Updates on the respiratory illness that has infected more than two million people and killed more than 150,000.
21 April 15:30 BST — Coronavirus brings forward Mars plans
The Arab world’s first Mars mission — a spacecraft called Hope — will ship from the United Arab Emirates (UAE) to Japan weeks earlier than planned, as a result of travel restrictions imposed by the COVID-19 pandemic.
Accelerating the shipment will mean that the probe, which will orbit the red planet and study the Martian atmosphere, will miss out on some planned tests. “We had to expedite activities in Dubai and basically focus only on the critical testing,” project leader Omran Sharaf told a virtual meeting of the Mars Exploration Program Analysis Group, a NASA-led international forum for planning Mars activities, on 17 April. “It got too risky for us if we waited,” he said.
Built by UAE and US engineers, the orbiter is scheduled to launch from Tanegashima Space Centre in Japan in a launch window that starts on 15 July, in which Earth and Mars are suitably aligned. The craft should reach orbit in 2021.
Hope was scheduled to ship by cargo plane to Japan in early May. But mission leaders brought the date forward to 20 April, to account for a 14-day quarantine imposed on all travellers entering the country. The team who travel with the probe will be quarantined for 14 days when they reach Japan, but moving the spacecraft early allows them to arrive at the launch site in time to prepare for launch.
A team that will receive the craft in Japan has already travelled the nation and been in quarantine.
The mission team has also had to navigate new restrictions on travel worldwide, including getting approval to fly at all, said Sharaf. The UAE’s airspace and airports are closed, and Japan has enhanced its visa requirements.
Last month, the European Space Agency and the Russian space agency Roscosmos delayed launch of their major rover ExoMars for two years, citing travel restriction imposed by the coronavirus pandemic as one reason.
17 April 16:00 BST — Wuhan death toll jumps by 50%
China’s death toll from the coronavirus has jumped sharply, after the city of Wuhan, where the virus emerged last year, added another 1,300 fatalities to its official count. The revision raises the death toll in the 11-million-person city by 50% to 3,869, and brings the China’s overall death toll to more than 4,600.
Deaths from the coronavirus are difficult to count in the absence of widespread testing. Chinese officials said the reasons for the revision included the addition of deaths of people at home and at medical institutions that weren’t reporting data to its epidemic network.
15 April 15:00 BST — Infections pass two million
The number of reported COVID-19 cases worldwide has passed two million, according to data compiled by researchers at Johns Hopkins University in Baltimore, Maryland. The milestone comes just two weeks after one million infections were recorded. The United States has the most cases — more than 600,000 — followed by Spain and Italy.
The death toll from the disease has also surged past 128,000 worldwide. Some 24,000 people have died in the United States, with more than 20,000 deaths in Italy.
The pandemic has spread to almost every region of the globe, with only about a dozen of the World Health Organization’s member states not yet reporting cases. The majority of these are small island nations in the Pacific Ocean, including Vanuatu, Tuvalu and Palau.
15 April 02:00 BST — Trump suspends World Health Organization funding
US President Donald Trump said on 14 April that he would halt the country’s funding for the World Health Organization (WHO), pending a review of how the organization has handled the coronavirus pandemic.
The president accused the WHO of mismanaging the outbreak and “covering up the spread” of COVID-19 in a White House press briefing on Tuesday evening. The announcement comes amid criticism of the Trump administration’s own handling of the outbreak, which has now claimed more than 26,000 lives in the United States.
But the WHO warned on 23 January that the coronavirus would be exported from China. And on 30 January, the organization called the coronavirus outbreak a public health emergency of international concern — its highest alert level.
The United States has contributed more than US$800 million to the WHO over the past two years, making it the largest contributor to the organization’s roughly $2.8-billion annual budget.
14 April 17:00 BST — Mathematician John Conway dies of COVID-19
Renowned British-born mathematician John Conway died aged 82 on 11 April, reportedly of complications arising from COVID-19.
Conway attained a legendary status among maths and science enthusiasts, mostly by designing mathematical games and puzzles. But his work transcended the boundary between recreational and ‘serious’ maths, turning play into research and vice versa. “He’s been known to carry on his person a few decks of cards, dice, ropes, pennies, coat hangers, sometimes a Slinky, maybe a miniature bicycle, all props he deploys to extend his winning imagination,” wrote biographer Siobhan Roberts in 2015.
His celebrity status was cemented by Martin Gardner’s popular maths column in the magazine Scientific American, which featured many of Conway’s contributions, beginning in 1970 with his Game of Life, a minimalistic 2D model universe in which ‘organisms’ grow and multiply on the basis of simple rules.
Conway had taught at Princeton University in New Jersey since 1987, and his research spanned several fields of mathematics. In algebra, he studied the ‘monster group’, an object that has an enormous — but not infinite — number of symmetries. With the late British mathematician Simon Norton, he formulated the ‘monstrous moonshine’ conjectures, linking the monster group to an entirely different subject in mathematical analysis.
Conway is also remembered for his work on the foundations of quantum mechanics. He investigated the idea of an experimenter’s free will and suggested that “if experimenters have free will, then so do elementary particles”.
9 April 22:30 BST — United Kingdom launches massive coronavirus diagnostic network
The UK government opened its first mass coronavirus-testing facility on 9 April.
The lab, in Milton Keynes, is the first of three such facilities to open. The others — in Glasgow and Alderley Park in Nether Alderley — are scheduled to open within the next two weeks. In March, the UK government requisitioned polymerase chain reaction machines from university labs across the country in order to outfit these central testing facilities.
The labs — which the government says make up the largest diagnostic network in UK history — will prioritize processing samples from health-care providers who are currently self-isolating, in order to allow them to return to work. The Milton Keynes facility can currently process thousands of tests per day, but is continuing to ramp up its capacity through the use of robotics.
The government hopes to be able to analyse 100,000 coronavirus tests daily by the end of the month, health secretary Matt Hancock reiterated on 9 April. Fewer than 300,000 tests have been carried out in the country so far, according to official reports.
Universities across the United Kingdom and around the world are also running COVID-19 diagnostic tests, as Nature previously reported. But these efforts in the United States have been hampered by bureaucratic and logistical barriers, and a lack of a cohesive national strategy.
8 April 22:00 BST — CERN scientists join the COVID-19 fight
More than 100 researchers and staff members at CERN are finding innovative ways to combat the coronavirus pandemic.
Scientists, engineers and technicians at the world’s largest particle-physics laboratory, near Geneva, Switzerland, are teaming up to fill crucial gaps in the local and international responses to the outbreak — from manufacturing and distributing large quantities of hand sanitizer to designing an open-source ventilator.
One of CERN’s strengths is its ability to connect people across a wide range of expertise and locations, says Beniamino Di Girolamo, a CERN particle physicist and the chair of the CERN Against COVID-19 task force. The group is working closely with local agencies, biomedical experts and the World Health Organization to ensure that CERN’s resources are being put to best use and that its designs are safe for patients.How the coronavirus pandemic is affecting the world’s biggest physics experiments
One of its main projects so far is the design of the High Energy Physics Community Ventilator, HEV. Because the researchers and technicians who work on CERN’s Large Hadron Collider have extensive experience in managing gas flows and control systems, Di Girolamo says, they were well-positioned to take on this project. The team posted its ventilator designs on the arXiv preprint server on 1 April and is currently soliciting feedback on a prototype from several medical professionals. The design should be ready for production “in a month, maximum”, says Di Girolamo.
