What 2020 Gave Science: Medical Advances and Learnings from COVID

(Today marks a year since the first COVID-19 case was confirmed in India. FIT is reposting this story in that light.)

The year 2020 has been unimaginable in all ways. A fierce and untamed virus put our lives to a halt and confined us all to our homes. Millions of people got infected and many lost their loved ones - even as doctors and healthcare workers around the world worked tirelessly to make sense of (and to treat) the deadly disease caused by the novel coronavirus.

The year - filled with disruptions and uncertainties - also brought with it leaps and advances that science has never seen before.

The rampant wave with which the virus struck meant that action had to be taken immediately - and the grave necessity led to record-breaking speed in all possible aspects of science - from a vaccine roll-out within a year to newer technologies for drugs.

1. Fastest Progress in Vaccine Development

The first COVID case was identified in China in December 2019.

It has only been a year, and the front-runners in the vaccine race are either in their phase 3 trials already - or some others, like Pfizer - have received emergency use authorisation in certain countries.

Britain last week became the first country in the world to approve the Pfizer/BioNTech vaccine, followed by Canada and the United States. Priority groups defined in the UK received the first COVID-19 vaccine shots on Tuesday as a mass vaccination programme got underway. The government has reportedly secured 800,000 doses of the Pfizer jab to begin with, but has placed order for 40 million in total, since two doses are needed. Four million doses are expected by the end of the year.

Commenting on the approval by the US Food and Drug Administration (FDA), Stephen Hahn, Commissioner, said in a statement on Friday, “The FDA’s authorisation for emergency use of the first Covid-19 vaccine is a significant milestone in battling this devastating pandemic that has affected so many families in the US and around the world.”

Hahn hailed the “scientific innovation and public-private collaboration worldwide” which made the vaccine possible at record-shattering speed.

Back home in India, several vaccine candidates are in the pipeline and are expected to be ready by mid-2021. The Serum Institute of India is as well as Bharat Biotech are conducting phase 3 trials of Covishield and Covaxin respectively in the country. 100 million doses of the former could be ready by January, and the latter’s rollout is expected by June 2021 if all goes well. Zydus Cadila has also begun phase 3 trials of its candidate on almost 30,000 volunteers.

All these developments aren’t just great news - they are also pathbreaking.

The process to design a vaccine and ensure it is safe for human use, takes anywhere between 10 to 15 years. For instance, the mumps vaccine, which was the fastest ever approved — took four years to develop. But with the world’s focus on COVID-19, governments have fast-tracked applications and regulations to get out a vaccine in the super-short timeline of 18 months.

Considering this standard, the fact that we already have approvals for vaccines coming in following safety and efficacy data - and many other candidates in line - shows the capabilities of our medical science and technology today.

In fact, not just approvals, but this speed has been consistently maintained since the very beginning - when the virus had to first be isolated and transported for developing test kits to detect the virus in people.

2. New Technology for Vaccines: mRNA Platform

The vaccines developed by Pfizer and Moderna - both use a technology that has never been used to create a vaccine so far. It involves using genetic material from the virus called mRNA, short for messenger RNA, which directs the body’s cells to stimulate the immune system.

India’s first indigenous mRNA vaccine candidate, developed by Pune-based Gennova Biopharmaceuticals, has also received approval to initiate phase 1 and 2 human clinical trials from Indian drug regulators.

According to the government’s press release, these mRNA vaccines carry the molecular instructions to make the protein in the body through a synthetic RNA of the virus. The host body uses this to produce the viral protein that is recognized and thereby making the body mount an immune response against the disease.

Additionally, mRNA vaccines are fully synthetic and do not require a host for growth, e.g., eggs or bacteria. “Therefore, they can be quickly manufactured in an inexpensive manner under cGMP conditions to ensure their "availability" and "accessibility" for mass vaccination on a sustainable basis,” the press release said.

The COVID-19 pandemic, therefore, has fast-tracked the optimisation and application of a vaccine manufacturing technology that can greatly benefit us in the future.

3. Importance of Mental Healthcare

The silver lining in the dark, dark cloud we have been living in for the past few months, has been a heightened sense of awareness about our mental health needs.

The pandemic, the resultant uncertainties, the blurring of boundaries between work and home, the loss of lives, jobs and livelihood - have all together shed light on the need to invest in and pay due attention to mental health and resilience.

The COVID-19 pandemic has triggered a parallel mental health crisis across the world - affecting those who had hitherto remained unaffected, and worsening the conditions of individuals who had already been struggling mentally with pre-existing conditions.

There has never been more conversation around mental health and the very serious implications it has on individuals suffering and those around them.

On the occasion of World Mental Health Day, an editorial published in The Lancet journal elaborated on the theme for this year - increased investment in mental health.

“At the best of times, good mental health is needed for a society to thrive. During a pandemic, good mental health is more important than ever,” the authors wrote.

“Without a focus on mental health, any response to COVID-19 will be deficient, reducing individual and societal resilience, and impeding social, economic, and cultural recovery. 2020 has been a difficult year for mental health.”

The Lancet

“Investment must be about more than just money if mental health services are to be made fit to address the challenges of the COVID-19 and post-COVID-19 era and to become resilient against future public health crises. There must be an investment of thought, time, and a commitment to change,” said the authors.

Therefore, investment in mental health infrastructure - and ensuring it is inclusive - are aspects highlighted further due to the year that was 2020.

4. Greater Understanding of Our Bodies, Hygiene and Immunity

We have never been more aware of flu, viruses, vaccines, and the ways of our own bodies as much as we are today. Today, we understand the need to maintain hygiene, to follow a healthy lifestyle, to eat, sleep and exercise well - because, in the end, this is all that can save us in the face of a health crisis such as COVID.

Those with compromised immunities, including older people as well as individuals with comorbidities are at a higher risk of complications - as opposed to young and healthy people with stronger immune systems.