Tag Archives: second wave

Countries turn to rapid antigen tests to contain second wave of COVID-19

By John Miller, Caroline Copley and Bart H. Meijer

ZURICH/BERLIN (Reuters) – Countries straining to contain a second wave of COVID-19 are turning to faster, cheaper but less accurate tests to avoid the delays and shortages that have plagued efforts to diagnose and trace those infected quickly.

Germany, where infections jumped by 4,122 on Tuesday to 329,453 total, has secured 9 million so-called antigen tests per month that can deliver a result in minutes and cost about 5 euros ($5.90) each. That would, in theory, cover more than 10% of the population.

The United States and Canada are also buying millions of tests, as is Italy, whose recent tender for 5 million tests attracted offers from 35 companies. Switzerland, where new COVID-19 cases are at record levels, is considering adding the tests to its nationwide screening strategy.

Germany’s Robert Koch Institute (RKI) now recommends antigen tests to complement existing molecular PCR tests, which have become the standard for assessing active infections but which have also suffered shortages as the pandemic overwhelmed laboratories and outstripped manufacturers’ production capacity.

PCR tests detect genetic material in the virus while antigen tests detect proteins on the virus’s surface, though both are meant to pick up active infections. Another type of test, for antibodies the body produces in response to an infection, can help tell if somebody has had COVID-19 in the past.

Like PCR (polymerase chain reaction) tests, antigen tests require an uncomfortable nasal swab. They can also produce more “false negatives,” prompting some experts to recommend they only be used in a pinch.

Still, the alarming rise in new infections globally has health officials desperately pursuing more options as the winter influenza season looms.

The World Health Organization reported more than 2 million new cases last week, bringing the total worldwide to 37 million, with more than 1 million deaths from COVID-19.

“These point-of-care tests could make a big difference,” said Gerard Krause, epidemiology department director at Germany’s Helmholtz Centre for Infection Research.

NO TEST NO FLIGHT

Krause said low-priority patients – those without symptoms – could initially be screened with antigen tests, leaving the more accurate PCR tests for those showing signs of the disease.

Antigen tests have already gained traction in the travel industry. Italian airline Alitalia offers Rome-Milan flights exclusively for passengers with negative tests and Germany’s Lufthansa has announced similar testing plans.

But the pandemic’s vast scale has strained the ability of countries to test all of their citizens, making it difficult to track the twisting paths of infection comprehensively and prevent a resurgence.

In the United States, for example, reliance on automated PCR machinery over the summer left many patients frustrated as they waited for a week or more for results.

Testing in Europe has also suffered glitches.

France does over a million tests a week but its free-for-all testing policy has led to long queues and delays in results, prompting French researchers to come up with a test they say can produce results in 40 minutes, without using a swab.

Italy does between 800,000 and 840,000 tests a week, more than double April’s levels, according to the Ministry of Health. But a government adviser, University of Padua microbiology professor Andrea Crisanti, said the country needs 2 million tests a week to really get on top of the virus.

In the Netherlands, where infection rates are among Europe’s highest, the government has been scrambling to expand weekly testing and lab capacity to 385,000 by next week from 280,000 now. The target is nearly half a million tests a week by December and just under 600,000 by February.

But people have been waiting days for a test. The authorities blame the overwhelming demand from those without clear symptoms for clogging up the system.

In response, the authorities have restricted rapid antigen tests to health workers and teachers, while others go on a waiting list.

‘GOLD STANDARD’

The various hitches highlight a conundrum for governments: how to get people back to work while tracing the virus within the population quickly – without running out of supplies.

Siemens Healthineers, which on Wednesday announced the launch of a rapid antigen test kit in Europe that can deliver a result in 15 minutes, said the volumes of such diagnostic tests being circulated globally now are “at the limits” of what manufacturers can supply.

Rivals including Abbott Laboratories and Becton Dickinson also offer numerous COVID-19 diagnostic tests, with more and more companies jumping in.