CERN staff are also manufacturing 3D-printed masks and face shields, and making hand sanitizer for local emergency-response departments. The centre is offering high-performance computing resources to epidemiologists and virologists searching for a COVID-19 vaccine. And some staff are distributing necessities to elderly and otherwise at-risk community members.
Going forward, Di Girolamo says, the task force plans to continue to source ideas from CERN staff, as well as taking requests from community partners in need of its expertise.
“We cannot just lock down,” Di Girolamo says. “There is a lot of energy at CERN. There are a lot of people who can help.”
8 April 16:00 BST — Tracking-app data suggest loss of smell is a key COVID-19 symptom
The loss of sense of smell and taste should be considered a symptom of COVID-19, suggest the first results from a UK-based symptom-tracking app. There have been many anecdotal reports of the phenomenon in relation to COVID-19, but loss of smell — known scientifically as anosmia — is not currently listed as a symptom of the coronavirus by the World Health Organization (WHO).
The COVID Symptom Tracker smartphone app, which has recruited more than 1.5 million people in the United Kingdom, asks users to record health information on a daily basis, including their temperature, any tiredness and other potential symptoms of coronavirus infection. An analysis of data collected between 24 and 29 March found that users who tested positive for COVID-19 were three times more likely to report losing their sense of smell and taste than were those who had symptoms of the virus but tested negative. Other common symptoms experienced by people who tested positive for COVID-19 were fever, persistent cough, fatigue, diarrhoea, abdominal pain and loss of appetite.
“This is an important study because it is the first to demonstrate scientifically and in a large population sample that loss of smell is a characteristic feature of COVID,” said Trish Greenhalgh, a primary-care health scientist at the University of Oxford, UK, in a statement to the Science Media Centre in London.
The analysis, which was published on the preprint server medRxiv on 7 April, looked at responses from app users who were tested for the virus, which in the United Kingdom is usually done only in hospitals. Of the 579 who tested positive for COVID-19, 59% reported losing their sense of smell, compared with 18% of the 1,123 who tested negative. Updated but as-yet unpublished figures from the same group show a similar trend (see ‘Tracking symptoms’). The study’s authors say that people experiencing loss of smell should self-isolate.
The team behind the app, at King’s College London and health-care start-up ZOE Global in London, also used the data to estimate the prevalence of COVID-19 among people who have not yet been tested. In an unpublished analysis described on their website, the researchers estimated that on 1 April, 4.9% of all users — around 80,000 individuals in the United Kingdom — are likely to have had the virus.
By taking into account the location, age and gender of their users, and extrapolating their sample to the whole population, the researchers estimated that 1.9 million people in the United Kingdom aged between 20 and 69 had symptomatic COVID-19 on this date. The latest data suggest that by 5 April, this figure might have fallen to 1.4 million, which they say indicates that social-distancing measures implemented in the nation are slowing the spread of the virus.
Efforts are under way to roll out a similar app in the United States.
8 April 07:00 BST — Modelling reveals the worst-case scenario that Australia has avoided
Australia’s health-care system has averted disaster and is in a good position to cope with the projected rise in COVID-19 cases, thanks to measures introduced there, say researchers whose models have informed the government’s response. Some of these models, presented to the government in early February, were released on 7 April by the Peter Doherty Institute for Infection and Immunity and the University of Melbourne.
The theoretical models, which have not been peer reviewed and are based on information on outbreaks outside Australia, suggest that without measures to mitigate the virus’s spread, hospitals would have been overwhelmed. This scenario would have seen a peak daily demand for 35,000 intensive care unit (ICU) beds by around May, according to government figures.
The figures suggested that social distancing, isolation and quarantine would reduce that peak daily demand to less than 5,000 beds. Australia currently has some 2,200 ICU beds, but plans to increase that to 7000.
Australia restricted entry to the country for travellers from mainland China on 1 February. Health officials have conducted more than 304,000 coronavirus tests, and have introduced contact tracing, quarantining and isolation, as well as broader physical-distancing measures, such as closing businesses and restricting gatherings.
“Australia has acted sufficiently early based in part on the work that we provided,” said James McCaw, an infectious-diseases epidemiologist at the University of Melbourne who contributed to the models, at an online press conference.
Australia currently has more than 6,000 confirmed cases, with 50 deaths. The daily count of new confirmed cases has declined to around 100, from a high of more than 500. “It looks like the curve is flattening, and flattening strongly,” said McCaw. “But our population is still largely susceptible. And so if we relaxed and went back to normal, we would see a rapid and explosive resurgence in epidemic activity.”
The authors conclude that social distancing needs to be part of ongoing efforts to isolate infected people and quarantine contacts to ensure that hospitals can cope, although they did not look at the effects of specific measures.
“We’re really in a very lucky position where we can think about the next steps and the very challenging questions ahead, but from a position of relative calm as opposed to crisis,” said McCaw.
Scientists welcomed the government’s decision to share the modelling that has informed its COVID-19 response. The move will allow experts to analyse the model and make recommendations, says Mikhail Prokopenko, a complex-systems researcher at the University of Sydney. At the moment, the model does not include detailed predictions of what might actually occur in Australia, which would be useful.
Australia’s proactive response and strong health system has put it in a position to control the virus — a privilege that not many countries can afford, said Jodie McVernon, an epidemiologist at the Doherty Institute, who led the modelling study.
The researchers will now refine their models with data on the emerging outbreak in Australia to assess the effectiveness of individual measures.
7 April 21:00 BST — No new reported COVID-19 deaths in China
For the first time since January, Chinese health officials reported no new deaths from COVID-19 on 6 April.
According to the Chinese National Health Commission, there were 32 new confirmed cases and 12 new suspected cases in the country yesterday. All were imported into the country from elsewhere. There are also 1,033 people with the infection but no symptoms who are under medical observation.‘We need to be alert’: Scientists fear second coronavirus wave as China’s lockdowns ease
Scientists and public-health officials are keeping a close eye on the situation in China as lockdowns begin to lift in response to the slowing of the outbreak there.
Since the outbreak began in December, there have been more than 80,000 reported cases in China, including over 3,300 deaths — the majority of which occurred in Wuhan, where the pandemic originated. The restrictions on movement into and out of Wuhan are lifting on 8 April.
6 April 20:50 BST — HIV researcher among scientists who have died of COVID-19
Gita Ramjee, a world-renowned HIV researcher, died of COVID-19 last week. She was 63.
Ramjee, who was based in South Africa, was known for her tireless work developing HIV-prevention tools such as vaginal microbicides, drugs designed to help stop the transmission of the virus to women. She ran many trials in South Africa — which has the world’s largest number of people with HIV — and often focused on at-risk populations such as sex workers.
Ramjee was the chief scientific officer at the Johannesburg-based Aurum Institute, a health-care non-profit organization aimed at eradicating HIV and tuberculosis. Scientists who worked with her praised her tenacity, passion and ability to connect with the communities in which she worked.
After completing her PhD in paediatric kidney diseases at what is now the University of KwaZulu-Natal in Durban, South Africa, Ramjee joined the country’s Medical Research Council. It was there that she found her calling as an HIV researcher with a focus on microbicides.
Ramjee had a “natural talent” for clinical-trial work, says Salim Abdool Karim, an epidemiologist at the Centre for the AIDS Programme of Research in South Africa (CAPRISA) in Durban.
