Restrictions tightened, but no new virus lockdown in Belgium

Belgian Prime minister Alexander De Croo stopped short Friday of imposing another full lockdown, as the country did in March, but introduced a series of new restrictive measures as the number of COVID-19-related hospital admissions and deaths continues to soar.

Already severely hit during the first wave of the pandemic, Belgium is now the second-worst country in the European Union in terms of coronavirus infections per 100,000 inhabitants.

“We want to ensure that our doctors and hospitals can keep doing their work, that children can continue attending schools and that businesses can continue working while preserving as much as possible the mental health of our population,” De Croo said as he unveiled the new restrictions during a press conference.

Belgium had already introduced a list of measures aimed at slowing infections, including a night-time curfew and closing bars and restaurants. Visits at nursing homes have also been limited, but many health experts think the new curtailment won’t be enough to break the contagion chain.

“We were told strong and hard measures would be announced, we don’t see them,” epidemiologist Yves Coppieters told broadcaster RTBF.

According to the latest official figures, some 10,000 new people are infected on a daily basis by the virus, which has already killed more than 10,500 people in the small nation of just 11.5 million. The health situation is so dramatic in nine out of 10 of Belgium’s provinces that authorities have recently warned intensive care units will hit their capacity by mid-November if new coronavirus cases continue to soar at the same pace.

To avoid a collapse of the health system, health minister Frank Vandenbroucke said that the number of beds available in ICUs will be increased to 2,300, while nonurgent operations will be postponed over the next four weeks.

Following government talks held via video conference after several ministers got infected by the virus, De Croo decided to reinforce the sanitary protocols mainly in the culture and sports sectors. Until Nov. 19, theaters and cinemas will be allowed to accommodate a maximum audience of 200, while sports fans are banned from attending matches. In amateur sports, competitions involving over-18 athletes are suspended.

“It’s a tough blow, but the moment is serious and we need to show solidarity,” said Mehdi Bayat, the president of the Belgian soccer union.

Detailing the measures, Flemish Minister-President Jan Jambon said attendance at universities will be limited to 20 percent of capacity in lecture halls, while amusement parks will be closed from Friday.






De Croo also sent a message of support to business owners and workers affected by the measures who struggle financially and are losing their jobs.

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Leaders in US, Europe divided on response to surging virus

Virus cases are surging across Europe and many U.S. states, but responses by leaders are miles apart, with officials in Ireland, France and elsewhere imposing curfews and restricting gatherings even as some U.S. governors resist mask mandates or more aggressive measures.

The stark contrasts in efforts to contain infections come as outbreaks on both sides of the Atlantic raise similar alarms, including shrinking availability of hospital beds and rising deaths.

Governors of states including Tennessee, Oklahoma, Nebraska and North Dakota are all facing calls from doctors and public health officials to require masks.

In Utah, a spike in cases since school reopened has created a dynamic that Republican Gov. Gary Herbert has called “unsustainable.”

But schools remain open and Herbert, who has been pressured by an outspoken contingent of residents opposed to masks, has resisted a statewide mandate. Instead, he announced last week that they would be required only in six counties with the highest infection rates, while leaving it to others to make their own rules. Meanwhile, many hospitals are being pushed to the breaking point.

“We are not just managing COVID. We are also managing heart attacks and strokes and respiratory failure and all those other things that need ICU-level care,” said Dr. Kencee Graves, chief medical officer for inpatient care at the University of Utah Health hospital in Salt Lake City. The hospital’s intensive care unit was filled by the end of last week, forcing the reopening of a backup intensive care unit.

“The sooner we take care of each other, wear masks, physically distance, the sooner we can have some gatherings in a safe way,” Graves said.

In Oklahoma, where the number of people hospitalized for the virus has reached record levels, doctors have called on officials to do more.

“We need face mask mandates to protect more of our Oklahoma citizens,” Dr. George Monks, the president of the Oklahoma State Medical Association, said in a tweet Sunday.

But Gov. Kevin Stitt has said repeatedly he has no plans to do so, citing concerns about how such a mandate would be enforced.

Oklahoma health officials reported a record high of 821 people hospitalized Tuesday with the virus or under investigation for the infection. Wyoming also reported a record high number of patients hospitalized for the virus.

New virus cases in the U.S. have surged in recent weeks from a daily average of about 42,000 in early October to about 58,000—the highest level since late July, according to Johns Hopkins University.

In one of the most troubling outbreaks, 10 residents of a nursing home in northwest Kansas have died from the virus, health officials said. All 62 residents of the Andbe Home in Norton County, as well as an unspecified number of employees, have tested positive for the infection.

The surge in new cases prompted a change of heart Monday from the mayor of North Dakota’s largest city, in favor of a mask mandate.

