HOW THE COVID – 19 PANDEMIC COULD PLAY OUT
We don’t know much about this novel coronavirus named COVID – 19. Therefore, nobody really knows how this pandemic is going to end.
Every country in the world was caught unprepared to face this deadly pandemic and payed dearly for it with human life and unprecedented economic losses. After paying this unimaginable price, we quickly started to learn some aspects of this new virus.
We know that it started in Wuhan, China. We have already sequestered its genome and know that it is a respiratory virus, belong to coronavirus family. It is highly contagious. It spreads with respiratory droplets while coughing, sneezing or talking. That is why it’s most important to wear a face mask to prevent its spreading. We also know that everybody, especially the elderly and immune-compromised individuals are especially vulnerable catching the disease and dying from it. Its symptoms range from nothing at all to bilateral atypical pneumonia, respiratory failure and death.
We have no effective treatment, drugs or vaccine for it. We can only treat COVID – 19 patients symptomatically, with respiratory support and respirators, if necessary with the hope that patients’ immune system would soon kick in and save them.
Since we don’t know how it is going to play out, we can only speculate with different scenarios :
Scenario # 1. Try to contain the virus with extremely strict infection containment rules. Mandatory isolation of the sick, testing and contact tracing, quarantine of all contacts, social distancing, obligatory face-mask use, hand washings and sanitizing with disinfectants.
Scenario # 2. Accept it is what it is. Try to learn to live with it. Pay the price with human life, until a herd–immunity develops and the disease goes away. This is the only alternative for poor countries. However, the precise herd – immunity threshold level is not known. Experts believe that it is more than 60 percent. When partly tried in Sweden, it caused a very high mortality rate and only 15 – 17 percent immunity. There is a long way to go with this scenario and many people have to die before a herd immunity level is reached.
Scenario # 3. As is being done now in the most countries - a mixture of containment measures and lockdowns until the infection curve is flattened and then gradually and cautiously open up businesses and hope for the best.
Scenario # 4. Mobilize and finance the scientific community worldwide to urgently develop an anti-viral vaccine and medications. Presently, 80 companies in 19 different countries are working to develop a vaccine.
I believe that combinations of these different scenarios will play out until an effective vaccine is developed for the entire world population.
I am frequently asked why is it so difficult and take so long to develop a vaccine? I am not a Virologist but I did literature research and will try to summarize what I know about the general principles and the methods of vaccine development for a better understanding.
The general principle of an anti-viral vaccine development is basically to expose the body to an altered and safe version of the virus. This prompts the body’s immune system to react and to produce neutralizing antibodies against the virus to stop its replication. There are two basic methods of vaccine development: traditional method and gene–editing method.
Traditional Method:The virus is killed, attenuated or a piece of the virus is mixed into an injectable solution for testing. This method is slow, takes very long time to develop, which is not ideal for a pandemic.
Gene – Editing Method: By genetic engineering, scientists use information from the genome of the virus to create a blueprint to select a specific part of viral antigen, which is made of DNA or RNA and holds genetic instructions. This genetically engineered blueprint is embedded in a vector (DNA plasmid, RNA lipid or an adenovirus) and mixed into an injectable solution for testing.
When this genetic blueprint is injected into human cells, cells machinery uses these genetic instructions to make viral proteins. That is how viruses replicate. Virtually all scientists want human cells to make spikeproteins (antigen) of coronavirus because COVID- 19 infects and enters inside of the cells throughits spikes.
Preclinical testingfirst starts in lab dishes of cultured human cells and lab animals to see if it prompts an immune response and is non-toxic. After sufficient testing and if results are satisfactory, only then multiphasic human experiments starts in human volunteers.
Phase 1: 10 to 100 people are tested and closely watched to see if the vaccine is safe and produces the desired results and prevents viral infection. If it does, then comes phase 2.
Phase 2: A couple of hundred people are tested next and if the desired results are there, then phase 3 starts.
Phase 3: Tens of thousands are tested. If it safely prevents infection in a large number of people then the Manufacturing Phasestarts. A huge amount of production and quality control is required for almost 8 billion of the world population.
