Germany to start first coronavirus vaccine trial

With more than 2.5 million people now infected worldwide in the COVID-19 pandemic, Germany has authorized the first clinical trial of a coronavirus vaccine. The first human tests will begin before the end of April.


German Health Minister Jens Spahn has announced the first clinical trials of a coronavirus vaccine. The Paul Ehrlich Institute (PEI), the regulatory authority which helps develop and authorizes vaccines in Germany, has given the go-ahead for the first clinical trial of BNT162b1, a vaccine against the SARS-CoV-2 virus.

It was developed by cancer researcher and immunologist Ugur Sahin and his team at pharmaceutical company BioNTech, and is based on their prior research into cancer immunology. Sahin previously taught at the University of Mainz before becoming the CEO of BioNTech.

In a joint conference call on Wednesday with researchers from the Paul Ehrlich Institute, Sahin said BNT162b1 constitutes a so-called RNA vaccine. He explained that innocuous genetic information of the SARS-CoV-2 virus is transferred into human cells with the help of lipid nanoparticles, a non-viral gene delivery system. The cells then transform this genetic information into a protein, which should stimulate the body's immune reaction to the novel coronavrius.

Watch video Global race to find coronavirus vaccine

Numerous vaccines in development

Aside from BNT162b1, which is now in the stage 1 testing phase, BioNTech — jointly with Pfizer — is working on three other similar mRNA vaccines. PEI head Klaus Cichutek, meanwhile, has said other pharmaceutical companies are also developing vaccines against SARS-CoV-2, based on a variety of vaccine platforms in Europe, China and the United States.

Read more: Pandemic driving tech solutions in sub-Saharan Africa

The first medical tests of BNT162b1 will involve 200 healthy volunteers between the ages of 18 and 55. The aim is to determine the immune response and whether the vaccine causes any unwanted side effects.

"Trials of vaccine candidates in humans are an important milestone on the road to safe and efficacious vaccines against COVID-19 for the population in Germany and internationally," the PEI said in a statement.


Cichutek said testing would be completed by June, at the earliest. After this stage is complete, the PEI will determine if the vaccine can progress to further trial stages. Cichutek warned, however, that an approved vaccine was unlikely to be ready for the general public in 2020.

More than 2.5 million people have been infected by the COVID-19 pandemic in the last four months, and at least 179,000 people have died.


RESEARCHERS AND THEIR SELF-EXPERIMENTS
An oral vaccination against coronavirus
Courage, curiosity or complete hubris? It's probably a mixture of all these things that causes many scientists to test their own inventions on themselves first. According to the Global Times, a Chinese doctor not only developed an oral vaccine against the SARS-CoV-2 but also tried it out himself. So far, he hasn't seen any side effects.

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German states announce new hotline for male victims of domestic violence

The coronavirus pandemic has seen a spike in reports of domestic violence in Germany. While this issue "predominantly affects women," two German states have announced a new hotline specifically for male victims.



Two German states have set up a hotline for men at risk of violence, ministers of Bavaria and North Rhine-Westphalia announced on Wednesday.

The hotline, specifically for men, can be used by male victims of domestic abuse or sexual violence, but also those by those who are at risk of other kinds of violence. Examples include victims of stalking and arranged marriage.

"With the hotline we hope to make an inroad in the struggle to tackle violence against men," Bavarian Family Minister Carolina Trautner and North Rhine-Westphalia's Equality Minister Ina Scharrenbach said in a press release.

The two ministers also called on other German states to join the initiative.

Lockdowns result in global increase in domestic violence

Domestic violence increasing due to coronavirus

Restrictions on public life have led to families spending a lot more time together at home, and German Families Minister Franziska Giffey has repeatedly warned about the impact of such restrictions on the victims of domestic violence.

Read more: Coronavirus: Fears of domestic violence, child abuse rise

Minister Scharrenbach stressed that domestic violence "predominantly affects women" and confirmed that most funding and resources will continue to go to helping female victims.

Women's refuges and resources to help victims of violence have been put under increasing pressure since social distancing regulations were introduced.

Many existing nationwide services for victims of abuse are also open to men. Figures from 2018 estimate that 18.7% of the victims of domestic violence between couples are male.

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PRIVATE NURSING HOME INDUSTRY
Here is the horrible reason why nursing homes are being unnecessarily overrun by the Trump pandemic

By Sarah Okeson, DCReport @ RawStory April 22, 2020

Former Kansas Gov. Mark Parkinson, a Democrat but the CEO of a nursing home industry group, wrote Trump after the 2016 election seeking a “collaborative approach” to regulation, much like the one the Federal Aviation Administration has had with the aircraft industry.

