Top Stories for Week of April 27, 2020

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Timeline of coronavirus’s arrival in the US shifts backward, underscoring what’s known and not known about path ahead.

The novel coronavirus circulated in January in California, weeks earlier than thought, and early deaths were likely mistaken for the flu, a county health officer reported on Friday. A 57-year-old woman had died of COVID-19 on Feb. 6, far earlier than any other reported cases in the US, said Sara Cody, the health officer in Santa Clara County, CA.

It was previously thought that the first US death from COVID-19, the respiratory disease caused by the virus, was in Washington state on Feb. 29, according to Reuters. News of the deaths in California could improve public health officials’ understanding of how the outbreak took hold in the US.

The California woman’s death and two other early cases–a 69-year-old man who died Feb. 17 and a 70-year-old man who died March 6–were confirmed to have been COVID-19 by the US Centers for Disease Control and Prevention after it tested tissue samples. The county had previously identified its first case of community transmission–infectious spread among people who had not been to China or other early hot spots–on Feb. 28, Cody said. But none of the three patients who died had traveled.

“What these deaths tell us is that we had community transmission probably to a significant degree, far earlier than we had known, and that indicates that the virus was probably introduced and circulating in our community far earlier than we had known,” Cody said.

Because the region was undergoing a bad flu season at the time, many cases may have been misclassified as influenza, she said. The cases were likely “iceberg tips,” Cody said, indicating that many more people were also infected. The three cases were discovered because the county medical examiner’s office was not satisfied that it had found the correct cause of death, Cody said. Because coronavirus tests were not available, they saved tissue samples, which they sent to the CDC. The testing parameters at the time by the CDC restricted testing to individuals with a known travel history and who sought medical care for specific symptoms.

US coronavirus deaths topped 52,000 on Saturday, doubling in a little over a week. The US has by far the world’s largest number of confirmed coronavirus cases at more than 820,000.

COVID-19 Addenda: 1) Don’t inject disinfectants Lysol warns, as Trump raises idea; 2) Deposed BARDA chief blasts Trump administration on promoting unproven drugs; and 3) New study shows nearly 9 in 10 COVID-19 patients on ventilators don’t survive.

1) The parent company of Lysol and another disinfectant warned Friday that its products should not be used as an internal treatment for the coronavirus after President Donald Trump wondered about the prospect during a White House briefing. Trump noted Thursday that researchers were looking at the effects of disinfectants on the virus and wondered aloud if they could be injected into people, saying the virus “does a tremendous number on the lungs, so it would be interesting to check that.”

That prompted a strong warning from the maker of disinfectants Lysol and Dettol, which said it was issuing a statement to combat “recent speculation.” The statement from Reckitt Benckiser said, “As a global leader in health and hygiene products, we must be clear that under no circumstance should our disinfectant products be administered into the human body (through injection, ingestion or any other route).”

2) Rick Bright, who was the director of the US Biomedical Advanced Research and Development Authority (BARDA) until last week, claims he was abruptly dismissed from his post and reassigned to another position because he resisted efforts to widen the availability of a potential coronavirus treatment that has been touted by President Donald Trump.

“I believe this transfer was in response to my insistence that the government invest the billions of dollars allocated by Congress to address the COVID-19 pandemic into safe and scientifically vetted solutions, and not in drugs, vaccines and other technologies that lack scientific merit,” Bright said in a statement.

Bright, who led BARDA since 2016, was removed from the post as well as from his role as deputy assistant secretary for preparedness and response, and assigned instead to a new public-private partnership under the National Institutes of Health (NIH) that aims to accelerate COVID-19 vaccine and treatment options.

3) And a giant study that examined outcomes for more than 2,600 patients found an extraordinarily high 88% death rate among COVID-19 patients in the New York City area who had to be placed on mechanical devices to help them breathe. The study, published in the Journal of the American Medical Association, is one of the largest reviews published to date of COVID-19 patients hospitalized in the US.

Bloomberg News reported that the researchers examined outcomes for coronavirus patients who were admitted between March 1 and April 4 to 12 hospitals in New York City and Long Island that are part of the Northwell Health  system. Overall, the researchers reported that 553 patients died, or 21%. But among the 12% of very sick patients that needed ventilators to breathe, the death rate rose to 88%.

The rate was particularly appalling for patients over 65 who were placed on a machine, with just 3% of those patients surviving, according to the results. Men had a higher mortality rate than women. As a result, some doctors are questioning their use in COVID-19 patients and have been trying to find methods for keeping coronavirus patients off them when possible.

The WHO launches a global initiative on treatments for COVID-19; US is noticeably absent from meeting.

World leaders pledged on Friday (April 24, 2020) to accelerate work on tests, drugs and vaccines against COVID-19 and to share them around the globe, but the US did not take part in the launch of the World Health Organization (WHO) initiative. French President Emmanuel Macron, German Chancellor Angela Merkel and South African President Cyril Ramaphosa were among those who joined a video conference to launch what the WHO billed as a “landmark collaboration” to fight the pandemic.

The aim is to speed development of safe and effective drugs, tests and vaccines to prevent, diagnose and treat COVID-19, the lung disease caused by the novel coronavirus–and ensure equal access to treatments for rich and poor.

“We are facing a common threat which we can only defeat with a common approach,” WHO Director General Tedros Adhanom Ghebreyesus said as he opened the virtual meeting.

During the H1N1 swine flu pandemic in 2009, there was criticism that distribution of vaccines was not equitable as wealthier countries were able to purchase more.

“We must make sure that people who need [treatments] get them,” said Peter Sands, head of the Global Fund to Fight on AIDS, tuberculosis and malaria. “The lessons from AIDS must be learned. Too many millions died before anti-retroviral medicines were made widely accessible.”

