March 24 coronavirus news

A new large scale international review of rapid Covid-19 tests finds that few of them meet the World Health Organization’s minimum acceptable performance standards. 

There are two kinds of rapid tests – molecular tests, including PCR, which are considered to be the gold standard of molecular diagnostics; and rapid antigen tests, which detect proteins of the virus. Proponents of rapid tests say these diagnostics can be utilized to quickly screen individuals as businesses and society continue to re-open. Airlines already are already employing rapid tests to screen passengers for flights. 

When looking at the antigen tests, the independent research group Cochrane, a collaborative of researchers and health professionals from 130 countries, found the were best used within the first week after someone began experiencing symptoms. In those conditions, the tests correctly identified 78% of people with Covid-19. Overall, when used to test among people who were symptomatic, rapid antigen tests positively identified 72% of people who had Covid-19. 

When the antigen tests were used among people who were asymptomatic, the tests were much stronger at ruling out infection than identifying it. The tests correctly identified a negative Covid-19 finding about 99% of the time in people who just had Covid-like symptoms or no symptoms at all. However, when tested among people with a positive Covid-19 diagnosis, the rapid antigen tests only identified them correctly 58% of the time. 

The reviewers also found a wide discrepancy in accuracy among the tests – ranging from 34% to 88%. The WHO’s minimum standards require a test to identify at least 80% of people with an infection and 97% of those without an infection. The SD Biosensor STANDARD Q and the Abbott Panbio antigen tests were identified as the two most accurate tests reviewed. 

When looking at the rapid PCR tests, the researchers found that on average they positively identified an infection 95% of the time, and correctly identified a negative diagnosis 99% of the time. However, the researchers noted that there were limitations to these findings, because most of the studies evaluated looked just at the Abbot ID Now and Xpert press rapid PCR tests. There wasn’t enough data to evaluate when the tests were most precise relative to symptom onset. 

Mexico's Foreign Minister Marcelo Ebrard announced the country had received 12 million AstraZeneca vaccine doses that remain at the final packaging process to start the distribution for Mexico and Latin American countries.

The foreign minister said Mexico and Argentina had promoted vaccine access to the region and went on to say, "We've proposed this with other vaccines and companies, but so far, in Mexico, we're also producing CanSino, and they're willing and have contracts with Latin America."

Mexico on Monday announced the first batch of China's CanSino Biologics vaccine —940,022 doses —were produced and packaged in the country.

Ebrard said the country is very close to starting distributing the AstraZeneca vaccine in Latin America, saying, "this would be a great step for Latin America and the Caribbean; we can act together, we can solve these important challenges, and we can guarantee that our people have access to what they're entitled to."

Pan American Health Organization Director Carissa Etienne said Tuesday that 33 of 35 member states had started immunizations, and 21 countries in the Americas will receive their first deployment of vaccines by the end of this week.

Correction: An earlier version of this post incorrectly stated the additional number of Covid-19 vaccines that Mexico received from AstraZeneca.

Education Secretary Miguel Cardona said about three-quarters of students in the US are back to some form of in-person learning, commending the work of local districts on reopening during the National Safe School Reopening Summit on Wednesday.

Cardona said more than 45% of elementary and middle schools are offering in-person school daily, and about 75% of schools have some form of in-person learning, like a hybrid method, according to new data from the National Center for Education Statistics.

"That's a great start," Cardona said. "We must continue that so every school K-8 offers in-person learning five days a week.

There are still inequities when it comes to in-person learning, Cardona said.

Some of these inequities will be addressed with the funding from the Biden administration's American Rescue Plan, which is providing more than $122 billion for K-12 schools to go towards reopening.

"We can address those inequities that I just talked about with that we can safely reopen our schools when we have to act wisely and with urgency to get it done," Cardona said.

A senior European diplomat is urging caution over the use of proposed new rules that would govern exports of Covid-19 vaccines to outside of the EU. The rules were announced by the European Commission earlier Wednesday.

The tougher export controls put forward by the Commission would see vaccine shipments assessed based on the destination country's rate of vaccinations and vaccine exports.

In a briefing to journalists, the diplomat said the EU and European countries need to, “be careful with the very the nuclear option of a pure export prohibition.” And if not used correctly in, “appropriate situations, it will backfire.”

“We speak as – I would say – a pharma superpower, we have a huge concentration of pharmacological companies on our territory,” whose presence, “counts for several percentages of our employment, of GNP,” the diplomat explained.

The existing export mechanism – which focuses on pharmaceutical firms – has been in place since the end of January and requires each company manufacturing Covid-19 vaccine to register its intention of exporting doses outside of the EU. European countries in collaboration with the Commission decide whether to approve or reject shipments.

In figures released today by the Commission, over 300 applications were made, with 43 million vaccines exported to 33 countries. Only one shipment of 250,000 doses of the AstraZeneca vaccine from Italy to Australia was blocked.

The diplomat welcomed this “excellent by-product” of the current mechanism. “We understand of course the need for more transparency, we are squarely behind the Commission in that respect,” adding that, “we have now a very precise view on how the export flows are organised.”

