ST. LOUIS — Washington University researchers are leading a new trial testing the anti-malaria drug chloroquine on 30,000 front-line health care workers worldwide, to determine whether the drug can prevent COVID-19, or decrease its severity.
Scientists across the globe have responded to the urgent call for a vaccine and treatments for COVID-19, and mobilized clinical trials to study drugs like chloroquine.
“This is a new virus for humans,” said Michael Avidan, a professor of anesthesiology at Washington U. and one of the study’s principal investigators. “It swept across the globe — and we had nothing.”
The university is leading an international group of physicians and scientists designing a trial to study the drug’s effectiveness, and, if effective, to determine the lowest dose required. A lower dose would likely mean fewer side effects and would make it possible to treat more people with a limited supply of chloroquine.
“I don’t know whether or not chloroquine works,” Avidan said. “The way to figure that out is to do rigorous, scientific experiments.”
This is at least the second chloroquine trial for Washington U. Last month, the university announced it was launching a trial testing the drug on patients admitted to Barnes-Jewish Hospital for treatment of COVID-19.
The drug gained prominence in March after President Donald Trump recommended it as a treatment, despite concerns leveled by health officials across the world. They warned that chloroquine and derivative hydroxychloroquine were unproven against the coronavirus, and could be dangerous.
This week, Trump announced he was taking hydroxychloroquine.
Hydroxychloroquine and chloroquine have been used for decades, primarily to treat malaria and some inflammatory conditions. Avidan said this is a potential benefit, because developing a new drug could take years.
“We don’t have years,” Avidan said. “The notion of repurposing drugs is a very important one when you’re facing a situation like this.”
Avidan said researchers will probably have to identify the most effective combination of medications for treating COVID-19, but short of a vaccine, no one drug is likely to be a panacea.
Avidan said St. Louis-area health care workers can apply to participate in the trial.
Health care workers who have previously been infected with COVID-19, and those with underlying conditions that could make it unsafe to take chloroquine, like heart ailments, will not be eligible.
“We think that this is a potential benefit for St. Louis,” Avidan said. “I’ll be extremely thrilled and excited if many health care workers in our region take up the opportunity. … We want the health care workers in the St. Louis region in Missouri and southern Illinois to be well represented.”
The trial will largely be conducted remotely. Enrollment and consent will be done online.
Three groups of participants will receive various doses of chloroquine, and one will receive a placebo.
Participants will communicate twice a week through text messages and online data entry. They will take the tablets for three months, either daily, twice a week or weekly. They will be monitored for two months after.
The researchers will take blood samples at the beginning of the trial and at the end, to test for antibodies. If a participant shows symptoms of COVID-19, they will have a nasal swab taken to test for the virus.
The trial has an adaptive design, meaning the researchers could add or remove therapies if the initial data indicates that they are effective, or ineffective.
Rising Pharmaceuticals, headquartered in East Brunswick, New Jersey, is donating about 300,000 doses of chloroquine, for the trial’s U.S. participants.
The company has been ramping up production, and has added a manufacturing site, said Chief Operating Officer Ira Baeringer.
It has also supplied chloroquine and hydroxychloroquine to five other trials.
Rising anxiety may be the common denominator as countries around the world gradually emerge from lockdowns due to the new coronavirus.
What a return to normal looks like varies widely. There are hungry migrant workers in India finally able to catch trains back to their home villages and wealthy shoppers in Maseratis and Rolls-Royces returning to the boutiques of America’s iconic Rodeo Drive in Beverly Hills, California. In Italy, once-packed restaurants and cafes are facing a huge financial hit as they reopen with strict social distancing rules.
And there are worries about job security. Airline engine maker Rolls-Royce announced plans Wednesday to cut 9,000 workers as it grapples with the collapse in air travel due to the pandemic. Read the full story here:
ST. LOUIS BUSINESS NEWS
Nations reopen yet struggle to define ‘a new normal’
By NICOLE WINFIELD and MIKE CORDER Associated Press
Republican political operatives are recruiting “extremely pro-Trump” doctors to go on television to prescribe reviving the U.S. economy as quickly as possible, without waiting to meet safety benchmarks proposed by the federal Centers for Disease Control and Prevention to slow the spread of the new coronavirus.
