Israeli scientists discover monoclonal antibody that neutralizes SARS-CoV-2

The coronavirus disease (COVID-19) currently has no treatment or vaccine, leaving countries grappling with the wrath of the infectious disease. Caused by the novel coronavirus, now called the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the viral infection has killed more than 257,000 people and infected at least 3.66 million. Scientists across the globe are racing to develop vaccines and therapies to combat the infection.

Israel has been one of the most active countries in battling COVID-19, and has been successful in "flattening the curve." The country has announced dozens of medical studies and technologies they are developing to contain the spread of the virus and treat those who are critically ill.

Now, in a significant medical breakthrough, Israel's Institute for Biological Research Institute (IIBRI) has wrapped up the development of a potential treatment for the coronavirus disease. The scientists say they have identified an antibody that neutralizes SARS-CoV-2 in vitro or outside of a living organism.

Identifying an antibody against SARS-CoV-2

Israel's Defense Minister Naftali Bennett said he witnessed a significant breakthrough accomplished by the IIBR in moving towards an antibody against the dreaded virus. The team had already completed the developmental phase and is now preparing for the mass-production of the potential treatment after obtaining a patent for the discovery.

Bennett visited the laboratories of the IIBR, a secretive unit that works under the auspices of the office of the Prime Minister. The team shows how the antibody can attack the virus in a monoclonal way and can neutralize it.

Monoclonal antibodies are laboratory-produced molecules engineered to serve as substitute antibodies that can restore, enhance, or mimic the immune system's attack on cancer cells. They are designed to bind to antigens that are generally more numerous on the surface of cancer cells than healthy cells.

Statement from the Israel Ministry of Defense

‪3 key parameters:

1. The antibody is monoclonal, new and refined, and contains an exceptionally low proportion of harmful proteins
2. The antibody is able to neutralize the coronavirus
3. The antibody was specifically tested on the aggressive coronavirus

"Based on comprehensive scientific publications from around the globe, it appears that the IIBR is the first institution to achieve a scientific breakthrough that meets all three aforementioned parameters simultaneously," Bennett said in a statement.

The IIBR has been leading Israel's efforts to develop a vaccine and treatment for the novel coronavirus, including testing of blood from those who have already recovered. Antibodies in the samples taken from recovered patients are now being studied for their potential as a possible cure for COVID-19. Antibodies are immune system proteins that are residues of the body's successful fight against a pathogen.

The breakthrough is a significant step in the fight against COVID-19 because the scientists developed it from a single recovered cell, hence, the term monoclonal antibody. This means that the antibody is more potent in developing an effective treatment. To compare, the antibodies that have been extracted across the globe are all polyclonal.

Promising milestone

IIBR is now working to patent its antibody discovery, possibly landing a contract for its commercial development. If the antibody continues to show promise as a cure for the coronavirus disease, it will make a significant impact across the affected countries, particularly the hardest-hit countries in Europe.

"This is an important milestone, which will be followed by a series of complex tests and a process of regulatory approvals. That said, the scientists at the institute believe that the nature of this breakthrough could lead to a shortening of the process, which could span over several months," Bennett added.

The IIBR has not only developed the antibody against the novel coronavirus, but it was also involved in collecting plasma from recovered patients in an attempt to aid in research. It has also taken part in the progress of developing a vaccine, along with MigVax, an affiliate of the MIGAL Galilee Research Institute. The scientists have reported being close to completing the first phase of developing a potent coronavirus vaccine.

The institute is working tirelessly to find a cure for the novel coronavirus, which has infected more than 16,000 in the country and has killed at least 238.

The IIBR and the town of Yeoham plan to open the country's first vaccine production facility. They will team up with two international pharmaceutical companies and present the plan for the quick establishment of the facility if the Israeli government provides approval.

The coronavirus global pandemic has now affected more than 187 countries and territories. North American and Europe reported the highest number of infections. The high infection rate of the pathogen is driving scientists to race in developing effective vaccines and treatments for the infection. Now, the United States has the highest number of infections, topping 1.2 million confirmed cases and more than 71,000 fatalities.

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Herd immunity: What it is and how it canC help stop COVID-19

Since the coronavirus pandemic began, the term "herd immunity" has been flung around as one solution to the devastating virus ravaging countries all over the globe since December 2019. The term explains the situation in which a high percentage of people in a given community (a city, state or entire country) is immune to a disease, either through vaccination or because those people have been exposed to the virus and their immune systems have built antibodies to protect them from it. People who tout it as the best defense against SARS-CoV-2, the virus that causes COVID-19, are correct in their thinking -- it's the best way to prevent contagious diseases from circulating throughout a population because it slows down or eliminates the spread of the virus from person to person.

