Trump to resume coronavirus briefings after hiatus

By Steve Holland

WASHINGTON (Reuters) – U.S. President Donald Trump, under fire over his administration’s response to the surging coronavirus, said on Monday he will resume holding news briefings on the pandemic after a lengthy hiatus.

He told reporters in the Oval Office the resumption was prompted by a “big flareup in Florida, Texas, a couple of other places.” The virus has killed 140,000 Americans and infected some 3.7 million, both figures leading the world.

White House debate has centered on whether Trump should risk doing daily briefings after he was mocked for musing that people might inject household disinfectants as a way to protect themselves from contracting the virus.

The briefings ended in early May after the new White House of chief staff, Mark Meadows, sought a new focus for the president’s messaging on the subject.

Trump said he expected the first new briefing would take place about 5 p.m. EDT (2100 GMT) on Tuesday.

“We’re going to give you a lot of briefings over the next week and the next few weeks,” he said.

He said he would bring in the heads of some companies involved in the search for vaccines and other treatments for the virus, such as Johnson & Johnson.

(Reporting by Steve Holland; Editing by Howard Goller)

How a vaccine made of mosquito spit could help stop the next epidemic

By Clare Baldwin

(Reuters) – Five years ago, in an office complex with a giant sculpture of a mosquito just northwest of Phnom Penh, Jessica Manning struck on a novel idea. Rather than spend more years in what felt like a futile search for a malaria vaccine, she would take on all mosquito-borne pathogens at once.

Her idea revolved around mosquito spit.

A lab technician Nhek Sreynik works with mosquitoes, at a lab in Kompong Speu Province, in Cambodia, June 11, 2020. REUTERS/Chantha Lach

Building on the work of colleagues and other scientists, Manning, a clinical researcher for the U.S. National Institute of Allergy and Infectious Diseases, believed she could use pieces of mosquito saliva protein to build a universal vaccine.

The vaccine, if it pans out, would protect against all of the pathogens the insects inject into humans – malaria, dengue, chikungunya, Zika, yellow fever, West Nile, Mayaro viruses and anything else that may emerge.

“We need more innovative tools,” said Manning. A vaccine like this would be “the Holy Grail.”

On Thursday, The Lancet published the initial results of this work with her colleagues: the first-ever clinical trial of a mosquito spit vaccine in humans.

The trial showed that an Anopheles mosquito-based vaccine was safe and that it triggered antibody and cellular responses.

Michael McCracken, a researcher not involved in the study, called the initial results “foundational.”

“This is big, important work,” said McCracken, who studies immune responses to mosquito-borne viruses at the Walter Reed Army Institute of Research in Maryland. “Mosquitoes are arguably the deadliest animal on Earth.”

A boy sits in the pediatrics ward at Kampong Speu District Referral Hospital, at the beginning of a dengue, also called ‘breakbone fever’, epidemic in Krong Chbar Mon, Cambodia April 2019. Jessica Manning/Handout

Malaria alone kills more than 400,000 people each year, according to the World Health Organization. Those deaths occur mostly in poor countries that do not receive as much vaccine research and funding. Because of global warming, however, those mosquitoes that thrive in the tropics are moving into more countries each year.

The global disruption of the COVID-19 pandemic has brought a sharp focus to infectious diseases and vaccine research. One of the key areas of concern are pathogens transmitted by mosquitoes.

The novel coronavirus, believed to have originated in bats, has so far infected more than 7.4 million people and killed nearly 420,000 worldwide. The Asian Development Bank estimates the pandemic could cost the global economy as much as $8.8 trillion.

TARGETING THE CARRIER

Manning’s research is specific to mosquitoes but is an example of how scientists are broadening their thinking about how to tackle infectious diseases, and the new types of tools they are developing.

What Manning is looking for is called a vector-based vaccine. A vector is the living organism – like a mosquito – that transmits a pathogen such as malaria – between humans, or from animals to humans.

All existing vaccines for humans target a pathogen. Manning’s goes after the vector.

The idea is to train the body’s immune system to recognize the saliva proteins and mount a response that would weaken or prevent an infection.

Scientists have known for decades that mosquito spit helps establish mosquito-borne infections and enhance their severity. Just recently, scientists have begun to exploit this.

