The Final Edition of Solving COVID series

Updated: Jun 17

1.Where things stand This is the final edition of our Solving COVID newsletter. The pandemic is by no means over, but in a sense, COVID has indeed been "solved." We now know that vaccines are the way out of this crisis. A number of them have proven remarkably effective at preventing severe illness and death, and at reducing spread of the virus. Over time we will fine-tune vaccination programs as we learn more about dosage, boosters, and long-term immunity. COVID-19 may never disappear completely, but with these potent tools in-hand, we are well equipped to bring it to heel. The international challenge we face is getting these shots into as many arms as possible, especially in areas with high-risk populations. If we fail, we risk prolonging the pandemic and endangering the progress we've made should a new vaccine-resistant variant emerge and sweep across the globe in yet another devastating wave. Let us hope we win this race against time.

2. COVID cases declined at 'virtually the same rate' after CDC mask guidance Despite fears that the CDC's mask reversal could potentially lead to a COVID-19 spike, cases in the United States remain in decline, The New York Times' David Leonhardt writes. New COVID-19 cases have been down by almost 75 percent since the middle of April, the Times noted, and the seven-day average recently declined to less than 20,000 for the first time since March 2020. "A crucial point is that the loosened guidelines probably did not cause many people to change their behavior in ways that created new risks," Leonhardt writes. When it was first announced, the CDC's mask guidance was criticized by some experts as being too abrupt. Overall, the data suggests "the optimists were better prognosticators than the pessimists," Leonhardt says, and when it comes to unvaccinated Americans who may have stopped wearing masks because of the guidance change, "there don't seem to be enough of them to increase the spread of the virus." 3. Nasal spray antibody treatment shows promise against COVID-19 in mouse study Researchers report in the journal Nature that a COVID-19 antibody treatment they engineered has proved very effective at neutralizing more than 20 variants of the virus, at least in a study involving mice. Antibody treatments for COVID-19 have not been very popular among doctors, partly because they are delivered intravenously and require high doses to be effective. The new treatment, created by attaching an immunoglobulin M (IgM) neutralizing antibody to the IgG antibodies used in most current antibody drugs, is delivered through a nasal spray. The researchers report that when they sprayed the designer IgM antibody into the noses of mice six hours before or after the mice were infected with the coronavirus, it sharply cut the amount of virus in the mice's lungs two days later. This is a "big feat of engineering," said Guy Gorochov, an immunologist at Sorbonne University in Paris, but the study leaves a lot of open questions about how effective the treatment will be in humans.

4. Moderna's COVID-19 vaccine could be available for kids as young as 5 by early fall Moderna's CEO Stéphane Bancel expects the company's COVID-19 vaccine will be available for kids as young as 5 by early fall. "I think it's going to be early fall, just because we have to go down in age very slowly and carefully," he said Monday during a virtual event. Moderna is currently testing its vaccine on children, and Bancel thinks the data will become available sometime in September, CBS Boston reports. Children are typically at lower risk of developing severe cases of COVID-19, but those with underlying health conditions are more likely to be hospitalized. As of now, children as young as 12 can receive Pfizer's vaccine, which uses the same mRNA technology as Moderna, and the company is also running a trial for the 5-11 age group.

5. A different kind of vaccine emerges A COVID-19 vaccine different from those made by Moderna, Johnson & Johnson, and Pfizer could be available to Americans "as soon as this summer," NPR reports. The three vaccines currently authorized for use in the U.S. work by instructing the body to manufacture something that looks like a piece of the virus, but isn't. Then, if ever infected with the real virus, the immune system is prepared. The new protein subunit vaccine, however, already contains that all-important bit, known as the spike protein, meaning the body doesn't have to produce it on its own. What's more, the protein subunit vaccine doesn't require "special refrigeration," and also contains an "adjuvant" that makes the shot "even more protective," per NPR. The technology itself isn't novel — there are hepatitis B and pertussis vaccines that use the same science. But the first COVID-19 iteration will likely come from biotech company Novavax, which is reportedly hoping to file for authorization in "the U.K., U.S., and Europe in the third quarter."

Source: here

One of the principal reasons that the Solving COVID series has come to an end is because the way out of the COVID pandemic is before us with the rollout of effective vaccination programs. The challenge will be to ensure that there is as rapid as possible distribution and vaccination of the global population in order to minimize further spread of the virus, death, and long term COVID symptoms. With an effective global vaccination program, we can expect return to ‘normality’ with international air travel, and a reduction in social distancing measures which we have all experienced. It will also be important to ensure that monitoring and vigilance remain in place as new variants emerge to ensure that these variants are still covered by the existing vaccines which have been produced thus far. It is likely that further vaccination with adapted vaccine technology such as with the mRNA vaccines from Pfizer BioNTech and Moderna, structural molecular changes to the vaccine can be implemented to take account of variants with supplemental booster doses.

It was interesting to note that in the United States when CDC mask guidelines were relaxed, there was not a significant increase and COVID infection admissions to hospital but rather a decrease an admissions. It seems that when it comes to unvaccinated Americans who may have stopped wearing masks because of the CDC guidance change, there didn't seem to be an increase in the spread of the virus.

In the pursuit of new technologies to treat COVID-19 infection, a nasal spray antibody treatment has been developed by attaching an immunoglobulin M to a neutralizing antibody to the IgG antibodies used in most antibody drugs and delivered through a nasal spray. The reason for this adapted approach is that intravenous antibodies to combat COVID-19 need to be used in such amounts that it has not been recognized as a popular treatment for COVID-19. The initial studies have been carried out in mice and will need to be fully evaluated before consideration can be given to application to a human population.

Moderna is in the final stages of phase III trials looking at its efficacy and safety for vaccinating the 5 to 11 year age group. It is hoping to conclude these trials soon and have FDA approval by the fall of this year.

The development of vaccines, despite the efficacy of the current vaccines available globally, continues unabated. Novavax has used a novel approach to create a vaccine which they hope to have approval for in the UK, US, and Europe by the fall of this year. The vaccine contains the protein subunit of the spike protein as the delivery package to the human body to stimulate immunity rather than the approach by the mRNA vaccines of Moderna and Pfizer BioNTech which have packaged an mRNA a delete the"a" molecule to manufacture the spike protein within the cells. Looking forward to the future, if this approach is successful in inducing effective immunity, one can envisage future vaccination boosters with variant type spike proteins already packaged to induce immunity in response to emerging variants. I anticipate that the mRNA vaccines will be able to achieve this as well by modifying the mRNA messenger molecule which will then be able to synthesize a variant spike protein in order to induce immunity as well. It is anticipated that Novavax can be stored in an ordinary refrigerator rather than needing the special storage and transportation arrangements for the mRNA vaccines. This has an important application advantage to aiding the distribution of vaccines to third world countries.

On a personal note, I would like to take this opportunity to thank the Week team for producing this illuminating, factual, and well-resourced series of articles to keep a demanding audience well informed and up-to-date with vaccine developments and methods used to tackle the global pandemic.

- Doctor Donald Greig

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