The problem with herd immunity and the novel coronavirus is that the world is nowhere close to having widespread resistance to COVID-19, and is still a long way from developing it. Experts estimate that from 60% to upwards of 90% of a population must have immunity to a disease for it to stop spreading. Most countries affected by COVID-19 have not surpassed the 1% mark, including the US, which currently has the highest number of cases out of all countries.

Let's explore what herd immunity looks like, what it means for COVID-19 and how the world can get there, explained by Dr. Jane Orient, executive director of the American Association of Physicians and Surgeons, Dr. Joseph Vinetz, a Yale Medicine infectious disease specialist, and the Centers for Disease Control and Prevention.

What is herd immunity?

Dr. Orient tells CNET that herd immunity is what slows and eventually stops outbreaks and epidemics -- this occurs only "when the pathogenic organism runs out of susceptible victims because of isolation, quarantine or immunity of exposed persons."

Dr. Orient, who says she really prefers the term "population immunity" because "we are not livestock," emphatically points out that "If it weren't for population immunity … we'd all die like the martians in The War of the Worlds." In H.G. Wells's famous story, the Martians who travel to Earth all die from Earth-borne pathogens that the Martians' immune systems couldn't fight.

Dr. Vinetz, of Yale Medicine, explains that a good example of herd immunity is the measles. "The idea is that if we have herd immunity, it means that we reduce the transmission of a disease within a population," Dr. Vinetz says. "The best example to think about is measles. If 95% of everyone is vaccinated against measles, that means 95% is immune to measles, which means that the risk of measles spreading from person to person is very low."

The goal, Dr. Vinetz says, is to remove the possibility of sustained transmission. To get to that point, the vast majority of people in a given community, city, state or country would need immunity. To do that, those people either need to contract the disease and recover from it, or get a vaccine against the virus.

While "active immunity" -- immunity a person builds in response to actually contracting a disease -- is most effective and long-lasting, experts beg people not to intentionally infect themselves with SARS-CoV-2 in an attempt to build immunity. That leaves us with the only other option: a vaccine.
How vaccines promote herd immunity

The purpose of vaccines, Dr. Orient says, is "to expose people to something that induces immunity without making them very sick," explaining that vaccines are either tiny doses of a pathogen, a dead microorganism or a microorganism that is similar but weaker.

"You need upwards of 70% of protective immunity in a population to prevent large scale propagation," Dr. Vinetz explains, and that often requires immunization, particularly in regard to diseases that have been almost eradicated in the US.

Dr. Vinetz again points to measles as the best example of that. It's easily preventable with a highly-effective vaccination, most commonly known as the measles, mumps and rubella, or MMR, shot.

But, in 2019, the US saw the highest number of measles cases since 1992, and the majority of cases were among people who did not get vaccinated against measles. The 1,282 measles cases in 2019 still pales in comparison to the estimated 3 to 4 million yearly cases before the vaccine was introduced, which provides strong evidence that vaccines are highly effective at reducing the occurrence of or eliminating diseases within a region.

Only one disease -- variola virus, better known as smallpox -- has been completely eradicated. No cases of naturally occurring smallpox have happened since the declaration of eradication in 1980, and babies no longer need the vaccine for this virus, because the global vaccination program was so successful.

"Disease rates are low in the United States today," the CDC explains on its website. "But if we let ourselves become vulnerable by not vaccinating, a case that could touch off an outbreak of some disease that is currently under control is just a plane ride away."

Vaccination development and approval requires careful analysis of the risk-to-benefit ratio, Dr. Orient says. "For extremely contagious, lethal diseases like smallpox, the risk-to-benefit ratio for vaccines is very favorable," she says. "For milder diseases, not necessarily so."

Vaccines can have adverse effects for some people, too, and immunity wanes over time, so the importance of vaccination depends on a number of factors, including severity and prevalence of the disease, vaccine safety and individual patient factors, Dr. Orient explains. "Everything is a trade-off," she says.

Dr. Orient urges people not to forget that vaccines, though crucial for some diseases, are not the only way to prevent disease: "Diseases are also prevented by hygiene, sanitation, vector control (e.g. mosquito control), or cure of the sick before disease can be transmitted."
Why we need herd immunity

If there is no herd immunity, people will continue to contract diseases and spread diseases, and, unfortunately, people will continue to die from these diseases. The CDC defines herd immunity, or community immunity, as "a situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely.

