If our experience with coronaviruses in the past few decades has taught us anything, it’s that outbreaks are inevitable, no matter what we do. You don’t have to look further than the fact that COVID-19 is the third coronavirus epidemic to affect human populations in 20 years, after severe acute respiratory syndromes (SARS) in 2003 and Middle East respiratory syndrome (MERS) in 2012. Coronaviruses make their homes in a variety of animal hosts, from bats to cats, dogs to camels, and it’s just a matter of time before another one makes the jump into people.
Another thing we know for sure is that we can’t rely on patchwork responses each time an outbreak occurs. Every time a new coronavirus emerges, researchers focus their attention on learning everything they can about the culprit, and biotech companies dip a careful toe into the investigational waters of developing a new treatment, but ultimately, when the cases subside, so does the interest and so does the research.
Dr. David Ho, director of the Aaron Diamond AIDS Research Center and professor of medicine at Columbia University, wants to put an end to that trend. Ho is a leader in the HIV field, having done groundbreaking research on how the virus works in the body, and pioneering the idea of combating infection early and with the strongest possible arsenal of combined anti-virals. Now, he’s turning to coronaviruses, hoping his HIV expertise will help him figure out how best to treat and contain novel coronaviruses. With a $2.1 million starting grant from Chinese technology mogul Jack Ma, Ho will oversee four research teams at Columbia whose goal is to find an effective treatment against COVID-19 and other coronaviruses.
“We put together a proposal in record time—probably no more than 72 hours,” says Ho. “We predict in the coming decade there will be more [outbreaks]. And we need to find permanent solutions. We should not repeat the mistake we made after SARS and after MERS, that once the epidemic wanes, the interest and the political will and the funding also wanes. If we had followed through with the work that had begun with SARS, we would be so much better off today.”
To ensure that the next response to a coronavirus outbreak is better than this one, Ho and his team are building a first-of-its-kind library of potential coronavirus drug candidates. Coronavirus, like HIV, is an RNA virus, meaning its primary genetic material is made up of RNA; after infecting a host cell it produces more of its own genetic material. So Ho is stacking his shelves with polymerase and protease inhibitors and other drugs that have been developed to fight HIV and other viruses like viral hepatitis, that can interfere with this replication. Ho says there are about 4,700 of these drugs, if you include their analogues (drugs that are structurally similar but may be made using slightly different formulas and might have varying side effect profiles). Because viruses seem to share some basic processes to replicate, that means there’s a strong chance of finding something that might be effective against not just SARS-CoV-2 but other coronaviruses that might pop up in coming years.
Ho is also studying samples from people infected with COVID-19 to find antibodies that might be attacking the virus—applying a strategy his team has been using to find new approaches to treating HIV.
Other researchers are tracking strains of coronavirus currently living in animals like bats, so together with the library of potential drug candidates, Ho says it might be possible to better combat the next coronavirus infection. “We have a goal to have [some] lead candidates [to treat COVID-19] in one year’s time. So we really have to get going,” says Ho. “But if we had done something like this after SARS and MERS, we would be further along already.”