In a season that seems so dark, and bad news hitting the headlines in wave after wave, you have to look hard to find reasons for hope. Yet there is always hope and humanity has survived many a crisis by looking for a light at the end of the tunnel and making a break for it when it appears. It’s funny but since the pandemic began every article I have written here that suggested hope has received the highest numbers of unsubscribes. If you are brave enough to look for evidence-based hope, read on.
To begin, the most important scientific news we have lately is that studies from laboratory experiments, hospitals, and data from whole countries are confirming that the biggest opportunity we have to stem the tide of this pandemic is one that we all have direct control of and responsibility for. Wearing masks is turning out to be the most effective thing we can do to prevent the spread of the disease and furthermore to minimize the severity of infection in those who do get sick. According to an article by Monica Gandhi, Professor of Medicine, Infectious Diseases and Global Medicine, University of California, San Francisco recent research has confirmed that the virus is dose-related. That means the amount of virus that we get in us determines in large part how sick we get. The smaller the dose, the less sick you get, and the larger the dose the sicker you get making the difference between those that land in the hospital and those who didn’t even know they are infected. The role of viral load or dose level in the severity of a disease has been known in the west for over 100 years and in Asia since the thirteenth century when Marco Polo noticed the Chinese wearing masks during disease outbreaks.
If the initial dose is small it is much easier for your immune system to get ahold of the infection leading to milder symptoms. If the dose of virus you get is large the immune system becomes overwhelmed with potentially catastrophic results. Laboratory experiments have shown that good cloth masks block 80% of the virus from entering the nose or mouth. In July the CDC estimated that 40% of those infected with Coronavirus remained asymptomatic, showing no symptoms and a number of other studies have confirmed this. In an outbreak on an Australian cruise ship in late March, the passengers were all given surgical masks and the staff was given N95 masks after the first case of COVID-19 was identified. Mask usage was apparently very high, and even though 128 of the 217 passengers and staff eventually tested positive for the coronavirus, 81% of the infected people remained asymptomatic. Two more recent outbreaks provide further evidence, one at a seafood plant in Oregon and the second at a chicken plant in Arkansas. In both places, the workers were provided masks and required to wear them at all times. In the outbreaks from both plants, nearly 95% of infected people were asymptomatic.
For more on mask-wearing and the severity of illness see the original article by Monica Gandhi
9 more reasons for hope: a vaccine is coming soon!
William Petri, Professor of Medicine, physician-scientist, and infectious diseases specialist at the University of Virginia, where I care for patients and conduct research into COVID-19.
Here is some good news about why researchers think that they will develop a successful vaccine to prevent COVID-19. Here is where the research stands, and why you can be optimistic about the delivery of a COVID-19 vaccine.
1. Human immune system cures COVID-19
In as many as 99% of all COVID-19 cases, the patients own immune system kills the infection, it is therefore likely that a vaccine will also be effective against this virus unlike HIV infection which the immune system cannot kill.
2. Antibodies targeting spike protein prevent infection
Antibodies, like those made by the immune system, bind to the spike protein, neutralize it and seven companies have developed, laboratory-manufactured antibodies that recognize the spike protein. These antibodies are entering clinical trials to test their ability to prevent infection in those who are exposed.
3. Spike glycoprotein contains multiple targets
The spike protein has many vulnerable spots where antibodies can attach, it will be difficult for the virus to mutate to avoid a vaccine. Too many mutations to the spike protein would change its structure and render it incapable of binding to ACE2, which is key to infecting human cells.
4. We know how to make a safe vaccine
The safety of a new COVID-19 vaccine is improved by researchers’ understanding of potential vaccine side effects and how to avoid them. In the case of the Oxford vaccine safety studies have been underway for two years now and even though they have been completed Oxford is doubling up on the safety studies specifically because there is a percentage of the population that is skeptical bout vaccine safety.
5. Several different vaccines in development
The U.S. government is making a major investment, committing $8 billion to seven different vaccines. The UK and wealthy vaccine manufacture’s in india are making similar investments.
Of over 160 possible vaccines in development, only one of these vaccines needs to prove safe and effective in clinical trials for a COVID-19 vaccine to be made available in 2021.
6. Vaccines passing through phase I and II trials
Phase I and phase II trials test if a vaccine is safe and induces an immune response. Moderna, Oxford, and Chinese company CanSino have all demonstrated the safety of their vaccines in phase I and phase II trials.
7. Phase III clinical trials are underway
Moderna and NIH and the vaccine from Oxford-AstraZeneca began phase III trials in July. Phase three is where the vaccine is tested in tens of thousands of people to see if it actually protects against the virus in the real world. Also, additional safety studies can show if more rare side effects may develop. Other COVID-19 vaccines will be starting phase III within weeks.
8. Accelerating vaccine production and deployment
Multiple countries around the world are paying for the production of millions of doses of vaccines and supporting vaccine manufacturing at an industrial scale even before researchers have demonstrated vaccine efficacy and safety. They are investing huge sums of money knowing that that investment may still be lost if phase three trials fail. It is rare for trials to fail in phase three but it can happen. The Aids virus is notorious for passing phase 1 and 2 and failing in phase three which is why we still don’t have an AIDS vaccine.
9. Vaccine distributors are being contracted now
Manufacturing and distribution pipelines are already being developed to ensure that the largest public health vaccination program in history will be carried out as rapidly as possible once a vaccine has been proven safe and effective.