Easy COVID-19 test tops research priorities as cases climb

A global research meeting wrapped up today to set priorities to answer key questions about COVID-19 and tackle the outbreak, with a simpler diagnostic test and treatment protocols at the top of the list.

Disease activity in China, meanwhile, continued its steady growth.

In other developments, more cases of the novel coronavirus were reported on a cruise ship quarantined in a Japanese report, and Cambodia offered safe passage for a separate cruise ship that has yet to report a case.

Also, research teams published new early findings, including that the virus is easily detected in saliva and that pregnant women in their third trimesters don't seem to pass the virus to their babies.

Priorities from research meeting

The 2-day research and innovation meeting that wrapped up in Geneva today yielded an agreed-on set of research priorities and will result in a research and development roadmap, the World Health Organization (WHO) said in a statement.

Also, the more than 300 participants who took part in the meeting on site or online outlined mechanisms for continuing their collaboration, which the WHO will facilitate. Research funders were also on hand to discuss how to mobilize resources so that crucial studies can start immediately.

At a media telebriefing today, WHO officials said Chinese researchers participated remotely, and they helped ground the discussions based on the realities on the ground in the outbreak region.

Soumya Swaminathan, MD, the WHO's chief scientist, said the top priority was a simpler diagnostic test, which will also be useful for lower-income countries that don't have complex lab facilities. She said another very high priority is information on optimal treatment and the best treatment protocols, which need studies based on standard data collection.

She said more research on transmission and epidemiology is also crucial. "We really need to understand this virus—its transmission, age-groups, underlying conditions, what makes it more severe, impacts of interventions," she said. "We have a lot to learn from studying all of these."

WHO officials said today there are four vaccines in development, with one or two of them poised to enter human trials in 3 or 4 months, and, if successful, a vaccine might be available for wider use in 12 to 18 months. They said researchers are still working on a master protocol to study existing therapies, used singly or in combination.

Cases continue steady rise in China

China yesterday reported 2,015 new cases, down from 2,479 reported the day before, raising the overall total to 44,653, according to the latest update from the country's National Health Commission (NHC). Also, officials reported 871 new serious cases and 97 more deaths, putting those totals at 8,204, and 1,113, respectively. So far 4,740 have been discharged from the hospital.

At today's media briefing, Ryan said deaths are on the rise, because there's a lag time between the time when cases surge, such as they did in the past 2 weeks, and when people with serious disease succumb from the disease.

Sylvie Briand, MD, PhD, the WHO's director of epidemic and pandemic diseases, said WHO officials have confirmed that China has adapted its case definition to include asymptomatic and mild cases that weren't included in the initial case definition. She said it's normal to adapt the case definition as outbreaks unfold, and Chinese health officials are now able to test contacts and look for transmission chains.

Mike Ryan, MD, who directs the WHO's health emergencies program, said the shift is likely to generate even more confirmed cases, likening the case definition change to throwing a wider net with a finer mesh. "This is what we want to see in the containment phase."

More Japan cruise ship cases

In developments outside of China, Japan's health ministry today reported 39 more COVID-19 cruise ship cases, raising the total to 174. Media reports said one of the newly confirmed patients is the Japanese quarantine office assigned to the ship.

The Diamond Princess has been in Yokohama port since Feb 3.

Meanwhile, another ship that has been denied entry by four countries over fears of the virus, even though no suspected or confirmed COVID-19 cases have been reported on it, was allowed by Cambodia to dock and for passengers to disembark.

At today's WHO media briefing, Tedros said the Westerdam is expected to arrive in Cambodia tomorrow. "This is an example of international solidarity," he said, adding that the WHO will issue a communique to countries about the need to make risk assessments based on evidence.

Singapore today reported three more cases today, all of them locally acquired, including two linked to a church, according to a statement from the country's health ministry. Singapore has now reported 50 cases.

At today's WHO media briefing, Ryan said that less than one fourth of the cases outside of China involve local spread, and that there are only eight cases for which a plausible exposure source hasn't been found. "We have a good view of the virus," he said. "There could be others, but this is what we see."

In its situation report today, the WHO said that, over the last 24 hours it received reports of 46 new cases outside of China, raising the total to 441 cases from 24 countries.

Saliva, pregnancy findings

In research developments today, investigators from Hong Kong writing in Clinical Infectious Diseases said they detected the COVID-19 virus in saliva samples from 11 of 12 people they sampled.

On serial sampling, they saw a declining trend, and they concluded that the findings are useful, because saliva samples could be a noninvasive specimen for testing. They also noted the saliva findings have implications for infection control.

Meanwhile, a research team from China in a case series of nine pregnant women hospitalized in Wuhan with lab-confirmed COVID-19 found that of samples collected from six, all were negative for the virus. The researchers published their report today in The Lancet.

The nine babies were delivered via caesarean section. The samples that tested negative included amniotic fluid, cord blood, neonatal throat swab, and breastmilk samples.

The authors concluded that the findings from the small group suggest no evidence of vertical transmission in women who have COVID-19 pneumonia late in their pregnancies.

See also:

Feb 12 Tedros media briefing comments

Feb 12 WHO R and D meeting press release

Feb 12 China NHC update

Feb 12 Japanese health ministry statement

Feb 12 Singapore health ministry statement

Feb 12 WHO daily situation report

Feb 12 Clin Infect Dis abstract

Feb 12 Lancet study

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