Tim Mahoney, who in addition to being Fargo’s mayor is also a general surgeon, has been largely supportive of Republican Gov. Doug Burgum’s approach of leaving management of the virus to local officials.

Mahoney, himself, cast the deciding vote against a mask mandate at a recent meeting of city officials. But with North Dakota leading the nation in new cases and up to one in four city residents now testing positive, Mahoney said a statewide change is in order.

The dynamic contrasts sharply with Europe, where national officials are battling a similar spike with measures including new lockdowns and smart phone apps that track the virus’ spread.

In Ireland, Prime Minister Micheal Martin announced a lockdown starting at midnight Wednesday that will close all non-essential stores, limit restaurants to carryout service and require people to stay within three miles (five kilometers) of their homes, while banning visits to other households.

It marks a near-return to restrictions imposed by the government in March, although schools, construction sites and manufacturing industries will remain open. If people comply with the restrictions, which will be in place until Dec. 1, the country will be able to celebrate Christmas “in a meaningful way,” Martin said.

But as cases surge, some decisions by European leaders to impose new restrictions are facing stiff opposition at the local level. After a tense faceoff, Britain’s government said Tuesday it had failed to reach agreement with Greater Manchester Mayor Andy Burnham, who has rejected tough new measures without money to support the workers and businesses that will be most affected.


Britain’s Communities Secretary Robert Jenrick expressed disappointment with Burnham, saying the mayor “has been unwilling to take the action that is required to get the spread of the virus under control.” Prime Minister Boris Johnson said Tuesday he would impose the restrictions, drawing criticism from Burnham.

“It cannot be right to close people’s place of work, to shut somebody’s business, without giving them proper support,” Burnham said. He said Manchester had sought 90 million pounds ($117 million) from the national government to help people get through the winter. It was unclear how much the city would receive.

In the Netherlands, which has one of the highest infection rates in Europe, a judge in The Hague rejected an appeal by more than 60 Dutch bars and restaurants to overturn a government four-week closure order.

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Virus, what virus? India gets back to work

India is on course to top the world in coronavirus cases, but from Maharashtra’s whirring factories to Kolkata’s thronging markets, people are back at work—and eager to forget the pandemic for festival season.

After a strict lockdown in March that left millions on the brink of starvation, the government and people of the world’s second-most populous country decided life must go on.

Sonali Dange, for instance, has two young daughters and an elderly mother-in-law to look after. She was hospitalised this year in excruciating pain after catching the coronavirus.

But after the lockdown exhausted the family’s savings, the 29-year-old had to return to work at a factory where she earns 25,000 rupees ($340) a month.

“Now that I have recovered, I am no longer so scared of the disease,” she told AFP amid the din of machinery at the Nobel Hygiene plant east of Mumbai.

Worst since 1947

The pandemic’s confirmed fatality rate has been heaviest in richer nations with older populations—the US death toll is double that of India despite having only a quarter of the population.

Poor countries have suffered far worse economic pain, with the World Bank predicting 150 million people could fall into extreme poverty worldwide.

Many children in the developing world are now working to help their parents make ends meet, activists say, while thousands of young girls have been forced into marriage.

In Varanasi in northern India, 12-year-old Sanchit no longer attends school and instead collects cloth discarded from bodies before cremation on the city’s ghats.

“On a good day, I earn around 50 rupees (70 US cents),” the boy told AFP.

The IMF projects India’s GDP will contract by 10.3 percent this year, the biggest slump of any major emerging nation and its worst since independence in 1947.

Lockdown catastrophe

When India went into lockdown, it was a human catastrophe, leaving millions in the informal economy jobless, penniless and destitute almost overnight.

No one wants to go back to that, said Gargi Mukherjee, 42, as she shopped in the New Market area of Kolkata, thronging with festival-season customers, many without face masks.

“For survival, people have to come out and do their jobs. If you don’t earn, you cannot feed your family,” she told AFP.

Experts caution that the October-November season—when Hindus celebrate major festivals such as Durga Puja, Dussehra and Diwali—may trigger a sharp increase in infections, as consumers crowd markets to snap up big-ticket items on discount.

“Of course corona is to be feared. But what can I do? I can’t miss the moments of Durga Puja,” said housewife Tiyas Bhattacharya Das, 25.

“Durga Puja comes once in the year, so I cannot miss the enjoyment of the shopping.”

Hunger or virus

Sunil Kumar Sinha, principal economist at the Mumbai-based India Ratings and Research agency, said Indians faced a stark choice.

“People have to choose whether to die of hunger or risk getting a virus that may or may not kill you,” he told AFP.

Indeed India’s relatively low mortality rate—about 1.5 percent of its more than seven million cases—has surprised many who warned coronavirus would lay waste to its crowded cities, beset by poor sanitation and crumbling public hospitals.