Such work is by nature often difficult and thankless, says Abdool Karim. But despite a series of underwhelming trial outcomes in the field and in her own work, he says, Ramjee never hesitated to dive into the next study. “It takes a particular kind of person to persist despite a string of negative results. And she was one of those.”
Ramjee was also an active advocate for women, says Quarraisha Abdool Karim, another CAPRISA epidemiologist.
“Gita was a unique investigator who understood that clinical trials are not just about clinics and laboratories and products, but fundamentally about people,” says Mitchell Warren, the executive director of AVAC, previously known as the AIDS Vaccine Advocacy Coalition, in New York City. “These were not trials about products. These were trials about women’s lives.”
Several other renowned scientists have also died from COVID-19 in recent weeks. Among them are John Murray, a pioneering tuberculosis clinical researcher at the University of California, San Francisco; James Goodrich, a paediatric neurosurgeon at Einstein College of Medicine in New York City, known for separating conjoined twins; and molecular biologist Michael Wakelam, the director of the Babraham Institute in Cambridge, UK.
Ramjee’s colleagues note the cruelty of losing her to the COVID-19 pandemic when she devoted so much of her life to eradicating another global outbreak. But, Warren notes, researchers tackling COVID-19 would do well to follow the example that Ramjee set. “We mourn. And then we do what Gita would do.”
2 April 21:00 BST — COVID-19 cases cross the one-million mark
More than one million cases of COVID-19 have been confirmed as of 2 April, according to data compiled by researchers at Johns Hopkins University in Baltimore, Maryland. But in much of the world, people exhibiting mild or no symptoms are unable to get tested, meaning that the true number of cases could be much higher.
The outbreak, which started in Wuhan in Hubei province, China, in early December, has now spread to 181 countries and regions. China was relatively successful in containing its outbreak to Hubei. But the virus has spread rapidly between and within other countries. China accounted for almost 80% of the first 100,000 patients identified, but the United States now contains more cases than any other country, with more than 20% of the world’s total.
The pandemic has resulted in a reported 51,485 deaths around the globe, and more than 209,000 people have been identified as having recovered from the disease.
2 April 00:00 BST — COVID-19 delays COP26
International climate talks scheduled for November in Glasgow, UK, have been postponed until 2021 as a result of the ongoing coronavirus crisis, United Nations officials announced on 1 April.
The climate meeting, known as COP26 — the 26th annual conference of the parties to the UN Framework Convention on Climate Change — was to be the most important set of talks since the signing of the Paris climate agreement in 2015. So far, international commitments to reduce carbon emissions have fallen well short of what would be needed to prevent temperature increases of more than 1.5–2 °C above preindustrial levels, the stated goal of the Paris agreement. Countries were expected to update and strengthen their commitments at the Glasgow meeting.Climate vs coronavirus: Why massive stimulus plans could represent missed opportunities
UN climate-change executive secretary Patricia Espinosa called COVID-19 the most urgent threat currently facing humanity, but stressed that climate change remains the biggest long-term danger. As the coronavirus threat recedes, she said, nations must look for ways to bolster their climate efforts. “This is a chance” Espinosa said “to shape the twenty-first-century economy in ways that are clean, green, healthy, just, safe and more resilient.”
The announcement followed a decision to delay a preparatory meeting, originally scheduled for June in Bonn, Germany, until October.
1 April 03:00 BST — Nearly 80% of US intensive-care patients have underlying conditions
More than three-quarters of people with COVID-19 in intensive-care units in the United States have at least one ‘underlying condition’ — a chronic health problem, such as diabetes or heart disease, that has been shown to contribute to hospitalization and severe illness.
The finding comes from the 31 March Morbidity and Mortality Weekly Report, published by the US Centers for Disease Control and Prevention. A study found that of about 7,000 people with COVID-19 for whom information about chronic conditions had been reported, just over one-third had an underlying condition. People with such conditions made up 71% of those hospitalized for COVID-19 and 78% of those who required intensive care.
Data from China and Italy have also shown that underlying conditions correlate with more severe COVID-19 outcomes, but this is the first such study in the United States. As of last week, the United States has more confirmed cases than any other country.
31 March 16:30 BST — Thousands of Italians take part in citizen-science project
Images and videos of locked-down Italians singing on their balconies to applaud health-care workers have circulated the world. But last week, thousands of citizens were out for another cause: science. For three evenings, on 23–25 March, 6,000 Italians appeared on their balconies to take part in a citizen-science experiment that has never attempted before — measuring light pollution with their smartphones.
The project, called Science on the Balcony and run by the Italian National Research Council, asked participants to turn off all the lights in their homes and launch an app designed for the study. Then they were asked to turn their phone screens towards the main light source that could be seen from their windows — for example, a street light or a sign. Using the phone’s sensors, the app measured the light source’s illuminance, or brightness, in units of lux.
The study was conceived by Luca Perri, an astrophysicist and science communicator at the Astronomical Observatory of Milan, and Alessandro Farini, a vision scientist at Italy’s National Institute of Optics in Florence. Like many nations, Italy has seen a steady increase in night-time light in recent decades. Such light pollution compromises astronomers’ view of space and presents environmental, economic, safety and public-health problems; it can, for instance, affect the immune system.How the coronavirus pandemic is affecting the world’s biggest physics experiments
But widespread data collection on light pollution requires a significant investment of time and money, and might need researchers to visit homes or place sensors there. And satellites detect only light reflected skywards, so they don’t give a full picture. The latest project allowed researchers to measure light inside homes, harnessing the collaboration and enthusiasm of locked-down citizens. Initial data confirm that people in every Italian province participated.
And Farini sees another advantage for science. “This pandemic risks creating doubts about science, because a lot of fake news is circulating,” he says. “With this experiment, we wanted to bring citizens closer to measurement techniques, to let them see the often complex process and allow them to participate in the scientific method.”
31 March 03:00 BST — Lockdowns might already have averted tens of thousands of deaths in Europe
Infection-control measures such as national lockdowns in many European countries are reducing the spread of the coronavirus. Across 11 countries, between 21,000 and 120,000 deaths were probably avoided by the end of March, according to a model by a group at Imperial College London.
The study, published by the Imperial College COVID-19 Response Team on 30 March, estimates the effects of non-pharmaceutical interventions, which include closing schools and banning mass gatherings, on the spread of the virus across parts of Europe, including Italy, Spain and the United Kingdom. The authors measured the effects through a change in the virus’s effective reproduction number.
If the effective reproduction number is greater than 1, infections will proliferate and the outbreak will continue to spread. If it is less than 1, the rate of new infections will decrease until the outbreak is under control. The report shows that some of the countries studied — including Italy, which implemented stringent lockdown measures three weeks ago — might have fallen below this threshold as a result of the interventions. Previous work by other groups has found that the strict lockdowns in China reduced this value to below 1, stemming the tide of the epidemic there.‘We need to be alert’: Scientists fear second coronavirus wave as China’s lockdowns ease
Because many countries still lack the capacity for widespread testing, the latest model uses reported COVID-19 deaths, rather than infection rates, to track the spread of the virus. Given the lag time between infection and mortality, it could take several weeks for the full effects of the interventions to be felt, especially in countries in the relatively early stages of their epidemics, such as the United Kingdom, according to the report.
The researchers are careful to note that they cannot attribute the transmission reduction to any particular intervention. And it’s too early to know whether the interventions as a whole are having the intended effect in some European countries. But, “if current trends continue, there is reason for optimism”, they write.
