"Confirmed coronavirus cases world-wide Friday exceeded 2.7 million, with more than 190,000 dead," reports the Wall Street Journal, citing data from Johns Hopkins University.

While America has just 4.3% of the world's population, "The U.S. accounted for nearly a third of the cases, exceeding 869,000, and more than a quarter of the deaths, at 49,963." [Note: This comparison might be skewed by the number of countries underreporting their cases or deaths.]

The Miami Herald reports: The coronavirus has killed more than 50,000 people in the United States, just four days after passing 40,000 U.S. deaths on Sunday, Johns Hopkins University reports. The total as of early Friday afternoon was more than 50,370, up about 400 deaths since Thursday night, the data shows...

More than 25,000 people have died in Italy, and more than 22,000 in Spain... Most of the U.S. deaths have occurred in New York City: 16,388, the university says.
Two weeks ago America had just 20% of the world's confirmed fatalities.

Amazon is asking warehouse employees who have stayed away from work during the pandemic to return for scheduled shifts beginning May 1, or request a leave of absence. Bloomberg reports: The move sets up a critical choice for employees at a company that has become a lifeline for Americans locked down to contain outbreaks of Covid-19. After the coronavirus began spreading through the U.S., Amazon offered unpaid time off without penalty for workers uncomfortable with coming in, along with $2-an-hour hazard pay for those who report for duty. The offers run through April. In a blog post published Friday, Amazon said it would extend the raise through May 16 but made no mention of unlimited unpaid time off. Amazon said it was "providing flexibility with leave of absence options, including expanding the policy to cover Covid-19 circumstances, such as high-risk individuals or school closures."

Citing a "primary outcome" of death, researchers cut short a study testing anti-malaria drug chloroquine as a potential treatment for Covid-19 after some patients developed irregular heart rates and nearly two dozen of them died after taking doses of the drug daily. From a report: Scientists say the findings, published Friday in the peer-reviewed Journal of the American Medical Association, should prompt some degree of skepticism from the public toward enthusiastic claims about and perhaps "serve to curb the exuberant use" of the drug, which has been touted by President Donald Trump as a potential "game-changer" in the fight against the coronavirus. Chloroquine gained widespread international attention following two small studies, including one with 36 Covid-19 patients published March 17 in France, found that most patients taking the drug cleared the coronavirus from their system a lot faster than the control group. The JAMA report said those trials didn't meet the publishing society's standards.

This month, Jaguar Health more than tripled the price of its lone FDA-approved drug, right after asking the federal government to expand the use of its drug to coronavirus patients. AmiMoJo shares a report: Jaguar Health drastically raised the price of a drug during the height of the pandemic, but executives argued the move was needed to stave off the company's collapse. Going into this year, the list price of a 60-pill bottle of Mytesi -- an antidiarrheal medication specifically for people with HIV/AIDS who are on antiretroviral drugs -- was $668.52. On April 9, Jaguar Health raised the price to $2,206.52, according to pricing data from Elsevier's Gold Standard Drug Database. On March 21, Jaguar Health asked the FDA to authorize emergency use of Mytesi for COVID-19 patients who were experiencing any diarrhea or "diarrhea associated with certain antiviral treatments" including remdesivir, among others.

One of every five New York City residents tested positive for antibodies to the coronavirus, according to preliminary test results described by Gov. Andrew M. Cuomo on Thursday, suggesting the virus had spread far more widely than known. The New York Times reports: The results also provided the tantalizing prospect that many New Yorkers who never knew they had been infected -- possibly as many as 2.7 million, the governor said -- had already encountered the virus, and survived. Mr. Cuomo also suggested the death rate was far lower than believed. The reliability of some early antibody tests to hit the market has been widely questioned, with some -- made in China without Food and Drug Administration approval -- found by health officials to be deeply flawed. Researchers across New York have worked in recent weeks to develop and validate their own, with federal approval.

In New York City, about 21 percent, or one of every five residents, tested positive for coronavirus antibodies during the state survey. The rate was 16.7 percent in Long Island, 11.7 percent in Westchester and Rockland Counties, and 3.6 percent in the rest of the state. Almost 14 percent of those tested in New York were positive, according to preliminary results from the state survey, which sampled approximately 3,000 people over two days at grocery and big-box stores. The governor suggested on Thursday that, based on the survey, the death rate in New York from Covid-19 would likely be far lower than previously believed, possibly 0.5 percent of those infected. On Thursday, Mr. Cuomo did not talk about any potential for immunity among those previously infected.

