Six Months of Coronavirus: The Mysteries Scientists Are Still Racing to Solve

From immunity to the role of genetics, Nature looks at five pressing questions about COVID-19 that researchers are tackling. Six months and more than ten million confirmed cases later, the COVID-19 pandemic has become the worst public-health crisis in a century. Ewen Callaway, Heidi Ledford, and Smriti Mallapaty write in Nature that scientists have learnt how the virus enters and hijacks cells, how some people fight it off and how it eventually kills others. They have identified drugs that benefit the sickest patients, and many more potential treatments are in the works. They have developed nearly 200 potential vaccines — the first of which could be proved effective by the end of the year. But for every insight into COVID-19, more questions emerge and others linger. Among them: Why do people respond so differently? What’s the nature of immunity and how long does it last? Has the virus developed any worrying mutations? How well will a vaccine work? What is the origin of the virus?

Software Tool Could Be Used to Limit Lockdowns, Safeguard Economy

People hunkered down at home while many businesses, churches, and schools closed this spring to curtail the spread of the COVID-19, but one George Mason University Engineering researcher says that drastic lockdown strategy may not fit all areas of the United States. Sai Dinakarrao, an engineering professor, is working with other researchers to develop a software tool that factors in differences between parts of the country.

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“Pooled Testing” for COVID-19 Holds Promise, Pitfalls

The nation’s top health officials are banking on a new approach to dramatically boost U.S. screening for the coronavirus: combining test samples in batches instead of running them one by one. Matthew Perrone writes for AP that the potential benefits include stretching laboratory supplies, reducing costs and expanding testing to millions more Americans who may unknowingly be spreading the virus. Health officials think infected people who aren’t showing symptoms are largely responsible for the rising number of cases across more than half of states.

Coronavirus: The Antibody Drugs Few People Have Been Discussing – Until Now

Since the start of the COVID-19 pandemic, researchers have been working around the clock to find an effective treatment. The first drug to show promise is dexamethasone, a cheap, widely available steroid. A large clinical trial run by the University of Oxford showed that the drug cut the risk of death for COVID-19 patients on ventilators by a third, and by a fifth for those on oxygen. Lara Marks writes in The Conversation thatwhat is encouraging about dexamethasone is that it provides a proof of concept for future therapies. The drug works by blocking the overactive immune response triggered by SARS-CoV-2, the coronavirus that causes COVID-19. This can cause excessive inflammation – a complication often far more damaging than the virus itself.

Gilead Sets Price of Coronavirus Drug Remdesivir at $3,120 as Trump Administration Secures Supply for 500,000 Patients

Gilead Sciences, the maker of the first covid-19 treatment found to have worked in clinical trials, remdesivir, said Monday it will charge U.S. hospitals $3,120 for the typical patient with private insurance. Hannah Denham, Yasmeen Abutaleb, and Christopher Rowland write in the Washington Post that sSoon after the announcement, the Trump administration said it had secured nearly all of the company’s supply of the drug for use in U.S. hospitals through September, with a contract for 500,000 treatment courses, which it will make available to hospitals at Gilead’s price.

The Danger of Drug Research in a Hurry

The number of studies on COVID-19 is increasing just as rapidly as the number of infections at the beginning of the pandemic. Felicitas Witte writes in the Frankfurter Allgemeine Zeitung [in German] that in mid-March there were still 84, today there are more than 2,200. Wolf-Dieter Ludwig, chairman of the drug commission of the German medical profession and an oncologist in Berlin, is concerned about the number. “This is more mass than class,” he says. “Many of the ongoing studies are so badly planned that it is already clear that a reliable result will not come out.” The corona crisis culminated in what he had been criticizing for a number of years: Medicines should come onto the market faster and faster, but the quality of the studies and ultimately the patient suffered as a result.

Decisions: Relying on the Correct Information, Finding the Right Balance

The reopening of the economies and the resulting – and expected – increase in the number of reported infections, have intensified, and deepened, the discussion over the economic and social lockdowns of the past three months, and the right approach in the face of more infections, let alone a second wave later in the year.

Juliet Samuel writes that the enormous costs of the lockdown so far do not mean that lockdowns will not be re-imposed – especially if a better approach to containing the more serious effects of the virus is not offered. Sweden has offered a better, “light touch” alternative, but has now come under criticism for having a higher deaths-per-million ratio relative to its Scandinavian neighbors, which opted for strict lockdowns. Carl-Johan Karlsson writes that a close examination of the Swedish case shows that it was not that the “light touch” approach was wrong, but rather that its architects have overlooked a major problem: changes made to the Swedish senior care system in the last decade left Swedish elderly exposed (3,200 of Sweden’s 5,000 deaths are over 70 years old).

There are terminological issues (does “infection” equal “sickness”?) and measurement issues (How do you find, with precision, what the R0 is?), and Ross Clark (also see here) addresses these issues.

Have political leaders got the balance right between listening to scientists and medical experts, and respectfully taking additional issues – say, the economic, social, psychological, and medical consequences of a lockdown — into account when formulating a response to the epidemic, issues beyond the scientists’ and medical experts’ remit? Because if these leaders have not done so, then they have abdicated their leadership responsibility. Alistair Haimes and Greg Weiner discuss these issues (note: keeping scientific advice and expertise in the proper perspective does not mean boorishly dismissing science and denigrating experts, as Brazil president Jair Bolsonaro has been in the habit of doing, with grave consequences for his country).

Finally, this question: Are governments and societies set up properly to deal with overlapping crises and costly catastrophes, both the low-probability, high-impact events (say, a meteorite hitting Earth; a new virus), or the slower moving but predictable (say, climate change). Arnold Kling, Philip Wallach, and the Economist argue that governments must fundamentally change the way they assess risks, prepare for them, and fashion policies to cope with and recover from them.