Megathread: President Trump announces 30-day Travel Ban between USA and Europe among other measures to curtail the Coronavirus Outbreak

Hi! I'm not in the pharmaceutical industry, but I did do some work in pharmacophore modeling back in high school, and in general I like to stay updated on developments in this area, so I think I might be able to provide some insight.

When it comes to viruses, there are two things people generally talk about when they talk about "cure": either a vaccine to protect someone from getting the disease or some combination of anti-virals that will cure someone who already has the disease.

So let's think about vaccines. There are multiple types: the more traditional notion of vaccines, where a weaker or deactivated of the virus is introduced to the immune system, and the immune system produces the necessary antibodies to deactivate that virus. There are other, newer vaccination modalities that use the same basic idea of introduction of some foreign virus-related material into the body to spur the immune system to react appropriately to that virus. For example, there are some studies being done that try to change the DNA within the body's own cells so that the cells use this new DNA to start producing the necessary antibodies - this approach would avoid the use of any viral specimen to introduce to the immune system.

But vaccines take time to develop, and there are two reasons why: the first is money, of which there is no shortage in this particular case (the entire world has a financial incentive to vaccinate COVID19 away); the second is scientific barriers, which is the primary issue here.

As it stands right now, vaccine development is honestly really hard. In scientific research, particularly stuff that involves laboratory work, things that logically should work sometimes don't work in vitro (what we use to refer to laboratory conditions and relatively simple testing conditions, like introducing a potential therapeutic agent to a cell culture and seeing how it behaves). And sometimes stuff works in vitro (in the laboratory condition, the simple cell culture for example), but it doesn't work in vivo (when it's tested inside an actual living thing). So you first have to find something that will work in laboratory conditions. After this, you have to do the first round of in vivo testing: namely, you have to see if this thing works inside living animals correctly; and for this stage, researchers typically use model organisms (rats, monkeys, etc.). Only after this stage does it typically go into testing and trial on humans, and even at this stage there's a lot of uncertainty: even if it seems to have no negative effects on a monkey, there might be some way that this works differently in vivo in humans. So only if you make it through all 3 stages, each of which gets generally gets harder, do you have a vaccine that is safe to give to the general public. Vaccine development timelines, with our current technology and safety testing process, are on the order of years: 5-10 years is not an uncommon figure in the industry. Due to the urgency of this pandemic, there has been some relaxation of the standards regarding animal testing: I think less extensive animal testing might be required for some vaccine candidates to get them to humans faster, but I've only read the news on this cursorily.

Okay so vaccines take a long time to make, but what about actual treatments for people who already have this? The way antiviral treatments work is by trying to stop the virus at some point between when the virus enters the host and when it eventually causes the host cell to burst and release more viruses. The way they generally attempt to do this is by trying to block some protein that the virus uses to anchor itself onto the cell or onto some protein that is somehow key to the virus's functioning. To identify this target protein or set of proteins for a novel strain of virus takes time; to determine the exact structure of this protein, if not already determined, takes time; to develop something that is shaped in a complementary manner to this protein so that it can bind to this protein and inhibit it takes time; and then it takes time to do the in vitro and in vivo testing mentioned earlier; and then it takes time to do the clinical trials to see if the therapy is safe for humans. And another layer of complexity is added when you consider how fast viruses mutate: this protein a researcher identifies as key to the virus's functioning might stop being essential as the virus mutates and changes its makeup.

So I guess the short answer is that we do have the technology in some respects, but even our best technology at the time has honestly not been able to overcome the basic scientific limitations we have in some respects.

/r/Coronavirus Thread Parent