With the Delta variant driving over 100,000 new infections per day across the United States, the COVID-19 pandemic is far from over. While COVID continues to rage, infectious disease experts are not only battling the ongoing pandemic but are on the lookout for the next virulent threat.
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Since 1900, there have been eight different pandemics that concerned public health across the globe, such as Zika, MERS, Ebola, Swine Flu, and others, which have led to the loss of millions of people and billions of dollars in economic losses. That’s one reason for the establishment of the Global Pandemic Prevention and Biodefense Center in Montgomery County, Maryland. When COVID broke last year, a task force urged for the formation of an organization that could peer past the current crisis and put on its prognostication hat to prepare for future threats. With its long history of thought leadership in infectious diseases and vaccines development, as well as its proximity to federal health and regulatory agencies, the BioHealth Capital Region was the perfect fit for the biodefense center.
The $2.5 billion Center will work to accelerate the development of human monoclonal antibodies (mAbs) to treat the world’s top 100 pathogens across 25 pathogen families most likely to result in disease outbreaks. Not only will the Center develop the mAbs, but it will also implement distribution and delivery protocols across the global public health and pandemic prevention ecosystem.
James Crowe Jr., an immunologist, and pediatrician at Vanderbilt University Medical Center who took part in a roundtable discussion on infectious diseases during the seventh annual BioHealth Innovation Forum said the COVID pandemic is something people do not want to go through again. By establishing the Center and mAbs stockpile, Crowe said the public health community can be one step ahead of future outbreaks, particularly those viral threats that are already known to science.
“We want to make antibodies for pathogens that are likely to create future threats,” Crowe said.
Andy Weber, Senior Fellow of the Council of Strategic Risks, called stockpiling the mAbs a “pandemic assuredness policy.” He pointed to the government’s efforts to create a national stockpile of vaccines for smallpox In case it was used as a biological weapon in the wake of the War on Terror. By proactively thinking about that possibility, Weber said the government has taken that threat off the table. Through a stockpile of antibodies for those 100 threats, Weber said they can remove the threat of biological outbreaks.
While antiviral drugs are important therapeutic options, Crowe noted that many of those medications are only effective when taken at the earliest stages of infection, which as COVID has shown can sometimes be an issue in stemming the virus. And, while vaccines are potent preventative options, Crowe said they can take time to develop and become authorized. However, Crowe noted that the speed with which the pharmaceutical industry developed vaccines for COVID-19 was impressive. While vaccines are a key to stemming the tide of infection, Crowe said there are issues of availability for some patients, including immuno-compromised and with certain comorbidities.
“Now that they have long-acting antibodies, they can act like vaccines and provide efficacy for up to a year,” Crowe said, adding that the protection is “vaccine-like.”
Not only do mAbs provide long-term protection, but they can also be used for early treatment and as post-exposure prophylaxis. And that kind of protection will be important in future pandemics. But, before that kind of protection can be assured, Crowe said there are issues that need to be addressed. The first is a different type of delivery mechanism for the mAbs. The current method is infusion, but Crowe said there have been accessibility issues due to the limited availability of space. He suggested that mAbs will have to become injectable, which will improve delivery.
In addition to better delivery into humans, Crowe said the Center will have to come up with logistics plans to transport drugs to frontline healthcare workers and into the arms of patients.
While COVID remains the focus of the day, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) and chief science advisor to the White House, called for an increase in vaccinations across the country. Speaking with Rich Bendis, Chief Executive Officer of BioHealth Innovation, Fauci said COVID has been “like nothing we’ve ever seen before.” Not only has the virus spread like wildfire across the globe, but Fauci also noted the political divisiveness over vaccines and mitigation strategies.
Despite the resistance to vaccinations, Fauci said he maintains the belief that vaccination can reduce the virus to something of a nuisance instead of a global public health crisis.
When asked about how he has successfully served the administration of seven presidents since assuming the role of director in 1984, Fauci said he has a simple plan – stick with the science. Typically, he said presidents appreciate the hard truths, although Fauci noted a recent exception to the rule, referring to tensions with former President, Donald Trump.
“I learned a lesson early on, always stick with the science and never be afraid to tell a President something that they… may not like to hear. Because you sometimes have to tell someone an inconvenient truth.”
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