Medical What makes it so hard to find a cure for the Corona virus?

[Delta2]

TL;DR Summary

why is it so hard to find an antibiotic for corona virus.

Corona has come and it doesn't seem to go away that easily. Why can't modern science find some cure that will prevent so many deaths? Why for example we can't find an antibiotic for this specific virus? What about other approaches(vaccine)?

I just wish a cure could be found so we may continue our lives normally again.

 

[256bits]

Haven't you heard.
They ( the medical establishment ) is working on it.

Secondly, by definition an antibiotic is used to treat bacterial infections.
Viral infections require a different approach.

It would be worth looking at the ways to hinder viral infections
https://en.wikipedia.org/wiki/Antiv... viruses,instead they inhibit its development.

 

[Rive]

...hard to find an antibiotic for corona virus...

In short: a virus is not exactly a living thing. You can't poison it to death.

Also, a virus uses the human cells to reproduce. Whatever you do to stop it reproducing, it'll affect the host cells.

Furthermore: a new medicine takes several years to develop. This virus is here only for less than a year. So what we can do now is really limited:
- to check if we already has something what works
- provide assistance/regulation for the immune system to fight it.
- keep the severely sick alive till their immune system does the job.

Ps.: please don't forget, that this is only a short answer. Due it's very nature, it can't be accurate.

 

[Fervent Freyja]

Currently, we don’t have enough understanding of biology to be able to find cures for most viruses.

 

[jim mcnamara]

Following up on @Fervent Freyja helpful comment - we have made several discoveries about the pathogenesis of the virus that is not really like other known viruses especially influenza, a few examples:
It kills lung alveolar cells by inducing oxidative stress
It raises blood pressure by preventing formation of molecules that lower BP
It triggers clotting of blood in tiny arteries damaging surrounding tissue
It degrades cognition and mental clarity,
It attacks sensory nerves, e.g., sense of smell goes away.
It has long lasting symptoms that do not improve much with therapy. (long haulers)

All of this is because the virus newly became infective for humans, it probably came from bats in Southern China. For reasons not understood, bats harbor literally hundreds of species of Coronavirus - all at one time. And they do not appear sick. Weird.

The downside is: this trend of new viruses is going to continue as humans expand their presence into new areas with new unknown pathogens in the mammals there. Recent additions of new diseases: HIV, Ebola, SARS, MERS, Covid-19. All nasty in their own way.

 

[DaveE]

Microbiology is complex, especially virology. We also don't have a "cure" for Influenza, HIV, Ebola, RSV, Hanta, Hendra, Dengue, EEV, West Nile, Rift Valley Fever...

I think the biggest problem is with the public's expectations. Lack of political leadership and an increasing lack of trust in expertise is creating false expectations. People (institutions, etc.) are making very rapid progress compared to past efforts, but these things take time.

Look for a vaccine first to assist public health efforts, but don't expect it to be perfect. If people cooperate we may have a "cure" for the epidemic (like masks, et. al.); this is what happened with SARS-1, for example, for which there is neither a cure or a vaccine (yet). But, a clinical cure for infected individuals isn't on the near horizon (not including your own immune system, of course).

 

[fdegregorio]

They are breaking all the rules to get new treatments and a vaccine. Things could be a lot worse had this happened a mere 50 years ago.

 

[fresh_42]

This article might provide some useful insights:

Coronavirus infection causes diffuse alveolar damage leading to acute respiratory distress syndrome. The absence of ex vivo models of human alveolar epithelium is hindering an understanding of Coronavirus disease 2019 (COVID-19) pathogenesis. Here, we report a feeder-free, scalable, chemically defined, and modular alveolosphere culture system for the propagation and differentiation of human alveolar type 2 cells/pneumocytes derived from primary lung tissue. Cultured pneumocytes express the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) receptor angiotensin-converting enzyme receptor type-2 (ACE2) and can be infected with virus. Transcriptome and histological analysis of infected alveolospheres mirror features of COVID-19 lungs, including emergence of interferon (IFN)-mediated inflammatory responses, loss of surfactant proteins, and apoptosis. Treatment of alveolospheres with IFNs recapitulates features of virus infection, including cell death. In contrast, alveolospheres pretreated with low-dose IFNs show a reduction in viral replication, suggesting the prophylactic effectiveness of IFNs against SARS-CoV-2. Human stem cell-based alveolospheres, thus, provide novel insights into COVID-19 pathogenesis and can serve as a model for understanding human respiratory diseases.

