If there is a signature pandemic experience many of us will recall with a shudder years from now, it will be getting tested for the virus—often with a nasal swab inserted farther up our nose than we ever thought possible. The test, which looks for cells containing genetic material of the SARS-CoV-2 virus, is reliable, but extremely unpleasant.
But there’s a simpler, easier alternative in the works: saliva tests, which require nothing more than spitting into a vial. And as my colleague Alice Park reports, researchers are making progress on a range of such tests for COVID-19, which could make testing easier, cheaper and more accessible.
The U.S. Food and Drug Administration gave emergency use authorization (EUA) to the first COVID-19 saliva test in April, but it required people to spit into a specialized container with a specific chemical mixture in the presence of a health care professional. The next authorization, issued in May, allowed people to provide their samples at home, but those samples also had to be collected in special tubes and could only be analyzed at a Rutgers University lab. Then, in mid-August, the FDA issued an EUA for a potentially groundbreaking saliva test called SalivaDirect. Unlike other saliva tests, SalivaDirect doesn’t require special (and potentially expensive) containers, any lab can apply to process the samples, and researchers don’t need special chemicals to extract the virus’ genetic material. For now, people using SalivaDirect need to collect their sample in front of a health care professional, but the company is asking the FDA for permission to allow home collection.
How accurate are saliva tests? In a preprint study published in August, SalivaDirect’s team found a 97% agreement between results from SalivaDirect and the PCR test—the current gold-standard method that looks for traces of SARS-CoV-2 genes and amplifies them. Moreover, in another study published in September in the New England Journal of Medicine, the researchers found that 81% of saliva samples tested positive for the virus one to five days after diagnosis, compared to 71% of the nasopharyngeal samples. That suggests saliva might more accurately show whether COVID-19 is still somewhere in the body later in a person’s infection timeline.
Now, SalivaDirect's team is exploring whether saliva tests could help find the virus in people who are infected but don’t show any symptoms—which some experts estimate could include up to 40% of infected people. Because they don’t feel sick, these asymptomatic people might be spreading the virus without knowing it, and thus represent a major public health threat.
More than 37.8 million people around the world had been infected by COVID-19 as of 1 a.m. E.T. today, and more than 1 million people have died. Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
On Oct. 12, there were 326,201 new cases and 3,922 new deaths confirmed globally. Here's how the world as a whole is currently trending:
Here is every country with over 400,000 confirmed cases to date ("per cap" is number per 100,000 people):
India has fought hard to control its child labor problem, passing laws to forbid children under 14 from working and prohibiting those from 14 to 18 from working in hazardous jobs. The country’s school system helped in this effort, in part by ensuring that kids had a place to go during the day. But the pandemic has reversed a lot of that progress, as The Guardian reports. With schools closed and parents out of work, children have been flooding back into the labor market. One anti-trafficking organization reports that it rescued 1,200 children—some as young as eight—between April and September who were working on farms for the equivalent of $10.50 per month. Among advocates’ biggest concerns: once children leave school, they are unlikely to return.
With more than 700,000 new cases of coronavirus across Europe in the past week—a stunning 34% increase over the week before—many countries across the continent are pulling back into their quarantine shells, reports the Associated Press. The U.K. has established a three-tier system, putting parts of the country at medium, high or very high alert and issuing restrictions accordingly. German Chancellor Angela Merkel called an urgent meeting of her country’s governors to mount a response. Italy has banned sports pickup games, limited social gatherings in private homes to six people and ordered restaurants and bars to close at midnight. Mask mandates have been imposed in numerous hotspots, including Paris, Brussels and Kosovo. It’s not just the rising infection rates driving this newfound urgency—it’s also the rate of deaths, which are up 16% in the past week compared to the week before.
Russia is pressing ahead with wider-scale testing of its Sputnik V vaccine despite international skepticism over its safety and efficacy, CNBC reports. The country’s Gamaleya Research Institute of Epidemiology and Microbiology, which developed the vaccine, has not shared research data from early clinical trials, while newer data that have been released have been questioned as incomplete or unreliable. Nonetheless, Russia is beginning trials in both Belarus and the United Arab Emirates, dismissing outsiders’ skepticism as “information warfare,” as one Russian official put it.
