The COVID-19 outbreak is causing chaos in global financial markets, freezing supply chains and causing companies all over the world to create work-from-home plans and ban business travel. At drug companies and research labs, though, countries are now racing to develop a cure for coronavirus, or at least its symptoms.
WHO is working 24/7 to analyse data, provide advice, coordinate with partners, help countries prepare, increase supplies and manage expert networks. Human trials will begin in April and will most like be ready in the second quarter of 2021 between May to June.
The outbreak was declared a Public Health Emergency of International Concern on 30 January 2020. In Singapore, MOH raised the Disease Outbreak Response System Condition or Dorscon, to orange on 7 February 2020 which means the outbreak is deemed to have moderate to high public health impact.
On 13 March 2020, the Ministry of Health (MOH) announced various social distancing measures to be taken to reduce the risk of local spread of COVID-19, including at workplaces. Such measures are to limit large crowds gathering in close proximity over prolonged duration.
Measures of social Distancing
A. Work from home
- Employers are encouraged to adopt telecommuting or videoconferencing to allow employees to work from home. Special attention should be paid to vulnerable employees (e.g. older employees, pregnant employees and employees who have underlying medical conditions) to enable them to work from home where feasible. Measures could include reviewing the work processes and providing the necessary IT equipment to employees.
B. Other arrangements
- There are job roles or functions where it is not feasible for the employee to work from home, such as frontline operations and fieldwork at construction sites, shipyards or plants. Other arrangements apart from telecommuting are possible and should be considered:
a.Reduce duration and proximity of physical interactions: If there is a need for physical meetings, the number of attendees could be limited and the duration shortened. They could also be dispersed to more than one meeting venue, and linked up through video-conferencing or tele-conferencing. Where possible, employers could also provide for wider physical spacing (of at least 1m apart) for workstations and between seats in meeting rooms.
b.Stagger working hours: Employers are encouraged to implement staggered working hours where feasible to reduce possible congregation of employees at common spaces such as entrances/exits, lifts, pantries/canteens etc. and allow employees to commute to and from work at off-peak hours. For example, if the normal working hours are from 9am to 6pm, employers can stagger reporting times at one-hour intervals between 7.30 am and 10.30 am, with corresponding staggered timings for end of work. Timings of lunch and other breaks can also be staggered.
c.Defer or scale down non-critical events: There may be other workplace activities which involve close and prolonged contact amongst participants which are not critical to business operations, such as welfare activities or celebratory functions. If these events cannot be deferred, employers should limit these to no more than 250 participants at any point in time and put in place precautionary measures such as temperature/health screening and online registration. During such events, employers should reduce the crowding of participants and improve ventilation where possible. For example, participants could be seated at least 1m apart, and be advised to reduce contact with others (e.g. avoid shaking hands).
C. Implement or enhance shift arrangements: For suitable workplace settings such as in manufacturing, employers can consider deploying employees in shifts, if such arrangements are not yet in place, while extending operational hours to maintain production output. Employers should consider clear separation of employees on different shifts, such as implementing human traffic management measures and stepping up cleaning of common areas during shift changeovers.
How do these Vaccines work?
- All vaccines work according to the same basic principle. They present part or all of the pathogen to the human immune system, usually in the form of an injection and at a low dose, to prompt the system to produce antibodies to the pathogen.
- Antibodies are a kind of immune memory which, having been elicited once, can be quickly mobilised again if the person is exposed to the virus in its natural form.
- Traditionally, immunisation has been achieved using live, weakened forms of the virus, or part or whole of the virus once it has been inactivated by heat or chemicals. These methods have drawbacks.
- The live form can continue to evolve in the host, for example, potentially recapturing some of its virulence and making the recipient sick, while higher or repeat doses of the inactivated virus are required to achieve the necessary degree of protection.
- Some of the Covid-19 vaccine projects are using these tried-and-tested approaches, but others are using newer technology
- One more recent strategy – the one that Novavax is using, for example – constructs a “recombinant” vaccine. This involves extracting the genetic code for the protein spike on the surface of COVID-19, which is the part of the virus most likely to provoke an immune reaction in humans, and pasting it into the genome of a bacterium or yeast – forcing these microorganisms to churn out large quantities of the protein.