Team Trump acquiesced, rolling back fines and proposing to weaken rules for infection prevention employees. That collaborative approach has failed, much as it did with the FAA , the agency that enabled failures in the design of the Boeing 737 Max.

Shoddy federal oversight of planes helped kill 346 people. The death toll from the pandemic, where health officials Seema Verma and Alex Azar helped turn our nation’s nursing homes into Trump death traps, is more than 46,000.

“Nursing homes are incubators of epidemics,” said Betsy McCaughey, the chair of the Committee to Reduce Infection Deaths.

So far, more than 7,000 residents or people connected to nursing homes have died. That number includes 12 residents at the Milford Center in Delaware owned by Genesis HealthCare which has an executive, Michael Wylie, who previously chaired the American Health Care Association board.

Parkinson was paid about $3.3 million in 2017 by the association which represents more than 14,000 nursing homes. The association had 45 lobbyists in 2019, including Brian Ballard, the former chairman of Trump’s fundraising committee.
Especially Vulnerable

Nursing home residents are especially vulnerable to infections spread among groups such as the flu and norovirus. In a normal year, almost 388,000 of our nation’s elderly and disabled die of infections they got in nursing homes.

Under Obama, the Centers for Medicare and Medicaid Services created a new position for nursing homes to try to help prevent infections from spreading. The employees, infection preventionists, are supposed to make sure nursing home staff properly clean their hands, disinfect surfaces and other measures to prevent illnesses in residents and staff.

The requirement was part of a 2016 rule that was the first major update to requirements for long-term care providers since 1991. The rule also included protections against abuse, neglect and exploitation of Medicare and Medicaid beneficiaries.

In 2016, a fifth of skilled nursing facilities were cited for actual harm or jeopardy to residents. Only 6.5% had no deficiencies in 2016.

Fines Drop

Under Trump, fines for nursing homes that injured or endangered residents dropped to an average of $28,405 compared to $41,260 during the last year of Obama’s administration. In 2017, CMS put an 18-month moratorium on fines and other penalties for some of the tougher regulations, saying it would use the time to “educate surveyors and the providers.”

Now, Verma and Azar want to weaken the infection preventionist position, changing the position from at least part-time to spending “sufficient time” at the facility. Nursing home inspectors started focusing exclusively on infection control after the pandemic started.

Knock ‘Em Out

More than 1,500 people or organizations commented on the proposed changes, many of them from the nursing home industry. The cutbacks, which also include weakening a resident’s right to file a grievance and allowing nursing homes to medicate residents with antipsychotic drugs indefinitely, are expected to save nursing home operators more than $600 million a year.

Some of the nursing home executives who asked federal regulators to weaken the standards for infection preventionists have had coronavirus outbreaks in their facilities.

Deb Fournier, the chief operations officer for Maine Veterans’ Homes, said in September that she supported the proposed Trump changes in employees charged with preventing infections.

“This will allow LTC facilities to use workforce resources in a manner that best meets the needs of their organizations,” she wrote.

Two people have died at the veterans’ home in Scarborough, Maine, and 38 people have gotten sick.

---30---

Company that failed to deliver ventilators awarded huge new contract from the Trump administration: report

 April 22, 2020 By Pro Publica


by Patricia Callahan and Sebastian Rotella

The Dutch company that received millions of taxpayer dollars to develop an affordable ventilator for pandemics, but never delivered them, has struck a much more lucrative deal with the federal government to make 43,000 ventilators at four times the price.

The U.S. Department of Health and Human Services announced Wednesday that it plans to pay Royal Philips N.V. $646.7 million for the new ventilators — paying more than $15,000 each. The first 2,500 units are to arrive before the end of May, HHS said, and the rest by the end of December.

Philips refused to say which model of ventilator the government was buying. But in response to questions from ProPublica, HHS officials said the government is purchasing the Trilogy EV300, the more expensive version of the ventilator that was developed with federal funds

The deal is a striking departure from the federal contract Philips’ Respironics division signed in September to produce 10,000 ventilators for the Strategic National Stockpile at a cost of $3,280 each.



“This kind of profiteering — paying four times the negotiated price — is not only irresponsible to taxpayers but is particularly offensive when so many people are out of work,” said Dr. Nicole Lurie, who served as the HHS assistant secretary for preparedness and response during the Obama administration. “And besides, most of these ventilators will come too late to make a difference in this pandemic. We’ll then ’replenish’ the stockpile at a ridiculously high price.”

“What else,” she asked, “won’t we be able to buy as a result?”

