Dec 3, 2020

Axios Science

Welcome back to Axios Science. This week we look at what's next for COVID-19 vaccine trials, AI advances and more.

Today's newsletter is 1,347 words, a 5-minute read.

1 big thing: What COVID-19 vaccine trials still need to do

Illustration: Sarah Grillo/Axios

COVID-19 vaccines are being developed at record speed, but some experts fear the accelerated regulatory process could interfere with ongoing research about the vaccines, Eileen and I write.

Why it matters: Even after the first COVID-19 vaccines are deployed, scientific questions will remain about how they are working and how to improve them.

The big questions: The first is whether people can have rare or delayed side effects, which could be detected in long-term trials with millions of participants.

  • "Most vaccine side effects do occur in the short term," Kathleen Neuzil, director of the Center for Vaccine Development and Global Health, said at an Infectious Diseases Society of America briefing Thursday. "But we don't know a lot about COVID, and we don't know a lot about the long-term consequences of COVID."
  • The tens of thousands of people currently enrolled in clinical trials in the U.S. will be tracked for at least two years to determine whether the vaccines pose any rare or delayed side effects.

How long immunity through vaccination lasts, and whether vaccines will stop transmission of the virus or just prevent people from becoming sick, are also open questions.

  • "It still has to be proven if the vaccine can flatten the curve and eradicate the virus in its own right," says Mark Poznansky, director of the Vaccine & Immunotherapy Center at Massachusetts General Hospital, adding that the immunology of the virus isn't completely understood.
  • On the other hand, Neuzil said early efficacy reports suggest "if we can get enough vaccine out there, we can have an impact on this pandemic very, very quickly."

What's next: The Food and Drug Administration is considering authorizing vaccines for emergency use — a faster process than full approval. Moderna and Pfizer have already submitted their requests for an emergency use authorization.

  • But some experts are afraid that once the FDA begins granting those EUAs, it'll be harder to maintain strict, placebo-controlled clinical trials to answer these l0nger-term questions.
  • Some argue that continuing to administer a placebo when a vaccine is available would be unethical, and there's also a concern that patients will leave trials where they might be getting a placebo.

The big picture: The accelerated development timeline means that "this question of whether it is appropriate to continue someone on placebo kicks in earlier than usual," says bioethicist David Wendler of the NIH's Clinical Center.

  • Trials that are already underway could likely justify continuing to use placebos if participants know they have a choice and consent to still potentially receiving a placebo, Wendler and his colleagues argue today in the journal Science.
  • Developers could help keep their trials going by guaranteeing that people who receive placebos will get a vaccine once their participation in the study is complete, they write.
  • Future trials would likely test two vaccines against each other, rather than testing one against a placebo, though there are limits to that approach.

What to watch: The FDA is set to meet on Dec. 10 to discuss Pfizer-BioNTech's EUA.

  • The breadth or narrowness of those EUAs will determine their impact on future research, says Alison Bateman-House, a professor of medical ethics at NYU's Grossman School of Medicine.
  • "If anyone who wants it can get it, you’ve killed the trials."

The bottom line: The EUA "is definitely not the end but hopefully maybe the beginning of the end" of the pandemic, Wendler says. "The question is what more do we need to figure out to get to the end?"

2. Catch up quick on COVID-19
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Data: The COVID Tracking ProjectHarvard Global Health Institute; Cartogram: Danielle Alberti and Andrew Witherspoon/Axios

More than 100,000 Americans are now in the hospital with coronavirus infections — a new record, Axios' Sam Baker and Danielle Alberti write.

Moderna filed an EUA for its COVID-19 vaccine on Monday and also announced it would begin testing its vaccine in children ages 12–17, per NYT.

The U.K. granted emergency approval to Pfizer-BioNTech's COVID-19 vaccine on Wednesday.

