In two infographics
How does this coronavirus end? The answer is still in development. While we can suppress the virus through intense public health measures, it will still come back the minute we let up. Life is going to suck until we have better treatment and a vaccine.
So how’s that going?
These two infographics show the current (20/3/20) state of development, based completely on reporting from STAT.
Let’s start with treatments, which could come online the fastest. These won’t end the virus, but it would at least save lives, and hospitals.
Treatment is anything that will save lives and reduce the burden on the health system. The main research seems to be along two lines, testing old drugs and finding some way to transfer antibodies from mice or other recovered people.
Every drug company is shaking out their medicine cabinet for something that might work. The pro is that these drugs won’t kill us, but the con is that they may not kill coronavirus.
Of these, remdesivir from Gilead (USA) is the furthest ahead, in Stage 3 trials. Remdesivir is the equivalent of a copier jam. It theoretically makes it difficult/impossible for the virus to copy itself. Sounds promising, except it didn’t work very well on Ebola. They’re testing it on COVID-19 now.
Johnson & Johnson and Pfizer are digging up whatever they have, as is French company Sanofi and Chinese company Ascletis. Interestingly, Pfizer has offered its manufacturing muscle to any breakthrough, to get it out there.
Note that I haven’t included the much-hyped chloroquine or hydroxychloroquine simply because STAT didn’t. They did mention in a separate article that the WHO was testing this drug, which is already approved for human use in certain countries.
With time, our bodies can naturally fight the coronavirus by producing antibodies. That’s how people recover. There are a lot of drugs trying to speed up that process, in different ways.
Mice: Regeneron uses proprietary mice to generate antibodies. Their drugs doubled survival rates for Ebola, so this is promising. Go mice.
Blood: Eli Lilly and Takeda are working with the blood of coronavirus survivors to try and extract the antibodies from them. Vir Biotechnology is using the blood of SARS survivors.
These treatments, however, are only for people who have already gotten the disease, and if you’re very far along they’re likely not helpful at all. Ultimately, the only way we kill this thing is the same way we eliminated Measles, Mumps, Rubella, etc. With a vaccine.
Long story short, if life is ever going to return to normal we need a vaccine. There is no business as usual without a vaccine and, honestly, we still need to completely rethink what business as usual even means.
The goal with all of these vaccines is to get our bodies to produce antibodies (so they know how to fight this coronavirus) or to otherwise give the body the information it needs to resist infection.
One way of doing this is with messenger RNA, which usually takes the code from DNA to make proteins. Scientists at Moderna, BioNTech, and CureVac are working on this. In a global dick-move, Donald Trump reportedly offered to buy CureVac’s technology for exclusive American use, which would also be pointless given that this is global.
Moderna is the furthest ahead, moving into Phase 1 with a healthy volunteer study this month. Note that these phases usually take years, but if something works you can count on it being accelerated.
Other researchers are sticking deactivated/reduced bits of COVID-19 code into harmless viruses, to give our bodies a clue without giving us the disease. These companies include Cansino in China, Johnson & Johnson in the US and Sanofi in France.
Cansino is the furthest ahead, having just gotten approval from the Chinese government to start human trials.
Arcturus (US) is engineering RNA into a liquid nanoparticle, thus a completely synthetic vaccine.
A collaboration between US and Chinese companies, Innovio is developing a DNA vaccine. They are starting clinical trials in April and have promised 1 million doses this year.
DNA, RNA, and mRNA ultimately code for proteins. A collaboration between GlaxoSmithKline and Chinese company Clover aims to create these proteins directly.
Great, So When?
We may be able to get treatments in months, but there’s no way around it, a working vaccine will take at least a year. Maybe years. The entire global economy suddenly depends on this activity, so it will get funding and attention, but the science can only move so fast, especially since we’re moving into the unknown.
So if you’re asking me when, I don’t know, I just read STAT News every day and wait. We also don’t know how this will be manufactured, distributed, and how much it will cost.
Whatever the cost, this is simply the only way out. People have discussed everyone just getting the disease but A) this would kill millions and B) we don’t know how long that immunity would last. Giving up simply isn’t an option.
Right now the only course action is intense suppression, but this also intensely suppresses our economy and throws millions of people into poverty, which also leads to death. The fact is that we need to get out from under this disease, and for that, we desperately need one of these medicines to work out, fast.