A study of macaque monkeys published in 2015 showed vaccination with sand fly saliva reduced leishmaniasis lesion size and parasite load. A study of mice published in 2018 showed immunization with Anopheles mosquito spit protected against malaria. Another mouse study published last year showed immunization with Aedes mosquito saliva improved survival against the Zika virus.

The study published in The Lancet was conducted in 2017.

The Phase I trial conducted at the National Institutes of Health Clinical Center in Bethesda, Maryland, tested for safety and side effects in 49 healthy volunteers.

Participants were randomly assigned to receive one of two versions of the vaccine or a placebo. After a few weeks, hungry mosquitoes were placed on the arms of study participants. The study measured immune response to the mosquito spit proteins but did not involve pathogens.

More trials are needed to determine the effect the mosquito spit vaccine would have against actual pathogens.

No systemic safety concerns were identified. One participant developed an 8-centimeter (3.15 inches) reddened area around the injection site and was treated with steroids and antihistamines.

“I’m not as worried about redness as I would be about something more systemic like fever, headache, muscle aches, nausea or vomiting,” said Stephen Thomas, an infectious disease expert at SUNY Upstate Medical University who was not involved with the study.

Thomas has previously worked on dengue vaccine programs for the U.S. Department of Defense and helped manage its response to Ebola and the Zika virus.

Another scientist at the University of Maryland is running a follow-up trial with more mosquito spit proteins and a different vaccine formulation.

Meanwhile, Manning has returned to Cambodia and is running a field study to identify vaccine-candidate spit proteins in Aedes mosquitoes. She also has a separate project sequencing the genomes of all pathogens found in Aedes and Culex mosquitoes, some of which can infect humans.

One worrying discovery so far? “They carry a ton of different viruses that we are only just discovering.”

(Reporting by Clare Baldwin; Editing by Elyse Tanouye and Bill Berkrot)

Fears of coronavirus second wave prompt flu push at U.S. pharmacies, drugmakers

By Caroline Humer and Julie Steenhuysen

NEW YORK (Reuters) – U.S. pharmacy chains are preparing a big push for flu vaccinations when the season kicks off in October, hoping to curb tens of thousands of serious cases that could coincide with a second wave of coronavirus infections.

CVS Health Corp, one of the largest U.S. pharmacies, said it is working to ensure it has vaccine doses available for an anticipated surge in customers seeking shots to protect against seasonal influenza.

Rival chain Rite Aid Corp has ordered 40 percent more vaccine doses to meet the expected demand. Walmart Inc and Walgreens Boots Alliance said they also are expecting more Americans to seek these shots.

Drugmakers are ramping up to meet the demand. Australian vaccine maker CSL Ltd’s Seqirus said demand from customers has increased by 10 percent. British-based GlaxoSmithKline said it is ready to increase manufacturing as needed.

A Reuters/Ipsos poll of 4,428 adults conducted May 13-19 found that about 60 percent of U.S. adults plan to get the flu vaccine in the fall. Typically fewer than half of Americans get vaccinated. The U.S. Centers for Disease Control and Prevention (CDC) recommends the vaccine for everyone over age 6 months.

Getting a flu shot does not protect against COVID-19, the respiratory disease caused by the novel coronavirus for which there are no approved vaccines. Public health officials have said vaccination against the flu will be critical to help prevent hospitals from becoming overwhelmed with flu and COVID-19 patients.

“We’re in for a double-barreled assault this fall and winter with flu and COVID. Flu is the one you can do something about,“ Vanderbilt University Medical Center infectious disease expert Dr. William Schaffner said.

Drugmakers last year produced nearly 170 million doses of influenza vaccine, according to the CDC. There were up to 740,000 hospitalizations and 62,000 deaths in the 2019-2020 flu season that ended last month, the CDC said.

While health insurance typically covers the flu shot at a doctor’s office and other groups offer free flu vaccine clinics, the adult vaccine retails for about $40, putting the U.S. market at up to $6.8 billion. The CDC secures some doses at a discount price in its child vaccination program.

Global revenue for influenza vaccines is about $5 billion, according to Wall Street firm Bernstein, and in the United States each additional 1 percentage point of Americans getting the vaccine is worth $75 million in revenues to drugmakers.