In an article March 30, ProPublica detailed how the agency’s Biomedical Advanced Research and Development Authority, known as BARDA, had anticipated a decade ago that hospitals would run short of life-saving ventilators in the event of a pandemic. BARDA tried to find a company that could produce an inexpensive, durable ventilator that could be operated by people with minimal training during a crisis. After a deal with one company fell apart, HHS in 2014 agreed to pay Philips $13.8 million to design the stockpile ventilator with an option to purchase 10,000 for $3,280 each. The company won Food and Drug Administration clearance for its Trilogy Evo Universal ventilator in July, and in September HHS put in its order.

But Philips didn’t deliver any ventilators to the stockpile even as the coronavirus spread across the globe and hospitals scrambled for ventilators to keep their patients alive. Rather than making the government-funded design, Philips has been manufacturing more expensive commercial versions of the Trilogy Evo at its Pennsylvania plant and selling them overseas and in the United States.

Philips said it was within its rights to sell the commercial versions first because its contract with HHS gave the company until 2022 to produce the cheaper stockpile version. Philips had only made the stockpile version in small batches and didn’t want to ramp up production on a ventilator that it hadn’t mass produced, a slower process than increasing production of other models, company spokesman Steve Klink explained last month. He also said the government contract did not cover all of the costs for the ventilators’ development.

Now the company won’t have to try. The Philips contract announced Wednesday is for the commercial version, the Trilogy EV300, with the government paying $15,039 each.

The HHS statement said the agency purchased “what was immediately available” under “negotiated pricing” with Philips. President Donald Trump directed HHS Secretary Alex Azar to invoke the Defense Production Act in brokering the deal, the statement said.

The government still expects Philips to produce the 10,000 stockpile versions of the ventilator, but no completion date was given in the statement.

Lurie was in charge of the HHS office that struck the 2014 deal with Philips. During her time, congressional Republicans elected on a Tea Party wave forced cuts in federal spending that hampered efforts to bulk up the stockpile. The goal of the Philips deal, Lurie said, was to produce a low-cost, easy-to-use ventilator and use the stockpile’s budget responsibly. But it was also an effort to show the industry that low-cost ventilators were feasible.

“This was a strategy to reduce health care costs,” Lurie said. “This feels like a conspiracy to keep them high.”

In a news release touting the deal on Wednesday, Philips said that it has been ramping up production and this year has delivered several thousand ventilators to U.S. hospitals — including one in hard-hit New York City. The company, which only makes ventilators in the U.S., said it wanted to continue selling ventilators to other countries in need. Klink declined to comment further.

John Hick, an emergency medicine specialist in Minneapolis who has advised HHS on pandemic response, said it would have been better to have a simpler and cheaper ventilator on hand.

“Don’t get me wrong, I am happy they are getting ventilators,” he said. “If you could buy four times as many for the price, why wouldn’t you do that?”

Hick hopes that federal officials will learn a lesson from the Philips deal.

“We have lost a lot of time,” he said. “It’s kind of like telling someone we are going to hurricane-proof your house after the hurricane has hit.”

Humanity must ‘tackle two crises at once,’ says Greta Thunberg of climate and COVID-19 on 50th Earth Day

April 22, 2020 By Common Dreams


4 VIDEOS ARE AT THE END OF THE ARTICLE

U.N. Chief António Guterres declared the pandemic “an unprecedented wake-up call” and urged world leaders to pursue a “green recovery.”

The 50th annual global Earth Day coming amid the coronavirus pandemic sparked fresh demands from Fridays for Future founder Greta Thunberg, United Nations Secretary-General António Guterres, and others for the international community to simultaneously tackle the COVID-19 and climate crises.

“Today is Earth Day and that reminds us that the climate and environmental emergency is still ongoing and we need to tackle both the corona pandemic, this crisis, at the same time as we tackle climate and environmental emergency, because we need to be able to tackle two crises at once,” said 17-year-old Thunberg.

She emphasized that while it is always “important” and “essential” to be guided by science, “during crises like this it is even more important that we listen to scientists, science, and to the experts. That goes for all crises, whether it’s the corona crisis or whether it’s the climate crisis.”

Thunberg’s comments came in a livestreamed conversation with Johan Rockström, a Swedish professor who is joint director of the Potsdam Institute for Climate Impact Research (PIK) in Germany, hosted by the Nobel Prize Museum. The teen activist, also a Swede, has twice been nominated for the Nobel Peace Price.

Thunberg’s youth-led climate action movement Fridays for Future marked Earth Day by releasing a short video entitled “Our House Is On Fire,” evoking a speech the activist delievered at the World Economic Forum’s annual summit in Davos, Switzerland in January 2018.