Even accounting for some likely undercounting, it is evident that the nightmare scenario of dead bodies piled in the streets as seen during the 1918 flu pandemic has mercifully not materialised.

‘Foot off the brake’

The unexpected reprieve has given Prime Minister Narendra Modi leeway to resist a fresh lockdown, with the human toll—and political cost—of another shutdown higher than seeing case numbers soar.

But Bhramar Mukherjee, an epidemiologist at the University of Michigan, warned the government should not simply let the virus run its course.

“In order to open up, you need to intensify public health measures… If you completely take your foot off the brakes, the virus will take off too,” Mukherjee told AFP.

Last month, the Indian Medical Association slammed the Modi government for its “indifference” to the sacrifices of front-line staff in one of the world’s worst-funded health care systems.

“It appears that they are dispensable,” it said.

Back in Kolkata, bookseller Prem Prakash, 67, was philosophical.

“You have to leave some things to fate,” he told AFP.

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Haircuts and golf in Melbourne as virus curbs ease

Residents of Australia’s second-biggest city flocked to salons and golf courses Monday as some stay-at-home restrictions were eased after coronavirus infection rates fell.

Melbourne’s five million people had been barred from leaving their homes with a few exceptions—including shopping for essentials, exercising, or going to work—for three months.

They still face a litany of travel restrictions and tough-to-remember rules for even the most mundane activities, but will now be able to get a much-needed haircut and do more outdoor socially distanced activities.

“We’re already fully booked until December,” salon owner Daniel Choi told AFP.

“From yesterday, there are so many messages for me: ‘I want a haircut’. They want to change their style.”

Salon owners still have to contend with restrictions on the number of people allowed on the premises at the same time, meaning those eager to correct self-inflicted dye jobs or improvised trims could face a long wait.

But for the lucky first customers there was a sense of elation.

“It’s a sense of relief actually that finally I could get it done,” said customer Karen Ng.

“It’s nice actually to have some normality.”

Golfers can also tee it up again, although they will have to go around in groups of two and, according to Golf Australia, “masks must still be worn when playing”.

“It’s a great sight… GOLFERS ON COURSE!” Green Acres Golf Club tweeted.

But many restrictions remain in place in the city.

Masks are mandatory, restaurants are limited to takeaways and deliveries, non-essential shops have to remain closed and there is a ban on travel outside the greater Melbourne area or more than 25 kilometres (16 miles) from home.

The city’s second round of stay-at-home restrictions began in July, when the state of Victoria saw around 190 new cases a day, rising to 700 in August.

Victoria recorded just four new cases on Monday.

But not everyone was happy with the limited easing, including Australia’s conservative treasurer Josh Frydenberg, who criticised the regional authorities for not going further.

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Iran announces its virus death toll passes 30,000

Iran announced Saturday that its death toll from the coronavirus has passed the milestone of 30,000, in what has been the Mideast region’s worst outbreak.

Health Ministry spokeswoman Sima Sadat Lari announced that the total death toll from the outbreak had reached at least 30,123.

She said that 4,721 virus patients are in critical condition.

Iran has been struggling with the coronavirus since announcing its first cases in February, with more than 526,000 confirmed cases to date.

In recent weeks, Iran has seen daily death tolls spike to their highest-ever levels, sparking increasing concern even as government officials continue to resist a total lockdown for fear of cratering the economy, which has been hard-hit by U.S. sanctions.

On Wednesday, Iranian officials announced a travel ban to and from five major cities, including the capital of Tehran and the holy city of Mashhad, that they said aimed to contain the virus’ spread.

The coronavirus has also spread to some of the highest levels of Iran’s government, which includes many older men. Among those recently infected is the head of the country’s atomic energy organization, while Iran’s vice president in charge of budget and planning tested positive on Sunday.

After downplaying the outbreak in its first weeks, Iranian officials have more recently begun to admit the scope of the epidemic within the country.

Deputy Health Minister Iraj Harirchi, who had tested positive for the virus in March after playing down its threat and refuting reports of mass deaths, told state TV on Wednesday that the country’s true death toll is about double the reported figures.

According to officials, there are also large numbers of patients in hospitals being treated as COVID-19 cases but who have not been tested, whose tests came out as false negatives or whose symptoms are not the same as those listed by the World Health Organization and who are therefore not counted in the official case numbers.

Like in many other countries, the spiraling outbreak in Iran reflects the government’s contradictory virus response. This week, as the daily recorded death toll hit the record for three times, authorities announced tighter restrictions for the hard-hit capital of Tehran.

Recently reopened universities and schools, as well as libraries, mosques, cinemas, museums and beauty salons, shut down. In the past week, the government mandated that all Tehran residents wear face masks outdoors and in public places, warning violators would be fined. Officials promised those who tested positive would be closely tracked.

