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An Antibody “Cocktail” for COVID-19: Bottoms Up!

By Shlomo Maital

             In medical research, sometimes old tried-and-true ideas become new.

             In HIV AIDS research, researchers tried to find an antibody that would defeat the virus, if injected or consumed by patients. It didn’t work. The virus always found a way. The solution? Cocktails – combinations of antibodies, which taken together the virus could not defeat. And to this day, those who are HIV positive do quite well, relatively, when they regularly take the new ‘cocktail’. One of those drugs is called “Retrovir”. David Ho is generally regarded as the HIV cocktail pioneer, supported by the Rockefeller Foundation.

           A similar approach proved effective with the Ebola virus. Late last year it was reported that: “ …a team of scientists demonstrated that a two-antibody cocktail called MBP134 could fully protect nonhuman primates and ferrets against lethal Ebola virus infections.”

           Now comes a biotech company called Regeneron, which has embraced the same principle. According to CNN and Peter Sullivan, writing for thehill.com:

   Regeneron is testing a cocktail of two antibodies to both treat and prevent the coronavirus, developed using people who have recovered from COVID-19 as well as genetically modified mice.   The company did not give a firm timeline for its work, but these antibody cocktails could be ready sooner than a vaccine.   A competitor company also working on the idea, Eli Lilly, said its antibody treatment could be as ready as early as September; it started trials earlier this month.  

“We have created a unique anti-viral antibody cocktail with the potential both to prevent and treat infection,” Dr. George Yancopoulos, chief scientific officer of Regeneron, said in a statement.   The antibody cocktail “could have a major impact on public health by slowing spread of the virus and providing a needed treatment for those already sick — and could be available much sooner than a vaccine.”

    We learned from treating HIV AIDS that a two-pronged approach is needed: Develop anti-viral drugs, while you develop anti-viral vaccines.  To this day no vaccine for HIV has been found.

      This is happening with COVID-19 as well. Drugs and vaccines.  Meanwhile, a vast army of hard-working scientists all over the world are collaborating, sharing results, and working day and night, to defeat this wily virus.

    They give us reason for much hope.

Conquering Ebola:  How They Did It

By Shlomo Maital

ebola

  As usual, the deaths and suffering from Ebola got far more media attention than the team of brave and creative people who have conquered it. (Global New York Times, Aug. 1-2, 2015, p. 6)

  It started in Canada.  Researchers at the Public Health Agency of Canada created an experimental vaccine (yup – that’s right,  a government agency!).  They took a piece of the virus’s covering and combined it with an animal virus (vesicular stomatitis virus), to set off an immune reaction against Ebola. I can only imagine the risks involved in working with such a virulent and often-fatal virus, in a lab. 

   A private biopharm company, NewLink Genetics, based in Ames Iowa, licensed the breakthrough vaccine, and last November, Merck, Big Pharma, did too. 

   The clinical trial was crucial.  It was led by the WHO,  Guinean Health Ministry, Doctors Without Borders, Epicentre Research and the Norwegian Institute of Public Health.

    Among the clinical trial innovations: a beer-keg-shaped storage device, the Arkteck, that kept the vaccines at minus 80 degrees without electricity, so that they could be transported.   The keg was invented by Global Good, a collaboration between an investment company Intellectual Ventures and Bill & Melinda Gates’ Foundation.

     None of those vaccinated in the trial,  about 4,000 people, contracted the disease, even when exposed to it.  The main use will be to vaccinate medical workers exposed to Ebola, rather than huge populations.

     What do we learn from this?  Simple.   To tackle a really hard problem, you need to put together global collaborations – governments, NGO’s, companies big and small, volunteers, African governments,   and they need to work together seamlessly, each contributing his or her own creativity and energy.  In the end, courageous lab workers did the job, but it took the whole ‘village’ to save a child, or many many of them. 

    The whole ebola virus vaccine eco-system deserves a Nobel.

Ebola — Fact vs Fiction

By Shlomo Maital

ebola

As a would-be journalist, I’ve followed closely how the media report on the Ebola virus epidemic in Africa.   America’s NPR (National Public Radio) is excellent – but even NPR has spread hysteria and has reported very badly on the issue.   There is something about this deadly little virus that kills half the people it afflicts, that frightens people. And the media play into these fears, by amplifying them. Shame on them.

