Going Viral: Finally, things are opening up in Europe

I did something on Monday that I haven’t done for a long time. I sat at a table outside a café and had a coffee.

The sun was shining, there were birds flitting about the small square in Wexford town, there were people out and about. And the coffee never tasted as good.

It was a good day, one that after nearly three months in lockdown, seemed “normal”.

Honestly, it felt liberating. While there are reports of a second wave of coronavirus emerging in Beijing and neighbourhoods there have been shut down, here in Wexford, life is good.

In Britain, stores are opening up again – prompting my brother-in-law, Pete, a police sergeant in Manchester to wryly comment on the family WhatsApp group: “Wishing all the shoplifters a safe return to work”.

All across Europe on Monday, there were signs of normalcy returning – or at least the first real steps in a process that will see the pandemic measures toned down before being turned off.

EU nations eased border controls on Monday as the number of coronavirus cases declined after three months of lockdown, but Spain’s continued closure, a patchwork of quarantine rules and remote-working mean pre-crisis travel levels are a way off.

But there is a feeling that we are beginning to bask in the light at the end of the tunnel.

GREEK FLIGHTS AND CIGARETTE RUNS

Greek airports allowed more international flights as the country sought to salvage its summer, German tourists flocking to neighbouring Denmark caused an eight-kilometre queue and Italians popped into France to buy lottery scratch cards.

In the Belgian village of Macquenoise, tabac stores did brisk trade as French citizens streamed across the border to buy cheaper tobacco after suffering higher prices at home since mid-March.

“It’s worth the effort,” said Nadege Caplain, making an early-morning 200-km round trip to buy cigarettes for her and her family.

The Schengen area of 22 EU countries plus Iceland, Liechtenstein, Norway and Switzerland operates control-free crossings. But for the past three months they have been mostly closed to all but goods traffic and cross-border commuters.

European officials hope the lifting of internal border controls will allow a gradual reopening to other countries from July and resuscitate a tourism industry that flatlined during the lockdown.

Tourism and recreation make up almost 10 per cent the EU economy and even more in the Mediterranean countries, some of which were hit hardest by the pandemic.

In Greece, passengers arriving from airports deemed high-risk by the EU’s aviation safety agency will be tested for the coronavirus and quarantined up to 14 days, depending on the result. Restrictions remain for passengers from Britain and Turkey. Arrivals from other airports will be randomly tested.

SLOWLY GETTING BACK TO FREE MOVEMENT

It will, however, not be a return to unfettered travel for the Schengen area’s 420 million inhabitants.

Spain will reopen its borders to most European visitors from June 21, 10 days earlier than previously planned, the government said in a further easing of coronavirus restrictions but a week later than some other EU member states.

One of the world’s most visited destinations, Spain has sent mixed signals on when it would reopen its borders as it tries to lure back tourists, having announced several dates in recent weeks.

From June 21 – when Spain’s state of emergency ends – it will allow the entry of visitors from the EU and the open-border Schengen area, which also includes non-EU countries such as Switzerland and Norway, Spanish Foreign Minister Arancha Gonzalez Laya tweeted.

Visitors from outside the EU or Schengen area will be able to visit Spain from July 1, though that will hinge on their country’s public health situation, Laya said.

British visitors would be able to travel to Spain from June 21 since Britain is still considered part of the EU, a Spanish foreign ministry source said.

SPAIN’S BORDERS CURRENTLY CLOSED

Spain’s borders are currently closed to tourists and those exempted from the entry ban must spend 14 days in quarantine as a precaution against the spread of COVID-19, which has so far killed more than 27,000 people in the country.

“Tourism is a key sector for the economic recovery,” Prime Minister Pedro Sanchez told a news briefing. “We have been able to corner the virus in our country and on the European continent... but the risk has not disappeared.”

Sanchez said Spain’s land border with Portugal would remain closed till July 1 because Lisbon had requested it.

The European Commission recommended on Thursday that Schengen area countries, which normally have no border checks, lift controls by June 15.

After Spain’s three-month-long state of emergency ends on June 21, wearing masks in public will remain mandatory until a cure or vaccine for COVID-19, the lung disease caused by the virus, is found.

Spain allowed German tourists to start visiting its Balearic Islands from Monday as a test programme.