President Donald Trump threatened Wednesday to hold up coronavirus relief money for Michigan after he said — erroneously — that the state had sent absentee ballots to millions of voters. It’s not clear that he can do so.
New Jersey has launched a website to debunk rumors and hoaxes associated with the spread of the new coronavirus, following a false text message of an impending national lockdown that circulated widely across the United States. Similar actions are underway in other states to knockdown potentially harmful misinformation.
U.N. Secretary-General Antonio Guterres warned Wednesday that the coronavirus pandemic threatens Africa’s progress and could push millions into extreme poverty.
Cambridge has become the first university in Britain to cancel all face-to-face lectures for the 2020-21 academic year because of the coronavirus pandemic, after 800 years of welcoming students to its cloisters, quadrangles, and classrooms.
President Donald Trump emphatically defended himself against criticism from medical experts that his announced use of a malaria drug against the coronavirus could spark wide misuse by Americans of the unproven treatment with potentially fatal side effects.
Second Lady Karen Pence visited Great Smoky Mountains National Park to talk about the mental health benefits of spending time outdoors as officials announced the second phase of a plan to reopen all park trails.
High schools nationwide have canceled or postponed traditional graduation ceremonies to avoid worsening the spread of the new coronavirus, but some are going ahead with full-fledged springtime commencement exercises as usual, with tweaks to account for health concerns.
Virtual safaris are helping to distract people under coronavirus lockdowns while attracting badly needed support for African wildlife parks hit hard by the disappearance of tourists.
Aircraft engine maker Rolls-Royce announced plans Wednesday to cut 9,000 workers as it grapples with the collapse in air travel.
Oprah Winfrey is giving grants to the cities she’s called home through her $12 million coronavirus relief fund. She announced Wednesday that her Oprah Winfrey Charitable Foundation will donate money to organizations dedicated to helping underserved communities in Chicago; Baltimore; Nashville, Tennessee; Milwaukee; and Kosciusko, Mississippi, where she was born.
Workers block off seats with red tape May 19 as they prepare for a large high school graduation ceremony in Hoover, Ala. (Associated Press)
High schools nationwide have canceled or postponed traditional graduation ceremonies to avoid worsening the spread of the coronavirus, but some are going ahead with full-fledged springtime commencement exercises as usual, with tweaks to account for health concerns.
Thousands of graduates, parents, siblings, and grandparents will gather at a nearly 11,000-seat stadium on Wednesday and Thursday nights in the Birmingham suburb of Hoover as its two high schools — among the largest in Alabama — hold traditional commencement exercises despite COVID-19.
A school in a nearby city held its ceremony Tuesday, with chairs for more than 540 graduates spread apart across a football field and a keynote address by Alabama’s state school superintendent, Eric Mackey. Few in attendance wore protective face masks, and seniors hugged and gathered in tight groups of friends for pictures.
Dr. Michael Saag, who treats infectious diseases at the University of Alabama at Birmingham, said the threat of spreading the coronavirus poses too great a risk to hold such ceremonies. Virus carriers without symptoms could unknowingly infect others, he said.
Saag has a particularly informed perspective: He survived COVID-19 after being infected in March.
“Having had this before, even if you survive it, which most people do, it’s still a harrowing thing to go through,” said Saag, now back at work.
School officials in Hoover announced the ceremonies in the city’s open-air baseball stadium, after Gov. Kay Ivey eliminated state restrictions on the size of group gatherings as long as people from different households stay six feet apart.
For the ceremonies, hundreds of chairs for graduates have been spread across the dirt infield; spectators will sit on metal bleachers or in blue stadium seats. Workers applied red tape to seats that spectators are to avoid.