The CDC issued revised quarantine guidance for people possibly exposed to COVID-19. If someone is asymptomatic and tests negative, they can quarantine for seven days instead of 14. Without a test and with no symptoms, quarantine can end after 10 days, per the new guidelines.

A disorder called POTS that affects the autonomic nervous system is providing insights for how to treat some people with long-term COVID-19 complications, WSJ's Sumathi Reddy writes.

3. An AI answers one of biology's biggest problems

The structure of T1037, part of a protein from a phage that infects viruses. Credit: DeepMind

Google's DeepMind this week reported solving one of biology's long-standing problems: predicting the 3D structure of proteins.

Why it matters: Being able to determine protein structure could help to speed up drug development and aid researchers in understanding the basic biology of disease.

The problem: Predicting how physics arranges the atoms in amino acids, giving rise to the twisted and folded structure of proteins, is one of biology's toughest challenges.

  • A protein's structure determines whether and how it binds to other proteins and molecules — biological processes that underpin life.
  • The structure also plays a role in how drugs bind to proteins in the body.
  • “We have been stuck on this one problem — how do proteins fold up — for nearly 50 years," John Moult, a professor at the University of Maryland and a co-founder of the Critical Assessment of Structure Prediction, or CASP, said in a press release.

What's happening: At Monday's meeting of CASP, DeepMind announced that AlphaFold 2 — its second contender in the assessment that has happened every two years since 1994 — can reliably and accurately predict protein structures to within the width of an atom.

  • CASP teams are given the sequences of proteins or parts of proteins over the course of a few months and submit the predicted structures.
  • About two-thirds of the time, AlphaFold accurately predicted the protein structure on par with X-ray crystallography and cryo-electron microscopy, tried-and-true experimental techniques for determining protein structures that are expensive, time-consuming and a scientific art form.
  • AlphaFold is a deep-learning network trained on about 170,000 protein structures. One area where the system struggled is with groups of proteins that can distort each other's shape, Nature News reported.

Keep in mind: Determining a protein's structure is a big step, but just one in the process of developing new drugs.

  • "But DeepMind’s methods could be a way of determining whether a clinical trial will fail because of toxic reactions or other problems, at least in some cases," NYT's Cade Metz writes.
4. Worthy of your time

A new AI can pilot balloons in the stratosphere (Axios)

China successfully lands historic robotic mission on the Moon (Miriam Kramer — Axios)

Amid Covid, the air hazards of gas appliances draw new scrutiny (Jonathan Mingle — Undark)

Researchers restore lost sight in mice, offering clues to reversing aging (Kelly Servick — Science)

The social life of forests (Ferris Jabr — NYT Magazine)

5. Something wondrous

A wide-angle view of the Large Magellanic Cloud. Credit: CTIO/NOIRLab/NSF/AURA/SMASH/D. Nidever (Montana State University)

The depths of the Large and Small Magellanic Clouds — satellite galaxies of our own Milky Way — can be seen in new photos taken by a dark energy camera, Axios' Miriam Kramer writes.

Why it matters: The images could reveal never-before-known details about our galactic neighbors — and insights into how other dwarf galaxies evolve.

Details: The Survey of the MAgellanic Stellar History's (SMASH), the most extensive study so far of the clouds, released the images this week.

  • "These satellite galaxies have been studied for decades, but SMASH is being used to map out their structure over their full, enormous extent and help solve the mystery of their formation," David Nidever, SMASH's principal investigator, said in a statement.
  • The full SMASH survey took about 50 nights of observatory time and covers an area 2,400 times larger than the full Moon, according to a statement from NOIRLab, an astronomy organization operated by the National Science Foundation.
  • The images were taken by the Dark Energy Camera in Chile, which has a wide field of view that allowed the researchers to get a good look at the relatively nearby galaxies.

1 fun thing: The data gathered by SMASH has already revealed that the two clouds collided with one another in the past, setting off a burst of star formation.

Go deeper: The Atlantic's Marina Koren on why looking at gorgeous galaxy images might be good for you