Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
Eli Lilly, a pharmaceutical company that has been the darling of Wall Street, said Tuesday that it will pause testing an antibody treatment similar to the one that President Donald Trump used a week ago.
The company paused the trial after an independent board of experts raised health concerns. Lilly has not said how many patients have gotten sick from the therapy, if any. It is not unusual for drug trials to occasionally hit pause to test a drug’s effectiveness and safety.
Lilly’s trial was focused on testing the benefits of its therapy on hospitalized COVID-19 patients who also got the drug remdesivir. The hope is that researchers can find therapies that shorten hospital stays for patients who get the virus. It is not a cure, but a treatment.
The Eli Lilly trial is of interest because it was sponsored by the National Institutes of Health.
“Safety is of the upmost importance to Lilly,” spokeswoman Molly McCully said in an email. “Lilly is supportive of the decision by the independent (Data and Safety Monitoring Board) to cautiously ensure the safety of the patients participating in this study.”
The drug is what is known as a monoclonal antibody, which experts view as being among the most likely technologies to help treat Covid-19. It’s a manufactured version of the antibodies that the body uses as part of its response to a virus.
“This is a good start,” said Eric Topol, the director and founder of the Scripps Research Translational Institute. “A lot is pinned not only on Lilly but on the whole family of these (monoclonal antibodies), because even though they’re expensive and they’re not going to make a gajillion doses, they could make a big difference in the whole landscape of the pandemic.”
Early reports about the Lilly drug can sound promising if you look at the results as a percentage, but not so much once you realize how few patients were involved. Let’s dig a little deeper into the testing results, published by StatNews:
In a more tantalizing finding, the medicine also appeared to reduce patients’ odds of ending up in the hospital. Just 1.7% of patients who received the drug, called LY-CoV555, eventually went to the emergency room or were hospitalized, compared with 6% of those who took placebo. That amounts to 72% relative reduction in risk.
Those hospitalization data, though, are from a small number of patients, again increasing the odds that the finding won’t hold up with further study. Five of 302 patients on LY-CoV555 were hospitalized, compared to nine of 150 patients who received placebo. Lilly declined to confirm the difference is statistically significant, citing the need for full publication of the results.
Again, the early result that caused so much excitement was the difference of five people who were hospitalized out of 302 people who got the drug, versus nine of 150 patients who instead got a placebo. As a percentage, it is a big difference. But as a study sample, it is tiny.
Lilly’s news comes one day after Johnson & Johnson paused testing on its Phase 3 vaccine trial after a volunteer came down with an illness that may or may not be related. AstraZeneca, another leading candidate for developing a COVID-19 vaccine, has already had to pause its drug trial for a month after it was put on hold by health authorities.
Johnson & Johnson paused its drug trial on its own, not under government order. That drug trial involves more than 60,000 people. It could restart right away or be on hold for a while, depending on what researchers learn about the one illness.
Drug trials like these often take years and more often than not do not produce viable vaccines or therapeutics. But the global race for a COVID-19 vaccine and for therapeutic drugs has intensified interest in this research.
Yes, you can be COVID-infected twice
Nevada scientists say they are confident that a local man was infected twice by the coronavirus, which may not be the news you wanted to hear. This is the first reinfection case that we know of in the U.S. and only the fifth worldwide, but it undercuts the notion that once you have the virus you will be immune, even for a time.
The details of the finding, published in the medical journal Lancet, says the 25-year-old man tested positive for the first time in April, then again in June. The two positive tests were separated by two negative tests.
As you know, President Trump claimed at a public rally this week that he is now “immune” since he says he has tested negative since having the virus.
A total and complete sign off from White House Doctors yesterday. That means I can’t get it (immune), and can’t give it. Very nice to know!!!
— Donald J. Trump (@realDonaldTrump) October 11, 2020
Other cases of reinfection have been reported in Hong Kong, the Netherlands, Belgium and Ecuador. These cases raise lots of questions about how long COVID-19 immunity lasts after infection, if there is any at all.
The COVID-19 brain fog
It seems that every day we learn one more thing about the effects of the coronavirus. The New York Times says doctors are seeing patients with COVID-19 “brain fog.”
It’s becoming known as Covid brain fog: troubling cognitive symptoms that can include memory loss, confusion, difficulty focusing, dizziness and grasping for everyday words. Increasingly, Covid survivors say brain fog is impairing their ability to work and function normally.
“There are thousands of people who have that,” said Dr. Igor Koralnik, chief of neuro-infectious disease at Northwestern Medicine in Chicago, who has already seen hundreds of survivors at a post-Covid clinic he leads. “The impact on the work force that’s affected is going to be significant.
Scientists aren’t sure what causes brain fog, which varies widely and affects even people who became only mildly physically ill from Covid-19 and had no previous medical conditions. Leading theories are that it arises when the body’s immune response to the virus doesn’t shut down or from inflammation in blood vessels leading to the brain.
Actress Alyssa Milano has spoken about the brain fog symptom. Other coronavirus patients say that they are experiencing brain fog seven months after first contracting the virus. One patient, Mirabai Nicholson-McKellar, described it this way in an interview with The Guardian:
“I can’t work more than one to two hours a day and even just leaving the house to get some shopping can be a challenge,” she says. “When I get tired it becomes much worse and sometimes all I can do is lay in bed and watch TV.” Brain fog has made her forgetful to the point that she says she burns pots while cooking.
“It often prevents me from being able to have a coherent conversation or write a text message or email,” she adds. “I feel like a shadow of my former self. I am not living right now, I am simply existing.”
Dr. Wilfred Van Gorp, former president of the American Academy of Clinical Neuropsychology, says many Covid survivors he has seen with brain fog also have problems ranging from headaches to difficulties tolerating loud noise and controlling emotions.
