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With a coronavirus vaccine still months off, companies are rushing to test what may be the next best thing: drugs that deliver antibodies to fight the virus right away, without having to train the immune system to make them.Antibodies are proteins the body makes when an infection occurs; they attach to a virus and help it be eliminated. Vaccines work by tricking the body into thinking there’s an infection so it makes antibodies and remembers how to do that if the real bug turns up.But it can take a month or two after vaccination or infection for the most effective antibodies to form. The experimental drugs shortcut that process by giving concentrated versions of specific ones that worked best against the coronavirus in lab and animal tests.“A vaccine takes time to work, to force the development of antibodies. But when you give an antibody, you get immediate protection,” said University of North Carolina virologist Dr. Myron Cohen. “If we can generate them in large concentrations, in big vats in an antibody factory ... we can kind of bypass the immune system.”These drugs are believed to last for a month or more and could give quick, temporary immunity to people at high risk of infection, such as health workers and housemates of someone with COVID-19. If they proved effective and if a vaccine doesn’t materialize or protect as hoped, the drugs might eventually be considered for wider use, perhaps for teachers or other groups.They’re also being tested as treatments, to help the immune system and prevent severe symptoms or death.“The hope there is to target people who are in the first week of their illness and that we can treat them with the antibody and prevent them from getting sick,” said Dr. Marshall Lyon, an infectious disease specialist helping to test one such drug at Emory University in Atlanta.Having such a tool “would be a really momentous thing in our fight against COVID,” Cohen said.Vaccines are seen as a key to controlling the virus, which has been confirmed to have infected more than 20 million people worldwide and killed more than 738,000. Several companies are racing to develop vaccines, but the results of the large final tests needed to evaluate them are months away.The antibody drugs are “very promising” and, in contrast, could be available “fairly soon,” said Dr. Janet Woodcock, a U.S. Food and Drug Administration official who is leading government efforts to speed COVID-19 therapies. Key studies are underway and some answers should come by early fall.One company, Eli Lilly, has already started manufacturing its antibody drug, betting that studies now underway will give positive results.“Our goal is to get something out as soon as possible” and to have hundreds of thousands of doses ready by fall, said Lilly’s chief scientific officer, Dr. Daniel Skovronsky.Another company that developed an antibody drug cocktail against Ebola — Regeneron Pharmaceuticals Inc. — now is testing one for coronavirus.“The success with our Ebola program gives us some confidence that we can potentially do this again,” said Christos Kyratsous, a Regeneron microbiologist who helped lead that work.Regeneron’s drug uses two antibodies to enhance chances the drug will work even if the virus evolves to evade action by one.Lilly is testing two different, single-antibody drugs — one with the Canadian company AbCellera and another with a Chinese company, Junshi Biosciences. In July, Junshi said no safety concerns emerged in 40 healthy people who tried it and that larger studies were getting underway.Others working on antibody drugs include Amgen and Adaptive Biotechnologies. The Singapore biotech company Tychan Pte Ltd. also is testing an antibody drug and has similar products in development for Zika virus and yellow fever.“I’m cautiously optimistic” about the drugs, said the nation’s top infectious diseases expert, Dr. Anthony Fauci. “I’m heartened by the experience that we had with Ebola,” where the drugs proved effective.What could go wrong?— The antibodies may not reach all of the places in the body where they need to act, such as deep in the lungs. All the antibody drugs are given through an IV and must make their way through the bloodstream to wherever they’re needed.— The virus might mutate to avoid the antibody — the reason Regeneron is testing a two-antibody combo that binds to the virus in different places to help prevent its escape.Skovronsky said Lilly stuck with one antibody because manufacturing capacity would essentially be cut in half to make two, and “you will have less doses available.” If a single antibody works, “we can treat twice as many people,” he said.— The antibodies might not last long enough. If they fade within a month, it’s still OK for treatment since COVID-19 illness usually resolves in that time. But for prevention, it may not be practical to give infusions more often than every month or two.A San Francisco company, Vir Biotechnology Inc., says it has engineered antibodies to last longer than they usually do to avoid this problem. GlaxoSmithKline has invested 0 million in Vir to test them.Giving a higher dose also may help. If half of antibodies disappear after a month, “if you give twice as much, you will have two months’ protection,” Lilly’s Skovronsky said.— The big fear: Antibodies may do the opposite of what’s hoped and actually enhance the virus’s ability to get into cells or stimulate the immune system in a way that makes people sicker. It’s a theoretical concern that hasn’t been seen in testing so far, but large, definitive experiments are needed to prove safety.“As best as we can tell, the antibodies are helpful,” Lyon said.___Marilynn Marchione can be followed on Twitter: @MMarchioneAP___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. 5919

