“This is a tragedy that did not have to happen” was Governor of New York Andrew Cuomo’s plaintiff cry at the end of a recent broadcast. I echo his sentiment, not only for the delayed and ineffective action of our federal government which Cuomo decried, but from a lifetime of experience in fighting disease. I know what is possible and am sad to say I have an intimate acquaintance of the decade and a half or our collective failures.
Anti-coronavirus drugs and vaccines could have stopped Covid-19 dead in its tracks well before it spread beyond Wuhan, but those drugs and vaccines still lie many months in our future. This is a story of my colleagues and friends who developed the medical war chest we so badly need now, only to be stopped dead, halfway through their pioneering work, due to a lack of interest and funding.
My friend Ron Crystal, MD, is a brilliant pulmonologist and researcher at Weill Cornell Medical School. Recognizing the threat of SARS and then MERS, Ron harnessed his team both in New York and Qatar to attack the problem. He demonstrated the ability of candidate vaccines he developed together with Jim Wilson, MD PhD, at the University of Pennsylvania to protect monkeys exposed to either SARS or MERS. First, he lost funding in the United States for his work on SARS, then from Qatar for his work on MERS, where he was dismissed with a curt note that read “MERS is no longer of interest.”
Stanley Perlman, MD PhD, who I first met in 1965 when he was a graduate student with my sister Florence at the Massachusetts Institute of Technology, has spent the past 40 years at the University of Iowa working on coronaviruses. That’s right, 40 years! Realizing that cold viruses can turn nasty (after all, the polio virus is a cold virus that too can be lethal) he began his work years before the SARS epidemic. He developed strains of mice that can be infected by SARS and MERS, necessary for the development of anti-coronavirus drugs and vaccines, only to mothball them for lack of funding. He is now in a race to revive those colonies, but it will take time.
Then there is Wayne Marasco, MD PhD, trained in the fight against HIV/AIDS in my own lab at Harvard’s Dana-Farber Cancer Institute. Realizing the pandemic potential of SARS and MERS, he rushed to China then Arabia and returned to his Harvard laboratories to develop monoclonal antibodies both to prevent and treat those exposed to the virus and to probe the virus for weaknesses in their defense against potential vaccines. Had his work been carried to fruition we might have a proven drug available to fight the current pandemic, given the similarity of the SARS and Covid-19 viruses and the known ability of some SARS monoclonal antibodies to bind to the Covid-19 virus. Wayne’s work too was shelved for lack of interest and funding.
Michael Farzan, PhD, Professor at Scripps Reserch Florida, is a star student of my star student Joe Sodroski. Together Joe and Michael spent years understanding the intricacies of how HIV evades the immune system. Once in his own lab he quickly applied lessons learned for HIV to identify the gateway that SARS uses—and as it happens it is the same one used by Covid-19 virus—to enter our body. He used this knowledge to design what may be the most effective approach to creating a vaccine. Had it worked for SARS in humans as it did in monkeys, the same vaccine might well work have worked against the Covid-19 virus. Had he been funded adequately to bring the vaccine to market, an anti Covid-19 vaccine might well have been approved and ready to use today. That was not to be, as the rug was pulled from under this work as it was for so many others.
Rolf Hilgenfeld, PhD, from the University of Lübeck was excited when scientists at Singapore’s research powerhouse Biopolis used his high resolution structure of key components of the SARS virus to develop a chemical inhibitor that acted not only to stop the growth of the SARS virus but of all coronaviruses tested. This drug, like more than a dozen found by scientists around the world, would very likely stop the Covid-19 virus too. None reached the market for lack of funding. The good news is that they can be revived. The bad news is that it will take time, time we all wish we had.
I write not to lament the past but to alert us all to what we must do to prepare for the future. This will not be our last pandemic. We know that pandemic flu will strike sooner or later, perhaps more lethal and vicious than that of 1918 with the potential to kill one to two billion people. We are unprepared. We know antibiotic resistant staphylococcus and tuberculosis can spread widely at any moment, yet we are unprepared. Hit thrice by a lethal coronavirus, we must be prepared for more to come. We are not defenseless. Science will eventually save us from Covid-19 but after how much needless suffering and economic ruin? Science can save us from what we know is on our doorstep but only if we invest in our future. Let us not have to cry again, “This tragedy need not have happened!”