“We believe it’s time people realize that climate change isn’t going to happen, but that it’s already happening,” Fridays for Future U.S. spokesperson Joe Hobbs said in a statement. “We hope that by watching this video people will realize they need to take action now, instead of putting it off until later.”

During a video address Wednesday, Guterres said: “On this International Mother Earth Day, all eyes are on the COVID-19 pandemic—the biggest test the world has faced since the Second World War. We must work together to save lives, ease suffering, and lessen the shattering economic and social consequences.

“But there is another deep emergency—the planet’s unfolding environmental crisis,” he added. “Biodiversity is in steep decline. Climate disruption is approaching a point of no return. We must act decisively to protect our planet from both the coronavirus and the existential threat of climate disruption.”

Guterres declared that “the current crisis is an unprecedented wake-up call” and outlined six “climate-related actions to shape the recovery and the work ahead,” urging world leaders to pursue a green recovery from the pandemic that ensures “a healthy and resilient future for people and planet alike.”

As the coronavirus has spread across the globe, killing nearly 180,000 people, infecting more than 2.59 million, and devastating the world’s economy, climate and environmental activists have called for a global Green New Deal and just recovery that prioritizes a rapid transition to renewable energy and other efforts to reduce planet-heating emissions and pollution more broadly. Recent studies tying poor air quality to COVID-19 deaths have added weight to those demands.

The U.N. chief’s comments Wednesday were welcome by 350.org, a global environmental advocacy group leading the calls for a just recovery from the public health crisis:

#EarthDay2020 BREAKING: Secretary General of @UN calls on governments to use their economic response to the Coronavirus pandemic to respond to the “even deeper emergency” of #ClimateCrisis with #JustRecovery for all (via @ReutersUK
) https://t.co/COCJ4AqycV #FightEveryCrisis
— 350 dot org (@350) April 22, 2020

Author and activist Bill McKibben, co-founder of 350.org, discussed Earth Day, the climate crisis, and the COVID-19 pandemic on Democracy Now! Wednesday morning. McKibben’s interview echoed his piece for The New Yorker last week entitled “How We Can Build a Hardier World After the Coronavirus.”

Among the key messages that the coronavirus pandemic is sending the world, according to McKibben, is the importance of listening to science. As he put it during the show: “If they say stand six feet apart, we stand six feet apart. If they say it’s time to stop burning coal and gas and oil, then that’s what we need to do.”

“Similarly, we’re learning lessons about delay in timing here that are crucial,” McKibben continued. “As you know, the countries that flattened the coronavirus curve early on are doing far better than those like ours, which delayed. That’s a pretty perfect analog to the 30 years that we’ve wasted in the climate crisis.”

“And I think third, maybe most powerfully,” he added, “the lesson that we’re learning is social solidarity is almost everything.”

Addressing how the ongoing coronavirus-related lockdowns have caused a massive decline in emissions and pollution around the world, McKibben said that “there are people on Earth who are getting literally their first lungfuls of clean air this month in their lives… Even as we all live through the horror of this pandemic, there are people who are glimpsing the way that the world could be.”

Facebook ‘complicit’ in Vietnam censorship: Amnesty

April 22, 2020 By Agence France-Presse

Amnesty International on Wednesday accused Facebook of “caving” to Vietnam’s strict censorship regime, after the US tech giant confirmed it was blocking content deemed illegal by the country’s communist government.

Authorities regularly sentence domestic critics to harsh prison terms but have come under fire recently for targeting dissent on the world’s most popular social network.
Facebook is a popular platform for activists in Vietnam, where all independent media is banned, but the company confirmed in a statement to AFP that it had been instructed by Hanoi to restrict access to content “deemed to be illegal”.

“We have taken this action to ensure our services remain available and usable for millions of people in Vietnam, who rely on them every day,” a spokesperson said.

But Amnesty said the decision was “a devastating turning point for freedom of expression” in the country.

“Ruthless suppression of freedom of expression is nothing new, but Facebook’s shift in policy makes them complicit,” said the rights watchdog’s William Nee.

More than 53 million people in Vietnam — over half the population — use Facebook. The platform is also a crucial marketing tool for local business.

Domestic social media networks have so far failed to win a share of that lucrative online market.

Since the beginning of the year, authorities have questioned hundreds of Facebook users over posts connected to the coronavirus pandemic and the government’s handling of the health crisis.

Several were slapped with fines and had their posts removed after admitting they had spread “fake news”.

The government introduced a new regulation this month that makes it easier for authorities to fine and jail online critics.

