Almost eight months after the White House first announced it would move from containment to mitigation measures to halt the spread of the COVID-19 epidemic, the government is now turning to vaccines to vaccinate the population and therapies to treat the disease.
Months after the announcement, the company would be working with tech giants Apple and Google on a contact tracking app (and nearly two months after Google and Apple rolled out their exposure notification capabilities) and nationwide widespread testing efforts with the largest national pharmacies (which were never received) initiating the coordinated assistance it needed), the administration appears to be abandoning its national efforts to halt the spread of the COVID-19 epidemic.
In an interview with Mark Meadows, Jake Tapper's chief of staff at CNN's White House, he said the US "will not control the pandemic … we will control the fact that we are given vaccines, therapeutics and other harm reduction measures . "
WIESEN: We will not control the pandemic
TAPPER: Why not?
M: Because it's a contagious virus
T: Why not make an effort to contain it?
M: We have to make sure we have the right mitigation factors to make sure people don't die. Pic.twitter.com/0DYgk4rB3T
– Aaron Rupar (@atrupar) October 25, 2020
The approval is a final nail in the coffin for a federal response that could have included a return to lockdowns to contain the spread of the virus, or national testing and contact tracing, and other harm reduction measures. The Meadows statement comes as the US sees a second peak in infection rates. There have now been over 8.1 million cases and over 220,000 deaths since the first confirmed infection on US soil on January 20.
The number of Covid cases, hospital stays and deaths will continue to increase sharply at the beginning of winter. until we all alone take enough collective action to slow the spread. There is no seasonal backstop and there will be no new national policy measure. https://t.co/YoCFZkhVSb
– Scott Gottlieb, MD (@ScottGottliebMD) October 23, 2020
Now the focus is on the vaccines, therapies and treatments being developed by large pharmaceutical companies and startups that are making their way through regulatory approval processes around the world.
The vaccines are in phase three of clinical trials
There are currently 12 vaccines in large late-stage clinical trials worldwide, including those from American companies Novavax, Johnson & Johnson, Moderna Therapeutics and Pfizer, which are testing tens of thousands of people in the US and UK as volunteers.
In China, the state-owned pharmaceutical company Sinopharm has filed an application with the Chinese Regulatory Commission for approval of a vaccine, and hundreds of thousands of civilians have already been vaccinated for emergencies with Chinese government approval, according to a report from the New Yorker. Meanwhile, the privately owned Chinese pharmaceutical company Sinovac is advancing phase 3 trials for its own vaccine in Brazil, Bangladesh and Indonesia. CanSino Biologics, another private Chinese company, developed a vaccine that was distributed to members of the Chinese military in late July.
A collaboration in the UK between Oxford University and the European pharmaceutical company AstraZeneca also recruits volunteers in Brazil, India, the UK, the US, and South Africa. In Australia, the Murdoch Children's Research Institute is trying to check whether a vaccine to prevent tuberculosis can be used to vaccinate against the coronavirus.
Finally, the National Center for Epidemiology and Microbiology in Gamaleya, in collaboration with the Russian State Direct Investment Fund in Russia, has claimed to have developed a vaccine that the country first registered on the market and cleared for widespread use. Russia has not released data from the clinical trials it allegedly conducted to prove the vaccine's effectiveness, and the World Health Organization still considers the treatment to be in the first phase of development.
Therapies in third phase clinical trials
If vaccines can prevent infection, a number of companies are also working to limit the severity of the disease in case someone becomes infected with Sars-Cov-2, the novel coronavirus that causes COVID-19.
The Milken Institute lists 41 different therapies that have made it into the third phase of their clinical trials (the final phase before approval for widespread use).
These therapies are divided into one of five main categories: antibody therapies, antivirals, cell-based therapies, RNA-based treatments, and the reuse of existing treatments that may be in pharmaceutical purgatory.
Antibody therapies use the body's natural defense systems, either drawn from the blood of people who have recovered from an infection or made in a laboratory to neutralize the spread of a virus or bacteria. In contrast, antivirals prevent a virus from spreading by attacking the viruses' ability to replicate. Cell-based therapies are designed to strengthen the immune system's ability to fight pathogens such as viruses or bacteria. Meanwhile, RNA-based treatments are another way to stop the virus from replicating by blocking the construction of viral proteins. Finally, several companies are searching their libraries of legacy drug compounds to see if candidates are eligible for COVID-19 treatments.
To date, only three therapeutics have been approved for the treatment of COVID-19. Dexamethasone has received approvals in the UK and Japan, while favilavir is used in China, Italy and Russia. and, known for its use by the President, remdesivir has been approved in the United States, Japan and Australia.
The US also uses convalescent plasma to treat hospital patients under emergency clearances. And special cases like the president's had access to other experimental treatments like Regeneron cell therapy under emergency clearances.
In each of these areas, several U.S. startups are developing potential COVID-19 therapies.
Adaptive Biotechnologies, Cytovia Therapeutics, and SAB Biotherapeutics all develop antibody treatments. Applied Therapeutics is leveraging understanding of existing connections to develop treatments for certain conditions associated with COVID-19. Cellularity has cell therapy that can reduce a patient's viral load by stimulating natural killer cells to attack infected cells. Humanigen has developed a new drug that can reduce deaths in high-risk COVID-19 patients with severe pneumonia. Meanwhile, Partner Therapeutics is working on a drug that can improve lung function in COVID-19 patients and potentially increase antibody production against the virus and restore damaged lung cells. Finally, Sarepta Therapeutics has worked with the U.S. Army Medical Research Institute for Infectious Diseases to find ways for its RNA-based treatment to stop the spread of coronavirus by attacking the virus' ability to replicate.
Beyond therapies, startups are finding other ways to help the nation fight the COVID-19 epidemic.
"At this point in time, the US doesn't have the best public health system, but at the same time we have world-class private companies that can sometimes operate much more efficiently than governments," said Eran Bali, CEO of Carbon Health, telling the audience at TechCrunch's Disrupt 2020 conference. “We recently started a program to help COVID-positive patients get better quickly, a rehabilitation program. Because as you know, even if you survive, it doesn't mean your body will not be affected. "
In fact, the pursuit of more effective home testing and remote treatments is arguably more important for consumers when the federal government refuses to make preventing the spread of viruses a priority, as consumers can voluntarily bans if the government does not.
"This is an opportunity to take a technology that is naturally about detecting viruses – that's exactly what CRISPR does in (its natural environment) bacteria – and using it to quickly diagnose coronaviruses," the one with the said Nobel Prize Winning Company Inventor of Basic CRISPR Gene Editing Technology, Jennifer Doudna. "What we find in the lab is that this means you can get a signal faster and you can also get a signal that is more directly correlated with virus levels."