Monday, the Biden administration released its new COVID-related initiative, Project Next Gen–which will likely confuse all of the genome sequencing people (boldface mine):
“Project Next Gen” — the long-anticipated follow-up to “Operation Warp Speed,” the Trump-era program that sped coronavirus vaccines to patients in 2020 — would take a similar approach to partnering with private-sector companies to expedite development of vaccines and therapies. Scientists, public heath experts and politicians have called for the initiative, warning that existing therapies have steadily lost their effectiveness and that new ones are needed…
Jha and others said the new effort will focus on three goals: creating long-lasting monoclonal antibodies, after an evolving virus rendered many current treatments ineffective; accelerating development of vaccines that produce mucosal immunity, which is thought to reduce transmission and infection risks; and speeding efforts to develop pan-coronavirus vaccines to guard against new SARS-CoV-2 variants, as well as other coronaviruses…
Jha and others said the new effort will focus on three goals: creating long-lasting monoclonal antibodies, after an evolving virus rendered many current treatments ineffective; accelerating development of vaccines that produce mucosal immunity, which is thought to reduce transmission and infection risks; and speeding efforts to develop pan-coronavirus vaccines to guard against new SARS-CoV-2 variants, as well as other coronaviruses.
These are laudable goals, but why they had to wait until April 2023–and several hundred thousand dead and likely millions debilitated–to begin is unclear. And that should be investigated by Congress.
That said, we still need programs to deal with the existing problem–and lie back and think of Biden won’t cut it. If nothing else, we need good surveillance, such as hospital asymptomatic and symptomatic patient intake data, so people can assess risk. We’re not doing anything on the masking or sick leave fronts, so at least, the Biden administration should fulfill its claim that “we’ve been give the tools” (we haven’t).
Anyway, hopefully, these efforts will move along rapidly.
Because anti-vaxxers have become embedded and are pushing GBD nonsense everywhere in government, including among the Democratic Party. Anti public health ideology is pervasive.
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“Public-private sector partnership” probably take so long for much the same reason MTAs take so long to process.
Lives are saved (or lost), fortunes are made and unmade, in those numerous tiny-printed words of IP contracts. But it’s usually super boring and slow.
Creating long lasting antibodies is an interesting goal. I think it’s overall wonderful that my pre-pandemic notions of mAbs- namely that they were too specialized to manufacture, far too expensive, and too slow- have been somewhat disproven. Cynically, pharma may see them as more profitable than small molecule compounds, and they may be more willing to work on Covid ones as a way to build out their capacities for making e.g. cancer blockbuster drugs, but there are far worse problems to have.
However, I have some Concerns about it as a “future thinking” pandemic response, either for our endemic Covid or for future pathogen threats. It seems like the main use case for Covid antibody treatments was for:
1) people who weren’t going to have rapid recall antibodies of their own available
2) people who we had a quick and certain diagnosis for, who were still early enough in the disease process for antibodies to play a role.
I think having a window to treat is a function of 1) an intact healthcare system that can functionally get people tested and drugs administered rapidly (far from a universal truth around here) AND, to some degree, specific to Covid’s biological quirks. Given immunocompromised people, we might always have some folks we know to carefully monitor and it is really important to have drug options on hand for them, but cynically that’s not going to make a good business strategy.
Candidly, I don’t believe the field of immunology actually knows how to produce mucosal vaccines that block transmission, but man is that a good goal! We’ll definitely learn useful things trying. Cynically, we’d need to have a Conversation about public health and the importance of getting (let’s face it, probably a lot more) doses “just” for the sake of Other People, but we would become a better country by having better tools and having that conversation in non-emergency mode. For example, if we had a good nasal mucosal vaccine, I would strongly favor booster mandates for folks working in elder care facilities and prisons, but exactly which settings require it is a *public policy* conversation we need to have a lot of different people weigh in on. Outside of “people are dying the world is on fire” emergency mode, bodily autonomy and employer coercion are actually fair points- it’s just on this last round the people arguing them were so derp-y it was nearly impossible to think about good sociology to go with good science.
Mixing antigens is a bit of alchemy; it’s hard to predict whether we can have a pan-coronavirus vaccine that won’t inevitably protect well against some flavors and not others; but it’s probably worth a try. Maybe we can use what we learn for malaria or something else with 60 surface antigens it epigenetically cycles through to mess with us.