"Even individuals not vaccinated (such as newborns and those with chronic illnesses)," the CDC continues, "are offered some protection because the disease has little opportunity to spread within the community."
SARS-CoV-2, the virus that causes COVID-19, is a hauntingly relevant example. This virus is new to humans, so no one had immunity -- either naturally or by vaccination -- from it when it first infected humans. Because no one has immunity, and the virus is contagious, it spreads quickly and easily.

What will it take to have coronavirus herd immunity?

There are two ways to produce herd immunity against a disease: develop and administer a safe and effective vaccination, or wait for the disease to make its rounds through a population.

A vaccination for SARS-CoV-2 is in the works, but it will likely be more than a year until the vaccine becomes available to the public. Without a vaccine, much of the US is currently stuck under shelter-in-place and social distancing orders, waiting for it to be developed, or for people to get the disease and recover from it to create herd immunity.

Too many important factors remain unknown, however, to simply allow the virus to continue its rampage without intervention:

    Scientists don't know if people can contract the SARS-CoV-2 virus more than once. 

    No one knows if a positive coronavirus antibody test means you are immune from contracting or spreading the virus.

    Research on COVID-19 treatment is ongoing, and there is no finite treatment. 

    Much of the population is at risk for serious complications, which can lead to death. But even young, healthy people may develop complications that lead to fatality, which raises questions about the nature of the virus. 

    It's impossible to know how many people have had the virus and did not report their case, either because they were asymptomatic or did not feel sick enough to get tested, or a test wasn't available.

Dr. Vinetz figures that the US is nowhere near the point of herd immunity to the novel coronavirus: "If we have 330 million people in the States and 1% are infected, that's 3.3 million people and that still means that 99% of the US population remains susceptible."

If you take Dr. Vinetz's estimation that at least 70% of a population must be immune to a disease to produce herd immunity, that means at least 231 million people in the US must contract and recover from the disease.

The actual number of COVID-19 cases in the US has not reached 1% of the population as of April 16 -- you can track the cases in the US total on the CDC website, which is updated continuously. "It doesn't require Einstein to figure out that we are nowhere close to herd immunity," Dr. Vinetz says.
When will we have coronavirus herd immunity?

Whether we will see herd immunity to SARS-CoV-2 in the future depends heavily on a number of factors -- particularly, Dr. Orient says, whether or not we allow people to move around. "If we lock everybody into solitary confinement, they won't get immune, unless and until there is an effective vaccine," she explains. "For some diseases, like the common cold (coronaviruses are one cause) there isn't much herd immunity because the virus changes or the vaccine just doesn't work, like malaria."

When asked about localized herd immunity, or herd immunity within specific regions with high numbers of coronavirus cases (such as New York and California), Dr. Vinetz says the concept doesn't really matter if people are allowed to roam around.

"We're such a mobile society," he says, so if stay-at-home orders are relaxed or removed, "if people start getting on buses and planes and trains and visiting other areas," localized herd immunity means nothing.

It's all very complicated, is the point.

Dr. Vinetz says he expects to see "continual rolling waves of [COVID-19] infection unless we intervene somehow," squashing the idea that there will be a big resurgence of SARS-CoV-2 in the fall of 2020 simply because it likely will not have died down or disappeared by that point. Unfortunately, that means we will likely be waiting through 2020 and into 2021 to reach herd immunity.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

 

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 source cnet.com

Social distancing and mental health: How to avoid taking the TB route in coronavirus

Social distancing and mental health  

At least 10 people on my Instagram have declared themselves “Queen of Quarantine”. Social distancing and isolation are the two new buzzwords, and the most trending hashtags. While this is great, because we can’t flatten the corona curve without following these tenets, it is easy to forget that for some, isolation can be tough, and even triggering. People with pre-existing mental health issues might find it hard to socially distance themselves – being alone (for someone who lives away from their family) could potentially be depressing as well.

Worse still, is when someone tests positive for an infectious disease. The diagnosis in itself is a huge shock- and then there is the stigma that silently but significantly underlines most of the social distancing and isolation.

But isolation is the need of the hour, and to meet this need better, there are certain lessons we can draw in this pandemic from India’s tuberculosis epidemic and experience. Society often tends to forget to be warm to those who are suffering – and the TB experience stands as testimony to this. Not all forms of TB are infectious. However, TB patients are often compelled to physically isolate. This is because in some cases of TB, such as pulmonary TB, patients are infectious for the first few weeks of treatment and require quarantine measures. Similarly, in Covid-19, though the exact potency of the virus is still under research, we know for a fact that it is highly contagious, and thus, isolation is best advised.

