Scientists did not anticipate the initial threat of SARS-CoV-2, but what if they could have.
In a commentary released this month by Amesh Adalja, a senior scholar at Johns Hopkins University Center for Health Security, society could be prepared for the next pandemic through a medical countermeasure strategy that maps out traits of two dozen viral families able to infect people.
“There are certain features of specific viruses in viral families: respiratory spread, genetic material made of RNA, being contagious during the incubation period, and infecting a lot of different animal species including mammals,” Adalja said. “Those types of things you can look at to telegraph where a pathogen might emerge from.”
Examining viral threats from a family-based model differs from the current list-based approach used by disease detectives and other researchers who study specific, well-characterized threats. It does not account for “Virus 201”, that unknown, novel infectious agent that may cause the next disease outbreak.
The viral family model could then inform the creation of antivirals, where there are few options currently available to fight respiratory viruses. Part of Adalja’s proposed program includes broad-spectrum antiviral development, which targets specific pathways shared by viral family members. Adalja writes that new antivirals could also help “spur development of therapies for routine infectious disease threats as well as novel pandemic threats.” Another aspect of the program is repurposing existing antivirals, possibly using artificial intelligence and machine learning tools to screen compounds against members of viral families.
Vaccine development through off-the-shelf platform technologies plays a critical role in combating Virus 201, Adalja said, adding that, “platform technologies are why we have vaccine candidates in phase II and III clinical trials already, just less than six months after the discovery of the coronavirus.” However, the speed and cost-effectiveness of these technologies do not mean it should replace traditional methods of vaccine R&D. There may be circumstances in which a traditional vaccinology approach could be more successful, according to Adalja.
The commentary also mentions the need for increased use of diagnostic technology. Several advanced tools have entered the market, including “pathogen-agnostic technologies” that can “test blood samples for hundreds of pathogens.” Other technologies, including whole genome sequencing and magnetic resonance, could greatly improve early warning systems to prevent pandemics.
Creating antivirals, vaccines, and diagnostics for unknown viruses must also be economically viable.
“There has to be a market for them, there has to be an interest in making them,” Adalja said. “No one cared about the coronavirus in humans when they were only causing the common cold. There wasn’t a big incentive to make a coronavirus vaccine.”
Adalja proposes a Virus 201 strategy, program, and the funding be created through the U.S. Department of Health and Human Services (HHS) Biomedical Advanced Research and Development Authority (BARDA) and the Department of Defense (DOD) Joint Program Executive Office for Chemical and Biological Defense (JPEO).
“A new congressional appropriation of $1 billion, divided equally between HHS and DOD, should be provided to enable these agencies to initiate a robust and coordinated strategy to accomplish this goal before the next virus threatens the globe. Specifically, an additional $500 million should be provided to BARDA and $500 million to JPEO to implement these initiatives,” Adalja added.