Birds are nesting, flowers are blooming and summer is fast approaching. Ordinarily, vacations might be front of mind. But these days, the only ‘v’ words on the agenda are ‘virus’ and ‘vaccination’.
More than 3m cases of Covid-19 – the disease caused by the new strain of coronavirus – have been confirmed worldwide. More than 200,000 have tragically died. And as the comprehensiveness of tracking varies from nation to nation, the true infection rate is probably much higher.
Boris Johnson has pointed to “real signs now that we are passing through the peak”. But he has also warned that a second spike in cases might emerge if we rush back to normality too quickly. The trouble is that prolonged lockdown measures could feasibly have their own lasting health implications – both human and economic.
It follows that the scientific community is working at lightning speed to tackle the virus. Research that would normally take years is being condensed into weeks, and giant leaps have been made since we explored the earlier stages of this fightback in March ('Fightback', IC, 20 March 2020). Collaboration has been integral to such progress, with tie-ups between listed pharma giants and support from smaller biotech companies – not to mention the starring role played by universities.
Some are trialling inoculations. Some are researching medicines. Others are enhancing and accelerating testing. Such tactics could theoretically offer a way out – or at least a means of suppression. So, where are we now?
Vaccines
At the last count 82 coronavirus vaccine candidates were undergoing preclinical evaluation and seven had entered human clinical trials, according to the World Health Organization (WHO). To put that headway into context, vaccines typically take over a decade to develop and the early stages are encumbered by lengthy laboratory and animal studies.
Europe’s first human trial of a Covid-19 vaccine started on 23 April, at Oxford University’s Jenner Institute. That may be a month later than similar projects in the US and China, but the team in Oxford is in a relatively strong position because its vaccine candidate is based on technology that has been used in a vaccine for Mers – a disease caused by a different strain of coronavirus.
Imperial College is running another British vaccine trial. Together, it and Oxford University have received more than £40m in government funding. But both projects are still a long way from completion. Vaccination trials cannot be rushed because the repercussions of releasing an unsafe vaccine into society could be far worse than the disease itself. What's more, data could be limited by falling active case numbers and distancing measures, which prevent trial candidates from gaining exposure to the illness. And even if the vaccines work, accelerating production is going to be a big job.
To that end, London-quoted Oxford Biomedica (OXB) has joined a consortium focused on scaling up Oxford University’s vaccine. Conveniently, the gene-therapy specialist recently opened a large viral manufacturing facility close by.
Big corporates with far-reaching expertise and supply-chain resources could offer more promise. GlaxoSmithKline (GSK) has linked up with France’s Sanofi (FR:SAN) to develop a vaccine based on its adjuvant platform, which can boost the immune stimulating response of an ordinary vaccine. However, this candidate won't be available until the second half of 2021. Both companies are also working on other vaccines. No bad thing; we're likely to need multiple options.
American group Moderna (US:MRNA) took its vaccine into human trials in mid-March. It was later awarded $483m in federal funding, enabling scaled-up manufacturing. Smaller US peer Inovio (US:INO) started human trials on 6 April and Johnson & Johnson (US:JNJ) expects to start its own clinical studies in the autumn. It has formed an initial partnership to manufacture its vaccine candidate, and aims to supply more than 1bn doses overall.
Treatment
There is currently no known treatment for Covid-19, notwithstanding the musings of President Trump. But work is under way to repurpose existing drugs.
Perhaps the best-known trial – to the market anyway – is Gilead’s (US:GILD). The group’s shares jumped after a report suggested that remdesevir, previously tested in Ebola, had shown good results in a trial. But days later, accidentally-posted draft WHO documents seen by the FT showed disappointing data. Gilead said the post “included inappropriate characterisations of the study”. The shares rose again on 29 April, after the group said it was aware of “positive data” emerging from the US National Institute of Allergy and Infectious Diseases’ study of the drug.
Among other examples, Sanofi and Regeneron (US:REGN) are testing rheumatoid-arthritis drug Kevzara in hospitalised Covid patients, and Sanofi is running two studies on hydroxychloroquine. The UK’s AstraZeneca (AZN) is determining whether type 2 diabetes drug Farxiga could prevent organ failure in those with pre-existing conditions. It is also trialling blood-cancer drug Calquence.
Testing
Testing should help to contain the virus, even if it can’t neutralise it. And though British health secretary Matt Hancock has conceded that our pharma giants “have no great history in diagnostics”, they are now working with smaller companies to build an industry “at scale” – demonstrating one way in which this crisis could alter the healthcare, and healthcare investment, landscape.
As part of Westminster’s five-pillar plan, and in more evidence of collaboration, GSK and Astra have set up a lab with Cambridge University for high-throughput testing and for the exploration of researching alternative testing reagents to overcome supply shortages.
Aim's companies are playing their part. Microcap Novacyt (NCYT) is supplying its gene-based tests to the Cambridge team. It has also signed a government contract to provide 290,000 tests per week for the NHS. Investors have piled in, lifting the shares from 14p in January to 404p.
Meanwhile, Omega Diagnostics (ODX) soared 700 per cent in April alone. As part of the UK’s Rapid Test Consortium, it is helping to make a point-of-care antibody test, which could gauge whether people develop immunity after having the virus. Separately, pending validation, it plans to make thousands of Mologic’s CE-marked antibody test per day.
At the larger end of the spectrum, Roche (SW:RO) and Abbott Laboratories (US:ABT) have each – among other Covid-19 tests – created their own ‘serology’ antibody kits. But while there is no proof yet that recovery protects against reinfection, it helps that both companies are huge and multi-segmental. Diagnostics comprised $1.8bn – or 24 per cent – of Abbott's first-quarter sales, balanced out by pharma, nutrition and devices. Arguably, such diversification is Abbott's greatest attribute, while there’s still so much to learn about this virus.
