From the moment the pandemic started to spread, people with an inventive turn of mind have been applying themselves to the problem of identifying, preventing, and treating the novel coronavirus. Here are just a few of their efforts and the challenges they face.
Testing
Seegene, a South Korean company, began work on creating a test for the virus before it had even spread beyond China. It used artificial intelligence to rapidly identify the chemicals needed for the test – a thought-saving invention that allowed them to complete the process in just a matter of days, rather than the usual months. The test was ready and approved by the authorities within a matter of weeks. And due to South Korea’s widespread use of robots, the tests themselves can be undertaken extremely rapidly. Robotic arms test 94 patient samples at once, returning results in only 4 hours – significantly faster and less prone to error than doing so by hand. As a result, the country has conducted over a quarter of a million tests for the virus – almost five times as many as the UK, despite having similarly sized populations. South Korea continues to test as many people as possible, while the UK has apparently scaled back its testing of mild cases, presumably due to a lack of testing capacity. In the US, due to a severe lack of testing kits, some biologists in San Francisco have organised a volunteer effort to manufacture them.
Preventing
Teams of scientists all over the world are currently testing potential vaccines for the virus, at least one of which will hopefully bear results. The Kaiser Permanente Washington Health Research Institute, in Seattle, has just begun a 6-week trial of a prospective vaccine, mRNA-1273, in healthy adult volunteers. It has shown promising results in animals, but the human test will be the clincher. This is not just a matter of determining its effectiveness and safety, but about working out the most effective dosage – those brave volunteers, for example, are testing doses of 25, 100, and 250 micrograms. Likewise, scientists at Russia’s Vector Institute have begun vaccine tests in animals, and researchers at China’s Academy of Military Sciences are beginning human trials too. Israel’s Institute for Biological Research is also about to begin its own trials.
Even if the trials are successful, however, getting vaccines to the world’s population will take a lot more ingenuity. Successful ones will need to be produced at great scale, and with great care.
Treating
Despite the extraordinary rapidity with which vaccines have been able to get from the lab into human patients - largely thanks to advances in artificial intelligence and genome sequencing - having one that works and is available to everyone who needs it will take a matter of months.
In the meantime, the sheer number of cases worldwide has given us the opportunity to learn more about how to treat the virus. Initial reports have suggested that a few already-existing antiviral drugs may be effective against it. Yet these experiments still need to be replicated and confirmed. One of the top candidates is remdesivir, which was apparently successful when used to treat the US’s first patient. The drug now needs to be properly compared with placebos, though fortunately its general safety for humans is already well-established. It had already been tested as a candidate for treating ebola and MERS. Remdesivir is now the subject of a few randomised controlled trials, some of which should be reporting soon, and the manufacturer is already ramping up production just in case.
Chinese officials have also reported success using favipiravir, after trialling it in hundreds of patients, though Japanese trials (it is a Japanese-made drug) so far suggest it only works in milder cases and there are concerns there about potentially serious side-effects. Physicians in various countries have also reported success with drugs like Kaletra (a combination of lopinavir and ritonavir), typically used to treat HIV, as well as chloroquine, which has been used to treat malaria for decades (as well as a variant, hydroxochloroquine). As with remdesivir, however, we’re still waiting for their efficacy to be fully confirmed in randomised controlled trials.
Should none of these candidates prove effective, there are also a host of other organisations developing drugs from scratch. We can expect many of them to be tested in humans over the coming months, particularly as the authorities have become far more willing than usual to approve such tests.
Apart from the chemicals, the treatment of coronavirus has physical challenges. There is a widespread concern that many countries lack sufficient respirators to provide oxygen to those patients who have severe cases of the disease. There are so few ventilators in the UK, for example, that we would have to “flatten the curve” to impossibly low levels unless there is a dramatic increase in ventilator capacity. In Italy, this has already become a severe issue, though some inventors have stepped in to fill gaps in the supply chain. When a hospital in Brescia desperately needed new valves for its machines, and the manufacturer was unable to supply replacements, they turned to a number of local 3D-printing companies to manufacture the part - despite the fact that the manufacturer apparently refused to share blueprints and threatened the 3D-printing companies with legal action for patent infringement. Similarly, some people have begun sharing open-source designs for ventilator parts on Facebook.
There are, however, legitimate concerns about the safety standards for manufacturing ventilators. Even small mistakes can be life-threatening, and defective ventilators may in some cases be worse than no ventilator at all. To resolve this, the UK government has successfully persuaded large manufacturers to switch production to ventilators, and has a screening process in place to ensure that the new ventilators and their components are provided by manufacturers with sufficient experience of compiling to existing safety regulations.
Similarly, although there have been severe shortages of hand sanitiser due to stockpiling, some entrepreneurs have begun to step into the gap. A few Scottish whisky distilleries and London gin-makers have shifted production into manufacturing the stuff, though the government may need to look at whether alcohol duties should be altered to enable them to carry this on without incurring major losses. Perfume makers in France, too, have shifted to making the gels.
For those people treating the virus at home, there has also been some research into what works best, though without the rigour of proper randomised controlled trials - at least not yet. There have been rumours that ibuprofen and similar non-steroidal anti-inflammatory drugs have worsened the disease in some patients, and while many of these rumours seem to be unfounded, some health authorities have recommended that paracetamol be used as a preferred painkiller just in case (while urging people not to stop taking ibuprofen if they were already doing so under doctor’s orders). A team at the Spiez Laboratory in Switzerland has also reported that taking echinacea extract might have been somewhat preventative of similar diseases like SARS and MERS, raising hope that it might have the same effect for the coronavirus. But such work has been announced so recently that it has not yet even been peer-reviewed.
Dealing
Although governments are beginning to assemble bailout packages for the most severely affected businesses, like restaurants and cafés, some inventors are helping people direct money to their favourite places, to help them through the difficult next few months. Crowdfunder.co.uk, for example, with support from Enterprise Nation, have allowed the use of their platform for supporting affected UK businesses entirely for free. Likewise, in San Francisco, married couple Kaitlyn Trigger and Mike Krieger spent a weekend setting up SaveOurFaves, a platform for restaurants to be able to sell gift cards, getting some up-front cash to enable them to reopen when the crisis is over. Similar initiatives seem to be popping up all over the world.
When it comes to supporting the vulnerable, too, a number of apps have been developed seemingly overnight, to link up healthy people with those who may need deliveries of essential supplies while they are self-isolating. We at the Entrepreneurs Network, for example, have partnered with a scheme covering London, called Dare to Care Packages.
As for shortages of items like toilet paper, apparently due to stockpiling, I’ve yet to see much in the way of innovative solutions. In the meantime, however, do not use kitchen roll or wet wipes as direct substitutes, as flushing them down the toilet will utterly wreck the country’s sewage system.
As social-distancing measures ramp up and schools and other childcare providers close, companies like Bubble in the UK are supporting hospital staff and other key workers to find vetted babysitters while they go to work (though the government should probably look at adapting its tax-free childcare policy to such solutions, as the system is not yet set up to account for digital platforms).
Next time
The pandemic has brought attention to a number of others organisations that may help us deal with future cases. Nextstrain, for example, uses open genomic data to aid our understanding of this outbreaks and other ones, tracking coronaviruses, flus, and other strains as they evolve.
Even when the worst of this particular crisis is over, the world’s businesses and governments must step up their support for research into general vaccines and treatments for future pandemic-capable strains. This has been a devastating, deadly wake-up call. It must never happen again.