“The complaints are very much similar to (those of) post-concussion patients,” he says, adding that there are also similarities to chronic fatigue syndrome.
Zandi says there could be many causes of brain fog in Covid survivors, from inflammation in the body to a lack of oxygen to the brain — the latter is a particular concern for those who spent time on ventilators.
Zandi adds that experiments in lab dishes have even suggested the virus can infect brain cells and choke off oxygen delivery to adjacent cells — although that work has yet to be peer-reviewed.
In yet another theory, researchers at UCLA say brain fog may be more like post-traumatic stress disorder. Their research explores whether the trauma associated with intensive COVID-19 treatment is so severe that it could have lingering psychological effects.
When attending virtual school, do school rules apply?
I was teaching a virtual college class the other day in which a student with his camera on sat in front of a poster with coarse graffiti on it. Nobody seemed to care. But an Associated Press story explores the unsettled world of virtual grade school and high school classes, where it is unclear if dress codes and backgrounds matter.
Can students have posters visible in the background backing social or political movements that others disagree with or find racist? Can they wear clothes at home that are banned from classrooms? How can a teacher respond when a student says or does something that the instructor deems rude, offensive or threatening?
Weeks into the fall semester, a growing number of school officials are navigating those grey areas.
In Colorado, Maryland and Pennsylvania, school administrators asked police to investigate separate incidents of toy guns, BB guns and a suspected rifle visible on video feeds from students’ homes. The actions raised complaints that they had overreacted to something that didn’t threaten either those students or their classmates.
There’s more. A Florida school district promised an investigation of an apparent high school student shouting racial slurs over a virtual class session. A Texas teacher was put on leave after parents noticed her virtual classroom is decorated with (virtual) posters backing LGBTQ rights and the Black Lives Matter movement.
“So many of our legal standards for speech at school are based on the notion that there’s a limited expectation of privacy when you’re at school, and certainly the expectation of privacy in your own home is much more expansive,” says Miranda Johnson, director of the Education Law and Policy Institute at Loyola University.
The Education Week Research Center’s survey of 900 educators found a wide range of enforcement plans for online learning. Some educators said they wanted the online environment to replicate in-person as closely as possible to build a sense of business as usual. Others said life today is stressful enough and it is time to give students a break. EdWeek reports:
One teacher, for instance, told students to dress appropriately as they would in school, not to eat or snack, limit distractions, and be mindful of their surroundings. Students who don’t follow these rules will be removed from the virtual classroom and given a zero, the teacher wrote.
But these types of strict guidelines have raised some concern among educators, who say that students need to be given grace during a difficult, scary time.
“Student well-being and faculty well-being should be the priority at this time, and teachers should be flexible where they can be,” said Ryann Fapohunda, the co-director of the Teaching and Learning Center at the National Cathedral School, an all-girls private school in Washington, D.C. “Is it more important how students dress and are presenting themselves, or their social-emotional well-being? If students are adhering to guidelines in class — participating, showing up — I’m inclined to not call them out for wearing a hoodie or being in pajama pants.”
“It’s a situation where we need to extend grace,” said Merisha Leak, the director of outreach for a charter school in Charlotte, N.C. “I don’t think it’s a school’s right or a teacher’s right to enforce school rules in someone’s home.”
Students might already feel vulnerable for opening up their homes to their classmates, she said, and teachers need to “come up with equitable practices that would work for all families in a way (in which) we aren’t causing anxiety or stressing anyone out.”
The Washington Post said Washington, D.C., area schools have set some baseline expectations:
The long-standing requirement that students wear appropriate clothing now includes not wearing pajamas. Some online guidance informs students that they can’t be in bed or wrapped up in blankets during class. Heading out of the room to get a snack from the fridge in the middle of a lesson is also a no-no.
And here is something I had not considered: how to discipline students who break the rules. Some schools have come up with virtual detention. The Post story notes:
For students who break rules, many districts, such as Georgia’s Clayton County Public Schools, will discipline them with one of two kinds of virtual suspensions: in school and out of school. In-school suspensions would see students working in a virtual classroom with others who have been punished. Out-of-school would see students doing assignments alone.
Mask-wearing effects: Eye makeup sales are fine, but lipstick sales are down
My wife told me the other day that she no longer bothers wearing makeup because she wears a mask. (If I was a better person, I would have noticed.) But it got me to wondering if this is a trend, and it is. Business Insider says:
Masks are changing the way Americans use makeup, with an interest in bold eye makeup prompting a rise in sales of products like eye shadow. Eye makeup sales are up 204% year-over-year for the three-month period ending on June 28.
Prestige makeup, meaning the more expensive brands sold at places like Sephora and department stores, has seen sales drop 37 percent in the last six months, according to NPD’s Jensen. Seventy-one percent of women surveyed by the firm said they “wear makeup less often due to Covid-19 lifestyle changes.”
Business Insider adds:
Lipstick, however, has been particularly hard hit during the pandemic and could indicate the demise of “the lipstick index,” a term coined by Estee Lauder chairman Leonard Lauder in 2001.
Amazon sales of “lip care and color” dropped 15% for the month ending on April 11. Meanwhile, sales of eye makeup grew by 204% in the three-month period ending on June 28, according to Kantar.
The “lipstick index” is a widely cited and sharply debated notion that even when the economy turns soft, bold lipsticks still prop up cosmetic sales.
By midyear, other cosmetic sales reflected that people were coloring their own hair and doing their own nails. Hair coloring product sales almost doubled while nail care product sales more than doubled. Other fancy skin care devices are surviving in the pandemic.
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