The Economist rides to the rescue. As always it brings us the truth, with the facts well explained.   In the Oct. 18 issue, here is what The Economist explains:

  • The number of infections (in West Africa – mainly Sierra Leone, Guinea and Liberia) is doubling every 2-4 weeks.   Meanwhile, though, Senegal and Nigeria have been declared ebola free. So it is possible to stamp it out.
  • If something doubles every, say, 3 weeks,   then in 10 doublings (30 weeks, or about half a year), it is 1,024 times greater.   So if 10,000 people have Ebola virus today in West Africa, 10 million will have it in half a year. This is why it is so urgent to come to the rescue of these three countries.
  • If the West does wake up and send help, the goal is simple: Get the infectious rate down, in West Africa,  from 1.5 to 2.2 persons per infected person (i.e. every person who has Ebola infects 1.5 to 2.2 other persons, today), to less than 1.   If this ratio, known as Ro, is less than one, then the power of compounding works to our favor.   Soon, Ebola disappears.     You can only get the Ro number down by having more hospitals, more trained health workers, faster medical care, etc.   Get people infected to quarantine quickly.  This is done instantly in the West,  but West Africa does not have the means. 
  • This is not a Western problem YET.   The West has a moral obligation to help West Africa, whose economies have been devastated.   But it WILL be a Western problem, if a half year goes by and the Ro remains at around 2. Then the Ebola will simply not be capable of being stamped out.
  • Why is Ebola so fatal and so dangerous? Because it is fiendishly clever, even though of course it does not have a brain. Ebola virus invades a cell, and makes it produce more viruses instead of the cell’s own DNA. Ebola has sugars on the outside coating of the virus, making it tough for the body’s immune system to attack it (antibodies stick to the glycoprotein instead of to the virus). The immune cells that the virus attacks race to the spleen, liver and lymph nodes and thus carry the infection there. Soon, the body over-reacts, and blood vessel walls become leaky, organs fail and the body goes into shock. President Obama has sent 3,000 U.S. soldiers to help Liberia. Much more is needed. Europe, of course, is sound asleep. And a lot of the money promised to   West Africa remains just that – a promise.   Unless the rich countries wake up, they will find themselves dealing with a problem that is one hundred times harder to solve.

 

  • All this – from a tiny virus!   How did it get so smart? It evolved – nature’s accidents created viruses that survive to procreate.

Why We STILL Need America – and Obama

By Shlomo  Maital

Long Ranger

 As a child, I recall listening to The Lone Ranger on the radio.  The Lone  Ranger wasn’t alone; his Indian friend Kemo Sabe rode with him. Together they fought evil, injustice, crime and helped the helpless.

  Today America is again The Lone Ranger.  Ebola outbreak?  America sends 3,000 soldiers to set up as many as 17 emergency treatment centers in Liberia.  Why? No other country can or will.  And Ebola is a threat to all of Africa and perhaps the world. Liberia is an entire nation under lock-down!  And health workers and journalists are murdered in Guinea, by suspicious villagers who think they are bringing the disease rather than fighting it.

  ISIS? (Obama is right.   It is really ISIL,  Islamic State in the Levant, because ISIL believes they will establish the Caliphate throughout the Mideast, including Lebanon and Israel. What you call things DOES matter!).   America to the rescue, leading a ‘coalition’, but have no doubt, most of the military action will be American.  Because Europe has given up defense spending and prefers to shelter under American defense spending.

    If there is a major humanitarian disaster somewhere in the world, that takes resources and abilities,  it will be largely America to the rescue. 

    So, yes, we can criticize America, Americans and their leader President Obama.  But as many have noted,  at present there is no other country who can come close to replacing America, in its will and ability to come to the rescue, like The Lone  Ranger.  And yes, America does stumble, fail to fully understand the cultures in which it operates, and yes, it does endlessly debate its decisions to intervene abroad.  But in the end,  like The Long Ranger, America is there.

    So – thanks, America.  We really do give you a bad rap.

 

Scientists Who Endanger Their Lives:  The Case of Ebola

By Shlomo  Maital    

ebola

   Scientific papers published in Science rarely involve heroism, drama, and life-threatening courage.   This one does:

Gire, SK, Goba, A et al. Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak. Science, 2014, online.

    Here is the story, as described in a dry press release by Harvard:

     “ n response to an ongoing, unprecedented outbreak of Ebola virus disease (EVD) in West Africa, a team of researchers from the Broad Institute and Harvard University, (MIT-Harvard),  in collaboration with the Sierra Leone Ministry of Health and Sanitation and researchers across institutions and continents, has rapidly sequenced and analyzed more than 99 Ebola virus genomes. Their findings could have important implications for rapid field diagnostic tests. The team reports its results online in the journal Science.”

       The research was led by Broad Institute researcher Pardis Sabeti, Augustine Goba, Director of the Lassa Laboratory at the Kenema Government Hospital in Sierra Leone, and Stephen Gire, first author,  a research scientist in the Sabeti lab at the Broad Institute and Harvard.  The team  shipped samples back to Boston, and then  20 people worked around the clock.   In one week:  they decoded gene sequences from 99 Ebola samples!  This is truly amazing. 