https://www.sciencedirect.com/science/article/pii/S1934590920304999

 

[Jarvis323]

Aside from a cure, there are a lot of things which could be done to save lives. Unfortunately, many life saving actions are simply ignored for uncertain reasons. As an example, it is thought that vitamin D deficiency is a major risk factor for Covid-19 complications.

https://www.medrxiv.org/content/10.1101/2020.09.04.20188268v1

It is also known that about 40% of caucasians and about 80% of colored people are deficient in vitamin D in the US in a normal year. Much higher deficiency levels should be expected due to lockdowns, and during fall/winter when there is less sun. This leaves the majority of the population at much higher risk for severe illness than necessary, with colored people disproportionally affected.

https://www.scientificamerican.com/article/vitamin-d-deficiency-united-states/

A simple act of having each person be evaluated for nutritional/or sunlight deficiency (other nutritional deficiencies are actually important as well, and many people have unhealthy diets), and then directing them on actions to satisfy basic nutritional requirements for a well functioning immune system would likely have saved tens of thousands of lives. It is quite frankly shocking that it is the case that a country is willing to shutdown its economy in response to a pandemic, but either doesn't care enough or is incompetent enough to ignore basic life saving actions such as advising/helping people to maintain a healthy immune system.

This is just one example of the situation that out health care system is so poor. Another is the minimalistic care that is provided to normal people compared to the wealthy. Most deaths from Covid-19 are from people who were sent home initially and were being only hospitalized once their illness became severe. In fact testing had been limited to severe cases as well. Yet early care and treatment makes a big difference. Those who were able to hire private doctors or get special care, were able to get tested and treated early.

Addressing these problems alone should be a major priority. And if it is a matter of cost, just remember that we seem to be willing to risk the entire economy in order to prevent deaths. Fixing a broken healthcare system is a small price comparatively.

That's just my opinion, and a US centric view, but it might apply elsewhere as well.

 

[phyzguy]

We don't really know how to cure viral infections. We just try to strengthen our immune system with vaccines so we can fight them off. If we knew how to cure viral infections, we wouldn't have to suffer through colds every time we get one. Scienetists have been working for many years to find a cure for colds, so far without success. The potential market is huge, so there is much incentive to find a way to cure viral infections, but so far we don't know how.

 

[Ygggdrasil]

We don't really know how to cure viral infections. We just try to strengthen our immune system with vaccines so we can fight them off.

This is not completely true, as there are viral diseases where antivirals can cure the disease. For example, there are now drugs that are able to cure 94-99% of people infected with the most common type of the hepatitis C virus. There is also evidence that monoclonal antibody treatments against Ebola are able to cure ~90% of those infected. Similar approaches (e.g. drugs targeting the RNA polymerase like remdesivir and monoclonal antibody cocktails like the one developed by Regeneron) are being tried against SARS-CoV-2, though the data have not been promising for either approach (see this for remdesivir and this for the antibody treatments).

On the broader question, here's a good article that covers many of the points mentioned by others in the thread. Mainly, 1) viruses have fewer drug targets than bacteria because of their much smaller genomes, and 2) there are a greater variety of viruses, so there are not broad-spectrum antivirals (unlike antibiotics which can target a large range of bacteria).

For vaccines, designing a new vaccine is not terribly difficult and it can be done quite quickly. The main bottleneck for vaccine development is testing. Because vaccines are given to a large number of healthy individuals, we need to be very careful about vaccine efficacy and safety. A vaccine that is not effective could do a lot of harm (though giving people a false sense of security) as would a vaccine with bad side effects.

