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The vaccine we’re testing in Australia is based on a flu shot. Here’s how it could work against coronavirus

Posted by Care Ana, Thursday, 25th June 2020 @ 3:48pm

  • A new trial has begun in Victoria this week to evaluate a potential vaccine against COVID-19.

    The vaccine is called NVX-CoV2373 and is from a US biotech company, Novavax.

    The trial will be carried out across Melbourne and Brisbane, and is the first human trial of a vaccine specifically for COVID-19 to take place in Australia.

    This vaccine is actually based on a vaccine that was already in development for influenza. But how might it work against SARS-CoV-2, the coronavirus that causes COVID-19?

    What’s in the mix?

    Vaccines trigger an immune response by introducing the cells of our immune system to a virus in a safe way, without any exposure to the pathogen itself.

    All vaccines have to do two things. The first is make our immune cells bind to and “eat up” the vaccine. The second is to activate these immune cells so they’re prepared to fight the current and any subsequent threats from the virus in question.

    We often add molecules called adjuvants to vaccines to deliver a danger signal to the immune system, activate immune cells and trigger a strong immune response.

    The Novavax vaccine is what we call a “subunit” vaccine because, instead of delivering the whole virus, it delivers only part of it. The element of SARS-CoV-2 in this vaccine is the spike protein, which is found on the surface of the virus.

    By targeting a particular protein, a subunit vaccine is a great way to focus the immune response.

    However, protein by itself is not very good at binding to and activating the cells of our immune system. Proteins are generally soluble, which doesn’t appeal to immune cells. They like something they can chew on.

    So instead of soluble protein, Novavax has assembled the SARS-CoV-2 spike protein into very small particles, called nanoparticles. To immune cells, these nanoparticles look like little viruses, so immune cells can bind to these pre-packaged chunks of protein, rapidly engulfing them and becoming activated.

    The Novavax vaccine also contains an adjuvant called Matrix-M. While the nanoparticles deliver a modest danger signal, Matrix-M can be added to deliver a much stronger danger signal and really wake up the immune system.

    Rethinking an influenza vaccine

    The Novavax vaccine for SARS-CoV-2 is based on a vaccine the company was already developing for influenza, called NanoFlu.

    The NanoFlu vaccine contains similar parts – nanoparticles with the Matrix-M adjuvant. But it uses a different protein in the nanoparticle (hemagglutinin, which is on the outside of the influenza virus).

    In October last year, Novavax started testing NanoFlu in a phase III clinical trial, the last level of clinical testing before a vaccine can be licensed. This trial had 2,650 volunteers and researchers were comparing whether NanoFlu performed as well as Fluzone, a standard influenza vaccine.

    An important feature of this trial is participants were over the age of 65. Older people tend to have poorer responses to vaccines, because immune cells become more difficult to activate as we age.

    This trial is ongoing, with volunteers to be followed until the end of the year. However, early results suggest NanoFlu can generate significantly higher levels of antibodies than Fluzone – even given the older people in the trial.

    Antibodies are small proteins made by our immune cells which bind strongly to viruses and can stop them from infecting cells in the nose and lungs. So increased antibodies with NanoFlu should result in lower rates of infection with influenza.

    These results were similar to those released after the phase I trial of NanoFlu, and suggest NanoFlu would be the superior vaccine for influenza.

    So the big question is – will the same strategy work for SARS-CoV-2?

    The Australian clinical trial

    The new phase I/II trial will enrol around 131 healthy volunteers aged between 18 and 59 to assess the vaccine’s safety and measure how it affects the body’s immune response.

    Some volunteers will not receive the vaccine, as a placebo control. The rest will receive the vaccine, in a few different forms.

    The trial will test two doses of protein nanoparticles – a low (5 microgram) or a high (25 microgram) dose. Both doses will be delivered with Matrix-M adjuvant but the higher dose will also be tested without Matrix-M.

    All groups will receive two shots of the vaccine 21 days apart, except one group that will just get one shot.

    This design enables researchers to ask four important questions:

    1. can the vaccine induce an immune response?

    2. if so, what dose of nanoparticle is best?

    3. do you need adjuvant or are nanoparticles enough?

    4. do you need two shots or is one enough?

