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Cluster: COVID-19

Cluster: COVID-19

A cluster of topics related to COVID-19. COVID-19 is the abbreviated name for coronavirus disease 2019, a respiratory disease caused by a novel coronavirus strain called SARS-CoV-2. COVID-19 was first detected in Wuhan City, China and the outbreak was declared a pandemic on March 11, 2020 by the WHO.

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Neelam Jhaveri
Neelam Jhaveri approved a suggestion from Golden's AI on 1 Apr, 2021
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Drive-through clinics in GoyangGoyang, South Korea allow people to stay in their cars as samples are taken from their noses and throats from staff in protective clothing. Samples are tested on site and the user receives a phone call or text message of their result and placed in isolation. The UK is also opening COVID-19 drive-throughs.

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Neelam Jhaveri
Neelam Jhaveri approved a suggestion from Golden's AI on 31 Mar, 2021
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  • COVID-19 Vaccine Janssen (JNJ-78436735; Ad26.COV2.S) – Non-replicating viral vector developed by Janssen Vaccines (Johnson & JohnsonJohnson & Johnson)
Edits on 30 Mar, 2021
Amy Tomlinson Gayle
Amy Tomlinson Gayle edited on 30 Mar, 2021
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The FDA issued a guidance document for Emergency Use Authorization for COVID-19 vaccines in October 2020, which states that before seeking emergency approval, vaccine makers should follow trial participants for at least two months to rule out major side effects. CDC director Robert Redfield, vaccine developers, and the FDA stated that a COVID-19 vaccine is unlikely to be widely available until the middle of 2021.

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Folding@home launched a program in March 2020 to assist researchers around the world who are working on finding a cure and learning more about the COVID-19 outbreak. The initial wave of projects have been used to simulate potentially druggable protein targets from the SARS-CoV-2 virus, and the related SARS-CoV virus, of which there is much more data available.

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Southwest Research Institute (SwRI) has virtual screening software which it used to evaluate two million drug compounds agianstagainst SARS-CoV-2. SwRI is partneredpartnering with Texas Biomedical Research Institute and their Rhodium software can scan 250,000 drug compounds using machine learning techniques.

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According to available evidence, the SARS-CoV-2 virus is transmitted between people through close contact and droplets produced by sneezing and coughing. The SARS-CoV-2 virus was initially reported to not be transmitted by airborne transmission, but hundreds of scientists urged organizations such as the WHO to address airborne transmission in an open letter outlining emerging evidence, which culminatedculminating in a National Academies workshop on airborne transmission of COVID-19. Preventative measures include the following: hand hygienesanitizing with alcohol-based sanitizers or soap and water; avoiding touching eyes, nose and mouth; coughing or sneezing into elbow or tissue; wearing a medical mask if you have symptoms and hand hygiene after disposing of a mask; and maintaining a social distance of 1 m from individuals with respiratory symptoms. In indoor environments, ventilation, filtration, and air disinfection have been suggested to decrease potential airborne transmission. See COVID-19 transmission dynamics and COVID-19 protocols for more information on disease transmission and mitigation strategies respectively, which include nonpharmaceutical interventions (NPIs) .

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Masks can be used as personal protective equipment (PPE) to keep the wearer of the mask from breathing in SARS-CoV-2 virus. Masks are also used as a respiratory source control where the aim is the protect others from exposure to exhaled viral particles. Standards, protocols, and methods for testing masks are found on the Mask Testing Protocols page.

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The WHO has guidelines that recommend health care workers cover their mouth and nose with surgical masks, and the CDC put out instructions for health care workers to wear N95 masks (N95 respirators). N95 masks are thicker and fit more snugly around the mouth and nose, blocking smaller particles than surgical masks. Both types of masks help prevent the spread of droplets from a cough or sneeze from reaching the mask-wearer’s mouth or nose. During the SARS coronavirus outbreak, a study found that any type of mask or respirator reducedreduces the risk of infections in health care workers by 85 percent. The CDC recommends that health care workers wear a respirator, also called an N95 mask, when around potential COVID-19 patients, which filters out more particles than a surgical mask. The CDC has a list of N95 masks approved by the National Institute for Occupations Safety and Health (NIOSH).

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Infected patients who wear surgical masks are less likely to spread infection to others. The CDC instructed hospitals to request athat patientpatients wear a surgical mask if they have a fever or respiratory illness, have recently traveled to Wuhan, or have come in contact with someone who traveled there.

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The purchasing of protective face masks by the public is feared to cause a shortage for health care workers during the COVID-19 pandemic. In addition to healthcare workers, a shortage of protective masks wouldthreatened to slow scientific research on treatments and vaccines to SARS-CoV-2 since personnel need to be protected from the pathogens that they work with in the lab. For healthy asymptomatic individuals, who are not healthcare workers or caring for patients at home, wearing of a face maskmasks waswere not initially not recommended by the WHO. The WHO stated on February 27, 2020, “The capacity to expand PPE production is limited, and the current demand for respirators and masks cannot be met, especially if the widespread, inappropriate use of PPE continues," referring to surges in global demand driven by misinformation, panic buying, and stockpiling. The WHO changed their stance in June 2020 to state that those over 60sixty or with medical conditions should wear a medical -grademedical-grade mask when in public when physical distancing is not possible and that the general public should wear three-layer fabric masks in those situations. The WHO advised governments to encourage mask wearing on public transport, in shops, or other confined areas.

