Can We Wipe Out All Coronaviruses for Good?
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Already the authors list is very impressive. Lots of people!
>The problem sparks when a viral strain, normally happily living in a bat, pig, or rodent
That's the rub right there. One of the reasons we were successful with smallpox is there wasn't an animal reservoir. One virus + no animal reservoirs + good vaccine = can be successful. Multiple known viruses and strains with multiple reservoirs and no good vaccines means this will not happen.
More to the point, this isn't really what the paper was looking at all. The actual (OA) publication[1] identified common and conserved areas which could potentially be used to study and target viruses throughout out the family. This might help with human SARS-CoV2 therapeutics, but it's main benefit is showing how molecular analyses will help fight future coronaviruses.
It does not ask or answer whether we can "engineer a universal vaccine against the entire viral family" nor did it "[draw] up a scientific recipe to potentially end coronaviruses once and for all."
1: https://science.sciencemag.org/content/early/2020/10/14/scie...
How is the FDA's reputation going to hold up when they approve all these vaccines a year or more after they were created and cost the lives of millions and trillions of dollars?
The FDA had no pandemic vaccine approval protocol which could have speed up the process. They could have used challenge trials with young healthy people. I can think of a pre approved process for mRNA vaccines where the delivery methods are approved but the only thing that changes is the mRNA payload.
I blame the government healthcare organizations for a lot of the impact from covid-19. First, they were anti-mask during the first major increase in the virus and now they are being overly cautious in approval of vaccines. They are way off on their cost - benefit math.
So whereas the US has currently had a total of about ~10 million cases to date, this represents about 3.3% of the total population. There have been about 200,000 deaths so far, so the US case-fatality rate is about 2% - note, the mortality rate is most likely quite a bit lower overall since it's spreading so much. This is simply deaths vs. observed cases.
EDITED(got the math off by a factor of 10 here previously - at 0.01% fatality it's not 360,000 - that said, see comments below, actually establishing that in clinical trials is not easy): Let's suppose we rush through a vaccine that turns out to cause fatal complications in 0.01% of the population, and we give it 90% of the population. Straight up - we've just killed 36,000 people. But that's assuming that the complications are binary - but COVID-19's complications aren't binary, and neither would negative side-effects be. So we might kill a bunch of people, and injure tens of thousands more seriously. Or we might have inadequately diverse trials and miss a whole population of potential negative side-effects (a classic problem in a lot of trials: university aged students with the distribution of whichever university developed the product are over-represented in samples).
You cannot rush clinical trials. To even stand a hope of getting to 0.01% risks you need a population of at least several thousand in your trial. You need to monitor them aggressively because hopefully you have good data that whatever can go wrong will be slow enough you can intervene, but...there are always risks. Clinical trials can and do go badly wrong and people involved in them are taking a selfless risk for the betterment of the rest of us - and that's a very different proposition to declaring "this'll probably be fine" and not collecting the data.
Phase III trials don't run with enough participants to detect 0.01% effects with any confidence. These are generally found postmarketing, like Vioxx. In terms of vaccine harm, a badly behaved swine flu vaccine caused 3 cases of narcolepsy per 100k juveniles vaccinated. This effect simply would never be seen in Phase III trials.
Finally, beyond the raw CFR we need to consider other adverse outcomes from covid: cognitive impairment following mechanical ventilation and cardiac damage are two that really worry me.
I've amended the post's math - it's definitely not as hard a point, but the secondary consideration I didn't include was that it's also not an all or nothing proposition - a fatality rate from a vaccine is one thing, but even COVID-19 doesn't just have a fatality rate - it's got a much much higher "severe long term complications" rate. Which is also very much what you're looking for with trials.
Having things look good after 3 months in a vaccine trial doesn't tell you if they look good after a year necessarily - and all of this is really weighted against "a sensible response to limit the spread of the virus is possible, the US is just not doing it".
EDIT: The other possibility is that a vaccine that just straight up doesn't work very well would also make the situation worse - churn out millions of doses, get a limited amount of immunity in the recipient population, government is compelled to wind back "mechanical" spread prevention measures - and the epidemic cinders for a while and then rips through the population because everything thinks they're immune.