Swiss diagnostics maker Roche, announced plans on Tuesday to launch a new antigen test by the end of the year. Its fully automated systems can provide a test result in 18 minutes and a single lab machine can process 300 tests an hour.

By early 2021, the Basel-based company said it could make some 50 million of the new tests a month, on top of the rapid point-of-care tests it already sells.

Roche said the test could be deployed in places such as nursing homes or hospitals, where speedy results could thwart a potentially lethal outbreak.

“The primary use case is the testing of symptomatic patients,” a Roche spokeswoman said. “The secondary use case is the testing of individuals suspected of infection … which could also include asymptomatic patients.”

Expert opinion, however, on just how to use antigen tests is evolving and remains the subject of debate.

Switzerland, where reported new infections spiked to 2,823 cases on Wednesday from as low as three per day in June, is only now validating the accuracy of the rapid tests.

“Deployment of the rapid tests – where it makes sense – will be integrated into our testing strategy,” a spokesman for the Swiss federal health ministry said. “We’ll update our testing recommendations in November.”

Sandra Ciesek, director of the Institute of Medical Virology at the University Clinic in Frankfurt, Germany said rapid antigen tests could be an option for asymptomatic patients planning to visit elderly patients at nursing homes.

But people should refrain from using them as a definitive substitute to judge their infection status.

“The PCR test remains the gold standard,” Ciesek said. “An antigen test should only be used as an alternative if PCR is not possible in a timely manner.”

(Reporting by John Miller in Zurich, Caroline Copley in Berlin, Emilio Parodi and Giselda Vagnoni in Milan, Josephine Mason in London, Bart Meijer in Amsterdam and Matthias Blamont in Paris; Editing by David Clarke)

Second UK lockdown? PM says second wave inevitable, new restrictions possible

By Guy Faulconbridge, Kate Holton and Andy Bruce

LONDON (Reuters) – British Prime Minister Boris Johnson said he did not want another national lockdown but that new restrictions may be needed because the country was facing an “inevitable” second wave of COVID-19.

Ministers were on Friday reported to be considering a second national lockdown, after new COVID-19 cases almost doubled to 6,000 per day, hospital admissions rose and infection rates soared across parts of northern England and London.

That rise in cases was part of a second wave that was now unstoppable, the prime minister said.

“We are now seeing a second wave coming in…It is absolutely, I’m afraid, inevitable, that we will see it in this country,” Johnson told UK media.

Asked about whether the whole of the country should brace for a new lockdown, rather than just local restrictions, he said: “I don’t want to get into a second national lockdown at all.”

But he did not rule out further national restrictions being brought in.

“When you look at what is happening, you’ve got to wonder whether we need to go further than the rule of six that we brought in on Monday,” he said, referring to the ban on gatherings of more than six people.

The United Kingdom has reported the fifth largest number of deaths from COVID-19 in the world, after the United States, Brazil, India and Mexico, according to data collected by Johns Hopkins University of Medicine.

The UK’s official number of new positive cases shot up by nearly a thousand on Friday to 4,322, the highest since May 8, after a separate ONS model pointed to about 6,000 new cases a day in England in the week to Sept. 10.

That was up from modelling of 3,200 cases per day in the previous week, with the North West and London seen as hotspots.

Health Minister Matt Hancock called a second national lockdown a last resort earlier on Friday and when he was asked about it said: “I can’t give you that answer now.”

SPREADING WIDELY ACROSS ALL AGES

The UK said its reproduction “R” number of infections has risen to a range of 1.1-1.4 from last week’s 1.0-1.2.

“We’re seeing clear signs this virus is now spreading widely across all age groups and I am particularly worried by the increase in rates of admission to hospital and intensive care among older people,” said Yvonne Doyle, Medical Director at Public Health England.

“This could be a warning of far worse things to come.”

Britain imposed new COVID regulations on the North West, Midlands and West Yorkshire from Tuesday. More than 10 million people in the United Kingdom are already in local lockdown, and restrictions for millions more could be on the way.