Kathy Murphy, the city school superintendent, said the ceremonies will comply with the rules.
“All of our students will be celebrated, even those who choose not to come, and we understand that. But we will call their names, their names will appear on the large Jumbotron,” Murphy said in a video posted online.
Schools in California planned virtual graduations after the state canceled traditional events, and students at an Illinois school walked across a stage in an otherwise empty auditorium. Some systems delayed ceremonies until the summer, and President Obama recorded a video graduation speech for seniors. At some schools, graduating classes were split into smaller groups for live ceremonies.
Some, mostly smaller schools have held traditional commencements for entire classes. But Spain Park and Hoover are two of the largest, top-ranked state schools. Both are in a heavily populated area, making such ceremonies all the riskier, critics said.
As a precaution, students are being given face masks, along with instructions not to hug friends, exchange high fives, toss caps or linger afterward. Tickets are limited, and everyone present must wear a face covering.
Still, the numbers of potential attendees are daunting at a time when sporting events, concerts, and movies are still prohibited because of crowd concerns.
Some 390 seniors will graduate on Wednesday night from Spain Park, meaning about 1,950 graduates and guests could attend. Another 690 will graduate on Thursday from Hoover High, so some 3,450 people could be inside Hoover Metropolitan Stadium.
Critics say that even with the rules, such huge ceremonies could hasten additional coronavirus transmission in metro Birmingham, an area of more than 1 million people. The city of Hoover, with 85,000 residents, sits astride Shelby and Jefferson counties, which have more than 1,770 cases of COVID-19 combined.
Bonnie Kaiser, a 2004 graduate of Hoover High School who teaches in the Department of Anthropology and Global Health Program at UC San Diego, was among 31 health professionals and system alumni who signed an open letter asking officials to reconsider the ceremonies.
“I think the thing is there’s not a way to do it safely even if everyone has perfect behavior as far as what is being recommended, and we know at a graduation that just will not happen,” Kaiser said in an interview.
Parents pleased that their children could have a traditional graduation ceremony flooded the school’s social media feeds with thanks to school officials, But critics also aired their complaints. And some top-ranked students said they won’t attend.
Omar Mohammad, a 17-year-old senior at Spain Park, organized a small protest outside the graduation site Saturday with about three dozen supporters. He plans to skip his graduation, calling the ceremony “unsafe and irresponsible.”
“All it takes is one asymptomatic person handing out fliers to others to make it spread,” Mohammad said. “This isn’t about graduation. It’s about Hoover. If you get a disease you can spread it.”
Murphy, the city superintendent, said the ceremonies are optional, and any student with health problems or safety concerns can set up a “more personalized” graduation with their principal.
South of Hoover in Alabaster, Thompson High School held a traditional graduation ceremony in its football stadium Tuesday night, limiting the crowd to 2,500 guests, or roughly half the normal capacity, but with no requirements for masks. Senior Jael Janae Johnson thanked God for the event in the opening prayer.
“This wouldn’t be possible without your will,” she said.
PROVIDENCE, R.I. (AP) — Public health officials in some states are accused of bungling coronavirus infection statistics or even using a little sleight of hand to deliberately make things look better than they are.
The risk is that politicians, business owners, and ordinary Americans who are making decisions about lockdowns, reopenings, and other day-to-day matters could be left with the impression that the virus is under more control than it actually is.
In Virginia, Texas, and Vermont, for example, officials said they have been combining the results of viral tests, which show active infection, with antibody tests, which show a past infection. Public health experts say that can make for impressive-looking testing totals but do not give a true picture of how the virus is spreading.
In Florida, the data scientist who developed the state’s coronavirus dashboard, Rebekah Jones, said this week that she was fired for refusing to manipulate data “to drum up support for the plan to reopen.” Calls to health officials for comment were not immediately returned Tuesday.
In Georgia, one of the earliest states to ease up on lockdowns and assure the public it was safe to go out again, the Department of Public Health published a graph around May 11 that showed new COVID-19 cases declining over time in the most severely affected counties. The daily entries, however, were not arranged in chronological order but in descending order.
