It has been very encouraging to hear that all of the hard work done by clinicians within the NHS to rapidly restructure services appears from 'on the ground' reports from colleagues to have been immensely helpful, supporting safe staffing levels for patients. We commend those colleagues involved whose hard work, dedication and quick thinking has no doubt had a huge impact on the health of the population. In this vein of hope, perhaps we can allow ourselves to glimpse forward.
The authors propose mitigation of social and economic ramifications of intermittent lock down using universal antigen testing. They suggest pilot programmes could be implemented in a number of towns and cities. Residents of those pilot areas would be able to live life as normal, apart from those households where anyone tests positive. Those households would need to quarantine until all members of the household tested negative. Direct comparison can be drawn with the wider UK to guide the feasibility of implementation nationally.
Sarah Gilbert and her team had already begun planning for how they could rapidly respond to pandemic infection before the COVID-19 outbreak began. When the genome for SARS-CoV-2 was published in January 2020 they began vaccine development. The team won an NIHR research grant for £2.2 million to develop their adenoviral vectored vaccine technology against novel coronavirus, which aims to trigger T-cell responses as opposed to relying solely on antibody responses. Her team has worked in parallel with other teams meaning volunteers were screened and vaccine manufacturing was scaled up simultaneously to the work on development. The trial will begin with 500 volunteers (by mid-May) and eventually expand to over 5000. The ideal potential outcome would be a result by Autumn 2020 demonstrating efficacy of the vaccine but of course this depends on many factors.
1.Peto J et. al. Universal weekly testing as the UK COVID-19 lockdown exit strategy. Lancet. 2020. [epub ahead of print] https://doi.org/10.1016/S0140-6736(20)30936-3
2. Lane R. Sarah Gilbert: carving a path towards a COVID-19 vaccine. Lancet. 2020; 395(10232): 1247. https://doi.org/10.1016/S0140-6736(20)30796-0.