Gilead Sciences, the company that makes the COVID-19 drug, announced in an open letter on Monday morning that it has decided to set a price of $390 per vial for the U.S. government, which would include Veterans Affairs and Department of Defense hospitals, and other governments of developed countries. But the discounted price will not include Medicare or Medicaid.

A typical five-day treatment course would include six vials, which would equate to $2,340 per patient, Daniel O'Day, Gilead Sciences chairman and CEO, said in the letter.

The U.S. government will continue to manage U.S. allocations of remdesivir to hospitals through September, the company said.

The letter added that the price for U.S. private insurance companies will be $520 per vial, which would total $3,120 per patient for a five-day treatment course of six vials.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world since the first cases of coronavirus disease 2019 (COVID-19) were observed in December 2019 in Wuhan, China. It has been suspected that infected persons who remain asymptomatic play a significant role in the ongoing pandemic, but their relative number and effect have been uncertain. The authors sought to review and synthesize the available evidence on asymptomatic SARS-CoV-2 infection. Asymptomatic persons seem to account for approximately 40% to 45% of SARS-CoV-2 infections, and they can transmit the virus to others for an extended period, perhaps longer than 14 days. Asymptomatic infection may be associated with subclinical lung abnormalities, as detected by computed tomography. Because of the high risk for silent spread by asymptomatic persons, it is imperative that testing programs include those without symptoms. To supplement conventional diagnostic testing, which is constrained by capacity, cost, and its one-off nature, innovative tactics for public health surveillance, such as crowdsourcing digital wearable data and monitoring sewage sludge, might be helpful.

Key Summary Points
The likelihood that approximately 40% to 45% of those infected with SARS-CoV-2 will remain asymptomatic suggests that the virus might have greater potential than previously estimated to spread silently and deeply through human populations.

Asymptomatic persons can transmit SARS-CoV-2 to others for an extended period, perhaps longer than 14 days.

The absence of COVID-19 symptoms in persons infected with SARS-CoV-2 might not necessarily imply an absence of harm. More research is needed to determine the significance of subclinical lung changes visible on computed tomography scans.

My youngest daughter with her horse’s first horse show. Third trip was perfect! So proud of them both!

J. David McSwane @davidmcswane

1/ A TaskRabbit contractor in San Antonio told me he stumbled onto a warehouse where people were repackaging non-medical Chinese masks so they could pass for medical use and be sold to Texas.

So began my latest journey into the world of COVID profiteers ..

1/ A TaskRabbit contractor in San Antonio told me he stumbled onto a warehouse where people were repackaging non-medical Chinese masks so they could pass for medical use and be sold to Texas.

So began my latest journey into the world of COVID profiteers ..


2/ His name was Lucas Rensko and he showed up in a warehouse where there were other “Taskers” earning about $20/hr ripping Chinese masks out of plastic bags and stuffing them into new ones that were identical but for one potentially deadly difference …

3/ The old packages were labeled in all caps “MEDICAL USE PROHIBITED.” The new bags didn’t have that warning.

BeforeAfter

4/ Medical workers’ best defense against a virus that ravages the body with horrifying complexity is a simple, but trustworthy, mask. But many thousands of these repackaged ones were potentially making their way into the Texas supply. Here's the warehouse:

5/ Before flying down to Texas to look into it, I did a little research from my DC apartment. Jaime Rivera, who hired the TaskRabbits, had posted some intriguing photos on Facebook of boxes of masks bursting at the seams and stacked high in his garage.



6/ These are labeled AYM-KN95. Early on the FDA approved these for use in healthcare settings. But they were taken off the list in May. They’re nowhere near the 95% effective required - tested as low as 39% in CDC tests …

7/ More curious was a screenshot Rivera posted of a $2k payment from “BM.” One of his Facebook friends noted “looks like code for a drug deal.”

8/ So I pulled out my phone and looked for him on Venmo and was delighted to see all his transactions were public.

