Lessons learned in China may help others in combating coronavirus
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first recorded in mid-December 2019 in Wuhan, China. However, it was not until 20 January 2020 that the Chinese authorities officially confirmed incidents of human-to-human transmission and admitted concerns about a major outbreak. Over the following days, both the death toll and the number of infections shot up as one Chinese city after another was locked down.
The current coronavirus situation
As of mid-March, it appears that China has finally managed to bring the outbreak under control after huge losses of human life and economic costs. However, these experiences are now being repeated outside of China as the coronavirus disease 2019 (COVID-19) is quickly spreading globally. On 11 March 2020, the coronavirus outbreak was designated a pandemic by the World Health Organization (WHO).
Are we about to see the same scenes repeat themselves all over again in other parts of the world, or will we be able to manage the pandemic better by taking into account the lessons learned in China? To understand what China has learned about the virus, I talked by phone to Supertrends expert Dr. Wenji Dong from Beijing, who has conducted research on gene therapy using viral vectors and has experienced at first hand the battle against the coronavirus in China.
Supertrends: How do you assess the outlook for the coronavirus outbreak?
Wenji Dong: Given the measures taken by authorities around the world and with the arrival of spring and summer, my prediction is that we will see a turning point in the coronavirus outbreak at the end of April or early May this year.
However, I think there is a high possibility that the virus will make a comeback when winter returns. Unlike SARS and MERS, this new coronavirus is highly contagious and difficult to identify, with relatively high pathogenicity. It is like a reinforced super virus – coronavirus version 2.0. It will probably take two to three years for this virus to go away completely.
What would be our best weapon against the coronavirus? Will it be medicine, antibodies from plasma-derived therapy, or a vaccine?
China has been testing more than 100 drugs. It takes so long time to complete clinical trials that we don’t even have enough patients now to complete the trials. I think Remdesivir is a promising medicine; however, it may not be possible to complete clinical trials within this year.
Theoretically, the antibodies developed by recovered patients might be used to strengthen the immune system of new patients. But it is almost impossible to scale up and industrialize this method. It is more suitable as personalized treatment. The solution to this is could be by cloning antibody genes from B cells of recovered patients, which may take longer time.
With our efforts to develop a vaccine, time is again the issue. The number of patients will be much lower when the weather turns warmer. This will cause difficulty in developing a vaccine.
Will we face this kind of virus outbreak more frequently in the future? What can we do if this happens?
I think so. SARS, MERS, and COVID-19 all belong to the family of betacoronaviruses. There are many kinds of coronavirus. I think it is likely that a similar virus outbreak will happen again.
The best control strategy against infectious disease outbreaks is to respond quickly and contain the infection source. China has done quite well this time in stopping the source of infection.
It may not be realistic to develop a vaccination against this particular virus, but it may be possible to develop vaccinations and medication against the virus family. Another thing to consider when developing a vaccination for coronavirus is antibody-dependence enhancement. This is a phenomenon in which preexisting poorly neutralizing antibodies leads to over-reaction of the immune system and is a potential risk for a coronavirus vaccination.
Have new developments in gene sequencing and genomics benefited the diagnosis and treatment of COVID-19?
Definitely. Developments in the field of gene sequencing and genomics have helped us to identify the genome sequence and develop the test kit very quickly. That is something that has never happened before. Gene sequencing technology can be used for the diagnosis of any infectious disease.
While the number of cases in Europe, Iran, and the US is growing rapidly, the control measures in China have been relaxed, and the focus is now more on containing imported cases. As WHO Director-General Tedros Adhanom Ghebreyesus noted, the steps China has taken to contain the outbreak at its source appear to have bought the world time. It is up to the world to use that time efficiently.
Supertrends expert Wenji Dong graduated with a Ph.D. in biochemistry and molecular biology from Beijing Union Medical College. He has worked with some of the top professors in molecular biology in China and as a team leader for national research projects. He is the founder of a gene therapy start-up company GenMedicn.