Rei writes: A paper recently published by The American Society of Tropical Medicine and Hygiene adds further support to recent CDC guidelines for minimizing the use of invasive ventilators. As physicians had been voicing concern that doctors were being too eager to put patients on invasive ventilation and may be doing more harm than good, the investigators looked into outcomes of intubated patients vs. non-intubated patients experiencing hypoxia. Unlike with other forms of pneumonia, they found that COVID-19 patients were unusually damaged by invasive ventilation but also able to tolerate higher levels of anoxia -- to the point that one doctor recalls having to tell patients to get off their cellphones so that they could be intubated. The recommendation is that guidelines be adjusted to discourage invasive ventilation unless a patient is physically struggling to breathe, rather than relying strictly on oxygen levels; otherwise, the use of non-invasive ventilation, such as CPAP and BiPAP, should be encouraged. When invasive ventilation is used, oxygen levels should be minimized in order to reduce the risk of damaging healthy tissue.

Health officials have prioritised two clinical trials that will be supplied with blood from recovered Covid-19 patients in the hope that transfusions can help save the lives of people hospitalised with the infection. From a report: NHS Blood and Transplant (NHSBT) has started to collect blood from recovered patients with a view to using the antibody-rich serum to boost the immune systems of patients struggling to overcome the virus. The limited supply of convalescent plasma will be given to patients enrolled on sub-studies in the Recovery trial led by Peter Horby at the University of Oxford, and the Remap-Cap trial led by the Intensive Care National Audit and Research Centre (ICNARC) in London. The Recovery trial will assess whether the plasma helps patients to recover before they are admitted to intensive care, while the Remap-Cap trial will investigate whether similar transfusions help to save patients who are already in high-dependency or intensive care units. At least one trial that was designed to assess whether the plasma could protect healthy people who are in close contact with Covid-19 patients, such as NHS staff and family members, was rejected by NHSBT amid a shortage of the donated serum.

The sandbox video game Minecraft has teamed with the United Nations for a PSA campaign that aims to spread helpful information and health tips amid the coronavirus pandemic. From the Hollywood Reporter: In an official blog post on Tuesday, a spokesperson from the game's Swedish developer wrote, "At Mojang, we find that distributing factual information is incredibly important, as that information will help people make informed decisions, which in turn may save lives. One thing we're doing to help is teaming up with the United Nations Development Programme (UNDP) and their partner, Heart17. Together, we'll spread the word under the banner of #TomorrowTogether."

The blog post noted that over the next week or so, Minecraft's social media channels will be devoted to sharing crucial health advice derived from the World Health Organization's safety recommendations. There will be three videos in the campaign that replay guidelines about practices such as handwashing and social distancing. "So if you suddenly come across a Creeper asking you to wash your hands, don't worry: their agenda has not permanently changed," the blog post continued. "In the game, they still want nothing more than to get cozy with you and proceed to blow up. But in our social channels, and for the time being, they also want to help put an end to the pandemic."

An anonymous reader quotes a report from The New York Times: A study released Monday by the Centers for Disease Control and Prevention shows that calls to poison hotlines this year for cases involving cleaners and disinfectants rose significantly compared with the same period over the previous two years, and charts a dramatic spike in March for both categories. Some of the physicians who collaborated on the research with the C.D.C. had discussed their observations with one another last month. "I was like: 'Am I the only one seeing a big increase in exposures to these disinfectants?'" said Dr. Diane P. Calello, the medical director of the New Jersey Poison Information and Education System, and one of the authors of the report.

Others saw the same trend, and wondered if the accidental poisonings were an insidious, secondary result of the coronavirus's spread. The group initiated the study to determine if there was a possible link between the rise in exposures and the recommendations from public health agencies to clean and disinfect as much as possible. From January through March, poison centers received 45,550 exposure calls related to cleaners (28,158) and disinfectants (17,392), the report said, representing overall increases of 20.4 percent compared with the same period in 2019 and 16.4 percent more than 2018. The authors warned that the actual number of exposures was likely even higher because the data only came from reported calls for help, and some people who were exposed probably did not report their cases to the hotlines.

LabCorp's at-home COVID-19 test, which is called 'Pixel,' has received the first Emergency Use Authorization (EUA) for such a test missed by the U.S. Food and Drug Administration (FDA). From a report: The test is an at-home collection kit, which provides sample collection materials including a nasal swab to the user, who then uses the included shipping package to return the sample to a lab for testing. Until now, the FDA has not authorized any at-home testing or sample collection kits for use, and in fact clarified its guidelines to specifically note that their use was not authorized under its guidelines when a number of startup companies debuted similar products for at-home collection and round-trip testing with labs already certified to run molecular RT-PCR tests to detect the presence of COVID-19. The FDA notes that only LabCorp's COVID-19 RT-PCR test has received this authorization, and that it still requires any such test to have an EUA before they can being offering services, whether or not the test is administered at home with the help of guidance from an authorized medical professional via telemedicine. Some labs facilitating at home serology tests using an exception in the FDA guidelines, but these are not viewed by the agency as tests that can confirm a case of COVID-19.