Because if it doesn't work, you haven't had a doctor give someone something with unforseen side-effects: they injected them with a deadly virus and killed them (in the worst case).
Now we have treatments like Regeneron which the President received, which most likely made a very big difference in his fairly rapid convalescence - doing it when you have more plausible interventions if it doesn't work is quite different.
I mean all of this stuff is, relatively, going at lightning pace - if we have a vaccine early next year, that's what, 1.5 years between initial detection and immunization for a novel virus? That is breakneck pace.
I believe the silver bullet for future pandemics will be pre-approved mRNA vaccine pathways with the only change to the specific vaccine being the mRNA payload that targets the pathogen. Then testing could be a lot more straightforward and quicker which could end future pandemics.
Might wanna check that math, dude.
Even with your preposterously deadly made-up vaccine, you’re only hitting about one month’s worth of COVID deaths.
[1] https://timesofindia.indiatimes.com/life-style/health-fitnes...
My question is why are you cosplaying as a mod?
The seminal book on this (for me) has been Dietrich Dörner's "The Logic of Failure".
The question you'd have to ask is whether some low level amount of coronaviruses is important to human survival. It seems like it's not. We have certainly seen the opposite effect -- people get pretty sick when you kill off all their gut bacteria (it lets unhelpful bacteria reproduce, and the bacteria actually perform digestive functions). Unfortunately, we didn't really realize that until we developed the technology to kill bacteria indiscriminately, so I see the worry. But I doubt anyone will be harmed by having too few coronavirus infections, so I'm probably not worried this time.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006373/
'Lower risk for cancer has also been associated with a history of febrile viral diseases.'
I am all for a controlled fashion.
Only recently. Widespread vaccine use is a fairly recent phenomenon.
> Eradicating smallpox has apparently saved 5 million lives a year!
It certainly saved lives but we really don't know how much. Every estimate is off of cherrypicked data.
> But I doubt anyone will be harmed by having too few coronavirus infections, so I'm probably not worried this time.
You just said we fucked up with bacteria and then you brush off viruses.
There was a time when the scientific consensus was to snuff out every small fire to prevent wildfires. Now we realize how horribly naive that was. By preventing small localized fires, we allowed kindle wood to mass which fueled gigantic wildfires. That fires are natural and helps forests clear and rejuvenate itself.
The same thing with parents and kids avoiding food/sickness. It lead to food allergies ( some of which can be deadly ) and poor adult immune system. Now we know a bit of sickness helps strengthen the immune system and introduction to a wide variety of foods helps prevent food allergies.
The history of humanity/science/etc is we were wrong. But as long as we learn and move forward, that's what is important.
I believe it is correct to say we eradicated the disease but we don't know if the virus died
Smallpox still exists in the form of monkeypox in the wild and as rabbitpox in labs
FDA approved a new drug to treat smallpox (only tested on monkeys and rabbits infected with monkeypox and rabbitpox) in 2018 because smallpox resurgence does remain a realistic threat and having a stock pile of at least two different vaccines that attack the virus in different ways is the only way to prevent it from becoming drug resistant
- Spread by contact
- Off-the-scale virulent
- Trivial to turn into a vaccine
- Not present in animal reservoirs
Off the top of my head, “How to Survive a Pandemic” by Michael Greger suggests pandemics may be an emergent, new-normal. Many of the factors which led to this pandemic are not going to be mitigated without broad, deep, and costly changes to how agriculture function. The medications used in raising and killing cattle, chicken, pigs, and etc combined with the scale of those activities act as a breeding ground for viruses which are statistically likely to become pandemics.
> We lost the “War on Terror”, we lost the “War on Drugs”, and as long as we keep declaring war on fundamental forces of nature, we will keep losing. The only way to win is not to play.
Cause ya know, that was pretty worthwhile.
Just because we didn't eradicate human feeding mosquitoes doesn't mean it wasn't hugely worthwhile to play the game of controlling them.
Coronaviruses are definitely not in that category.
If/when we have another, more damaging pandemic, I expect the lesson about how powerful a tool social distancing is to sink in more widely (we are somewhat accidentally having a mild flu season so far; just changing attitudes about what is appropriate when symptomatic would be a benefit, you don't need to do big lockdowns to benefit).