DEPENDS WHERE YOU ARE GOING

Elsewhere, the right to travel in the EU will depend on where you live and where you are going.

The Czech Republic has a traffic-light system, barring entry for tourists from ‘orange’ or ‘red’ countries such as Portugal and Sweden.

Denmark will allow in tourists from Iceland, Germany and Norway, but notably not Sweden, on condition they book at least six nights’ accommodation.

Britain’s two-week quarantine for visitors means Britons will face the same confinement in France.

Before the crisis, an average of 3.5 million people crossed an internal EU border every day, according to a 2019 European Parliament report, some 1.7 million of them commuters.

Many of the latter are now working from home, while continued restrictions and health concerns are expected to curb tourism and business travel.

At Brussels Airport, day one of the reopening will see around 60 flights operating, 10 per cent of normal.

EU WANTS ALL OPEN BY JULY 1

The European Commission is urging members of the Schengen visa-free travel area to coordinate on how external borders are opened.

“International travel is key to tourism and business, and for family and friends reconnecting,” EU Commissioner for Home Affairs, Ylva Johansson, said.

“You should open up as soon as possible,” said Johansson when asked about internal borders, explaining that the European Centre for Disease Control had said internal borders was "not an effective way of dealing with the pandemic now".

The Commission is now asking member states to agree on a list of non-EU countries where travellers could come from starting from July.

Conditions for lifting restrictions to non-EU countries will include looking at the infection rates and the country’s capability to deal with the virus. Restrictions should remain in place for countries with a worse outbreak.

“It will apply to all countries in a similar or better outbreak situation to the EU,” Johansson said, clarifying that not all external borders should open from July 1.

Exceptions to restrictions will apply to students, as well as highly-skilled non-EU workers.

The EU has recommended that travel restrictions are lifted for Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia.

STORES OPEN UP ACROSS ENGLAND

Pent-up demand has prompted queues at some shops as rules are relaxed in England after a three month lockdown.

Long queues were reported outside Primark shops in London and Birmingham ahead of their 8am opening time on Monday.

The chain, which like other clothing shops has been closed since March 23, does not offer online shopping meaning customers can only buy in the store.

All shops in England are allowed to open, although retailers have had to introduce strict safety measures.

Jaydee Darrock, from Warwickshire, was one of the first inside Primark’s Birmingham store after queuing from about 7am. She described it as “surprisingly calm”.

“We thought it would be chaotic, it's not, it’s quite nice,” she said.

In Manchester people waited for almost an hour for some shops. Big queues formed outside Primark,TK Maxx and Foot Locker.

There were also large crowds outside the Nike store on Oxford Street, Central London, although some people complained on Twitter that there had been a lack of social distancing.

Lines also formed outside the Sports Direct in Worthing, although at other shops across the country demand was more subdued.

Although food shops, pharmacies, banks and other essential retailers have stayed open, vast swathes of the High Street, from bookshops to clothes outlets, have been closed for nearly three months.

WELSH GOVERNMENT REVIEWS ITS LOCKDOWN

The reopening of non-essential shops is on the table at the next review of Wales' lockdown, First Minister Mark Drakeford told a press conference on Monday.

He said retailers “will be well prepared if we can give the go ahead to re-open”.

Ministers are expected to announce their next steps on Friday. In Wales, retailers were told at the last lockdown review to get ready.

Drakeford said the sector had put in place “new arrangements” such as safe ways for shoppers to enter and leave stores, social distancing in shops and protection for retail employees.

But he warned a “stop-start approach, where we do too much too soon” would be worse for the economy if a second clampdown is needed.

Ahead of Friday's announcement, Drakeford said ministers are looking at a “package” in three areas.

As well as reopening schools on June 29, he listed reopening non-essential retail “where businesses are able to comply” with physical distancing, and “relaxing further restrictions on more outdoors activity”.

WARY OF A SECOND WAVE OF INFECTIONS

Northern Ireland has also reopened non-essential retail, as have other countries across the EU.

The Welsh first minister told the daily coronavirus press conference ministers were “looking and learning from the experiences of other countries around the world”.

Many countries have reopened cafes outside only, he said, but others have reintroduced restrictions “because lockdown has led to cases of increasing”.

Drakeford said he was keen for the economy to re-open in Wales but cautioned against a return to a “pre-pandemic normal”.

