Benjamin Thompson
Welcome to Coronapod.
Noah Baker
In this show, we’re going to bring you Nature’s take on the latest COVID-19 developments.
Benjamin Thompson
And we’ll be speaking to experts around the world about research during the pandemic.
Amy Maxmen
I really don’t know how this plays out. We also don’t know a ton about this virus, so there’s so many open questions. I just have a really hard time making predictions because I don’t know how the outbreak is going to change.
Noah Baker
Hello, and welcome to episode ten of Coronapod. My name’s Noah Baker, and I’m joined, as ever, by reporter extraordinaire, Amy Maxmen, but Benjamin Thompson is not here this week. In his place is a new voice that you might not have heard before, Richard Van Noorden. Richard, why don’t you start off by telling people who you are what your last two months have been like?
Richard Van Noorden
Hi, Noah. Hi, Amy. Yes, I’m a feature editor at Nature, so I’ve been commissioning a lot of long stories about the coronavirus, and I’ve also been coordinating some of our coronavirus coverage. So, it has been frenetic and very, very busy and I am amazed at people who say they have lots of free time now, but it’s been exciting and great to feel that I’m doing something useful.
Noah Baker
Amy, how has your week been?
Amy Maxmen
It’s been good. It’s been very busy. Yeah, I’m with Richard on this one – definitely not making bread or sewing quilts or anything like that.
Noah Baker
I have been making bread and sewing quilts, but I won’t tell anyone that.
Amy Maxmen
Laughs. Well, you’re maybe more efficient than I am.
Noah Baker
I have been doing it like in bed in the evenings and first thing in the morning. So, this week, Donald Trump has sort of strengthened his position on the WHO. So, we’ve talked on the Coronapod before about the threat to withhold funding or withholding funding from WHO for a period time, and now he’s sort of set an ultimatum.
Amy Maxmen
Yeah, so, on Monday and Tuesday, it’s the World Health Assembly, and that’s kind of when the 194 member states that are part of the WHO get together, and there’s agendas put forward and they vote on different measures. So, almost at 11pm Eastern time, Donald Trump put out a tweet that included a four-page letter that basically explains the rationale for why he suspended funding on 14 April and what he expects. So, first of all, the letter contained a number of assertions which various groups have come out as saying are false. For example, he said The Lancet published a paper on this strange new pneumonia in China in December, and The Lancet came out and said, ‘No, our first paper on COVID was on 24 January.’ And then he says he wants to see an investigation in 30 days that proves Dr Tedros at the World Health Organization is not colluding with China and that the WHO represents US interests. And I should just say, it’s just very odd for the World Health Assembly because if you compare that to the way that other countries put forward the measures they want to see, it’s very formulaic, sort of agenda items that people discuss at the meeting and not in a tweet.
Noah Baker
Yeah, absolutely. What has the reaction been of other member states of the UN and WHO to this statement?
Amy Maxmen
I talked to some people who are observers at the World Health Assembly. So, if you’re not a world leader kind of at the table who’s voting or speaking and pushing for your agenda, you’re an observer. Like the Gates Foundation would be an observer. They were just upset at the tone of the letter. It’s accusatory and it’s actually not really clear on what exactly has to happen, what exactly has to be shown. So, there’s kind of a guttural reaction as far as that goes. So, they think that’s not really going to be effective. The other thing they’re upset about is sort of by withholding funding right now and requiring kind of attention be devoted to this issue right now, that’s also not received really well. One of the people I spoke with, what she said is that it’s sort of like throughout this pandemic, people have been saying it’s like we’re building the plane while flying because there’s many things that have to get together while there’s a crisis going on. She said this is kind of like taking out the engine of the plane while flying because it’s a big diversion in the middle of so many other things that really have to be addressed, like getting medical equipment around the world and figuring out how various countries are doing. We often ask, is there really x number of cases in Somalia or Yemen or are they undercounting cases? That’s when you want kind of a multinational body to be in there to make sure that reporting is happening in a lot of countries.