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The CDC initially recommended that the general public not wear face masks unless they arewere sick or caring for a person who is sick. However, on April 3, 2020, the CDC recommended that the general public voluntarily wear a facial covering when out in a public space where social distancing guidelines are difficult to maintain. The CDC published guides for how to make a variety of face masks using common materials. 2013 Research on influenza transmission suggests that homemade facial coverings and masks made from household items like 100% cotton t-shirts, scarves, and tea towels can block some aerosolized bacteria and viruses, but they are not as effective as commercially available surgical masks. The paper states that "an improvised mask should be viewed as the last possible alternative if a supply of commercial face masks is not available, irrespective of the disease against which it may be required for protection."

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Various countries or regionregions of countries mandated masks to be worn in public spaces to slow the spread of COVID-19. In the United States a nation-wide, federal-level mask order is not possible due to the sovereignty of U.S. statesUS. Accordingly, U.S.US states specify their own local policies and regulations around wearing masks. Some states require that masks be worn in certain public settings (such as inside businesses) while others have enacted no such requirements.

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For medical staff, in addition to masks, personal protective equipment (PPE) includes faceshields, gowns, bouffant caps, and gloves. For more information go to Personal protective equipment.

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Hand washing is recommended over the use of hand sanitizer, but alcohol-based hand sanitizers provide some benefit against the spread of SARS-CoV-2 and are recommended for use when hand washing is not available. Both hand washing and alcohol-based hand sanitizers target viral envelopes. The increased purchasing of hand sanitizer during the COVID-19 pandemic has led to a shortage of alcohol-based hand sanitizer. Numerous distilleries in Canada and the US distilleries have begun manufacturing hand sanitizer.

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An analysis of 22twenty two studies concluded that human coronaviruses such as SARS, MERS, and endemic human coronaviruses (HCoV) can persist on surfaces like metal, glass or plastic for up to 9nine days. The study found that the viruses can be inactivated within 1one minute by surface disinfection procedures with 64-71% ethanol, 0.5% hydrogen peroxice, or 0.1% sodium hypchlorite. Biocidal agents such as 0.05-0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate were found to be less effective.

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VHP is commonly used to decontaminate rooms, butand it has been shown to be effective in sterilizing N95 masks without degradation of theirin performance. The systems usually use about 1000 ppm1000ppm VHP, so some amount of evaporation is needed to allow the levels to drop below the NIOSH recommended level of 1ppm.

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Chai Bio will release a test that can be used with swabbing of areas like door handles and hard surfaces in the environment for SARS-CoV-2 testing. The test is intended for detection of the novel coronavirus in schools, senior centers, first responders, hackerspaces and community labs, public health departments, and in individuals. The BeagleBoard.org Foundation is working with Chai to make machines and test kits available in communities and makerspaces through board donations and has interest in promoting the technology around the world.

Droplet digital PCR (ddPCR) was used to test for SARS-CoV-2 viral RNA in aeorsols collected on gelatin filters in patient and medical staff areas at Renmin Hospital of Wuhan University, Wuchang Fangcang Field Hospital, and public areas in Wuhan.

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UV sanitizers use ultraviolet C (UVC) light, which kills bacteria and viruses.

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CleanSlate UV is a Toronto-based company that produces devices that sanitize items with UV light. Their UV light devices are used in hospitals to for staff to sanitize stethoscopes, badges, and phones.

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Conventional UVC light sources are a hazard to humans due to being carcinogenic and cataractognic. Far-UVC light generated by filtered excimer lamps emitting in the range of 207-222 nm wavelength inactivates bacteria and viruses without harming exposed mammalian skin. Far-UVC has strong absorbance in biological materials and cannot penetrate the outer layer of human skin, nor the outer tear layer on the outer surface of the eye. Far-UVC can traverse and inactivate bacteria and viruses because they are typically at dimensions of microns or smaller. UVC was shown to inactivate airborne aerosolized H1N1 influenza viruses by researchers at Columbia University in 2018. The authors propose the use of very low dose-rate far-UVC overhead light in indoor public locations as a tool to reduce the spreading of airborne-mediated microbial diseases.

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XAG is an agricultural technology company whose with agricultural robots and drones that have been adapted for testing scenarios to spray disinfectant to reduce the spread of COVID-19 and have been deployed in Guangzhou. High concentrated disinfectants can be sprayed from drone nozzles or robot jet sprayers and diluted with moisture in the air and potential targets include hospitals and schools.

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Sonovia is a textile company that developedis developing an anti-pathogen fabric that was sent to labs in China to be tested for use as a preventative measure against spread of COVID-19.