Movement restrictions this spring somewhat checked the spread of the disease. Then the government swiftly reopened the country, desperate to boost its stricken economy. Since June, the case count has steadily increased—and spiked to new heights in recent weeks.

Long before the virus hit, Iran’s economy was ailing, pummeled by U.S. sanctions after the Trump administration’s unilateral withdrawal in 2018 from Tehran’s nuclear accord with world powers. As the death toll soared this week, the nation’s currency plunged to its lowest level ever, following the U.S. administration’s decision last week to blacklist Iranian banks that had so far escaped the bulk of re-imposed American sanctions.

As Iran approaches winter, the seasonal influenza could be an added and serious issue for the country, as it has had purchasing the flu vaccine amid new American sanctions on Iranian banks.

Iran’s Red Crescent Society said in a tweet on Tuesday that they were in charge of importing two million flu vaccine doses into the country, but that new U.S. sanctions prevented the import.

Meanwhile on Saturday, the United Arab Emirates has announced its highest single-day total of new cases of the coronavirus amid a spike in the Gulf nation that is home to Abu Dhabi and Dubai.

The country’s Health Ministry said tests found 1,538 new cases of the virus, pushing the overall number of cases to 114,387.

The ministry said another four people died from the virus, pushing the overall death toll to 459. Overall recoveries are at 106,354.

Recorded infections have soared again in recent weeks, as authorities have relaxed restrictions and resumed schools for in-person instruction. Dubai has reopened its airport for international travelers and embarked on an active campaign promoting itself as a tourism destination amid the pandemic.

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Preliminary results find COVID-19 vaccine candidate based on inactivated SARS-CoV-2 virus is safe

A Chinese COVID-19 vaccine candidate based on the inactivated whole SARS-CoV-2 virus (BBIBP-CorV) is safe and elicits an antibody response, findings from a small early-phase randomised clinical trial published today in The Lancet Infectious Diseases journal have found.

A previous clinical trial reported similar results for a different vaccine that is also based on inactivated whole SARS-CoV-2 virus, but in that study the vaccine was only tested in people aged under 60 years.

The latest study included participants aged between 18 and 80 years, and found that antibody responses were induced in all recipients. Participants aged 60 and over were slower to respond, taking 42 days before antibodies were detected in all recipients compared with 28 days for participants aged 18-59. Antibody levels were also lower in those aged 60-80 years compared with those aged 18-59 (Mean neutralising antibody titre 42 days after receiving a 8μg vaccine dose was 228.7 for people aged 18-59, and 170.9 for those aged 60-80).

The trial was not designed to assess efficacy of the vaccine, so it is not possible to say whether the antibody responses induced by the vaccine, called BBIBP-CorV, are sufficient to protect from SARS-CoV-2 infection.

Professor Xiaoming Yang, one of the authors of the study, from the Beijing Institute of Biological Products Company Limited, Beijing, China, said: “Protecting older people is a key aim of a successful COVID-19 vaccine as this age group is at greater risk of severe illness from the disease. However, vaccines are sometimes less effective in this group because the immune system weakens with age. It is therefore encouraging to see that BBIBP-CorV induces antibody responses in people aged 60 and older, and we believe this justifies further investigation.”

There are currently 42 vaccines for COVID-19 in clinical trials. These vary in type and include DNA plasmid vaccines, inactivated virus vaccines, adenovirus-vectored vaccines, RNA vaccines, protein subunit vaccines and virus-like particle vaccines. Some of these have already been shown to be safe and to elicit immune responses in early phase clinical trials.

The BBIBP-CorV vaccine used in the study reported here is based on a sample of the virus that was isolated from a patient in China. Stocks of the virus were grown in the lab using cell lines and then inactivated using a chemical called beta-proprionolactone. BBIBP-CorV includes the killed virus mixed with another component, aluminium hydroxide, which is called an adjuvant because it is known to boost immune responses.

The first phase of the study was designed to find the optimal safe dose for BBIBP-CorV. It involved 96 healthy volunteers aged between 18 and 59 years and a second group of 96 participants aged between 60 years and 80 years. Within each group, the vaccine was tested at three different dose levels (2μg, 4μg and 8μg, 24 participants per group), with two vaccinations administered on day 0 and 28. A fourth group within each age group (24 participants in each age group) were given two doses of a placebo vaccine. In total, in phase 1 of the study, 144 participants received the vaccine and 48 received the placebo.

The second phase of the study was designed to identify the optimal timing schedule for vaccination. 448 participants aged between 18 and 59 years were randomly assigned to receive either one 8?g shot of vaccine or placebo, or two shots of 4μg vaccine or placebo (at 0 and 14 days, 0 and 21 days or 0 and 28 days). In this second phase, there were 112 participants per group, with 336 receiving the vaccine, and 112 receiving the placebo.

