On Jan. 11, 2020, the headlines weren’t about the novel coronavirus.
That day, the United States Congress was preparing articles of impeachment and Iran finally admitted that it shot down a Ukrainian airliner by mistake.
In China, however, two less-noticed stories were developing that would ultimately have profound consequences for the entire world.
From Wuhan came the first reports that a regular customer at a seafood market had died from an unidentified virus, while in Shanghai, a team of researchers had, with amazing speed, just produced the entire genetic sequence of the virus.
The first story was confirmation of an approaching descent into a global public health catastrophe. The second represented potential salvation from it.
Professor Zhang Yongzhen led the team of scientists that identified the viral building blocks of the SARS-CoV-2 genome. According to news reports, on Saturday the 11th, Zhang was persuaded by a colleague in Australia to share the data online.
And so he did.
That decision didn’t stop the virus in its tracks, but it gave scientists around the world a giant leap forward in combating a new and highly contagious disease, newly dubbed COVID-19.
“The sharing of expertise and experiences from China was very important,” says Raywat Deonandan, an epidemiologist with the faculty of health sciences at the University of Ottawa.
“We can complain about maybe some lack of transparency, maybe some incomplete data, but what was shared is critical in allowing us to respond to this pandemic.”
In an age of unparalleled mobility and transportation, there has never been such a dangerous virus that spread so quickly around the globe. But so, too, did information about the virus, traded and shared by researchers everywhere.
Understanding the virus helped other scientists develop tests to diagnose it, which assisted hospitals, doctors and nurses to treat it. And while that alone saved countless lives, the bigger breakthrough would take much longer and remained fraught with uncertainty: creating a vaccine.
The holy grail of a pandemic — a vaccine — would protect humans from the virus and bring life on earth back to normal.
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Work began almost immediately on close to 200 vaccine variants in pristine laboratories from China, Russia and India to Germany, the U.K. and the United States.
The virus, however, wasn’t waiting. In February, it had spread from China to as far away as Europe. It took a terrible toll in Italy and Spain. By March, COVID-19 had reached the west coast of North America and clusters of infections began to mushroom in New York City, but also in nursing homes in the province of Quebec.
Communities and entire nations were locked down in ways that few people had ever experienced. At the same time, governments committed billions of dollars to fast-track research.
In early May, the European Commission president, Ursula Von Der Leyen, announced to applause that countries from Europe and elsewhere had “collectively pledged 7.4 billion euros for vaccines, diagnostics and treatments,” and had done so in the space of a few hours.
A vaccine couldn’t come quickly enough. The virus seemed unstoppable, and all previous vaccines had required at least four years to be developed.
The basic concept is straightforward: elicit the human body’s immune response to an invading virus. Some vaccines use a weakened version of a virus, or fragments of it, or a completely harmless virus to trigger the immune system.
But the complete genetic sequence from China spurred new ideas, such as a vaccine made from part of the virus’s genetic code. Messenger RNA (mRNA) can tell human cells to produce spike proteins just like the ones on the surface of this coronavirus. In theory, the immune system will produce antibodies and activate T-cells to attack the infection and, most importantly, will be ready for the actual virus when it shows up.
“We never touch the virus,” said Gregory Glenn of Novavax. “We make the protein. And we can inject that and have an immune response to the spike protein that will be protective.”
Simple and, seemingly, safe.
“The genetic sequence was critical in all of this,” says Deonandan. “It allowed us to identify the nature of the virus very, very quickly so we knew it was a coronavirus, and we could predict how its behaviour would unfold.”
With extraordinary government collaboration, manufacturers moved rapidly through development, testing and trials. Among rival pharmaceutical makers there was competition, but also co-operation.
“All the vaccine manufacturers are working together, co-operating wherever required,” said Adar Poonawalla, the chief executive of Serum Institute of India. “We are all in a race to battle the disease — there is no one-upmanship here.”
For Poonawalla, the sooner there is a vaccine the sooner lives can be saved.