- Other approaches, even newer, bypass the protein and build vaccines from the genetic instruction itself. This is the case for Moderna and another Boston company, CureVac, both of which are building Covid-19 vaccines out of messenger RNA.
Three phases of Vaccine trials
- They are usually small trials, recruiting only a few patients. The trial may be open to people with any type of advanced cancer, usually those who have already had all other available treatments.
- Phase 1 trials aim to find out:
1.How much of the drug is safe to give
2.What the side effects are
3.How the body gets rid of the drug
4.If the treatment helps shrink the cancer
- Patients are recruited very slowly onto phase 1 trials. So even though they don’t recruit many people, they can take a long time to complete. They are often dose escalation studies.
- This means that the first few patients that take part (called a cohort or group) are given a very small dose of the drug. If all goes well, the next group has a slightly higher dose.
- The dose is gradually increased with each group.
- The researchers monitor the side effects people have and how they feel, until they find the best dose. In a phase 1 trial you may have lots of blood tests because the researchers look at how your body copes with and gets rid of the drug. They carefully record any side effects you may have and when you have them.
- The main aim of phase 1 trials is to find out about doses and side effects. They need to do this first, before testing the potential new treatment to see if it works. Some people taking part may benefit from the new treatment, but many won’t.
- These trials can be for people who all have the same type of cancer, or for people who have different types of cancer.
- Phase 2 trials aim to find out:
1. If the new treatment works well enough to be tested in a larger phase 3 trial
2.Which types of cancer the treatment works for
3.More about side effects and how to manage them
4.more about the best dose to use
- These treatments have been tested in phase 1 trials, but you may still have side effects that the doctors don’t know about. Treatments can affect people in different ways.
- Phase 2 trials are usually larger than phase 1. There may be up to 100 or so people taking part.
- Sometimes in a phase 2 trial, a new treatment is compared with another treatment already in use, or with a dummy drug (placebo). Some phase 2 trials are randomised. This means the researchers put the people taking part into treatment groups at random.
- These trials compare new treatments with the best currently available treatment (the standard treatment).
- Phase 3 trials aim to find out:
1.Which treatment works better for a particular type of cancer
2.More about the side effects
3.How the treatment affects people’s quality of life
- They may compare standard treatment with:
1. A completely new treatment
2.Different doses of the same treatment
3. Having the same treatment more, or less often
4. A New way of giving a standard treatment (radiotherapy for example)
- Phase 3 trials usually involve many more patients than phase 1 or 2. This is because differences in success rates may be small.
- So, the trial needs many patients to be able to show the difference. Sometimes phase 3 trials involve thousands of people in many different hospitals and even different countries. Most phase 3 trials are randomised. This means the people taking part are put into treatment groups at random.
- After which, if the drug works, it is then licensed as a vaccine.
Updates on the Vaccine race
- About 35 companies and academic institutions are racing to create such a vaccine, at least four of which already have candidates they have been testing in animals.
- The USA has also begun undergoing the first human trial to evaluate a candidate vaccine against the new coronavirus has begun in Seattle, US health officials said on Monday (Mar 16), raising hopes in the global fight against the disease. But it may be another year to 18 months before it becomes available, once it has passed more trial phases to prove it works and is safe.
- As of 16 March, German biopharmaceutical company CureVac has been working on the development of an mRNA-based vaccine to protect against Covid-19 coronavirus infection and is currently undergoing human trials.
- An antiviral treatment called remdesivir, made by US-based Gilead Sciences, is already in the final stages of clinical trials in Asia and doctors in China have reported it has proven effective in fighting the disease.
- Pharma giant Pfizer announced on 17 March 2020 that they are working on a potential COVID-19 vaccine with BioNTech, a German company working on new kinds of immunotherapy treatments. It will be a RNA-based vaccine that will seek to prevent people from contracting the new coronavirus and will take a minimum, between a year and 18 months to develop and certify for general human use.