When snow falls in a flurry and the weather is cold outside, escaping the elements becomes a top priority.With COVID-19 causing some warming shelters to stop operations this winter, however, the impacts could literally mean the difference between life and death.“We’re going to see a lot of people die to be perfectly honest,” said Robin Wood-Mason with The Delores Project, a homeless shelter in Denver, Colorado, that focuses on women and transgender folks.He says during a normal winter, this shelter can provide a warming space for dozens of people each day. But with a static population and a lack of social distancing, local health guidelines have forced them to shut their doors for warming shelters this season.“It’s heartbreaking,” Wood-Mason said of the warming shelter not being able to open this winter. “Here in Denver, we’ve got thousands more people experiencing than there are shelter beds available.”Across the country, other warming shelters are also being impacted by COVID concerns.“We’re just starting to inch into those winter months when we know things are going to get colder, things are going to look and feel a little different into our regions,” said Andrea Carlson with the American Red Cross.She says the days of having people packed in to one large room to get warm are gone. Now, they’re putting people into multiple separate spaces and following new COVID safety protocols.“Distanced between each other, masks are required, you do have some health checks when you come into the warming center,” Carlson said.As winter weather rolls in, and limited capacity issues mean more people are staying outside, The Delores Project believes more people will be exposed to harsh weather and the virus.“It means that we’re really going to see people get sick,” Wood-Mason said. “It’s going to put a new burden on the hospital system and our first responders.” 1887

With coronavirus cases surging in Florida, President Donald Trump said Tuesday that he’s “flexible” on the size of the Republican National Convention in Jacksonville.The president spoke as a growing number of Senate Republicans said they’d skip the event, and even as the White House tried to tamp down nationwide concern about the virus’s spread.Asked in an interview Tuesday whether he’d want to limit the gathering if the state’s coronavirus cases continue to rise, Trump replied that the decision “really depends on the timing.”“We’re always looking at different things,” Trump said during an interview on Gray Television’s “Full Court Press with Greta Van Susteren.”“When we signed a few weeks ago, it looked good,” the president continued. “And now, all of a sudden, it’s spiking up a little bit. And that’s going to go down. It really depends on the timing. Look, we’re very flexible.”There were about 452 new reported cases per 100,000 people in Florida over the past two weeks, which ranks second to Arizona in the U.S. for new cases per capita.He spoke as Republican lawmakers increasingly expressed concern about the gathering. Republican Sens. Chuck Grassley of Iowa, 86, and Lamar Alexander of Tennessee, 80, were among those saying they would stay away from the event. The virus takes a high toll on older people.Grassley was explicit about the reason for skipping the convention for the first time in his 40 years in public office.“I’m not going to go, and I’m not going to go because of the virus situation,” he said on a conference call Monday with Iowa reporters.Alexander, who is retiring after this year, was more subtle.In a statement released by his office Tuesday, he acknowledged that choices must be made and that fewer people gathered for the event is desirable. Alexander did not mention Trump, the pandemic or the fact that health experts say the virus is more transmissible among people in close proximity for prolonged periods.“Sen. Alexander is an honorary chair of the Tennessee Trump campaign, but he will not be attending the convention because he believes the delegate spots should be reserved for those who have not had that privilege before as he has had,” the statement said.About a dozen states are reporting worrying spikes of cases. The White House is trying to tamp down the nationwide concern despite more than 2.9 million confirmed COVID-19 cases and more than 130,000 deaths.Trump has falsely declared that 99% of cases of COVID-19 are harmless, a claim that is not supported by science.Florida is one of the nation’s hardest-hit states, and hospitals are warning they’re in danger of being overwhelmed. Florida’s COVID-19 positive test rate is 18.7%, making it second only to Arizona among states where coronavirus infections are surging. According to public health experts, a rate of 10% or more indicates the virus is spreading in communities.The rate is a snapshot of current conditions, and measures like social distancing, wearing masks, avoiding crowded indoor locations and frequent hand-washing can bring it down.Florida reached a grim milestone over the weekend, with health officials reporting that more than 200,000 people have tested positive for the coronavirus since the start of the outbreak.The highest number of confirmed cases in one day came Saturday, when more than 11,400 cases were reported in the state. More than 3,700 people have died.The convention is scheduled to begin Aug. 24. Officials in Jacksonville, Florida, began requiring face masks in public a week ago.“If you want to have a convention, and I think we should have a convention, I think you should do whatever you can to make it as safe as possible, so that would be with face masks and social distancing,” Grassley said.Grassley said he plans to continue his tour of all of Iowa’s counties, visiting 29 counties during the current two-week break. He and his staff will wear masks, but he doesn’t plan on requiring it for Iowans who come to see him.“There’s no way a United States senator can force anybody in Iowa to wear a mask,” he said. “It’s going to be up to the individuals and I would say that there’s generally a rule that if you’re 6 feet apart, you don’t have to wear a mask, but I think doing both makes common sense and I’m going to encourage people to do both.”___Associated Press writers David Pitt in West Des Moines, Iowa, and Ricardo Alonso-Zaldivar in Washington contributed to this report.___Follow Kellman at http://www.twitter.com/APLaurieKellman 4509