London Mayor Sadiq Khan said later on Friday that it was “increasingly likely” that additional measures would soon be required in Britain’s biggest city. He said he had seen evidence about the spread of the virus in London which was “extremely” concerning.

COVID-19 cases started to rise again in Britain in September, with between 3,000 and 4,000 positive tests recorded daily in the last week. This is still some way behind France, which is seeing more than 10,000 new cases a day.

“COVID-19 infection rates have increased in most regions, particularly the North West and London,” the ONS said.

The ONS said there had been clear evidence of an increase in the number of people testing positive aged 2 to 11 years, 17 to 24 years and 25 to 34 years.

Johnson was criticized by opposition politicians for his initial response to the outbreak and the government has struggled to ensure sufficient testing in recent weeks.

Asked by LBC radio why the testing system was such a “shambles”, Hancock said Dido Harding, who is in charge of the system, had done an “an extraordinary job.”

(Reporting by Guy Faulconbridge, Kate Holton and Sarah Young; Editing by Raissa Kasolowsky, Mike Collett-White, Philippa Fletcher, William Maclean)

Explainer: What is a second wave of a pandemic, and has it arrived in the U.S.?

By Julie Steenhuysen

CHICAGO (Reuters) – Infectious disease experts, economists and politicians have raised concerns about a second wave of coronavirus infections in the United States that could worsen in the coming months.

But some, including Dr. Anthony Fauci, the U.S. government’s top infectious disease expert, said it is too soon to discuss a second wave when the United States has never emerged from a first wave in which more than 120,000 people have died and more than 2.3 million Americans have had confirmed infections with the novel coronavirus.

Here is an explanation of what is meant by a second wave.

WHY DESCRIBE DISEASE OUTBREAKS AS WAVES?

In infectious disease parlance, waves of infection describe the curve of an outbreak, reflecting a rise and fall in the number of cases. With viral infections such as influenza or the common cold, cases typically crest in the cold winter months and recede as warmer weather reappears.

Fears about a second wave of COVID-19, the respiratory disease caused by the coronavirus, stem in part from the trajectory of the 1918-1919 Spanish flu pandemic that infected 500 million people worldwide and killed an estimated 20 to 50 million people. The virus first appeared in the spring of 1918 but appears to have mutated when it surged again in the fall, making for a deadlier second wave.

“It came back roaring and was much worse,” epidemiologist Dr. William Hanage of Harvard University’s T.H. Chan School of Public Health said.

Epidemiologists said there is no formal definition of a second wave, but they know it when they see it.

“It’s often quite clear. You’ll see a rise involving a second group of people after infections in a first group have diminished,” epidemiologist Dr. Jessica Justman of Columbia University’s Mailman School of Public Health said.

U.S. COVID-19 cases spiked in March and April and then edged downward in response to social-distancing policies aimed at slowing the transmission of the virus from person to person. But unlike several countries in Europe and Asia, the United States never experienced a dramatic drop in cases marking the clear end of a first wave. There is now a plateau of about 20,000 U.S. cases daily.

“You can’t talk about a second wave in the summer because we’re still in the first wave. We want to get that first wave down. Then we’ll see if we can keep it there,” Fauci told the Washington Post last week.

The easing in recent weeks of social-distancing mandates in numerous U.S. states as businesses have reopened has caused an acceleration in infections.

IS TALK OF WAVES JUST SEMANTICS?

To many epidemiologists, it is a matter of semantics.

“Do you want to call it an extension of the first wave or a second wave superimposed on the first? You could argue it either way,” Justman said.

Dr. Eric Toner, a senior scientist at the Johns Hopkins Center for Health Security, said he does not find “waves” to be an especially useful term in describing a pandemic.

“When you’re underwater, it’s hard to tell how many waves are passing over your head,” Toner said.

Toner said current increases in U.S. cases have less to do with the virus and more to do with people’s behavior.

