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‘Actually Diabolical’: Contained in the Coronavirus That Outsmarted Science – The Wall Avenue Journal

‘Actually Diabolical’: Contained in the Coronavirus That Outsmarted Science – The Wall Avenue Journal

The brand new coronavirus is a killer with a crowbar, breaking and getting into human cells with impunity. It hitchhikes throughout continents carried on coughs and careless palms, pushed by its personal pressing necessity to outlive.

It has a gregarious facet that makes it onerous to withstand. It loves a celebration. The persistent social climber claims its victims world wide by using on moments of probably the most harmless of human interactions—a shared chuckle, a dialog, an embrace. And it’s a liar. SARS-CoV-2, which causes Covid-19, typically misleads the physique’s immune methods.

Taken by itself phrases, SARS-CoV-2 is the infectious illness success of the previous 100 years.

Nearly unmatched within the annals of rising human contagions, it has parlayed a number of probability infections right into a pandemic of round 27 million confirmed circumstances to date.

Doctors long expected the advent of such a virus, besides, the shrewdness of the coronavirus caught many abruptly, and goes a protracted solution to explaining how the world has struggled to comprise it ever since.

“We underestimated it,” mentioned

Peter Piot,

the top of the London Faculty of Hygiene & Tropical Medication and a co-discoverer of Ebola, who fell sufferer to the coronavirus himself in March.

Dr. Qian Zhang at Rockefeller College retrieves blood samples from a centrifuge as a part of a undertaking to review how the coronavirus impacts completely different individuals.



Picture:

KHOLOOD EID for The Wall Avenue Journal

Trendy journey made it simple for the brand new coronavirus to unfold to frequent fliers. It slipped unnoticed aboard a cruise ship in Japan and into Zumba lessons in South Korea. It contaminated mourners at a funeral in suburban New York, a choir in Skagit County, Wash., and college students on spring break in Florida.

Initially, it was extensively believed the virus made its residence in bats, which harbor a whole bunch of various sorts of coronaviruses. But it surely ventured into new species.

In Hong Kong,

Yuen Kwok-yung

had been ready greater than a decade for a virus like this to floor.

The 63-year-old infectious illnesses professor on the College of Hong Kong turned enthralled with bat coronaviruses since making the connection between bats and the unique SARS outbreak in 2003, which was attributable to a associated coronavirus. He amassed a database of animal surveillance, exhibiting that 39% of Chinese language horseshoe bats may very well be harboring SARS-related coronaviruses. In 2007, he wrote in Scientific Microbiology Critiques that these findings represented “a time bomb.”

From Bat to Human

SARS-CoV-2 is similar to recognized SARS-related coronaviruses in bats, particularly horseshoe bats. It’s believed {that a} bat virus mutated in an effort to infect people.

Potential coronavirus mutation

Human to human

Bat respiratory tract

Protein

Gene

Cell

The bat virus hooked up to cells in a bat’s respiratory tract.

Scientists suspect the bat virus mutated to develop into in a position to infect an intermediate host, resembling a civet or pangolin, earlier than mutating once more to develop into in a position to infect people, in a course of referred to as spillover.

After human an infection, the virus was free to copy and infect others by coughing, sneezing and different contact.

Potential coronavirus mutation

Human to human

Bat respiratory tract

Protein

Gene

Cell

The bat virus hooked up to cells in a bat’s respiratory tract.

Scientists suspect the bat virus mutated to develop into in a position to infect an intermediate host, resembling a civet or pangolin, earlier than mutating once more to develop into in a position to infect people, in a course of referred to as spillover.

After human an infection, the virus was free to copy and infect others by coughing, sneezing and different contact.

Bat respiratory tract

Potential coronavirus mutation

Human to human

Protein

Gene

Cell

The bat virus hooked up to cells in a bat’s respiratory tract.

Scientists suspect the bat virus mutated to develop into in a position to infect an intermediate host, resembling a civet or pangolin, earlier than mutating once more to develop into in a position to infect people, in a course of referred to as spillover.

After human an infection, the virus was free to copy and infect others by coughing, sneezing and different contact.

Bat respiratory tract

Protein

Gene

Cell

The bat virus hooked up to cells in a bat’s respiratory tract.