HEAVIER TOLL

CDC Director Robert Redfield has said that flu and COVID-19 combined could exact a heavier toll on Americans than the initial coronavirus outbreak that began this winter.

Some experts said creative ways must be developed to ensure that people are vaccinated against flu because patients may be less likely to see their doctors in person out of fear of getting infected with the coronavirus in medical offices.

Pharmacies, public health clinics and other flu shot providers may need to develop drive-up clinics – popular with COVID-19 diagnostic tests – for flu vaccines, said Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Disease.

“My goal is that every single vaccine dose that gets made gets into somebody’s arm to protect them. I don’t want any vaccines left on the shelves or in doctors’ offices,” Messonnier said in an interview.

One reason for reluctance among Americans to get the flu shot is that it does not always prevent disease, in part because the flu strains selected as targets of the vaccine months ahead of time are not always a perfect match for the dominant flu strains that actually circulate in any given season. But the shots reliably reduce hospitalizations every year, according to experts.

“Even if it protects 35 to 40 percent of the population, it’s a lot better than zero,” University of Minnesota influenza expert Dr. Michael Osterholm said.

In a survey commissioned by CVS Health between January and May, consumers who said they will definitely or are likely to get a flu shot rose from 34 percent to 65 percent. They also said they would increasingly go to pharmacies and less often to a doctor’s office or healthcare centers.

Rite Aid Chief Pharmacy Officer Jocelyn Konrad said the pharmacy chain, which provided about 2.6 million flu shots last year, upped its order by 40 percent this year.

Rite Aid said social distancing policies may cut into workplace flu clinics but that it may offer voucher programs to employers and is considering setting up drive-through clinics. In Australia, where the winter flu season is underway, such sites are already in use.

Some U.S. doctors are also considering clinics in parks and community centers and even home visits for vulnerable patients, said David Ross, vice president of commercial operations for North America at Seqirus.

“As we look at immunization this coming fall, it will play an enormous role in this battle against COVID-19,” Ross said.

(Reporting by Caroline Humer in New York and Julie Steenhuysen in Chicago; Additional reporting by Grant Smith in New York; Editing by Michele Gershberg and Will Dunham)

Monkeys infected with COVID-19 develop immunity in studies, a positive sign for vaccines

By Julie Steenhuysen

CHICAGO (Reuters) – Two studies in monkeys published on Wednesday offer some of the first scientific evidence that surviving COVID-19 may result in immunity from reinfection, a positive sign that vaccines under development may succeed, U.S. researchers said on Wednesday.

Although scientists have assumed that antibodies produced in response to the new coronavirus virus are protective, there has been scant scientifically rigorous evidence to back that up.

In one of the new studies, researchers infected nine monkeys with COVID-19, the illness caused by the novel coronavirus. After they recovered, the team exposed them to the virus again and the animals did not get sick.

The findings suggest that they “do develop natural immunity that protects against re-exposure,” said Dr. Dan Barouch, a researcher at the Center for Virology and Vaccine Research at Harvard’s Beth Israel Deaconness Medical Center in Boston, whose studies were published in the journal Science.

“It’s very good news,” Barouch said.

Several research teams have released papers – many of them not reviewed by other scientists – suggesting that a vaccine against the virus would be effective in animals.

In the second study, Barouch and colleagues tested 25 monkeys with six prototype vaccines to see if antibodies produced in response were protective.

They then exposed these monkeys and 10 control animals to SARS-CoV-2, the official name of the novel coronavirus.

All of the control animals showed high degrees of virus in their noses and lungs, but in the vaccinated animals, “we saw a substantial degree of protection,” Barouch said. Eight of the vaccinated animals were completely protected.

These studies, which have been peer reviewed, do not prove that humans develop immunity or how long it might last, but they are reassuring.

“These data will be seen as a welcome scientific advance,” Barouch said.

