19.
Herman Cain was 74.
(Greta)
All experts say wearing a mask in public will help mitigate the spread of the virus.
Dr. Michael Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
He spoke with Plugged In’s Steve Redisch about how coronavirus has gripped the U.S.
(Plugged In Interview - Dr. Michael Osterholm)
MO: This has just been one big hot forest fire. This is a coronavirus pandemic that is not like one we've seen with influenza before. And we may knock it down, put it put it out, you might say in some areas, only to have it be receded with embers from adjoining fires. And that's what's happening right now. This is just one constant forest fire looking for human wood to burn. And wherever we have mitigation strategies that are able to suppress, it we're seeing less activity. Otherwise, this is going full tilt.
SR: Is the virus mutating?
MO: The virus is mutating. But we have to be very careful how we talk about that, so it doesn't give people a sense that, oh my, look what's happening here. Just like you and me. If we looked at pictures of us 30 years ago or 20 years ago, 10 years ago and now we'd say oh, look how he's changed, but it would be the same us. And we know that this virus is changing as it ages, but it's not clear yet that any those changes are functionally different or make the virus do things that it didn't do before, whether it be increased transmission or whether it caused more severe disease. And those are studies that are still ongoing. But I think it’d be very premature to suggest that something's happened to this virus that makes it a more dangerous or less dangerous virus to deal with.
SR: What is the balance between testing and getting this thing under control, how much testing do we have to do? do we have enough tests? and what would you suggest as far as testing is concerned?
MO: Well first of all I've never really understood the issue about doing too much testing in terms of what it means for the epidemic. That would be like saying if you doubled the number of pregnancy tests you could cut down the number of pregnancies by half. You know, I mean, either you're pregnant or you're not OK? Testing more or less isn't going to determine the number of pregnancies in a community.
And so what we're trying to do is find as many people who we can who are infected with the virus, with the idea of hopefully having them, in a sense, isolate themselves so they don't transmit on to others. Meaning don't be out in the public spaces and so forth if you're infected.
At this point, we don't have a national plan for testing and how to use it. We developed a plan at our center, several months ago published at, in one of our viewpoints on our Web site about smart testing. Smart testing is when you test the right person with the right test at the right time for the right result to have the right outcome. And if you don't have all those linked together, it is a wasted test. A test is returned in eight to 10 days is pretty much meaningless. A test that doesn't ever get returned, even if it's done the first day, is pretty much meaningless. A test that doesn't detect whether or not you really are infected in any accuracy, so that therefore you don't know how to judge the test results isn’t necessarily a smart test.
And if you're testing the wrong people, you know, the people who basically just want to be routinely tested because that makes them feel more comfortable, even though they may not be exposing themselves to the virus - aren't the people we should be testing right now. We should be testing those who are clinically ill, who we believe may have the infection or their contacts. We maybe want to test in certain environments like congregate care areas like long term care to make sure we don't get the virus into them. But the idea of just more testing is better isn't the case, but lots of testing is necessary.
SR: Vaccines, what is, how do you see when a vaccine is developed and approved and ready for distribution? How do you see that going as far as being able to get the vaccines out and the making sure that the public understands that how effective the vaccines will be?
MO: Well, as we have said many, many times, a vaccine is just a vaccine. It means nothing until it's a vaccination, till it's actually in your arm. And that is the critical point. And so what we need to do now is start broadcasting loud and clear all the information we have on what's going on with these vaccine trials, with complete transparency so that the public will know every day what's happening, how many people have been vaccinated? What's happening? What kind of reactions are they having? What are the plans for evaluating the data and how it will then be considered in terms of approval process to complete transparency is critical.
Remember there's not just one vaccine in the race here. There's a number of them. And I'd be happy if all of them work so that we could actually have overlapping vaccines that might very well give us quicker protection, meaning that we can vaccinate more people sooner. But at this point, we have to just take a step back and say, you know, we can be hopeful for these vaccines, but hope is not a strategy.
Will we have a vaccine or vaccines by the end of the year? Likely. But the question is, what does that mean, you'll have a vaccine? Will it be rushed in terms of its evaluation such that people lack confidence in it? How long will it protect for, even if it is adequately evaluated and the safety issues around it elucidated? We just don't know that yet.
And so we all recognize the only real light at the end of the tunnel for us with this disease is a safe and effective vaccine for the world, not just for the United States.
(Greta)
Identifying and isolating everyone who comes into contact with an infected person is one of the most time consuming and challenging tasks for health workers.
But in Nigeria, some local leaders are stepping up to the task of helping tracers do their jobs.
