This might be the only way to beat COVID for good

This might be the only way to beat COVID for good

The new coronavirus, like all viruses, mutates and evolves. Quick. Variant after variant. Subvariants between variants.

The virus is asset. But our efforts to contain it are reagent. Thirty-four months into the COVID-19 pandemic, we still haven’t found a way to get ahead of the virus and provide people with immunity that endures even as the virus evolves.

That has to change, experts told The Daily Beast. And there are many ways could change, if we can focus our resources.

Broadly effective nasal vaccines that provide long-term immunity. Universal vaccines that should work against present and future variants. Or, at least, faster ways to deploy new boosters.

But even the best new medicine is useless if people don’t take it. The public’s desire to get vaccinated, rather than the availability of a new and better vaccine, could be the main reason we continue to lag behind the virus.

“How do we get out of the groundhog day Loop?” James Lawler, an infectious disease expert at the University of Nebraska Medical Center, asked, referring to Bill Murray’s 1993 comedy about a man trapped in an endlessly repeating day. “I I’m not sure we’ll do it soon.”

The novel coronavirus has mutated steadily since jumping from animals to humans in China in late 2019. A year later, early forms of the virus gave way to a more severe variant, Delta, which in turn has been superseded by the most contagious. Omicron variant and its succession of sub-variants – BA.1, BA.2, BA.4 and BA.5 – from last fall.

All of the major variants and sub-variants have changes to the spike protein, the part of the virus that helps it latch onto and infect our cells. Lately, more and more mutations are also appearing on other parts of the virus.

Yes, more than two-thirds of the planet’s 7.8 billion people have been at least partially vaccinated. Billions of people have fresh natural antibodies from recent infection. This immunity wall prevented the worst outcomes. Hospitalizations and deaths are down from their most recent peak in February.

But there is no indication that the SARS-CoV-2 virus is slowing down. New variants arrive as mutations accumulate. Anticipating a future where COVID is more or less a permanent problem, health officials around the world are trying to come up with strategies not defeat the virus, but manager this.

US President Joe Biden is starting to cast COVID as an annual problem, like the flu. On Tuesday, Biden encouraged Americans to get the new messenger RNA boosters that vaccine makers Pfizer and Moderna have adapted for Omicron and its subvariants.

More variant-specific boosters could follow, Biden said. “As the virus continues to change, we will now be able to update our vaccines every year to target the dominant variant,” he said. “Just like your annual flu shot, you should get it between Labor Day and Halloween.”

But there is a problem with an annual approach to COVID mutations. Antibodies to the best mRNA vaccines tend to wear off after about four months. If you’re only boosted once a year, you could be underprotected for up to eight months in a row.

Maybe. The thing is, we don’t know for sure how well and for how long the new boosters will work. “We still need this information to know if this is a viable strategy,” Peter Hotez, a vaccine development expert at Baylor College, told The Daily Beast.

Equally problematic, health officials and the pharmaceutical industry are currently searching for variants, formulating new recalls based on the dominant form of the virus at the time. But it takes months to reformulate vaccines, get clearance from health officials in each of the nearly 200 countries, and then manufacture and distribute doses.

I am truly perplexed by the widely held assumption that the future of the pandemic is bright.

We are moving slower than the virus. A new variant could evolve in just a few months. But it took nearly a year to bring an Omicron-specific booster to market. There is a risk that a new variant will have so many mutations that it will evade antibodies from a vaccine designed for the previous variant. In this case, the annual approach to reinforcement could result in an even longer protection gap.

There are several ways to catch the virus, experts told The Daily Beast. Industry could formulate new boosters faster and government regulators could approve them faster.

Another approach is a vaccine that you inhale instead of injecting. A nasal vaccine could stimulate a broader and longer-lasting immune response, targeting the parts of the body – the nose and throat – where SARS-CoV-2 prefers to lodge before spreading to the lungs and other organs.

There’s also the prospect of a universal ‘pan-coronavirus’ vaccine designed to induce immunity against SARS-CoV-2. and related coronaviruses, of which there are dozens.

These universal antibodies might be slightly less effective than antibodies against a single virus, but this somewhat reduced immunity should hold even if a particular virus mutates into a drastically different form. “Any potent set of antibodies that can neutralize an RNA virus like CoV-2 can select for escape mutants,” Barton Haynes, an immunologist at Duke University’s Human Vaccine Institute who is working on a novel, told The Daily Beast. universal vaccine.

Several nasal vaccines are in development, including one at the University of Iowa, and a dozen major universal vaccines are also in development. The two main efforts are the Coalition for Epidemic Preparedness Innovations in Norway and the US National Institute of Allergy and Infectious Diseases.

But all of these efforts depend in part on government support. And the country with the deepest pockets, the United States, is closing the purse strings after years of generous support for COVID research.

Faster recall deployments would also depend on government funding, as well as major reforms to licensing processes in countries whose regulators tend to lead the way. Again, that means the United States, a country not necessarily known for its regulatory efficiency.

But there is an even greater obstacle. Vaccine and booster use has plateaued around the world as the pandemic approaches its fourth year and fatigue sets in. In the United States, only a quarter of people aged 50 to 64 received the first two boosters. Even if the industry rolled out a new booster every few months and regulators quickly approved it, would enough people be bitten fast enough to slow the transmission of the virus?

Lawler said he was skeptical. “The problem is that we are likely to have very low uptake of new vaccines. Each booster dose had decreasing absorption.

Government messaging could help, but it also depends on funding becoming scarce. “We need an advocacy program to get people to agree to annual or regular reminders, but so far that’s not happening,” Hotez said.

So the world is settling into an annual approach to COVID, but without the tools to make sure an annual strategy works. It’s not necessarily a huge problem right now, because billions of people still have antibodies from a past infection.

But as these antibodies fade, we will have to make a choice. Induce antibodies with better and faster vaccines, or endure another huge wave of infections.

The alternative – to pretend that COVID will just go away – is naïve. “I’m really perplexed by the widely held assumption that the future of the pandemic is bright,” Lawler said. “It repeats the exact same forecasting errors that we have collectively exposed over the past two years. I guess I should have learned by now that we are not learning.

#beat #COVID #good

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