CNBC reports: Microsoft is working with a consortium of pharmaceutical companies to recruit people who have recovered from Covid-19 to donate their plasma, which could be used in treatments for the disease. To help get the word out, the company is launching a chatbot, which it refers to as its "plasmabot," to lead people through a series of questions to determine if they're a candidate to donate plasma. The plasmabot, which goes live this weekend, will also provide information about the procedure and direct them to a nearby site where they can safely make the donation...

In a blog post, Microsoft says there are two possible approaches with collected plasma: Make transfusions directly available to those who are battling the virus, or incorporate the antibodies to help develop a medicine. Microsoft's head of research Peter Lee said the company is supporting the efforts of a plasma alliance formed by companies like Octapharma, Takeda, CSL Behring and others. That project kicked off in late March, and counts the Bill & Melinda Gates Foundation among its advisors.

After conducting its own research into the approach, Lee said he believes it has the "potential to save lives." So the company is setting aside computing resources and other infrastructure, as well as engineering talent. It is also promoting the plasmabot through a website, and it's search, web and social channels.

Microsoft is getting behind the effort now because plasma of recovered patients is only useful for a limited time. "There's a window from onset of symptoms that lasts from 21 to about 56 days," said Lee.
Meanwhile, a Florida newspaper reports that the Mayo Clinic is also coordinating its own study with a network of hospitals across America to "gauge the effectiveness" of plasma treatments.

This week U.S. president Donald Trump suspended America's $900 million annual contribution to the World Health Organization. Richard Horton, editor-in-chief of the prestigious medical journal The Lancet, called Trump's move a "crime against humanity...."

The Hill reports: "Every scientist, every health worker, every citizen must resist and rebel against this appalling betrayal of global solidarity," he added...

The American Medical Association (AMA) late Tuesday called Trump's decision a "dangerous step in the wrong direction" and urged him to reconsider. "Fighting a global pandemic requires international cooperation and reliance on science and data. Cutting funding to the WHO — rather than focusing on solutions — is a dangerous move at a precarious moment for the world," the AMA said in a statement. European Union foreign policy chief Josep Borrell, meanwhile, said Wednesday that there was "no reason justifying" Trump's move...

And Bill Gates said in a tweet that halting funding to the WHO amid a world health crisis "is as dangerous as it sounds."

"Their work is slowing the spread of COVID-19 and if that work is stopped no other organization can replace them," the Microsoft co-founder and billionaire philanthropist added. "The world needs @WHO now more than ever."
Agreeing with Bill Gates was 95-year-old former U.S. president Jimmy Carter. Newsweek quotes Carter's newly-released statement calling the WHO "the only international organization capable of leading the effort to control this virus."

The head of the United Nations also called the WHO "absolutely critical to the world's efforts to win the war against COVID-19."

While criticizing the WHO, this week an article in the Atlantic called president Trump's moves "a transparent effort to distract from his administration's failure to prepare for the COVID-19 pandemic." The Democrats speaker of the House added that Trump's decision "is dangerous, illegal and will be swiftly challenged."

But the science magazine Nature still published an editorial harshly criticizing Trump's attempt to defund the WHO. "[E]ven talk of doing so in the middle of a global health and economic crisis cannot be condemned strongly enough." They argue that withholding America's funds "will place more lives at risk and ensure that the world takes longer to emerge from this crisis... It is right that researchers, funders and governments have been protesting against Trump's decision, and they must continue to do so in the strongest terms."

And Newsweek also published the comments of the WHO's Director-General, who had this message for its critics. "[O]ur focus, my focus, is on stopping this virus and saving lives... This is a time for all of us to be united in our common struggle against a common threat, a dangerous enemy.

"When we're divided, the virus exploits the cracks between us."

Newsweek reports: There is no evidence to back claims the coronavirus that has caused the COVID-19 pandemic emerged from a lab in China, scientists have told Newsweek.