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Multilevel Antimicrobial Polymer (MAP-1) developed at Hong Kong University of Science and Technology (HKUST) with Chiaphua Industries kills viruses, bacteria and spores. MAP-1 can be made into hand sanitizers, paints, coatings, and incorporated into air and water filters, clothing, and surgical masks.

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BioCote -BioCote—an antimicrobial coating company.

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Aurabeat Sanitizing Air Purifier is certified to eliminate >99.9% of airborne COVID-19, has been certified by the US basedUS-based not-for-profit research organization MRIGlobal, and is cleared by the FDA.

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Equipment used for airway management includes endotracheal tubes, introducers, and stylets.

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Critical COVID-19 cases may also show multiorgan and systemic manifestations such as sepsis, septic shock, and multiple organ dysfunction (MOD). In addition to respiratory support, extracorporeal membrane oxygenation (ECMO) may be necessary. ECMO is a machine similar to a heart-lung by-pass machine used in open-heart surgery. The device pumps and oxygenates the patient’s blood outside the body so that the heart and lungs can rest.

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BlueDot is an AI company that tracks, contextualizes, and anticipates infectious disease risks. BlueDot’s system identified an article in Chinese on Dec. 31, 2019, about “pneumonia of unknown cause” and issued an alert to its clients almost one week before the U.S. Centers for Disease Control and Prevention and the World Health Organization issued their public alerts. BlueDot’s analysis of the likely destinations for spread of 2019-nCoV (SARS-CoV-2) in the Journal of Travel Medicine.

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Zoe, a health science company headquartered in London, originally started as a nutrition science company, butand ithas now launched a COVID-19 symptom tracker and online dashboard for the United Kingdom. The company says it has gathered data from over 1 million volunteer contributors.

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American Enterprise Institute offers live tracking and updates of state level strategies for 2019-nCov through their @COVID2019action Twitter, and they offer news and analysis on the measures that states and individuals can or are taking to combat infection and spread.

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GISAID is a nonprofit organization dedicated to the collection of influenza relatedinfluenza-related data and genome sequencing who are working to study and track the sequencing of SARS-CoV-2 and related clinical and epidemiological data.

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Nextstrain is working to collect and incorporate all available data on SARS-CoV-2 genomes and provide analysis and situation reports. They are also working to buildbuilding a database on the genomic epidemiology of SARS-CoV-2 with data provided from GISAID.

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Worldometer offers a live tracker for SARS-CoV-2 relatedSARS-CoV-2-related data, including case reports, death rates, countries, incubation, age, symptoms, and news.

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Drive-through clinics in Goyang, South Korea allow people to stay in their cars as samplesamples are taken from their noses and throats from staff in protective clothing. Samples are tested on site and the user receives a phone call or text message of their result and placed in isolation. The UK is also opening COVID-19 drive-throughs.

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Corona 100m is an app in South Korea that alerts users if they are within 100m of a location the government marked as a high-risk area for COVID-19. The app uses public government data and can see the date a patient was confirmed with the disease, demographic data, and their location history.

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The Japanese medical advice company Agree, offers a free app for a limited time that allows users in Japan to consult with doctors about their symptoms, which prevents overtaxing medical centers.

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Apple is evaluating coronavirus apps to help prevent the spread of misinformation and hadhave reportedly rejected apps that are not from recognized institutions like governments or hospitals.

Timeline

December 21, 2020

MoreA more contagious COVID-19 variant, B.1.1.7, is circulating in the UK

December 8, 2020

Covid-19 vaccine: First person receives Pfizer jab in UK.

December 8, 2020

The first person receives Pfizer COVID-19 vaccine in the world as part of a mass vaccination program, in the UK.

August 23, 2020

The FDA issues EUA for convalescent plasma.

May 1, 2020

The FDA grants EUA for remdesivir.

March 16, 2020

The Moderna Therapeutics vaccine trial starts.

March 11, 2020

WHO Declaresdeclares COVID-19 to be a Pandemicpandemic.

January 31, 2020

WHO Issues Global Health Emergency

January 31, 2020

WHO issues a global health emergency.

November 19, 2019

China’s first confirmed Covid-19 case traced back to November 17

November 17, 2019

China’s first confirmed COVID-19 case is traced to November 17, 2020.
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Amy Tomlinson Gayle
Amy Tomlinson Gayle edited on 29 Mar, 2021
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Treatments in development for COVID-19 focus on three primary areas: symptoms, anti-inflammation, and anti-viral growth. Certain treatments (below) have been granted FDA emergency use authorization (EUA) for the treatment of COVID-19. EUA authorizations may allow unapproved medical products or the use of approved medical products for unapproved uses in an emergency to diagnose, treat, or prevent serious or life-threatening conditions or diseases. Potential drug and vaccine targets include proteins, enzymes, and processes that allow virus entry into cells or virus replication and immune system regulatory pathways.

