Wonksplainer: WHAR CORONAVIRUS VACCINE?

My, my, my, Corona!

Hey! Remember me, pendejos ? Although I'm officially retired from this socialist rag… I mean, beacon of light and hope for all who struggle in the darkness of Trumplandia, I wanted to come back and give you my pithy thoughts on this little nasty virus boppin' about the land and when we could expect some relief.

First we'll tell you a bit about the little we know about the virus, then a primer on how vaccines are developed, approved and distributed, and finally a summary of what is actually being done by whom regarding vaccines and also, importantly, treatments. The Orange Idiot, of course, can't be expected to know the difference between a vaccine and therapeutic, so please, somebody print this out in crayon font and slip him a copy. But before we get to all that, please, please:

There are plenty of good articles out there already on the pandemic/spread/symptoms/etc., and I recommend these three:

 Doktor Zoom Tells You to Wash Your Damn Hands 

 A UK Article Targeted at Health Care Workers There, But With Good Stuff 

 An Editorial on What the US Should Do, But Also With Lots of Excellent Charts 

WHO OR WHAT IS A 'COVID-19'?

Okay, let's look at the pendejito causing all the fuss. Below is a nice mug shot of it courtesy of our friends at the New England Journal of Medicine . It's important to note here that this is a general diagram of a coronavirus, and the one floating around named severe  acute respiratory syndrome coronavirus 2 or SARS-CoV-2 to its friends, which causes COVID-19 (the disease name), is a TYPE of coronavirus. Sort of like how that asshole seagull that shit on me during my run yesterday is a "bird" and there are lots of different kinds of birds. Some coronaviruses cause colds and some are used to give Corona beer that special taste. (That last part is totally true, by which we mean NOT TRUE.) Anywho, there are three main structures you need to understand about coronita , the various proteins that stick out like little crown tops (hence the moniker "corona" which means "crown" in a certain, excellent language), the RNA (just think of DNA if you don't know the difference) and the membrane, which isn't labeled in the diagram, but is that circular wall-like structure.

New England Journal of Medicine 

So, last thing first: The membrane!

This is where hand washing is important. The detergent/soap breaks ups that membrane, completely disassembling the coronavirus. That's why the 20-second thing matters. If you have coronavirus on your hands, simple soap will destroy it better than anything.

Okay, next thing is the RNA.

Humans have RNA too, but without going into a BIOCHEM 101 lecture, let's just say it works in partnership with DNA to manufacture all your proteins. In an RNA virus like coronita, it works just like our DNA, coding for the virus proteins it needs.

And finally and most importantly for the vaccine discussion, the proteins.

The few (compared to animals) proteins coronita makes for itself serve different functions. Some of them are used like little transport tunnels for molecules to move through, but some of them are used like docking stations to connect to the outside of our cells and inject that RNA inside. Once the RNA gets inside, it merges into our DNA (sneaky fuck!) and then uses our very own cells to manufacture more viruses until there's a ton inside the cell and BOOM, MOFO! The cell bursts and all the new viruses emerge, ready to fuck up more cells and go nuts multiplying and infecting.

Now, remember all this as we discuss ...

WHAT IS 'VACCINE'?

Your body's immune system is pretty amazeballs. For a critter like chicken pox or measles, where they don't mutate and always look the same, once your immune system has seen it, it will positively NUKE THAT MOTHERFUCKER INTO OBLIVION the next time it gets into your blood and that second time you will not get sick at all. How does it work? Again, the super short version is that your immune system sees the surface proteins on the virus that first time and creates novel antibodies that are like jigsaw puzzle pieces that recognize/fit those surface proteins. The first time you're infected, the virus replicates faster than your body can create the antibodies, and it wins that first fight. The second time, though, your immune system sees that chicken pox (or whatever) coming and generates a Quicksilver-level response that takes out all the viruses before they infect many cells. Vaccines work by injecting you with specially selected proteins from the virus (or in the old days, non-infective versions of the whole virus) that will elicit that first wave response, as if you are actually infected. Then, if and when you are actually infected, you get that Quicksilver, Bruce Lee immune response and the virus is nuked from orbit.

SO WHAR VACCINE?

And now for the Debbie Downer portion of this story!

Trump says we'll have a vaccine like next Tuesday at lunch, while actual scientists who aren't afraid to speak say 12-18 months. Well, kids, I'm here to say it may actually be never. Let that sink in for a minute. "Never" is actually the most likely. Look, don't kill the messenger. Vaccine development is pretty fucking hard. Notice we don't have an HIV or HCV (Hepatitis C) vaccine. We know a TON about those two viruses and have been throwing a zillion dollars, people and resources at developing vaccines for those with not even a glimmer of hope.

Again, vaccine development could be an entire grad school class, so I won't go into too many details. The biggest challenge is to find a virus protein that will give you a Goldilocks immune response. One that will give you that immune memory/Quicksilver effect without a super crazy, over the top response where your whole immune system goes nuts (us cool science kids call that a "cytokine storm") and makes you super sick at best or kills you at worst. Sometimes, you just can't find that protein. That's what's been the case so far for HIV and HCV.

Okay, but let's say we DO find a good vaccine candidate. It's two years before you can get your shot, baby. You need to first do your animal studies (three months AT BEST), then file the Investigational New Drug (IND) application with the FDA that allows you to inject human subjects (another three months AT BEST). And THEN you do your Phase One safety studies in humans (three months if you're super fast, but honestly six months to get this done is more realistic). And THEN your real study, the biggie Phase Three study to prove that your vaccine is preventative, that's six months at least. And THEN another three months to crunch the data, and another two months if you're amazing to pull everything together and file with the FDA.

If they are crazy nuts they could emergency approve you in three months (nine months is the super accelerated version now, but hey, scream "PANDEMIC!" and who knows) and then the vaccine is available. And THAT'S if you have some vaccine candidate ready now, which some companies and labs claim to have.

Sorry, gang.

 
 assets.rbl.ms 

SO WHAT WE DO THEN?

Okay, more sunshine and puppy dogs now! Treatments! Antivirals!

Though still no walk in the park, this is where I'm personally more optimistic. We fucking cured HCV, which until we did was a death sentence for patients. Now, eight weeks of pills (very, very expensive pills and a whole other TED Talk why that's okay, you critics of my industry!) and you're walking on sunshine. HIV? Not cured. (Except for two very interesting case studies. Hit me up on the Tweeter or email if you're interested in those) But now it's a basically a chronic condition where for many patients they've knocked down the virus levels to non-infective numbers.

We have lots of potential anti-virals ready to test and some are already being tested in the clinic against Coronita. How do they work? Well, golly gang, I'm over my usual word limit for a Wonkette story so let's just say, a variety of ways, hitting at different points in the virus replication cycle (bonus trivia: viruses are not considered "alive" so it's not their life cycle). As a betting man, THIS is where I think we'll actually nuke this fucker from orbit. Stay tuned.

It was grand to be back for one story! Follow me on Twitter or email me if you like!

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