    While it’s not yet clear how the vaccine will perform for SARS-CoV-2, Novavax has reported it generated strong immune responses in animals.

    And we know NanoFlu performed well and had a good safety profile for influenza. NanoFlu also seemed to work well in older adults, which would be essential for a vaccine for COVID-19.

    We eagerly await the first set of results, expected in a couple of months – an impressive turnaround time for a clinical trial. If this initial study is successful, the phase II portion of the trial will begin, with more participants.

    The Novavax vaccine joins at least nine other vaccine candidates for SARS-CoV-2 currently in clinical testing around the world.

    Readmore: 
    COVID-19 Antibody Test


Keep your nose out of it: why saliva tests could offer a better alternative to nasal COVID-19 swabs

Posted by Care Ana, Thursday, 25th June 2020 @ 3:46pm

  • Saliva is one of our biggest foes in the COVID-19 pandemic, because of its role in spreading the virus. But it could be our friend too, because it potentially offers a way to diagnose the disease without using invasive nasal swabs.

    Our research review, published in the journal Diagnostics, suggests saliva could offer a readily accessible diagnostic tool for detecting the presence of SARS-CoV-2, the virus that causes COVID-19, and might even be able to reveal whether someone’s immune system has already encountered it.

    COVID-19 testing is a crucial part of the pandemic response, especially now countries are gradually lifting social distancing restrictions. This requires widespread, early, accurate and sensitive diagnosis of infected people, both with and without symptoms.

    Our review looked at the results of three different studies, in Hong Kong, the nearby Chinese mainland city of Shenzhen, and Italy. All three studies found SARS-CoV-2 is indeed present in the saliva of COVID-19 patients (at rates of 87%, 91.6%, and 100% of patients, respectively). This suggests saliva is a potentially very useful source of specimens for detecting the virus.

    Saliva spreads the SARS-CoV-2 virus via breathing, coughing, sneezing, and conversation, which is why guidelines suggest we maintain a distance of at least 1.5 metres from one another. We also know SARS-CoV-2 can survive in tiny droplets of saliva in an experimental setting.

    Saliva is an attractive option for detecting SARS-CoV-2, compared with the current tests which involve taking swabs of mucus from the upper respiratory tract. Saliva is easy to access, which potentially makes the tests cheaper and less invasive. Saliva can hold up a mirror to our health, not just of our mouth but our whole body.

    For this reason, saliva has already been widely investigated as a diagnostic tool for chronic systemic diseases, as well as for oral ailments such as periodontal disease and oral cancers. But less attention has been given to its potential usefulness in acute infectious diseases such as COVID-19, perhaps because researchers and clinicians don’t yet appreciate its full potential.

    What a mouthful

    When we get sick, much of the evidence is present in our saliva – from the germs themselves, to the antibodies and immune system proteins we use to fight them off. Saliva also contains genetic material and other cellular components of pathogens after we have broken them down (for the full biochemical breakdown of the weird and wonderful things in our saliva, see pages 51-61 of our ).

    Saliva is also hardy. It can be stored at –80℃ for several years with little degradation.

    This means it would be relatively straightforward to track the progression of COVID-19 in individual patients, by collecting saliva at various times during the disease and recovery. Saliva tests from recovered patients could also tell us if they have encountered the disease for a second time, and how strong their immune response is.

    However, there is no research yet available on using saliva to monitor immune responses. This will be well worth investigating, given the pressing need for a reliable and cost-effective way to monitor the population for immunity to COVID-19 as the outbreak continues.

    Could saliva testing replace nasal swabs?

    An ideal saliva test would be a disposable, off-the-shelf device that could be used at home by individuals, without exposing them or others to the risk of visiting a clinic.

    One drawback with the research so far is that it has involved small numbers of patients (each of the three studies we reviewed involved no more than 25 people), and there is little published detail on exactly how these studies collected the saliva – whether from the mouth or throat, whether by spitting, drooling or swabbing, and whether collected by the patient or by a clinician.

    Nevertheless, based on the modest amount of research done so far, saliva looks like a promising candidate for COVID-19 testing. More research is now needed, in larger groups of people, to learn more about how to COVID-19 Antibody Test for SARS-CoV-2 in the saliva of both symptomatic and non-symptomatic people.

