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by foogazi 2301 days ago
Are there national laboratories with the capabilities to find a cure?

Is there a NASA equivalent for infectious diseases to launch a covid-19 moonshot?

2 comments

Looks like there are a lot of companies deploying clinical trials to test existing antivirals already.

The NIH and all are likely already researching this strain, and importantly they're also funding labs in universities nationwide (since there's no reason to expect that a team of scientists who come up with the insights needed to find a cure would happen to already work for the government).

The government tends to be really good at getting things with clearly defined goals done, and they're good at rapidly scaling any work that needs massive funding an institutional support. But finding a cure for a viral infection is more of a creative task (and not a task that is important enough to be worth it likely - vaccination and preventative measures are probably more important and more feasible to implement since they don't necessarily require a scientific breakthrough).

The WHO is saying a vaccine is 18 months out, and I’m very curious what that means. I haven’t seen any detail as to why it takes that long.

It’s short enough that clearly they expect it won’t be very hard, like no one would say a general cure for cancer is 18 months out. So what is preventing us from speeding it up more? Why can’t it be made in 6 months, or 3 months? Is the majority of that 18 months a basic r&d phase of figuring out what will work? If so, why can’t it be parallelized and sped up with more resources? Is it time for clinical trials? To ramp up manufacturing? I can’t help thinking that for a disease that prevents such a big risk to society, there must be clever ways to speed up the normal process for this kind of thing, perhaps with some government involvement in funding or coordinating efforts.

> People have been saying a vaccine is 12-18 months out, and I’m very curious what that means. I haven’t seen any detail as to why it takes that long.

All the things you said are factors. Clinical trials are one of the biggest because you have multiple phases to observe to guarantee safety.

It's no use shipping a vaccine in 3 months after a small test and have everyone die in a year because of a side effect no one waited long enough to see.

Drug development and safety is a very complex space from what I've learned

Guaranteeing safety is absolutely a crucial part of it. And if you pull something out that doesn't work, giving people a false sense of immunity would also make things worse.

And safety shouldn't be underestimated. The story of dengue vaccine development is a cautionary tale. The first time you get dengue is usually not too bad, but it can be deadly if you get it again. Part of that is hypothesized to be driven by your own immune system, which, once immunized against one strain, produces antibodies against it in the next infection. However, if it's a slightly different strain of dengue the second time around, the antibodies meant to neutralize the disease are believed to make the disease more virulent instead (antibody-dependent enhancement). The immune system makes it worse. So when a dengue vaccine that didn't fully immunize against all strains was developed (not deliberately, people tried to immunize against all strains but this is a case where less efficacy than expected made things worse), it didn't make things better. It ended up priming people to get dengue.

Biology is super weird - even something as "simple" as vaccine development has a lot of unknown unknowns. And as dengue showed us, it's not just a case of "it might not work," because it could make things worse. That's why we have to run these clinical trials and take time to do things right, especially for something that would be as widely deployed as a coronavirus vaccine.