27 March 15:00 GMT — Virus could have killed 40 million without global response
The COVID-19 pandemic could have infected 90% of the world’s population and killed 40.6 million people if no mitigation measures had been put in place to combat it, according to estimates from an influential modelling group at Imperial College London.
The report from the Imperial College COVID-19 Response Team, published on 26 March, highlights the importance of acting early to suppress the outbreak. The analysis says that introducing social distancing, testing and isolation of infected people would cut worldwide deaths to 1.9 million, if carried out when each country’s fatality rate was 0.2 deaths per 100,000 people per week. Implementing these measures only when the death rate reaches 1.6 per 100,000 people per week would lead to 10.5 million lives lost globally, it finds. According to Nature’s analysis of death rates from Our World in Data — counting each day at the centre of a rolling weekly window of deaths — Italy hit the 0.2 threshold on 2–3 March, the United Kingdom on 17 March and the United States on 22 March.
The report did not quantify the social and economic impact of mitigation policies.
The analysis was published as the UK Prime Minister Boris Johnson and the nation’s health minister, Matt Hancock, announced that they had tested positive for the coronavirus. In a video address to the nation, Johnson said he had only mild symptoms and would continue to work remotely while isolating for seven days.
27 March 03:00 GMT — Global infections number half a million
The number of confirmed COVID-19 cases around the world crossed 500,000 on 26 March, according to statistics compiled by the Center for Systems Science and Engineering at Johns Hopkins University in Baltimore, Maryland. The pandemic currently spans 175 countries and every inhabited continent.
By the end of the day on 26 March, the United States had overtaken China for the highest number of confirmed cases. Italy is also poised to surpass China in the coming days. Italy and Spain now have the two highest death tolls, with Italy accounting for more than one-third of the global total.
COVID-19 has claimed the lives of nearly 23,000 people. More than 120,000 have recovered from the disease.
26 March 13:15 GMT — United Kingdom pledges to roll out extensive antibody testing
The United Kingdom could begin large-scale testing for coronavirus antibodies within days, government officials have said. If the roll-out goes ahead as planned, the country could become the first to implement at-home testing on this scale — but researchers caution that properly validating the accuracy of such tests and manufacturing them in large quantities presents a significant challenge.Covert coronavirus infections could be seeding new outbreaks
On 25 March, a UK government official said that the country had ordered 3.5 million ‘finger-prick’ tests and planned to order millions more. The test will analyse drops of blood for antibodies that show whether a person has previously been infected with the coronavirus that causes COVID-19. This will show who might now be immune and aid researchers in understanding the virus’s spread. These ‘serological tests’ should become available to the public in days rather than weeks or months, said Sharon Peacock, director of the national infection service at Public Health England (PHE), a UK health agency. Peacock suggested that the bulk of the UK tests, which will be available to buy from Amazon and pharmacies to perform at home, had not yet arrived.
Most tests to diagnose coronavirus infection have involved laboratory-based testing using the technique known as PCR, which checks for active infection. But an urgent goal has been to develop serological tests, which can detect past infection. These are now being deployed worldwide. Singapore, for instance, has been using the tests for more than a month to trace known infections and monitor at-risk populations.
But thoroughly evaluating the efficacy of the tests and the rate of false positives is essential, says Robert Garry, a virologist at Tulane University School of Medicine in New Orleans, Louisiana, whose team is developing its own serological test.
The blood test will need to distinguish between antibodies against the COVID-19 virus and those against other seasonal coronaviruses to which people are commonly exposed, he says. “I would expect the false-positive rate to be very high because of this prior exposure — unless they figured out how to make the serological test very specific,” he says. Garry says that for a validated test, he would expect a false-positive threshold of less than 5% — meaning fewer than 5 out of 100 people without the antibodies test positive — although he could see that being relaxed to 10%. Even with ready access to clinical samples, understanding false-positive levels on this timescale would require a massive effort, says Garry.How much is coronavirus spreading under the radar?
PHE is evaluating the tests to ensure they work as claimed, said Peacock, who anticipates this will be done by the end of the week.
But supply is likely to remain limited, says David Wraith, an immunologist at the University of Birmingham, UK. It will be challenging for companies to manufacture millions of tests and for any one government to secure so many during a global pandemic, meaning that health-care workers must be given priority access, he says.
It is not clear who is developing the UK test. A PHE spokesperson said the agency was talking to a range of companies. Peacock added that highly vulnerable members of the public who test positive will also require further tests before they can resume normal life.
26 March 3:00 GMT — 100 scientific organizations call to end Trump’s ban on fetal-tissue research
A group of 100 research societies, professional organizations and universities is calling on US President Donald Trump to lift restrictions on the use of fetal tissue in research, arguing that the limits delay necessary work on potential treatments for COVID-19.
“We believe that researchers should have all of the biomedical research tools out there to develop treatments for COVID-19,” says Eric Anthony, director of policy at the International Society for Stem Cell Research in Skokie, Illinois, a key signatory of the letter sent on 25 March.
Fetal tissue, often received from abortion clinics, has long been used in vaccine research. But last June, the Trump administration, following a campaign by opponents of abortion, moved to ban government scientists from using fetal tissue in research once their existing supplies ran out. The rules also included restrictions for non-government scientists funded by the US National Institutes of Health (NIH), requiring that new grant applications for research that uses fetal tissue pass ethics review by an agency-appointed board.
The US Department of Health and Human Services (HHS), which oversees the NIH, invited nominations to that ethics board in February, and the comment period closed last week.
Signatories to the letter asking for relief from the federal restrictions include the American Academy of Pediatrics, Johns Hopkins University, Massachusetts General Hospital and Harvard University.
At least one government scientist has appealed for an exemption to the rules in order to do coronavirus research, according to a story in The Washington Post last week. An HHS spokesperson told Nature that the agency has made no decision about the request, and that the “Trump Administration has activated a whole-of-government, whole-of-America approach to prepare for and respond to COVID-19”.
25 March 11:00 GMT — India starts three-week lockdown
India has commenced a 21-day lockdown, after Prime Minister Narendra Modi ordered the country’s 1.3 billion residents to remain in their homes from midnight on 24 March.
Many countries have introduced travel restrictions to slow the spread of the coronavirus. But the lockdown in India, which has the world’s second-largest population, will dwarf similar measures in other nations.
Currently, the country has roughly 500 reported cases, and 9 reported deaths, but researchers say that infections are probably going undetected there given the size of its population. The country had tested about 15,000 people for the coronavirus by 20 March, according to Our World in Data.
Under the new restrictions, flights and train services are suspended, and road access is restricted in every state. Medical centres, petrol stations and grocery stores are exempt from the lockdown.
“The nation will have to certainly pay an economic cost because of this lockdown. However, to save the life of each and every Indian is our topmost priority,” said Modi during a televised address.
25 March 01:00 GMT — The outbreak in Italy went undetected for weeks
The novel coronavirus SARS-CoV-2 was present in northern Italy as early as 1 January.
An epidemiological analysis of Lombardy, the epicentre of the outbreak in Italy, reveals that the first onset of symptoms in the country occurred weeks before COVID-19, the disease caused by the virus, was reported there on 20 February. The study looks at nearly 6,000 laboratory-confirmed cases to track how the outbreak unfolded in the region. It was posted to the arXiv preprint server on 20 March.Covert coronavirus infections could be seeding new outbreaks
The undetected spread in January is “very striking”, says Michele Tizzoni, who models infectious diseases at the ISI Foundation in Turin, Italy, but was not involved in the work. “At that time, we were probably still talking about Wuhan.”