Richard Van Noorden
So, what’s the response been from the World Health Organization, other people there? Can they effectively freeze America out because America is like a ribbon right through the World Health Organization, in terms of the people who work there? So, what do they do when Trump says we’re effectively trying to distance America from this organisation?
Amy Maxmen
That’s a really good question. I mean there’s roughly 80 centres that are WHO collaborating centres based in the US, and all of those have researchers that work closely with the WHO. So, I’ve been asking people, ‘What are these collaborations?’ We have CDC people who are in Geneva who work really closely with the WHO. What happens to these collaborations? So, our top public health advice in the US is often with people who work with the WHO, so I don’t know exactly what happens with those collaborations. Is Trump saying that they have to end? No one really knows. That’s kind of another funky thing about the letter, is it’s not actually even clear what’s happening. So, I get a lot of, ‘I hope not’, sort of responses when I ask these questions.
Noah Baker
I think this may be a bit of naïve question, but I feel like we’ve talked a lot about how the US pulling funding and removing itself from the WHO could harm the WHO and the activities of the WHO, but what about in the other direction? I mean this isn’t just a one-way system. The US also benefits from the WHO. Is this going to harm the US at all?
Amy Maxmen
Well, yeah, I think in a couple of ways. So, one, there’s just the fact that we’ve made investments in global health for so long, if we want kind of our investments to matter, then we do have to collaborate with the WHO on them. So, that’s one way that it would sort of be a lost effort, people’s time and money, if we’re not going to get it out there. There’s a number of other things as well. There’s also kind of intelligence. So, there’s a number of countries where the US doesn’t have a lot of staff and embassies to find out about what’s going on in those countries. I mean China would have been one. We don’t have as many inroads to China as, say, the WHO did. So, we might have not known about that outbreak if we didn’t have people that were working with the WHO in China. One of the sources I spoke with mentioned that we should be really aware of what’s going on in Central and South America right now because we see COVID rising in a number of those countries and that could affect what happens in our country, and it’s really helpful to have WHO people who are working closely with, say, Venezuela, where we don’t have a lot of people. We want to know what’s going on, so that communication is really vital. And then finally, countries that do not pay their membership dues are not allowed to vote. Now, I talked to people about when exactly this kicks in, like when are your voting rights suspended, and I’m not sure exactly when that kicks in. But I can tell you what I heard from one of sources is that when it comes up that the World Health Organization should be, let’s say, restructured so that it responds better to pandemics, then the US wouldn’t have a say in what that looks like. And other countries, like, let’s just say, namely, China, might be able to shape that agenda a little bit more.
Noah Baker
Which seems to be the polar opposite of what Trump is trying to achieve here with this action.
Amy Maxmen
Yeah, and that’s the real irony here. If you talk to anybody who’s been at these World Health Assemblies or who’s watched the WHO for a long time, if anything, the WHO really does represent a lot of US interests, so if we pull back on that, the WHO might focus on areas that other countries care a lot about. For example, every year at the World Health Assembly, there’s big talks about patents and IP that help insure that drugs reach the world’s poorest, and the US has been pretty staunch defender of patent rights. Well, maybe that sort of changes if the US now withdraws.
Noah Baker
In terms of this outbreak and what this might mean in the States, so far, the WHO guidance hasn’t been particularly strongly followed by the United States of America, and right now, there’s lots of talks about reopening various states and trying to reduce lockdowns there. I’m just thinking, what might this mean for people in the States given that, so far, there isn’t much following of guidance in the first place? Is it going to suffer any differently from this or is it going to need the WHO any more in the future or is it just not really going to make a difference to this particular outbreak from the US’s perspective?
Amy Maxmen
That’s a really interesting question. One thing that has come up, during the World Health Assembly, if you look at the different agenda items that different countries put forward or are bound together to put forward, there is a lot of talk about just what you’re saying, about how countries haven’t totally listened to the World Health Organization. For example, it is true that China was most likely hiding a number of cases in the earliest parts of January and maybe even in December. What Trump is saying and other countries are saying is that it does seem like that happened, but the WHO didn’t do anything about it. Maybe they didn’t know about it so they couldn’t force more openness and by the same token, the World Health Organization can’t do anything about a pretty poor response in the US and areas in which we’re not following their guidance. So, a lot of the agendas put forward this idea of how can the WHO have a little bit more power, and I don’t think the US would want to relinquish any of its power, so I guess what I’m trying to say is…
Noah Baker
It feels bit like a rock and a hard place for the WHO to be sitting between.
