Nigeria on Wednesday logged 453 fresh COVID-19 cases, and in the process raised the national tally to 47743 positive cases.
Interestingly, 33943 patients, according to the Nigeria Centre for Disease Control (NCDC), have been discharged and 956 deaths have been recorded throughout the 36 states of the federation, and the Federal Capital Territory, Abuja.
Of the 453 new cases from 16 states, Lagos logged 113, Abuja 72, Plateau 59, Enugu 55, Kaduna 38, Ondo 32, Osun 26, Ebonyi 20, Ogun nine, Delta eight, Borno seven, Akwa Ibom six, Oyo five, Bauchi, Kano, and Ekiti one case each.
However, not less than 5.7 billion doses of the coronavirus vaccines have been pre-ordered around the world. This is in spite of the fact that none of the vaccines under development has proved its efficacy yet in clinical trials.
Perhaps, it’s because some people get really sick from COVID-19. A study by investigators at the Stanford University of Medicine and other institutions has turned up immunological deviations and lapses that appear to spell the difference between severe and mild cases of COVID-19.
That difference may stem from how our evolutionarily ancient innate immune system responds to SARS-CoV-2, the virus that causes the disease. Found in all creatures from fruit flies to humans, the innate immune system rapidly senses viruses and other pathogens.
As soon as it does, it launches an immediate though somewhat indiscriminate attack on them and mobilises more precisely targeted, but slower-to-get-moving, “sharpshooter” cells belonging to a different branch of the body’s pathogen-defense forces, the adaptive immune system.
“These findings reveal how the immune system goes awry during coronavirus infections, leading to severe disease, and point to potential therapeutic targets’’, says Bali Pulendran, professor of pathology and of microbiology and immunology and the senior author of the study.
Scheduled to be published August 11 in Science, the lead authorship is shared by Stanford postdoctoral scholars Prabhu Arnunachalam, Florian Wimmers, Chris Ka Pun Mok, and Mahen Perera, both assistant professors of public health laboratory sciences at the University of Hong Kong.
Three molecular suspects
The researchers analysed the immune response in 76 people with COVID-19 and in 69 healthy people. They found enhanced levels of molecules that promote inflammation in the blood of severely ill COVID-19 patients.
Three of the molecules they identified have been shown to be associated with lung inflammation in other diseases but had not been shown previously in COVID-19 infections.
“These three molecules and their receptors could represent attractive therapeutic targets in combating COVID-19”, said Pulendran, who is the Violetta L. Horton Professor. His lab is now testing the therapeutic potential of blocking these molecules in animal models of COVID-19.
The scientists also found elevated levels of bacterial debris, such as bacterial DNA and cell-wall materials, in the blood of those COVID-19 patients with severe cases. The more debris, the sicker the patient—and the more pro-inflammatory substances circulating in his or her blood.
The findings suggest that in cases of severe COVID-19, bacterial products ordinarily present only in places such as the gut, lungs and throat may make their way into the bloodstream, kick-starting enhanced inflammation that is conveyed to all points via the circulatory system.
But the study also revealed that, paradoxically, key cells of the innate immune system in the blood of COVID-19 patients became increasingly paralyzed as the disease got worse. Instead of being aroused by the presence of viruses or bacteria, these normally vigilant cells remained functionally sluggish.
If high blood levels of inflammation-promoting molecules set COVID-19 patients apart from those with milder cases, but blood cells are not producing these molecules, where do they come from? Pulendran believes they originate in tissues somewhere in the body—most likely patients’ lungs, the site of infection.
“One of the great mysteries of COVID-19 infections has been that some people develop severe disease, while others seem to recover quickly”, Pulendran said. “Now we have some insights into why that happens.”
Pulendran is a member of Stanford Bio-X and a faculty fellow of Stanford ChEM-H.
However, first shipments of a COVID-19 vaccine created by Western laboratories have often been snapped up by the United States.
Five vaccines—three Western and two Chinese—are in Phase 3 efficacy trials involving thousands of people.
In a surprise announcement, Russian President Vladimir Putin claimed Tuesday that a vaccine dubbed “Sputnik V”—after the Soviet satellite—conferred “sustainable immunity” against the novel coronavirus.
As research laboratories around the world race to develop a vaccine, manufacturers have received financing to help them prepare to have millions of doses ready to administer in 2021 or even before the end of the year.
Oxford University, working with the Swedish-British pharmaceutical group AstraZeneca, hopes to have results by September while the US biotech company Moderna, partnering with the US National Institutes of Health (NIH), is aiming for the end of the year, possibly November.
US: 700 million doses
President Donald Trump has launched “Operation Warp Speed” in a bid to develop, manufacture and distribute a COVID-19 vaccine to all Americans by January 2021.
Hundreds of millions of dollars have been directed to vaccine developers including nearly $500 million to Johnson & Johnson at the end of March.
The United States has allocated funding to more companies than other nation in the hope that one of them will come up with the vaccine to counter the highly contagious virus.
So far, Washington has handed out at a total of least 9.4 billion dollars to seven vaccine developers and signed manufacturing contracts with five of them to provide 700 million doses.
The companies involved are: Johnson & Johnson, Moderna, Oxford/AztraZeneca, Novavax, Pfizer/BioNTech, Sanofi/GSK, Merck Sharp and Dohme.
Two vaccine developers—Oxford/AztraZeneca and Sanofi/GSK—have signed or are in advanced negotiations with the European Commission to provide a combined 700 million vaccine doses.
Britain, because of Brexit, is negotiating a separate pre-order of 250 million doses from four developers.
Japan is counting on 490 million doses from three suppliers including 250 million from Novavax of the United States.
Japanese pharmaceutical giant Takeda bought the rights to a Novavax vaccine for Japan, which has funded the research. It would be produced locally.
Brazil chose a similar model, ordering 100 million doses from AstraZeneca, and partnering with China’s Sinovac to produce 120 millions of “CoronaVac,” which is already undergoing testing with Brazilians.
Clinical tests of two Chinese vaccine candidates—Sinovac and Sinopharm—are well underway but only a few international partnerships have been announced, the one with Brazil and a possible one with Indonesia.
Russia said 20 nations have pre-ordered one billion doses of Sputnik V and that with foreign partners it would be able to produce 500 million doses a year in five countries.
Developing countries
The Coalition for Epidemic Preparedness Innovations (CEPI), launched in 2017 by Norway, India, the Bill and Melinda Gates Foundation and the Wellcome Trust, seeks to ensure that there is “equitable access” to future vaccines.
It has pre-ordered 300 million doses from AstraZeneca for dozens of developing countries in a partnership with The Vaccine Alliance (Gavi).
Billions of doses would be produced for Asia and elsewhere by the giant Serum Institute of India (SII), the largest vaccine producer in the world.
Novavax and AstraZeneca have separately signed agreements with SII to produce a billion doses each for India and low- and middle-income countries on the condition, of course, that they prove their efficacy in clinical trials.