“The virus isn’t going away and coming back. The virus is still here. It’s up in some places and down in others,” Toner said.

WHAT IS THE FORECAST FOR THE COMING MONTHS?

Vice President Mike Pence last week wrote an opinion piece in the Wall Street Journal trying to ease concerns over a second wave of U.S. cases. White House economic adviser Larry Kudlow said on Monday that a “second wave” is not coming.

Dr. Theo Vos of the University of Washington’s Institute for Health Metrics and Evaluation called those assurances “wishful thinking.”

Based on global models, his group has predicted that the coronavirus will surge in the fall as colder temperatures arrive in the United States.

“It’s likely to start picking up in October,” Vos said, with increased cases hitting in November, December and January.

(Reporting by Julie Steenhuysen; Editing by Peter Henderson and Will Dunham)

No second wave of coronavirus: U.S. White House adviser Kudlow

WASHINGTON (Reuters) – White House economic adviser Larry Kudlow said on Monday there is no second wave of the coronavirus pandemic, even though there are some flare-ups in states such as Florida, and it is unlikely there will be widespread shutdowns across the country.

“There are some hotspots. We’re on it,” Kudlow said in an interview with CNBC. “We know how to deal with this stuff now. It’s come a long way since last winter and there is no second wave coming.”

Cities and states across the country this spring issued restrictive work-from-home and social distancing orders to try to slow the spread of the respiratory infection, keeping shoppers out of stores and driving up lay-offs. Then, as cases and deaths steadied or dropped in some places, some states that eased restrictions began to see a rise in infections, including Arizona and Florida that saw record numbers of new cases, generating fears about another chill to economic activity.

While the U.S. Congress has already passed three massive spending bills to support the economy and fight the novel coronavirus, it is working on another deal with the White House, which Kudlow said could be reached later this summer. The size of the new package, commonly called “Phase Four,” has not been determined and it may include state and local aid, Kudlow said. In general, he said, he would like any relief bill to move toward longer-term economic incentives.

(Reporting by Lisa Lambert and Susan Heavey; Editing by Chizu Nomiyama)

Some scold, others cheerlead: U.S. states tackle reopening differently

By Maria Caspani and Jonathan Allen

NEW YORK (Reuters) – The two most populous U.S. states took markedly different approaches to reopening on Monday with New York scolding local governments for not enforcing social distancing and California encouraging counties to restart economies if they met criteria.

Scenes of merrymakers gathering outside bars prompted the governor of New York, the state hardest hit along with New Jersey by the coronavirus pandemic, to urge local officials and businesses on Monday to strictly enforce reopening guidelines.

“To the local governments I say, ‘Do your job,'” Governor Andrew Cuomo told reporters. Over the weekend he criticized New York City street crowds outside bars and asked people to adhere to six feet (two meters) of distance from others.

Both Cuomo and neighboring New Jersey Governor Phil Murphy said they were keeping open the option of reimposing restrictions if officials fail to stop large public gatherings that risk leading to a second wave of infections.

In California, Governor Gavin Newsom has left it up to individual counties on when to reopen once they meet state guidelines. He reminded county officials of the risks of not restarting economies, as well as reopening them.

Newsom told a news briefing on Monday people could not be “locked away for months and months and months,” especially those among the 5.5 million Americans who have lost their jobs since mid-March. He said some had also lost health coverage and were among the many people suffering severe mental and physical health problems during the pandemic.

In enforcing coronavirus restrictions, he said the state and counties could not “see lives and livelihoods completely destroyed without considering the health impact of those decisions as well.”

“As we mix, as we reopen, inevitably we’re going to see an increase in the total number of cases; it’s our capacity to address that that is so foundational,” said Newsom.

NEW FORECAST

California is one of four states that is projected to see the biggest spike in deaths in the months ahead, according to the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

Its new forecast on Monday forecast over 200,000 deaths due to COVID-19 in the United States through the beginning of October, mainly due to reopening measures underway.