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Remdesivir received US FDA approval on October 22, 2020 for treatment of COVID-19. Remdesivir , a Nuc inhibitor drug that inhibits viral replication, was granted emergency use authorization by the FDA on May 1, 2020. Gilead announced the submission of their New Drug Application (NDA) for remdesivir to treat COVID-19 under the product name Veklury in August 2020. An expansion of the EUA issued on August 28, 2020 allowed Veklury to be provided to hospitalized patients irrespective of disease severity. Randomized clinical trials for remdesivir in treatment of hospitalized COVID-19 patients showed a decrease in recovery time compared with placebo.

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Convalescent plasma to treat COVID-19 was issued EUA on August 23, 2020. At this time convalescent plasma had been used to treat 60,000 COVID-19 patients. Randomized clinical trials for COVID-19 convalescent plasma are ongoing. Convalescent plasma is donated similar to blood from individuals that have recovered from COVID-19 and contains antibodies against COVID-19.

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The FDA issued an EUA on November 19, 2020 for the combination treatment of baricitinib together with the FDA approved drug remdesivir for treatment of suspected or laboratory confirmed COVID-19 in hospitalized adults and pediatric patients two years of age or older requiring supplemental oxygen, invasive mechanical ventilation, or extracorpeal membrane oxygenation (ECMO).

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Monoclonal antibodies manufactured to target the SARS-CoV-2 spike protein and inhibit the attachment of virus and entry into human cells have received EUA under conditions wherewhen patients are not hospitalized or receiving oxygen therapy. The following are approved under EUA as single or combination monoclonal antibodies for treatment of COVID-19 by intravenous delivery: Bamlanivimab (Eli Lilly), casirivimab and imdevimab (Regeneron) and bamlanivimab and etesevimab (Eli Lilly). In clinical trials, bamlanivimab alone or the casirivimab and imdevimab combination were found to reduce the risk of hospitalization. Bamlanivimab/etesevimab was found to reduce risk of hospitalization or death.

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The following COVID-19 vaccines have received government regulatory approval in different parts of the world (as of March 2021).

Comirnaty (BNT162b2) – mRNA-based vaccine developed by Pfizer, BioNTech and Fosun Pharma

Moderna COVID-19 Vaccine (mRNA-1273) – mRNA-based vaccine developed by Moderna, BARDA and NIAID

COVID-19 Vaccine AstraZeneca (AZD1222, Covishield) – Adenovirus vaccine developed by BARDA and Operation Warp Speed (OWS)

Sputnik V – Recombinant adenovirus vaccine (rAd26 and rAd5) developed by the Gamalaya Research Institute, Acellena Contract Drug Research and Development

COVID-19 Vaccine Janssen (JNJ-78436735; Ad26.COV2.S) – Non-replicating viral vector developed by Janssen Vaccines (Johnson & Johnson)

CoronaVac – Inactivated vaccine (formalin with alum adjuvant) developed by Sinovac

BBIBP-CorV – Inactivated vaccine developed by the Beijing Institute of Biological Products; China National Pharmaceutical Group (Sinopharm)

EpiVacCorona – Peptide vaccine developed by the Federal Budgetary Research Institution State Research Center of Virology and Biotechnology

Convidicea (Ad5-nCoV) – Recombinant vaccine (adenovirus type 5 vector) developed by CanSino Biologics

Covaxin – Inactivated vaccine developed by Bharat Biotech and Indian Council of Medical Research (ICMR)

Unnamed inactivated vaccine developed by the Wuhan Institute of Biological Products and China National Pharmaceutical Group (Sinopharm)

CoviVac – Inactivated vaccine developed by Chumakov Federal Scientific Center for Research and Development of Immune and Biological Products

ZF2001 – Recombinant vaccine developed by Anhui Zhifei Longcom Biopharmaceutical and the Institute of Microbiology of the Chinese Academy of Sciences

  • Comirnaty (BNT162b2) – mRNA-based vaccine developed by Pfizer, BioNTech and Fosun Pharma
  • Moderna COVID-19 Vaccine (mRNA-1273) – mRNA-based vaccine developed by Moderna, BARDA and NIAID
  • COVID-19 Vaccine AstraZeneca (AZD1222, Covishield) – Adenovirus vaccine developed by BARDA and Operation Warp Speed (OWS)
  • Sputnik V – Recombinant adenovirus vaccine (rAd26 and rAd5) developed by the Gamalaya Research Institute, Acellena Contract Drug Research and Development
  • COVID-19 Vaccine Janssen (JNJ-78436735; Ad26.COV2.S) – Non-replicating viral vector developed by Janssen Vaccines (Johnson & Johnson)
  • CoronaVac – Inactivated vaccine (formalin with alum adjuvant) developed by Sinovac
  • EpiVacCorona – Peptide vaccine developed by the Federal Budgetary Research Institution State Research Center of Virology and Biotechnology
  • Convidicea (Ad5-nCoV) – Recombinant vaccine (adenovirus type 5 vector) developed by CanSino Biologics
  • Covaxin – Inactivated vaccine developed by Bharat Biotech and Indian Council of Medical Research (ICMR)
  • Unnamed inactivated vaccine developed by the Wuhan Institute of Biological Products and China National Pharmaceutical Group (Sinopharm)
  • CoviVac – Inactivated vaccine developed by Chumakov Federal Scientific Center for Research and Development of Immune and Biological Products
  • ZF2001 – Recombinant vaccine developed by Anhui Zhifei Longcom Biopharmaceutical and the Institute of Microbiology of the Chinese Academy of Sciences
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The FDA issued guidance document for Emergency Use Authorization for COVID-19 vaccines in October 2020, which states that before seeking emergency approval, vaccine makers should follow trial participants for at least two months to rule out major side effects. CDC director Robert Redfield, vaccine developers, and the FDA stated that a COVID-19 vaccine is unlikely to be widely available until the middle of 2021.