Around 10 percent of Vietnam’s current crop of political prisoners were jailed because of their activity on Facebook, Amnesty says.

© 2020 AFP

2019 was Europe’s hottest year ever: EU


April 22, 2020 By Agence France-Press


Last year was the hottest in history across Europe as temperature records were shattered by a series of extreme heatwaves, the European Union’s satellite monitoring surface said Wednesday.

In its annual report on the state of the climate, the EU’s Copernicus Climate Change Service (C3S) said that 11 of the continent’s 12 warmest years on record have been since 2000 as greenhouse gas emissions continue to rise.

Warm conditions and summer heatwaves contributed to widespread drought across southern Europe, while areas of the Arctic were close to one degree Celsius hotter than a typical year, it said.

Overall, temperatures across Europe have been 2C hotter during the last five years than they were in the latter half of the 19th century, C3S’s data showed.

2019 globally was second-hottest only to 2016, a year that experienced an exceptionally strong El Nino warming event.

C3S director Carlo Buontempo said that while 2019 was Europe’s hottest year on record, it was important to focus on the continent’s long-term heating.

“One exceptional warm year does not constitute a warming trend, but to have detailed information from our operational service, that covers many different aspects of our climate, we are able to connect the dots to learn more about how it is changing,” he said.

Some parts of Europe experienced periods up to 4C hotter than the historic baseline last year, and heatwaves — notably in June and July — saw temperature records shattered in France, Germany and Britain.

The Paris climate deal commits nations to limit global temperature rises to “well below” 2C above pre-industrial levels.

To do so, and to stand any hope of meeting the accord’s more ambitious cap of 1.5C of warming, the UN says emissions from fossil fuel use must fall 7.6 percent annually by 2030.

– ‘Massive emissions reductions’ –
While carbon pollution levels are expected to drop significantly in 2020 due to the economic slowdown from the pandemic, there are fears that emissions will surge back once a vaccine is found.

“The response to the COVID-19 crisis could exacerbate the climate crisis if bailouts of the fossil fuel industry and fossil-intensive sectors are not conditional on a transition to clean technologies,” said Cameron Hepburn, director of the University of Oxford’s Smith School of Enterprise and the Environment.

Andrew Shepherd, director of the University of Leeds’ Centre for Polar Observation and Modelling, said C3S’s data was all the more worrying as it foreshadowed accelerated melting of the Greenland Ice Sheet.

“We can’t avoid the rapid changes in climate that are happening around our planet, even if they occur miles away in the polar regions, because they affect our weather today and will affect our coastlines in the future,” he said.

Anna Jones, a climate scientist at British Antarctic Survey, said she wasn’t surprised by the C3S findings.

“Concentrations of greenhouse gases in the atmosphere are obstinately increasing as a result of human activity,” she said.

“With this rise come changes in our climate – warming trends and events of extreme weather.”

“For things to improve, we need massive reductions in greenhouse gas emissions – there is no other way,” Jones added.

© 2020 AFP

Senators want to ban U.S. from purchasing animals from China's 'wet markets'


Dareh Gregorian,
NBC News•April 22, 2020


A bipartisan group of senators is proposing a bill to ban the U.S. from buying animals from the Chinese "wet markets" that have been blamed for outbreaks including the current coronavirus crisis.

The government has previously used animals — including cats and dogs — purchased at those markets in gruesome experiments at a federal lab in Maryland.

Sen. Joni Ernst, R-Iowa, said the purchases effectively subsidized the markets, which are believed to be the source of the current crisis as well as the 2002 SARS outbreak.

“As Iowans, and all Americans, continue to battle COVID-19, we need to do all we can to ensure something like this never happens again. That includes preventing any more American tax dollars from going to unregulated ‘wet markets’ in China,” Ernst said.

The bill proposed by Ernst and Sens. Mike Braun, R-Ind., Jeff Merkley, D-Ore., and Joe Manchin, D-W.V., would ban agencies and government grantees and contractors from spending money at the markets.
 

Image: Feline (WCW)

NBC News reported last year that U.S. government scientists had bought hundreds of dogs and cats from "meat markets" in China and Vietnam that were then euthanized and fed to cats at the USDA's Agricultural Research Service's Animal Parasitic Disease Laboratory in Beltsville, Maryland.

The experiments — some of which the agency said in scientific reports were aimed at studying a parasite that causes the food-borne illness toxoplasmosis — are believed to have been conducted between 2003 and 2015.

Jim Keen, a former USDA scientist, told NBC News the experiments sounded "crazy." "Cannibal cats, cats eating dogs — I don't see the logic," Keen said.