The IHME, whose estimates are cited by many health experts, projected Florida will see its deaths nearly triple to 18,675 deaths from 6,559 on June 10, while California can expect to see deaths increase by 72 percent to 15,155 from 8,812, it said.

Georgia and Arizona also have sharp increases in deaths forecast by the institute.

New York and New Jersey between them account for more than a third of the nearly 116,000 U.S. deaths, but deaths and hospitalizations have been on the decline of late. Both have followed strict health guidelines for reopening businesses when all measures of infection drop – new cases, deaths, hospitalizations and positive rates among those getting tested.

Scott Gottlieb, the former Food and Drug Administration director who has advised the White House on the coronavirus, said on Monday that flare-ups needed to be addressed with aggressive contact tracing and targeted responses.

“We’re not going to be able to shut down the country again this summer. We’re probably not going to be able to shut down the country again this fall,” he said on CNBC.

(Reporting by Doina Chiacu in Washington, Jonathan Allen and Maria Caspani in New York, Lisa Shumaker in Chicago, Andrew Hay in Taos, New Mexico; Writing by Sonya Hepinstall and Andrew Hay; Editing by Howard Goller, Bill Tarrant and Cynthia Osterman)

Fears of second U.S. coronavirus wave rise on worrisome spike in cases, hospitalizations

By Lisa Shumaker, Carl O’Donnell and Michael Erman

(Reuters) – About half a dozen states including Texas and Arizona are grappling with a rising number of coronavirus patients filling hospital beds, fanning concerns that the reopening of the U.S. economy may spark a second wave of infections.

The rally in global stocks came crashing down on Thursday over worries of a pandemic resurgence. The last time the S&P 500 and Dow fell as much in one day was in March, when U.S. coronavirus cases began surging.

A recent spike in cases in about a dozen states partially reflects increased testing. But many of those states are also seeing rising hospitalizations and some are beginning to run short on intensive care unit (ICU) beds.

Texas has seen record hospitalizations for three days in a row, and in North Carolina only 13% of the state’s ICU beds are available due to severe COVID-19 cases. Houston’s mayor said the city was ready to turn its NFL stadium into a make-shift hospital if necessary.

Arizona has seen a record number of hospitalizations at 1,291. The state health director told hospitals this week to activate emergency plans and increase ICU capacity. About three-quarters of the state’s ICU beds are filled, according to the state website.

“You’re really crossing a threshold in Arizona,” said Jared Baeten, an epidemiologist at the University of Washington. “The alarming thing would be if the numbers start to rise in places that have clearly already peaked and are on their downtrend,” he said, referring to New York and other Northeastern states where new cases and deaths have plummeted.

Health experts worry there could be a further rise in infections from nationwide protests over racial injustice and police brutality that packed people together starting two weeks ago.

STATES WITH RISING CASES

Arizona, Utah and New Mexico all posted rises in new cases of 40% or higher for the week ended June 7, compared with the prior seven days, according to a Reuters analysis. New cases rose in Florida, Arkansas, South Carolina and North Carolina by more than 30% in the past week.

Dr. Anthony Fauci, the top U.S. infectious disease official, told Canada’s CBC news that more cases are inevitable as restrictions are lifted.

“We also as a whole have been going down with cases,” Fauci said. “But I think what you mentioned about some states now having an increase in the number of cases makes one pause and be a little bit concerned.”

Even if hospitals are not overwhelmed by coronavirus cases, more hospitalizations mean more deaths in the coming weeks and months, said Spencer Fox, research associate at the University of Texas at Austin.

“We are starting to see very worrying signs about the course the pandemic is taking in cities and states in the U.S. and around the world,” he said. “When you start seeing those signs, you need to act fairly quickly.”

Total U.S. coronavirus deaths are now over 113,000, by far the most in the world. That figure could exceed 200,000 at some point in September, Ashish Jha, the head of Harvard’s Global Health Institute, told CNN.