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Operation Warp Speed (OWS) is a partnership between the US Department of Health and Human Services, which includes the CDC, FDA and NIH, and the Biomedical Advanced Research and Development Authority (BARDA) and the Department of Defense (DoD). The goal of OWS is to produce and deliver 300 million doses of safe and effective vaccines. Initial doses aim to be available by January 2021 and OWS has a broader strategy to accelerate development, manufacturing, and distribution of COVID-19 countermeasures.

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OWS funded Janssen, Moderna and, AstraZeneca, Novavax, Pfizer, Sanofi and GlaxoSmithKline, supporting COVID-19 vaccine development and large-scale manufacturing. OWS funded Regeneron, supporting their COVID-19 anti-viral antibody treatment. Task orders with Emergent BioSolutions and ,Texas A&M University, and FUJIFILM are aimed to advance US manufacturing capabilities. Grand River Aseptic Manufacturing (GRAM) in Michigan, USA received a contract with OWS for fill and finish manufacturing of critical vaccines and therapeutics.

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Exothera is a contract development and manufacturing organization (CDMO), launched by Univercells in March 2020, which plans to work on vaccines for COVID-19 through supporting vaccine innovators and providing manufacturing services.

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In Canada, vaccine production may take place at the Human Health Therapeutics Research Centre in Montreal. The Canadian government has signed deals with Moderna, Pfizer/BioNTech, Novavax, and Janssen to reserve millions of doses of COVID-19 vaccine.

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Vernardi, a biotech startup, has VaxiPatch technology under development in a partnership with BARDA. VaxiPatch was invented by Daniel R. Henderson, CEO of Vernardi and will undergo preclinical testing at University of California, Davis.

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COVID-19 diagnostic testing is performed onwith sputum, nose, and throat swabs. In early March 2020, governments restricted COVID-19 testing to central health agencies or a few accredited laboratories for a real-time reverse-transcription PCR (RT-PCR)-based protocol selected by the WHO. Reverse transcription means a reverse transcriptase enzyme is used to convert RNA template to cDNA before PCR amplification, which produces a large number of copies of the cDNA. Real-time PCR is sometimes called quantitative PCR (qPCR or qRT-PCR). Tests that use PCR are also referred to as nucleic acid amplification tests (NAAT) as they amplify deoxyribonucleic acid (DNA). The COVID-19 real-time RT-PCR test detects the presence of the E gene of SARS-CoV-2, coding for the envelope surrounding the viral shell and the gene for the enzyme RNA-dependent RNA polymerase. Once samples are received in a laboratory, it takes 24-48 hours for results. The tests were confirmed to be accurate with whole genome sequencing. The US Centers for Disease Control and Prevention (CDC) has an RT-PCR assay that includes primers for the nucleocapsid phosphoprotein in the virus shell and for the RNA-dependent RNA polymerase gene. In the UK, COVID-19 testing is done by accredited laboratories. In the US COVID-19 testing was initially done exclusively by the CDC which later began sending out RT-PCR test kits to state health laboratories. Some clinical tests on sale in the US were made available under CLIA waivers, which regulate the facility where the tests are conducted, rather than the tests themselves. The FDA announced on February 29 that CLIA-certified labs do not need to obtain emergency use authorization (EUA).

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The FDA issued a policy on March 16, 2020 to accelerate the availability of COVID-19 diagnostic tests, which includes the following: Eacheach state takes responsibility for tests developed and used by their laboratories and labs developing tests engage directly with state authorities; the FDA does not intend to object to the distribution of tests after validation and during preparation of an EUA request; Recommendationsrecommendations are provided for developers of serological tests which identify antibodies or proteins in the blood in response to infection.

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Many diagnostic or screening methods are in development and still need verification. The aim is to develop diagnostic tests that could potentially be deployed more widely in hospitals and clinics, and with quicker turn-around times. The purpose of diagnostics and screening is not only for patient isolation but also for overall monitoring of the spread of COVID-19. The Foundation for Innovative New Diagnostics (FIND) is a global non-profit organization concerned with the development and delivery of diagnostics for diseases that affect poor populations. FIND is collaborating with the WHO and a third-party, referral laboratory to conduct an independent evaluationsevaluation of SARS-CoV-2 diagnostic tests in order to verify manufacturer’smanufacturers' claims, and establish diagnostic accuracy. Results will be shared with the global health community.

