Rapid Medical Countermeasure Response to Infectious Diseases Enabling Sustainable Capabilities Through Ongoing Public- and Private-Sector Partnerships: Workshop Summary (2016) / Chapter Skim
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6 Developing MCMs for Coronaviruses
6 Developing MCMs for Coronaviruses
Pages 63-78
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From page 63... ...
In this chapter, panelists discussed the important period of opportunity for development and action prior to a virus reaching an emergency-level epidemic threshold. (Detailed technical accounts of the MCM development process are included at the end of this chapter in the Chapter 6 Annex.)
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From page 64... ...
• 1,075 total cases confirmed by World Health Organization, 404 deaths (38 percent fatality rate) o Most cases in Saudi Arabia (951 cases, 372 deaths)
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From page 65... ...
With funding from Fogarty International Center at NIH, the EcoHealth Alliance sought to identify the wildlife origin of SARS. While crossover from civets into humans was of particular interest, the data suggested that civets are not the wild reservoir but instead are infected in the live animal markets of Southern China.
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From page 66... ...
. With funding from NIAID, EcoHealth Alliance continues to look across Southern China for these bat viruses, interviewing and taking samples from people potentially at risk (e.g., those trading bats in the markets, hunting bats, living in caves)
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Assesssing Viral Divversity Many groups area doing viraal discovery inn wildlife, Daaszak said. T The challen nge is to rankk the viruses for follow-uup genetic annd experimenttal studiess to assess fu urther potentiial for spillovver to humanns.
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From page 68... ...
Commercial SARS Vaccine Development An important consideration is not only the dynamic nature of infectious disease threats but also the dynamic nature of the industry on which we depend to develop these vaccines, said Mansoura of Novartis. She briefly described a SARS vaccine development program on behalf of Jeffrey Ulmer, global head of External Research at GSK Vaccines, who worked on the SARS vaccine while at Chiron in 2003.
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From page 69... ...
Arguably, she concluded, a decade of coronavirus vaccine development has been lost, and said it is time to ask the hard questions about what the cost of that inaction could be, before the consequences are seen. Small Biotechnology Company Platforms Targeting Emerging Infectious Diseases Michael Wong, senior medical director for Infectious Diseases at Sarepta Therapeutics1 shared his perspective on some of the challenges 1 The statements made are Wong's personal observations and are not made on behalf of Sarepta Therapeutics.
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From page 70... ...
Wong also mentioned the difficulty in articulating to countries and populations the need to ensure the safety and efficacy of a product, and a real-life, onthe-ground need to respond in an emergency -- previously alluded to regarding clinical trials during the EVD outbreak. "We need to keep the dialogue going about how this is done within developmental, legal, and ethical frameworks so that we are ready to respond correctly," he said.
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From page 71... ...
Universal influenza vaccine efforts have arisen from decades of research to identify potentially universal strategies, yet there is still a long way to go and the coronavirus field is not yet ready for that, Cassels stated. Daszak agreed that developing pan-coronavirus platforms will be very difficult.
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From page 72... ...
Daszak also shared that during the recent Ebola outbreak, EcoHealth Alliance issued a press release and an analysis predicting which countries would be the first to be infected as a result of global air travel.2 The United States was predicted to be one of the top three countries that would receive infected individuals from countries with EVD, and it was predicted the patient would arrive into Dulles, Boston Logan, Newark, and/or JFK airport. They anticipated a lot of attention and coverage, but 2 See http://www.ecohealthalliance.org/press/101-ecohealthallianceidentifiesebolas flightpathtotheus (accessed September 30, 2015)
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Richard Hatchett, chief medical officer and deputy director at BARDA, noted that BARDA is working on this type of assessment tool. He also emphasized the importance of a holistic assessment, considering not only the biological properties of viruses and hosts but also the social and behavioral contexts in which a disease could emerge to become a crisis.
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From page 74... ...
Daszak of EcoHealth Alliance said it is important to be working for the long term on products such as a pan-coronavirus vaccine platform and working on an animal vaccine, but near-term public health control measures, such as changing behavioral risks, increasing infection control in hospitals, are just as critical. Despite the analysis of travel patterns showing a clear risk that people with EVD would arrive in the United States, airports were very slow to enact the simple measure of screening the temperature of arriving passengers, Daszak said.
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David Swerdlow Associate Director for Science, National Center for Immunization and Respiratory Diseases, CDC In 2012–2013, ASPR, BARDA, and CDC collaborated to create a coronavirus risk assessment tool based on IRAT, Swerdlow said. As discussed by Katz in Chapter 5, IRAT uses information about novel influenza virus isolates (virus properties, population properties, viral ecology)
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From page 76... ...
A fruit bat species was repeatedly sampled for the occurrence of 55 viruses from 9 viral families. Using statistical methods to estimate the total unknown diversity of viruses from that species, they estimate 58 unknown viruses in that bat species, and extrapolate about 320,000 unknown viruses in all mammals, including about 72,000 in known bat species (Anthony et al., 2013)
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From page 77... ...
Michael Osterholm Director, Center for Infectious Disease Research and Policy (CIDRAP) Osterholm noted that, while culling civets in the markets in Southern China helped to control the SARS outbreak, there has been no similar success in controlling human exposure to animal carriers of MERS mainly because of the social implications of camels.
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