If you are one of those who believes that a Coronavirus vaccine is just around the corner, you need to read this piece: “In 1984, President Reagan’s Health and Human Services Secretary, Margaret Heckler, said, “We hope to have a vaccine ready for testing in about two years.” Almost four decades later, there is still no vaccine. If Heckler’s words now seem like wishful thinking, the Trump Administration has worried scientists and physicians with what may prove to be a similar overpromise. In May, it unveiled a plan to deliver “hundreds of millions of doses” of a covid-19 vaccine by the end of this year. The plan’s name—Operation Warp Speed—is meant to spark hope. But, in science, true hope is clear-eyed and brings a tight focus on the barriers and potential setbacks that exist along the path to desired results.”
So what is the problem? Why does it take so long to create vaccines for diseases like HIV or Coronavirus (the latter is apparently proving far more difficult to understand than HIV)?: “Quite simply, this is a disease that we are only beginning to understand: since the outbreak began, it has become evident that its effects are, like those of aids, astonishingly diverse and complex. Still largely thought of as a respiratory disease—it can indeed inflict devastating damage to the lungs—it is actually, as Fauci noted, capable of roving throughout the body. There are cases in which it causes kidney failure, stroke, or a so-called cytokine storm, an overreaction of the body’s immune system that can lead to multiple organ failure. In children, infection can lead to multisystem inflammatory syndrome, a condition that can damage the heart and other vital organs. covid-19 has a startling spectrum of severity—from no symptoms to death—depending on a host of poorly understood factors.”
The second challenge seems to be that since Coronavirus is not well understood, it is hard to figure out what exactly a virus for the said disease should give us immunity from: “Currently, we are not even sure how to assess protective immunity if we had a vaccine in hand—whether protection would be broad among all age groups and encompass the healthy as well as those whose clinical conditions, such as diabetes, heart disease, and obesity, predispose them to covid-19. Even more worrying, for those who imagine a vaccine might end the pandemic like turning off a light switch, a number of recent studies suggest that people who’ve had the disease may not emerge with robust, lasting immunity. If so, it’s possible that the initial protection offered by a successful vaccine would similarly wane, and people could be infected again…(Even a vaccine as comparatively simple as the annual flu shot reduces the risk of flu sickness for only about forty to sixty per cent of recipients.)”
Challenge #3: a lot of studies that have been published on Coronavirus trials either point to adverse side effects of the purported vaccines or highlight lack of effectiveness or lack of rigour in the trials: “Some twelve hundred clinical studies have been designed since January, but many are too small to have much chance of producing clear results. Researchers have been publishing their papers online before they have undergone peer review. In May, the biotech company Moderna published initial results of an early trial of their vaccine in a press release. Moderna’s vaccine dominated research news again last week, after fuller results of that trial were published in The New England Journal of Medicine. That work is still a preliminary achievement, since there were only fifteen healthy volunteers in each of three vaccine dose groups, and, in the moderate- and high-dose groups, almost every volunteer had side effects. An accompanying editorial from Penny Heaton, of the Gates Foundation, cautioned that we won’t really know about the safety of Moderna’s vaccine until many thousands receive it, nor whether the reported immune response in volunteers is actually protective against the virus. There are clear risks with proceeding to human trials in haste. As Kenneth Frazier, the C.E.O. of Merck, pointed out last week, there have been cases, in the past, in which trial vaccines “not only didn’t confer protection, but actually helped the virus invade the cell, because it was incomplete in terms of its immunogenic properties.” Promises to have a vaccine ready by the end of the year, he said, did a “grave disservice to the public.””
Challenge #4 seems to be POTUS: “Since Donald Trump took office, his Administration has worked to systematically disassemble key elements of federal pandemic planning. In 2018, it largely disbanded the National Security Council unit responsible for pandemic preparedness, which was formed during the Obama Administration, after having ignored the council’s playbook for fighting pandemics. It removed Rick Bright, from his job as a Health and Human Services official in charge of vaccine development, after he submitted a three-hundred-page complaint about the Administration’s coronavirus response. Most recently, the White House directed the National Institutes of Health to cut off federal grant funding to the EcoHealth Alliance, an organization headquartered in New York that studies the global spread of viruses from animals to humans, and which collaborated on research about coronaviruses with researchers based in China.”
Challenge #5 is that the best researchers, the most effective scientists know that rushing things doesn’t help. They know that speed doesn’t help when you are delving into a completely new problem that no one fully understands: “Anthony Griffiths, a virologist and an Ebola expert whose focus is on animal modelling, stated the value of deliberate science plainly. “I learned lessons from Ebola. I understand speed,” he told me. “But, if you do science in a rush, you are at risk of going down the garden path.” Griffiths hopes to use observations of the progress of the disease in animal hosts—genetically manipulated mice, golden Syrian hamsters, and rhesus monkeys—to learn about its mechanisms and to test possible treatments. This could help determine how much virus has to be present to cause infection, and what the routes to inoculation might be, with the aim of uncovering the dynamics of human immunity against the coronavirus. “I would love to be first, but we’re not going to be,” he told me. “But we want to put ourselves in the best position to do the kind of work that can help understand the performance of the vaccine, and what its limitations may prove to be.”
Griffiths works closely with Nahid Bhadelia, an infectious-diseases physician at Boston Medical Center who is an expert in emerging pathogens. In 2014, during the Ebola outbreak in West Africa, she was part of a W.H.O. team that treated patients and training local caregivers. Part of her role is to draw the attention of neidl scientists to evolving and unexplained clinical findings of covid-19, such as those that Fauci highlighted, so that they investigate them in the laboratory. For example, she has observed patients who tested positive for sars-CoV-2, the virus that causes covid-19, then repeatedly tested negative, and then tested positive again. “Have they become reinfected or has their immunity waned?” she said. “Or were they just shedding virus from the initial infection?””
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