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We Are in the Midst of This Coronavirus Outbreak—Now What?

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Last Friday, more than 720 readers of WIRED’s coronavirus newsletter tuned in to a livestream with editor in chief Nicholas Thompson and senior correspondent Adam Rogers. Over the course of an hour, Thompson and Rogers answered questions from readers about the current state of the Covid-19 pandemic, covering everything from testing to virology to the scientific rationale behind wearing a mask. The conversation has been edited and condensed.

Nicholas Thompson: There are now more than a million coronavirus cases worldwide, which means there are actually many more than that. More than 50,000 deaths. In my home city of New York, people are dying every two minutes. We’re in the midst of a worldwide tragedy.

This is a story that WIRED has been covering since the beginning. Our science desk started writing about what was happening in China in early January. We started raising major alarms in February. We devoted pretty much our entire editorial resources to it in the beginning of March. And one of the people who has been doing the most intense, thorough, fantastic work is my colleague Adam Rogers, who’s here with me today. He’s broken all kinds of stories. He’s written incredibly informative guides. He’s been deep in many of the questions and he was incredibly early at making everybody at WIRED and everybody reading his work aware of what was going to happen and what we needed to do to both mitigate the risks for ourselves and to help civic understanding of what was happening.

Adam, I want you to lay out where we are on three different questions: where we are on testing, where we are on treatments, where we are on vaccines.

Adam Rogers: Dealing with a pandemic has phases that are pretty well understood, whether they get executed the way people would hope or not. There’s a containment phase, then a mitigation phase, and then a management phase.

One of the hallmarks of a containment phase is testing and trying to figure out who’s infected and whether they have symptoms or not. Who actually has the virus? In the early phases of the pandemic when it was starting in China and in Asian countries, they were doing really well at testing. There were stories about how South Korea was testing hundreds of thousands of people, more than 10,000 a day in some cases. Whereas in the United States we really failed at that abjectly at the beginning for a lot of bureaucratic reasons and perhaps some other ones. And those are things that pretty much every media organization, including ours, has dedicated a lot of person hours to trying to untangle.

In recent days, the United States kind of plateaued at about 100,000 tests per person. The way those tests work right now is what’s called RT-PCR. They’re molecular tests. They look for the genetic material of the actual virus in spit or snot in the back of the throat or way back inside your nose—nasal pharyngeal tests. Initially, apparently some inaccuracies delayed those tests. Then there were problems with the supply chain for the parts for them. There are a lot of companies making them.

One of the issues here is that the data on those tests is not very good. The federal government has not been really forthcoming with them so what anybody can really know about how many tests are being done and where is patchy.

Got a coronavirus-related news tip? Send it to us at covidtips@wired.com.

Because it’s a new virus, initially there were no therapeutics at all. For a while people were talking about chloroquine and hydroxychloroquine, these old malaria drugs also used for immune disorders, because they seem to have some efficacy against the virus in vitro, in Petri dishes in a lab. People got very excited about that, including in Silicon Valley, on social media, and one researcher in France has been pretty active in trying to promulgate the idea. Real randomized control trials of those drugs have just begun, even though doctors on the front lines were using them as compassionate use drugs very early. As they started to see the first patients, for example, at Montefiore in New York, they were using hydroxychloroquine. There are also ongoing tests for a drug called remdesivir that was developed actually to use against Ebola. So there’s a trial going about that drug now.

Physicians on the front lines are able to use something called compassionate use: If somebody is in grave condition you can use a drug that’s approved for something else, but not necessarily for this. So physicians are using antivirals, antiretroviral therapies like those used on HIV. Nobody knows what works. Those tests are still happening. The idea is that somebody is in such grave condition that they might well die. The potential side effects or inefficacy of the drug are immaterial compared to that outcome.

And then in terms of the vaccine, people have bandied around numbers like a year to 18 months away. That’s a guess. What you have to do to get a vaccine is understand the immunology of the virus. It’s a new virus, so people are still trying to figure that out. Then figure out what the pieces of virus that hang on the outside of the virus are that the immune system in a human responds to. Then synthesize that, turn it into something that works as a drug, then start giving it to people.

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