Adam Lauring, an associate professor at the University of Michigan Medical School and an expert in the evolution of viruses, told Newsweek: "This claim is a conspiracy theory and it is not supported at all by the available data... The SARS-CoV-2 virus has some key differences in specific genes relative to previously identified coronaviruses — the ones a laboratory would be working with," said Lauring. "This constellation of changes makes it unlikely that it is the result of a laboratory 'escape.'"

Alexandre Hassanin, a lecturer at France's Sorbonne University National Museum of Natural History department of origins and evolution, similarly highlighted to Newsweek: "Even if it is difficult to prove that a laboratory accident did not take place, you should know that SARS-CoV-2 is not closely related to any previous viruses; it was never sequenced (even partially) in previous studies, and the COVID-19 outbreak began in November/December, as in previous SARS epidemic events (2002 and 2003)."

Hassanin said: "These two points suggest therefore that the current outbreak was not the consequence of a laboratory accident."
An anonymous reader adds: Today the Associated Press also called it "an outlier theory" being spread by president Trump and officials in his administration "without the weight of evidence."

On Twitter, Eric Hundman, an Assistant Professor at NYU Shanghai, had stern words for anyone still spreading this misinformation. "Insinuating that the virus escaped from a lab in China by saying 'well, there's no evidence that it didn't' is not only untrue, it amounts to disinformation that could further ratchet up US-China tensions and distract from more urgent priorities.

*There actually is scientific evidence against the "escaped from a lab" theory."
He then cites five different scientists who wrote in Nature magazine that "We do not believe that any type of laboratory-based scenario is plausible."

In fact, "Most experts push back on the lab leak theory," CNN reported earlier this month. "I think it has no credibility," they were told by Vincent Racaniello, a microbiology professor at Columbia University who hosts a podcast called "This Week in Virology."

And they got the same response from Dr. Simon Anthony, a professor at the public health grad school of Columbia University and a key member of PREDICT. "It all feels far-fetched. Lab accidents do happen, we know that, but... there's certainly no evidence to support that theory."

That's also the opinion of America's intelligence community. Business Insider writes: The US intelligence community has also been investigating whether the virus was collected by researchers and then accidentally leaked from a Chinese lab but has found no evidence to date backing it up, according to Politico, which cited multiple sources familiar with the matter. Or, as Politico puts it: Congressional intelligence committees have been asking various agencies if hard evidence exists to support it. So far, there is none, multiple sources familiar with the matter told POLITICO.
UPDATE (4/19/20): On Sunday even Dr. Deborah Birx, the White House's Coronavirus Task Force response coordinator, acknowledged "I don't have evidence that it was a laboratory accident."

GeekWire reports: The University of Washington School of Medicine's Virology Lab is reporting encouraging results from trial runs of a new test from Abbott Laboratories that detects the antibodies created by people who have had COVID-19, whether they knew they had it or not. "This is a really fantastic test," Keith Jerome, who leads UW Medicine's virology program, told reporters today. He said UW's lab could process 4,000 samples per day starting next week, and conceivably ramp up to 14,000 samples per day within a couple of weeks.

The test will be made available through health care providers, in medical clinics or perhaps through workplaces... Epidemiologists say knowing who has had the virus will be key to tracking the true spread of COVID-19, and giving assurances to people who are returning to school and work — particularly in front-line jobs ranging from first responders and health care workers to grocery store clerks.

"It's possible this could be part of a back-to-work process," Jerome said. It's not yet clear how much immunity people develop to COVID-19 in the course of fighting off the virus, but if SARS-CoV-2 behaves like other coronaviruses, people with antibodies should have at least some protection from re-infection...

There's also a chance that being able to detect antibodies for COVID-19 will speed the development of vaccines in the months ahead.
1 million of the tests will be shipped this week in the U.S., and up to 4 million in the month of April, GeekWire reports.

And by June the company plans to be shipping 20 million tests per month.

In a preprint academic paper published in early April, MIT researchers describe a model that quantifies the impact of quarantine measures on the spread of COVID-19, the novel coronavirus. From a report: Unlike most of the models that have so far been proposed, this one doesn't rely on data from studies about previous outbreaks, like SARS or MERS. Instead, it taps an AI algorithm trained to capture the number of infected individuals under quarantine using the SEIR model, which groups people into classes like "susceptible," "exposed," "infected," and "recovered." This approach potentially achieves accuracy higher than or comparable to previous work, which could help to better inform governments, health systems, and nonprofits as they make treatment and policy decisions about social distancing. For instance, the model found that in places like South Korea, where there was immediate government intervention, the virus spread plateaued more quickly.

