Covid-19 Vaccine, Treatment: World push sees initial success

Funded by governments, pharmaceuticals and research labs across the world have stepped up their efforts to find vaccines and treatments for the new coronavirus, using a variety of different technologies and some of them have claimed initial success.

In a first, scientists in the United States on Monday said that clinical trials on human had begun for a vaccine developed by its National Institute of Allergy and Infectious Diseases and the US biotech firm Moderna.

French pharmaceutical giant Sanofi and American drugmaker Regeneron said they had started clinical trials for Kevzara, a drug currently used to treat rheumatoid arthritis and which they hope will reduce lung inflammation in severe cases of coronavirus illness.

On Tuesday, China joined in saying it has also given the go-ahead for researchers to begin human safety tests of an experimental vaccine.

European Union and Australia have also claimed important breakthroughs against the virus that has killed more than 8,000 people worldwide and infected more than 200,000.

This unprecedented speed – given that the outbreak began in December last year - is thanks in large part to early Chinese efforts to sequence the genetic material of Sars-CoV-2, the virus that causes Covid-19. China shared that sequence in early January, allowing research groups around the world to grow the live virus and study how it invades human cells and makes people sick.

Coronaviruses have caused two other recent epidemics – severe acute respiratory syndrome (Sars) in China in 2002-04, and Middle East respiratory syndrome (Mers), which started in Saudi Arabia in 2012. In both cases, work began on vaccines that were later shelved when the outbreaks were contained.

One company, Maryland-based Novavax, has now repurposed those vaccines for Sars-CoV-2, and says it has several candidates ready to enter human trials this spring. Sars-CoV-2 shares between 80% and 90% of its genetic material with the virus that caused Sars.

Moderna, meanwhile, built on earlier work on the Mers virus.

However, experts at the World Health Organization say they do not expect any fully tested and approved vaccine to reach the market until the middle of next year.

But recent developments have been promising.

Medical authorities in China have said a drug used in Japan to treat new strains of influenza appeared to be effective in coronavirus patients, The Guardian reported yesterday citing Japanese media reports.

Zhang Xinmin, an official at China's science and technology ministry, said favipiravir, developed by a subsidiary of Fujifilm, had produced encouraging outcomes in clinical trials in Wuhan and Shenzhen involving 340 patients.

Patients who were given the medicine in Shenzhen turned negative for the virus after a median of four days after becoming positive, compared with a median of 11 days for those who were not treated with the drug, public broadcaster NHK said.

In addition, X-rays confirmed improvements in lung condition in about 91% of the patients who were treated with favipiravir, compared to 62% or those without the drug.

Fujifilm Toyama Chemical, which developed the drug – also known as Avigan – in 2014, has declined to comment on the claims.

Meanwhile, a team of hundreds of scientists in US has identified 50 drugs that may be effective treatments for people infected with the coronavirus.

According to The New York Times, the Quantitative Biosciences Institute Coronavirus Research Group, based at the University of California, San Francisco, is testing an unusual new approach. The researchers are looking for drugs that shield proteins in our own cells that the coronavirus depends on to thrive and reproduce.

Scientists at Mount Sinai Hospital in New York and at the Pasteur Institute in Paris have already begun to test the drugs against the coronavirus growing in their labs. The far-flung research group is preparing to release its findings at the end of the week.

There is no antiviral drug proven to be effective against the virus. When people get infected, the best that doctors can offer is supportive care — the patient is getting enough oxygen, managing fever and using a ventilator to push air into the lungs, if needed — to give the immune system time to fight the infection.

If the research effort succeeds, it will be a significant scientific achievement: an antiviral identified in just months to treat a virus that no one knew existed until January.

In Australia, researchers said they had mapped the body's immune response to the novel coronavirus. Authors of the study, published in the journal Nature Medicine, said it was the first time experts had mapped the body's general immune response to the new disease.

It said the findings had two practical applications. First, it will help virologists develop a vaccine because the goal in vaccination is to replicate the body's natural immune response to viruses.

The second practical application is screening. These immune system "markers" could in theory predict with greater accuracy which patients are likely to have mild symptoms and which are at risk of dying.

The majority of COVID-19 deaths occur in patients who are elderly or have existing medical conditions, such as heart disease and diabetes. Children, on the other hand, appear to show few or no symptoms. More research was needed to work out why, but the immune system does naturally slow down as people age.

Their observations could also help health authorities make better predictions in future disease outbreaks about who is most at risk.

However, according to Benjamin Neuman, a virologist at Texas A&M University-Texarkana, immunizing against the pathogen is a long shot: There has never been a very successful human vaccine against any member of the coronavirus family.

"This is going to be a lot of trial, a lot of error, but we have a lot of options to try," Neuman said.

"A vaccine has to have a fundamental scientific basis. It has to be manufacturable. It has to be safe. This could take a year and a half -- -- or much longer," wrote H Holden Thorp, the editor-in-chief of the journal Science.

"Pharmaceutical executives have every incentive to get there quickly -- they will be selling the vaccine after all -- but thankfully, they also know that you can't break the laws of nature to get there."

The pandemic, says Annelies Wilder-Smith, professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine, "will probably have peaked and declined before a vaccine is available".

A vaccine could still save many lives, especially if the virus becomes endemic or perennially circulating – like flu – and there are further, possibly seasonal, outbreaks. But until then, our best hope is to contain the disease as far as possible. To repeat the sage advice: wash your hands.