Jha said the United States was the only major country to reopen without getting its case growth to a controlled level – defined as a rate of people testing positive for the coronavirus remaining at 5% or lower for at least 14 days. Nationally, that figure has been between 4% and 7% in recent weeks, according to a Reuters analysis.

Health officials have stressed that wearing masks in public and keeping physically apart can greatly reduce transmissions, but many states have not required masks.

“I want the reopening to be successful,” Harris County Judge Lina Hidalgo, the top executive for the county that encompasses Houston, told reporters. “But I’m growing increasingly concerned that we may be approaching the precipice of a disaster.”

(Reporting by Michael Erman and Carl O’Donnell in New York and Lisa Shumaker in Chicago; Additional reporting by Lewis Krauskopf in New York and Brad Brooks in Austin, Texas; Writing by Lisa Shumaker; editing by Peter Henderson and Bill Berkrot)

‘This is about livelihoods’: U.S. virus hotspots reopen despite second wave specter

By Andrew Hay

(Reuters) – Facing budget shortfalls and double-digit unemployment, governors of U.S. states that are COVID-19 hotspots on Thursday pressed ahead with economic reopenings that have raised fears of a second wave of infections.

The moves by governors of states such as Florida and Arizona came as Treasury Secretary Steven Mnuchin said the United States could not afford to let the novel coronavirus shut its economy again and global stocks tanked on worries of a pandemic resurgence.

As Florida reported its highest daily tally of new coronavirus cases on Thursday, Governor Ron DeSantis unveiled a plan to restart public schools at “full capacity” in the autumn, arguing the state’s economy depended on it.

North Carolina reported record COVID-19 hospitalizations for a fifth straight day on Thursday, a day after legislators passed a bill to reopen gyms, fitness centers and bars in a state where more than one in ten workers are unemployed.

Governors of hotspot states face pressure to fire up economies facing fiscal year 2021 budget shortfalls of up to 30% below pre-pandemic projections in the case of New Mexico, according to data from the Center on Budget and Policy Priorities think tank. Nevada, which has seen cases increase by nearly a third in the past two weeks, is suffering 28% unemployment, based on U.S Bureau of Labor statistics.

“This is about saving lives, this is also about livelihoods in the state of Arizona,” Governor Doug Ducey told a news briefing, adding that a second shutdown of the economy was “not under discussion” despite official figures showing a 211% rise in virus cases over the past 14 days.

About half a dozen states including Texas and Arizona are grappling with rising numbers of coronavirus patients filling hospital beds.

Ducey and Texas Governor Greg Abbott say their hospitals have the capacity to avoid the experiences of New York, where the system was stretched to near breaking point as some COVID patients were treated in hallways and exhausted workers stacked bodies in refrigerated trailers.

‘FOOT ON THE BRAKE’

A second wave of coronavirus deaths is expected to begin in the United States in September, the Institute for Health Metrics and Evaluation said on Thursday, citing a surge in mobility since April. Its latest model projects 170,000 deaths by Oct. 1, with a possible range between 133,000 and 290,000.

A note of caution came from Utah, where Governor Gary Herbert said most of the state would pause its reopening after a 126% rise in cases over the past two weeks.

Austin, Texas on Thursday also said it would likely extend stay-at-home and mask orders past June 15 after the state reported its highest new case count the previous day. Austin health officials blamed a record week of infections on easing business restrictions and Memorial Day gatherings.

There was no talk of new shutdowns.

In New Mexico, Health Secretary Kathy Kunkel pointed to outbreaks at the Otero County Prison Facility, as well as in nursing homes and assisted living facilities, as factors behind an uptick in cases.

“It means a little bit of a foot on the brake, watch carefully for the next couple of weeks, not much in the way of major changes in what we’re doing,” said Human Services Secretary David Scrase.

(Reporting By Andrew Hay in Taos, New Mexico; Additional reporting by Brad Brooks in Austin and David Schwartz in Phoenix; Editing by Bill Tarrant and Daniel Wallis)