Amy Maxmen
It’s definitely a rock and a hard place. The only way they could have more power is if countries actually wanted to give them more power, and I think in Trump’s letter or when it was followed up by a proposed amendment by Rand Paul, and in that they’re sort of saying the WHO should be representing American interests more strongly. If you have 194 countries voting on this, I think only one of them might vote that one of those countries gets the most power.
Noah Baker
What might this mean for the future of big kind of international health cooperations? So, the WHO has existed since the Second World War. The US was one of the founding members of the WHO. This is a big part of how the world responds to public health crises, but also just public health day to day. Now the US, one of the founding members, is threatening to pull out. Is this the beginning of the end of international cooperation over health?
Amy Maxmen
I hope not. At the moment, it does seem like, on the whole, other countries sort of stepped up. A lot of speakers at the World Health Assembly – like Angela Merkel and Germany as a whole, China, Japan – promised to commit more funds and also that they were proud of the job the WHO was doing and they saw the importance of international collaborations. So, at the moment, it does seem like the US is the odd guy out here. That said, this sentiment could spread. I think that was another reason why people were alarmed and upset by the tone of the letter because it’s very accusatory and it’s very polarising. If that notion catches on around the world or in certain countries, that could be really detrimental. But luckily, at the moment, it doesn’t seem like that’s happening.
Noah Baker
In the future, one of the big problems that it’s likely that we’ll come across, that the WHO could be very involved in, is how to distribute any vaccine that may or may not be developed. This is going to be a big problem, trying to get it to the places that it’s needed, and that’s one of the things the WHO is well placed to do. I say that as a kind of clunky segue into talking about vaccines. It’s something that we haven’t really talked about much on Coronapod yet, but this week, there have been some early results of some of the trials that are going on. Richard, I wonder if you can give us a little rundown of the latest on vaccines.
Richard Van Noorden
Yeah, well, it’s reasonably positive news this week, as positive as it can be because we’re only talking about the very first tests of vaccines in people, which are really safety trials, which I think as someone says, these tests only tell you whether the thing is poisonous, not whether it actually works. And so far, it seems to be fine in some of the first results that were released. And the result that people were getting moderately pleased about was from the US Biotech firm Moderna. This was the first data from a human trial, and they found that it’s safe and that when you inject it into people, 45 people who got some of this vaccine developed an immune response. There were antibodies in their blood that recognised the new coronavirus, and the levels were similar to or a bit higher than those found in the blood of people who’ve caught the virus and recovered from it. And Moderna is going to move on now to test it in a large number of people to see whether the thing is actually effective. So, it’s a positive start. More positive news this week from another team at Oxford University. First, they have been trialling their vaccine in people, but the news, most recently, was that their vaccine protected six monkeys from pneumonia, although the monkey’s noses did still have a lot of virus in, as much as those of un-vaccinated monkeys. But that’s still positive. And a Chinese group, Sinovac Biotech, they reported similar, reasonable, good results out of some early animal tests of their vaccine. So, it’s all fairly positive, but there’s still a lot of unanswered questions. Will the antibodies that we see are being produced, when we get these vaccines, be enough to protect us? Maybe we’ll need more than one shot. Will the antibodies that we produce be lasting? So, all of this, yet to be discovered in trials that check effectiveness rather than just, really, safety. And most people still think we’re at least a year away from distributing these vaccines on a large scale. Although, the researchers at Oxford have said we’ll be able to get some vaccine out by September, should their trials in people work, but I wouldn’t think that would be on a large scale.
