Solving COVID: August 26, 2020

Expectations are rising that a COVID-19 vaccine will be ready for the public by the beginning of next year. At least three vaccines — developed by Moderna, Oxford-AstraZeneca, and China's CanSino — are in final Phase III testing, and Pfizer and its German partner BioNTech announced they will also take their vaccine candidate into Phase III testing, with the goal of seeking regulatory review by October. That could mean an approved vaccine by January. "I believe that it is realistic that we will know sometime in late 2020 whether some COVID-19 vaccines are safe, exactly how effective they are, and which ones should be used to vaccinate the U.S. population in 2021," writes William Petri, an infectious disease specialist at the University of Virginia. The U.S. has committed $8 billion to the production of vaccines even before Phase III trials. Petri explains, "once a vaccine is proven safe ... a stockpile of it will already exist and it can be distributed immediately." [Reuters, The Conversation]

Researchers at Israel's Technion-Israel Institute of Technology are reporting that their breath test has shown promising results in a trial of 140 people in Wuhan, China. The smartphone-sized prototype requires only that users breathe into the breathalyzer-like device for 2 to 3 seconds. "There are no accessories, it requires no lab processing, and it gives results within 30 seconds of blowing," said Techion's Hossam Haick. The test uses an array of gold nanoparticles to identify volatile organic compounds (VOC) particular to the COVID-19 coronavirus. "If everything goes well with further clinical studies," said Haick, "I hope it will be available and regulated within six months." He expects the tests will cost $2 to $3 apiece. In the trial, the breath test correctly identified COVID-19 in all 49 confirmed patients, and gave false positives for seven others. [Science Daily, The Times of Israel]

Rhode Island has provided cause for optimism in the effort to safely reopen some schools and child-care programs during the pandemic. A federal study on 666 Rhode Island child-care centers that reopened this summer found that new COVID-19 cases and secondary transmission linked to the centers were limited. During a two-month period, there were 52 confirmed and probable cases reported across 29 programs, and 20 of the programs reported only one case, the study found. Enrollment was restricted to 12 (then raised to 20), staff members and students were confined to specific groups, masking was required for adults, and everyone was screened daily for symptoms. Rhode Island also allowed the centers to reopen at a time of low community spread. Jennifer Nuzzo, a Johns Hopkins epidemiologist, called the data "encouraging," though she doesn't think the study alone is enough to extend the findings to schools since "we think transmission risk may increase with age." [The Washington Post]

The National Institutes of Health is set to study a compound similar to remdesivir to see if it could be effective in treating COVID-19. Scientists at the NIH have determined that Gilead Sciences' GS-441524 compound "merits further exploration" and plan to "independently test the therapeutic hypothesis for GS-441524 in treating" the coronavirus. This compound, which has been "de-emphasized" by Gilead, apparently "works in the same way as remdesivir to inhibit viruses," Stat News writes, but it has not been tested yet in humans. University of Texas MD Anderson Cancer Center researchers had been pushing for such tests, and NIH says it plans to conduct preclinical studies "quickly and make the results available to the research community for further consideration." [Stat News]

The Centers for Disease Control and Prevention now says that not everyone exposed to COVID-19 necessarily needs to receive a test — but experts are pushing back. The CDC has updated its guidance to say that those who are within close contact of someone with COVID-19 but don't have symptoms don't "necessarily need a test" unless they're in a vulnerable group. The old guidance said "testing is recommended for all close contacts of persons with" COVID-19. University of Washington biology professor Dr. Carl Bergstrom called these changes "remarkable and troubling," writing, "The whole point of contact tracing is to find asymptomatic contacts of known cases and isolate them." Dr. Leana Wen of George Washington University tweeted that "this makes no sense" considering "people without symptoms account for up to 50 percent of transmission." A Department of Health and Human Services spokesperson said the guidance "fully supports public health surveillance testing." [CNN]