“We are waves of the same sea, leaves of the same tree, flowers of the same garden.”
– Roman philosopher Seneca
While the life in China is, in a cautiously optimistic mood and in small steps, trying to move back to normal, the past weeks have become a drastic turning point of the COVID-19 outbreak, as regions outside China, particularly Europe, are becoming epicentres of the pandemic (See Figure below). Faced by this somehow unexpected and highly unfortunate development, we need to find both immediate and long-term solutions to stop the rapid spread, quickly, together. In this third COVID-19 blog from OSI Beijing, i.e. after an overview in the most difficult moment of the outbreak in China and some observations of the management process from an environmental viewpoint, let us take a look at the current development in China when it comes to science and knowledge sharing.
Key policy messages on the science-supported battle against COVID-19
The most acute and brutal situation in Wuhan and other heavily affected regions in China has, to a large extent, been curbed. Even more attention is now focused on the scientific breakthroughs that are urgently needed to secure and sustain the stabilised outbreaks as well as to prevent, or at least minimise the effects, if or when the next wave of outbreak emerges, both in China and beyond. The key policy focuses include:
- Faced by so many unanswered and unclear issues related to COVID- 19, such as route of transmission, pathogenic mechanism, diagnosis and treatments, a science-supported and evidence-based approach is more central than ever.
- Vaccine development is the top priority and safety requirements must be followed.
- Research and development for drugs, medical equipment and clinical treatment need to go hand-in-hand for effective treatment and to reduce the mortality rate.
- Advanced research and scientific breakthroughs should support the treatment of critically ill patients, through integrating scientific research, clinical research and clinical treatment.
- New technologies such as artificial intelligence and big data should be important support and tools to improve accuracy and efficiency, which will be vital to the prevention and control of COVID- 19.
- Biosecurity needs to be an important part of emergency responses and public health, which needs to be supported by scientific research and capacity building.
- Research related to responding actions, support system development, resilience building in the situation of a spreading epidemic needs to be developed and strengthened.
- Develop an integrated approach to combining life science, biotechnology, medical science and other related fields to achieve breakthroughs in core technologies and strategic research capacity.
- Strengthen information exchange as well as research and practical cooperation with WHO and countries in the heavily affected regions and countries.
China’s COVID-19 experience sharing
Prof. ZHONG Nanshan, China’s leading epidemiologist, has been fighting at the frontline of the outbreak from day one since he declared the person-to-person transmission nature of this new virus. With a large amount of first-hand information and newly gained experience, he is actively sharing China’s experience with leading experts in Europe and the US. He has, for instance, shared his perspectives of the management of COVID-19 infection in China through an on-line lecture organised by European Respiratory Society(ERS). Key issues include:
- Transmission features, such as route, dynamics and virus carriers.
- Diagnostic process and techniques, particularly test methods to differentiate COVID-19 from influenza.
- Clinical characteristics that could help better understand incubation periods and symptoms as well as to shed light on various treatments and their outcomes.
- Remaining challenges to be solved, which are still the main reasons behind the high mortality of critically ill patients.
In concluding his lecture, Prof. ZHONG Nanshan provided a striking comparison between the modelling results and the actual outcomes. The predicted number of affected cases in China, according to some research at the beginning of the outbreak, would reach around 170 000. As of March 23, the actual number of cases was 81 054. However, if actions were taken 5 days erlier, according to modelling results, the number could have been limited to around 20 000…
Progress on vaccine research
Given the increasingly severe and urgent situation all over the world, a race to develop a Covid-19 vaccine is fully on, in China, in the US and in Europe. While being fully aware that the development of a vaccine will take time and not be able to stop the outbreak right here and now, the progress could send a hopeful and calming sign to the world. Both the US and China have started clinical trials, closely following each other, in the past days.
About 1000 Chinese scientists are working on vaccine development, with nine vaccines developed through five different approaches, namely inactivated vaccines, genetic engineering subunit vaccines, adenovirus vector vaccines, nucleic acid vaccines, and vaccines using attenuated influenza virus as vectors. For instance:
- Using messenger ribonucleic acid (mRNA) technology that copies the genetic code of the virus instead of the actual virus. To date, no mRNA vaccine has been approved for humans. China’s own mRNA vaccine candidate, is undergoing animal trials and is expected to enter the clinical phrase in mid-April.
- Ad5-nCoV, a genetically engineered vaccine that could simulate an attack made by the virus to human cells and trigger the human body to be primed to respond to the fatal infection caused by the virus. Clinical trials are being conducted on volunteers as of March 21, according to the Chinese media.
Most teams are expected to complete preclinical research in April and some are moving forward faster, such as Ad5-nCoV. Given both the pressure and speed of the current vaccine development race, it is extremely important when it comes to safety and ethics. The regulations and technical standards as well as the WHO-requirements must be followed strictly.
Global research efforts
The outbreak has prompted an explosion of research on the coronavirus and according to Nature, as of 12 March there had been around 900 papers, preprints and preliminary reports related to coronavirus (See Figure below). China, US and UK have contributed the largest number of the research papers (See Graph below). This wide participation and strong engagement from the research communities worldwide provide a solid ground for implementing the WHO initiative of A Coordinated Global Research Roadmap -2019 Novel Coronavirus.
Given the urgent need and increased interest, Swedish research and innovation funding agencies, such as the Swedish Research Council (VR) and Sweden’s Innovation Agency (Vinnova) have opened new calls and special initiatives to contribute to the global fight against COVID-19 through their virus research and Innovative Medicines Initiative(IMI).
At this extraordinary moment, the on-going fight against COVID-19 is, and need to be, a truly global one. People all over the world need a sense of light, hope and progress. From science, sharing and joint efforts – we will see the light, hope and progress, soon…
Nannan Lundin, Linnea Yang and Jessica Zhang
Featured image source: The Guardian (Illustration Dom McKenzie)