Participants were asked to report any adverse events for the first seven days after each vaccination and these were verified by the research team. Thereafter, participants recorded any adverse events using paper cards for the following 4 weeks. During phase 1, laboratory tests were carried out after the first and second vaccinations to assess kidney function, liver function and other organ functions. Blood samples were taken to test antibody levels for SARS-CoV-2 before and after vaccination.

No serious adverse events were reported within 28 days of the final vaccination. The most common side effect was pain at the injection site (phase 1 results: 24% [34/144] of vaccine recipients, vs 6% [3/48] of placebo recipients). A small number of participants reported experiencing a fever (phase 1 results: 4% [5/144] of vaccine recipients, vs 6% [3/48] of placebo recipients). There were no instances of clinically significant changes in organ functions detected in laboratory tests in any of the groups.

The greatest antibody responses were elicited by two 4μg doses of the vaccine at either days 0 and 21 or 0 and 28 (Mean neutralising antibody titres 28 days after second vaccination were 282.7 for two 4μg injections at day 0 and 21, and 218.0 for two 4μg injections at day 0 and 28).

Professor Xiaoming Yang said: “Our findings indicate that a booster shot is necessary to achieve the greatest antibody responses against SARS-CoV-2 and could be important for protection. This provides useful information for a phase 3 trial.”

The authors noted some limitations with the study, including the short duration of follow up at just 42 days. They also highlighted that the study did not include children and adolescents aged under 18. Trials with these groups will be carried out when the full analysis of data from adult groups is completed, the researchers say.

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Drug tricks cancer cells by impersonating a virus

A new cancer drug helps the immune system destroy tumors by impersonating a virus and “infecting” cancer cells.

The drug, called BO-112, is in human trials and mimics the structure of a double-stranded RNA molecule, a type of genetic material found in some viruses. Viruses inject their RNA into cells during infection, but cells can spot this viral RNA using specific receptors, and call upon the immune system to intervene when viruses strike.

BO-112 takes advantage of this cellular defense mechanism — once injected inside a tumor, the drug helps to alert the body’s immune system to the cancer’s presence. To hide from the immune system, cancer cells often cloak themselves in disguises, and also stop signals that could alert the body of their location. But when treated with BO-112, tumors throw up red flags that the immune system can spot.

The drug, which has been tested in mice and a a few dozen people, could help amplify the effects of existing cancer treatments designed to rally the immune system, study author Dr. Anusha Kalbasi, an assistant professor of radiation oncology at the University of California, Los Angeles and member of the UCLA Jonsson Cancer Center, told Live Science in an email. 

In other words, once BO-112 reveals the location of a tumor, other treatments could more easily target it. “I do think the power of BO-112 is in its ability to enable other immunotherapies to maximize their benefit,” Kalbasi said. 

In a new study, published Oct. 14 in the journal Science Translational Medicine, Kalbasi and his colleagues tested BO-112 in lab dish experiments and a mouse model of melanoma, a kind of skin cancer. In a separate clinical trial, published the same day, 44 human patients took BO-112 with and without additional cancer treatments, so researchers could begin to analyze how safe and effective the drug is in people. The early results hint that BO-112 can make tough-to-treat tumors vulnerable to immunotherapy, but the team now needs to confirm that those results hold up in larger groups. 

Unmasking cancer cells 

Cancer immunotherapy works by ramping up the body’s immune defense against tumors, but cancer cells use various tricks to resist these attacks. 

For instance, an immunotherapy called “adoptive T cell therapy” involves extracting a patient’s immune cells, modifying them to better recognize specific tumors and then reintroducing them to the body, according to a statement. These T cells detect tumors by scanning for specific molecules on their surfaces, called antigens — but some tumors can slow or stop production of these antigens, or prevent them from being displayed on a cell’s surface, thanks to specific genetic mutations, making them effectively invisible to T cells.

In theory, forcing such tumors to build and present antigens on their surface would make them visible to T cells; Kalbasi and his colleagues tested this idea in several mouse studies.

They first engineered mouse tumor cells with mutations that would reduce the number of antigens on their surfaces. In lab dish studies, the mutant tumor cells could not be detected by T cells.   

But when the team turned on a gene called NLRC5 in the engineered tumors, the cells generated antigens in spite of the other mutations they’d introduced. Activating this gene made the tumor cells visible to T cells, leaving the cancer open to attack. The same strategy worked when the team moved from lab dishes to actual lab mice; however, for the same approach to work in humans, scientists would need to somehow turn on the NLRC5 gene in a patient’s tumor cells. 

To achieve the same result more practically, the team turned to BO-112. Similar to NLRC5, the drug makes cancer cells produce antigens; rather than switching on a specific gene, the drug instead tricks the tumor into reacting as if it’s being infected by a virus.

