HOW CLOSE ARE WE TO A VACCINE FOR COVID-19?

Trials a problem, but other drugs could also help

One of the first questions asked whenever an infectious disease pandemic looms is: “Is there a vaccine?”

The short answer is usually “no.” But the longer answer is that the world has never been more geared up to develop vaccines against emerging infectious diseases.

The rapid genetic sequencing and open publication by Chinese researchers of this latest coronavirus has been a boon for researchers, who have started work on vaccines, treatments and diagnostics.

Another advance is the development of Cepi, an organization set up in response to the lack of scientific progress when Ebola ripped through West Africa in 2014-16. Cepi’s mission is to rapidly respond to epidemics by providing the money to researchers to develop vaccines.

It harnesses the power of so-called “rapid response platforms,” which use what Dr. Richard Hatchett, its chief executive, describes as a “common backbone” that can be adapted quickly for different pathogens by inserting new genetic or protein sequences. It is already working on a vaccine against another coronavirus, Middle East respiratory syndrome (Mers), and Cepi announced in January that a vaccine for COVID-19 would be ready for testing by the end of May.

Israeli, Chinese and U.S. scientists also suggest they are close to making a vaccine. Such rapid progress is remarkable, but having a vaccine ready for testing is just the start of the journey. It will have to be trialled and will need regulatory approval — a long process that can be speeded up, as was done for the Ebola vaccine first used in the Democratic Republic of the Congo two years ago.

The biggest hurdle is manufacturing and distributing it at scale. The most optimistic pharmaceutical salesman would admit that it would only be ready by the end of this year — by which time, the outbreak may well have run its course.

Even then, it would probably be given to “key populations” first — health workers and the contacts of affected patients — before any mass vaccination.

But what doctors are pinning their hopes on are drugs for diseases, such as HIV and malaria, that they are repurposing for the coronavirus. The most promising is remdesivir, an antiviral drug developed by Gilead Sciences that began tests this week.

U.S. doctors first used the drug on a patient who didn’t respond to treatment in January — within 24 hours he showed improvements, eventually making a full recovery.

HIV anti-retroviral drugs have also been flagged as potential options, and there are at least two studies in China looking at a combination of lopinavir and ritonavir.