Researchers and clinicians from Massachusetts General Hospital joined with colleagues from the Boston/Cambridge science ecosystem for a Grand Rounds session last week to provide details on an unprecedented team effort to respond to the challenges posed by the COVID-19 pandemic.
Hosted by Katrina Armstrong, MD, chief of the medicine at Mass General, and Bruce Walker, MD, director of the Ragon Institute of MGH, MIT and Harvard, the presentation featured experts in clinical care, epidemiology, diagnostics, fundamental science, vaccine development and therapeutic development.
The speakers are members of the newly formed Greater Boston Consortium for Pathogen Readiness (GBCPR), a multi-institutional collaboration of scientists from across the Boston-Cambridge ecosystem.
Here are some key takeaways:
- On average, each person with COVID-19 could infect two other people. Given that assumption, ending the epidemic could mean needing to achieve immunity in 50 percent of the population, either through exposure or vaccination.
- Vaccine development for COVID-19 is proceeding faster than ever before, but this may not be fast enough. While clinical trials for vaccines could begin shortly, the large-scale production of millions of vaccines is unlikely to start before January 2021.
- There’s good reason to think a vaccine will be effective because there’s evidence the body develops natural immunity to the virus after exposure, the virus has limited strain diversity so far and the virus has a spike protein that appears to be a promising antibody target.
- Testing existing drugs to see if they can be repurposed to treat COVID-19 is a good strategy and should include antiviral drugs as well as drugs traditionally used for other purposes. The key is to look for molecules that act on enzymatic functions similar to those the virus employs to replicate in the body.
- The full spectrum of clinical presentation in COVID-19 is difficult to understand because the focus has been on diagnosing those who are already sick, which tend to be the most severe or fatal cases. It’s still not clear how long patients are contagious after their symptoms are gone, or why some cases progress rapidly after a week or more of mild symptoms.
- Lessons from previous coronavirus outbreaks demonstrate that treatment and prevention efforts may require finding a “Goldilocks” model of immunity. Too little immunity may not be enough to protect against infection, while too strong of an immune response could exacerbate the disease, putting the patient at greater risk.
- To ramp up diagnostic capacities, GBCPR members are scrambling to support hospital-based microbiology labs in developing and implementing their own lab-based diagnostic tests.
- Philanthropic donations are providing the crucial funding needed for consortium members to immediately start addressing these challenges.
Speakers at Grand Rounds included:
- Lindsey Baden, MD, of Brigham and Women’s Hospital (clinical presentation)
- Marc Lipsitch, DPhil, of the Harvard T.H. Chan School of Public Health (epidemiology)
- Pardis Sabeti, DPhil, of Harvard Medical School and the Broad Institute of Harvard and MIT (diagnostics)
- Galit Alter, PhD, of the Ragon Institute of MGH, MIT and Harvard (mechanisms of infection)
- Mark Namchuk, PhD, of Harvard Medical School (therapeutics translation)
- Dan Barouch, MD, PhD, of the Ragon Institute and Beth Israel Deaconess Medical Center
- Mark Schwartz, a member of the MGH Board of Trustees (philanthropy)
About the Greater Boston Consortium for Pathogen Readiness (GBCPR)
The GBCPR was established at Harvard Medical School on March 2, 2020, to support large-scale collaborative efforts among the hospitals, research institutes, biotech and pharma companies (such as Moderna) in Boston and Cambridge, the Massachusetts Department of Public Health and philanthropic foundations. Consortium members are also collaborating with Chinese colleagues at the Guangzhou Institute of Respiratory Health. Learn more.