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Covid-19 Situation Report

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Covid-19 Situation Report COVID-19 SITUATION REPORT March 26, 2020 | Joshua Sharfstein, MD HTTP://CORONAVIRUS.JHU.EDU © 2020 Johns Hopkins University. All rights reserved 3 The U.S. Has Followed the Trajectory of Other Heavily Impacted Countries More cases in U.S. per day than any country. More cases reported per day in U.S. than at peak of Chinese epidemic. Source: CSSE COVID Dashboard, Johns Hopkins © 2020 Johns Hopkins University. All rights reserved 4 What’s New This Week New York For Mayors There has been Even if a slower rise than in a major surge of New York, other cities could follow seriously ill patients in a similar path. Strong control New York City. measures remain necessary. © 2020 Johns Hopkins University. All rights reserved 5 What’s New This Week Therapeutics For Mayors Rising demand for chloroquine – despite Instead of chasing after no high-quality studies demonstrating unproven therapies, mayors effectiveness – has created shortages for should support the gathering patients who need these medications for of high-quality evidence to find other conditions. out what works. © 2020 Johns Hopkins University. All rights reserved 6 What’s New This Week Many biotech companies are investing in COVID-19 vaccines I-Mab Biopharma BioNTech and Applied DNA Sciences Clover and GSK Altimmune Completes announce research Announces Fosun Pharma form Vaxart Announces Subsidiary, LineaRx, First Development Development of TJM2 Moderna’s Work on a Australia ramps up Integral Molecular COVID-19 vaccine Initiation of and Takis Biotech collaboration to Tonix Pharmaceuticals Milestone Toward A to Treat Cytokine Potential Vaccine efforts to fight Accelerates strategic alliance in Coronavirus Vaccine Collaborate for evaluate coronavirus Announces Research Single-Dose Intranasal Release Syndrome Against COVID-19 coronavirus with Collaboration with Coronavirus Vaccine Associated with Severe China Program Development of a (COVID-19) vaccine COVID-19 Vaccine genetic sequence in Southern Research to Research and Critically-Ill Linear DNA Vaccine candidate with hand Sanofi joins forces Develop a Potential Vaccine Patients with Candidate Against pandemic adjuvant with U.S. Department to Protect Against New Coronavirus Disease Wuhan Coronavirus system Coronavirus Disease 2019 (COVID-19) of Health and Human (COVID-19) Based on 2019-nCoV Generex signs contract Services to advance a Horsepox Virus (TNX-1800) Medicago Develops with EpiVax to develop Ii- novel coronavirus Plant-Based vaccine Novavax Advances Key peptide vaccines to Coronavirus Vaccine Development of Novel address the Coronavirus Candidate COVID-19 Vaccine pandemic Jan Jan Feb Feb Feb Feb Feb Feb Feb Feb Feb Feb Feb Feb Feb Mar Mar Mar Mar Mar Mar Mar Mar Mar 13 30 2 3 7 11 12 17 18 20 24 25 26 27 28 3 4 6 9 12 13 15 16 17 Heat Biologics iBio and CC-Pharming Dyadic and The Israel Launches Program to Institute for Biological Initiate Joint Develop Vaccine CanSinoBIO’s Inovio Collaborating Research (IIBR) Predictive Oncology Development of Designed to Protect Launches New AI Investigational Vaccine With Beijing Advaccine Expand Collaboration Against COVID-19 Coronavirus Vaccine Zydus Cadila looks to Against COVID-19 Platform for Vaccine To Advance INO-4800 Johnson & Johnson to Combat Emerging Approved for Phase 1 Announces expedite Covid-19 Coronavirus and Drug Development Vaccine Against New Diseases Targeting Clinical Trial in China Collaboration with U.S. vaccine development Coronavirus In China Department of Health Coronaviruses and CureVac focuses on Acute Respiratory Israeli company & Human Services to Serum Institute of the development of Kamada working on Accelerate Syndromes (COVID- India brings Covid-19 19, MERS, and SARS) mRNA-based ‘passive vaccine’ for Development of a coronavirus vaccine to coronavirus Potential Novel vaccine into animal AJ Vaccines To Develop Coronavirus Vaccine testing Vaccine for COVID-19 protect people worldwide Breakthrough From Israel’s MIGAL Research Institute in Development of Corona virus (COVID- 19) Vaccine 7 7 What’s New This Week Serology Tests For Mayors FDA has cleared the first This is an example of a tool that will help serology tests, which inform local efforts over time and help measures the antibody with strategic decisions on opening the response to the virus. economy. We are not stuck in this period of uncertainty forever. © 2020 Johns Hopkins University. All rights reserved 8 Focus: When is it appropriate to end extreme social distancing? Dr. Tom Frieden • President and CEO, Resolve to Save Lives • Former Director, U.S. Centers for Disease Control and Prevention • Former Health Commissioner, New York City © 2020 Johns Hopkins University. All rights reserved 9 COVID-19 DR. TOM FRIEDEN | MARCH 26, 2020 March 10, 2020 COVID-Pandemic Severity Assessment Framework by Age COVID-19 is more severe for older people and those with underlying health conditions Likely severity of COVID-19, based on what is known about spread and severity Scaled measure transmissibility of compared to historic seasonal and pandemic influenza Scaled Measure of Clinical Severity Adapted from Reed et al. Emerg Infect Dis. 2013;19:85-91. Data as of March 9, 2020. 