The coronavirus pandemic has unleashed an unprecedented fight against a deadly disease whose outbreak has led to a near-global lockdown to contain the spread of COVID-19. Billions of public and private money have been invested in research on a scale never seen before in such a short period of time.
This is not what the medical world would have chosen, but the events of the past two years could not have happened without COVID-19 — the pathogen has served as a giant catalyst that has given rise to various technologies, data and research that provide insight into other diseases.
The Guardian tells how the emergence of the terrible coronavirus has changed the world of science and medicine in a short historical period.
When 21-year-old Tom Pooley became the first person to receive an experimental plague vaccine in medical trials last summer after testing on mice, he was inspired by the thought that his participation could help rid the world of one of the most brutal killers in human history.
“I was made very clear that I was the first person to receive this,” says Pooley, a student studying radiotherapy. – I was given to understand that it is as safe as possible. There are risks, but these are talented people: being the first is a great honor.” Based on the Chadox technology developed by the Oxford Vaccine Group and AstraZeneca, a single shot is administered painlessly in less than five seconds, he said. That night after receiving the experimental vaccine, the young man became slightly unwell, but after three hours he recovered; the little ordeal went on quickly compared to the centuries-old battle against a plague threat that killed 171 people in Madagascar as recently as 2017.
This is just one example of how scientists are increasingly looking at how treating COVID-19 can help treat other diseases.
Other similar vaccines against dengue, Zika and a range of pathogens are expected to be tested. Another Ebola vaccine study is already in human trials. As Professor Sarah Gilbert, creator of the Oxford Vaccine, said: “We have cake and we can put a cherry or pistachios on top if we need another vaccine, and then we are ready to go.”
The lessons learned from the coronavirus pandemic and the emerging new norms will change medical science forever. The world is currently on the cusp of a number of potentially significant breakthroughs, largely due to growing research into high-tech vaccines that could benefit patients with cancer and a range of infectious diseases.
Meanwhile, new studies on “long-term COVID” may shed light on blood clotting, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and other conditions associated with the stubborn virus. Obesity and vitamin levels are under the microscope; while digitalization and increased cross-border cooperation may soon bear fruit.
“COVID has spurred the rapid application of prior knowledge into practice,” says Dinan Pillay, member of the Independent Sage science team and professor of virology at University College London. – The development of science takes many years and needs opportunities for implementation. COVID has provided a lighter regulatory environment with accelerated trials so, for example, the development of a vaccine has been very fast.”
Before COVID, a new vaccine or drug could have taken a decade or more to go through all the stages of development and regulation, the scientist said, but they have now been deployed within 12 months of the first description of the disease. “Now we expect much faster translation and adoption of scientific advances,” says Pillay. “Caution to this is the continued need for equal access to these advances, which remains to be seen for COVID vaccines and drugs.”
Just five years ago, many were hesitant to invest in experimental drugs that use synthetic molecules that direct human cells to produce specific proteins that can protect against disease. No product based on mRNA technology (which stands for messenger ribonucleic acid and provides recipes for making proteins) has ever been approved, but within two years, the rapid development and success of Pfizer/BioNTech and Moderna’s coronavirus strikes have changed the game. writes The Guardian.
Major U.S. pharmaceutical giant Pfizer has already been working with German startup BioNTech, which has significant mRNA expertise, on a flu shot even before COVID. Then the focus shifted to the development of a pandemic vaccine and the urgent need to create a treatment that will accelerate the transition to the next frontier – research into treatments based on RNA, a strand of DNA that transmits the instructions needed to make proteins.
“This has been an unforeseen benefit of the pandemic because RNA and mRNA vaccine technology has been researched for at least 10 years,” says Richard Bucala, head of rheumatology, allergy and immunology at the Yale School of Medicine. “It was only during the pandemic that large sums of money were really invested in RNC. The development of a vaccine is empirical in nature: it is very difficult to know whether it will work. This is extremely risky. Nobody wants to do research and development. You don’t realize it’s a failure until you’ve experienced tens of millions. But the accidental success of RNA technology changed everything.”
The relative public acceptance of the unusual high-tech approach has also played a key role, with approval from various regulators giving confidence to both investors and the industry. This could open the floodgates for further approvals if the new vaccines make an impression in human trials.
Researchers have already set their sights on another deadly disease, malaria, which is estimated to have killed nearly half of all people since the Stone Age. Last year, it remained the leading cause of global death from infectious diseases, killing more than 600,000 people, mostly young children.