Amy Maxmen
I have a question. This idea about one of those vaccines, you said it could be ready as early as September. In my experience, I guess vaccine trials take such a long time because once you start giving them to lots of people, you might see rare side effects which matter, I think, a lot more when you’re giving a vaccine to like healthy people versus a drug to somebody who’s on their deathbed, so I think the tolerance for side effects is really low in vaccines, is my impression. And then also, just to see if it works, don’t you have to give it to enough people and just wait for the people who didn’t get the vaccine to get infected, which is just sort of, how do they plan on shortening that part of it?
Richard Van Noorden
Yeah, it has said September. I mean, I must say, it’s a bit unclear to me what they mean by that. I mean, if they have one vial, does that count?
Amy Maxmen
And does it mean they’ve finished phase III trials?
Richard Van Noorden
Well, they have actually enrolled more than 1,000 people in their UK trial, and some people have been given a placebo, so they’re already onto what you would call a phase II trial, really – comparing placebo to the vaccine. So, they are quite far advanced. They have 1,000 people. That is quite a large phase II trial, and they haven’t seen any safety problems yet in the monkey study. And there was a concern that it was possible you might end up developing an exacerbated disease when you are challenged with the virus, but Sarah Gilbert on the Oxford team has said, ‘We don’t need any more data from animal trials. What matters now is testing human efficacy.’ So, they’re certainly moving very, very, very fast.
Noah Baker
So, we’ve talked about these various different trials that are coming out, three that you mentioned just there, but they’re not, importantly, all the same vaccine. There’s different types of vaccine and some of them are even quite experimental vaccines that have never been licensed before. There’s a lot of them. I think there’s eight different types of vaccine that we know of that are currently being trialled. Richard, can you have a go at trying to run down the different types of vaccine that are currently being trialled?
Richard Van Noorden
Yeah, so the most familiar kind is simply injecting you with SARS-CoV-2, the new coronavirus, but inactivated with a chemical so it can’t infect you, or weakening or attenuating it, as they call it, by passing it through animal cells until it picks up mutations so that it can’t cause disease. And the Chinese trial I mentioned from Sinovac Biotech is one of those inactivated viruses, and that is quite a common way of making vaccines and it’s quite easy to see how it could work. But the Moderna approach is different, and what Moderna are doing is injecting us with RNA from the coronavirus, the RNA gets into our bodies and then we ultimately create coronavirus proteins from the RNA, and the hope is that our bodies will recognise that and will go, ‘Oh, there we go,’ and we’ll generate antibodies. That’s called a nucleic acid vaccine because all you’re doing is injecting nucleic acid, RNA, into the body. Other groups are working on DNA instead of RNA. Usually, these groups are injecting some version of genetic instructions to make the coronavirus spike protein inside our bodies. This is the protein that the virus uses to latch on to our cells and it’s thought that this will be most likely to get an immune response. Now, these are easy to develop. All you have to do is make genetic material. You don’t even need the virus. But as you said, they’re unproven. There are no licensed vaccines yet that use this technology. That’s, in part, because it’s a relatively new approach and we haven’t yet needed to make vaccines using DNA or RNA for familiar problems like influenza because we already have a great way to make those vaccines. But it’s definitely less tested and tried. Now, a lot of people are quite doubtful about whether the Moderna approach would work, and we still don’t really know.
Noah Baker
So, we’ve got attenuated virus, inactivated virus, DNA, RNA. That’s four approaches. What’s next?
Richard Van Noorden
The Oxford group are trying another idea, and this is quite a common idea, which is to essentially use a viral vector – some kind of virus like the measles virus that the body will already generate a reaction to – and within that virus, inserting a coronavirus gene. So, the virus will go in, it will replicate and then, out of that, will come the gene and then again, the protein will be made inside our bodies. And what the Oxford group are doing is they’re using a chimpanzee virus which they hope our bodies have not really seen before so wouldn’t be very familiar with, so we’ll generate a very active response to.
Noah Baker
I can imagine when people hear that, they may initially think, ‘Hang on, you’re going to try to immunise us against SARS-CoV-2 by infecting us with another virus?’ They aren’t just infecting you with a virus. This virus contains the genetic material of SARS-CoV-2 but it also is not infectious. It’s not dangerous, that virus.