 

[Laroxe]

In fact we do have a number of antiviral drugs, generally they are active against 1 or a very few particular virus. We have to consider that virus's are a huge group of organisms, most of which we haven't even classified. In the case of Covid 19 we have learned a great deal about it in a very short time, largely because of the huge amounts of money invested in research. I doubt that any other virus has been subject to this sort of attention and they are screening thousands of pre-existing drugs and compounds for potential activity. Trying to develop a specific antiviral from scratch, while possible because of the information we have, will still take much longer. The reason that we don't have a cure for colds is that there are in excess of 100 different virus's that can cause them, then as the effects are relatively minor there is little motivation for governments to invest huge sums of money in research.
I'm not sure that its fair to suggest that issues like Vit D have been ignored, there is a lot of information available and its part of many national guidelines. However it would be wrong to think that this would have a major effect. In a similar way its always the case that only severely ill people get hospitalised with infections, there are in fact real problems with introducing infections like this into hospital settings and the majority will still recover.
I think with Covid 19 the only real advantage of wealth is in the ability to isolate ones self in comfort, while they may receive care in a better environment they still don't have access to a cure, one doesn't exist.

I think everyone wants to get back to some sort of normality and it looks as if an effective vaccine might be our best hope.

 

[Jarvis323]

I'm not sure that its fair to suggest that issues like Vit D have been ignored, there is a lot of information available and its part of many national guidelines. However it would be wrong to think that this would have a major effect. In a similar way its always the case that only severely ill people get hospitalised with infections, there are in fact real problems with introducing infections like this into hospital settings and the majority will still recover.
I think with Covid 19 the only real advantage of wealth is in the ability to isolate ones self in comfort, while they may receive care in a better environment they still don't have access to a cure, one doesn't exist.

While the information is available if you search for it, there is more to do in order to realize the life saving potential of addressing the problem. Despite the information, most people in some counties (including the US where a large percentage of the worlds deaths come from) are still deficient of Vitamin D. And without guidance some who happen to have stumbled across some information might be overdosing on Vitamin D. The way to save lives if that was a goal, would be to have people connected to physicians and/or nutritionists to evaluate them and prescribe the proper actions.

It may be wrong to assume it wouldn't make a big difference. The data suggests it would make a major difference.

The majority will recover, and that is the justification for limiting testing to severe patients, and to send most people home untreated and without close monitoring. The fact is that despite the majority recovering, overall hundreds of thousands still have died. If you're wealthy and have private care, you can have your risk largely reduced by getting tested more frequently, monitored more closely, and treated at the proper time when justified. If everyone had those privileges, it might make a big difference in the death toll.

The point is that we could save a whole lot more lives than we have if that was a priority. That's a general problem that goes beyond Covid-19 though.

 

[Laroxe]

I would probably agree that the US seems to be a bit slow on its evaluations of Vit D, the official bodies seem unconvinced by the evidence of effectiveness, but of course in the absence of other control strategies they may have a point. Its part of the official advice and has been covered widely in the media, they recommend around 400iu daily, a dose that wouldn't require medical advice.
The main justification for sending people home without testing was the very limited availability of the tests, only the most seriously ill would be tested and only those would be admitted. People are always advised to return if symptoms worsen and changes can happen very quickly, the level of monitoring needed to make this useful simply couldn't be provided. Testing people who are asymptomatic is useful in controlling the spread but in the absence of any useful interventions doesn't improve outcomes, nor does it lead to hospital admission.
The major factor in the control of mortality is in the availability of good care, admitting lots of people who don't need it would overwhelm the system.
To reduce the mortality risk the priority is in reducing the spread of the infection and that is more an issue of social control than healthcare, people need to take more responsibility for their own behaviour.

 

[phyzguy]

This is not completely true, as there are viral diseases where antivirals can cure the disease. For example, there are now drugs that are able to cure 94-99% of people infected with the most common type of the hepatitis C virus. There is also evidence that monoclonal antibody treatments against Ebola are able to cure ~90% of those infected. Similar approaches (e.g. drugs targeting the RNA polymerase like remdesivir and monoclonal antibody cocktails like the one developed by Regeneron) are being tried against SARS-CoV-2, though the data have not been promising for either approach (see this for remdesivir and this for the antibody treatments).

