Nobel Laureate Peter Medawar once defined a virus as “a piece of bad news wrapped up in protein.” He wrote in 1983 that “no virus is known to do good.” The key to stopping the novel coronavirus is that no virus can multiply on its own. It must invade a living cell. All hopes rest on a drug, vaccine or other therapy to disrupt the virus attack or impede its replication machinery. This is complicated science, not the instant “game changer” that President Trump has touted in the unproven antimalarial drug hydroxychloroquine.
Traditionally, it takes years to develop, test and manufacture a vaccine; the one that worked in Congo against Ebola was under development for a decade. These hurdles haven’t changed, although one factor giving science a head start is that the whole genome of the coronavirus was sequenced and shared rapidly by China. Also, a new process of preliminary research reports unleashed a torrent of open source information. Traditionally, it takes years to develop, test and manufacture a vaccine.
What might save us? More than 70 vaccines are being researched. The Norway-based Coalition for Epidemic Preparedness Innovations, an international public-private collaboration started in 2017, has been funding a number of experimental projects. One of them, created by Moderna of Cambridge, Mass., and the Vaccine Research Center of the National Institute of Allergy and Infectious Diseases, is attempting to use synthesized genetic material, known as messenger RNA, that would help the body recognize the virus and target it, rather than the established method of using attenuated pathogens or protein particles from the real virus. The approach underscores the value of acquiring the whole genome sequence so early. Other vaccine development efforts are also delving into whether it is possible to manipulate genetic material to create an effective vaccine in a new way. Two companies are experimenting with taking a snippet of genetic code and entwining it with a harmless virus, hopefully spurring the body to produce antibodies that would go after a coronavirus invasion.
A second overall approach is to create antiviral drugs and other therapies that could interfere with the steps that the coronavirus takes to infect a cell or replicate inside it. Some are looking to see whether existing drugs or vaccines against other illnesses, already tested for safety, might be repurposed, such as the antiviral remdesivir, which Gilead Sciences has put into five clinical trials around the world. It didn’t succeed in the 2019 Ebola outbreak, but in test-tube and animal studies earlier had shown some potency against other coronaviruses. Yet another approach would be to create entirely new drugs or therapies, such as using the plasma of recovered patients to provide the protective antibodies needed to help ward off the virus.
The science is immensely challenging. But we can take heart knowing that so many creative, persistent and indefatigable researchers are working on more than 140 experimental drug treatments and vaccines, cooperating across company lines and national borders.