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As of April, 2020, the majority of COVID-19 nucleic acid tests use real-time RT-PCR that targets ORF1b, ORF8, nucleocapsid (N), spike (S) protein, RNA-dependent RNA polymerase (RdRP) or envelope (E) genes of SARS-CoV-2. Samples tested are usually swabs from the upper respiratory system but it is possible to use serum, stool, ocular secretions, or saliva. There are nucleic acid amplification tests that use CRISPR and isothermal amplification.

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Besides detecting viral RNA, other diagnostic tests detect viral protein or antibodies produced by a person infected with SARS-CoV-2, using antibody-based methods or serological tests such as ELISA and lateral flow immunoassay. Rapid antigen tests are point-or-carepoint-of-care tests where antibodies are used as probes to detect viral protein. Antibodies produced by a person exposed to the virus are detected in blood samples using serological tests, also called antibody tests. Antibodies are still found in patients after they recover from the illness.

The US FDA issued an EUA for the serology point-of-care (POC) test, Assure COVID-19 IgG/IgM Rapid Test Device in July 2020 for certain laboratories and reissued the EUA in September 2020 for use with fingerstick blood samples in POC settings like a doctor’s office or urgent care centers without the need for sending samples to a central lab. The WHO supports the use of tests for SARS-CoV-2 antibodies at a population level or in specific groups to help understand the risk associated with infection and data about the percentage of people with detectable COVID-19 antibodies. It is not known if people with SARS-CoV-2 antibodies are immune to secondary infections. Antibody tests can check if a person has previously been infected with SARS-CoV-2 but are not recommended to diagnose current infection because it may take 1-3 weeks for the body to produce detectible antibodies.

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The US FDA issued an EUA for the serology point-of-care (POC) test, Assure COVID-19 IgG/IgM Rapid Test Device, in July 2020 for certain laboratories and reissued the EUA in September 2020 for use with fingerstick blood samples in POC settings like a doctor’s office or urgent care centers, without the need for sending samples to a central lab. The WHO supports the use of tests for SARS-CoV-2 antibodies at a population level or in specific groups to help understand the risk associated with infection and gather data about the percentage of people with detectable COVID-19 antibodies. It is not known if people with SARS-CoV-2 antibodies are immune to secondary infections. Antibody tests can check if a person has previously been infected with SARS-CoV-2 but are not recommended to diagnose current infection because it may take 1-3 weeks for the body to produce detectible antibodies.

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In real time PCR, cycle threshold (Ct) is the number of cycles for the fluorescent signal to exceed background level. Ct levels are inversely proportional to the amount of target nucleic acid, which is the amount of SARS-CoV-2 virus present, alsopresent—also known as viral load. Higher viral load and lower Ct has been correlated with disease severity, lung lesions with margins not easily differentiated, and changes in follow-up CT (computed tomography) in patients with COVID-19 pneumonia. Patients with severe COVID-19 have been reported to have a higher viral load and longer virus-shedding period comparecompared with mild disease.Another research study from China showed no correlation between viral load and disease severity. Viral loads in nasal swabs between symptomatic and asymptomatic individuals were not significantly different in an Italian study. In addition to real-time RT-PCR, digital PCR (digital RT-PCR) has been applied to studies on viral load to study disease progression.

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Edits on 25 Mar, 2021
Meredith Hanel
Meredith Hanel edited on 25 Mar, 2021
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Aurabeat Sanitizing Air Purifier is certified to eliminate >99.9% of airborne COVID-19, has been certified by the US based not-for-profit research organization MRIGlobal, and is cleared by the FDA.

Edits on 25 Mar, 2021
Neelam Jhaveri
Neelam Jhaveri approved a suggestion from Golden's AI on 25 Mar, 2021
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BBIBP-CorV – Inactivated vaccine developed by the Beijing Institute of Biological Products; China National Pharmaceutical GroupChina National Pharmaceutical Group (Sinopharm)

Henry Ogolla
Henry Ogolla approved a suggestion from Golden's AI on 25 Mar, 2021
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The SARS-CoV-2 virus, previously called 2019-nCoV, was described by researchers at the CAS Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences by Peng Zhou and colleagues, led by Zheng-Li Shi. Notable variants of SARS-CoV-2 that have emerged include B.1.1.7 (UK variant), B.1.351 (South Africa variant) and P.1 (BrazilBrazil variant). These variants spread more quickly and all contain the mutation N501Y at a position where the virus interacts with receptor on the surface of lung cells to gain access.

Henry Ogolla
Henry Ogolla approved a suggestion from Golden's AI on 25 Mar, 2021
Edits made to:
Article (+12/-12 characters)
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The SARS-CoV-2 virus, previously called 2019-nCoV, was described by researchers at the CAS Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences by Peng Zhou and colleagues, led by Zheng-Li Shi. Notable variants of SARS-CoV-2 that have emerged include B.1.1.7 (UK variant), B.1.351 (South AfricaSouth Africa variant) and P.1 (Brazil variant). These variants spread more quickly and all contain the mutation N501Y at a position where the virus interacts with receptor on the surface of lung cells to gain access.