What you flush down your toilet could be brought back up to detect COVID-19.“Anytime that we are talking about poop, it’s a subject that either brings laughter or disgust; maybe a combination of the two,” said John Putnam with Colorado Public Health and Environment. Putnam is helping lead a team to test human waste to determine molecule levels linked with the coronavirus.“This gives you early warning that there could be an upsurge or a lessening of the disease in the community,” he said.Putnam says a person that’s been exposed to COVID-19 will pass the virus through their feces and possibly even urine. The waste eventually flows into sewer systems, which scientists will now collect.“We can then take a sample at a wastewater plant and send it to a lab,” he said.Labs at places like Metropolitan State University of Denver.“One of the advantages of this approach is that everybody in the community makes a contribution to the sewage,” said Rebecca Ferrell, Ph.D., a biology professor at MSU Denver.She says that when people get infected with COVID-19, they often shed the virus for several days before showing symptoms. Adding that this specialized stool sampling can alert scientists that the virus is in a community before people start getting sick.“It can give you extra warning about what might be happening in the hospitals then days maybe even a week later when people get sick enough that they are going to make demands on health care that you need to anticipate,” Ferrell said.With the cost to collect this data much cheaper than other options, Ferrell says more scientists are now teaming up with more wastewater treatment plants across the country.“These are the kinds of techniques where a relatively small investment early on can help us to get those resources to the right place and we can keep the mortality low,” she said.Hoping to get ahead of the pandemic, testing number two is becoming the number one priority for some scientists. 1965

With news of two highly effective COVID-19 vaccines on the horizon, health officials and scientists are giving us new insight into how we could gain herd immunity."If we think of the population as a single group of people with all similar risks and susceptibilities and behaviors, we need 60% of people to be immune, meaning that not only they don’t get sick, but also they don't pass on the virus to other people," says Dr. Stuart Ray, an infectious disease professor and herd immunity expert at Johns Hopkins University.Dr. Ray says achieving herd immunity with the help of a COVID-19 vaccine would mean enough people would either get the vaccine or already have recovered from the virus and be immune to help stop the spread of the virus."It's a little bit like this notion that if you’re going to pass on a message from a lot of people in a group, they have to speak the same language. And the more people don't speak the language, the harder it's going to be to pass that message and there’s a threshold at which the message just gets stopped," says Dr. Ray.Still, it would take a certain number of people to get the vaccine and have that immunity last in order to reach herd immunity. Stanford University's Dr. Bali Pulendran hopes that we can achieve herd immunity, even though there are a certain number of people who are still hesitant to take the vaccine."I think we should remember that a vaccine that is 95% effective is only effective if the majority of people in a population take it. If only half the population or only 60% of the population take it, then we are unlikely to have achieved the level of herd immunity that you need for curbing the disease," says Dr. Pulendran.And if the new COVID-19 vaccine requires two doses, how crucial will it be to make sure people receive that second round of immunization?Asked whether follow up will be a concern, Dr. Ray says, "I think it is a possible concern. We’re going to do a lot of learning. So, one of the things we’ve learned is that some vaccines we thought you needed multiple doses, one dose works pretty well."Doctors say research will be ongoing on the vaccine and the virus itself to ensure people will be protected as much as possible, because so many are hopeful for an end to COVID-19. 2268

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