“While the virus has receded and fewer people are becoming ill, coronavirus has not gone away – it continues to be present in Wales and there is still a risk we will face a second wave of illness later in the year,” he said. “This is why we will continue to need to take precautions and measures to prevent the spread of the virus as restrictions are lifted.”

FACE MASKS MANDATORY ON PUBLIC TRANSPORT

Anyone travelling on public transport in England must wear a face covering from Monday under a new rule.

More than 3,000 extra staff including police officers are being deployed at stations to make sure people comply.

Passengers without a covering will be asked to wear one, or will face being refused onboard or fined £100 (Dh460).

People with certain health conditions, disabled people and children under the age of 11 will be exempt from the rule.

In the coming days, hundreds of thousands of free coverings will be handed out at railway stations. The government says masks can be homemade, such as a scarf or bandana.

As well as on transport, all hospital visitors and outpatients also have to wear masks.

The UK government changed its advice on face masks to stop the spread of coronavirus earlier this month, as more people used public transport to go back to work. It is now in line with advice from the World Health Organisation.

The new rules apply to England and require anyone travelling by bus, coach, train, tram, Tube, ferry or plane to cover their face while on board.

They exclude school transport, taxis and private hire vehicles – although Uber has made face covering compulsory for

or passengers and drivers.

The rules apply only while travelling – not while waiting – but the rail industry has asked people to cover their face as they enter a station.

RULES ONLY APPLY IN ENGLAND

The compulsory rules do not apply in Scotland, Wales or Northern Ireland –but their governments recommend that people cover their faces in places where social distancing is difficult, including on public transport.

Passenger numbers are expected to reach about 20 per cent of capacity on the railways by early next month.

All National Health Service hospital staff – not just medics – visitors and outpatients will also have to wear face coverings in England.

The government said people should arrive at hospital with a face covering, but if not a face mask will be provided in emergencies.

However, the doctors’ union the British Medical Association has criticised the government for not properly planning for the rules in hospitals, saying some NHS services have been left “confused and unprepared”.

The BMA said it was inappropriate for hospitals to have to supply masks to patients and visitors who arrive without a covering, especially following shortages of some types of personal protective equipment.

MEME OF THE DAY

I came across this and though it was share-worthy. While it’s not fully related to the coronavirus pandemic it does strike a chord…

THAILAND ENDS CURFEW, MARKS 21 DAYS WITH NO LOCAL CORONAVIRUS CASES

Thailand on Monday lifted a nationwide curfew after more than two months and allowed restaurants to resume selling alcohol as the coronavirus crisis eased, with 21 days since a recorded case of local transmission.

The Southeast Asian nation of about 70 million people was the first country outside China to report a case of coronavirus, on Jan. 13, and has been a relative success story in containing it, with just 3,135 confirmed cases and 58 fatalities. Some 2,987 patients have recovered.

Officials have credited Thais’ early adoption of wearing masks – ubiquitous in public since January – as well as its border closure, shuttering of many business and the curfew for the retreat of the new virus that has infected 7.9 million worldwide and killed more than 430,000.

Other establishments allowed to reopen on Monday were schools with less than 120 students, exhibition halls, music concerts, film productions, playgrounds, amusement parks and sports competitions without spectators.

Pubs, bars and karaoke outlets will remain closed, but restaurants that reopened two weeks ago with social distancing will now be able to serve alcohol.

Monday was the second time in five days that Thailand reported no new cases.

All new cases in the past three weeks have been found in quarantine among Thais returning from abroad, said Taweesin Wisanuyothin, a spokesman for the government’s COVID-19 task force.

TAKING STOCK

HOW I’M PRETENDING TO GROW £10,000 IN PLAY MONEY

On Sunday, I rebalanced my portfolio to try and stem then recuperate some of the losses from last week. It didn’t quite work out as planned as markets across Europe continued their downward trend.

A reminder that this is all pretend, I started out in lockdown with £10,000 – about Dh45,000 to invest on the London Stock Exchange, I don’t pay for trades and I can only buy or sell when the market is closed. There’s no minimum on the amount of stocks I can buy, just as long as I can afford them.

Halfords gained slightly, while my other three stocks were marginal decliners, leaving me a loss of £289.25 on the day.