Instead, by the time the first case was detected in Italy, the virus had already spread to most towns and cities in southern Lombardy. Over the next several weeks, nearly half of the patients who tested positive for COVID-19 were hospitalized; about one-fifth of those required intensive care.
The new picture of the outbreak in Lombardy makes it clear that “aggressive containment strategies are required” to stop the spread of the virus, the authors write. Although public activities and gatherings in the region were banned just three days after the first positive test, the virus’s undetected spread in the previous weeks meant that it had already taken hold, with the number of cases doubling roughly every three days.
These data will be vital to other countries and public health organizations getting ready to face their own outbreaks of the pandemic, Tizzoni says. His advice to them? “Be prepared. Even if you don’t see much.”
24 March 11:00 GMT — Lockdowns eased in Hubei province
Chinese authorities are reopening travel to and from Hubei province, the epicentre of the COVID-19 outbreak, ending two months of lockdowns that were introduced to help slow the disease’s spread. Only one new infection has been reported in Hubei since 18 March.How blood from coronavirus survivors might save lives
From 25 March, flights and trains in and out of all cities in Hubei province — except for the capital, Wuhan — will resume, and roads will reopen, according to an announcement posted on Hubei province’s website. Access to Wuhan, where the first cases were reported and spread, will remain restricted until 8 April. Until then, all those entering or leaving the city will have to take a test to prove that they are not infected with SARS-Cov-2, the virus that causes COVID-19.
The Hubei announcement says that factories and businesses can gradually reopen, as long as they follow transmission prevention measures. Universities, schools and child-care centres will remain closed pending “a scientific assessment of the epidemic control situation”. (Schools in most other regions of China also remain closed.)
Other cities in China are slowly returning to some sense of normality. But scientists are warning that there is a risk of renewed COVID-19 transmission once people start mixing again.
23 March 21:15 GMT — United Kingdom implements stringent lockdown
The United Kingdom is implementing drastic measures to prevent the spread of the coronavirus, joining other nations that have put in place unprecedented rules to fight the pandemic.
Prime Minister Boris Johnson announced in a televised broadcast on 23 March that people living in the United Kingdom must stay at home and travel outside only for essential purposes. The police will have powers to enforce the rules and fine people who stray from them.
People will be allowed to leave their houses only to shop for food and medical supplies, exercise once a day, and travel to work if strictly necessary. Shops that sell non-essential items will close and gatherings of more than two people in public will be banned.
The United Kingdom had already issued guidelines for social distancing, but Johnson said that although huge numbers are complying, “the time has now come for us all to do more”. The government had also been broadly criticized for not putting in place stricter measures to curb the spread of the virus sooner. The latest rules will be kept under review but will last for at least three weeks.
The United Kingdom has recorded 6,650 confirmed cases of the virus, with 335 deaths, but the true figures are feared to be much higher.
The country joins other European nations that are already on lockdown; in some of these, measures are stricter and people cannot leave their houses without a permit. Lockdowns are in effect in Spain and Italy — which is experiencing the world’s worst outbreak of COVID-19, the disease caused by the coronavirus. Germany has also banned public gatherings of more than two people.
More than a dozen US states are implementing stay-at-home orders, affecting more one-third of the US population. Details of these orders, and the lengths of time for which they will apply, vary from state to state, but they generally include the closures of all non-essential businesses, and continued or more stringent bans on public gatherings. On 19 March, California, the nation’s most populous state, was the first state to order a lockdown, following the lead of San Francisco three days earlier.
In New York state, home to about 5% of worldwide COVID-19 cases, authorities can fine businesses that do not comply with orders, but people will not face penalties. In Oregon, however, people who violate the governor’s order can be tried for a misdemeanour offence.
President Donald Trump has also approved the mobilization of US National Guard troops in New York, California and Washington to set up medical stations and deliver aid to residents.
23 March 17:35 GMT — Global infections pass 300,000
The number of COVID-19 coronavirus infections worldwide passed 300,000 over the weekend. The World Health Organization (WHO) reported 332,935 cases — across nearly every country — as of 23 March, with 14,510 deaths.
WHO director-general Tedros Adhanom Ghebreyesus said in a press briefing that it took 67 days from the first reported case to reach the first 100,000 cases, 11 days after that to reach 200,000 and just another 4 days to top 300,000 infections.
20 March 12:15 GMT — Most COVID-19 deaths now in Italy
Deaths from COVID-19 in Italy have exceeded those reported in China, after 473 people died in Italy in 24 hours. The coronavirus has so far killed 3,405 people there, according to official statistics from 19 March. In China, 3,242 people have died of the disease since the outbreak began in December, according to the World Health Organization (WHO).
Globally, the number of confirmed coronavirus cases has doubled in less than two weeks, to more than 200,000.
On 19 March, seven countries confirmed their first coronavirus cases, including Zambia, Gambia, Mauritius and Kyrgyzstan, according to the WHO.
19 March 20:00 GMT — Coronavirus hospitalizations occur at any age, says US CDC
COVID-19 can be severe enough to require hospitalization in adults of any age, according to a report from the US Centers for Disease Control and Prevention (CDC).Covert coronavirus infections could be seeding new outbreaks
The report, released on 18 March, analyses the severity of COVID-19 cases in the United States from 12 February to 16 March by age group. Although mortality is highest in adults over 65 — consistent with data reported from China, Italy and elsewhere — 20% of US hospitalizations occurred in people aged 20–44 years.
The CDC’s report excludes cases imported from Wuhan, China, or from Japan, so it did not count people who were infected on cruise ships in those areas. In total, age data were collected for 2,449 infected people. Of them, 29% were between 20 and 45 years old.
That statistic is roughly consistent with numbers released by the Italian Higher Institute of Health, which reported on 15 March that 24% of cases in the country occurred in adults aged 19–50. These data do not include age-group breakdowns for severe cases, only fatalities. Deaths from COVID-19 in Italy surpassed those in China on 19 March.The coronavirus pandemic in five powerful charts
Among people with COVID-19 aged 20–44 in the United States, the CDC’s report estimates that up to 21% required hospitalization. But only 2–4% of infected people in that age bracket required intensive care, significantly fewer than in any other adult age group. And fatalities remain low among young adults, the report shows.
No data were collected regarding underlying conditions that have been shown to make people more susceptible to the disease, so it is unclear whether the young adults being hospitalized are those who are most vulnerable. Still, the report stresses, severe illness “can occur in adults of any age”.
19 March 11:00 GMT — No new confirmed cases in Hubei province
On 18 March, Hubei, the Chinese province at the centre of the coronavirus outbreak, recorded no new cases of COVID-19 for the first time since the beginning of the epidemic, according to the country’s National Health Commission. Eight deaths were reported in the province that day.
A month ago, Hubei was confronting several thousand new confirmed cases each day. Since December, it has recorded more than 67,000 people with COVID-19, and more than 3,000 deaths.
Across China, there were 39 new cases recorded on 18 March, and 13 deaths.
Italy now faces the largest number of new cases per day, with 3,526 confirmed yesterday. New cases have also surged in the United States, Iran, Spain, France and Germany.