Potential coronavirus mutation

Scientists suspect the bat virus mutated to develop into in a position to infect an intermediate host, resembling a civet or pangolin, earlier than mutating once more to develop into in a position to infect people, in a course of referred to as spillover.

Human to human

After human an infection, the virus was free to copy and infect others by coughing, sneezing and different contact.

Bats’ cells can survive surges in metabolism—their hearts can go from 10 beats a minute throughout hibernation to 1,000 beats in flight. It’s thought their structure makes them ideally suited to be a reservoir the place a virus can keep, biding its time earlier than leaping to a different host species, an occasion referred to as a spillover.

On the finish of December, Dr. Yuen, who has been recognized to point out off his photograph assortment of bats in caves, was starting to suspect his fears have been realized after listening to a few thriller pneumonia afflicting sufferers round 600 miles away in Wuhan. He warned Hong Kong officers that one thing was coming, serving to spur town’s response.

After Chinese officials posted the gene sequence of the new coronavirus to share with scientists world wide on Jan. 12, he and others grew more and more positive the place the killer got here from. It was so just like recognized bat SARS-related coronaviruses, it will need to have as soon as been one among them, Dr. Yuen mentioned.

Even with spillover, a virus that jumps to a brand new species doesn’t at all times unfold. Some, like avian flu, an influenza initially in birds that may infect people, largely cease with the brand new host and don’t transfer from human to human.

However across the identical time on the HKU-Shenzhen hospital, the place Dr. Yuen additionally heads the microbiology and infectious-disease division, six members of the family had returned to the southern Chinese language metropolis after a go to to Wuhan. They started to really feel unwell. The virus had obtained to them, from the oldest member of the family, who finally died, to a 10-year-old boy.

The cluster steered the virus had a harmful trait, Dr. Yuen mentioned: It was spreading between people.

Dr. Yuen Kwok-yung in Hong Kong recognized a connection between bats and the unique SARS outbreak in 2003, and warned in regards to the new coronavirus.



Picture:

Xiaomei Chen/South China Morning Put up/ZUMA PRESS

He shared his findings with specialists from the Chinese language Middle for Illness Management and Prevention, including to a rising physique of proof that led China to verify to the world that the virus was leaping from individual to individual.

Even in these early days, mentioned Dr. Yuen, “I suspected that this virus might unfold extensively all through the world just like the 1918 Spanish flu.”

A borrowed life

All informed, there are extra viruses than stars within the recognized universe. Trillions upon trillions of viruses float within the air and trip on the clouds. Scientists on the College of British Columbia estimate that 800 million viruses rain onto each sq. meter of the planet daily. A coronavirus itself is so small that 500 of them may match throughout the diameter of a human hair.

Many scientists can’t resolve whether or not a virus is definitely alive in any standard sense. All viruses lead a form of borrowed life, chemists say. They’re a submicroscopic essence of the necessity to reproduce that by nature is at cross-purposes with humankind.

“Viruses don’t assume. They don’t have wishes,” mentioned Columbia College virologist

Angela Rasmussen.

Within the absence of want, they’ve objective: to unfold, multiply and survive.

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THE COVID STORM

The Wall Avenue Journal is analyzing the causes of the Covid-19 disaster and the bungled response that adopted. Get alerts for every new installment, together with our each day coronavirus briefing.

At the least 320,000 completely different viruses infect mammals. There are 219 virus species which might be recognized to have the ability to infect people. One researcher discovered greater than 100 completely different viruses residing inside human lungs. At the least six different forms of coronavirus are recognized to contaminate people. A number of trigger the widespread chilly.

SARS-CoV-2 isn’t the primary virus to have its impact broadened by travel. Smallpox, which killed 300 million individuals or extra within the twentieth century alone, first traversed the world by crusing with the Vikings a thousand years in the past, new analysis into the historical past of epidemics suggests.

The coronavirus belongs to a class of viruses that work by transmitting chemical code, referred to as RNA, sealed inside a protecting protein envelope. RNA is a nucleic acid current in all residing cells that normally acts as a messenger to relay genetic directions in DNA, telling the cells what to do. As soon as the virus will get inside a bunch cell, it seizes the cell’s reproductive equipment.

A Portrait of SARS-CoV-2

Coronaviruses are named for the crown-like spikes on their floor. They largely infect animals. At the least seven strains infect people, together with this new virus. 4 trigger widespread colds. Two others rank among the many deadliest of human infections: extreme acute respiratory syndrome, or SARS, and Center East respiratory syndrome, or MERS.