This is how things stand after Monday trading

Net worth £12,696.63

Dignity, 700 shares: £1995.00

Halfords, 1500 shares: £2664.00

PowerHouse, 1200 shares: £3960.00

Ryanair, 375 shares: £4068.75.00

Cash in hand: £8.88

£ loss on last trading day: £298.25.

% gain overall: 27 per cent

£ Gain overall: £2696.63

COVIDIOTS, YOBS AND GOONS

A frequent reminder that covidiots have two left feet…

FLOUT-LOUT COVIDIOTS IN A CONGA LINE

A group of boozy Scottish youngsters have been filmed ignoring social distancing rules to do a conga in a Glasgow park, The Sun is reporting.

A large crowd of at least 50 covidiots can be seen dancing around a grassy area of Kelvingrove Park in the short clip from last night.

Some of the group are holding cans or bottles, while others are filming themselves joining in the conga.

Most are holding onto the person in front of them and there appears to be no social distancing, with youngsters much closer to each other than two metres.

In another video from earlier in the day, dozens of boozing teens can be seen sitting or standing in groups in the west end park, many of which appear to include more than eight individuals.

Under current lockdown restrictions, Scots are allowed to meet one other household outside, as long as social distancing is maintained.

DOCTORS AND PATIENTS

COVID-19 'LONG-HAULERS' COMPLAIN OF MONTHS-LONG SYMPTOMS

When Megan Desjardins attempts to garden these days, she has to take multiple breaks to catch her breath. A recent walk on the beach with her family left her exhausted and in need of a long nap.

In early June, her chest was sore, her nose was numb, her arms were weak, and she had to lean on a chair just to hold the telephone up to her ear.

“You wake up every day thinking ‘OK, what pain is it going to be today? What am I going to experience today?’” she shared with CTV News during a call from her home in Comox, British Columbia.

Desjardins believes she contracted COVID-19 during a trip to Costa Rica and Panama in January and February. She said she experienced the first signs of illness – chest pain, raw itchy eyes, and a headache – on March 17.

That was 12 weeks ago.

“I’m a healthy person normally,” she said. “I’m not overweight, I don’t smoke, I don’t drink, I don’t have recurring serious chest or health issues… this isn’t just a little cold that lasts for a couple weeks. It’s been three months.”

Desjardins, and thousands of other self-described “long-haulers,” believe the chronic symptoms they have experienced for weeks and even months are the result of COVID-19 infection, even though many of them have never tested positive for the disease.

UNABLE TO BE TESTED

That’s because most of them were unable to get tested when they first started showing symptoms due to the availability of tests in their area, or they received a negative test result when they were finally able to get one weeks later.

This doesn’t mean, however, they never had the disease and doctors and researchers say there are a number of possible explanations as to why they’re experiencing these symptoms and why they tested negative for COVID-19.

Ken Borg, who never bothered to get tested when they were finally made available in his area, said he lived a health lifestyle before he fell ill from what he believes to be COVID-19. He played hockey twice a week and went snowshoeing three times a week.

Now, Borg is easily tired out by a round of golf with his friends.

“It’s been a long recovery,” he said from his home in Ottawa. “I’ve never had as many naps as I’ve had over the last three months.”

He believes he was infected with coronavirus at a house party in early March, which included several attendees who had recently returned from abroad.

On March 11, the 58-year-old retiree experienced his first symptom – a congested throat.

Since then, Borg has experienced waves of fatigue, chest pain, heart palpitations, high-blood pressure, as well as red, painful lesions on his toes, or “COVID toes” as the condition has been sometimes called.

And while the heart palpitations appeared to have stopped last week, Borg said he still experiences fatigue and his breathing isn’t completely back to normal. And that has taken 14 weeks.

13 WEEKS RECOVERING SO FAR

It’s been a long journey for Tracey Thompson, too. She started showing symptoms on March 15.

While she initially didn’t have any of the usual respiratory symptoms associated with COVID-19, such as coughing or trouble breathing, she did experience a fever, gastrointestinal issues, and fatigue.

“I was very concerned about it,” she recalled from her home in Toronto. “I didn’t know what was going on and I was definitely not OK. It wasn’t anything I had experienced before.”

As the weeks dragged on, Thompson said new symptoms would appear, disappear, and then reappear with no warning. She had days where she felt like she was in a fog, she had rolling fevers, sore throats, chest pain, and lost her sense of smell and taste.