18 March 10:00 GMT — Deaths outside China surpass those inside the country
The total number of people who have died from COVID-19 outside China has overtaken deaths inside the country for the first time since the disease emerged, according to reports by the World Health Organization (WHO) on 16 March. The number of confirmed infections outside China surpassed those inside the country on the same day.
As of 17 March, there were 179,112 confirmed cases of COVID-19 globally, including 81,116 in China. Of the 7,426 deaths from the disease, 3,231 have been in China.
Europe had the largest 24-hour spike in new infections, with 8,507 reported since 16 March, and 428 deaths. Several regions recorded their first cases, including Somalia, Benin, Liberia and the Bahamas.
17 March 00:30 GMT — First vaccine clinical trials begin in the United States
The first phase I clinical trial for a potential COVID-19 vaccine has begun in Seattle, Washington.
Four adults, the first of 45 eventual participants, received their first doses of an experimental vaccine developed through a partnership between the US National Institute of Allergy and Infectious Diseases (NIAID) and Moderna, a biotechnology company based in Cambridge, Massachusetts. But although it is an important milestone, the phase I trial is just the beginning of a long process to test the drug’s safety and efficacy.
The trial is being conducted at Kaiser Permanente Washington Health Research Institute, and will test a range of doses of the vaccine. Over the next 6 weeks, participants will receive their first doses, followed by a second 28 days later. Follow-up visits both in person and over the phone will assess participants’ health over a 14-month period, and blood samples will help researchers evaluate the body’s immune response to the experimental vaccine.
The potential vaccine is based on messenger RNA, which directs the body to make a protein found on the coronavirus’s outer shell. The hope is that this will elicit an immune response that protects against infection.What China’s coronavirus response can teach the rest of the world
The team at Moderna had already been working on a vaccine for Middle East respiratory syndrome, which is caused by another coronavirus. The viruses’ similarities helped the researchers pivot to the search for a COVID-19 vaccine.
As a result, the phase I trial was “launched in record speed”, according to a statement from NIAID Director Anthony Fauci on 16 March. It took just 66 days from genetic sequencing of the virus to the first human injection of the vaccine candidate.
Researchers hope to have initial clinical-trial data within three months. But even in the best-case scenario, the vaccine would not be widely available to the public for at least another year, according to NIAID.
13 March 23:00 GMT — US president declares ‘national emergency’
US President Donald Trump called the coronavirus outbreak a national emergency on Friday afternoon. This gives his administration broad authority in its response to the disease, including access to up to US$50 billion in federal funds to combat the epidemic. Trump said that as many as half a million tests would be ready by early next week.How much is coronavirus spreading under the radar?
Earlier in the day, the president announced measures to speed up testing in the United States, including providing funding to develop rapid tests and appointing a new federal coordinator to oversee the efforts.
More than 1,800 people have tested positive for the virus in the United States and at least 41 have died, according to The New York Times. The virus has now been detected in 47 states and the District of Columbia.
13 March 22:10 GMT — Harvard University orders research labs to shut down
Research laboratories at Harvard University in Cambridge, Massachusetts, have been ordered to prepare to shut down research operations amid the growing coronavirus outbreak. Harvard is one of the first major research universities to announce that it will wind down laboratory research. Dozens of universities worldwide have already moved teaching activities online or been closed in a bid to control the spread of the virus.
Despite Harvard’s move, labs there doing direct research on coronavirus will be able to continue their operations, a representative of the university’s medical school told Nature.
All labs must begin implementing a plan to stop all laboratory research activities by 18 March, said e-mails sent from deans to students and staff members in the faculty of arts and sciences and the medical school on 13 March. The suspension is expected to last for at least six to eight weeks, the e-mails say. Labs that work with live animals will be able to designate staff members for essential animal care, but microbial labs have been ordered to “freeze everything down”, says Tanush Jagdish, an evolutionary biologist at the university.The race to unravel the United States’ biggest coronavirus outbreak
Exemptions will be made for essential experiments that “if discontinued would generate significant financial and data loss”, according to the e-mails.
Jagdish says that the announcement caught everyone in his lab off-guard. “For labs to be shut down in general was something we did not expect.” The labs that he works in had already implemented measures to prevent the spread of the coronavirus disease COVID-19. These included alternating shifts and making cleaning protocols stricter, in addition to extra cleaning that was instituted at the department and university levels. Until lab work can resume, researchers are devoting their time to writing grant proposals and theses, among other remote work, he says.
On 10 March, Harvard had mandated that gatherings of more than 25 people be held remotely, but the latest guidelines state that all meetings and courses should do this, regardless of size. In addition to conducting lab meetings by video chat, people have been discussing starting daily or weekly remote social hours, Jagdish says. “It helps to know that we’re all in this together.”
13 March 22:00 GMT — Europe now centre of pandemic, says WHO
Europe has now become the epicentre of the COVID-19 pandemic, says the World Health Organization (WHO).
More cases are now being reported there every day than were reported at the height of China’s epidemic, director-general Tedros Adhanom Ghebreyesus said in a 13 March press briefing. There are more reported cases and deaths in Europe than in the rest of the world combined, apart from China, Tedros said.
Italy, which has the largest outbreak in Europe, reported 2,651 new cases in the past day.
More than 132,000 cases of COVID-19 have now been reported from 123 countries and territories, according to the WHO.
11 March 16:35 GMT — Coronavirus outbreak is a pandemic, says WHO
After weeks of resisting mounting pressure from scientists, politicians and others, the World Health Organization (WHO) in Geneva, Switzerland, has decided to describe the coronavirus outbreak as a pandemic.Why does the coronavirus spread so easily between people?
The declaration comes after a 13-fold rise in the number of cases outside China in the past two weeks, and a trebling of countries affected — but does not change WHO strategy for tackling spread of the virus, director-general Tedros Adhanom Ghebreyesus said in an 11 March press briefing.
“WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction,” said Tedros.
“Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this coronavirus. It doesn’t change what WHO is doing, and it doesn’t change what countries should do,” he said. “Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.”
Many scientists had been calling for the change in language for weeks — after large outbreaks were detected in South Korea, Iran and Italy. At the time, some researchers suggested that countries would soon move from efforts that involve containing as many new cases as possible to social-distancing measures, such as school closures, that do not rely on knowing who is infected with the virus and who is not.
The virus has now been found in more than 100 countries. It has infected some 120,000 people, killing more than 4,000 of them. Several nations have closed schools in a bid to stop the virus, and Italy has entered an unprecedented countrywide lockdown.
“This is not just a public health crisis, it is a crisis that will touch every sector — so every sector and every individual must be involved in the fight,” said Tedros.
Researchers have been working rapidly since the outbreak came to light in January to characterize the virus, work out why it is so infectious, find out where it came from and help with diagnosing infections.
11 March 12:30 GMT — Transgenic animals for coronavirus research in high demand
Labs are scrambling to get their hands on transgenic animals that can be used to study the coronavirus and test drugs and vaccines. Ordinary mice seem to be resistant to infection by this coronavirus, so researchers conduct studies in rodents that produce a human version of the protein ACE2, which the virus uses to enter cells.Labs rush to study coronavirus in transgenic animals — some are in short supply
But these mice — originally developed for research into severe acute respiratory syndrome, or SARS — are in short supply. One US breeding facility, the Jackson Laboratory in Bar Harbor, Maine, has received requests for 3,000 mice, and is now establishing a colony of these animals.