SARS-CoV-2

Different Coronaviruses

24 mo.

34 mo.

Envelope

Common period of time in months that folks retain immunity to every viral illness:

6 months

6 months

Unknown

Viruses

6 months

6 months

6 months

Lifelong

SARS-CoV-2

Different Coronaviruses

24 mo.

34 mo.

Envelope

Common period of time in months that folks retain immunity to every viral illness:

Unknown

6 months

6 months

Viruses

6 months

Lifelong

6 months

6 months

SARS-CoV-2

Different Coronaviruses

34 mo.

24 mo.

Envelope

Common period of time in months that folks retain immunity to every viral illness:

Unknown

6 months

6 months

Viruses

6 months

Lifelong

6 months

6 months

SARS-CoV-2

Envelope

Common period of time in months that folks retain immunity to every viral illness:

Unknown

Different Coronaviruses

24 mo.

6 months

6 months

6 months

6 months

34 mo.

Viruses

6 months

Lifelong

With out that maneuver, the coronavirus is impotent. It may by no means reproduce and churn out the tens of millions of latest coronavirus cells in a spreading an infection. When it kills, it’s virtually out of carelessness. Its personal survival relies on sparing its victims to proceed as autos for its propagation.

Whereas estimates differ extensively, SARS-CoV-2 seems to kill about 0.6% of the individuals it infects—about six instances that of a typical flu. By comparability, two different human coronaviruses are much more deadly however more durable to contract. SARS-CoV, the unique SARS within the 2003 outbreak, has a case fatality price of 9.6%, whereas MERS, which stands for Center East respiratory syndrome, which was first reported in 2012, has an excellent larger case fatality price of 34%.

However the present coronavirus causes severe signs in a lot of its victims. As

David Hui,

a respiratory illness skilled on the Chinese language College of Hong Kong, mentioned, it’s “gentle, till it decides to develop into nasty.” He mentioned the consequences have been extreme in roughly 20% of the individuals it afflicts.

Investigators shortly realized that SARS-CoV-2 normally seeks out kind II lung cells within the individuals it hijacks. These coat membranes lining the nostril, throat and sinuses, and deep into the lungs. The coronavirus pries the cells open with a molecular construction referred to as a spike protein that it makes use of like a crowbar to pressure entry.

In photographs that scientists made to review it, the spherical virus bristles with spikes. The spike protein locks onto a receptor referred to as the angiotensin-converting enzyme 2, or ACE-2, which usually regulates a protein that will increase blood strain and irritation. The receptors appear to be extra quite a few amongst older individuals and better typically amongst males than ladies.

Researchers on the Francis Crick Institute in London used a method referred to as cryo-electron microscopy to match this construction to the spike protein of a bat coronavirus most like that of SARS-CoV-2. They noticed delicate variations within the spike of SARS-CoV-2 that make it in a position to bind about 1,000 instances extra tightly to a human cell than the bat virus, the scientists mentioned.

How SARS-CoV-2 Multiplies: The virus makes use of its spike protein to connect to a receptor referred to as the ACE-2 in a human cell and pries its manner inside. The virus then injects its RNA into the human cell’s nucleus and takes over. The viral RNA makes use of the host cell to copy itself. New virus cells are launched, typically destroying the host cell within the course of. (Supply: Genome.gov)

As soon as inside a human cell, the brand new coronavirus has a uncommon capacity to silence alarms that may usually alert the immune system to mobilize antibodies and virus-killing cells, in response to microbiologists on the Icahn Faculty of Medication at Mount Sinai, New York. To take action, it makes particular proteins that intrude with the cell’s surveillance system, scientists on the College of Minnesota reported in Could.

Bewildering issues

Medical doctors who first encountered it identified it as a respiratory virus. They appeared for signs of fever, cough and shortness of breath. However Covid-19 triggered bewildering complications.

Individuals complained of nausea or diarrhea. Some had arrhythmias and even coronary heart assaults. Some suffered kidney harm or liver failure. Some misplaced their sense of scent or style. Different sufferers turned up at clinics with blood clots or swollen purple bumps on their toes.

In most international locations the place the virus triggered outbreaks, it despatched individuals to the hospital with delirium, blackouts, mind irritation or strokes, researchers on the U.Ok.’s Liverpool College reported in The Lancet Neurology in July.