Because she works in a restaurant in Toronto that’s currently closed because of the pandemic, Thompson has been able to ride the wave of new symptoms in isolation at home.

“I’m in limbo,” she said. “Every week I keep thinking, ‘OK it’s going to be over’ and every week it’s not and I can’t get any answers.”

Thompson has tried to find those answers by calling telehealth and visiting her local testing unit, but she hasn’t been given a clear explanation as to what is happening to her. She believes her symptoms are from a COVID-19 infection.

That’s why she resorted to a popular Facebook support group called Survivor Corps, which aims to connect COVID-19 survivors and share information on the disease. And it appears Thompson isn’t the only one in search of answers.

SYMPTOMS LAST FOR MONTHS

The Survivor Corps group has more than 54,000 members, many of whom describe themselves as “long-haulers” who have suffered from symptoms for weeks or even months.

Another popular COVID-19 support group, has had more than 4,000 members join their discussion channels on the messaging platform Slack.

One of their busiest Slack channels is dedicated to people who have had symptoms for more than 30 days. It’s a place where members can “feel connected and supported through infection, symptoms, and recovery,” according to the founders.

Body Politic recently conducted a survey of 640 of their long-haulers, which is not peer-reviewed or representative of the entire group, and found that symptoms among respondents were not limited to cough, fever, and shortness breath.

In fact, some of the more widely reported symptoms included fatigue, body aches, headache, brain fog, gastrointestinal issues, dizziness, chills, sweats, and trouble sleeping.

Interestingly, the survey found the majority of respondents were between the ages of 30 and 49 – 62 per cent. The survey also noted that nearly half of respondents – 48 per cent – were denied testing or didn’t receive a test for another reason. Of the quarter who tested negative for COVID-19, they were, on average, tested six days later into their illness than those who tested positive.

TESTING NEGATIVE

While many respondents in the survey and commenters in the support groups tested negative for COVID-19, if they were tested at all, that doesn’t necessarily mean they didn’t have the disease.

In March, when Desjardins, Borg, Thompson, and many others in these groups started showing symptoms, nasal swabs used for testing for COVID-19 were in high demand and in most areas, reserved for those with compromised immune systems, health-care workers, people in close contact with infected individuals, and travellers recently returned from international locations.

During this time, people with mild symptoms who did not require hospitaliSation and who were not at a higher risk of a serious outcome were advised to isolate themselves at home and monitor their symptoms.

It wasn’t until the end of April to mid-May, when testing became more widely available to residents in Canada, that people like Desjardins and Thompson were finally able to get tested.

Like many others in the support groups, they both tested negative.

Thompson said a health-care worker at Mount Sinai Hospital’s assessment centre in Toronto emailed her to tell her that even though she received a negative result, she most likely had COVID-19 at some point and she’s “not crazy.”

“She’s like ‘Oh yeah, you definitely had it,’” Thompson recalled.

LOOKING AT PERSISTENT SYMPTOMS

Dr. Iris Gorfinkel, a family physician and medical researcher in Toronto, has been particularly interested in the topic of long-term symptoms.

That’s because several of her patients and her sister, a family doctor based in Chicago, are currently going through it.

Gorfinkel said there are a number of possible explanations as to why long-haulers receive negative test results when they are tested. She said there’s the possibility that the test isn’t picking up the virus because it’s only taking the sample from the area inside the nose.

“When we do a swab, we’re limited to the one area that the swab has touched,” she explained during a telephone interview in early June. “If I swab the nasal pharynx, I’m testing the one area that that’s touched... There could be tons of virus that’s like two inches below that.”

Initially, COVID-19 was considered a respiratory illness, but Gorfinkel said researchers now know coronavirus, or SARS-CoV-2, can infect different organs or regions in the body, such as gastrointestinal areas and the neurological space. She said the virus has been found in stool samples, in blood, and even in cerebral spinal fluid.

Another potential explanation for the negative test results may be that the virus has already damaged these areas in the body and has since cleared by the time the person is tested, Gorfinkel said. For example, she said the loss of smell and taste is a result of damage to the olfactory nerve.

RELIABILITY OF NASAL SWABS

In addition to Gorfinkel’s explanations above, there have been concerns about the reliability of nasal swabs after several documented cases of false positive and false negative test results.