VOA’s Timothy Obiezu has more from Abuja.
(Nigeria Contact Tracing by Timoothy Obiezu)
Daniel Sila is the town crier in this Abuja village. His job is to disseminate vital information from the village chief to people who live in the community.
In recent months his message has been about COVID-19, and ways to prevent it.
He is also helping health officials with their contact tracing mission.
((Daniel Sila, Community Town Crier)) (in Pidgin English)
"They came in their vehicles. I wore coronavirus protection clothing with them.”
((NARRATOR))
This community was among the first in the Abuja region to record the spread of the coronavirus.
((Danjuma Dogo, Community Secretary))
"The first time was about seven cases, the second was about fourteen. The conclusion when that testing was done, I think it was about 70-something.”
((NARRATOR))
Health officials have responded by conducting extensive testing here. But as the number of cases grew, so did the difficulty of contact tracing.
Village officials like Dogo are helping health workers locate positive cases.
((Danjuma Dogo, Community Secretary))
"They came with the list and we responded quickly by working together with them to fish out those ones affected. I was part of the committee. Because the list was with me, we had to go round, checking who and who is affected.”
((NARRATOR))
Nigeria has so far reported some 41-thousand cases of COVID-19. But the fear and stigma attached to the disease have limited the number of people who show up for testing or report symptoms. Last month the coronavirus task force committee criticized the unwillingness of Nigerians to participate in contact tracing. Until Nigerians respond they said the pandemic cannot be brought under control.
Timothy Obiezu, for VOA News, Abuja.
(Greta)
While voluntary compliance and attitudes about face masks and social distancing are also an issue here in the United States there is a lot about COVID-19 that we are just learning.
Such as why some patients report a wide range of symptoms and others have none.
Or why children may not be as infectious in spreading the virus to others.
More from my conversation with Dr. Anthony Fauci.
(Greta interviews Dr. Anthony Fauci - Part 2)
AF: We know now, and there are more studies that are coming out that children between 10 and 19 transmit to humans to adults as easily as adults transmit to adults. If you're up to 10 years old, a study from Korea said that in fact, it's less likely to transmit to adults. However, a more recent study came out and found out that very young children have anywhere from 10 to 100 times the amount of virus in their nasal pharynx. So we've got to be careful if it's in the nasal pharynx, you can assume that it may be able to transmit. So we're still learning a lot about infection in children and how likely it is for them to transmit to others.
GVS: If you and I both get covid and you get a mild case, I get a severe case, but we both survive it. Who is there, are we going to the same amount of antibodies? or am I going to have a more robust antibodies in my system because I dealt with a bigger problem?
AF: That's a very good question. We don't know definitively to the answer to that, but it is likely that the longer you have virus replicating in you and the higher the concentration, the more of a potent immune response. The only problem with that assumption, Greta, is that there's so much variability in the human species. This polymorphism we call it, that your ability to amount a good response, even though you get seriously ill, may not be as good as my ability to amount immune response, even if I don't. But in general, the more exposure, the more replication you get, the better chance there is to get an immune response.
GVS: Why is there seem to be so many variability in what people get from this one virus?
AF: I've been dealing as you know, Greta you've been interviewing me with it for years, with viruses for decades and decades. I've never seen a virus that has this wide range of difference in its manifestations.
Up to 40, 45 percent of people get no symptoms at all. There are some they get mild symptoms, some get sick enough to be in bed for weeks at a time and get residual effects even after. Some have to go to a hospital. Some get intensive care. Some require ventilation and some die. It is a very, very unusual to see that wide range. We don't know. It may have to do with the level of receptors, there may be genetic distribution. We don't really know the answer to that. We do know though, that there are people, mainly elderly and those with underlying conditions who have serious consequences of infection. But we don't know why if I got infected and I had no symptoms and you got infected and you had to stay in bed for three weeks, we don't have any idea why that's the case.
GVS: If you get infected or I get infected, we have no symptoms. Are we immune from a second round or can we get Corona or can we get it again?
AF: You have some degree of an immune response, but we don't know what the duration of that is. Whenever you recover and clear the virus from your body, that means that your immune system was responsible for that. What we do not know is how long that protection lasts. It could be a matter of several weeks or months. Or it could be much longer. We're doing a prospective study on that right now.
(Greta)
That is all the time we have today.
Many thanks to my guests, Dr. Anthony Fauci and Dr. Michael Osterholm.
For the latest updates on COVID-19 - please visit our website at VOANews.com.
And don’t forget to follow me on Twitter @Greta.
Thank you for being Plugged In.
####