In a separate evaluate, researchers at Columbia College Vagelos School of Physicians and Surgeons discovered that as much as a 3rd of these contaminated had neurological signs.

By coming into contact with this virus, “you wouldn’t know what sort of impact a gathering with it could have: Possibly you can be unscathed, however perhaps you’ll die,” mentioned the College of Oxford’s

Sarah Gilbert,

whose group is growing a vaccine in opposition to the virus that’s in late-stage human trials.

Heidi Larson

first met the virus when her husband began feeling torpid and feverish. He misplaced his urge for food and struggled to elevate a spoon. When she touched his brow, it burned. “However fever can imply many issues,” she mentioned.

Prof. Larson, an anthropologist specializing in vaccines, had spent years working world wide and has survived typhoid in Nepal and eosinophilic meningitis in Fiji. Her husband is 71-year-old Dr. Piot, the virus hunter who co-discovered Ebola. He was the primary to run the United Nations company to fight AIDS, the situation attributable to HIV, earlier than happening to move the London Faculty, the analysis college targeted on public well being and tropical drugs.

With no indicators of Dr. Piot’s fever subsiding over the course of every week, their suspicions started to sink in. A check confirmed: The person who had spent his life combating viruses was now besieged by one.

By the 14th day, his fever spiking, they rushed to the emergency room and he was instantly admitted. He had no respiratory difficulties however his oxygen saturation ranges have been dangerously low, a situation referred to as silent hypoxia. In his extra lucid moments, he stored pondering: “It obtained me. The virus obtained me.”

Dr. Piot was relieved when he was discharged. However then got here a second wave: He obtained chills and a type of pneumonia. He thinks his physique was hit by a so-called cytokine storm, a facet impact for a lot of victims wherein the physique’s immune system goes into overdrive and assaults extra than simply the invader.

Dr. Peter Piot, the top of the London Faculty of Hygiene & Tropical Medication and a co-discoverer of Ebola, mentioned we underestimated the brand new coronavirus.



Picture:

mike blake/Reuters

Prof. Larson examined optimistic for antibodies, suggesting she was additionally a sufferer, however her signs have been completely different, too: conjunctivitis and splitting complications.

5 months on, Dr. Piot is recovering, although he nonetheless experiences lingering results. They each are involved about long-term penalties but to be revealed.

“This virus is basically diabolical, it got here like a thief within the night time with an insatiable urge for food for victims to devour,” Dr. Piot mentioned. “It behaves in contrast to some other virus. It spreads by our respiratory system as a result of there are receptors in our noses and throats—however then it goes by your whole physique: blood vessels, the guts, each organ may very well be focused. It’s loopy.”

The virus has contaminated tens of millions of people that by no means obtained sick or have been solely mildly ailing, which allowed it to breed whereas its victims unfold it in ever-widening circles. Against this, those that develop into contaminated with the Ebola virus don’t develop into infectious till they really present signs and normally are too sick to journey.

When researchers on the College of California, San Francisco examined individuals for SARS-CoV-2 in San Francisco’s Mission District, 53% of these contaminated hadn’t proven any overt ailing results.

Covid and the Physique

The coronavirus begins out focusing on the cells that line the lungs and respiratory tract, affecting completely different individuals in wide-ranging methods and with very completely different ranges of severity. Widespread signs are coughs and fever. Because the virus reproduces, the contaminated lung cells are destroyed and new damaging virus constructions are launched to probably trigger extra harm. The mind, kidneys, coronary heart, vascular and digestive methods might be affected. Potential signs embody:

Coronary heart

Nervous System

Irritation of the guts lining, coronary heart assaults and irregular coronary heart rhythms.

Lack of scent and style; seizures, strokes and hallucinations.The virus has been detected in cerebrospinal fluid, which is discovered within the mind and spinal wire.

Eye, Nostril and Throat

Runny nostril and conjunctivitis, an irritation of the membranes lining the eyeball and eyelids. The virus has been detected in eye-fluid samples.

Lungs

The replicating virus damages tiny air sacs referred to as alveoli within the lungs. Immune cells set off an inflammatory response in opposition to the an infection, however an excessive amount of irritation can harm lung cells and blood vessels.

