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Scientists can’t tell yet how deadly the new virus that’s spreading around the globe really is — and deepening the mystery, the fatality rate differs even within China. As infections of the virus that causes COVID-19 surge in other countries, even a low fatality rate can add up to lots of victims, and understanding why one place fares better than another becomes critical to unravel. “You could have bad outcomes with this initially until you really get the hang of how to manage" it, Dr. Bruce Aylward, the World Health Organization envoy who led a team of scientists just back from China, warned Tuesday. (Neergaard, 2/26)

One of the hopes of people watching China’s coronavirus outbreak was that the alarming picture of its lethality is probably exaggerated because a lot of mild cases are likely being missed. But on Tuesday, a World Health Organization expert suggested that does not appear to be the case. (Branswell, 2/25)

Problems with a government-created coronavirus test have limited the United States’ capacity to rapidly increase testing, just as the outbreak has entered a worrisome new phase in countries worldwide. Experts are increasingly concerned that the small number of U.S. cases may be a reflection of limited testing, not of the virus’s spread. While South Korea has run more than 35,000 coronavirus tests, the United States has tested only 426 people, not including people who returned on evacuation flights. Only about a dozen state and local laboratories can now run tests outside of the Centers for Disease Control and Prevention in Atlanta because the CDC kits sent out nationwide earlier this month included a faulty component. (Johnson, McGinley and Sun, 2/25)

The first clinical trial in the U.S. of a possible coronavirus treatment is underway in Nebraska and is eventually expected to include 400 patients at 50 locations around the world, officials said Tuesday. Half of the patients in the international study will receive the antiviral medicine remdesivir while the other half will receive a placebo. Several other studies, including one looking at the same drug, are already underway internationally. (Funk, 2/25)

The NIH-sponsored study is part of public health officials’ race to determine quickly whether the Gilead drug, called remdesivir, is effective in treating Covid-19, the illness caused by the new coronavirus. The study is designed to enroll up to nearly 400 patients globally, who will be randomly selected to receive remdesivir or a placebo. While the illness has led to thousands of fatalities world-wide, most people who become infected experience flu-like symptoms such as fever and cough before recovering on their own, health officials have said. (Walker, 2/25)

Participants in the US treatment group will receive 200 milligrams of remdesivir intravenously when they're enrolled in the study. They will receive another 100 milligrams while they are hospitalized for up to 10 days total. A placebo group will receive a solution that resembles remdesivir but contains only inactive ingredients, the NIH said.(Holcombe, McLaughlin and Almasy, 2/26)

In new research developments, a team from Wuhan, China, reports that even asymptomatic patients with COVID-19 pneumonia have abnormal lung findings on computed tomography (CT), and a group from Beijing noted that viral loads from infected patients appear to peak 5 to 6 days after symptom onset. (Beusekom, 2/25)

And in other news —

Kaiser Health News: As The Coronavirus Spreads, Americans Lose Ground Against Other Health Threats
For much of the 20th century, medical progress seemed limitless. Antibiotics revolutionized the care of infections. Vaccines turned deadly childhood diseases into distant memories. Americans lived longer, healthier lives than their parents. Yet today, some of the greatest success stories in public health are unraveling. (Szabo, 2/26)

Many researchers currently think that bats were the source of the coronavirus (now officially called COVID-19), and that it may have moved through pangolins — the world's most highly trafficked animal — as an intermediate host before moving into humans through the wildlife trade. There are three key ways new diseases find their way into human populations, De Leo says. (Venton, 2/24)