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Conversation with a Nobel Prize winning virologist


Past and Future Pandemics: A conversation with Nobelist David Baltimore

Credit: California Institute of Technology

There are no two identical pandemics, but each time they occur, there is a lesson that will tell you about the next pandemic. Honorary Dean and professor of biology at Robert Andrews Milican, David Baltimore is a virologist who studied HIV during the AIDS epidemic of the 1980s and 1990s.

In 1975, Baltimore was awarded the Nobel Prize in Physiology or Medicine for discovering the enzyme used by viruses such as HIV to copy RNA into DNA. These so-called retroviruses then permanently insert DNA copies of those genes into the host cell, making it impossible to truly eliminate the infection. The novel coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2, or SARS-CoV-2) is not a retrovirus, but still causes the most destructive world. Since the AIDS epidemic.

We talked to Baltimore on the phone and heard his views on the pandemic, this pandemic, and how to prepare for an inevitable pandemic.

First, can you tell us about the AIDS epidemic timeline?

In fact, the AIDS epidemic begins with the observation of patients with various strange symptoms in a doctor’s office in Los Angeles, all of which suggest a failure of the immune system. It was a syndrome I had never seen before. Specific skin disorders, oral disorders, and other things that make no sense when taken together. These patients were mostly homosexual men and were consulted by a doctor who specializes in treating homosexual men.

Doctors reported these cases to the Centers for Disease Control in Atlanta, which was reported as a strange event, though other doctors in other areas were aware of similar problems. It was. It became an unknown cause, and it took a while before the cause was recognized as a virus. Or HIV.

After it became clear that it was a virus, it could be thought of as an infectious disease transmitted from person to person. It helped a lot in identifying the type of problem, but was clearly an agent we have never seen before. It turned out to be a virus in the class of viruses I worked on 10 years ago called retroviruses. We have discovered that retroviruses have a unique enzymatic ability to make DNA copies of RNA. That’s why I won the Nobel Prize in 1975. By the early 1980s, this type of virus was established, but we had never seen a virus that caused this type of disease.

The HIV virus was eventually found to be a virus endemic to African monkeys, infected with chimpanzees, infected humans, and was poorly and effectively transmitted to humans. It is not enough to mean that it is not a highly infectious virus. In the 1980s and 90s, everything became clear.

On the other hand, the HIV virus has spread all over the world. It is fairly evenly deadly, causing a pandemic of illness and death. Fortunately, people are studying inhibitors of such viruses, and there were some drugs on the shelves that were quickly tested for their ability to stop the disease. In fact, one of them, AZT, turned out to be very effective, but the effect was short-lived because the virus mutated. However, this has provided clues that this is the direction of drug development. Many other drugs in that class are manufactured by different pharmaceutical companies, and in the end we got pretty good antiviral compounds.

of By studying the nature of the virus, we discovered other weaknesses that were the targets of drug discovery. We have a wide variety of medicines to treat this disease. AIDS is maintained as a chronic disease today, but its lethality is mostly controlled, at least in developed countries where drugs are more consistently available. We are now living with the AIDS virus, HIV, as part of our world.

As a result, the AIDS epidemic was eventually slowed by therapeutic drugs, but not by a vaccine against HIV. Why didn’t you have an HIV vaccine?

This is a very interesting story as we believe that most viruses can create vaccines when they are first discovered. Historically, we have produced vaccines against a very wide range of viruses such as smallpox and polio, measles, mumps and rubella. In its history, we expected to make a vaccine.

I was thinking about this in the 80’s, but when I looked into the virus, I found it had features that suggested it might not be able to make a vaccine. A feature of this is that the virus can and does mutate freely and will always show different immune profiles. Despite research by scientists from companies and universities around the world, there is no vaccine. Not so resistant to control, this deadly virus has never really existed. Still Some of my colleagues work … to develop a vaccine.

So this is the background behind the introduction of COVID-19. What is the difference between that pandemic and this one? For example, you said that HIV is less contagious, but the COVID-19 virus is more contagious.

Yes, one of the main differences is that SARS-CoV-2 is very infectious, whereas HIV is very infectious.

There are many other differences between the two viruses. First, viruses are part of a very different virus family. SARS-CoV-2 is a coronavirus. HIV is called a retrovirus or lentivirus. They have many completely different evolutionary histories and mechanics. Both are viruses, very small pathogens that grow only inside cells, but behave differently.

However, both are similar in that they are of animal origin. I think that in the case of HIV it is a monkey, and in the case of SARS-CoV-2 it is a bat. Both are new to humans. Coronaviruses have never been a big problem, so there is no cure for them. They were a small focus issue for the viruses that cause SARS and MERS. [Middle East respiratory syndrome] These are coronaviruses, but their outbreaks were contained relatively quickly.

How are you working on this current pandemic? Do you focus on drug treatment and vaccine development?

At the moment, there is no way to deal with the virus. We hope that drugs developed for other purposes will work against coronavirus, but of course there is no vaccine. We are starting from scratch. But we do have huge weapons to tackle this. There are companies that have manufactured vaccines against many other viruses and developed drugs like HIV.