Where are we at with developing a vaccine for coronavirus?

Posted by Care Ana, Thursday, 25th June 2020 @ 3:44pm

  • SARS-CoV-2, the virus that causes COVID-19, is changing how we live. With a rapid increase in cases, we are now isolating in our homes to “flatten the curve”.

    However, it will be nearly impossible to eradicate the virus simultaneously all around the world. And when we do emerge from isolation, the virus could potentially re-establish itself.

    Our best chance to keep it in check in the future will be to develop a vaccine.

    Australia’s CSIRO has just begun testing two new vaccine candidates. These are just two of many potential vaccines that scientists are working on around the world.

    Vaccine design basics

    All vaccines must contain two components:

    • the adjuvant, a molecule that acts as a “danger signal” to activate your immune system

    • the antigen, a unique molecule that acts as a “target” for the immune response to the virus.

    The adjuvant must be mixed with the antigen to activate an immune response. But you can’t induce any old immune response – you must trigger the right type of response for the infection you’re targeting.

    Researchers divide immune responses broadly into those that make:

    • antibodies, which bind to the surface of viruses to prevent infection of cells

    • T cells, which kill cells that have become infected with the virus.

    Adjuvants and antigens are selected to induce antibody and/or T cell responses to ensure we have the right kind of immune response against the right target.

    The ideal vaccine would be safe, easy to administer, simple and cheap to manufacture, and provide long-term protection against COVID-19. This protection would, hopefully, completely prevent infection with SARS-CoV-2.

    But, to begin with, we’d even be happy with a vaccine that could reduce the amount of virus generated during a typical infection. If an infected person is making less virus, they are less likely to infect others. Less virus could also reduce the amount of damage caused by an infection in the patient.

    Know your enemy

    To design an effective vaccine for SARS-CoV-2, we need to understand the virus.

    The genetic sequence of SARS-CoV-2 is very similar to two other coronaviruses – 79% identical to the original SARS (severe acute respiratory syndrome) from 2003, and around 50% identical to MERS (Middle East respiratory syndrome) from 2012.

    Researchers working on SARS and MERS vaccines are now providing critical basic information on vaccines that may work for SARS-CoV-2.

    Other researchers working on viral vaccines for dengue, Zika, hepatitis C, HIV and influenza are also pivoting to use their knowledge for SARS-CoV-2.

    The SARS-CoV-2 virus uses ribonucleic acid (RNA) as its genetic material. This is usually associated with high mutation rates, which can be a problem for vaccines, as viruses can mutate their antigens to evade the immune response. Fortunately, SARS-CoV-2 seems to have a moderate rate of mutation to date, meaning it should be susceptible to a vaccine.

    The SARS-CoV-2 viral particle is covered by “spike” proteins. This spike protein binds to a molecule on the surface of lung cells called the human angiotensin-converting enzyme 2 (ACE2).

    There’s a lot of spike protein on the outside of the virus, making it a prime target for our immune response. So most researchers have focused on the spike protein as an antigen for SARS-CoV-2.

    There’s a lot we still don’t know

    Importantly, for SARS-CoV-2 vaccines, we don’t yet know what type of immune response is needed.

    We know patients who recover from COVID-19 can produce antibodies, but we don’t know what kind of antibodies.

    We know COVID-19 patients who develop severe disease have low numbers of T cells, but we don’t have clear evidence of whether T cells can protect against COVID-19.

    We know some experimental vaccine designs for MERS and SARS can make disease symptoms worse in animals, but we don’t know whether this would happen with SARS-CoV-2.

    Since there are still a lot of unknowns, we have to cover all bases. Fortunately, dozens of vaccine designs are now advancing towards clinical testing.

    Vaccines in the pipeline

    Vaccine development during a pandemic happens at a global scale and is underway in several countries, including Australia.

    The first vaccine to make it into clinical trials in mid-March is a lipid-encapsulated mRNA vaccine. For this vaccine, a short piece of the genetic material from the virus (mRNA) is coated with an oily layer (lipid).

    The lipid helps the mRNA get inside a person’s muscle cells, and the mRNA provides a blueprint to make the spike protein the antigen (target). The mRNA itself acts as an adjuvant (danger signal).