1

SARS-CoV-2

infects lung

tissue

Immune

cells produce

inflammatory

proteins

2

3

Irritation

causes harm

4

Clots kind to

restore harm

Capillary

Kidneys

Blood clots in capillaries, resulting in acute kidney harm.

Digestive System

Diarrhea and different gastrointestinal points.

Cardiovascular System

Blood clots that may result in stroke or pulmonary embolisms, and microclots that may make it onerous for lungs to oxygenate blood.

Musculoskeletal System

Muscle and joint aches; painful, purplish swelling within the toes.

Nervous System

Coronary heart

Lack of scent and style; seizures, strokes and hallucinations.The virus has been detected in cerebrospinal fluid, which is discovered within the mind and spinal wire.

Irritation of the guts lining, coronary heart assaults and irregular coronary heart rhythms.

Eye, Nostril and Throat

Runny nostril and conjunctivitis, an irritation of the membranes lining the eyeball and eyelids. The virus has been detected in eye-fluid samples.

Lungs

The replicating virus damages tiny air sacs referred to as alveoli within the lungs. Immune cells set off an inflammatory response in opposition to the an infection, however an excessive amount of irritation can harm lung cells and blood vessels.

1

SARS-CoV-2

infects lung

tissue

2

Immune

cells produce

inflammatory

proteins

Irritation

causes harm

3

Capillary

4

Clots kind to

restore harm

Kidneys

Blood clots in capillaries, resulting in acute kidney harm.

Digestive System

Diarrhea and different gastrointestinal points.

Cardiovascular System

Blood clots that may result in stroke or pulmonary embolisms, and microclots that may make it onerous for lungs to oxygenate blood.

Musculoskeletal System

Muscle and joint aches; painful, purplish swelling within the toes.

Nervous System

Coronary heart

Lack of scent and style; seizures, strokes and hallucinations.The virus has been detected in cerebrospinal fluid, which is discovered within the mind and spinal wire.

Irritation of the guts lining, coronary heart assaults and irregular coronary heart rhythms.

Eye, Nostril and Throat

Runny nostril and conjunctivitis, an irritation of the membranes lining the eyeball and eyelids. The virus has been detected in eye-fluid samples.

Lungs

The replicating virus damages tiny air sacs referred to as alveoli within the lungs. Immune cells set off an inflammatory response in opposition to the an infection, however an excessive amount of irritation can harm lung cells and blood vessels.

1

SARS-CoV-2

infects lung

tissue

2

Immune

cells produce

inflammatory

proteins

3

Irritation

causes harm

Capillary

4

Clots kind to

restore harm

Kidneys

Blood clots in capillaries, resulting in acute kidney harm.

Digestive System

Diarrhea and different gastrointestinal points.

Cardiovascular System

Blood clots that may result in stroke or pulmonary embolisms, and microclots that may make it onerous for lungs to oxygenate blood.

Musculoskeletal System

Muscle and joint aches; painful, purplish swelling within the toes.

1

3

2

4

6

5

7

8

1

Nervous System

Lack of scent and style; seizures, strokes and hallucinations.The virus has been detected in cerebrospinal fluid, which is discovered within the mind and spinal wire.

2

Eye, Nostril and Throat

Runny nostril and conjunctivitis, an irritation of the membranes lining the eyeball and eyelids. The virus has been detected in eye-fluid samples.

3

Coronary heart

Irritation of the guts lining, coronary heart assaults and irregular coronary heart rhythms.

4

Lungs

The replicating virus damages tiny air sacs referred to as alveoli within the lungs. Immune cells set off an inflammatory response in opposition to the an infection, however an excessive amount of irritation can harm lung cells and blood vessels.

1

SARS-CoV-2

infects lung

tissue

2

Immune

cells produce

inflammatory

proteins

Irritation

causes harm

3

Capillary

4

Clots kind to

restore harm

5

Kidneys

Blood clots in capillaries, resulting in acute kidney harm.

6

Digestive System

Diarrhea and different gastrointestinal points.

7

Cardiovascular System

Blood clots that may result in stroke or pulmonary embolisms, and microclots that may make it onerous for lungs to oxygenate blood.

8

Musculoskeletal System

Muscle and joint aches; painful, purplish swelling within the toes.

Within the early days of the pandemic, researchers thought youngsters could be much less affected by the coronavirus, with decrease charges of hospitalization and few deaths. However the very younger are extra weak than initially suspected.