        What the team did was to act rapidly to collect samples of Ebola from a Sierra Leone hospital last April, when the outbreak began, and then gathered additional samples as the virus spread and mutated.  They did this under life-threatening conditions, especially those on the ground on-site, because at the time there was insufficient protective gear for hospital workers, and some indeed died. 

       They gathered 99 samples of Ebola in all. Then they decoded the genome of each sample.  This was unprecedented in its speed.   What they found was important.  The Ebola virus has only 7 genes (!) compared to the human genome, comprising more than 20,000 genes.  Like all viruses, Ebola penetrates the human cell and commandeers its DNA mechanism, to make more viruses rather than human DNA.  Ebola is fatal in 52 per cent of all cases.

      The Broad Institute researchers found that Ebola initially spread from an animal to a human.  BUT —  from then on, it ONLY spread among humans.  The initial call to avoid mangos and meat was uncalled for.  And like all viruses, they found that the virus evolved and mutated very quickly in humans.  So, we are in a race, between ‘brilliant’ humans with huge brains, and ‘stupid’ viruses with only 7 genes ..and at the moment, the viruses seem to be winning. 

   I salute the courageous scientists and their assistants on-site, for risking their lives to help save the lives of others.  Sometimes, not often, science is life-threatening,  and quickly, life-saving. 

     In this space, I’ve been fiercely critical of Big Pharma, which rips us off by charging scandalously high prices for drugs with minimal impact.  But for once,  Big Pharma is doing the right thing.   GSK Glaxo Smith Kline is helping the U.S. National Institutes of Health to develop an Ebola vaccine.  Only GSK’s huge productive capacity can do this quickly enough to combat the spread of Ebola. 

    

 

 

 

 

 

By Shlomo  Maital    

   Scientific papers published in Science rarely involve heroism, drama, and life-threatening courage.   This one does:

Gire, SK, Goba, A et al. Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak. Science, 2014, online.

    Here is the story, as described in a dry press release by Harvard:

     “ n response to an ongoing, unprecedented outbreak of Ebola virus disease (EVD) in West Africa, a team of researchers from the Broad Institute and Harvard University, (MIT-Harvard),  in collaboration with the Sierra Leone Ministry of Health and Sanitation and researchers across institutions and continents, has rapidly sequenced and analyzed more than 99 Ebola virus genomes. Their findings could have important implications for rapid field diagnostic tests. The team reports its results online in the journal Science.”

       The research was led by Broad Institute researcher Pardis Sabeti, Augustine Goba, Director of the Lassa Laboratory at the Kenema Government Hospital in Sierra Leone, and Stephen Gire, first author,  a research scientist in the Sabeti lab at the Broad Institute and Harvard.  The team  shipped samples back to Boston, and then  20 people worked around the clock.   In one week:  they decoded gene sequences from 99 Ebola samples!  This is truly amazing. 

        What the team did was to act rapidly to collect samples of Ebola from a Sierra Leone hospital last April, when the outbreak began, and then gathered additional samples as the virus spread and mutated.  They did this under life-threatening conditions, especially those on the ground on-site, because at the time there was insufficient protective gear for hospital workers, and some indeed died. 

       They gathered 99 samples of Ebola in all. Then they decoded the genome of each sample.  This was unprecedented in its speed.   What they found was important.  The Ebola virus has only 7 genes (!) compared to the human genome, comprising more than 20,000 genes.  Like all viruses, Ebola penetrates the human cell and commandeers its DNA mechanism, to make more viruses rather than human DNA.  Ebola is fatal in 52 per cent of all cases.

      The Broad Institute researchers found that Ebola initially spread from an animal to a human.  BUT —  from then on, it ONLY spread among humans.  The initial call to avoid mangos and meat was uncalled for.  And like all viruses, they found that the virus evolved and mutated very quickly in humans.  So, we are in a race, between ‘brilliant’ humans with huge brains, and ‘stupid’ viruses with only 7 genes ..and at the moment, the viruses seem to be winning. 

   I salute the courageous scientists and their assistants on-site, for risking their lives to help save the lives of others.  Sometimes, not often, science is life-threatening,  and quickly, life-saving. 

     In this space, I’ve been fiercely critical of Big Pharma, which rips us off by charging scandalously high prices for drugs with minimal impact.  But for once,  Big Pharma is doing the right thing.   GSK Glaxo Smith Kline is helping the U.S. National Institutes of Health to develop an Ebola vaccine.  Only GSK’s huge productive capacity can do this quickly enough to combat the spread of Ebola. 

Blog entries written by Prof. Shlomo Maital

Shlomo Maital

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