(Reporting by Julie Steenhuysen; Editing by Bill Berkrot)

T cells play a role in fighting coronavirus; COVID-19 affects children differently

By Nancy Lapid

NEW YORK (Reuters) – The following is a brief roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Immune system’s T cells play a role in attacking the coronavirus

While the immune system’s B cells make antibodies that block the novel coronavirus, its T cells provide another line of attack, according to new research. Researchers found that T cells from recovered patients can target the virus. That is promising news for vaccine developers because it is “consistent with normal, good, antiviral immunity,” Shane Crotty, from the Center for Infectious Disease and Vaccine Research at the La Jolla Institute for Immunology in California, told Reuters. “The types of immune responses targeted by many candidate vaccines are now shown to be the types of immune responses seen in COVID-19 cases that successfully recovered from the disease.” Furthermore, some people who never had COVID-19 nonetheless had T cells that could attack the virus, Crotty’s team reported on Thursday in the journal Cell. This suggests that past exposure to other coronaviruses (such as those that cause the common cold) had somehow primed their T cells to recognize and attack this new coronavirus. That might influence their susceptibility to COVID-19 disease, he said, either preventing them from getting infected or from developing severe disease.

Coronavirus affects adults and children differently

Children appear to have much lower rates of infection with the new coronavirus than adults, but most reports on COVID-19 in youngsters have focused only on small groups. A team of Chinese researchers has analyzed data from 24 earlier studies involving a total of nearly 2,600 children with COVID-19, enabling them to shed light on ways in which the virus acts differently in pediatric patients. They reported on Sunday in the Journal of Medical Virology that the most common laboratory test abnormality observed in adults was a low level of immune cells called lymphocytes (B cells and T cells). This condition, known as lymphopenia, developed in up to 80% of adults but in less than 10% of children. On the other hand, children – particularly infants – were more likely to have elevated levels of cardiac enzymes that indicate heart injury. They also found additional differences. The rates of severe illness and critical illness in adults were 14% and 5%, respectively (according to earlier reports). That compared with 4.4% and 0.9% in children. Fever occurred in up to 99% of adults but in 43% of children; cough in up to 82% of adults but 43% of children. Shortness of breath and acute respiratory distress syndrome (ARDS) were rare in children, but digestive tract symptoms like diarrhea were more common in kids than in grownups.

Coronavirus can infect patients taking hydroxychloroquine

Taking hydroxychloroquine for other medical conditions might not protect against the new coronavirus, French doctors say. The drug had nearly become a standard of care for patients with COVID-19 in many hospitals, even though randomized trials have not yet confirmed its value. But people around the world use decades-old hydroxychloroquine to treat malaria as well as inflammatory conditions like lupus and rheumatoid arthritis, and researchers are seeing occasional cases of coronavirus infection in these patients despite long-term use of the drug. A report on Sunday in the Journal of Antimicrobial Chemotherapy describes two such patients, one with rheumatoid arthritis and the other with a condition called mixed connectivitis. The authors say they also know of at least three other patients in Italy who became sick with COVID-19 despite taking hydroxychloroquine for chronic arthritis. “Patients actually taking long-term hydroxychloroquine are potentially immunosuppressed patients since they are living with chronic inflammatory diseases and thus do not represent the general population exposed to COVID-19,” the French doctors acknowledge. “However, these observational data are not in favor of a universal protective effect of hydroxychloroquine.”

New barcoding technique can help process 100,000 screening tests per day

A big challenge in preventing the spread of the new coronavirus is to identify and quarantine infected people who do not have symptoms. Laboratory workers can test blood samples from thousands of patients per day, still not enough to efficiently screen heavily populated areas. Now researchers at the OSU James Comprehensive Cancer Center in Columbus, Ohio say they have a way to screen over 100,000 samples per day. Their system, dubbed REMBRANDT, makes copies of the virus and introduces two barcodes that simplify patient identification. Barcoding of samples for screening is not new, but the OSU method takes a unique biochemical approach, aiming for a single barcoding and virus-copying step. “Barcodes on products in the supermarket and molecular barcodes for REMBRANDT work the same way,” investigator Richard Fishel told Reuters. “In this case, each patient has a unique combination of letters that allows for their simplified identification. With ten Next Generation sequencing machines, REMBRANDT can test every Ohio resident for COVID-19 infection every 10 days – an important step in contact tracing and reducing the spread of infection.” His team’s report, published on Sunday on the preprint server bioRxiv, has not yet been peer reviewed. “Our next step,” Fishel said, “will be to collaborate with hospitals and public health departments to clinically validate REMBRANDT and make it available to a wider audience.”