Without an injection of BO-112, the lab mice’s tumors did not succumb to adoptive T cell therapy, because the T cells could not detect the tumors in the first place. However, after the injection, the T cell treatment suddenly worked, Kalbasi said.

“When we added BO-112, the tumors either decreased in size or stopped growing for a period of time,” he said.

From mice to humans

However, in mice with large tumors, the cancer eventually began to grow again, Kalbasi noted. In mice with small tumors, the combinatory treatment was more effective, as the tumors shrunk more dramatically in size and sometimes disappeared altogether, he said.

To probe whether B0-112 works in human patients as it does in mice, another group of researchers conducted a small clinical trial, sponsored by the pharmaceutical company Highlight Therapeutics. Most of the patients handled the treatment well, although three of the 44 participants experienced a severe reaction, including lung inflammation and a significant drop in platelet levels, which are important for blood clotting, according to the report. 

Of the 44 patients, 28 patients who did not experience these side effects received injections of B0-112 along with existing immunotherapy drugs, called nivolumab and pembrolizumab. These treatments “remove the brakes off the body’s T cells” so they can target tumors more effectively, Kalbasi said. In the clinical trial, BO-112 made tumors more sensitive to these two drugs; after eight to 12 weeks of treatment, 10 patients with metastatic cancer reached “stable disease,” meaning their tumors had stopped growing, while the tumors of three other patients actually began to shrink. 

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That said, “the number of patients is too low to draw a formal conclusion about the responses because the main objective of this first in-human clinical trial was safety,” the authors wrote. However, these early results hint that BO-112 could be an effective strategy to take down tumors that are resistant to immunotherapy, they noted.

“Every cell type has a different capacity to sense double-stranded RNA,” the molecule that BO-112 mimics, Kalbasi added. “So we will be watching carefully to learn what factors in each patient may predict a better response to BO-112,” since some cancers might be more sensitive to the treatment than others. Given that BO-112 is currently administered as a direct injection into tumors, initial trials will likely focus on cancer types with “superficially accessible” tumors, such as melanoma, lymphoma, breast cancer and bladder cancer, said Dr. Joshua Brody, director of the Lymphoma Immunotherapy Program at the Icahn School of Medicine at Mount Sinai, who was not involved in the study.

“The exciting opportunity presented by these two studies, both in the lab and in patients, is that we have medicines that can improve antigen presentation and thereby make immunotherapies — which would otherwise fail — become effective in inducing cancer remissions,” Brody told Live Science in an email.

Originally published on Live Science. 

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Italy imposes mask mandate outside and in as virus rebounds

Italy imposed a nationwide outdoor mask mandate Wednesday with fines of up to 1,000 euros ($1,163) for violators, as the European country where COVID-19 first hit hard scrambles to keep rebounding infections from spiraling out of control.

The government passed the decree even though Italy’s overall per capita infection rate is among the lowest in Europe. But Premier Giuseppe Conte warned that a steady, nine-week rise in infections nationwide demanded new preventive measures to stave off economically-devastating closures and shutdowns.

“We have to be more rigorous because we want to avoid at all cost more restrictive measures for production and social activities,” Conte said.

The decree was passed on the same day that Italy added 3,678 new infections and 31 deaths to its official coronavirus toll, the highest increase in new cases since the peak of the outbreak in April. Both hard-hit Lombardy and southern Campania added more than 500 cases each.

Italy has over 36,000 confirmed COVID-19 deaths, the second-highest number in Europe after Britain.

Even though the World Health Organization doesn’t specifically recommend masks outdoors for the general population, the trend has taken off in Italy, particularly as new clusters have been identified in southern regions that largely escaped the first wave of infection.

The new mask mandate was contained in a government decree extending the state of emergency until Jan. 31. It requires residents to have masks on them at all times outdoors, and wear them unless they can guarantee that they can remain completely isolated from anyone other than family. That effectively makes them obligatory outdoors in all urban and semi-urban settings, with exemptions for eating in restaurants and bars.

In addition, masks must now be worn indoors everywhere except private homes, but even at home, Conte urged Italians to keep their distances with relatives, given most new infections are occurring within families.

“The state can’t ask citizens to wear masks in their own homes,” Conte said. “But we have a strong recommendation for all citizens: Even in our families we have to be careful.”

Exceptions include for outdoor sporting activities, children under 6 and for people with health conditions that preclude wearing masks.

Fines ranging from 400 to 1,000 euros ($463 to $1,163) are foreseen for violations, Italian news agency ANSA said.

Italy thus is joining Spain, Turkey, North Macedonia, India and a handful of other Asian countries in imposing a nationwide, outdoor mask mandate. Spain has had such a requirement in place since mid-May and Turkey since last month.

