The future of Covid-19 research
For the last year, the whole world has been held prisoner at the mercy of SARS-CoV-2 and has endured substantial emotional and economic strain.
Through recent investment of more than £35 million from the British government, it hopes to “future-proof” against new SARS-CoV-2 variants.
The government have approved £30 million investment into the Wiltshire-based Porton Down facility. Porton Down is one of few BSL 3 facilities in the UK and is ready to begin future-proofing the UK by improving vaccination platforms to be able to provide effective immunity against future variants.
Upon the emergence of Covid-19 in 2019, this area of research quickly dominated the scientific field. But it was clear that we were not equipped to cope with the sheer quantity of research to be done in the urgent time scale.
Safety is a core element of scientific research - safety of scientists and medics, patients, the public and the environment. Hence, biosafety and biocontainment measures are in place alongside thorough risk assessments to ensure research achieves its goals whilst ensuring the safety of the team. Biosafety levels are ranked 1 through 4 and are determined by the disease infectivity, transmissibility and severity.
In this case, SARS-CoV-2 would be a Biosafety level (BSL) 3 risk. BSL 3 is generally defined as “infectious agents or toxins that may be transmitted through the air and cause potentially lethal infection through inhalation exposure” and requires all work to be conducted in biocontainment cabinets.
Very few establishments in the UK have BSL 3 facilities, which could have resulted in significant restrictions for Covid-19 research and treatment/vaccine development. It was hence decided that only preparative techniques such as handling and propagating live viral particles are required to be conducted under BSL 3 techniques and conditions. Other techniques, such as diagnostic testing and handling of patient specimens, can be performed under BSL 2 practices, enabling many more facilities to conduct Covid-19 research and hence speed up the process.
Just as vaccines become available and as we are slowly developing a deeper understanding of the virus, we are struck again with the emergence of variant strains. Variants arise through mutations to different aspects of the viral particle. ‘Successful’ variants are ones whose mutations provide it with a survival advantage. However, the advantage could be in many forms.
Variants are categorised into 3 groups: Variants of Interest (VOI), Variant of Concern (VOC) or Variant of High Consequence (VOHC).
VOIs are predicted to have mutations associated with differences in receptor binding, reduced antibody neutralisation, reduced efficacy to treatments and increased transmissibility and severity. One such example of a VOI is B.1.526 which was first detected in New York in November 2020 and shows reduced efficacy against many treatment options including bamlanivimab as well as reduced effectiveness of vaccines. Despite all this, B.1.526 and other VOIs are not deemed a serious threat to the current efforts in Covid-19 research as the effects are comparatively minor and are not likely to severely impact the effectiveness of vaccines.
VOCs, as the name suggests, are causes for concern, as they share many of the attributes of VOIs. They also lend themselves to increased transmission and increased disease severity leading to a significant increase in hospitalisations and deaths, as well as interference with diagnostic tests. More significant procedures are required to contain the spread of these variants in the population. One of the first of these VOCs was the B.1.1.7 variant originating from the United Kingdom, which showed a 50% increase in transmission that almost certainly impacted upon the death rate. However, this variant had no obvious impact on the effectiveness of monoclonal antibody therapies or vaccine effectiveness. The more recent South African variant, B.1.351, similarly showed a 50% increase in transmission, but also showed decreased susceptibility to monoclonal antibody treatments and decreased effectiveness of the vaccine.
VOHCs are similar to VOCs but are much more severe and will likely lead to a disproportionately large number of cases, hospitalisations and deaths. What is becoming evident is that the severity of variants is increasing and although we haven’t yet come across any VOHCs, the key word here has to be YET. It is unlikely that in the near future the pandemic will be under control across the globe, despite incredible efforts. And so, eyes are now pointing towards the longer-term future and how we can be prepared for further variants that may escape our current protection and prevention systems.
As mentioned earlier, the government have approved £30 million investment into the Wiltshire-based Porton Down facility. Porton Down is one of few BSL 3 facilities in the UK and is ready to begin future-proofing the UK by improving vaccination platforms to be able to provide effective immunity against future variants.
Alongside this, an additional £ 5 million will be devoted to building up a library of mRNA vaccines. As new variants arise, their DNA can be used to develop a new mRNA vaccine in a matter of days. These can then be banked, ready to be rapidly scaled up and delivered, as and when it may be needed.
These investments help us develop more effective vaccines as well as enabling rapid response to new strains, and in turn, give us the upper hand in what could be a long fight against Covid-19.