Scientists partnered with pharmacists to develop a shot of “self-amplifying” RNA (also known as saRNA) for it. This technology is based on the successful RNA malaria vaccine for mice developed at Yale University and is in advanced preclinical testing. For the first time, it can be tested on humans within two years.
In early February, The Guardian continues, Moderna began testing an HIV vaccine based on the same mRNA technology as the COVID vaccine. If they are successful, a single shot could provide lifelong protection. The technology is now being studied to see if it can help control largely treatment-resistant conditions such as rabies, the Zika virus, and cancers of the colon, skin, breast, and other parts of the body.
Professor David Dimert, an immunologist at George Washington University, says: “The COVID pandemic has really demonstrated the success of mRNA vaccines. So the path from discussion of its use in the treatment of HIV to phase I clinical trials has passed at an accelerated pace.”
Dr. Jeffrey Betoni, Professor of Microbiology, Immunology and Tropical Medicine at the George Washington School of Medicine and Public Health, adds: “This vaccine activates the immune response against HIV by stimulating cells in the lymph nodes. This procedure is not only unique to Phase I trials; this is unique to vaccines. It’s very new.” Moderna alone is developing trials of at least 30 more mRNA-based therapies in six different areas of medicine.
Meanwhile, more attention is being paid to how to deal with obesity as it has become a leading contributor to COVID: 78% of patients in the US hospitalized between March and December 2020 were overweight. In June, the first FDA-approved anti-obesity drug hit the market since 2014 that could be twice as effective as previous weight loss drugs, after a study of nearly 2,000 patients showed that the participants lost an average of 15% of their body weight.
A synthetic version of the appetite-reducing hormone has already been used at much lower doses to treat type 2 diabetes, but amid growing evidence that significant weight loss reduces COVID severity, regulators have approved it. The availability of a drug that can improve both blood glucose levels and body weight could have far-reaching public health implications outside the context of the coronavirus, especially for people who, despite their best efforts, have remained overweight.
COVID has also shed light on the potential benefits of vitamin D. Norway, Finland and Iceland, where there is an emphasis on maintaining healthy levels of the vitamin, have consistently low coronavirus death rates compared to other northern hemisphere countries with less focus on the solar nutrient. Amid an ongoing search for what exactly makes some people more vulnerable to COVID than others, attention to vitamin D earlier this year led to the publication of an article in the Lancet, co-authored by dozens of experts, suggesting that a lack of the vitamin could be the root cause of many diseases.
“For vitamin D deficient participants, genetic analyzes provided strong inverse evidence for all-cause mortality,” the statement said, calling for more trials and a new look at disease prevention strategies. “There are several potential mechanisms by which vitamin D may protect against cardiovascular mortality… There are also potential mechanisms that affect vitamin D in cancer.”
Digital health has also come to the fore as a result of the response to the pandemic. “The use of smartphone apps and the public’s understanding of disease prevalence data and knowledge is now widespread,” says Professor Dinan Pillay. “People are increasingly accustomed to receiving medical advice remotely, through virtual consultations, while other information collected in applications is sent to medical professionals.”
Home testing is also a significant advance as it allows people to effectively diagnose themselves and thus limit their exposure to others. This happened along with a rapid clinical evaluation. “COVID has provided insight into how science can best be applied to future health challenges,” says the scientist.
And as more in-depth studies on “long-term COVID” begin to emerge, they are shedding more light on other long-term conditions. The crucial link here could be microcoagulation, an area that Resia Pretorius, Chair of Physiological Sciences at Stellenbosch University in South Africa, has been studying for a long time, but the need for further understanding has become even more pressing due to COVID. The model under study suggests that small clots in the blood capillaries that prevent oxygen from reaching the tissues can cause long-term symptoms of COVID.
Pretorius is currently leading a study to look further into this issue to see if microclotting could somehow help unravel the mystery of the “long COVID” after studies in her lab found significant masses in patients. Preliminary results from her initial study suggest that anti-clotting treatments may help relieve lingering COVID symptoms.
If there is any area of optimism in the history of the COVID pandemic, it is the movement towards scientific collaboration and the impressive achievements made in such a relatively short period of time.
“It’s been such a terrible time for so many people,” agreed David Brown, an oncologist and cancer immunotherapy scientist at Yale Cancer Center in New Haven, whose team is working to introduce RNA technology into a cancer vaccine. “I hope that some of the scientific advances made during this period can help us in the treatment of other diseases, so that at least one glimmer of hope can appear for a way out of this extremely difficult situation.”