Richard Van Noorden
Right, exactly. These viruses are weakened. They in themselves will not cause you to, for instance, catch measles or catch the chimpanzee virus exactly. And really, they’re being used because they’re quite good at, essentially, delivering the coronavirus spike gene into our cells. The problem with injecting with DNA or with RNA is will there be enough? Will it get into our cells? This is perhaps much more like what would happen if you actually got almost an inactivated virus infection. And, of course, we need all these ideas because we will need more than one vaccine. There is no way, if only one of these vaccines work, just distributing it to everyone who needs it is going to be the task of another year or two years. There’s no way it’s going to be able to be distributed around the world that quickly, so we’re going to need lots of different approaches. Plus, who knows what kind of immunity they’ll give us. They might work better for some people’s situations than others. So, we’re going to need a multiplicity of approaches, for sure.
Noah Baker
And speaking of multiplicity of approaches, if we include both types of viral vector vaccine – that’s replicating and non-replicating – that takes us up to a total of six types of vaccine, but there’s still more.
Richard Van Noorden
Yeah, I mean you can just inject proteins from the coronavirus into the body. Why put in the DNA? Last time we looked at this, we had 28 teams looking at this. The virus’s spike protein, again, is a very popular choice. Actually, this has been done with the SARS virus and again, it’s been shown that you can protect monkeys against infection from SARS with these proteins or protein subunits that you are injecting into the animal. And these might need some sort of adjuvant – sort of immune-stimulating molecules – and you may need multiple doses and all this because, again, you’re not getting the full virus here, you’re just getting the spike protein. So, there’s an idea. And yet another idea is a concept called a virus-like particle. It’s like an empty shell that looks like a virus and it smells like a virus, I don’t know, but it isn’t the virus. There’s nothing in the middle of it at all. There’s just the proteins on the outside. It’s kind of synthetic and it must be sort of manufactured and again, the hope is that that will generate its own immune response.
Noah Baker
So, eight different types of vaccine, or vaccine platforms as their known, and more than 90 vaccines being developed in total around the world. The race is very much on, and assuming that any of these actually do race through these trials and show efficacy soon, there’s still another hurdle, which is you need to start manufacturing these vaccines.
Richard Van Noorden
The interesting thing about all of this is that we’re going to have to do this so quickly that we’re going to have to start almost probably manufacturing these vaccines before we know whether they work, which sounds like there’s going to be wastage, and there will be. But it’s just going to have to be done because if we don’t start manufacturing now, it will take another year or more to get the manufacturing going. So, this week, we heard that BARDA had invested more than US$ 1 billion in manufacturing the Oxford vaccine, and BARDA has already invested money in Moderna’s work together with Johnson & Johnson. So, there is money being put into manufacturing some of these vaccines already, and it’s just a case of taking our bets, and it will be worth putting in the money even if it turns out some of the vaccines don’t work very well.
Noah Baker
Moderna have been selling stock this week. I mean is this just financial hubris or is it a real sign of how confident they are in what they’ve got?
Richard Van Noorden
I’m going to be pretty cautious and say they announced this in a press release, so no one’s actually seen the data, so it’s not a great way, I would say, to announce the results of such an important safety trial. And yes, their stock prices have gone up. I think it may have dipped again as sceptics pointed out that we haven’t really seen much of this data yet. Interestingly, the US National Institute for Allergy and Infectious Diseases – is that NIAID? How do you say it, Amy?
Amy Maxmen
NIAID.
Richard Van Noorden
Really rolls of the tongue. Yeah, so they are actually running the trial for Moderna. They made this prototype, this construct, and this announcement came from the early stages from this trial, but NIAID did not itself immediately put out a press release on this, presumably because they wanted it to be cautious about this. The company’s just said, ‘We would never put out a press release about something that we weren’t sure of,’ and that’s been their response. And they have a lot of vaccines for infectious diseases in their pipeline, but they haven’t actually yet bought a vaccine to market. So, scientists are sort of hopeful but reserving judgement, but I don’t think anyone’s going to slam them at this stage because they’re working very fast and, as I say, we need all the vaccines we can get.