11 Adaptive Response Cases Over Time Early detection (lab testing, alert clinical systems) and case isolation (home, hospital, other facilities) Extensive testing Extensive testing Disease Contact tracing Contact tracing Control Health care infection prevention and control Appropriate clinical care including staff surge when needed Community engagement with clear communication, assessment of community acceptance leading to adjustment of approach Everyday personal NPIs (wash hands, cover coughs, stay home if ill) Non- Environmental NPIs (clean surfaces, increase ventilation) Pharmaceutical Personal NPIs (household quarantine, mask in community if ill) Interventions (NPI) Community NPIs Community NPIs Community Community (high-risk group (general social NPIs NPIs social distancing and distancing [SD] and (general SD (general SD closing schools) closing schools [CS]) and CS) and CS) Address ongoing health care needs including supply chain management and increased telemedicine Supporting Support continued social and economic activity including learning, emergency services, essential activities society Protect vulnerable populations Pharmaceutical Treatments interventions Vaccines Version 2.0, 20 March 2020 Containment Mitigation Suppression Prevention 12 TWO Reasons for Sheltering-in-Place Strengthen health care 1 2 and public health Health care Flatten the Curve Safer surge: 1. Many mildly ill patients, 2. Intensive care capacity, 3. Continuity of care So health care facilities for people with non-coronavirus-related conditions are not overwhelmed, especially with patients Public health who need intensive care Capacity for testing, contact tracing, isolation for viral pneumonia of ill people, quarantine of contacts 13 DRAFT CRITICAL PERFORMANCE TARGETS Empowered incident manager aligned Daily briefing with 1 with political leaders 4 accurate numbers on infected, ill, deaths, and updated guidance Can test every patient with pneumonia, by credible 2 every symptomatic person, capacity for spokesperson drive-through (or equivalent) testing Health care workers 5 adequately protected Can start contact tracing within hours of with policies, training, 3 case identification, obtain contacts for and sufficient personal >95% of cases, track >95% of contacts, protective equipment test 100% of symptomatic contacts, monitor >95% of quarantined contacts for 14 days 14 DRAFT CRITICAL PERFORMANCE TARGETS Health care systems able surge safely to Community engagement 6 care for large numbers of mildly ill patients, 9 with assessment of a large increase in patients needing community perceptions intensive care, and for patients needing and behaviors and ongoing, non-coronavirus-related care effectiveness of messaging System in place to resume targeted 7 or general social distancing measures rapidly if needed Rapid and smooth 10 coordination with state, federal, and county Capacity to support nutrition, governments and health 8 learning, physical and mental departments wellbeing, and social needs during sheltering-in-place 15 THREE Considerations for When It’s Safe to Come Out Again 1 2 3 Cases no longer Stronger health Public health spreading widely care system capacity Fewer unlinked cases, falling Able to withstand blip of Test patients and trace case rates, contact tracing cases without risking health contacts immediately, isolate keeping up with case reports care worker and patient lives the ill, quarantine contacts 16 THREE Considerations for How to Safely Loosen the Faucet on Sheltering-in-Place 1 2 3 Medically vulnerable Prioritize Prepare to tighten the continue to shelter societal benefit faucet if cases spike Potentially, those with Day care, maybe schools Test patients and trace prior illness will be (protecting the vulnerable), contacts immediately, isolate protected – but we don’t infrastructure, partial safe the ill, and quarantine know this yet re-opening, sanitizer/temp contacts effectively checks 17 .
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