Drugs Targeting Cytokines Tried Against Covid-19

(p. A9) Doctors have used the term “cytokine storm” to describe an overactive immune response triggered by external pathogens such as bacterial and viral infections.

Proteins called cytokines are part of the immune system’s arsenal for fighting disease. When too many are released into the bloodstream too quickly, however, it can have disastrous results, including organ failure and death.

As with other diseases, it is a mystery why cytokine storms are experienced by some but not all Covid-19 patients, doctors say. Genetics may be a factor.

. . .

Drugs called corticosteroids can be used to treat patients with cytokine storms, but studies are mixed on their effectiveness, with some studies indicating that Covid-19 patients may be at a higher risk of death when treated with steroids. Some doctors are reluctant to use steroids because they broadly dampen the immune response, which is risky in patients fighting infections.

Drugs targeting specific cytokines rather than the entire immune system may be more effective, doctors say.

Among the most promising targeted treatments, doctors say, is Roche’s rheumatoid-arthritis drug tocilizumab, which is marketed under the brand name Actemra. The drug was approved in 2017 to treat cytokine storms caused by cancer treatments known as CAR-T cell therapies.

For the full story, see:

Jared S. Hopkins, Joseph Walker. “Haywire Immune Reaction Linked to Most Severe Cases.” The Wall Street Journal (Friday, April 10, 2020): A1 & A9.

(Note: ellipsis added.)

(Note: the online version of the story has the date April 9, 2020, and has the title “Haywire Immune Response Eyed in Coronavirus Deaths, Treatment.”)

“The Spontaneous, Uncoordinated Effort of Businesses, Entrepreneurs and Innovators”

(p. A1) True Value Co. heard from its more than 4,500 affiliated hardware stores last month that hand sanitizer was flying off the shelves, leaving store staff with none for themselves.

At the company’s factory in Cary, Ill., which makes cleaning products and paint, John Vanderpool, the company’s divisional vice president of paint, recalled asking, “What can we do to help here?” After a tip from his wife, a pharmacist, he consulted with the Food and Drug Administration, then huddled with his maintenance team and engineers over two weekends to retool two paint-filling lines to produce jugs of FDA-approved hand sanitizer.

Starting this week they are being shipped free to stores for their own use. The product will go on sale to the public eventually.

The changeover at True Value’s factory from paint to hand sanitizer is one of countless private-sector initiatives that represent an underappreciated asset in Americans’ fight against the coronavirus. It is a 21st-century version of the “Arsenal of Democracy,” the mobilization of industrial might that helped win World War II, only this time to make personal protective equipment, ventilators, tests and vaccines instead of uniforms, ammunition, tanks and bombers.

And where that arsenal was orchestrated by the federal government, this one has been largely the spontaneous, uncoordinated effort of businesses, entrepreneurs and innovators driven as much by the urge to contribute as by future profit.

. . .

(p. A9) Joel Mokyr, an economic historian at Northwestern University, said national crises such as wars and pandemics historically generate a hive of entrepreneurial innovation, from the late 18th-century search in England for a treatment for smallpox to a German drive in the run-up to World War I to use atmospheric nitrogen for explosives.

“We have this huge reservoir of creative energy spread around the economy. When you have an event like this all of a sudden, everyone says, ‘Oh wow let’s look at this problem—let’s see what I can do to solve it.’ ”

This time, innovators are exploiting tools and methods that didn’t exist in previous crises. In mid-March, Lennon Rodgers, director of the Grainger Engineering Design Innovation Lab at the University of Wisconsin in Madison, fielded a plea from the university’s hospital to make 1,000 face shields.

He often gets requests from around the campus to manufacture random items and “initially, I didn’t take it too seriously,” he recalled. But after his wife, an anesthesiologist, told him the shields were indispensable for dealing with highly infectious patients, he scoured hardware and craft stores for parts.

He teamed up with Delve, a local design firm, and Midwest Prototyping, a contract manufacturer, to design their own “Badger Shield,” named after the University of Wisconsin mascot. They expected to use 3-D printers, then concluded that wouldn’t achieve the necessary scale. They uploaded the design to their website along with the necessary parts for anyone to download. A few days later Ford Motor Co. did, and, with tweaks of its own, began turning out face shields for Detroit-area hospitals.