Even soccer fans who don’t root for Portugal or the Juventus Football Club do root for forward Cristiano Ronaldo, the five-time world player of the year. So it came as a shock that, as Reuters and othersources report, Ronaldo has tested positive for the coronavirus. He has left the national team for now and is doubtful for both its next game on Saturday and the Champions League opener next Tuesday.
The Situation in the U.S.
The U.S. had recorded more than 7.8 million coronavirus cases as of 1 a.m. E.T. today. More than 215,000 people have died. Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
On Oct. 12, there were 41,653 new cases and 317 new deaths confirmed in the U.S. Here's how the country as a whole is currently trending:
Breaking: U.S. regulators have paused enrollment in Eli Lily's COVID-19 monoclonal antibody treatment citing potential safety concerns, CNBC reports. The company is testing its antibody treatment in combination with remdesivir, an antiviral drug now commonly used to treat the virus.
For the second time in as many months, a late stage vaccine trial is on hold after a subject developed an unexplained illness. Last month it was AstraZeneca that had to put on the brakes; this time it’s Johnson & Johnson. The company is not disclosing the nature of the illness, citing privacy concerns, but did issue a statement noting that such delays “are an expected part of any clinical study.” That is indeed the case, especially when the sample group consists of tens of thousands of people. The first step is to determine if the subject received a mere placebo—which would exonerate the actual vaccine. But even if the sickened individual received the vaccine, the illness could be unrelated. For now, the AstraZeneca trial remains on hold in the U.S. It is too early to say when Johnson & Johnson, which hopes to enroll 60,000 people in its trials, can resume work.
Testing shortages were a major problem early in the U.S. outbreak. Now, with labs having geared up to process as many as 1 million tests nationwide per day, a new issue is developing, according to The Wall Street Journal: a shortage of labor to process the tests. Lab workers are reporting long hours and burnout; labs are responding by raising salaries, offering flexible hours and hiring traveling technicians willing to go where they’re most needed. It is a measure of the pandemic’s continued severity that, with a national workforce of 337,000-plus lab technicians, more hands are still needed.
It’s not just mask-free events and a lack of social distancing that are responsible for the recent outbreak of coronavirus cases in U.S. President Donald Trump’s circle—it’s also the Administration’s reliance on a single, rapid test that is not universally reliable and was not always used correctly by White House staffers. As The New York Times reports, the rapid test, manufactured by Abbott Laboratories, received an FDA emergency use authorization, but only for people within the first seven days of the onset of symptoms. Testing asymptomatic people, as the White House routinely did, was an off-label use.
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of October 13, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
A Troubling Case of Reinfection
An unnamed, 25-year-old Nevada resident contracted COVID-19 in April, recovered, and then became reinfected in May—this time with a more severe case. Testing showed that the man was sickened by two different strains of the virus—evidence that he was indeed infected twice, as opposed to simply suffering from a resurgence of symptoms. The case calls into question just how robust the immune response is in patients who have been sickened once. Still, the fact that such reinfection is so far exceedingly rare gives epidemiologists hope that the man's case represents more fluke than trend. Read more here.
'Brain Fog' Plagues Virus Survivors
Thousands of people who have recovered from the virus are experiencing ongoing cognitive symptoms like memory loss and confusion, the New York Times reports. One patient reports forgetting the details of a 12-day trip to Paris they took just a few weeks earlier. Another could not recognize her own car in her apartment’s parking complex. Experts' best guess is that the issues are caused by an overactive immune response or inflammation of blood vessels leading to the brain. Read more here.
The Global Economy Remains Infected
Gloomy news comes from the International Monetary Fund, which expects the global economy to contract by 4.4% by the end of 2020, the AP reports, marking the worst downturn since the Great Depression. For perspective, global economic output fell by a mere 0.1% after the financial crisis of 2008. Bad as the news is, it’s better than an earlier IMF forecast, which called for a 5.2% fall-off. The slight improvement is due to China’s better-than-expected rebound and to economic stimulus measures passed in the U.S. and elsewhere. Read more here.
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com.
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Today's newsletter was written by Jeffrey Kluger and edited by Alex Fitzpatrick.
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