Researchers have also already reported initial results from studies in monkeys infected with coronavirus. The animals seemed to experience only a mild illness, similar to that in many humans. Scientists are now seeking animal models to mimic the more severe version of the illness.
11 March 07:30 GMT — Major chemistry meeting among cancelled scientific conferences
The American Chemical Society (ACS), the world’s largest scientific society, cancelled its meeting in Philadelphia, Pennsylvania, on Monday, 13 days before it was due to begin on 22 March.
The conference is one of a growing number of scientific meetings and conferences being cancelled because of coronavirus outbreaks. Governments and health officials are increasingly calling for the restriction of large gatherings, in an attempt to reduce the virus’s spread.
The ACS said the decision to cancel was based on several factors, including a rise in COVID-19 cases in the greater Philadelphia area and input from members who were increasingly concerned about travelling to and attending a large meeting. About 800 participants had already cancelled their registrations before the announcement, an ACS press officer told Nature.
10 March 03:30 GMT — Call for more funding
At least US$8 billion is needed to address the most pressing threats posed by the new coronavirus, says the Global Preparedness Monitoring Board (GPMB), an independent group co-convened by the World Health Organization and the World Bank Group to combat public-health emergencies.
The money is needed in addition to the tens of billions of dollars already pledged by the International Monetary Fund, the World Bank Group and individual governments.
The GPMB released a report on 9 March calling on advanced economies, such as the members of the Group of Seven and Group of 20 industrialized nations, and financial institutions, to provide money to address five priority areas. These include strengthening weak health-care systems; supporting the World Health Organization’s efforts to help vulnerable countries; developing diagnostics, therapeutics and vaccines; strengthening regional surveillance; and ensuring that sufficient protective equipment is available for health workers.
9 March 04:00 GMT — Global cases pass 100,000
The number of known global cases of COVID-19 passed 100,000 over the weekend. On 8 March, the World Health Organization reported 105,586 confirmed cases across more than 100 countries and territories. Although the outbreak has been slowing in China, where it originated, the country still accounts for almost 80% of confirmed cases.
6 March 11:30 GMT — US Congress approves US$8.3 billion for coronavirus response
The United States Congress has passed an emergency spending bill that will allocate US$8.3 billion for the country’s coronavirus response. The House of Representatives passed the bill in a near-unanimous vote on Wednesday afternoon; the Senate followed suit on Thursday.
The bill will provide more than $3 billion to the Centers for Disease Control and Prevention, the National Institutes of Health, and the Food and Drug Administration for research on diagnostics, therapeutics and vaccines. Each US state will reportedly receive at least $4 million for state and local government responses. The bill also includes a provision to ensure that an eventual vaccine is affordable.
Other funding will contribute to the global coronavirus response and provide support for small businesses that are struggling in the wake of the outbreak. The bill will now go to President Donald Trump to be signed.
Elsewhere, the US National Science Foundation in Alexandria, Virginia, opened up a Rapid Response Research funding mechanism for non-medical coronavirus-related research. Such calls are often used to award funding for work exploring the impacts of natural disasters such as hurricanes and wildfires, and allow for an expedited review of research proposals.
5 March 15:30 GMT — China study suggests children are as likely to be infected as adults
Children are just as likely to become infected with the new coronavirus as adults, finds one of the most detailed studies yet published on the spread of the virus, known as SARS-CoV-2. The analysis — based on data from Shenzhen in China — provides a partial answer to one of the most pressing questions surrounding the outbreak: the role of children.
Previous studies have suggested that kids are much less likely than other age groups to develop severe symptoms when infected by the coronavirus. But it was not clear whether this was because they weren’t getting infected or because they were fighting off the infection more effectively.
“Kids are just as likely to get infected and they’re not getting sick,” says Justin Lessler, an infectious-disease epidemiologist at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. He co-led the study with three other epidemiologists — Qifang Bi, also at Johns Hopkins, Ting Ma at the Harbin Institute of Technology in Shenzhen and Tiejian Feng at the Shenzhen Center for Disease Control and Prevention. They posted the analysis to the medRxiv preprint server on 4 March.
The study is unique in that it looked at not only people who were infected with the virus, but also large numbers of their close contacts, some of whom were infected and many of whom were not. The researchers followed 391 people who were diagnosed on the basis of their symptoms, and 1,286 of their close contacts to see whether these contacts tested positive for the virus even if they didn’t show symptoms. Overall, the team found that children under 10 who had potentially been exposed to the virus were just as likely to become infected as other age groups, with between 7% and 8% of contacts of known cases later testing positive.
The authors also found that people who lived in the same household as someone infected with the virus were about six times more likely get infected than those who made contact with an infected person in other settings.
“This may be the first clear evidence that children are as susceptible as adults to SARS-CoV-2 infection,” says Ben Cowling, an infectious-disease epidemiologist at the University of Hong Kong. He wonders whether the fact that outbreaks haven’t been observed in schools could be down to the fact that children’s symptoms are mild.
Lessler says it’s still not clear whether children are important in transmitting the virus, as they are for influenza; children routinely develop flu symptoms and are common hubs in chains of transmission. “That’s one of the current critical remaining questions and we’re trying to figure out how to answer it,” he says. “I have a 7-month-old and a 6-year-old and I can’t imagine that, if they have any virus at all, they’re not getting it on somebody.”
The study could have important implications for slowing the spread of the virus through measures such as school closures. “Once we say containment is not an option, we can’t ignore the kids,” says Lessler.
“This is a key piece of data that may support school closures as an effective intervention,” Caitlin Rivers, an epidemiologist at Johns Hopkins Bloomberg School of Public Health, said in a tweet on 5 March.
5 March 12:55 GMT — World Bank pledges US$12 billion for coronavirus response
On 3 March, the World Bank Group pledged up to US$12 billion, including $8 billion in new funding, to support countries dealing with the coronavirus outbreak. The funding will be fast-tracked and consists of grants and low-interest loans, as well as technical support.
Most of the package is earmarked for strengthening health systems and improving access to treatment. The World Bank said it would prioritize funding for countries at high risk and with low capacity to deal with the outbreak. Half of the pledged money is from the International Finance Corporation, and is intended to strengthen global supply chains and support key industries such as pharmaceuticals.
4 March 12:00 GMT — Repurposed drugs in coronavirus spotlightMore than 80 clinical trials launch to test coronavirus treatments
Drugs used to treat HIV and an experimental antiviral drug developed to fight Ebola virus are among those that are rapidly being tested against the new coronavirus. There are no approved treatments for diseases caused by coronaviruses. But hundreds of clinical trials of drug candidates are planned or underway, with much of the focus on remdesivir, a candidate drug originally developed to treat the Ebola virus.
The drug, developed by the pharmaceutical firm Gilead Sciences of Foster City, California, is being tested in partnership with Chinese health authorities in randomized, controlled trials; two of these are set to finish in April. The compound works by trying to prevent the replication of the virus. “Remdesivir has quite high efficacy across all different coronaviruses and therefore it is one of the prime candidates to start being tested,” says Vincent Munster, chief of the viral ecology unit at the US National Institutes of Health.
2 March 21:00 GMT — Infections worldwide top 90,000
The number of people worldwide who have been infected with the coronavirus has passed 90,000. More than 3,000 have died since the outbreak began in December. The vast majority of cases — more than 80,000 — have occurred in China, but around 60 other countries are now also dealing with outbreaks. Many nations are preparing for a global pandemic, as reports of cases caused by spread within communities — rather than being imported from China — rise.