Elsewhere in Europe, such outdoor mandates are in effect in hot spot cities such as Paris, Brussels and Pristina, Kosovo. In many Asian countries, social pressure to wear masks outdoors has made binding government decrees unnecessary. The Australian state of Victoria has had one in place for weeks.

Italy has one of the lowest infection rates in Europe, at 46.5 cases per 100,000 residents over the last two weeks. By contrast, the Czech Republic counts 327 per 100,000 while Spain has 302, France 248 and Belgium 233 per 100,000.

While Paris and Brussels have closured bars to cope with the rising infections and Britain has capped pub hours, Conte has said that Italy wouldn’t impose any curfews or close bars.

The Vatican, which followed Italy’s strict lockdown in spring and summer, also imposed an outdoor mask mandate this week in the tiny city state in the center of Rome. Pope Francis, however, didn’t wear a mask during his indoor general audience Wednesday, even as he greeted well-wishers and shook their hands.

Italy became the epicenter of the European outbreak after the first domestic case was identified Feb. 21 in northern Lombardy. The country largely tamed the virus with a strict, nationwide 10-week lockdown, but infections have crept up since August vacations.

There have been various hypotheses for why Italy’s rebound has been slower than in neighboring countries like Spain or France, where daily new cases often top 10,000. Chief among them is the fact that Italians, seriously scared by the devastation of the initial outbreak in the north, have generally abided by mask mandates and social distancing norms.










Also, Italy’s national health care system has continued to aggressively trace new infection, as well as test passengers on arrival from at-risk countries—and even from its own island of Sardinia after the jet-set destination became a hotspot this summer.

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Madrid starts partial virus lockdown amid political scuffle

Madrid awoke Saturday to its first day under a partial lockdown, with police controlling travel in and out of the Spanish capital that has become Europe’s biggest hot spot for the second wave of the coronavirus.

The two-week ban imposed by Spain’s national government on reluctant regional officials started Friday night at 10 p.m. (2000 GMT).

The measures prohibit all nonessential trips in and out of the capital and nine of its suburbs—affecting around 4.8 million people. Restaurants must close at 11 p.m. and shops at 10 p.m., and reduce occupancy to 50% of their capacity.

Spain’s Socialist prime minister, Pedro Sánchez, said the steps were “critical” to stop a surging caseload and prevent a repeat of the horrific scenes of March and April that saw hospitals overrun with dying patients.

Even though the measures are light compared with the home confinement mandated across Spain during the first wave of the virus, they have sparked a ferocious political battle between Sánchez’s left-wing coalition government and the Madrid administration, run by a right-wing rival.

The Madrid government led by Isabel Díaz Ayuso of the conservative Popular Party said it would enforce the orders but it has also filed an appeal at the National Court with hopes to annul them. Ayuso and her regional ministers have said the restrictions will cause “chaos,” hurt an already weakened economy and violate their jurisdiction as regional authorities.

Ayuso’s message has reached at least some residents who see the issue as having more to do with politics than public health.

“I think we have gone to the extremes,” said Ángel Davila, a 52-year-old engineer at Atocha train station. “I think that the measures they have put in place aren’t correct. They are not based, according to what I have studied, on medical information. It is a political thing now more than anything else.”

Health experts, however, have been urging Madrid to take stronger action for weeks, but Madrid’s health chief Enrique Ruiz Escudero argues they are not necessary.

The health ministry ordered compliance after Madrid refused to accept a set of health metrics to dictate when cities with populations of 100,000 of more need to adopt heavier restrictions to curb the virus. The measures were approved by a majority of regional health authorities from Spain’s 19 regions and autonomous cities, with Madrid in the minority against them.

The government orders only allow people to cross the municipal borders to commute for work, for a medical appointment, legal errands, or appointments with a governmental administration.

The region had already applied similar measures to certain areas, and limited social gatherings to a maximum of six people, but the infections kept rising.

Madrid is leading the resurgence of the virus in Spain, which has Europe’s highest cumulative caseload—770,000 since the onset of the pandemic.

The capital had a two-week infection rate of 695 cases per 100,000 residents Thursday, more than twice the national average of 274 cases and seven times the European average, which stood at 94 per 100,000 residents last week, according to the European Center for Disease Control and Prevention.

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Bacteria virus combo may be cause of neonatal brain infections in Uganda

A newly identified bacteria and a common virus may be the underlying cause of infection-induced hydrocephalus in Uganda, according to an international team of researchers.

“Thirteen years ago, while visiting Uganda and seeing a stream of kids with hydrocephalus after infection I asked the doctors, ‘What is the biggest problem you have that you can’t solve?'” said Steven J. Schiff, Brush Chair Professor of Engineering and professor of engineering science and mechanics, neurosurgery and physics, Penn State. “‘Why don’t you figure out what makes these kids sick?’ was the reply.”