Still, vaccines take time. One of the developers of the new mRNA vaccines, Moderna, began last March testing just 45 volunteers — a small number to limit the potential harm. It took two doses and 10 weeks of monitoring — you can’t hurry up the human body’s response to experimental treatments.
As results were processed and vaccine doses fine-tuned, regulatory approval also became more responsive, and next phases were started quickly.
More than 30,000 participants were needed for Moderna’s final, Phase 3 trials. It helped enormously that the search for volunteers was easy – they were everywhere in large numbers, and a raging pandemic ensured no shortage of those who would test positive, which is essential in vaccine trials.
“The duration of the trial is determined by how quickly you can get people testing positive for the disease,” says Deonandan. “So the more people you have, the more likely they’re going to test positive. So this compressed what would have been years of data collection into weeks. It changed everything.”
By summer, the rate of COVID-19 infection eased up in many places, and the vaccine still seemed far off. But governments began to line up for them.
In Canada, the Trudeau government secured doses by the millions from Pfizer-BioNTech, Moderna, Johnson and Johnson and others: contracts for more vaccines per capita than any country in the world. The over-purchase is sort of an insurance policy against failure, but if successful would cover more than 150 million people — four times greater than Canada’s population.
In August, Prime Minister Trudeau announced, “We’re making sure that if one of these potential vaccines is successful, Canada and Canadians will have access to the doses they need.”
The importance of those pre-purchases would become apparent within weeks as a new wave of the pandemic swept in with the autumn weather. In September the world reached what the UN secretary-general called an “agonizing milestone”: the astonishing loss of one million lives from COVID-19. The number of cases surged once more, followed predictably by an increase in hospitalizations and deaths.
But as a dark winter loomed, a bright light flickered on.
“We have a vaccine for the world,” declared Andrew Pollard of the Oxford-AstraZeneca Vaccine Group in late November.
More than one vaccine manufacturer delivered startling results from their trials. Pfizer-BioNTech’s vaccine showed greater than 90 per cent effectiveness. Pfizer chairman Albert Bourla called the results overwhelming: “It is a great day for science. It is a great day for humanity.”
In December there were cheers for the first recipients of vaccines among front-line workers in Toronto. And it was hard not to get emotional when the first shot in Quebec City was given to an 89-year-old woman in long-term care. The province’s Public Security Minister Genevieve Guilbault called it the “first ray of sun in a long time.”
Tanya Harvey, a registered nurse in Calgary, appeared to tear up after getting her shot.
“It’s going to give us back our families, our communities, our lives, our loved ones. And it’s going to save people that we would have otherwise have lost.”
The swiftness of the science, the funding, the trials, the vaccine production and the global partnerships have paid off.
Vaccines that normally take years were produced in months. One of the epidemiologists who’s become a mainstay in the media helping Canadians understand infection curves and other cold data, Deonandan sounds almost awestruck by the scientific achievements: “The speed is the result of a singular focus of the entirety of civilization on one problem.”
He suggests the breakthroughs would not have been possible in the past, but technological advancements, the co-operation of researchers and the willingness of governments to engage unreservedly created what he calls “one of those magical moments in public health history.”
Canada, it seems, made a good call on which vaccines to pre-purchase, securing contracts on the first ones to be approved. And it has boosted its spending commitment to $865 million toward the international effort to bring treatments and vaccines to poorer countries. The World Health Organization’s director-general, Tedros Adhanom Ghebreyesus, singled out this country’s effort, saying he “would like to thank Canada and Prime Minister Trudeau for committing to share surplus doses of COVID-19 vaccines.”
Much of the world has only encountered COVID-19 during the seasons of warmer weather – now comes our first full-on winter pandemic. It is getting cold and the isolation will only be greater than it was last spring. Who knows how bad it will get in our hospitals and for the elderly before it’s over. Fatigue from the pandemic and frustration with political leadership is growing.
But vaccines are coming and much sooner than most experts believed possible just last winter. In what has been a very dark year, how lucky we are to have that first “ray of sun.”
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