South Korea, Italy and Iran are fighting the largest outbreaks outside China.
2 March 20:45 GMT — WHO raises alert to ‘very high’
At a press briefing on 29 February, the World Health Organization (WHO) announced that it had raised the global alert for COVID-19 to the highest possible level, short of calling it a pandemic. The virus has now spread to some 60 locations outside China, with new cases detected in Ireland, Monaco, Azerbaijan, Qatar and Ecuador.
The global alert for the spread and impact of the coronavirus outbreak increased from ‘high’ to ‘very high’. The alert remains ‘very high’ in China.
The global change was based on an assessment by WHO epidemiologists, which took into account the continued increase in the number of cases and affected locations, and the difficulties that some regions, including Iran and Italy, are facing in containing the spread of the coronavirus.
Tedros Adhanom Ghebreyesus, director-general of the WHO, said at the briefing that most cases were linked and could still be traced to known contacts or clusters, with no evidence of the virus spreading freely in communities. “As long as that is the case, we still have a chance of containing this virus, if robust action is taken to detect cases early, isolate and care for patients and trace contacts,” said Tedros.
The organization therefore once again resisted declaring the outbreak a pandemic. Mike Ryan, director of the WHO’s emergencies programme, said that such a decision would mean that efforts to contain and slow down the spread of the virus have failed, which has proved to be untrue in China, Singapore and other regions.
The WHO is still holding out hope that the virus can be contained, but we have probably crossed that threshold, says Adam Kamradt-Scott, a global health-security researcher at the University of Sydney, Australia.
Some countries have already begun to prepare their pandemic plans, which is an important precautionary measure, says Nigel McMillan, an infectious-disease researcher at Griffith University in Brisbane. Australia, for example, initiated its coronavirus emergency response on 27 February. The WHO is being overly cautious in not declaring a pandemic, says McMillan.
2 March 20:30 GMT — Transmission details emerge from WHO China analysis
China has mounted “perhaps the most ambitious, agile and aggressive disease containment effort in history” against a new infectious disease, the World Health Organization (WHO) said in a report released on 28 February, after nine days of meetings and site visits in China from 16 to 24 February. The report analyses data from the outbreak in China, and recommends steps that the country and others should take to curb COVID-19.
Daily reports of new cases are declining in the country, the WHO confirmed — so much so that authorities are now having problems recruiting participants for the more than 80 clinical trials there that are testing potential treatments for the coronavirus. Some experimental treatments should be prioritized over others, the health agency recommended.
The report’s analysis of data from China finds 99.9% similarity between the 104 strains of the coronavirus, named SARS-CoV-2, collected from people between December 2019 and mid-February 2020. This means that the virus is not mutating significantly. The median age of people infected is 51 years. And most cases of spread from person to person have been in hospitals, prisons or households, which implies that close contact is often required for the virus to spread between people. Airborne spread is not believed to be a major driver of transmission, the report says. In one preliminary study from the province of Guangdong, people in the same household as someone with COVID-19 had a 3–10% chance of being infected.
The WHO credits China’s ability to rein in the epidemic to a variety of measures. One is that 1,800 teams of epidemiologists have rapidly tracked tens of thousands of contacts of people infected with the virus in Hubei province, where the outbreak emerged. Up to 5% of these contacts ended up having the disease and were diagnosed quickly. And the report says the lockdown on travel out of Hubei — an unprecedented measure in a province of this size — curbed wider spread of the disease to China’s 1.4 billion citizens.
2 March 17:45 GMT — Coronavirus fears cancel huge physics meeting
Senior Nature reporter Davide Castelvecchi reports from Denver, Colorado, where the world’s biggest physics meeting has been cancelled because of coronavirus fears.
The meeting was scheduled to host 11,000 attendees. Some researchers are finding other ways to share their work, including informal meet-ups and virtual talks.
Several other scientific meetings have also been cancelled, as virus outbreaks emerge and escalate in countries around the world.
28 February 12:45 GMT — Coronavirus spreads to sub-Saharan Africa
The coronavirus outbreak has spread to 46 countries other than China — and now seems to be spreading faster outside China than inside.This Nigerian doctor might just prevent the next deadly pandemic
Several nations reported their first infections this week; cases included the first to be confirmed in sub-Saharan Africa, in Nigeria. The Nigeria Centre for Disease Control reported the case on 27 February and said it was working to trace the infected person’s contacts. Health authorities and researchers have feared the virus’s spread to African countries including Nigeria, where weak health systems could quickly be overwhelmed by a local outbreak.
The World Health Organization reports that more than 82,000 people worldwide have now been infected — more than 3,600 of those outside China. Cases in South Korea, which is handling the world’s second-largest outbreak, have exploded to more than 2,300.
China’s outbreak seems to be slowing, with the daily number of new cases dropping. Authorities reported 327 new infections nationwide on 27 February. A week earlier, on 20 February, that figure had been around 900. Outside China, about 750 new cases were reported on 27 February.
26 February 18:30 GMT — Brazil reports first case in South America
A case of COVID-19 has been confirmed in Brazil — the first in South America. On 26 February, Brazil’s minister of health, Luiz Henrique Mandetta, confirmed that a man who travelled to northern Italy between 9 and 21 February has the disease. Italy’s outbreak has escalated to 324 cases and 12 deaths, according to a virus tracker maintained by Johns Hopkins University in Baltimore, Maryland.
The Brazilian case is in a 61-year-old man who sought care for a fever, cough and sore throat yesterday at a hospital in São Paulo, where he tested positive for COVID-19. Officials say he is in stable condition and will be quarantined at home for 14 days. “We should only take those with severe respiratory conditions to the hospital,” said Mandetta in a tweet.
Algeria, Greece, Afghanistan, Bahrain, Iraq and Oman have all reported their first cases within the past two days. The virus’s appearance in South America now means that it has spread to every continent except Antarctica.
25 February 22:30 GMT — Trump requests emergency funding for coronavirus response
The administration of President Donald Trump has requested up to US$2.5 billion to fund the US response to COVID-19. In a 24 February letter to Congress, the Office of Management and Budget requested $1.25 billion in new funding and proposed to make up the rest by repurposing funds allocated to other programmes, including $535 million assigned to the Ebola response.Time to use the p-word? Coronavirus enters dangerous new phase
Democratic legislators immediately criticized the requested sum as overdue and insufficient. The US government has allocated several times that figure for past outbreak responses: Congress approved about $5.4 billion for the 2014 Ebola outbreak, and in 2009 about $7.7 billion was directed to the H1N1 influenza pandemic response.
Public-health policy analysts expect the government to make some funds available, but it’s unclear how much will be appropriated, and how soon. “My expectation is that something will eventually be passed,” says Josh Michaud, a public-health policy analyst at the Kaiser Family Foundation, a non-profit organization in Washington DC. “What eventual form that is and whether it conforms to the risk that coronavirus poses is another question.”
25 February 21:00 GMT — Researchers anticipate unstoppable spread
Despite the World Health Organization’s decision not to describe the escalating coronavirus outbreak as a pandemic, some scientists say that the spread is already moving into a new, dangerous phase. They say measures to limit spread will have to shift from containment to mitigation, as countries including Iran, Italy and South Korea report growing outbreaks with hundreds of infections.