For the full story, see:

Greg Ip. “Health Crisis Awakens Spirit Of Private-Sector Innovation.” The Wall Street Journal (Friday, April 17, 2020): A1 & A9.

(Note: ellipsis added.)

(Note: the online version of the story was updated April 16, 2020, and has the title “Shoes to Masks: Corporate Innovation Flourishes in Coronavirus Fight.”)

Engineering the Bar Code “Was Fun!”

(p. A13) If he had followed instructions from his boss, George Laurer might never have succeeded in designing the Universal Product Code.

In 1971, a supervisor at International Business Machines Corp. told the electrical engineer to devise a bar code based on previous models involving circular symbols resembling dart boards. While the boss was on vacation, Mr. Laurer concluded that little circles wouldn’t do, partly because smears of ink left by printing presses could scramble the code. Instead, he and others came up with a row of stripes, whose varying width and spacing conveyed a reliable code.

. . .

. . . , as he noted in the title of his memoir, “Engineering Was Fun!”

For the full obituary, see:

James R. Hagerty. “Bar Code Designer Defied Instructions.” The Wall Street Journal (Saturday, December 14, 2019): A13.

(Note: ellipses added.)

(Note: the online version of the obituary has the date Dec. 12, 2019 and has the title “George Laurer, Defying Instructions, Created Universal Bar Code.”)

Laurer’s memoir, mentioned above, is:

Laurer, George J. Engineering Was Fun! 3rd ed. Morrisville, NC: Lulu.com, 2012.

Firm Founders “Learned to Cope With a Lot of Adversity and Have a Lot of Resilience”

(p. B6) I’m a sucker for good stories about the founding of companies.

Yvon Chouinard started apparel maker Patagonia in a chicken coop; James Dyson went through 5,000 prototypes on his way to inventing a bagless vacuum cleaner; Steve Ellis opened Chipotle burrito shops simply to earn enough money to start a gourmet restaurant (he never got that far).

Airbnb Inc.’s story takes the cake. In 2008, a couple entrepreneurial types living on Ramen noodles in San Francisco cooked up an online home-sharing scheme. They recruited a computer scientist, funded their idea in the early days by maxing out credit cards and selling politically-themed cereal boxes, and held on until their company shook up the entire lodging industry.

. . .

“There’s this crazy idealism that founders have,” Brian Chesky, one of those Airbnb founders and the company’s chief executive, told me this week in a video chat. “They’ve learned to cope with a lot of adversity and have a lot of resilience.”

For the full commentary, see:

John D. Stoll. “ON BUSINESS; Airbnb Defied the Startup Odds. Will It Survive a Pandemic?” The Wall Street Journal (Saturday, April 18, 2020): B6.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date April 17, 2020, and has the title “ON BUSINESS; Airbnb Defied the Odds of Startup Success. How Will It Survive a Pandemic?”)

Small Is Not Always Beautiful

(p. A16) Zaid Kurdieh has so many fava beans growing at his farm in upstate New York that he could send 4,000 pounds a week to the best chefs in New York City. In Kentucky, Robert Eversole and Thomas Sargent planted enough winter greens to fill the all the salad bars at the University of Kentucky and still have enough left over to feed fans at the state’s two major spring horse races.

But the coronavirus pandemic has postponed the Kentucky Derby and shut the university. And in New York, chefs who would normally be shelling Mr. Kurdieh’s fava beans for their spring menus have closed their restaurants.

So these small farmers, like many others across the country who spent decades building a local, sustainable agricultural system, are staring at their fields and wondering what to do now that the table has been kicked out from under the modern farm-to-table movement.

. . .

Farm-to-table — the term has become a fixture in the culinary lexicon — started in the 1970s, when Chez Panisse and a handful of other restaurants hatched what then seemed like a radical notion: Build menus from food grown by nearby farmers who are thoughtful about everything from the seeds they select and the soil they grow them in to the communities they feed.

That idea grew into a pipeline connecting farmers, ranchers and chefs that in 2019 had generated $12 billion in income for small-scale producers including cheesemakers and vintners. Governments, hospitals and schools have come to see the value in buying locally grown food. No Silicon Valley tech company worth its stock price would dare to design a cafeteria without local food.