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

Trump signs $8.3 billion spending bill to boost coronavirus response

WASHINGTON (Reuters) – U.S. President Donald Trump on Friday signed an emergency spending bill for $8.3 billion to ramp up the nation’s response to the coronavirus, providing funds for state and local officials to combat the spread of infections as the number of cases grows in the United States.

The funding measure includes over $3 billion for research and development of vaccines, test kits and medical treatments, $2.2 billion to aid public health activities on prevention, preparedness and response, and $1.25 billion to help international efforts aimed at reining in the virus.

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

U.S. Senate nears passage of $8.3 billion coronavirus funding as concerns mount

By Richard Cowan and David Morgan

WASHINGTON (Reuters) – The U.S. Senate on Thursday was poised to pass an $8.3 billion bill aimed at controlling the spread of the coronavirus and help develop vaccines, as some of the Trump administration’s top health officials briefed members of the House of Representatives on the crisis.

A Senate vote would follow House passage of the legislation on Wednesday, 415-2.

Senate Majority Leader Mitch McConnell, a Republican, said of the emergency funding bill, “It’s a serious agreement to meet a serious challenge and today we will send it to President Trump’s desk.”

Trump is expected to sign the bill into law upon final approval by Congress.

Action by Congress comes as U.S. deaths related to coronavirus infections rose to 11 on Wednesday and new cases were identified on both coasts – around New York City and Los Angeles.

The money to fight coronavirus includes over $3 billion for research and development of vaccines, test kits and medical treatments. Another $2.2 billion would aid public health activities on prevention, preparedness and response to outbreaks.

Washington would dedicate $1.25 billion in coming weeks and months to help international efforts aimed at reining in the virus, which was first detected late last year in China and has since spread around the globe.

Thursday’s briefing by U.S. health officials in the Capitol came a day after Vice President Mike Pence held separate meetings with House Democrats and Republicans to discuss plans for responding to any coronavirus outbreak.

Health and Human Services Secretary Alex Azar and Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, were among those taking questions from House members on Thursday.

Representative Rosa DeLauro, who chairs a House panel that oversees federal spending on health programs, said she did not get satisfactory answers from officials about access to testing and diagnostics and how to help people who do not get paid sick days through their jobs or who have no health insurance.

Republican Representative Tom Cole, however, gave an upbeat assessment. “We’re still behind the curve there, but the sense is we’ll be moving pretty quickly and able to catch up.” He was referring to the growing number of tests that will be manufactured and could total around 1 million by next week.

The funding bill moving through Congress also would provide for low-interest federal loans to businesses affected by a coronavirus outbreak.

(Reporting by Richard Cowan, David Morgan and Lisa Lambert; Editing by Dan Grebler)

U.S. lawmakers hit snag over vaccine costs in bill to battle coronavirus

By Richard Cowan

WASHINGTON (Reuters) – The U.S. Congress and President Donald Trump neared agreement on Tuesday on legislation to battle the spreading coronavirus with as much as $9 billion, but a dispute over the cost of vaccines held up a deal, Senate Democratic Leader Chuck Schumer said.

Leaders in the House of Representatives and Senate hoped to resolve the dispute and approve the emergency legislation by the end of this week.

A source close to the negotiations, who asked not to be identified, said that two issues must first be resolved: Democrats insist that the spending bill contain language stating that any coronavirus vaccine be priced at a “fair and reasonable” level. Democrats also want the government to help pay for vaccines to help those who might not be able to afford them.

Republican aides were not immediately available for comment.

Trump said the measure would appropriate about $8.5 billion – far above the $2.5 billion he initially requested last month. And House Majority Leader Steny Hoyer, noting that the measure was still being written in Congress, said it could inject “$8 or $9 billion” into the U.S. economy.

Depending on when Republicans and Democrats settle their dispute, the bill could be debated by the full House on Wednesday or Thursday. Once passed by the House, the Senate is expected to attempt to act promptly.

The legislation is one part of a multipronged approach emerging from Washington following multiple deaths in Washington state this week from illnesses caused by the highly contagious coronavirus.