For example, the May 7 totals came right before April 26, which was followed by May 3. A quick look at the graph made it appear as if the decline was smoother than it really was. The graph was taken down within about a day.
Georgia state Rep. Jasmine Clark, a Democrat with a doctorate in microbiology, said the graph was a “prime example of malfeasance.”
“Sadly it feels like there’s been an attempt to make the data fit the narrative, and that’s not how data works,” she said.
Republican Gov. Brian Kemp’s office denied there was any attempt to deceive the public.
Guidelines from the Trump administration say that before states begin reopening, they should see a 14-day downward trend in infections. However, some states have reopened when infections were still climbing or had plateaued. States have also been instructed to expand testing and contact tracing.
The U.S. has recorded 1.5 million confirmed infections and over 90,000 deaths.
Vermont and Virginia said they stopped combining the two types of tests in the past few days. Still, health officials in Virginia, where Democratic Gov. Ralph Northam has eased up on restrictions, said that combining the numbers caused “no difference in overall trends.”
In Texas, where health officials said last week that they were including some antibody results in their testing totals and case counts, Republican Gov. Greg Abbott said Monday that the numbers were not being commingled. Health officials did not respond to requests for clarification.
Georgia’s Department of Public Health also regularly publishes a graph that shows cases over time, except new infections are not listed on the day they came back positive, which is the practice in many other states. Instead, Georgia lists new cases on the day the patient first reported symptoms.
That practice can shift the timeline of the outbreak and make it appear as if the state is moving past the peak.
Kemp spokesperson Candice Broce insisted that the governor’s office is not telling the department what to do and that officials are not trying to dress up the data to make Kemp look better, saying that “could not be further from the truth.”
As for the May 11 graph, Broce said public health officials were trying to highlight which days had seen the highest peaks of infections. “It was not intended to mislead,” Broce said Tuesday. “It was always intended to be helpful.”
Thomas Tsai, a professor at the Harvard Global Health Institute, said the way Georgia reports data makes it harder to understand what the current conditions are, and he worries that other states may also be presenting data in a way that doesn’t capture the most up-to-date information.
Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, said a lot of these cases are not necessarily the result of any attempt to fool the public. For example, she said, states may not have updated information systems that allow them to tell the difference between an antibody test and a viral test.
Still, if states are mixing a lot of testing numbers together, “you’re not going to be able to make good decisions about reopening and about what level of disease you have in the community,” Nuzzo said.
In other developments, the White House scrambled to defend President Donald Trump’s decision to use the malaria drug hydroxychloroquine to fend off the coronavirus. The drug is unproven against the virus, and the president’s move spurred fears that many Americans might start using the medication, which carries potentially fatal side effects.
White House press secretary Kayleigh McEnany emphasized that “any use of hydroxychloroquine has to be in consultation with your doctor.”
About 4.9 million people worldwide have been confirmed infected by the virus, and about 320,000 deaths have been recorded, according to a tally by Johns Hopkins University that experts believe is low.
Russia and Brazil are now behind only the United States in the number of reported infections, and cases are also spiking in such places as India, South Africa and Mexico.
New hot spots emerged Tuesday in Russia, and the country recorded nearly 9,300 new infections in 24 hours, bringing the total to almost 300,000, about half of them in Moscow. Authorities say over 2,800 people with COVID-19 have died in Russia, but some say the number is surely higher than that.
President Vladimir Putin’s approval rating has sunk to 59%, the lowest in the two decades he has been in power, Russia’s independent pollster Levada Center reported. The plunge reflects growing mistrust and uncertainty among the public, Levada said.
Some experts argue Russian authorities have been listing chronic illnesses as the cause of death for many who tested positive for the virus. Officials angrily deny manipulating statistics, saying Russia’s low death toll reflects early preventive measures and broad screening.
Long reported from Washington, Amy from Atlanta. Associated Press writers around the world contributed.