Since the pandemic hit, that conduit has shut down. The loss in sales could run as high as $689 million, with much higher costs in jobs and other businesses that make up the farm-to-table economic ecosystem, according to a report compiled in March by the National Sustainable Agriculture Coalition.

For the full story, see:

Kim Severson. “Farm-to-Table Falters, and Growers Are in Limbo.” The New York Times (Friday, April 10, 2020): A16.

(Note: ellipsis added.)

(Note: the online version of the story has the date April 9, 2020, and has the title “The Farm-to-Table Connection Comes Undone.”)

Low Quality Parts from Corrupt Contractors Endanger Russian Sailors in Deep-Diving Subs

(p. A22) OFF THE COAST OF NORWAY — There could hardly have been a more terrifying place to fight a fire than in the belly of the Losharik, a mysterious deep-diving Russian submarine.

. . .

A fire on any submarine may be a mariner’s worst nightmare, but a fire on the Losharik was a threat of another order altogether. The vessel is able to dive far deeper than almost any other sub, but the feats of engineering that allow it do so may have helped seal the fate of the 14 sailors killed in the disaster.

. . .

(p. A23) As for the accident itself, few expressed surprise that a jewel of the Russian submarine fleet might catch fire not very far from its home base — probably in water no more than 1,000 feet deep — leaving most of its crew dead. The Russians, some experts said, seem to have a greater tolerance for risk than the West.

. . .

Mr. Lobner, the former American submarine officer, said “we have nothing except unmanned vehicles” operating at such depths.

Still, while some see an engineering marvel, others see evidence that Russia may be unable to build the kind of sophisticated, autonomous underwater drones the United States appears to rely on.

“They would rather adapt existing systems, modernize them, and try to muddle through,” Mr. Boulègue said. “So, no wonder these things keep exploding,” he said. Mr. Boulègue believes accidents have been far more common than publicly known.

John Pike, director of the think tank GlobalSecurity.org, said the Losharik fire suggested that the Russian military was still contending with some longstanding issues: corrupt contractors, and problems with quality control in manufacturing, spare parts supply chains and maintenance.

“I assume that every other sub in the Russian fleet has similar problems,” Mr. Pike said. “I just think the whole thing is held together with a lot of baling wire and spit.”

For the full story, see:

James Glanz and Thomas Nilsen. “A Deep-Diving Sub, a Deadly Fire And Russia’s Secret Undersea Agenda.” The New York Times (Tuesday, April 21, 2020): A22-A23.

(Note: ellipses added.)

(Note: the online version of the story was updated April 21, 2020, and has the title “A Deep-Diving Sub. A Deadly Fire. And Russia’s Secret Undersea Agenda.”)

Entrepreneurially Nimble Amish Pivot to Make Face Masks

(p. A9) SUGARCREEK, Ohio — On April 1, John Miller, a manufacturer here with deep connections to the close-knit Amish community of Central Ohio, got a call from Cleveland Clinic. The hospital system was struggling to find protective face masks for its 55,000 employees, plus visitors. Could his team sew 12,000 masks in two days?

He appealed to Abe Troyer with Keim, a local lumber mill and home goods business and a leader in the Amish community: “Abe, make a sewing frolic.” A frolic, Mr. Miller explained, “is a colloquial term here that means, ‘Get a bunch of people. Throw a bunch of people at this.’”

A day later, Mr. Troyer had signed up 60 Amish home seamstresses, and the Cleveland Clinic sewing frolic was on.

. . .

Almost overnight, a group of local industry, community and church leaders has mobilized to sustain Amish households by pivoting to work crafting thousands of face masks and shields, surgical gowns and protective garments from medical-grade materials. When those run scarce, they switch to using gaily printed quilting fabric and waterproof Tyvek house wrap.

For the full story, see:

Elizabeth Williamson. “In Ohio, Amish Families Pivot to Make Medical Gear.” The New York Times (Friday, April 10, 2020): A9.

(Note: ellipsis added.)

(Note: the online version of the story was updated April 16, 2020, and has the title “In Ohio, the Amish Take On the Coronavirus.”)