A number of factors can affect the outcome of the tests, including the quality of the sample, the type of tools used in the test, and what stage of infection the patient was in when they received the test.

According to one study, a false negative result became more likely if the patient was tested a week after their first symptoms emerged.

Timing was the reason Borg said he never bothered to get tested. He said by the time he was eligible for a test, he figured it was too late and the result would just come back negative. Instead, he said he’s waiting for a serology or antibody test to become available in Canada, which might indicate whether he had COVID-19 due to the presence of antibodies to the virus in his blood.

Even without the confirmation of a positive test result, Desjardins, Borg, and Thompson, and countless others in the support groups are convinced they contracted COVID-19 and that is what’s behind their persistent and sometimes debilitating symptoms.

“People in my situation are pretty frustrated because you kind of feel like you fall through the cracks of the health-care system,” Desjardins said. “I’m pretty positive that this is what I have.”

‘MEDICAL MYSTERY’

Because research on COVID-19 is still in its infancy, there could be more than one explanation as to why some patients experience chronic symptoms and the majority don’t.

Amir Attaran, a professor of law and epidemiology at the University of Ottawa, said he was reluctant to speculate on why this happens to certain individuals, but said he thinks it’s related to the immune system.

“There is undoubtedly in some COVID patients an abnormal reaction of the immune system that can contribute to the pathology that they experience,” he said during a telephone interview in early June.

While Attaran didn’t feel comfortable going into specifics, Rob Kozak, a clinical microbiologist at Sunnybrook Hospital in Toronto who helped isolate the SARS-CoV-2 virus in March, said there could be several reasons for an abnormal immune response.

Kozak said there is the possibility that “molecular mimicry” is occurring, where proteins in the virus might resemble proteins in the person and the immune system has trouble distinguishing between them.

“The immune system has been all geared up fighting the virus and it recognizes proteins on the virus and goes out and attacks it. But then once all the virus is cleared, it sees proteins in the host that look not identical, but similar, and it thinks the fight is still going on,” he explained from Toronto.

Another explanation, according to Kozak, is that even after the infection clears, viral RNA or genetic material from the virus remains in the body and the immune system detects it and launches another attack.

LIMITED DATA

“The immune system doesn’t realise that the fight is over,” he said. “It sees these parts of virus and it continues to produce inflammation, produce cytokines [small proteins that regulate inflammatory responses], produces inflammatory response.”

Kozak said the long-lasting symptoms in certain individuals could be the result of either explanation or a combination of both. However, he said because there are so few cases and limited data, it’s difficult to know what is really responsible for the various conditions.

Gorfinkel, too, agreed there is the possibility of an overzealous immune response that is unique in certain patients.

“There are lots of individuals who will get it, who are older, who are at high risk, they've got every risk factor, and yet they get over it,” she said. “It’s not just a question of being older and having chronic conditions, it’s much more complicated than that.”

While Gorfinkel said the immune system may play a role in what is occurring in long-haulers, she also said these patients could have other health problems or conditions that are causing these symptoms, but they’re being overlooked because of all of the attention on COVID-19.

“So when patients have problems, and COVID is a huge footprint in the brain does that mean that it’s always COVID? No. We have to still think could it be other diagnoses?”

SYMPTOMS STEM FROM PSYCHOLOGICAL ISSUES?

Because the topic of the pandemic has become unavoidable, Gorfinkel said that some individuals may be experiencing physical symptoms stemming from psychological issues.

“Previous influenza epidemics have been associated with an increase in anxiety, insomnia, fatigue and depression,” she said.

What’s more, Gorfinkel said people who did contract COVID-19 may have lingering physical symptoms that are the result of the psychological trauma they have experienced during the crisis.

Finally, Attaran said doctors and researchers still need time to study the viral pathogenesis – how the virus causes pathology and illness – before they can fully understand the long-term symptoms in some individuals.

“This is just going to be a great medical mystery for years to come,” he said. “We’ll figure it out.”

And while these chronic symptoms may only affect a minority of COVID-19 patients, this uncertainty combined with prolonged illness can be life-altering for those experiencing it.

“I think the majority of people don’t get it,” Thompson said. “It’s not like anybody’s visiting me in the hospital or anything like that, but… I don’t think that people understand how debilitating it is.”

Gorfinkel, however, said the body is capable of eventually recognizing a viral infection and developing an adequate response to it over time.