Meredith Hanel
Meredith Hanel edited on 24 Mar, 2021
Edits made to:
Timeline (+2 events) (+121 characters)
Timeline

December 21, 2020

More contagious COVID-19 variant, B.1.1.7, circulating in the UK

December 8, 2020

Covid-19 vaccine: First person receives Pfizer jab in UK.
Meredith Hanel
Meredith Hanel edited on 24 Mar, 2021
Edits made to:
Article (+305 characters)
Article

The SARS-CoV-2 virus, previously called 2019-nCoV, was described by researchers at the CAS Key Laboratory of Special Pathogens, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences by Peng Zhou and colleagues, led by Zheng-Li Shi. Notable variants of SARS-CoV-2 that have emerged include B.1.1.7 (UK variant), B.1.351 (South Africa variant) and P.1 (Brazil variant). These variants spread more quickly and all contain the mutation N501Y at a position where the virus interacts with receptor on the surface of lung cells to gain access.

Meredith Hanel
Meredith Hanel edited on 24 Mar, 2021
Edits made to:
Timeline (+4 events) (+133 characters)
Timeline

August 23, 2020

FDA issues EUA for convalescent plasma

May 1, 2020

FDA grants EUA for remdesivir

March 11, 2020

WHO Declares COVID-19 a Pandemic

January 31, 2020

WHO Issues Global Health Emergency
Meredith Hanel
Meredith Hanel edited on 24 Mar, 2021
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TypesDetection of SARS-CoV-2viral testsRNA
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Detection of viral protein and antibodies

Besides detecting viral RNA, other diagnostic tests being developed to detect viral protein or antibodies produced by a person infected with SARS-CoV-2 using antibody-based methods or serological tests such as ELISA and lateral flow immunoassay. AntibodiesRapid mayantigen betests are point-or-care tests where antibodies are used as probes to detect viral protein. For serological tests, antibodiesAntibodies produced by a person exposed to the virus are detected in blood samples using serological tests, also called antibody tests. Antibodies are still found in patients after they recover from the illness.

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Comirnaty (BNT162b2) – mRNA-based vaccine developed by Pfizer, BioNTechBioNTech and Fosun Pharma

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The following COVID-19 vaccines received government regulatory approval in different parts of the world (as of March 2021).

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Approved COVID-19 vaccines

The following COVID-19 vaccines received government regulatory approval in different parts of the world.

Comirnaty (BNT162b2) – mRNA-based vaccine developed by Pfizer, BioNTech and Fosun Pharma

Moderna COVID-19 Vaccine (mRNA-1273) – mRNA-based vaccine developed by Moderna, BARDA and NIAID

COVID-19 Vaccine AstraZeneca (AZD1222, Covishield) – Adenovirus vaccine developed by BARDA and Operation Warp Speed (OWS)

Sputnik V – Recombinant adenovirus vaccine (rAd26 and rAd5) developed by the Gamalaya Research Institute, Acellena Contract Drug Research and Development

COVID-19 Vaccine Janssen (JNJ-78436735; Ad26.COV2.S) – Non-replicating viral vector developed by Janssen Vaccines (Johnson & Johnson)

CoronaVac – Inactivated vaccine (formalin with alum adjuvant) developed by Sinovac

BBIBP-CorV – Inactivated vaccine developed by the Beijing Institute of Biological Products; China National Pharmaceutical Group (Sinopharm)

EpiVacCorona – Peptide vaccine developed by the Federal Budgetary Research Institution State Research Center of Virology and Biotechnology

Convidicea (Ad5-nCoV) – Recombinant vaccine (adenovirus type 5 vector) developed by CanSino Biologics

Covaxin – Inactivated vaccine developed by Bharat Biotech and Indian Council of Medical Research (ICMR)

Unnamed inactivated vaccine developed by the Wuhan Institute of Biological Products and China National Pharmaceutical Group (Sinopharm)

CoviVac – Inactivated vaccine developed by Chumakov Federal Scientific Center for Research and Development of Immune and Biological Products

ZF2001 – Recombinant vaccine developed by Anhui Zhifei Longcom Biopharmaceutical and the Institute of Microbiology of the Chinese Academy of Sciences

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Commissioner Dr. Stephen Hahn stated that the FDA may consider EUA of a vaccine before trials are complete. Director of the Infectious Diseases Division of Vanderbilt University Dr. David Aronoff and others voiced concerns about not waiting until clinical trials are complete and reviewed. The FDA issued guidance document for Emergency Use Authorization for COVID-19 vaccines in October 2020 which states that before seeking emergency approval, vaccine makers should follow trial participants for at least two months to rule out major side effects. CDC director Robert Redfield, vaccine developers and the FDA stated that a COVID-19 vaccine is unlikely to be widely available until the middle of 2021.