    This vaccine is now being given to volunteers in a phase I clinical trial in Seattle.

    The main advantage of this vaccine is that it can be manufactured very quickly. The DNA sequence of SARS-CoV-2 used to design this vaccine was first published in January and the vaccine was ready for trials in mid-March, which is an incredibly tight turnaround for a vaccine.

    But this type of vaccine has not been widely used in humans and we don’t know if it will induce robust immune responses. While modest immunity would be better than no immunity, we may need additional, more potent vaccines in the longer term.

    Another type of vaccine researchers are exploring is called a subunit vaccine. In a subunit vaccine, the spike protein is used as the antigen (target), mixed with an adjuvant (danger signal) to activate the immune system. The shape of the spike protein must be highly consistent to generate a robust immune response.

    A team at the University of Queensland is using a “molecular clamp”, which is a short piece of protein that holds a larger protein in the correct shape. They are working together with CSIRO, which is now producing large quantities of this clamped antigen and is beginning testing of this and other vaccines.

    There are also newer approaches, such as “viral vector” vaccines. Scientists make a viral vector by taking genetic material from SARS-CoV-2 and inserting it into a harmless virus. When this is given to a person, the docile viral vector can’t cause any disease but it looks like a vicious virus to the immune system, and so it can generate robust immune responses.

    These vaccines were rolled out rapidly for the Ebola epidemic in West Africa in 2014 and in Congo in 2018/19 with promising results.

    They’re on their way for SARS-CoV-2, with CSIRO beginning to test a viral vector called ChAdOx1.
    Readmore: 
    COVID-19 Antibody Test


How do we detect if coronavirus is spreading in the community?

Posted by Care Ana, Thursday, 25th June 2020 @ 3:41pm

  • The daily number of new coronavirus (SARS-CoV-2) cases is now nine times higher outside China than in the country where the disease was first detected.


    In Australia, reports this week of local transmission of the coronavirus, which causes the disease now called COVID-19, are a turning point in our disease management.

    Our disease surveillance systems are well placed to keep abreast of COVID-19 and provide some reassurance that transmission is unlikely to go undetected in the community. But there’s still more we could do.

    Why is the coronavirus hard to detect?

    Detecting all people with COVID-19 is a global problem. There are too many existing respiratory infections, such as colds and flus, in any country to be able to test everyone with coronavirus symptoms.

    Each of us gets around two to three upper respiratory tract infections a year. Globally, that amounts to around around 18.75 billion infections a year.

    There are not enough testing kits readily available to test people at this scale.

    So who is tested?

    In Australia, people are currently tested for the coronavirus if they’ve travelled from or through a country considered to pose a risk of transmission in the 14 days before getting sick, or if they have a link to a known case.

    This testing criteria has changed as the outbreak progressed, and will continue to do so.

    Apart from directly COVID-19 Antibody Test people suspected of having COVID-19, Australia has a surveillance plan to detect coronavirus in people or populations who don’t know they’re infected.


    Australia’s emergency response plan for mitigating COVID-19 says we will use surveillance networks set up for the influenza pandemic emergency reponse plan and some of this is already occurring.

    The Australian Sentinel Practices Research Network (ASPREN) is a network of GPs who log the number of patients they see in total, compared to the number of patients they see with influenza-like illness. These GPs collect samples from a small subset of those patients to see if COVID-19 is circulating. Samples are then sent to SA Pathology for testing.

    Another surveillance network that may be activated is FluCAN. This reports on the number of hospitalisations due to a disease, usually influenza, as well as clinical data from the cases. The information helps public health experts get a better picture of how severe the disease is, and the symptoms.

    But while these systems can monitor disease levels in those sick enough to seek medical care, they don’t give us an indication of the amount of milder disease that might be circulating in our communities.

    This is where an online surveillance system called FluTracking can help. Anyone in the community can join and answer two simple questions each week about whether they have a fever and/or a cough.

    The system provides information on how much influenza-like illness is circulating in the community. If we’re seeing more than usual, it might signify a community outbreak.

    FluTracking was activated for COVID-19 surveillance last month.

    What else could we be doing?