“We know that the body’s immune system is capable of incredible feats and that is true even long after a disease is established,” she said. “So just because they’ve had it for months, that does not mean it’s going to go on forever after that.”

SCIENCE AND RESEARCH

THE RACE FOR A COVID-19 VACCINE

I came across this compilation piece by NBC outlining where we stand in terms of treatments and vaccines against coronavirus. It’s by no means a comprehensive list of the work being done globally, but shows just how hard researchers in the US are working.

It’s going to be a long road to safe and effective treatment, but pharmaceutical companies and research facilities are exploring a variety of therapeutics to find a way to combat the virus.

Pharmaceutical companies are studying drugs already approved by the US Food and Drug Administration to see if any might work in fighting COVID-19, the disease caused by the novel coronavirus. Simultaneously, companies are in the process of developing vaccines for the virus that can be deployed to protect the uninfected population.

Repurposed drugs could be a faster route to an effective treatment, but they would still need to go through clinical testing to ensure their effectiveness. Malaria drug hydroxychloroquine and Ebola antiviral remdesivir are being tested in small batches of infected patients. Even with promising results, it’s unclear at this time whether any of these treatments will be successful in the larger population.

A vaccine tailored to combat the virus is the long-term solution. But according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, the earliest a coronavirus vaccine would be deployable would be a year to 18 months from now. Any vaccine would have to go through three phases of clinical trials and then apply for approval by the FDA.

In the US, Johnson & Johnson in a partnership with Janssen Pharmaceuticals identified a lead vaccine candidate. They expect to initiate human clinical trials by September and the first batches could be available for emergency use in 2021.

Here’s a list of some of the potential treatments and where they stand in development.

VACCINE CANDIDATES

MRNA-1273 by Moderna

Trial Status: Filed an Investigational New Drug Application with the FDA for Phase II testing.

REGM3048-3051 by Regeneron

Trial Status: Preclinical testing, human testing goal for early summer

INO-4800 by Inovio Pharmaceuticals

Trial Status: Phase I clinical testing.

Unnamed Vaccine by Johnson & Johnson/Janssen Pharmaceutical Company

Effect on Covid-19: Vaccine (preventative)

Trial Status: Vaccine candidate has been selected. Aiming for Phase I clinical trials to begin in September 2020.

BNT162 by Pfizer/Biontech

Trial Status: Phase I/II clinical testing began. Will enroll up to 360 healthy individuals.

Unnamed Vaccine by Sanofi, GSK

Trial Status: Ongoing at lab in Meridien, Connecticut. Estimate phase I clinical trials to begin in the second half of 2020.

NVX-CoV2373 by Novavax/Emergent Biosolutions

Trial Status:Identified vaccine candidate and aims to being Phase I clinical trials in mid-May.

PittCoVacc by UniverIty of Pittsburgh, UPMC

Recommended Use: SARS, MERS, SKIN CANCER

Trial Status: Preclinical Testing in animals

ChAdOx1 nCoV-19 by Moderna

Trial Status: Phase I/II clinical testing in 1,112 volunteers in a study conducted by University of Oxford.

POTENTIAL TREATMENTS

PICLIDENOSON by Can-Fite

Recommended Use: Anti-Viral

Effect on Covid-19: Prophylactic and a treatment

Trial Status: Gone through phase I And II Of clinical trials for rheumatoid arthritis

EIDD-2801 by Drug Innovation Ventures at Emory

Recommended Use: SARS, MERS, Ebola, Influenza

Effect on Covid-19: Oral treatment taken at onset

Trial Status: FDA approved Investigational New Drug application. Human clinical testing will begin in April.

BLD-2660 by Blade Therapeutics

Recommended Use: Fibrosis

Trial Status: Phase II clinical testing at Vanderbilt University Medical Center.

MERIMEPODIB ORAL SOLUTION by BioSig Technologies

Recommended Use: In development for chronic hepatitis C and psoriasis.

Trial Status: Phase II clinical testing in in adults with COVID-19 who are hospitalized and either require supplemental oxygen or are on non-invasive ventilation or high flow oxygen devices.

REPURPOSED TREATMENTS

ACTEMRA by Roche

Recommended Use: Rheumatoid arthritis

Effect on Covid-19: For severe lung inflammation

Trial Status: Phase III clinical testing in patients with severe COVID-19 pneumonia.