By the top of July, almost 340,000 youngsters within the U.S. had examined optimistic for Covid-19, or 8.8% of all reported circumstances. Nobody is certain but how readily youngsters transmit the virus or whether or not they’re extremely contagious after they present no signs.

The virus’s personal inner chemistry alone wasn’t sufficient to account for a lot variation of signs, severity and deaths.

Forensics group

There isn’t any scarcity of potential contributing causes: previous age, gender, underlying continual illnesses resembling diabetes, lack of well being care and poor weight-reduction plan. Investigators additionally turned their consideration to gene variations which may make some uniquely weak.

“The immune system in individuals is as various as magnificence, top, intelligence and some other human characteristic,” mentioned molecular immunologist

Michel Nussenzweig

at Rockefeller College in New York. “Not all people is similar of their capacity to battle an infection.”

At Rockefeller and the New York Genome Middle, scientists are evaluating all the genomes of these most severely affected by the coronavirus to those that expertise solely gentle signs—after which to the coronavirus itself. They’re a part of a community in 50 international locations that’s learning the brand new illness by analyzing the DNA from tens of millions of individuals.

Like against the law scene forensics group, these scientists extract the virus from nostril swab mucus collected from the individuals it contaminated and, by high-speed genome sequencers, scale back it to biochemical code for evaluation. Some samples are drawn from individuals who suffered not more than a fever and a cough. Others come from autopsies.

At this degree of molecular biology, the virus and its sufferer are one, their genetic materials intermingled in a tiny vial awaiting processing.

Sporting a blue masks, purple gloves and a blue lab coat,

Melissa Marton,

the affiliate director of the New York Genome Middle’s analysis sequencing lab, opened a biosafety field with a razor and gingerly eliminated a rack holding 94 tubes of virus samples. Every one was labeled with an figuring out bar code.

A robotic sorted them behind a plexiglass barrier inside a biosafety hood with a specialised air flow system. The likelihood for the virus to interrupt out at this level in processing is small however not zero. “That’s why we take further precautions,” she mentioned.

Each few days, shipments of RNA from the virus and DNA from the sufferers it contaminated arrived on the heart in Manhattan’s SoHo district from regional hospitals. The genome consortium to date has collected 1,600 samples for sequencing.

They will already inform the virus is evolving.

The 4 bases of virus RNA are written in an alphabet composed of nucleotide chemical substances: adenine (A), cytosine (C), guanine (G) and uracil (U). In its rush to make new copies of itself, the virus is vulnerable to random errors.

“The virus adjustments on a reasonably clockwork foundation,” mentioned computational biologist

Michael Zody

on the genome heart. “Each two weeks or so, it appears that evidently the virus picks up a brand new mutation.”

Melissa Marton and Robert Furatero on the New York Genome Middle.



Picture:

KHOLOOD EID for The Wall Avenue Journal

That provides as much as about 25 random adjustments a 12 months, a lot lower than the seasonal flu, which has a mutation price of just about 50 mutations a 12 months. A lot of the adjustments within the coronavirus don’t make any distinction now.

In time, it’s potential that some would possibly make it simpler to transmit from individual to individual or develop into deadlier. To date, greater than 1,200 pure variations in coronavirus strains world wide have been recognized.

Just lately, researchers led by biologist

Bette Korber

at Los Alamos Nationwide Laboratory in New Mexico recognized a single change within the 30,000 chemical characters of the coronavirus RNA. In a piece of code that impacts its spike protein, a single “A” had turned to “G,” the scientists mentioned.

That model has develop into extra widespread in virtually each nation, in contrast with the unique model that first arose in Wuhan. It might have out-competed the unique pressure, however might not be making sufferers any sicker, the scientists mentioned.

“Any of those mutations may functionally make the virus completely different,” mentioned

Emma Hodcroft

on the College of Basel in Switzerland who tracks its world transmission. “However this virus could be very younger and we haven’t seen any proof of this taking place but. It’s solely been in people a number of months, and it’s doing very nicely.”

—Graphics by Kevin Hand/WSJ

—Illustration at high by Jessica Kuronen/WSJ

Write to Robert Lee Hotz at sciencejournal@wsj.com and Natasha Khan at natasha.khan@wsj.com

Copyright ©2020 Dow Jones & Firm, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

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