Here are some scientific and medical achievements related to Covid to be thankful for this Thanksgiving

Eighteen months after the start of the Covid-19 pandemic, infectious disease expert Dr Mark Kortepeter explains why he is grateful that things aren’t worse and celebrates advances in viral genomics, mRNA vaccines , monoclonal antibodies and other technologies.

Millions of people across the United States will travel and gather around a table on Thanksgiving to participate in one of our country’s most cherished annual traditions. there is natural worry from public health authorities about this opportunity for a further surge in Covid, which got me thinking of the old adage: it could always be worse. Despite the historic devastation that has occurred and continues to occur, I reflected on what could have happened if SARS-CoV-2 had surfaced in 2003, when the first new coronavirus, SARS-CoV- 1 surfaced, rather than in 2019, when SARS -CoV-2 (the virus that causes Covid-19) emerged.

As devastating as the Covid-19 pandemic has been, I am grateful it was no worse. There have been many timely scientific achievements that would not have been there in 2003 to mitigate the blow.

Previous outbreaks of novel coronavirus

Prior to 2003, we considered coronaviruses to be simple causes of the common cold. The emergence of the first “new” Severe Acute Respiratory Syndrome (SARS) coronavirus pandemic in 2003 (now known as SARS-CoV-1) served as a red flag that coronaviruses could be fatal. But we were lucky then. The world was able to eliminate the SARS-CoV-1 virus by month. One thing in our favor was that SARS-CoV-1 did not spread until symptoms appeared. This made it easier to control, because when a person was exposed, they could be quarantined with enough time to prevent them from passing the virus on to others. This is not the case with SARS-CoV-2, which can spread before the onset of the disease, and even from asymptomatic individuals.

In recent years, the world has also been grappling with multiple regional outbreaks caused by another new coronavirus, the Middle East Respiratory Syndrome Virus (MERS). These two novel coronaviruses (SARS-CoV-1 and MERS) have sparked significant scientific interest, which has given the world a good start to studying how novel coronaviruses cause disease before Covid has arrived.

Viral genomics

In 2003, viral genomics was a nascent field. Previously, the sequencing of viral genomes was done manually. Now we have automated machines that can sequence a viral genome in a matter of hours. This rapid capability has enabled us to understand and share the genomics of SARS-CoV-2 within weeks the identification of a group of patients in China with pneumonia and the monitoring of the evolution of the virus.

MRNA vaccine platforms

The mRNA platforms were conceived from more than a decade ago by the Defense Advanced Research Projects Agency (DARPA) to develop a rapid way to manufacture vaccines in a pandemic. In early 2020, armed with rapid viral genome sequencing, vaccine developers were able to take advantage of mRNA technology, scale up manufacturing, and develop distribution chains. Vaccines have saved millions of lives since their launch last year.

Monoclonal antibodies

The first monoclonal antibody was approved in the United States in 1986. In the years that followed, faster development and manufacturing methods were discovered. We’re a step ahead of what we were in 2003. We now have monoclonal drugs licensed for dozens of diseases, such as rheumatoid arthritis, migraines, Crohn’s disease, melanoma, and even Ebola. So when Covid arrived, it made sense for pharmaceutical companies to take advantage of this technology to find monoclonal to treat or prevent it.

Ebola virus

Why would anyone be grateful for Ebola? Previously, I conducted Ebola virus research in the Biosafety Level 4 Containment Lab and also helped hospitals prepare for Ebola or other serious illnesses requiring specialized containment. The 2014-2016 Ebola epidemic forced hospitals to reinvigorate their preparedness for diseases requiring infection control. In essence, they were prepared by Ebola for the “real” event, Covid. The other aspect that Ebola laid bare was the need for real-time clinical research during a rapidly evolving epidemic where people are dying. Some of the research networks that arose during Ebola were able to pivot quickly when Covid started.

The Internet and online streaming platforms

At the end of 2019, my debilitated 91-year-old father had to go to a retirement home. It was heartbreaking when the family were barred from direct contact with him because of Covid. No doubt his mental decline was accelerated by this lack of family contact. Six months after the start of the epidemic, we were able to establish a brief daily online chat. It was imperfect, but better than nothing.

Consider how different things would have been if Covid had struck even five years ago. We wouldn’t have had the bandwidth and internet platforms to connect like we did – to “visit” family members or continue working and studying remotely. Perhaps we would have had to do business over the phone. Or, more worryingly, we might have simply continued to work as usual in offices, schools and other crowded environments, which led to more opportunities for rapid viral spread long before counter- measures.

Why don’t tigers get colds? They roam as individuals or in small groups, making virus transmission inefficient.

A word of caution as the holidays approach

I have listed some of the ways the scientific, medical and public health communities have been able to push the boundaries to save lives in our response to Covid. They were able to take advantage of technology platforms whose foundations had been laid in previous decades, but which were much more mature in development in 2019 than they would have been in 2003. That’s why I am acknowledging that SARS-CoV-2 surfaced in 2019, rather than 2003. The old English proverb “necessity is the mother of invention” rings true for the Covid pandemic. To be sure, many technological breakthroughs accelerated during the pandemic out of necessity as the number of bodies continued to rise.

While it is easier and safer to get together through online platforms, we do come together at Thanksgiving for a very basic need: the need for fellowship. But it is this need that is our greatest vulnerability in the face of a pandemic respiratory virus. My public health teacher once asked my classmates, “Why don’t tigers have colds? His response was that they wandered as individuals or in small groups, rendering virus transmission inefficient.

So, as you gather this Thanksgiving with your friends and family, to thank or sadly, to remember loved ones lost during the pandemic, remember that Covid is always on the lookout for new hosts. It spreads when we get together, especially in tight spaces indoors. The spread of any infectious disease easily occurs within the household as we tend to let our guard down with family and friends. Consider your vulnerabilities and take precautions to minimize opportunities to spread around the table, so that a Happy Thanksgiving doesn’t leave you with an unwanted visitor in the days following the celebration.

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