The world shares a collective trauma as we reach the six-month mark from the first confirmed human COVID-19 case in December of 2019. En masse this has meant months of self-quarantine cabin fever, remote learning/work, financial stress, safety fears, and widespread uncertainty. Depending on location, restrictions may or may not be lifting and community health guidelines may be moving through further phases of reopening. However, at the end of the day, only an effective treatment or cure will free everyone from this nightmare.
So where are we in terms of vaccine development? As a matter of fact, a COVID-19 vaccine candidate was proposed within hours of the first human case and over 170 potential vaccines are currently under review for viability. This includes two highly anticipated options from Moderna Therapeutics and Sinovac Biotech, the only labs currently reported to have had their candidates enter Phase Two of evaluation. However, the process of developing a vaccine and that of testing it for efficacy and safety are entirely different. One of the most common techniques for vaccine development follows a strict protocol for generating the antigen through a viral cell culture. Then, modified viruses are used to trigger an immune response in patients so they can develop the antibodies without individually being put at risk. These vaccines are called Live attenuated vaccines and the protocol is applicable to any number of common viral infections, likely including COVID-19.
Even though the protocol is well-researched and the process to develop vaccine candidates is quick, each promising candidate will undergo months, or even years, of studies and trials before they are made available for commercial sale or mainstream use. There are measures in place, however, to expedite the process. In addition to all of the COVID-19 candidates being fast-tracked, in a proactive response to the pandemic, labs have already begun mass-producing some of the most viable candidates so that distribution can begin immediately upon approval.
Nevertheless, the vaccine process will still take months of trials before it becomes a realistic option. Be that as it may, there are treatments that may be much more imminent. Though a vaccine appears to be the only way to eradicate the COVID-19 virus, a treatment of effective antiviral drugs could provide frontline workers with much-needed relief and be instrumental in reducing fatal outcomes, even when case numbers are on the rise. Some of the antiviral drugs currently being reviewed for use are already approved as treatments for other viral infections, meaning that they could be much closer on the horizon than a vaccine. While the World Health Organization (WHO) notes that no drugs have been proven to treat COVID-19, “a number of medicines have been suggested as potential investigational therapies, many of which are now being or will soon be studied in clinical trials.” This means that as soon as a therapy is successful in clinical trials, it will be made available without the delay of an additional approval process.
What is the difference between a treatment and a cure? What does either mean in terms of quarantine regulations, social distancing practices, community health guidelines, and frontline healthcare workers? Though an effective treatment would not end the pandemic, it would allow for more efficient protocols by frontline healthcare workers and a significant flattening of the curve and strain taken off of hospitals and treatment centers. Dr. Florian Krammer, a Professor at Icahn School of Medicine at Mount Sinai, notes that even with a vaccine, the COVID-19 virus will remain in the population, but will likely cause “sniffles” rather than causing “severe disease” similar to the four other known coronaviruses which cause common colds. At the end of the day, only a vaccine will mark the true end of social distancing and a return to “normal” community health practices… if we intend to return at all.
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