MONDAY, Sept. 21, 2020 (Healthday News) — As the U.S. coronavirus case count neared 200,000 on Monday, public health experts debated whether the spread of the virus will continue to slow or a new surge will come, as cold weather returns to much of the country.

“What will happen, nobody knows,” Catherine Troisi, an infectious disease epidemiologist at The University of Texas Health Science Center at Houston, told The New York Times. “This virus has surprised us on many fronts, and we may be surprised again.”

In the United States, fewer new coronavirus cases have been detected week by week since late July, but the nation’s daily count of new cases has started to climb again in recent days, the Times reported. Meanwhile, at least 73 other countries are seeing second surges in new cases.

Dr. Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health in Baltimore, told the Times it was conceivable that the death toll in the United States could reach 300,000 if Americans start to relax social distancing measures.

As case counts started trending upward again, 1,400 public schools in New York City reopened Monday for nearly 90,000 pre-K students and children with advanced disabilities. The remaining 1 million students will start their school year online, with the option of returning to classrooms in the next few weeks, the Times reported.

The reopening is not as ambitious as New York Mayor Bill de Blasio first promised all students having the option to return to classrooms. Still, New York is one of the few cities in the country where some children are back in classrooms, the Times reported

School officials told the newspaper they can’t wait to see their youngest students, but pre-K classes will not be the same this year.

“We’re all about the hugs, the sitting together, rolling around on the floor together,” said Julie Zuckerman, the principal of Public School 513 in Washington Heights, which has offers pre-K. “That can’t happen now.”

Coronavirus distribution plan unveiled

Meanwhile, the details of a plan to rapidly deliver a future coronavirus vaccine to Americans were unveiled by federal officials last week.

Two of the key parts of the plan are to begin distributing a vaccine with 24 hours of any approval or emergency authorization and offering the vaccine for free, the Times reported.

Officials from Operation Warp Speed — the multiagency effort created to quickly vaccinate Americans against coronavirus — also said the timing of a vaccine was still unclear, the Times reported. That is despite repeated statements from President Donald Trump that a shot could be ready before the election on Nov. 3.

“We’re dealing in a world of great uncertainty. We don’t know the timing of when we’ll have a vaccine, we don’t know the quantities, we don’t know the efficacy of those vaccines,” Paul Mango, the deputy chief of staff for policy at the U.S. Department of Health and Human Services, told the Times. “This is a really quite extraordinary, logistically complex undertaking, and a lot of uncertainties right now.”

Who will get the vaccine first? Initial distribution of a vaccine, possibly on an emergency basis, would to a limited group of high-priority people, such as health care workers, in the final three months of this year and into next year, the Times reported. The Department of Defense is providing logistical support for shipping and storing the vaccine, and for keeping track of who has gotten a vaccine and whether they got the full two doses, the newspaper said.

To achieve this, existing databases would be linked up so that, for example, a patient who received a vaccine at a public health center in January could go to a CVS pharmacy 28 days later in another state and be assured of getting the second dose of the right vaccine, the Times reported.

Right now, three drug makers are testing vaccine candidates in late-stage trials in the United States. One of those companies, Pfizer, has said that it could apply for emergency authorization as early as October, while the other two, Moderna and AstraZeneca, have said they hope to have something before the end of the year.

In a sign that the Pfizer vaccine trials are moving along smoothly, German pharmaceutical company BioNTech, which is developing a coronavirus vaccine with Pfizer, announced recently it was buying a new production plant so it can ramp up production of a COVID-19 vaccine when needed, CNN reported.

New Drug May Help Prevent Severe COVID

A single infusion of an experimental drug dramatically lowers levels of coronavirus in the bodies of newly infected patients and cuts their chances of hospitalization, the drug’s maker has reported.

Eli Lilly’s announcement did not include detailed data and hasn’t been peer-reviewed or published yet, the Times reported.

The news comes from interim results of a trial sponsored by Eli Lilly and the U.S. National Institutes of Health. NIH officials would not comment on the announcement until they have seen more detailed data from the trial, the Times reported.

How does the drug work its magic? It is a monoclonal antibody, a manmade copy of an antibody produced by a patient who recovered from COVID-19, the Times reported. Scientists around the world have high hopes that that monoclonal antibodies will prove to be powerful coronavirus treatments, but they come with a caveat: They are difficult to manufacture, and would take time to produce, the Times reported.

In the trial, 452 newly diagnosed COVID patients received the monoclonal antibody or a placebo infusion. Some 1.7 percent of those who got the drug were hospitalized, compared with 6 percent of those who received a placebo — a 72 percent reduction in risk, Eli Lilly said.

At the same time, blood levels of the coronavirus plummeted among those who received the drug, and their symptoms were fewer and milder, the Times reported.

This is the first treatment aimed at patients who are not already seriously ill and hospitalized, the newspaper added.

Dr. Myron Cohen, director of the Institute for Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill, told the Times he was impressed by the findings.

“It’s exciting,” said Cohen, who was not involved in the study. The trial appears to be rigorous, and the results are “really compelling,” he added. Other monoclonal antibody drugs to combat the coronavirus are in development, he noted.

Cases keep mounting

By Monday, the U.S. coronavirus case count passed 6.8 million as the death toll passed 199,000, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Monday were: California with over 788,000; Texas with more than 722,000; Florida with over 683,700; New York with nearly 454,000; and Georgia with over 289,000.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

By Monday, India’s coronavirus case count had passed 5.4 million, just over one month after hitting the 3 million mark, the Times reported.

Nearly 88,000 coronavirus patients have died in India, but when measured as a proportion of the population, the country has had far fewer deaths than many others. Doctors say this reflects India’s younger and leaner population.

Still, the country’s public health system is severely strained, and some sick patients cannot find hospital beds, the newspaper said. Only the United States has more coronavirus cases.

Meanwhile, Brazil posted over 4.5 million cases and nearly 137,000 deaths as of Monday, the Times tally showed.

Cases are also spiking in Russia: The country’s coronavirus case count has passed 1.1 million, the Times reported. As of Monday, the death toll in Russia was over 19,400.

Worldwide, the number of reported infections passed 31 million on Monday, with over 961,000 deaths, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.