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I'd like to, again, remind people of what the biological realities are of this virus and how that shapes our response in the world and in each country.
The first thing to absorb is that this virus kill a substantial number of >65 year olds, and a non-trivial number of <65 years olds. The precise % will improve (perhaps 0.5% overall in European demography) but the number is large enough to be unacceptable.
It is unacceptable because these people are part of our society - our family and friends; it is also unacceptable because trying to care for this number of people in our healthcare systems is likely to flood the system.
To change this we need to change the biology of the virus (how it infects people; how our body responds). To do this we need a vaccine or a drug, and a successful drug might be to the viral biology or to the response to virus by the human immune system.
We don't necessarily need a "cure", or a perfect vaccine. Something which prevents 50% of the people with a bad response to a reasonable one would be useful, or prevents 50% getting to hospital.
Overall I suspect we need to get severe events down something in the order of 10 fold, but I am not a critical care/epidemiological modeller, but 2 fold would be very useful, and 3 two fold changes would mean 8 fold reduction.
The recent vaccine trials (jenner group) in macques was a glass-half full, glass half empty; half full because the vaccinated macques did not show viral pneumonia, half empty because they did show viral infection in their upper respiratory tract.
The more recent Ig tracking and T-cell repertoire tracking of people who have had the disease points towards some level of immunity happening at least by infection (consistent as well with the majority of people shrugging off the infection and severe cases recovering)
Although we can't be sure how long the immunological memory will last (quite simply, we don't have the time nor necessarily the samples) again in a glass half full way we can be reasonably reassured by this
On drugs, I am waiting for the first read out of the RECOVERY trail in the UK - well powered, randomised. Again, brace yourself I suspect for glass-half empty/glass half full results. Strangely even negative results on a good trial is good because ... you don't waste time
Other more targeted drugs are feasible. My favourite next bet is neutralising antibodies to the virus, which were successful in Ebola. I'd love to know where those drugs are at the moment (any Phase I yet?).
And there are a host of potential things to trial on the human host response, including convalescent plasma (very much old school), which has just entered the RECOVERY trial.
In the meantime, until we can change the biology, we have to live alongside the virus. This will be like walking on eggshells everywhere.
Some thoughts; the virus is not obviously biologically different anywhere around the world; humans are not that different biologically around the world. There might be glimmers of difference we can leverage (this goes to human genetic studies) this is more to understand biology
More substantially we can change how human society is organised. This has swung from extremes ("lockdown") to light changes ("wash your hands everyday"). Test-Track-Trace is an eye-watering complex way to reduce contacts, but doable
South Korea shows what is possible, but it does involve large scale societal tracking, accessible and fast testing and considerable organisation on tracking. The recent mini-outbreak and follow up is indication of what this takes.
The "sensing" part of testing I think is very feasible to scale up. The logistics of administering tests and getting them back is the more complex part. Here different countries are taking different approaches - we need to rapidly innovate and learn.
(The slightly tedious "corona olympics" mindset of people in the press - making everything a between country comparison not a between country learning opportunity I find annoying and also always coloured by the respective press position at least in the UK).
Will all this work? In some sense the testing and containment has been shown to work in South Korea, Australia and New Zealand. Can we change the biology of us or the virus? We can't be sure, but we have many chances.
Let's keep our focus on the glass half full.
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