Even without a Covid-19 vaccine, there’s reason for hope

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A lot of hope has been placed on the possibility of a Covid-19 vaccine by the end of this year.

However, overcoming the technical challenges of developing a vaccine — and the safety issues inherent in making one that works for the populations most at risk — is no easy feat.

While it may be possible to deliver a vaccine by the end of this year, absolutely every step of its development would have to go perfectly. From experience, I can tell you how rare that is.

But even without a vaccine, there is reason for hope that a medical solution to the crisis will soon be at hand. It will likely take the form of anti-Covid drugs that will be able to treat patients newly infected and prevent others from becoming ill. These drugs can likely help us bridge the gap between where we are today — with only masks, hand hygiene and physical distancing to protect us — to where we hope to be tomorrow — with a vaccine in hand.

Recent studies have shown two types of drugs with particular promise. The first are antivirals — drugs that act on the virus itself and prevent it from replicating. Antivirals generally target either the enzymes a virus needs to copy its genome (polymerases) or those needed to cut larger proteins into smaller functional fragments (proteases). Coronaviruses, in general, are a target-rich environment for antivirals and this coronavirus, SARS-CoV-2, is no different than the others since it uses an active protease, a key protein responsible for the reproduction of the virus, to copy itself.

In a study published last month in Science, researchers announced their discovery of two new drug candidates that inhibit the SARS-CoV-2 protease. In test tube experiments, they found that the chemicals could bind to the protease and prevent replication, with one of them — a chemical designated 11a — more promising than the other. Chemical 11a will soon be tested for safety in humans, but early results from this study in dogs and mice suggest that the drug is both effective and non-toxic.

The other set of drugs showing promise are monoclonal antibodies, which are lab-created antibodies that work by blocking SARS-CoV-2 spike proteins from attaching to the ACE2 cell receptors in our body. By blocking the attachment, they prevent infection altogether. In another study published in June in Science, a separate set of scientists discovered two antibodies that each prevented different parts of the SARS2 spike protein from binding to the ACE2 receptor. While each of the antibodies on its own can neutralize the virus, together they are even more effective at preventing infection.

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