The global invasion of the novel Coronavirus, now christened COVID-19, shows no sign of stopping. In the most recent situation report from the World Health Organisation (WHO), there are upwards of 85,000 confirmed cases of the virus, 1753 of which are new cases in the last 24 hours alone. While 93% of these cases remain in China, the virus has spread to 53 countries with Mexico and San Marino being the most recent victims.
The chaos caused by these multiple ‘epidemics in different parts of the world’ is widespread and severe; the Six Nations Italy v Ireland fixture was postponed, the Chinese economy and airline industry have taken huge financial blows and, despite reassurances from the President of the Olympic committee, there are growing concerns that Tokyo 2020 may be impacted by the virus.
Closer to home, measures are being taken to ensure that we are as prepared as possible for the instance in which COVID-19 could reach Oxford. In emails sent from the University of Oxford as well as individual college bursars, students and staff are ‘asked to maintain scrupulous hygiene’. In the past week, a hygiene station has been established outside the dining hall in Christ Church mandating students to wash their hands before entering. Accomodation is also being offered to students in most colleges for those who are encouraged not to, or are unable to, return to mainland China this vacation. It is important to note that while the WHO’s global risk assessment remains ‘very high’, they have stated that ‘if you are not in an area where COVID-19 is spreading, or have not travelled from an area where COVID-19 is spreading…your risk of infection is low.’ So, while precautions are welcome, they should not be met with blind panic.
Until recently, the main approach has been containment. Unfortunately, this aim to slow the spread of the virus and prevent it from reaching other countries is being met with growing pessimism. Border control measures may become increasingly unfeasible and travel bans may not only lose effectiveness but could backfire by preventing the export of goods including pharmaceuticals. One of the main hopes now is that scientists across the world will be able to quickly develop a vaccine against the virus.
Science Strikes Back
Coronavirus is a family of viruses named after crown like projections on their surface. These projections are modified proteins and are essential to the entry of the virus into cells. As early as late January, scientists had sequenced the genome of COVID-19 from several patients. The analysis of these genomes helps to understand where the virus came from, what it looks like and how it may be evolving.
The rapid scientific response to the virus meant that by the 19th of February a research team based in the Department of Molecular Biosciences at The University of Texas at Austin had mapped the structure of the surface spike proteins using a technique called cryo-electron microscopy. These spikes are the main way in which the virus binds receptors on host cells and forces its way in in order to replicate. Knowing the structure of these proteins is crucial to developing vaccines and this map has been sent out to dozens of research groups. The next step is to produce and inject these spike proteins into animals to see how well they trigger antibody production. When any foreign protein is discovered in our bodies, our immune system makes specific proteins called antibodies to fight them. However, this takes time. Exploiting harmless forms of these spike proteins is one way of producing a vaccine against the virus by causing the body to produce antibodies.
Last week, US biotech company Moderna announced they have produced an experimental vaccine- only 42 days after receiving the viral genetic sequence. Plans are to test it on 45 individuals in Phase I trials next month but their CEO, Stephane Bancel, was quick to deliver the reality check that it isn’t expected to be an approved vaccine for 12 to 18 months. Unlike protein based vaccines, Moderna specialise in mRNA based therapeutics. mRNA delivers a set of instructions to the cell so that they produce proteins to recognise and fight the virus.
Yet, Moderna are not the only company working on vaccines. Many companies and research groups are tackling this problem with a variety of different approaches as it is unknown which method will work best. Another team of researchers at MIGAL Galilee Institute, Israel are also in the race to be the first to develop a vaccine. Using previous work done on making a vaccine against a virus that affects poultry, infectious bronchitis virus (IBV), scientists hope that tweaking the same system used on IBV to the new coronavirus will give rapid access to a vaccine. This is based on evidence of a high similarity between the genetic sequences of IBV and COVID-19. They claim they could have a vaccine ready for the 90-day-minimum regulatory period in as little as a couple of weeks.
With panic and the potential for misinformation spreading more quickly than the disease itself, it is essential that a way of fighting the virus is found sooner rather than later.
Update (4/3/2020): Yesterday, on the third of March, the government has unveiled its Coronavirus action plan as the number of UK cases continues to rise. Within this document it outlines what is already known about COVID-19, the actions that have been taken so far in response to the epidemic and what the future plan is. One alarming figure is that is is estimated up to one fifth of employees may be off work during a period of peak contagion.
The report claims that the UK is ‘well prepared for disease outbreaks…having taken significant preparedness work for an influenza pandemic for over one decade.’ The plans are based on a ‘reasonable worst case scenario’ and so do not reflect what is most likely to happen, but prepare for more severe situations. In the event that the current situation worsens, the focus of the government will shift from containing the virus to delaying its spread and mitigating its impact by providing the best care possible for those who become ill. Actions to limit the spread of the virus could include school closures and reducing the number of large-scale gatherings. If the virus does become widespread, the government has established plans to ensure stockpiles of medicines and protective equipment are distributed efficiently and the level of service provided by the emergency services will be maintained.