European Commission President Ursula von der Leyen said that the objective at a global pledging effort on May 4 would be to raise 7.5 billion euros ($8.10 billion) to ramp up work on prevention, diagnostics and treatment.

“This is a first step only, but more will be needed in the future,” von der Leyen told the conference.

Leaders from Asia, the Middle East and the Americas also joined the videoconference, but several big countries did not participate, including China, India and Russia. A spokesman for the US mission in Geneva had earlier told Reuters that the US would not be involved.

US President Donald Trump has lambasted the WHO as being slow to react to the outbreak and being “China-centric” and announced a suspension of funding. Tedros has steadfastly defended the WHO’s handling of the pandemic and repeatedly committed to conducting a post-pandemic evaluation, as the agency does with all crises. Macron, Merkel, Ramaphosa, and Spain’s Prime Minister Pedro Sanchez were among those voicing strong support to WHO.

“As new diagnostics, treatments and vaccines become available, we have a responsibility to get them out equitably with the understanding that all lives have equal value,” said Melinda Gates, co-chair of the Gates Foundation (Seattle), which was WHO’s second largest donor last year.

Trump signs into law $484 billion measure that replenishes coronavirus aid program for small businesses.

President Donald Trump signed a $484 billion bill Friday to aid employers and hospitals under stress from the coronavirus pandemic that has killed more than 50,000 Americans and devastated broad swaths of the economy.

The bill is the latest effort by the federal government to help keep afloat businesses that have had to close or dramatically alter their operations as states try to slow the spread of the virus. Over the past five weeks, roughly 26 million people have filed for jobless aid, or about 1 in 6 US workers, says The Associated Press. Trump thanked Congress for “answering my call” to provide the critical assistance and said it was “a tremendous victory.”

But easy passage of this aid installment belies a potentially bumpier path ahead for future legislation to address the crisis. Trump said most of the funding in the bill would flow to small business through the Paycheck Protection Program, which provides money to small businesses to keep workers on their payroll. “Great for small businesses, great for the workers,” Trump said.

The measure passed Congress almost unanimously Thursday (April 23, 2020) as lawmakers gathered in Washington as a group for the first time since March 27. They followed stricter social distancing rules while seeking to prove they can do their work despite the COVID-19 crisis.

“Millions of people out of work,” said House Speaker Nancy Pelosi, D-Calif. “This is really a very, very, very sad day. We come to the floor with nearly 50,000 deaths, a huge number of people impacted, and the uncertainty of it all.”

Anchoring the bill is the Trump administration’s $250 billion request to replenish a fund to help small- and medium-size businesses with payroll, rent and other expenses. This program provides forgivable loans so businesses can continue paying workers while forced to stay closed for social distancing and stay-at-home orders.

The legislation contains $100 billion demanded by Democrats for hospitals and a nationwide testing program, along with $60 billion for small banks and an alternative network of community development banks that focus on development in urban neighborhoods and rural areas ignored by many lenders. There’s also $60 billion for small-business loans and grants delivered through the Small Business Administration’s existing disaster aid program. Passage of more coronavirus relief is likely in the weeks ahead.

Martin Shkreli has asked a federal judge to release him early from prison, saying he “has been conducting significant research into developing molecules to inhibit the coronavirus” and would continue doing so if set free.

Shkreli, who is scheduled to be released in October 2023, says he suffers from asthma and allergies which make him susceptible to contracting COVID-19 if he remains in prison. He was sentenced in March 2018 to seven years after being convicted of securities fraud for lying to investors in his hedge funds and manipulating shares in Retrophin Inc., a biotech company he founded. Shkreli’s lawyers say his research into finding a cure for the coronavirus is a “compelling reason” to allow the 37-year-old to serve the remainder of his term at home.

The infamous “Pharma Bro,” who gained notoriety for unapologetically raising drug prices, was moved from a low-security camp in New Jersey last year after the Wall Street Journal reported he was using a contraband mobile phone to secretly run a pharmaceutical company and post on Twitter.

He’s currently at FCI Allenwood, a more secure facility in Pennsylvania which has about 1,260 inmates. Visits have been halted at the facility, which has one confirmed case of the virus, according to the federal Bureau of Prisons website. Prison infections have prompted many to request early release. Twenty-three federal inmates have died of the disease. As of April 21, 2020, there were 540 federal inmates and 323 staff members who have confirmed positive test results for COVID-19 nationwide, according to the government.

IPO Sector: ORIC Pharmaceuticals Inc., a Phase 1 biotech developing small molecule therapies for treatment-resistant cancers, increased the proposed share offering for its upcoming IPO. The South San Francisco, CA-based company now plans to raise $94 million by offering 6.3 million shares at a price range of $14 to $16.

The company had previously filed to offer 5 million shares at the same range. At the midpoint of the range, ORIC Pharmaceuticals will raise 25% more in proceeds than previously anticipated to command a fully diluted $443 million market cap. The cancer biotech will use the bulk of the proceeds from the IPO to advance its lead drug, ORIC-101, in prostate cancer and other solid tumors.

Healthcare stocks, especially those with drug development focuses, have outperformed the broader market. The Nasdaq Biotechnology Index is trading at the highest level since 2015 and out-pacing the S&P 500. “COVID-19, is likely to get solved with capital and science,” said Bank of America Corp.’s Gregg Nabhan, global vice chairman of global equity capital markets. “Healthcare companies are somewhat insulated from long-term economic volatility.”

ORIC Pharmaceuticals was founded in 2014 and plans to list on the Nasdaq under the symbol “ORIC.” J.P. Morgan, Citi, Jefferies, and Guggenheim Securities are the joint bookrunners on the deal. It is expected to price this week.

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