Noah Baker
And then I guess one other thing that we still need to understand, which is only just starting to be understood, is how much it’s possible to develop an immunity at all, even without a vaccine, whether or not people are developing immunity from the virus after they’ve had it. But there have been some studies that have come out in the last couple of weeks which are suggesting that maybe a vaccine might work, and I feel like I’m stepping on your toes, Amy, because I think this might actually be your one good thing this week.
Amy Maxmen
I can list a different good thing but, yeah, I can talk about this too.
Noah Baker
I mean that was sort of a transition into the one good thing… but sort of forced.
Richard Van Noorden
Segue, segue.
Amy Maxmen
Okay, now I got it. Yes, so this time, instead of talking about my chihuahua Delores, I thought why don’t I talk about things that other people might care about more. So, there’s a few papers that came out this week about antibodies and, for example, one of them looked at almost 70 people who had been infected by the coronavirus. Everybody generated antibodies. A large number of them generated a significant level of antibodies that were neutralising or protective and stopped the virus from infecting human cells, so that’s a really good sign. And not only did they find these very potent antibodies that are protective, even in the people who didn’t have levels of the antibodies that they could detect, what they found is there were these immune cells that were clearly capable of producing these antibodies, so that just suggests that, in theory, you could have a vaccine that could elicit this specific kind of neutralising antibody that would be really potent. So, that’s really positive. And that’s not a given. Anthony Fauci, who’s leading the US response on this, he’s like a leader in the field of HIV vaccines, so ask him about vaccines and that’s kind of why he’s pretty blunt about we don’t even know if we’ll have one because he’s learnt about disappointment. But it does seem like it’s something that will be feasible.
Noah Baker
That is really good news, and it’s going to put my one good thing to shame because you’ve found a really genuinely good thing, and mine is just watching SNL on YouTube, which I don’t think really counts in the same way, but I am going to jump in with it anyway. So, I’m a big fan of Saturday Night Live and I have been really enjoying watching how a TV show, an institution in the States which, admittedly, is sometimes a bit hit or miss, but an institution in the States, is continuing to try to produce content when no one can go into their very famous studio. And there’s something really special, to me, about watching Kate McKinnon try to do a sketch on her own about a cat sanctuary in which every single cat she talks about is just a different version of her own cat with a different costume on.
Amy Maxmen
Laughs. Oh my gosh, that’s like Delores. She has like a red coat. She has a bunny outfit.
Noah Baker
Laughs.
Amy Maxmen
I have to see this skit.
Noah Baker
I think they’re just brilliant. There’s something so make do and mend about it, which is making me smile. Even people that do these things that normally I think are amazing are sitting at home trying to draw moustaches on their cats. Richard, this is your first time on Coronapod but, as you probably know from listening to it, we try to talk about one good thing at the end of every week. Do you have a good thing that you can bring to us?
Richard Van Noorden
I have so many good things, and they’re all involved around just heartening things that people are producing in this pandemic. My first good thing is a new field of psychology in science. The Twitter feed Bookcase Credibility, with its tagline, ‘What you say is not important as the bookcase behind you,’ has a great analysis of bookcases on Zoom and Skype interviews. Really excellent stuff there, and I’m sure a journal will be following soon. It’s just fantastic. I’ve also been getting into print-and-play board games. We actually have a board games group at Nature, which meets up occasionally, about once a month, but obviously, we can’t meet up now, so it turns out that there are print-and-play free board games that you can just print off and play yourself or, in my case, with my wife, and they’re pretty fun and they cost no money and it’s just incredible the ingenuity that people have and making them available for free. So, that’s fantastic. And I’ve also massively been enjoying, it’s really behind the times now because John Oliver has plugged it on Last Week Tonight, but the marble league stuff is a compelling sport involving watching marbles around a track with commentators commenting on them. But perhaps more wholesome here in the UK is that our national broadcaster the BBC has taken to asking the families of the UK to recreate great football goals in their backyards, and then producing professional commentary on them, and it’s just incredible as you watch nine-year-old Sophie managing to overhead kick the ball into a bin and celebrating with her dad. All of these things, it’s just great that people are still finding ways to celebrate sport and laugh at people and come together in these ways, even though no one can actually meet anybody else.
