States start testing for COVID-19, screening more broadly

Today in a news conference, Nancy Messonnier, MD, director of the Centers for Disease Control and Prevention (CDC) National Center for Immunization and Respiratory Diseases, said states can now begin testing for COVID-19 using CDC test kits that employ two reagents instead of three.

Messonnier said the Food and Drug Administration has okayed the use of test kits with two reagents, and she said positive tests will be verified by the CDC.

"We expect all states will be doing testing by the end of next week," Messonnier said. She also said that by next week, six US flu surveillance sites will also begin testing for COVID-19, in an effort to cast a wider net on the novel coronavirus, which has spread to 53 countries since it was first identified in Wuhan, China, less than 3 month ago.

California health officials today announced a second case involving a patient who isn't an evacuee, a patient from Santa Clara County, according to a media report. County health officials announced plans for a 4 pm (PST) media briefing to share more details. Meanwhile, two more Americans repatriated from the Diamond Princess cruise ship have also been diagnosed as having COVID-19, Messonnier said. There are now 44 cases in Americans repatriated from Wuhan or the cruise ship, 12 cases in Americans who had a travel history to China, 2 cases in spouses of known cases, and 1 case possibly tied to community spread in California.

Broader definition for case investigations

Messonnier also said the country should expect to see more cases tied to the most recent case confirmed in California, what is likely to be the first instance of community spread in the United States.

"The situation has evolved and continues to evolve very quickly," she said. The CDC will now begin testing patients for COVID-19 if they have recent travel history to China, or Iran, Italy, South Korea, or Japan, as well as fever and signs of respiratory illness. This broadens the PUI, or persons under investigation, the CDC is testing for the novel coronavirus.

Patients with signs of severe lower respiratory infections without alternative diagnosis (such as influenza) will also be tested.

The California patient, currently being treated at UC-Davis Medical Center, was severely sick for several days, but was not tested for COVID-19 because he or she had no travel history to China or known contact with cases. Messonnier contradicted media reports, which have said physicians were denied COVID-19 testing for the patient for up to 4 days, before the patient was tested on Feb 23.

"According to CDC records, the first call we got about this patient was Sunday the 23rd," Messonnier said.

Yesterday UC-Davis said three people were being kept in isolation because of possible exposure to the virus, including one person who was showing symptoms of the virus and being tested.

Ramping up mask production

In an exclusive report, Reuters said President Trump was considering using the Defense Production Act to quickly ramp up domestic manufacturing of protective masks and clothing, two officials told the news agency.

The news comes the same day a whistleblower from the US Department of Health and Human Services said federal workers who met planes of evacuees from Wuhan were not donning personal protective gear and were not trained in public health emergency protocols.

The Washington Post published a heavily redacted account of the whistleblower's report. The whistleblower is seeking federal protection, and says she was improperly reassigned after raising her concerns.

US vaccine makers take on COVID-19

Altimmune announced today advancement toward the development of a single-dose intranasal COVID-19 vaccine.

"With the spread of COVID-19 outside of China, including the first case of unknown origin in the United States, we have taken action to develop and make our vaccine technology available to help address this crisis," said Vipin K. Garg, PhD, President and Chief Executive Officer of Altimmune in a press release. "We believe that our intranasal vaccine technology is especially well suited to provide systemic protection against respiratory infections that affect the upper and lower airways and can therefore be a useful tool in preventing further spread of COVID-19."

The new vaccine is based on the same platform vaccine technology as NasoVax, the company's influenza vaccine candidate.

Inovio Pharmaceuticals Inc., meanwhile, is looking to pair with a large drug maker on COVID-19 vaccine distribution. Innovio said the company would like to produce 1 million doses of a vaccine by the end of the year, but it needs to partner with a bigger company to meet that goal.

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