The A.R.S. announced it was permanently halting the experiments after the NBC News report.

The White Coat Waste Project, a non-profit that combats wasteful government spending on animal testing and waged a year-long campaign against the cat experiments, applauded the senators for their bill, which it said would "ensure government employees don’t ever go on another taxpayer-funded shopping spree for cats, dogs or any other animals" at the markets.

"The government never should have spent taxpayer dollars at China's wet markets, and this bill will make sure it never does again,” said Justin Goodman, the groups vice president of advocacy and public policy.

'The call has been answered': Animal shelters across the U.S. are emptying amid coronavirus pandemic

Cameron Oakes, NBC News•April 19, 2020

Megan Lemaire always wanted a dog growing up, but was never allowed to have one.

So when Lemaire, a 22-year-old student at Washington University in St. Louis, heard that area shelters needed foster families to care for animals during the coronavirus outbreak, she and her roommate applied to provide a home to a pet in need.

They drove to the shelter, where they were paired with the second dog they met — Vorhees, a pitbull mix. "We just really loved her," Lemaire said.

As coronavirus spreads across the U.S., Americans in some of the country's hardest-hit regions have stepped up to foster and adopt animals, keeping them out of shelters. NBC News contacted shelters and animal advocacy organizations with facilities in California, Michigan, New Jersey, Connecticut, New York, Texas, Washington, Florida, Georgia, Illinois, and North Carolina. Every single organization said it was overwhelmed by the outpouring of community support that got animals out of shelters and into loving foster and adoptive homes.

Megan Lemaire takes her foster dog, Vorhees, on a walk in St. Louis.

 Vorhees has lived with Megan and her roommate for three weeks. (Arno Goetz)

Humane Society of the United States President and CEO Kitty Block said that the organization has worked with its 400 shelter partners to spread the word about the need to clear shelters by placing pets with foster and adoptive homes. "The call has been answered," Block said.

Matt Bershadker, president and CEO of the American Society for the Prevention of Cruelty to Animals (ASPCA), said that the organization has seen a 70 percent increase in animals entering foster care in their New York City and Los Angeles programs compared to this time last year.

In Los Angeles, Bershadker said the organization is delivering kittens to foster and adoptive families using ride-sharing apps. A spokesperson for Los Angeles County Animal Services told NBC News in an email that the county placed 307 animals in foster care and found homes for 919 pets in March.

Health & Wellness
Victoria Gingrey, a spokesperson for The Humane Society for Tacoma and Pierce County in hard-hit Washington state, told NBC News that the shelter has placed 475 animals in adoptive homes since March 1. The shelter had only 25 animals available for adoption as of Wednesday, which Gingrey said is "pretty low" for this time of year.

The Liberty Humane Society shelter in Jersey City, New Jersey, across the Hudson River from the pandemic's epicenter in New York City, put out a plea to the public to foster pets, but Executive Director Irene Borngraeber said she did not know whether people would step up to care for the animals.

Borngraeber said the shelter was "overwhelmed" by the level of response they received from the public. "We were actually able to place every single one of our animals into foster care, the day before [New Jersey's] shelter-in-place order formally went into place," she said.

Baytown Texas Adoption Center was able to clear out its shelter by March 28. The shelter, just 30 minutes outside of Houston, had no foster program in place when the state announced its first coronavirus case on March 4. But April Moore, the animal services manager for the city, said that the shelter began building a foster program on March 16. Just eight days later, the shelter placed its first dog in a foster home. The shelter had just one dog left in its care when NBC News spoke to Moore on Wednesday.


In Georgia, shelters have also found success placing animals in adoptive and foster homes. "We've seen an incredible outpouring of support," Atlanta Humane Society Spokesperson Christina Hill, said. "It's been really heartwarming to see that."

Hill told NBC News that the shelter has placed 217 animals in foster homes since March 11, and found 151 animals permanent homes between March 11 and 15. As of Tuesday, Atlanta Humane Society had only 15 animals in the shelter.

And between April 5 and April 12, Chicago Animal Care and Control had no adoptable animals, according to an emailed statement from spokesperson Jennifer Schlueter.

Now for the bad news

The shelters are empty now, but experts worry about the future.
Shelter directors told NBC News they worry that the economic impact of the pandemic, which hit the U.S. at the start of peak breeding season, may cause an influx of homeless pets in the coming months.

Early spring marks the beginning of "kitten season," when animals tend to reproduce in large numbers. Usually, shelters work with animal control officers to trap and sterilize homeless animals to combat overpopulation. And new adoptions are spayed or neutered before the adoption process is completed.