On the broader question, here's a good article that covers many of the points mentioned by others in the thread. Mainly, 1) viruses have fewer drug targets than bacteria because of their much smaller genomes, and 2) there are a greater variety of viruses, so there are not broad-spectrum antivirals (unlike antibiotics which can target a large range of bacteria).

For vaccines, designing a new vaccine is not terribly difficult and it can be done quite quickly. The main bottleneck for vaccine development is testing. Because vaccines are given to a large number of healthy individuals, we need to be very careful about vaccine efficacy and safety. A vaccine that is not effective could do a lot of harm (though giving people a false sense of security) as would a vaccine with bad side effects.

Are there any antivirals that are effective against colds or flu?

 

[Ygggdrasil]

Are there any antivirals that are effective against colds or flu?

It would be difficult to generate antivirals against colds because colds are not caused by a single virus but a large number of unrelated viruses.

Tamiflu is an antiviral that targets the influenza virus. It is effective at decreasing the duration and severity of illness but only if taken within 36-48 hours of the onset of symptoms.

 

[Astronuc]

Are there any antivirals that are effective against colds or flu?

Tamiflu is an antiviral that targets the influenza virus. It is effective at decreasing the duration and severity of illness but only if taken within 36-48 hours of the onset of symptoms.

From personal experience, it reduced severity of symptoms within 12-18 hours. I received the first dose within 24 hours and continued for four days.

I had started coughing (thought it might be allergies or a cold) Sunday evening. Some time during the night, I awoke with a high fever, which I measured at ~103-104°F (39-40°C). Early Monday morning, I called an urgent care clinic and made an appointment. They determined that I had influenza (by looking down my nose and throat), but no swab. I was prescribed Tamiflu; that was about Monday noon. I took the prescription to a nearby pharmacy, but it would take 3 hours to fill the prescription, so I went home to wait. About 4 pm on Monday afternoon, I returned to the pharmacy, procured the prescription, went home and took the first dose. The fever started to dissipate that night and was mostly gone by the next morning (Tuesday). A strong cough persisted through Wednesday.

For the cough, I was prescribed a form of codeine, but I had an allergic reaction to it, in which I developed a rash and itching/burning skin. I stopped taking the codeine and opted for dextromethorphan, which reduced the coughing without the itching/burning skin reaction.

 

[Evo]

I don't know if this is the appropriate place for this, let me know by PM if you think it should go elsewhere.

Soon after we started to treat COVID-19 patients in early February in Wuhan, we noticed that nearly half of the patients who died had high blood pressure, which was a much higher percentage compared to those with only mild COVID-19 symptoms," said Ling Tao of the department of cardiology at Xijing Hospital in Xian, China. The team of researchers, led by Fei Li and Tao, and also including researchers from the National University of Ireland Galway, published their findings in the European Heart Journal.

On a positive note, if you are taking an ACE Inhibitor or ARB, you have a much smaller chance of morbidity. I am taking one of the ARB's that they recommend, by coincidence, I am believed to have had a mild case of Covid-19 in March, tests for mild cases were not available to the public at that time.

https://www.yahoo.com/lifestyle/youre-twice-likely-die-covid-180132427.html

The scientists reviewed the records of nearly 3,000 patients in Wuhan, the initial epicenter of COVID-19. A bit under 30% of them had high blood pressure, and of those, 4% died. (1.1% of those with normal blood pressure died.) Not to mention, "Patients with a history of hypertension but without antihypertensive treatment were associated with a significantly higher risk of mortality compared with those with antihypertensive treatments"—in other words, 7.9% died when they stopped taking their heart medication.

"The researchers then pooled data from three other studies involving nearly 2,300 patients to investigate the role played by RAAS inhibitors, a class of drugs commonly used to treat blood pressure, such as ACE inhibitors and ARBs, in COVID-19 death risk," reports the BBC. "They found the risk of death to be lower among the patients who took RAAS inhibitors compared with those treated with other drugs such as beta blockers, calcium channel blockers (CCBs) or diuretics."