Noah Baker
I have to say, after ten weeks of doing Coronapod, it is so helpful to have someone new to come in with new, fresh good things because we might have started to scrape the barrel.
Amy Maxmen
Although I wanted to say like pace yourself, pace yourself.
Noah Baker
You might run out of good things.
Richard Van Noorden
Three more good things next week.
Noah Baker
Well, thank you so much everyone. We’ve talked about an awful lot there. We will be back next week with episode 11 of Coronapod, and for now, I’ll say goodbye and goodnight and good morning, actually, to Amy in California. So, bye everyone.
Amy Maxmen
Thanks. Bye guys.
Richard Van Noorden
Thanks.
Noah Baker
Finally this week, a few people have asked us on Twitter if we can talk about the many coronavirus research papers being published around the world. Well, we’ve heard you, and here are a few of our top picks from the last month or so. First off, we’ve got a paper published on the preprint server MedRxiv back on 22 April, which suggests that spit could provide a solution to testing shortages. Now, the gold standard test for coronavirus infections requires a long swab to be inserted through your nose and rubbed against the back of your throat. But aside from being a bit uncomfortable, swabs like this are in short supply at the moment. Plus, this invasive procedure can prompt people to cough or sneeze, potentially launching a barrage of viral particles at the tester. But according to this latest study from the Yale School of Public Health, a person’s saliva can also be used to accurately diagnose a COVID-19 infection, and that could make tests safer and more widely available. The research team collected both saliva and conventional throat swabs from people hospitalised with COVID-19. They didn’t detect any virus in some of the patients’ throat swabs, but did detect it in the same patients’ saliva samples. What’s more, their saliva testing also showed that two healthcare workers who felt fine and had negative throat tests were actually infected. The study hasn’t been peer reviewed yet but you can find it over on MedRxiv. I’ll put a link in the show notes.
Noah Baker
Next up, we’ve got a pair of papers published in Nature and Science respectively at the beginning of May. Both of them are trying to get a hold on which measures were responsible for halting the epidemic in China. It seems that it’s not a simple picture. The Nature paper, by a British team, suggested that quick detection and isolation of infected people was the most effective approach to contain COVID-19 cases in China. But they say even with those efforts in place, the number of cases would have soared if officials hadn’t also restricted travel and social interactions. In the Science paper, an international team from Italy and China found that after authorities in Wuhan and Shanghai locked down the cities, people cut their encounters with others from 15-20 per day down to just two. The drastic social distancing was enough to bring the epidemic under control in the two cities. The team’s modelling suggested that in Shanghai, school closures also lowered the number of new infections per day, especially at the peak of the epidemic. But alone, that wouldn’t have stopped the spread.
Noah Baker
And finally, we’ve got a paper published in the New England Journal of Medicine on 13 May, which aims to understand the extent to which the coronavirus can infect organ systems. Although primarily it’s considered to be a respiratory disease, many non-respiratory symptoms have been observed in patients with COVID-19, like intestinal distress, rashes or stroke. A team in Germany conducted autopsies on 27 people and found evidence of the Coronavirus not only in the lungs but also in the kidneys, the heart, brain, blood and other organs. By scrutinising databases of genetic activity, the team found that three genes known to encourage SARS-CoV-2 infection are highly active in kidney cells, which helps to explain the kidney damage seen in some patients with the illness. If you want to read more about the studies I’ve talked about, I’ll put links to all of them in the show notes. And if you want to read more about the latest coronavirus literature, Nature is publishing summaries of key papers all the time. I’ll also throw a link to those in the show notes. And that’s it for this week’s episode of Coronapod. It’s hard to believe that it’s been ten episodes already. If you’ve got any questions or comments for us then please do get in contact. You can find us on Twitter - @NaturePodcast – or you can get in touch at podcast@nature.com. We really want to hear from you. In the meantime, remember there’s a coronavirus-free episode of the Nature Podcast going up every week. You can find that in the same place that you found this, published every Wednesday, and I’ll see you next week for episode 11. Until then, stay safe.