Someone named Brennan Mulligan was paying him and others on Venmo to repackage masks. Check it out …


9/ Turns out Mulligan is a successful San Francisco tech/apparel businessman. He runs SKYOU, whose 3D design software lets people customize apparel that ships directly from China …

10/ Makes sense, I thought. As I found in this story, a lot of apparel and textile businesses used China connections to make their way into the mask market.
The Secret, Absurd World of Coronavirus Mask Traders and Middlemen Trying To Get Rich Off Government Money
The federal government and states have fueled an unregulated, chaotic market for masks ruled by oddballs, ganjapreneurs and a shadowy network of investors.
https://www.propublica.org/article/the-secret-absurd-world-of-coronavirus-mask-traders-and-middlemen-trying-to-get-rich-off-government-money


11/ That “131 boxes to TDEM” is delivery of KN95s to the Texas Division of Emergency Management, Texas’ FEMA, which supplies to hospitals inundated with patients. As you can see … Texas is in trouble.

12/ Rivera and I talked on the phone at length. He agreed to meet in person but then cut off contact as my questions became more uncomfortable. Here’s some of what he told me …

13/ Mulligan had hired him through TaskRabitt to pick up masks arriving in Texas airports via Southwest Cargo jet. Some he delivered to TDEM, others needed to be repackaged.

14/ Rivera spoke as if it was just common sense. They needed to take MEDICAL USE PROHIBITED off the package so Texas could accept the masks. It’s not a big deal, he said, because Texas will inspect the masks. He said it was just red tape.

15/ As our conversations progressed, Rivera started to worry that maybe this wasn’t such a good idea. He was desperate, he said. His main income - doing jobs via TaskRabbit - had dried up because of the pandemic.

16/ That’s when Rivera mentioned he and Mulligan had been contacted by the U.S. Department of Homeland Security.

“His analogy was you’re telling somebody you have a Ferrari but you’re selling a Honda,” Rivera said.

17/ “Are you worried you were complicit in a crime?” I asked

“The more we talk about it, yes,” he said.

Before he hung up and cut off communication, he added: “I’m not the brains of the operation, and I’m definitely not the wallet for it.”

18/ The wallet was Mulligan, who didn’t respond to my calls but sent some brief emails. He blamed the FDA’s flip-flopping on chinese masks and onerous Chinese customs regulations.

19/ He couldn’t get the masks out of China without the non-medical disclaimer, he explained. And the Texas emergency agency would reject anything that had the disclaimer.

20/ He and other mask brokers told me they shipped all these masks in after the FDA cleared a bunch of KN95s, but before they could sell them the FDA kicked a bunch of manufacturers off the list.

21/ So “the only solution,” he said, was to repackage masks. But problem was - the masks he was repackaging weren’t on the FDA’s list of masks OK’d for emergency use. Mulligan says he broke no U.S. laws.

22/ I told TDEM what I had learned and they confirmed Mulligan and Rivera had tried to sell the poor quality masks and Texas rejected them. TDEM’s vetting is really good, a spokesperson said.

23/ Mulligan tried to sell them to another guy, who was trying to sell masks to hospitals in Illinois, but the buyer told me he walked away when he learned they’d been repackaged.

24/ So Mulligan is stuck where a lot of opportunistic mask brokers are - with tons of sub-par masks that governments can’t and shouldn’t buy.

25/ Oh, yeah, and that Homeland Security investigation? The agency said it’s real, but the statement also reads like the law enforcement equivalent of ¯_(ツ _/¯.

26/ There’s a lot more detail in the story, some funny anecdotes and whatnot. I hope you’ll read it.
He Removed Labels That Said “Medical Use Prohibited,” Then Tried to Sell Thousands of Masks to Officials Who Distribute to Hospitals
Using TaskRabbit and Venmo, a Silicon Valley investor and his business partner had workers repackage non-medical KN95 masks so he could sell them to Texas emergency workers.
https://www.propublica.org/article/he-removed-labels-that-said-medical-use-prohibited-then-tried-to-sell-thousands-of-masks-to-officials-who-distribute-to-hospitals

27/ If you know more about PPE brokers and investors, shoot me a note: david.mcswane@propublica.org
28/ and if you want to get our next big stories, sign up for propublica’s Big Story newsletter:
Sign Up For the Big Story Newsletter — ProPublica
http://go.propublica.org/bigstory-social
PS - it remains a mess out here in the Wild West of PPE trading - companies pooping up overnight, untested, some whose owners have questionable backgrounds. Federal agencies say they’re vetting these companies but we’ve found a ton of problems

1436. Several wrestlers expressed their anger about being watched in the shower by these men.
Coach Hellickson and Assistant Coach Jordan told the wrestlers that if they did anything to act out that they would find themselves in trouble with the school.