    There are questions, however, about how early in an outbreak the surveillance systems will detect cases.

    Will they detect community transmission when an outbreak reaches ten cases? Or will it take hundreds or even thousands of cases to trigger a warning through the network?

    Innovations from other countries suggest there are additional measures Australia could adopt to improve our surveillance networks.

    Testing at home or on the road

    London adopted a system at the end of January to test mild cases of disease in the patients’ homes. This helps with self-isolation and reducing disease spread.

    Meanwhile, Edinburgh has opened a drive-through testing clinic to reduce the chances of viral spreading.

    Australia’s emergency response plans include provisions to mobilise flu clinics to help keep patients from overwhelming emergency services. Drive-through services could be an excellent addition to these existing plans.

    Rapid testing

    One of the biggest concerns with current testing is the time it takes to ship a sample to a laboratory for testing. This can result in a delay of one to two days before getting the results. During peak epidemic times, testing can’t cope with demand.

    Researchers in China, however, have reportedly developed a rapid coronavirus test that can detect the virus using a fingerprick of blood in 15 minutes. The test detects if the body has mounted an immune response (Ig M antibodies) to the virus.

    While the data is not yet published, the researchers reported success from the 600 samples they tested.

    Rapid diagnostic tests are typically cheap to manufacture, can be mass produced, and can be easily used by health workers outside a laboratory.

    Reporting on negative test results and surveillance systems

    Positive COVID-19 cases from all the surveillance sources are reported as they occur. But while influenza surveillance reports include the number of negative tests results, it’s unclear whether COVID-19 surveillance reports will do the same.

    Reporting on negative tests results could help ease community concern that coughs and sneezes people see on the train or in their office are unlikely to be due to the undetected spread of COVID-19.

Face Mask SafeMask Master Series ASTM Level 2 Azalea 50/Bx, 10 BX/CA

Posted by Care Ana, Wednesday, 24th June 2020 @ 11:46am

    • Face Mask SafeMask Master Series ASTM Level 2 Azalea 50/Bx, 10 BX/CA1293368 | Medicom - 2056 - Disposable mask


    • DESCRIPTION:

      SafeMask Master Series Face Mask Azalea Disposable Latex Free ASTM Level 2 50/Box, 10 BX/CA
      Face Mask SafeMask Master Series ASTM Level 2 Azalea 50/Bx, 10 BX/CA

      See item 1126761 as a suggested substitute. PLEASE NOTE: 1126761 is not an exact match as it is a Level 1 mask.

      This item has limited stock and is subject to quantity restrictions due to the impact of the Coronavirus on the supply chain. In some cases, backorders will not be accepted on items with depleted stock and item quantity restriction information may change daily. Orders with these items may pend for inventory validation and the items may be cancelled without notice. 

      This item has limited stock and is subject to quantity restrictions due to the impact of the Coronavirus on the supply chain. In some cases, backorders will not be accepted on items with depleted stock and item quantity restriction information may change daily. Orders with these items may pend for inventory validation and the items may be cancelled without notice.

Insta-Gard Earloop Face Mask ASTM Level 1 Blue 25/Bx, 4 BX/CA

Posted by Care Ana, Wednesday, 24th June 2020 @ 11:44am

    • Insta-Gard Earloop Face Mask ASTM Level 1 Blue 25/Bx, 4 BX/CA9880097 | Cardinal Health - AT7511-WE - Disposable mask


    • DESCRIPTION:

      Insta-Gard Earloop Face Mask Blue Disposable Latex Free ASTM Level 1 25/Box, 4 BX/CA

      • COLOR:

        Blue

        This item has limited stock and is subject to quantity restrictions due to the impact of the Coronavirus on the supply chain. In some cases, backorders will not be accepted on items with depleted stock and item quantity restriction information may change daily. Orders with these items may pend for inventory validation and the items may be cancelled without notice.
        Insta-Gard Earloop Face Mask ASTM Level 1 Blue 25/Bx, 4 BX/CA

