Ricki Lewis

If we take the advice of health experts, we won't be attempting a return to normal life in the US until we get better at identifying people infected with the novel coronavirus. That need is driving researchers across the nation to look for ways to expand our toolbox of testing options. And now a new test, developed using CRISPR gene editing technology, has been added to the mix.

About 5.4 million tests have been done in the US, according to the COVID Tracking Project, in a population of 328.2 million. That might sound like enough to keep ahead of an infectious disease that has "only" killed in five figures, but such an assumption grossly oversimplifies the situation.

Controlling the pandemic in the US is going to require a daunting number of diagnostic tests – not just for the sick, but to verify when they're better (two tests 24 hours apart for hospital discharge), in contact tracing to limit spread, and in the many individuals who've been infected but have few or no symptoms.

"In a few countries, the use of diagnostic testing on a massive scale has been a cornerstone of successful containment strategies," write Matthew P. Cheng, MDCM. McGill University Health Centre and colleagues in a recent article in Annals of Internal Medicine. The US isn't on that list and has been struggling to catch up.

To continue reading, please go to Genetic Literacy Project, where this post first appeared.

I awoke on Monday morning to the sad news that Max Randell had passed away on April 18. He would have been 23 on October 9.

Maxie wasn't expected to live past the age of 8, or even much past toddlerhood, according to some doctors. But gene therapy, and his incredible family, had something to say about that. COVID-19 didn't claim him – his body just tired of fighting.

Max Randell's legacy is one of hope, to the rare disease community whose family members step up to participate in the clinical trials that lead to treatments. In this time of the pandemic, attention has, understandably, turned somewhat away from the many people who live with medical limitations all the time. I'll explore that story next week.

A Devastating Diagnosis

Max was diagnosed at 4 months of age with Canavan disease, an inherited neuromuscular disease that never touched his mind nor his ability to communicate with his eyes, even though his body increasingly limited what he could do. Fewer than a thousand people in the US have the condition.

To continue reading, please go to my DNA Science blog at Public Library of Science, where this post first appeared.

One of the most terrifying aspects of the COVID-19 pandemic is that we don't know what makes one person die, another suffer for weeks, another have just a cough and fatigue, and yet another have no symptoms at all. Even the experts are flummoxed.

"I've been puzzled from the beginning by the sharp dichotomy of who gets sick. At first it was mostly older people with chronic disease, and then a young person with low risk would show up. It can be devastating and rapid in one individual but mild in another," said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Disease on a media webinar.

What lies behind susceptibility to COVID-19? Gender? Genetics? Geography? Behavior? Immunity? All of these factors may be at play, and they overlap.

To continue reading, go to Genetic Literacy Project, where this post first appeared.

Daily life in the age of coronavirus has affected us in different ways. For science writers, it means that many of the physicians and scientists we would in normal times talk to are too busy saving lives. At the same time, the science and medical journals are spewing articles faster than we can keep up, peer review necessarily delayed.

For the first half of March, I wrote breaking news articles and quickly burnt out. No one was giving interviews as the publication cycle continually compressed, sometimes doubling back to correct errors as new information flooded in.

And then the webinars began, some for media, some for physicians. I've been doing as many as I can, from government agencies, patient advocacy groups, and the journals. This is my sixteenth piece on the novel coronavirus, thanks largely to these constant updates from the experts. My favorite webinar series is the Live Stream Q&A sessions from The Journal of the American Medical Association's editor-in-chief Howard Bauchner, MD.

I especially liked the webcast on April 2 with Frank Snowden, PhD, professor emeritus of history of medicine at Yale and the author of Epidemics and Society: From the Black Death to the Present, published fortuitously this past fall. Listening to him reminded me of my favorite books about plagues and pandemics, which I'll list at the end.

Dr. Anthony Fauci, who needs no introduction with his face plastered on tee shirts and donuts (I've joined his Facebook fan club), does the JAMA webinar regularly, most recently on April 8. So I'm going to pretend that both gentlemen are sitting here with me and my cats in my living room, briefing me on the past and future of COVID-19, and how it fits into the grand sweep of epidemiology.

To continue reading go to my DNA Science blog at Public Library of Science, where this post first appeared.

New York City has become a curious mosaic of crowds and barrenness, people packed into hospitals and homes, yet familiar favorite spaces eerily empty. The haunted cityscapes that accompany this article will fill again once we have a vaccine.

If all goes extremely well — with global cooperation, advances and insights to come, overlapping clinical trial phases, and a lot of luck — a year from now a vaccine or even vaccines against the novel coronavirus may exist. But that's a best-case scenario. Experts tend to be conservative.

"It's hard for me to see that we'd have a vaccine on this side of January. The process is designed to be slow, reflective, peer-reviewed and evidence-based. It takes a long time, not the science part nor to build the vaccine, but to conduct safety testing in enough people across enough time," said Gregory A. Poland, MD, director of the Mayo Clinic's Vaccine Research Group and editor-in-chief of the journal Vaccine.

To continue reading please go to Genetic Literacy Project, where this post first appeared.

Three otherwise healthy patients go to the emergency department with severe acute respiratory failure. Only one ventilator, required to sustain life until the worst of the coronavirus infection has passed, is available. Who gets the vent?

That's what "A Framework for Rationing Ventilators and Critical Care Beds During the COVID-19 Pandemic," a Viewpoint just published in the Journal of the American Medical Association (JAMA), addresses. Douglas White, MD, MAS, Endowed Chair for Ethics in Critical Care Medicine at the University of Pittsburgh School of Medicine and Bernie Lo, MD, from the University of California, San Francisco, wrote the Viewpoint, which links to a full policy document that's been in the works since 2009. It is being implemented in several states and can easily be adapted to any hospital, Dr. White said in a Webinar on March 27.

To continue reading go to Genetic Literacy Project, where this post first appeared.

How does the COVID-19 pandemic compare to other infamous viral infections that have plagued us in modern times? It's a question that's been asked repeatedly in social media circles in recent weeks as people struggle to gain a better understanding of what we are facing.

Recently, I received an answer that was terrifying.

The subject was raised during a March 18 webinar featuring Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. He is the nation's top infectious disease expert, who was described recently by the Washington Post as the "grandfatherly captain of the corona­virus crisis".

Dr. Fauci was asked by the editor of the Journal of the American Medical Association to put the virus in historical context. His  response:

To continue reading, go to Genetic Literacy Project, where this article first appeared.

It's impossible to keep up with entries at ClinicalTrials.gov that include the search term "COVID-19."

Last week when I posted Can Existing Drugs Treat COVID-19? From Viagra to Thalidomide to Cough Syrup here at DNA Science, the number of studies was a tad over 100. Right now, it's at 158, a 50% increase. These are just registered studies – being listed doesn't imply approval, but rather intent to carry out an investigation.

On March 18, Dr. Anthony Fauci, who no longer needs introduction, mentioned chloroquine as an example of a drug that might possibly be repurposed against the novel coronavirus, and that several clinical trials are already evaluating its safety and efficacy against the new disease. Dr. Fauci said this at a webinar series that the Journal of the American Medical Association holds regularly for media. The drug has been used for years to treat malaria, rheumatoid arthritis, lupus, and other conditions.

To continue reading, go to DNA Scienced, where this post first appeared.