"In contrast to our initial hypothesis, we found that RAAS inhibitors, such as ACE inhibitors or angiotensin receptor blockers, were not linked to an increased risk of dying from COVID-19 and, in fact, may be protective," said Professor Li. "Therefore, we suggest that patients should not discontinue or change their usual antihypertensive treatment unless instructed by a physician."

 

[member 656954]

Allegedly, the Covid-19 strain that has just caused a lockdown of South Australia is new with a shorter incubation period and causing fewer symptoms. Mutations are one aspect that may make it hard to combat.

(I say 'allegedly' because it may not be correct.)

There is also suspicion that PFAS exposure exacerbates covid-19, and since PFAS is endemic in our environment, if this is true, it introduces an added complexity to treatment.

And, we've not really examined corona viruses in the degree of detail that we are having to with Covid-19 because they're not usually so globally impactful. That limit of what we know hinders rapid response because we're coming up a knowledge curve.

 

[Astronuc]

The situation at Moderna - https://nymag.com/intelligencer/2020/12/moderna-covid-19-vaccine-program.html

By late January, scientists in China had sequenced the SARS-CoV-2 genome. Soon after that, Moderna scientists in Cambridge fed that code into mRNA which was shuttled to cells via the LNP and, sure enough, the cells began to produce the protein necessary to trigger the body’s immune response. “It all just clicked. It was working just as designed,” says Smith. It took only 42 days to develop the vaccine. (The previous record was four years.) By late March, Moderna’s mRNA-1273 was being administered to subjects in its first human trial, an experience Smith describes as surreal.

Aside from a vaccine, one of the only effective treatments is a combination of Regenron's monoclonal antibody with Gilead's Remdesivir and dexamethasone. The treatment was given to Donal Trump, but is not widely available apparently. Monoclonal antibody treatments are expensive and difficult to manufacture.

https://www.beckershospitalreview.c...as-been-given-for-his-covid-19-treatment.html
https://www.sciencemag.org/news/202...t-president-donald-trump-s-covid-19-treatment

 

[Laroxe]

The situation at Moderna - https://nymag.com/intelligencer/2020/12/moderna-covid-19-vaccine-program.html
Aside from a vaccine, one of the only effective treatments is a combination of Regenron's monoclonal antibody with Gilead's Remdesivir and dexamethasone. The treatment was given to Donal Trump, but is not widely available apparently. Monoclonal antibody treatments are expensive and difficult to manufacture.

https://www.beckershospitalreview.c...as-been-given-for-his-covid-19-treatment.html
https://www.sciencemag.org/news/202...t-president-donald-trump-s-covid-19-treatment

I'm not sure that these can be described as an effective treatment, dexamethasone is effective at managing the abnormal immune overreaction seen in people who become seriously ill, but the effectiveness of the others remains questionable.

Current thinking is that the important issue is in the timing of any intervention, it "may" be that the monoclonal antibodies may prevent the disease getting worse if given very early, in fact very soon after any symptoms develop. They don't seem to do much by the time someone is hospitalised with sever symptoms, in fact they may make things worse. This then raises the problem of who should get the antibodies and how, they are given intravenously and you can't admit everyone to hospital with mild symptoms. There appear to be similar problems with antibody rich plasma from people who have recovered.
Remdesivir another expensive drug with limited, if any effect, again would need early administration. Dexamethasone isn't given early as it might increase risk, its only used when there is evidence of an immune over reaction.

We then run into the issue that if we shorten the length of the illness what effect might this have on the development of immunity.
One positive effect of the huge injection of funding into vaccine research has been the rapid advance in the use of mRNA. The vaccines are really only the starting point in what is likely to be some revolutionary changes in medicine that goes beyond vaccine development, they seem to be the ideal complement to other biologic drugs used in cancer and immune conditions.

The link reviews the latest FDA guidance on monoclonal antibodies.
https://www.fda.gov/news-events/pre...orizes-monoclonal-antibody-treatment-covid-19