Conquering COVID Part 1.1:
The Countless Unsung Heroes in the Battle to Beat this Thing Has Begun!
(aka Almost 100 Clinical Studies and Counting)
March 19, 2020
by Mark A. Moyad, MD, MPH
“I am concerned, of course, but I am also incredibly optimistic.”
Hello everyone! Me again, your favorite public health dude, boomer or professional social distancing advocate (notice I was able to endear myself to countless generations via just one introductory sentence - that was genius!). As I stated last week, I am hopeful that there will be no Part 2 in my musings to you, but instead we decided to add a Part 1.1 as we move toward eventually containing or eliminating this thing.
This week I am compelled to spend my time on the topic of immediate unsung heroes of the world. They are all around us, all the time. We just have to, at times, look really hard for them because it is easy to get caught in the relentless cycle of doom and gloom or negativity. One negative thought can beget another negative thought and then suddenly there is an avalanche of negative thinking to the point where someone becomes convinced things will go down a terrible path. One of the many ways to break this cycle, in some individuals, is via breaking a sweat or exercising since it can reboot the brain-hence the saying “you are only one workout away from being in a good mood” or “you never regret a workout after the workout” or “the runners high” and on and on. Still, partial or persistent negative thinking comes in all shapes, sizes, and solutions because it can be mild-to-severe. If it becomes regular or more severe then there is also wonderful professional help out there - please consider seeking support.
Regardless, another way to beat the negative onslaught is to appreciate what is going on all around us right now! I want to mention some of the heroes of the week in the fight against COVID-19. Have you ever heard of Jennifer Haller (age 43) or Neal Browning (age 46)? No? I did not either, but now if they sold posters, calendars, or even a T-shirt with their faces on them then I would certainly buy one. They are some of the first 45 volunteers of the first vaccine trial for COVID-19. Researchers at the Kaiser Permanente Research Institute in Seattle have started this dose and safety exploration trial in healthy individuals in a variety ages, thus
making it arguably the fastest designed and implemented clinical trial of a vaccine in my lifetime. The vaccine, called by some “mRNA-1273,” was developed by the NIH (National Institutes of Health) and Moderna Inc.
Wow! Keep in mind that it has only been a little more than two months since researchers were able to solve and provide the actual genetic sequence of the virus itself! Wow spelled backwards! Will the trial work? I have no idea - if I had that kind of soothsaying ability I would be BFFs with Jeff Bezos, or at least be his next door neighbor on our own private island (aka our private jets would be parked next to each other in the same garage and when I would see him every morning on the way to “work” I would fondly refer to him as “JB” and he would call me “MM” or “Double M” - sorry I digress).
Anyhow, the issue is not so much if this vaccine will work, but when a vaccine will work, and the
when only becomes faster when the clinical trials or research begins! The beauty in medical research is the learning curve! It can be quite fast today like no other time in human history! I think of the most recent success story with hepatitis C, where only years ago it was a fatal situation for many (I know this personally from my own family), and now it can be cured or controlled within 8 weeks in countless people! Look at prostate cancer. All of these drugs and newer therapies, but what gets missed is the numerous, even phase 3 clinical trials that did not work in the past on the road to reach this point. And, yet they provided more information to support the greater research learning curve. Thus, the real unsung heroes of the fight against bad diseases are the VOLUNTEERS or the participants of these clinical trials! The infinite number of women and men that have and continue to sacrifice with the collective goal or hope to end suffering! Simply amazing! It is not easy to fathom this level of selflessness.
Thank you, Jennifer, Neal, and all the others! The fact that, as parents, they were willing to sacrifice their potential safety or general health for greater knowledge to start research on the path to controlling or curing this virus again is nothing less than incredible!
So, the race has begun! Now, here comes the momentum! In physics, momentum is the product of mass and velocity, and what is now happening is a large amount of mass and velocity, which means a heck of a lot of momentum! Inovio company is expected to start its own safety vaccine study in the next month, and then Johnson and Johnson, Altimmune, Novavax, GSK, Regeneron, and on and on the number of companies moving toward designing and initiating clinical studies is remarkable!
Vaccine research is generally targeting
the protein known as “spike” on the surface of this virus (you see it in the many photos on the internet), which allows it to invade human cells. Block that freakin' (I wanted to use a different word) spike protein or other players at the entry point, or do not even allow spike to be produced, or let the body recognize the spike as something that must be eliminated via your own immune system or with novel therapies and you have something. Human lungs are especially vulnerable to the spike attachment so, again, eliminating the ability of the virus to construct the spike or other viral parts are also moving at a rapid pace. There are almost 100 clinical studies being constructed or in progress globally against this virus (Maxmen A. Nature 2020;578:347-348 and U.S. govt websites). Laboratory models are being developed and tested right now to determine the number of weaknesses with this virus, and I believe there are many points to target.
There are even multiple companies coming together to isolate immune products from people having recovered from the virus, so they can eventually be utilized in something called “passive immunity” where you give a person who is ill immediate immune assistance. Snakebites, spider bites, rabies, botulism, tetanus, hepatitis, newborn babies with certain conditions … the long list of lives that have been saved via passive immunization has already been remarkable in the field of medicine. Separately, we are also waiting on the results of several pilot studies over the next few weeks with several drugs to treat patients moderately or severely impacted by this thing! In the meantime, many people (especially young and healthy individuals) should at least consider donating blood at their local blood bank if they are able/qualified to donate. Please discuss this topic within your circle of family, friends, etc. There will be shortages at many local health centers for some time. For more information please go to
www.redcrossblood.org.
Additionally, please remember, heart healthy = immune healthy! Take care of your body from head-to-toe! This is the time (actually it is always the time to do this, but you know what I mean here) to take the daily walk or consider some
Shinrin-yoku (google that one - it is glorious & medical reference - Ideno Y, et al. BMC Complement Altern Med 2017;17:409 or Li Q. Sante Publique 2019;S1:135-143.), quit or reduce tobacco exposure (again this virus has a penchant for lung tissue - improve your lungs now), learn yoga online, take your medications, analyze your diet, reduce excessive alcohol intake … or simply determine where you can personally improve while social distancing. Again, no guarantee that it fights the virus, but I apologize that it will only potentially help you live longer and better. Interestingly, one of the first reviews of past studies or clinical trials (meta-analysis) of positive mood induction in general, or for example before influenza vaccination, just suggested a potential improvement in immune response (Ayling K, et al. Psychosom Med 2020;82:10-28). Interesting, yes, preliminary yes, but fascinating. Stay positive please because it may come with many side benefits!
Thank you for reading my latest installment and I wish you and your family the best of health.
I am concerned, of course, but I am also incredibly optimistic! I look forward to modern day science and you of course, kicking COVID-19 and cancer in the gluteus maximus!
All of my best always,
Mark A. Moyad MD, MPH
PS. 90% of the Starbucks are now open in China (on January 28, 2020 they had closed more than half of them). Optimism comes from many sources, including coffee.