But most of the shelters NBC News contacted have halted spay and neutering procedures, saving surgical veterinary care and essential supplies for the sickest animals. The Humane Society of Greater Miami is spaying and neutering shelter animals once per week, but the clinic is closed to the general public.

Susie, a dog fostered and adopted during the coronavirus pandemic, plays with her new owner. (Courtesy Atlanta Humane Society)

With an estimated 22 million Americans now unemployed, the shelter directors said that they worry it will be difficult to find homes for the surge in newborn animals they expect to see, and that already-adopted pets may be surrendered by families that can no longer afford to care for them.

The majority of shelters NBC News spoke to have programs to get pet food to families in need. Other shelters, like the Humane Society of Greater Miami, do not have a pet food bank but provide the food and supplies foster families need to care for their pets.

Bershadker said that the ASPCA has provided 9,000 pets with food at its distribution centers in New York City, Miami, Fla., Asheville, N.C., and Los Angeles. He said the organization expects to serve 100,000 pets by mid June.

"The idea behind this is to provide the critical resources to pet owners so that they can responsibly keep and care for the pets that they love and they're bonded to — keep them out of the shelter in the first place," Bershadker said.

And with at least 720,000 coronavirus cases in the U.S. as of Saturday, shelters are concerned they may see an influx of animals surrendered or abandoned by sick owners.

Scott Giacoppo, president of the National Animal Care and Control Association, told NBC News that the best way to prevent that type of overcrowding is to make a plan for what will happen to a pet if the owner becomes sick with COVID-19. He said that owners should put a list of multiple people who would take their pet in on their front door, along with contact information and care instructions, in case animal control is called for an unresponsive pet owner.

Ziggy plays with his new owner and two of his foster kitten housemates. He was fostered and adopted during the coronavirus pandemic. (Courtesy Atlanta Humane Society)

If foster families are no longer able to care for their animals, the shelters NBC News spoke to said they either recruit a new family to take the animal or take the animal in while they try to find the animal a new home. "While we always want to empower our foster care providers to take an active role in helping the pet in their care find their new home," said Moore. "We are also prepared to take a pet back into care at the shelter when or if the need arises."

Hill said that more than 70 percent of the animals in Atlanta Humane Society's foster care program have already been adopted. But she emphasized that it is important for foster families to try to let the shelter know as soon as possible if they can no longer care for the pet, so that the shelter can find another home.

Shelters are also in need of more financial and material donations to help provide essential care for their animals. But James Bias, executive director of the Connecticut Humane Society, said that it is important to find out what a local shelter needs before trying to donate. "Reach out. Check their website, check their social media," Bias said. "Don't assume that they're going to need certain things and just show up with those items."

In St. Louis, Lemaire has now had Vorhees at home for three weeks. In addition to the comfort of daily dog snuggles, Lemaire said having a dog has provided a lot of structure to a schedule that would have otherwise revolved around remote classes. Lemaire said she does not plan to adopt Vorhees because of the uncertainty of post-graduate life, and has worked with the organization she fosters for, the Center for Animal Rescue and Enrichment STL, to place the dog in a permanent home. Lemaire said that the experience has been "a true dream come true."

New analysis recommends less reliance on ventilators to treat coronavirus patients

By SHARON BEGLEY APRIL 21, 2020

ADOBE

By using ventilators more sparingly on Covid-19 patients, physicians could reduce the more-than-50% death rate for those put on the machines, according to an analysis published Tuesday in the American Journal of Tropical Medicine and Hygiene.

The authors argue that physicians need a new playbook for when to use ventilators for Covid-19 patients — a message consistent with new treatment guidelines issued Tuesday by the National Institutes of Health, which advocates a phased approach to breathing support that would defer the use of ventilators if possible.

As the pandemic has flooded hospitals with a disease that physicians had never before seen, health care workers have had to figure out treatment protocols on the fly. Starting this month, a few physicians have voiced concern that some hospitals have been too quick to put Covid-19 patients on mechanical ventilators, that elderly patients in particular may have been harmed more than helped, and that less invasive breathing support, including simple oxygen-delivering nose prongs, might be safer and more effective.

The new analysis, from an international team of physician-researchers, supports what had until now been mainly two hunches: that some of the Covid-19 patients put on ventilators didn’t need to be, and that unusual features of the disease can make mechanical ventilation harmful to the lungs.