KEVZARA (sarilumab) by Regeneron and Sanofi

Recommended Use: Rheumatoid arthritis

Effect on Covid-19: For severe lung inflammation

Trial Status: Phase III testing with critical COVID-19 patients

HYDROXYCHLOROQUINE by Sanofi, Sandoz

Recommended Use: Malaria, Lupus

Trial Status: Clinical trials launched at Columbia University in New York, University of Minnesota and Rutgers Cancer Institute of New Jersey. The FDA issued guidance that the drug should be prescribed to hospitalized adolescent and adult patients when a clinical trial is not feasible.

REMDESIVIR by Gilead Sciences

Recommended Use: Ebola

Trial Status: Two Phase III clinical studies have begun, one in patients with severe manifestations and one in patients with moderate manifestations. Clinical trials at 50 sites globally with goal of 394 patients

KALETRA/ALUVIA by AbbVie

Recommended Use: HIV

Trial Status: Clinical trial in China among 20 individuals showed no improvement, clinical trial with 2400 patients to begin in Australia

OLUMIANT by Eli Lilly

Recommended Use: Rheumatoid arthritis

Trial Status: Laboratory research to evaluate the benefits and risks

FAVIRPIRAVIR by Fujifilm Toyama Chemical

Recommended Use: Influenza

Effect on Covid-19: Normilisation of fever in patients in early diagnosis (4 days or less)

Trial Status: Phase II clinicial testing in 50 patients in collaboration with Brigham and Women’s Hospital, Massachusetts General Hospital and UMass Medical School. Being tested in patients in China and it has been effective in those without severe symptoms

LOSARTAN by Merck

Recommended Use: High blood pressure

Trial Status: Phase I testing in 50 patients with COVID-19 and respiratory failure at University of Kansas Medical Center.

PUL-042 by Pulmotect, Inc.

Recommended Use: Respiratory complications in cancer patients

Trial Status: Phase II clinical testing in Kentucky, Texas, and Oklahoma.

ENOXAPARIN by Sanofi

Recommended Use: Anti-coagulant

Trial Status: Phase IIII clinical testing at University of Iowa Hospitals.

CANAKINUMAB by Novartis

Recommended Use: Systemic Juvenile Idiopathic Arthritis and Periodic Fever Syndromes

Trial Status: Phase III clincal testing

UMIFENOVIR by Pharmstandard

Recommended Use: Influenza

Trial Status: Restrospective cohort studies in China showing various results. Some showed no difference in outcomes and some saw slightly more favourable outcomes.

BCG VACCINE by Organon USA Inc.

Recommended Use: Tuberculosis

Trial Status: Phase 4 Clinical testing in 1,800 health care workers taking care of COVID-19 patients at four sites in the US.

HYPERBARIC OXYGEN by Karolinska Institutet

Recommended Use: Variety of medical uses ranging from hearing loss to thermal burns.

Trial Status: Phase 2/3 clinical testing in 200 adults with COVID-19 with at least two risk factors for increased mortality.

NITRIC OXIDE INHALATION THERAPY by Masssachusetts General Hospital

Recommended Use: Respiratory issues and illnesses

Trial Status: Phase 2 clinical testing in 260 adults at Massachusetts General Hospital in patients with COVID-19 presenting respiratory symptoms.

SIROLIMUS by Pfizer

Recommended Use: Immunosuppressive agent used to prevent rejection of organs after transplant.

Trial Status: Phase 2 clinical testing in 30 adults hospitalized with COVID-19 and hypoxia. The drug will be given orally over 14 days.

VAZEGEPANT by Biohaven Pharmaceuticals, Inc.

Recommended Use: Migraines

Trial Status: Phase 2/3 clinical testing in 120 patients hospitalized with COVID-19 and requiring supplemental oxygen.

QUESTIONS AND ANSWERS

I’m not an expert, but I might be able to help you make a bit of sense of this. And we can all get through it together. Isn’t this what this is all about.

Send your questions for me to Readers@gulfnews.com.

That’s it for now. Let’s check in with each other tomorrow. I have used files from Reuters, AP, DW, Sky News, Twitter and other European and North American media outlets in today’s blog. And remember to stay safe.

Mick O’Reilly is the Gulf News Foreign Correspondent based in Europe