By that time, the doctors at CURE Children’s Hospital of Uganda, had seen more than a thousand infants with infection-caused hydrocephalus and were unable to culture a single thing in the laboratory. They have now seen over 8,000 similar children in this one, small Ugandan hospital.

“Hydrocephalus is the most common childhood neurosurgical condition that we see in the population that we serve,” said Edith Mbabazi-Kabachelor, director of research, CURE Children’s Hospital of Uganda. “If hydrocephalus is left untreated in children less than two years old, the progressive increase in head size will lead to further brain damage, resulting in the majority of these children dying, and those that survive being left with severe cognitive and physical disability.”

Severe systemic bacterial infection during the first four weeks of life accounts for an estimated 680,000 to 750,000 yearly neonatal deaths worldwide. Hydrocephalus is the most common brain disorder in childhood and the largest single cause of childhood hydrocephalus is neonatal infection, accounting for an estimated 160,000 yearly cases, said Schiff.

Over a 5-year study in Uganda, supported by the U.S. National Institutes of Health, using advanced genomic techniques the team uncovered the major bacterial and viral underpinnings of these infections, the researchers report today (Sept. 30) in Science Translational Medicine.

Schiff and his team have studied this problem for more than 10 years, but in the last five years, they took a different approach, using DNA and RNA sequencing techniques to identify the causative agents. The researchers looked at blood and cerebrospinal fluid drawn from 100 cases of post-infectious hydrocephalus and control patients without infection in Uganda. There were 64 infants with post-infectious hydrocephalus and 36 with non-post-infectious hydrocephalus. All infants were under three months old. The researchers prepared the samples in two ways—fresh-frozen and preserved—and they sent samples to two different laboratories in the U.S., where samples were analyzed with different techniques. This was to ensure valid and reproducible results.

“We found this weird bacteria dominating,” said Schiff.

The bacteria was a previously unidentified strain of Paenibacillus thiaminolyticus, now named Mbale after the city where the CURE Children’s Hospital is located.

“The initial link between hydrocephalus and Paenibacillus was made through high-throughput sequencing and PCR analyses at the Center for Infection and Immunity in the Mailman School of Public Health at Columbia University, a renowned center led by W. Ian Lipkin,” said Schiff.

High-throughput sequencing allows sequencing of more than one DNA molecule at the same time, and PCR analysis multiplies existing DNA samples so that they are easier to analyze and identify.

“You build a field of dreams—in this case a platform for pathogen discovery—and wait for the right partner and the right project,” said W. Ian Lipkin, John Snow Professor of Epidemiology and director, Center for Infection and Immunity, Mailman School of Public Health, and professor of pathology and neurology, College of Physicians & Surgeons, Columbia University. “Steven Schiff is a remarkable investigator and this is such a project. It stands out for impact amongst hundreds we’ve done over a period of more than 30 years. Our team is delighted to have had an opportunity to help implicate an agent and contribute to control of this devastating disorder.”

The researchers managed to grow the difficult-to-culture new bacterial strain at Penn State, and tested it on mice. While the common variants of Paenibacillus are harmless, the Mbale strain was lethal to the mice.

The researchers found the new bacterial strain in the cerebrospinal fluid of the infection-induced hydrocephalic children and then only in the youngest patients.

“While we tested infants up to three months old, we mostly identified the cause of infections in those less than six weeks of age,” said Schiff. “If we didn’t study them really early in life, then the infection had already burned out. Between 6 and 12 weeks there were very few positive results.”

Schiff was not satisfied with finding the proposed bacterial cause of the problem, he said. He reasoned that other diseases had both a bacterial and viral component and so the team looked for viral, fungal and parasitic genetic material. They found cytomegalovirus (CMV) in the cerebrospinal fluid of the infection-caused hydrocephalic infants, but not in that of the other hydrocephalus patients.

CMV is a common virus found around the world. The virus causes minor symptoms, if any, in most adults, although babies may be born with congenital CMV or acquire it early in life and be significantly harmed by neurological damage. The researchers only found CMV in the cerebrospinal fluid of babies with post-infection hydrocephalus.

While the researchers believe they have found the source of the infections that cause the high prevalence of hydrocephalus, they do not know where the babies encounter the new bacteria. According to Schiff, the bacteria may be soil- or water-born and more work is necessary to find the bacterial source.

The researchers are creating predictive models that, coupled with data they are now analyzing from thousands of infants and satellite-acquired rainfall to predict optimal treatment for individual locations. The researchers said they do not know if this particular bacterial virus combination exists outside this area of Uganda. However, the same strategy of using DNA and RNA to diagnose previously unknown causes of similar infections can be used in many other regions in the developing world where similar cases are seen.

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