“This is one of the first coherent, comprehensive, and reasonably clear discussions of the pathophysiology of Covid-19 in the lungs that I’ve seen,” said palliative care physician Muriel Gillick of Harvard Medical School, who was one of the first to ask if ventilators were harming some Covid-19 patients, especially elderly ones. “There is mounting evidence that lots of patients are tolerating fairly extreme” low levels of oxygen in the blood, suggesting that such hypoxemia should not be equated with the need for a ventilator.

If a Covid-19 patient is clearly struggling to breathe, then invasive ventilation makes sense, wrote Marcus Schultz of Amsterdam University Medical Centers and his colleagues.

But using low levels of blood oxygen (hypoxemia) as a sign that a patient needs mechanical ventilation can lead physicians astray, they argue, because low blood oxygen in a Covid-19 patient is not like low blood oxygen in other patients with, for instance, other forms of pneumonia or sepsis.

The latter typically gasp for breath and can barely speak, but many Covid-19 patients with oxygen levels in the 80s (the high 90s are normal) and even lower are able to speak full sentences without getting winded and in general show no other signs of respiratory distress, as their hypoxemia would predict.

Related:
With ventilators running out, doctors say the machines are overused for Covid-19

“In our personal experience, hypoxemia … is often remarkably well tolerated by Covid-19 patients,” the researchers wrote, in particular by those under 60. “The trigger for intubation should, within certain limits, probably not be based on hypoxemia but more on respiratory distress and fatigue.”

Absent clear distress, they say, blood oxygen levels of coronavirus patients don’t need to be raised above 88%, a much lower goal than in other causes of pneumonia.

Without effective drugs, surviving severe Covid-19 depends on supportive care, including breathing support where necessary. But recommendations for that care are largely based on guidelines for other viral pneumonias and sepsis. That explains the second reason ventilators aren’t helping more patients: Covid-19 affects the lungs differently than other causes of severe pneumonia or acute respiratory distress syndrome, the researchers point out, confirming what physicians around the world are starting to realize.

In this video, we look at how ventilators work, and how they are used to treat patients with Covid-19.

For one thing, the thick mucus-like coating on the lungs developed by many Covid-19 patients impedes the lungs from taking up the delivered oxygen.

For another, unlike in other pneumonias the areas of lung damage in Covid-19 can sit right next to healthy tissue, which is elastic. Forcing oxygen-enriched air (in some cases, 100% oxygen) into elastic tissue at high pressure and in large volumes can cause leaks, pulmonary edema (swelling), and inflammation, among other damage, contributing to “ventilator-induced injury and increased mortality” in Covid-19, the researchers wrote.

“Invasive ventilation can be lifesaving, but can also damage the lung,” Schultz told STAT.

It’s important to highlight “aspects of Covid-19 that differ from other diseases that require respiratory support,” said Phil Rosenthal of the University of California, San Francisco, editor of the journal. Patients with Covid-19 pneumonia are often less breathless “compared to other patients with similar [blood oxygen] levels,” he said, adding that this difference “may allow physicians to avoid intubation/ventilator support in some patients.”

There is a growing recognition that some Covid-19 patients, even those with severe disease as shown by the extent of lung infection, can be safely treated with simple nose prongs or face masks that deliver oxygen.The latter include CPAP (continuous positive airway pressure) masks used for sleep apnea, or BiPAP (bi-phasic positive airway pressure) masks used for congestive heart failure and other serious conditions. CPAP can also be delivered via hoods or helmets, reducing the risk that patients will expel large quantities of virus into the air and endanger health care workers.

Earlier this month, the Mount Sinai Health System in New York developed a protocol to repurpose sleep apnea machines for Covid-19 patients, while in Rhode Island, the Department of Public Health, University of Rhode Island, and others are collecting the devices for hospitals to use instead of ventilators where possible.

“We use CPAP a lot, and it works well, especially in combination with having patients lie prone,” Schultz said.

The Covid-19 treatment guidelines released by the NIH do not specifically address what criteria physicians should use for putting patients on a ventilator. But in a recognition of the damage that the ventilators can do, they recommend a phased approach to breathing support: oxygen delivered by simple nose prongs, escalating if necessary to one of the positive-pressure devices, and intubation only if the patient’s respiratory status deteriorates. If mechanical ventilation becomes necessary, the NIH said, it should be used to deliver only low volumes of oxygen, reflecting the risk of damaging healthy lung tissue.

“Patients can tolerate low oxygen levels in the blood often remarkably well,” Schultz said. “They do not need to be intubated [unless levels are] getting too extremely low for too long.” Some patients “were asked to get off their cell phone because they had to be intubated,” he added. “That is not necessary, and we frequently decided not to intubate."

This story has been updated with additional comments from outside experts.

About the Author
Sharon Begley
Senior Writer, Science and Discovery