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Developing a vaccine for covid-19

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1790 (Published 04 May 2020) Cite this as: BMJ 2020;369:m1790

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Coronavirus may stay with us forever!

Dear Editor

The recent pandemic caused by the novel coronavirus, SARS-CoV-2, has shown its peak in many countries and now the world is hoping for an end to this pandemic soon. Vaccines are already developed and under clinical trials [1]; the targeted monoclonal antibodies are under development to treat the severely ill patient who cannot benefit immediately from a vaccine and may soon enter the clinical trials [2]. All this sounds very hopeful to believe that the pandemic is to end very soon. Many fear that the mutation of the virus may mean another pandemic is not impossible. Will the lessons learned from this pandemic make the world more prepared and ready to combat the coronaviruses in future?

We know that the novel coronavirus, SARS-CoV-2, was not the first coronavirus known to infect humans but did we learn enough from the previous outbreaks? The previously known coronaviruses to infect human include: HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV- HKU1, SARS-CoV-1 and the MERS-CoV [3,4]. The first four coronaviruses caused a mild upper respiratory disease, whereas the last two infected the lower respiratory tract and caused more severe disease in humans. Scientists had been warning for years about a potentially dangerous outbreak and were calling for a holistic approach to prevent a pandemic [5,6] but yet we had to face CoViD-19. The novel coronavirus has shaken the world with over four million people infected worldwide to date and caused a major global lockdown in the recent world history, compelling the public health organisations across the world to work towards a common goal.

Despite coronaviruses having infected humans in the past in masses, it is no match to the scale of the pandemic we have seen recently. Millions of people across the world have been infected with this virus and it is highly likely that it is now going to stay with us forever. The mutations are inevitable and future contagions are not impossible in this connected global world that we live today. The scientist, however, will understand the virus behaviour, and health organisations may be able to establish international viral surveillance, like flu, to predict potential mutations in a global preparedness to fast track future vaccinations against the virus. It is also possible that coronavirus becomes a seasonal infection to be managed in future by a world-wide seasonal vaccination program, perhaps, similar to the flu. Is the world economy able to bear yet another potential multimillion-dollar seasonal vaccination program that can offer equitable access to corona vaccines globally? The buyout for the low and middle-income countries can be very challenging.

References:
[1] BMJ 2020;369:m1679; https://doi.org/10.1136/bmj.m1679
[2] Researching antibodies to target COVID-19; https://www.astrazeneca.com/media-centre/articles/2020/researching-antib...
[3] Emerging coronaviruses: Genome structure, replication, and pathogenesis. https://doi.org/10.1002/jmv.25681
[4] Coronavirus occurrence and transmission over 8 years in the HIVE cohort of households in Michigan, https://doi.org/infdis/jiaa161
[5] Isolation and characterization of a bat SARS-like coronavirus that uses the ACE2 receptor. https://doi.org/10.1038/nature12711
[6] A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence. https://doi.org/10.1038/nm.3985

Competing interests: No competing interests

11 May 2020
Hamid Merchant
Subject Leader in Pharmacy
University of Huddersfield, UK
Queensgate