"Our model shows that quarantine restrictions are successful in getting the effective reproduction number from larger than one to smaller than one. The [model] is learning what we are calling the 'quarantine control strength function,'" said George Barbastathis, MIT professor of mechanical engineering, who developed the model over the course of several weeks with civil and environmental engineering Ph.D. candidate Raj Dandekar as a part of a final class project. "That corresponds to the point where we can flatten the curve and start seeing fewer infections."

The world's biggest trial of drugs to treat Covid-19 patients has been set up in the UK at unprecedented speed, and hopes to have some answers within weeks. From a report: The Recovery trial has recruited over 5,000 patients in 165 NHS hospitals around the UK in a month, ahead of similar trials in the US and Europe, which have a few hundred. "This is by far the largest trial in the world," said Peter Horby, professor of emerging infectious diseases and global health at Oxford University, who is leading it. He has previously led Ebola drug trials in west Africa and the Democratic Republic of the Congo (DRC). The Recovery team expects to be the first to have definitive data. "We're guessing some time in June we may get the results," said Prof Horby. "If it is really clear that there are benefits, an answer will be available quicker." But he warned that in the case of Covid-19, there would be no "magic bullet."

China on Friday raised its coronavirus death toll by 50 percent in Wuhan, the city where the outbreak first emerged, amid accusations that the government had concealed the extent of the epidemic. From a report: Officials placed the new tally at 3,869 deaths from the coronavirus in the central Chinese city, an increase of 1,290 from the previous figure. The number of cumulative confirmed infections in the city was also revised upward to 50,333, an increase of 325. The move appeared to be a response to growing questions about the accuracy of China's official numbers and calls to hold the country responsible for a global health crisis that has killed more than 142,000 people and caused a worldwide economic slowdown. China has been criticized as having initially mismanaged and concealed the extent of the epidemic, though it ultimately swung into action and seemingly tamed the virus. Recently, as other countries have grappled with their own outbreaks, Chinese officials have come under even greater pressure to explain how exactly the epidemic unfolded in Wuhan.

The University of Oxford's Big Data Institute found that 56% of the general population, or 80% of current smartphone owners, would need to use a contact-tracing app for it to be effective in helping stop the coronavirus. The BBC reports: If there is lower uptake, academics say the app would still help slow the spread of Covid-19. They add that letting people self-diagnose the illness could be critical. The experts say "speed is of the essence", and that delaying contact tracing by even a day from the onset of symptoms could make the difference between epidemic control and resurgence. "There would be more people receiving notifications as a result of false warnings," explained Prof Christophe Fraser.

The team estimates that 56% of the general population must use the app to halt the outbreak. Prof Fraser said that equated to 80% of all existing smartphone owners, based on data from Ofcom. "That's a very ambitious target," the professor acknowledged. "It's not something that would typically happen for a new app - even an incredibly popular one - but if we can explain that this is a public health intervention, that will be new and different. [...] More than 80% of people surveyed said they were likely to or would install this app when it was explained in detail what it would be doing." Even if fewer people install the app, the team estimates that one infection will be averted for every one to two users.

In his annual shareholder letter, Amazon CEO and founder Jeff Bezos said that a next step for the company could be regularly testing its employees for the coronavirus, even if they show no symptoms. From a report: "Regular testing on a global scale, across all industries, would both help keep people safe and help get the economy back up and running," he wrote Thursday. Amazon first discussed the concept of developing its own testing capabilities last week. Bezos' public support for this initiative follows a similar push on Wednesday from banking and financial services leaders, who told President Donald Trump in a conference call that more widespread coronavirus testing is needed before the public would feel comfortable going out regularly again, The Wall Street Journal reported. This work is part of early-stage discussions by the White House, state governments and business leaders on how they will start reopening the economy following weeks of restrictive stay-at-home orders and mandated store closures. Along with far more testing, calls for people to regularly use face masks in public places are gaining more traction.

On Tuesday, General Motors revealed that its first ventilators are ready for delivery. "The automaker has a contract with the US Department of Health and Human Services to license-build 30,000 Ventec Life Systems V+ Pro critical care ventilators," reports Ars Technica. "These ventilators are designed to treat the most critically ill patients, who need invasive intubation (tubes inserted into the lungs) as opposed to non-invasive machines like CPAP or BiPAP devices, which are also often referred to as ventilators." Ars Technica reports: GM says that it will ship the first 600 ventilators by the end of April, with "almost half the order" ready by the end of June and the full 30,000 by the end of August. The company has the capacity to produce more if needed. The automaker has leveraged its logistics chain and worked with suppliers to source parts and assemblies, and it has worked closely with Ventec to make these urgently needed medical devices.