The scientific community expects vaccines against COVID-19 to be relatively easy to create. But we have no experience to continue. I never made a vaccine against coronavirus. We have no experience of whether this class of viruses is immunologically manageable or difficult. I’m hoping that the virus spreads so effectively that I don’t have much time to affect its spread.

Therefore, we chose the only route known to work to slow the spread of the virus. It is to prevent people from gathering. This virus, like other viruses, exists only by spreading from one person to another. Its spread requires close contact with each other, and so we are now asking people to be 6 feet away, wearing masks and staying at home.

We’re trying to stop the infection by doing something new on this scale without drugs or vaccines. We must accept social disruption, economic activity disruption, intellectual activity disruption, and all normal behavior disruption.

Colds are also often caused by coronaviruses. Why is it not considered a pandemic?

A cold is also a pandemic. But it’s not deadly. There are hundreds of cold-causing viruses, some of which are coronaviruses, but you usually don’t have to worry. They often cause a mild cold in children, which then disappears.

This kind of coronavirus is not the cause of serious illness, so don’t worry. Even if they cause a pandemic, that is, there are many people in the world who are getting a sense of smell-we allow our immune system to deal with it.

Ignoring common cold viruses is probably not a great idea. Public health officials sometimes study the cold to understand at least its natural history and where it is distributed, how infectious it is, and so on. But it doesn’t put a lot of resources into it because it’s not a real challenge to our society.

The COVID-19 virus, unlike infection, is fatal with 1-5% of infections. , This is virtually non-fatal. To our knowledge, COVID-19 was previously unseen in humans, so there was no preexisting immunity. It kills people and the level of disruption of the normal functioning of our society is absolutely extraordinary, so now we are mobilizing to prevent its spread. I’ve never seen anything like this since the 1918 flu epidemic.

Looking back, are there any thoughts that epidemiologists and public health authorities should do different things to address the AIDS pandemic?

Well, the AIDS epidemic was treated very poorly. At the time, in the early 1980s, it appeared to be an illness that primarily affected gay men. At that time, homosexuality was treated as a deviation. President Reagan didn’t want to use the words AIDS, HIV, or even gay. As a result, homophobia has been very slow in responding to the HIV epidemic. First, it took 10 to 2 years to recognize that this is a very widespread virus in the homosexual community, but outside that, especially in Africa.

We had to realize that we need to treat it not only as a disease for certain types of people, but as a threat to society. It was then much more effective at preventing it by preventing contact and treating it with the accompanying medication. But it took a long time.

In 1986, I co-chaired a committee of the National Academy of Sciences and published a report on Contrast with AIDS. This was an activity that should be done by the federal government, but the federal government was afraid to touch it. Therefore, it was carried out by the National Academy of Sciences, which devised plans for the country to study the virus, respond to it, and act. The money was earmarked by Congress and we started a serious research program. But five years have passed since I learned about the nature of the virus.

The beginning of the response to COVID-19 was very similar to the response to HIV. We tried to make pigeonholes as an illness for certain people who are Chinese for COVID-19 and for gays only for AIDS. We tried to ignore it. The scientific community knew that viruses do not affect just one group of people, but infect all. As soon as we found out that COVID-19 was infectious, we found it to spread all over the world. I noticed that the terrible epidemic in New York City actually started in February, but no one was paying attention to it. And it came from Europe, not from China.

The scientific community understands that the new pandemic is part of the history of the pandemic, and what happened once happened again.

What can we, as a society, do to prepare for the next viral pandemic?

We invest resources in protecting ourselves, epidemiology, public health, vaccines, quick response, and General science.

There should be a public health executive who constantly studies these issues, looks at all the viruses in nature, and says one by one, “What would we do if this becomes loose?” And prepare yourself. It’s all possible. It’s not really that expensive. But that, in the first place, means that we cannot rely on our industry because it is economically unattractive.

That is what must be done by the public, which means that there must be money saved for it. What I’ve seen throughout my life is that every time an outbreak occurs, I need to study this and prepare for the next problem. But within a few years, it lost its impetus, money was reallocated to other issues, and it was no longer possible to keep a watch on the natural world. We don’t maintain our ability to develop vaccines or medicines, so when the next illness occurs we have to start over. It is myopic. But that is a political reality.

Researchers are working on medicines and vaccines, and the rest of the society seems to be mobilized in its own way by home directives and safeguards, but what do you particularly think we can do better?

Well, I’m very impressed with what’s really going on. Some companies simply said, “I’m spending my expertise on this issue and I’m not worried about its economics.” I think we can address this issue, but it’s too late. What we saw in this epidemic is that once the genie is out of the bottle, it’s, so to speak, widespread and rapid, and it’s too late to prepare all the defenses. It’s too late.

You should learn from now. The next time this happens, we should already have a national program to make sure it is less vulnerable.

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California Institute of Technology

Pandemics of the past and future: Conversation with a Nobel Prize-winning virologist (April 20, 2020)
Acquired on April 20, 2020

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