        • BRAND

          Insta-Gard

        • COLOR

          Blue

        • COMPOSITION/INGREDIENTS

          Polypropylene Outer Facing / Polypropylene Inner Facing

        • DISPOSABLE

          Disposable

        • FILTER

          Submicron Filtration

        • FLUID RESISTANT

          ASTM Level 1

        • FOR

          Procedure

        • ITEM

          Face Mask

        • ITEM TYPE

          Earloop

        • LATEX/LATEX-FREE

          Latex Free

        • QUANTITY

          25/Box

        • WITH

          Eye Shield

Purchase Medical Face Masks and Surgical Face Masks

Posted by Care Ana, Wednesday, 24th June 2020 @ 11:42am

  • Licensed Medical Professionals turn to Henry Schein as their source for medical face masks and surgical face masks - Disposable mask

    Henry Schein Medical is a leading distributor to health care providers, and does not sell or distribute product to non-medical professionals or the general public.

    Explore the various face masks we carry below:

    Henry Schein Ear Loop Face Masks

    Ear Loop Face Masks

    Henry Schein Molded Face Masks

    Molded Face Masks

    Henry Schein Surgical Face Masks

    Surgical Face Masks

    3M Respirator Face Masks

    Respirator Face Masks

    Crosstex International Face Shield Masks

    Face Shield Masks

    N95 Face Masks

    N95 Face Masks

    Henry Schein Medical Face Masks

    Henry Schein is your number one source for medical face masks and surgical face masks. It is our goal to provide you and your staff with the highest quality of personal protection products and service solutions. Our infection prevention and solutions page is a great resource center to learn more about the safety and health precautions your practice should be taking.

    We carry a large variety of face mask products. These should be worn both by healthcare workers and patients when necessary. When wearing our products properly, they will guard against large splashes, droplets or sprays from entering the nasal and oral regions.

    Face Mask Levels

    Our inventory of products are rated on the American Society for Testing and Materials (ASTM). The three levels consist of:

    ASTM Level 1 – Low fluid resistance
    ASTM Level 2 – Moderate fluid resistance
    ASTM Level 3 – High fluid resistance

    When choosing your specific face mask, make sure you choose the appropriate level in which procedures you will be preforming. Our masks include ear loop masks, procedure masks, respirators, surgical masks and face shield masks. Click here for a helpful reference to face masks or for guidelines and recommendations in selecting personal protective equipment.

    Purchase Face Masks

    For any questions regarding face masks or personal protective equipment products on the Henry Schein Medical website, fill out our request for info page and someone will be in touch with you shortly.

Face coverings

Posted by Care Ana, Wednesday, 24th June 2020 @ 11:39am

  • In England, Scotland, Wales and Northern Ireland, members of the public are currently being advised to wear face coverings (which can include face masks or reusable face coverings) in enclosed spaces where social distancing is not always possible. This includes places where you may come into contact with others who you do not normally meet.

    It is now compulsory for members of the public to wear face coverings on public transport in England. It’s also important to note that while wearing a face mask can help reduce the risk of transmission, it should not be used as a replacement for social distancing or self-isolation. 

    We stock a range of face coverings online so whether you're looking for a fashion forward set for the style-conscious or a pack of handy disposable masks for when you're out and about, we've got you covered. 

    Shop all face coverings or read on for more information.
    50PCS Medical Disposable Masks With CE FDA Certified 

    Disposable masks

    We currently stock three types of disposable face masks online. Our priority is always to ensure that those who need them have enough supply. We have worked with the Government and Public Health England, as well as our partners in the Care Homes sector to give them access to stock, before we make them available to customers.

    Boots Soft Loop 3PLY Face Mask - Offers proven filtration & can help reduce the spread of viruses. This is a non-fluid resistant mask, meaning it does not provide barrier protection against respiratory droplets/splashes. It does not provide protection from aerosols (airborne viral particles). It offers 98% bacterial filtration efficiency.

    Elasticated 3PLY Face Mask - Non-fluid resistant mask, meaning it does not provide barrier protection against respiratory droplets/splashes. It does not provide protection from aerosols (airborne viral particles). It offers 95% bacterial filtration efficiency.

    Soft Loop 3PLY Face Mask - Fluid resistant which provides barrier protection against respiratory droplets/splashes but not from aerosols (airborne viral particles). It offers 98% bacterial filtration efficiency.

    Readmore: We Asked Sleep Consultants How to Survive the Newborn Days


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