Dr. Jason Kindrachuk, an infectious disease expert, examines the progress so far and the challenges that remain for researchers studying Covid-19 vaccines and treatments.
While we have made monumental strides in our pandemic response efforts, we are still in a relative ... [+]
I’m often asked about what to expect in biomedical research by undergraduate and graduate students. One of the key pieces of advice I always mention is it’s not a great career choice if you’re hoping for consistency and a traditional 9-5 work schedule. Period. This certainly holds true for infectious disease researchers in 2020.
Nearly two months ago, my family and I relocated from Winnipeg, Canada, where I have an active research program in emerging viruses, to Saskatoon (~500 miles/800 km distance) to help support coronavirus disease 2019 (COVID-19) research efforts at the Vaccine and Infectious Disease Organization-International Vaccine Centre (VIDO-InterVac) at the University of Saskatchewan for the next 12 months.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Covid-19, has claimed more than 940,000 lives worldwide thus far. Since that time, countless researchers, clinicians and public health experts from across the globe have dedicated themselves completely to lend their time, energy and expertise to the pandemic in an effort to help society get back to some sense of normalcy. For many of us, Covid-19 is all we think about day in, day out, and physical and mental fatigue is rampant.
Why don’t we have all of the answers about Covid-19 yet?
In these last seven months, we have learned a decade’s worth of information about this virus and the accompanying disease. While there has been no licensed vaccine for coronaviruses in humans, there are currently 35 Covid-19 vaccines in clinical and 145 in preclinical development. Further, 46 potential therapeutics are currently in various clinical trial stages. This is amazing progress for a virus that was only identified in January. However, we continue to chase a myriad of unanswered questions as the pandemic progresses in real-time.
These are exhausting times on all fronts, including in the research laboratory where researchers have worked tirelessly since January to identify and characterize SARS-CoV-2 and identify the mechanisms underlying clinical illness. To put things in perspective, while we have been studying ebolaviruses for more than four decades, we are still learning how these viruses are able to cause such devastating disease and where they hide in nature.
The unfortunate reality is that there is no single research question that will give us the eureka moment that will get us through this pandemic. Instead, it is a laundry list of questions that remain to be answered and which will help inform further clinical and public health recommendations. For example, establishing model systems in cell culture in the laboratory or animal models of infection for investigating how viruses cause disease (pathogenesis) and for testing drug candidates can be extremely time consuming.
We are still in a relative infancy in our understanding of SARS-CoV-2 and Covid-19.
We know that Covid-19 can cause lung damage, including pneumonia and, at worst, lung failure, but designing studies using cells from the lungs in order to test treatments is not so straightforward. Here are just a few of the questions researchers need to consider: What type of lung epithelial cell(s) should be selected for these studies – cells from the upper or lower respiratory tract? Can I use immortalized cells (e.g. tumor cell lines) for my analyses or should I be using “normal” non-disease cells which grow and replicate at much slower rates and often require specialized protocols? How biologically-relevant are the cells that I’ve select to the questions I am trying to answer? Should I be looking at single cell systems or use models that better mimic organ systems but often require additional optimization and expertise? These questions often require weighing faster results and insights versus data that may be more biologically relevant. However, there is a much bigger bottleneck to consider.
A race against time inside a high-containment lab
Work with an infectious virus, like SARS-CoV-2, requires a containment level 3 laboratory. This means a series of specialized containment protocols based on recommendations from agencies around the globe, including the US Centers for Disease Control and Prevention and the Public Health Agency of Canada. It also means more time. An experiment or test that my lab might run in a traditional CL2 laboratory will usually take two-three times as long in high-containment between additional procedures for cleaning and disinfection, as well as increased time due to the extra precautions taken by the researcher when handling infected or potentially infected material.
A typical day could require three trips in and out of the high-containment lab when we are running studies on specific time intervals, with the first entry occurring anytime around 7 or 8 am and the last one ending at 8pm. I’ve been involved in high-containment research for over a decade now, including a makeshift diagnostics laboratory in Liberia during the West African Ebola virus disease epidemic. Our personal protective equipment in containment laboratories is purposeful and meant to provide redundancy in protection. Multiple glove layers that are sealed with tape help protect us from contact with virus- laden biological samples. Disposable full-body coveralls and HEPA-filtered air from a powered air-purifying respirator help create an additional barrier of protection and clean air for us to breath without having to use a mask and face-shield. There is a strategy and order for putting on all of your PPE and as well for taking all of it off. This is augmented by additional protective measures and protocols within the lab to always ensure safety by building a redundancy for limiting potential exposures.
What does this mean?
Simply put, we are witnessing a truly historic event where the speed and breadth of this pandemic has been matched by a global effort to identify, characterize and create novel vaccines and therapeutics for a virus that emerged less than eight months ago. Researchers from numerous disciplines continue to work tirelessly and humbly, lending their time, energy and expertise to help contain Covid-19. While we have made monumental strides in our pandemic response efforts, we are still in a relative infancy in our understanding of SARS-CoV-2 and Covid-19. However, insights from across the globe continue to help inform public health decisions and guide policies that will inevitably help us overcome Covid-19 and hopefully make us more prepared for future pandemics.
