As a professional improv comedian, Pam Victor ’88 is uniquely positioned to make the best out of the COVID-19 quarantine. Victor, founder and president of Happier Valley Comedy, a nonprofit improv comedy theater in western Massachusetts, shares her best advice for taking the techniques of improv comedy and adapting them for real life—especially in stressful times like these.
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Dr. Annie De Groot ’78: Designing a Vaccine
Within hours after scientists in China released the gene sequence for the novel coronavirus, Dr. Annie De Groot ’78 and her team at EpiVax, the Providence, Rhode Island–based biotech firm she co-founded in 1998, got to work doing what they do best—developing a vaccine to combat the virus.
It’s a moment De Groot says that she and her company have been preparing for for more than two decades. As an infectious disease specialist, De Groot has become widely known for her use of mathematical modeling and computer science to chart the body’s response to pathogens—including avian influenza, HIV and tuberculosis—and produce and ensure the equitable distribution of vaccines to mitigate serious diseases, especially among vulnerable populations.
The work De Groot and her EpiVax colleagues are doing now in the fight against COVID-19 is focused on designing a vaccine that uses fragments of proteins, or peptides, that look like the virus. The body’s immune cells then learn to seek out and destroy anything carrying those peptides. The advantage of such a vaccine, according to De Groot, is that it can be produced quickly—in some cases, in just a few months. Though highly effective, peptide-based vaccines don’t prevent infection. Instead, they greatly reduce the severity of illness by helping the body fight disease, which at this point, De Groot says, is an important tool in our arsenal against COVID-19 that could “buy us some time” and help front-line health-care workers.
De Groot recently took some time to discuss the impact of COVID-19, how it compares to other headline-making diseases, and what we need to look out for once a vaccine is developed and ready for use.
There are now well over 1 million cases of COVID-19 worldwide. Given our experience with other pandemics and epidemics, was this avoidable? Should we have been better prepared?
This crisis was undoubtedly avoidable. We should have started mobilizing with testing, equipment and strategies when the news of the virus first came out of China. In addition, our “just in time” economy has made it challenging to stockpile things like personal protection equipment and ventilators and drugs. Our economy is built to provide those things on an “as needed” basis. That’s a great system for reducing costs, but not so great when you have a spike in demand such as the one caused by this pandemic.
We’ve had epidemics in recent years—H1N1, Zika, SARS—that caught the public’s attention, but not nearly as much as COVID-19. What’s different this time?
When we think about the dangers posed by a new virus we consider several factors: how fast it spreads, how treatable it is, and how severe it is. COVID-19 differs from the other diseases mentioned in that it is highly contagious. It has an infection rate of 2.2, meaning that each infected person will spread it to 2.2 other people. This is significantly higher than SARS or Zika. In addition, in many infected people, the symptoms are mild. Infected people are often out and about in the community spreading the virus without even knowing they are sick. COVID-19 is also not treatable. It doesn’t respond to antiviral medications that are effective in H1N1, for example. Because it is a novel virus, we do not have any natural immunity from past flu seasons as we might with new strains of the flu. While the exact death rate of COVID-19 has not been determined, it is likely to be in the range of 1 percent, a rate 10 times higher than seasonal flu.
In your experience as an infectious disease specialist, what concerns you most about COVID-19?
It poses a real risk to our health-care system. If we look at epicenters like northern Italy and now New York, we see health-care providers who lack basic protective equipment who are putting their own health and the health of their families at risk to care for patients. The hospitals in epicenters are ill-equipped to deal with the number of people who need high levels of care. Once a person is admitted to the hospital, his or her stay is likely to be 10 to 14 days. That’s a long time for that bed to be unavailable. Providers are being forced by circumstances to make unimaginable choices about who gets care and who doesn’t. People on the margins—the uninsured, the homeless, the undocumented—are particularly vulnerable.
You’ve been spending your days on COVID-19 vaccine work. What’s happening on that front?
EpiVax is working on a peptide-driven vaccine targeted specifically to health-care workers and first responders that would ease the severity of the disease if contracted. We’ve been preparing for this moment for the past 22 years. We have the algorithms and immunoinformatic tools to design an effective vaccine in a very short time.
Where are you in the process?
Right now, we are working on nine different vaccines with an international assembly of collaborators. The projects vary based on the design of the vaccine, the delivery method, and the way they influence the immune system. Some of the most promising projects are T cell–directed vaccines. These vaccines stimulate the immune system to produce CD4 T helper cells and CD8 T cells, both of which are involved in protective cellular immunity. This reduces viral load, and thus reduces symptoms. This approach is particularly promising because it is already known to be a safe approach in humans, so the time it takes for approval could be markedly shorter than the years required by more traditional approaches.
Are there any obstacles in your way, making it harder for EpiVax to do its work?
Funding is the biggest obstacle. We need $1.75 million to begin our work and $3.25 million to start a phase-one trial.
So, realistically, how far away are we from a successful vaccine?
Our advanced immunoinformatics tools are accelerating the development of a safe and effective vaccine that could be ready in five to six months, sometime in the fall.
Recently, a lot of attention has been paid to a few available drugs to treat COVID-19, including the antimalaria drug hydroxychloroquine. What are your thoughts on these potential treatment options?
The drugs that have been in the news lately have not been shown to be effective in any kind of reliable study. There is no guidance on dosing and very little evidence that the drugs are making any difference in the course of the disease. The focus on the possible effectiveness of these drugs has made it very difficult for people who need them for indicated conditions (lupus, rheumatoid arthritis) to get them.
Your approach to vaccine development, and health care in general, has a strong social justice foundation. From that perspective, what are your concerns about the way this pandemic is being managed right now?
Accessing the health-care system is difficult for the poor, the homeless, and the underinsured in the best of times. In an environment where health-care resources are scarce, vulnerable populations will be the first to suffer, and the last to get relief.
In that respect, what will you be watching out for once a successful vaccine becomes available?
The rich and powerful always get to the front of the line. Just look at what has been happening with testing—NBA players get tested for the virus even when they have no symptoms, while people with symptoms are being told to stay at home and wait it out. We need to ensure equitable access to treatments.
Your motto at EpiVax is “science without fear.” What can you say that might allay people’s fears right now?
We are scientists. We are vaccinologists. We got this. Scientists all over the world are collaborating to fight this virus. That’s a beautiful thing.