Asked why the expanded legislation was being brought forward now, the diplomat said they felt it, “probably it is a sign of some nervousness which is reigning,” in some European counties. 

“The Commission is not deaf for what lives in member states, they hear cries for help or indignation, and it's up to the Commission to reflect on that and to put proposals on the table,” he added.

European leaders will meet on Thursday and Friday to discuss this proposal and the wider coronavirus crisis in Europe. If signed off, the expanded export mechanism would “apply until six weeks from its entry into force,” according to the Commission’s draft text.

More new research suggests that Covid-19 vaccines are effective in preventing Covid-19 in the real world, Dr. Anthony Fauci, chief medical adviser to President Biden, said during a White House virtual briefing on Wednesday.

SARS-CoV-2 is the name of the virus that causes Covid-19.

Two new papers, published in the New England Journal of Medicine on Tuesday, have added to that growing body of research.

One study of employees at UT Southwestern Medical Center in Texas found that among those who were fully vaccinated, the infection rate was 0.05%. That was compared with 2.61% of the non-vaccinated employees and 1.82% of the partially vaccinated employees. The other study, on fully vaccinated workers at the University of California, San Diego and the University of California, Los Angeles, also showed a very small positivity rate after vaccination.

"Now, 70% of Americans 65 years of age or older have received at least one dose," Fauci said.

"Every day, 2.5 to 3 million people get vaccinated. So, every day we get closer and closer to that extraordinary degree of effectiveness, which we're seeing at the community level – and at the end of the day, that is what it is that is going to end this pandemic in this country."

Watch:

Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said on Wednesday that the latest Covid-19 data in the United States has her worried.

"I continue to be worried about the latest data, and the apparent stall we are seeing in the trajectory of the pandemic," Walensky said. "CDC is watching these numbers very closely."

Walensky added, "We have made such extraordinary progress in the last several weeks, and if we choose to invest in prevention right now, we will ultimately come out of this pandemic faster and with fewer lives lost."

She applauded the pace of Covid-19 vaccinations in the United States.

"I've been so impressed by the pace of vaccination," Walensky said during the briefing.

“So many Americans have embraced vaccination and have chipped in with their families and communities to help others get vaccinated," Walensky said. "We are now vaccinating between 16 and 20 million people a week — and this means that we are closer to resuming activities we love to do with those we care about the most."

Hear her concern: 

US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky touted “substantial progress” toward vaccinating the nation’s educators Wednesday as the Biden administration’s deadline to get school staff vaccinated by the end of the month approaches.

She continued, “This is substantial progress towards our goal of getting our teachers and school staff vaccinated by the end of March.”

There were about 3.7 million teachers in the fall of 2020, per the National Center for Education Statistics.

This progress comes as the Department of Education is set to hold a summit on the safe reopening of schools Wednesday afternoon, with President Biden expected to announce $81 billion in funding for states toward supporting reopening measures via the $1.9 trillion Covid relief bill.

“During the summit, we will continue the important dialogue of school reopening and hear firsthand experience from school administrators, teachers, staff, and students about how they have been able to successfully get back to in person learning,” Walensky said.

The antiviral drug remdesivir shortens the duration of illness even among non-White patients, who have a higher risk of severe disease, doctors reported Wednesday.

The study, published in the journal JAMA Network Open, adds to evidence the drug can relieve the burden of coronavirus illness, even if it’s not a cure.

Remdesivir, sold under the brand name Veklury, was approved in October. It was the first drug to get full approval from the US Food and Drug Administration for use in treating Covid-19.

“Receipt of remdesivir was associated with faster clinical improvement in a cohort of predominantly non-White patients,” Dr. Brian Garibaldi of the Johns Hopkins University School of Medicine and colleagues wrote in their report. Garibaldi was among the team of doctors who treated then-President Trump for a coronavirus infection last year. 

The team looked at the records of 2,483 patients with Covid-19 treated in the Johns Hopkins system. Of those, 342 received remdesivir, and 184 of these patients also received corticosteroids.

And while patients given remdesivir were less likely to die, the findings on this were not statistically significant, the team said. 

Only very ill patients got remdesivir – those with low oxygen levels and indications of organ damage.

“Our study included a much higher percentage of patients from underrepresented minority groups than previous remdesivir clinical trials. Approximately 80% of patients in our cohort were non-White individuals compared with 30% to 47% in clinical trials,” the team wrote.

“Because underrepresented minority groups have shouldered a disproportionate burden during the COVID-19 pandemic but have not been widely represented in clinical trials, our results provide important evidence that receipt of remdesivir is associated with decreased time to clinical improvement in these populations," they wrote.

As more states expand coronavirus vaccine eligibility to anyone 16 and older in the general population, local health officials are growing concerned that demand may become more of a challenge than supply.  

It could happen within the next four to six weeks, Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials, told CNN on Wednesday morning. 

“We will get to the point pretty quickly where we're saying, ‘OK now we're into the really hard phase of this where we're down to the population that is not so willing to get the vaccine,’ ” Freeman said.