Conditional approvals

Gamaleya Research Institute of Epidemiology and Microbiology (Russia)

The Russian Ministry of Health issued a registration certificate on August 11, 2020 for a COVID-19 vaccine developed by the Gamaleya Research Institute of Epidemiology and Microbiology in Moscow, that had been tested in 76 people. The vaccine was dubbed Sputnik V. The certificate allows the vaccine to be given to a small number of citizens from vulnerable groups such as medical staff and the elderly. The certificate is similar to the FDA granting emergency use authorization. It is stipulated in the certificate that the vaccine cannot be widely used until January 1, 2021. It is expected that at this time larger clinical trials will have been completed. The certification of the vaccine received criticism for being premature and potentially exposing those who receive the vaccine to unnecessary risk. The vaccine is manufactured by Binnopharm in Zelenograd. The vaccine uses an adenovirus carrier engineered to carry the spike protein of SARS-CoV-2.

Results from small-scale Phase 1/2 clinical trial published in The Lancet show that neutralizing antibodies to SARS-CoV-2 were generated in dozens of subjects with mostly mild side effects. A T cell response was reported within 28 days. A large-scale Phase 3 trial received approval on August 26 which is expected to enroll 40,000 volunteers.

China National Biotec Group Company (CNBG)

In China an experimental COVID-19 vaccine was approved for use in individuals working in high risk professions on July 22, 2020. The vaccine was developed by Sinopharm’s China National Biotec Group Company (CNBG). At the time the vaccine had completed Phase 3 clinical trials in UAE, Peru, Morocco and Argentina.

Beijing Institute of Biotechnology/ CanSino Biologics

The vaccine called Ad5-nCoV that was developed by the Beijing Institute of Biotechnology and the company CanSino Biologics was approved by the Chinese government for use for military personnel on June 25, 2020. The vaccine is being tested in clinical trials in China and in Canada in a collaboration between CanSino Biolgics and the National Research Council of Canada (NRC). In the vaccine development, a proprietary HEK293 cell line of the NRC and part of the work of Dr. Frank Graham (McMaster University, Canada).

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Monoclonal antibodies

Monoclonal antibodies manufactured to target the SARS-CoV-2 spike protein and inhibit the attachment of virus and entry into human cells have received EUA under conditions where patients are not hospitalized or receiving oxygen therapy. The following are approved under EUA as single or combination monoclonal antibodies for treatment of COVID-19 by intravenous delivery: Bamlanivimab (Eli Lilly), casirivimab and imdevimab (Regeneron) and bamlanivimab and etesevimab (Eli Lilly). In clinical trials, bamlanivimab alone or the casirivimab and imdevimab combination were found to reduce the risk of hospitalization. Bamlanivimab/etesevimab was found to reduce risk of hospitalization or death.

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Anti-inflammatory drugs used to treat COVID-19 in hospitalized patients include dexamethasone and other corticosteroids. Anticoagulation such as low-dose heparin and enoxaparin may also be given to hospitalized COVID-19 patients.

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COVID-19 potentialexperimental and approved treatments
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COVID-19 treatments and vaccinesvaccine

Remdesivir is an experimental drug approved by the US FDA on October 22, 2020 which has been shown to shorten the time to recovery from SARS-CoV-2 infection by interfering with viral replication.

There are no FDA regulated vaccines for prevention of COVID-19.TreatmentsTreatments in development for COVID-19 focus on three primary areas: symptoms, anti-inflammation, and anti-viral growth. Certain treatments (below) have been granted FDA emergency use authorization (EUA) for the treatment of COVID-19. EUA authorizations may allow unapproved medical products or the use of approved medical products for unapproved uses in an emergency to diagnose, treat or prevent serious or life-threatening conditions or diseases. Potential drug and vaccine targets include proteins, enzymes, processes that allow virus entry into cells or virus replication and immune system regulatory pathways.

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Remdesivir received US FDA approval on October 22, 2020 for treatment of COVID-19. Remdesivir , a Nuc inhibitor drug that inhibits viral replication, was granted emergency use authorization by the FDA on May 1, 2020. Gilead announced the submission of their New Drug Application (NDA) for remdesivir to treat COVID-19 under the product name Veklury in August 2020. An expansion of the EUA issued on August 28, 2020 allowsallowed Veklury to be provided to hospitalized patients irrespective of disease severity. Ongoing Phase 3 Randomized Clinicalclinical Trialstrials for remdesivir arein NIAIDtreatment ACTT-1of Trial,hospitalized GileadCOVID-19 GS-US-540-5773patients Trialshowed anda Gileaddecrease GS-US-540-5774in Trialrecovery time compared with placebo.

Edits on 20 Nov, 2020
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Baricitinib in combination with remdesivir

The FDA issued an EUA on November 19, 2020 for the combination treatment of baricitinib together with the FDA approved drug remdesivir for treatment of suspected or laboratory confirmed COVID-19 in hospitalized adults and pediatric patients two years of age or older requiring supplemental oxygen, invasive mechanical ventilation or extracorpeal membrane oxygenation (ECMO).

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Bacillus Calmette-Guérin (BCG) vaccination (typically given at birth and/or during childhood) was intended to target tuberculosis caused by the bacteria Mycobacterium tuberculosis and has been reported to also protect against various other infectious diseases. BCG vaccine is under investigation for benefits against SARS-CoV-2. The WHO stated that there is no evidence that BCG protectionprotects people from coronavirus infection.

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