The advent of commercial genome sequencing has recently, and credibly, been compared to the invention of the microscope, a claim that led me to wonder whether this new, still relatively obscure technology, humming away in well-equipped labs around the world, would prove to be the most important innovation of the 21st century.
And unexpectedly, Covid-19 has proved to be the catalyst. “What the pandemic has done is accelerate the adoption of genomics into infectious disease by several years,” says deSouza, the Illumina chief executive. He also told me he believes that the pandemic has accelerated the adoption of genomics into society more broadly — suggesting that quietly, in the midst of chaos and a global catastrophe, the age of cheap, rapid sequencing has arrived.
Science Staff Writer Kelly Servick discusses how physicians have sifted through torrents of scientific results to arrive at treatments for SARS-CoV-2.
Sarah also talks with Wesley Reinhart, of Pennsylvania State University’s Department of Materials Science and Engineering and Institute for Computational and Data Science, about why we should be building smart cities from smart materials, such as metamaterials that help solar panels chase the Sun, and living materials like self-healing concrete that keep buildings in good shape.
From Scientific American (March 1, 2021):
Enter the intranasal vaccine, which abandons the needle and syringe for a spray container that looks more like a nasal decongestant. With a quick spritz up the nose, intranasal vaccines are designed to bolster immune defenses in the mucosa, triggering production of an antibody known as immunoglobulin A, which can block infection. This overwhelming response, called sterilizing immunity, reduces the chance that people will pass on the virus.
The development of highly effective COVID vaccines in less than a year is an extraordinary triumph of science. But several coronavirus variants have emerged that could at least partly evade the immune response induced by the vaccines. These variants should serve as a warning against complacency—and encourage us to explore a different type of vaccination, delivered as a spray in the nose. Intranasal vaccines could provide an additional degree of protection, and help reduce the spread of the virus.
Researchers are scrambling to understand the biology of new coronavirus variants and the impact they might have on vaccine efficacy.
Around the world, concern is growing about the impact that new, faster-spreading variants of the SARS-CoV-2 virus will have on the pandemic.
In this episode of Coronapod, we discuss what these variants are, and the best way to respond to them, in the face of increasing evidence that some can evade the immunity produced by vaccination or previous infection.
As new coronavirus variants sweep across the world, scientists are racing to understand how dangerous they could be. WSJ explains. Illustration: Alex Kuzoian/WSJ
How does each of the available Covid-19 vaccines work?
Once the vaccine is injected, the mRNA is taken up by the macrophages near the injection site and instructs those cells to make the spike protein. The spike protein then appears on the surface of the macrophages, inducing an immune response that mimics the way we fight off infections and protects us from natural infection with SARS-CoV-2. Enzymes in the body then degrade and dispose of the mRNA. No live virus is involved, and no genetic material enters the nucleus of the cells.
Although these are the first mRNA vaccines to be broadly tested and used in clinical practice, scientists have been working on mRNA vaccines for years. And despite this wonderful parody piece. opens in new tab saying that the technology is “obvious,” in fact the breakthrough insight that put the mRNA inside a lipid coating to prevent it from degrading is quite brilliant — and yes, this may be the first time the New England Journal of Medicine has referenced a piece in The Onion. (Last reviewed/updated on 11 Jan 2021)
How should early side effects be managed?
Analgesics and antipyretics such as acetaminophen or ibuprofen are effective in managing post-vaccine side effects including injection-site pain, myalgias, and fever. However, the CDC does not recommend prevaccine administration of these drugs, as they could theoretically blunt vaccine-induced antibody responses.
Because of the small risk of anaphylaxis, sites that administer the vaccines must have on hand strategies to evaluate and treat these potentially life-threatening reactions. The CDC has issued recommendations on how sites should prepare. opens in new tab. (Last reviewed/updated on 11 Jan 2021)
How long will the vaccines work? Are booster doses required?
Since the vaccines have been tested only since the summer of 2020, we do not have information about the durability of protection. Data from the phase 1 trial of the Moderna vaccine suggested that neutralizing antibodies persisted for nearly 4 months. opens in new tab, with titers declining slightly over time. Given the absence of information on how long the vaccines will be protective, there is currently no specific recommendation for booster doses. (Last reviewed/updated on 11 Jan 2021)
Do the vaccines prevent transmission of the virus to others?
Many commentaries on the results of the vaccine clinical trials cite a lack of information on asymptomatic infection as a limitation in our knowledge about the vaccines’ effectiveness. Indeed, this is a theoretical concern, since up to 40% of people who get infected with SARS-CoV-2 have no symptoms but may still transmit the virus to others.
Nonetheless, there are several good reasons to be optimistic about the vaccines’ effect on disease transmission. First, in the Moderna trial. opens in new tab, participants underwent nasopharyngeal swab PCR testing at baseline and testing at week 4, when they returned for their second dose. Among those who were negative at baseline and without symptoms, 39 (0.3%) in the placebo group and 15 (0.1%) in the mRNA-1273 group had nasopharyngeal swabs that were positive for SARS-CoV-2 by RT-PCR. These data suggest that even after one dose, the vaccine has a protective effect in preventing asymptomatic infection.
Second, findings from population-based studies now suggest that people without symptoms are less likely to transmit the virus to others. Third, it would be highly unlikely in biological terms for a vaccine to prevent disease and not also prevent infection. If there is an example of a vaccine in widespread clinical use that has this selective effect — prevents disease but not infection — I can’t think of one!
Until we know more, however, we should continue to emphasize to our patients that vaccination does not allow us to stop other important measures to prevent the spread of Covid-19. We need to continue social distancing, masking, avoiding crowded indoor settings, and regular hand washing. (Last reviewed/updated on 11 Jan 2021)
Over the course of the pandemic, scientists have been monitoring emerging genetic changes to Sars-Cov-2. Mutations occur naturally as the virus replicates but if they confer an advantage – like being more transmissible – that variant of the virus may go on to proliferate.
This was the case with the ‘UK’ or B117 variant, which is about 50% more contagious and is rapidly spreading around the country. So how does genetic surveillance of the virus work? And what do we know about the new variants? Ian Sample speaks to Dr Jeffrey Barrett, the director of the Covid-19 genomics initiative at the Wellcome Sanger Institute, to find out Coronavirus – latest updates See all our coronavirus coverage.
Virologist Angela Rasmussen talks about her battle against misinformation in the media, the virus, vaccines, disinfecting surfaces, home testing, and the next pandemic.
Eric J. Topol, MD: Hello, I’m Eric Topol for Medscape, and this is Medicine and the Machine. I’m so glad to have my colleague and partner in this podcast, Abraham Verghese, with me from Stanford. Today, we have the rarefied privilege to discuss the whole pandemic story, the virus and vaccines, with one of the country’s leading virologists, Dr Angela Rasmussen. Welcome, Angie.
Angela L. Rasmussen, MA, MPhil, PhD: Thank you so much for having me, Eric. It’s wonderful to be here.