The absence of warmth

In TB, the isolation is often caused by the stigma attached to TB. Patient narratives reveal that people tend to avoid being in the same physical space as them not just while they are on treatment but in some cases even after they are cured. These people could be community members, family members, and in some cases even partners.

In both cases, physical isolation – which translates to the absence of human touch and warmth – has a significant impact on the patient’s mental health, often leading to feelings of alienation, worthlessness, self stigma, and depression. TB treatment is long and is known to have mental health side effects in addition to other side effects. The length of treatment and the side effects often result in psychological distress, hopelessness, depression and in extreme cases mental health breakdowns.

News from all over the world has been pouring in about racism against people from East and Southeast Asia during the coronavirus pandemic. The fear and frenzy is gradually taking the form of a foe with which TB and HIV patients and survivors are all too familiar – stigma. And as can be observed from both these diseases, the stigma associated with a disease often not only heightens the mental health issues a patient may face as a result, but also drives the testing for, and reporting of the disease, underground.

In Mumbai, the hands of potential Covid-19 patients who needed home quaratine were stamped.

If we do not stop and take stock of how these diseases have played out, we are bound to take the same route with Covid-19, and the future of public health then, does not look pretty. If patients abandon treatment mid-way, they might still be infectious or develop an infection subsequently, and pose the threat of spreading this infection. As a result, infection rates could go up and endanger public health.

What can we do to address the impact coronavirus has on mental health?

Phone a friend, revive the art of letter writing even if what you are sending out is actually a long email or participate in a silly social media challenge. While we must continue to remain physically distant from each other, we need to find other ways to rekindle the spark of human connection – the antidote to isolation.

Workplaces should institute work-from-home policies and provide paid leave to those affected so as to alleviate the psychological stress that comes from the threat of financial insecurity. In the informal sector, where workers do not have the luxury of working from home, employers ought to provide access to clean water, soap, and sanitisers as well as economic and social support to workers in the form of paid leave in case of ill health.

The need for empathy

At a programmatic level, we need to develop a National Covid-19 programme along the lines of the national TB programme, and integrate mental health as a critical component of it. Patients and families have to be provided counseling and support right from the time of diagnosis through the process of treatment. Additionally, public information campaigns targeted at communities and health personnel ought to be launched to increase literacy about the impact coronavirus has on mental health as well as the ways to deal with it.

Coronavirus has caused one too many casualties. Do not let your empathy be one of them. When you interact with another person, take your precautions, but remember to see the humanity in them instead of reducing their existence to “potential carrier” or “Covid-19 patient”. Dehumanisation and othering have a catastrophic impact on mental health of the person at the receiving end of such behavior.

Why should that be your concern?

Albert Camus, in his novel The Plague, wrote “From now on it can be said that plague was the concern of all of us.” This is as true for the coronavirus today as it was for the plague then. Covid=19 can happen to anybody. Please remember, we are all in this together.

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Chromosome Length May Indicate Development of Respiratory Infection

The rate of experimentally induced upper respiratory infection increased in healthy adults with shorter telomere length (a structure at the end of a chromosome) in specific leukocytes, according to research in JAMA. The results were identified in comparison to participants with longer telomeres.

Telomeres, DNA-protein complexes at the end regions of chromosomes, decrease in length with every cell division.

“Telomere shortening in leukocytes (white blood cells) has implications for immunocompetence and is associated with increased synthesis of proinflammatory cytokines and poorer antibody response to vaccines,” according to background information accompanying the article. “Shorter leukocyte telomere length also is associated with aging-related morbidity and mortality from conditions with immune system involvement, including infectious diseases, cancer, and cardiovascular disease.”

Investigators assessed telomere length in 152 healthy adults, then quarantined participants to administer nasal drops containing a common cold virus; participants were then monitored for 5 days for development of infection and clinical illness.

Among all patients, 69% developed respiratory infections and 22% developed a cold. An association was seen between those with shorter telomere lengths in all 4 cell types and increased odds of infection following exposure to the virus.

Those with the shortest CD8CD28 telomere length had a rate of infection of 77%, compared to 50% for those in the group with the longest telomeres. Among participants with the shortest telomeres, 26% became clinically ill. The rate for clinical illness was 13% for those in the group with the longest telomeres.

“In this study of healthy young and midlife adults, shorter CD8CD28 cell telomere length was associated with upper respiratory tract infection and clinical illness following experimental exposure to rhinovirus,” the authors concluded. “Because these data are preliminary, their clinical implications are unknown.”

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