Earlier on Tuesday the Federal Reserve cut interest rates by a half percentage point to a target range of 1.00% to 1.25% in an attempt to cushion the economy against the impact of the virus, which could slow consumer spending and disrupt business activities.

U.S. health officials have been ramping up the government’s ability to do more testing of patients suspected of having been infected by the new coronavirus, which was first detected in China late last year.

There also are efforts by pharmaceutical companies and Washington to speed the development of a vaccine for the coronavirus.

While details were still not available, the House’s emergency spending could contain money to help state and local governments respond to local health emergencies and possibly provide interest-free loans for small businesses affected by an outbreak, Democratic lawmakers said.

On Wednesday, the top four leaders of the House and Senate are scheduled to be briefed by Capitol officials on responses to the coronavirus and the possible impact on day-to-day operations of Congress.

A senior House Democratic aide said there have been no discussions of limiting tourism in the Capitol complex or shutting public galleries for viewing House and Senate debates.

Last Friday, House lawmakers were advised to develop alternative work arrangements for aides if the virus becomes widespread.

(Reporting by Richard Cowan, David Morgan, Jeff Mason and Lisa Lambert; Editing by Chizu Nomiyama and Jonathan Oatis)

U.S. measles cases in 2019 highest since 1992

FILE PHOTO: Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia September 30, 2014. REUTERS/Tami Chappell/File Photo/File Photo

By Alex Dobuzinskis

(Reuters) – The United States recorded 971 cases of measles in the first five months of 2019, surpassing the total for any year since 1992, which was before the disease was declared eradicated in the country, federal officials said on Thursday.

The United States declared measles eradicated from the country in 2000, but officials with the U.S. Centers for Disease Control and Prevention warned on Thursday that the country risks losing its measles elimination status.

There were a total of 2,126 U.S. cases of measles in 1992, the CDC said in a statement.

The disease has spread mostly among school-age children whose parents declined to get them vaccinated.

Public health officials blame the resurgence on the spread of misinformation about vaccines. A vocal fringe of parents opposes vaccines, believing, contrary to scientific studies, that ingredients in them can cause autism.

“Measles is preventable and the way to end this outbreak is to ensure that all children and adults who can get vaccinated, do get vaccinated,” CDC Director Robert Redfield said in a statement.

“Again, I want to reassure parents that vaccines are safe, they do not cause autism,” Redfield said.

When measles was declared eradicated in the United States in 2000, it meant the virus was no longer continually present year-round although outbreaks have still happened via travelers coming from countries where measles is common.

Communities in New York City’s Brooklyn borough and Rockland County, an area of New York state about 30 miles (50 km) north of Manhattan, are dealing with measles outbreaks that have lasted nearly eight months.

Other measles cases have occurred in Oklahoma and Washington state.

Decades ago, before widespread use of the measles vaccine, about 3 million to 4 million people a year became sick with the disease in the United States with 400 to 500 deaths a year.

(Reporting by Rama Venkat in Bengaluru; Editing by Richard Chang and Diane Craft)

U.S. measles outbreak grows with 60 new measles cases across 26 states

FILE PHOTO: Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia September 30, 2014. REUTERS/Tami Chappell/File Photo/File Photo

(Reuters) – The United States recorded 60 new measles cases last week, taking confirmed cases for the year to 940, the worst outbreak since 1994 and since measles was declared eliminated in 2000, federal health officials said on Monday.

The U.S. Centers for Disease Control and Prevention reported a 6.8% increase in the number of measles cases in the week ended May 24 in an outbreak that has now reached 26 states. The agency has been providing weekly updates every Monday.

Experts warn that the outbreak is not over as the number of cases edges closer to the 1994 total of 958. That was the highest number since 1992, when the CDC recorded 2,126 cases.

Public health officials have blamed the measles resurgence on the spread of misinformation about vaccines, as a vocal fringe of parents oppose vaccines, believing, contrary to scientific studies, that ingredients in them can cause autism.

Although the virus was eliminated from the United States in 2000, meaning the disease was no longer a constant presence, outbreaks still happen via travelers coming from countries where measles is still common, according to the U.S. Centers for Disease Control and Prevention.

(Reporting by Shubham Kalia and Saumya Sibi Joseph in Bengaluru; Editing by Phil Berlowitz)