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US study suggests COVID-19 pandemic may be accelerating antimicrobial resistance

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Analysis of antimicrobial resistance in 271 US hospitals finds higher rates of antibiotic-resistant infections in both COVID-19 patients and SARS-COV-2 negative patients admitted during the pandemic compared to pre-pandemic

Reports and Proceedings


Among those hospitalized during the pandemic, both COVID-19 patients and those tested for SARS-COV-2 but negative, had higher rates of antibiotic-resistant bacterial infections compared to patients hospitalized before the pandemic, according to a study evaluating the pandemic’s impact on antimicrobial resistance (AMR) in 271 hospitals across the USA, to be presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Lisbon, Portugal (23-26 April).

The study, by Dr Karri Bauer of the pharmaceutical company MSD, a trade name of Merck & Co., Inc, Kenilworth, NJ, USA and Dr Vikas Gupta, of the medical technology company Becton Dickinson (BD) and colleagues, also found that drug resistant infections were significantly higher in hospital-onset cases during the pandemic.

 An estimated 1.2 million people worldwide died in 2019 from antibiotic-resistant infections [1], and this number is predicted to increase ten-fold by 2050 [2]. The COVID-19 pandemic presents many challenges for appropriate antibiotic use and stewardship, and there have been studies reporting that the pandemic was associated with AMR secondary infections, possibly due to the increase in the use of antibiotics to treat COVID-19 patients and disruptions to infection prevention and control practices in overwhelmed health systems. While conclusive evidence is lacking, these signals underscore the importance of continued monitoring of the impact of COVID-19 on AMR rates.

To provide more evidence, researchers conducted a multicenter, retrospective cohort analysis of all adults (aged 18 years or older) admitted to 271 hospitals across the USA before and during the COVID-19 pandemic, who had spent at least one day in hospital and had a record of discharge or death.

 Patients were categorized according to when they were admitted: before the pandemic (from July 1, 2019, to February 29, 2020), or during the pandemic (from March 1, 2020, to October 30, 2021), and based on their COVID-19 status (with a positive SARS-CoV-2 result defined by positive PCR or antigen test within 7 days prior to admission or during hospitalization). All admissions with at least one AMR infection (defined as a first positive culture for select gram-negative or gram-positive pathogens resistant to antibiotics) were recorded.

Researchers assessed AMR rates per 100 admissions before and during the COVID pandemic and examined whether drug-resistant infections were acquired in the community-onset setting (defined as a culture collected less than 2 days after admission) or in the hospital-onset setting (more than 2 days after admission).

In total, 1,789,458 patients were admitted to the hospital in the pre-pandemic period and 3,729,208 during the pandemic. The number of patients admitted to the hospital with at least one AMR infection was 63,263 in the pre-pandemic period and 129, 410 during the pandemic.

The analyses found that the AMR rate was 3.54 per 100 admissions before the pandemic and 3.47 per 100 admissions during the pandemic. However, patients who tested positive or negative for COVID-19 had higher levels of AMR than patients before the pandemic—4.92 per 100 admissions and 4.11 per 100 admissions, respectively (see table in notes to editors).

For hospital-associated infections, the AMR rate was 0.77 per 100 admissions before the pandemic and 0.86 per 100 admissions during the pandemic, and highest at 2.19 per 100 admissions in patients with COVID-19. When looking at community-onset infections, the AMR rate was 2.76 per 100 admissions in the pre-pandemic period, and 2.61 per 100 admissions during the pandemic.

“These new data highlight the importance of closely monitoring the impact of COVID-19 on antimicrobial resistance rates,” says Dr Bauer. “It is particularly worrying that antibiotic resistance has been rising during the pandemic in both SARS-CoV-2 positive and negative patients. Hospital-acquired infections are a major concern, with antimicrobial resistance rates significantly higher during the pandemic than before.”

 Despite these important and timely findings, the authors note that additional evaluation of the pandemic’s impact on antimicrobial resistance is needed. “As healthcare capacity remains at the forefront of everyone’s mind, it will be critically important to keep a pulse on the growing impact of drug-resistant infections,” said Gupta. “This type of data and surveillance will help healthcare leaders identify needed resources to support antimicrobial stewardship programmers – and also support more detailed and sophisticated forecasting of future trends and outbreaks.”

 This study is limited to US hospitals and evaluation of the impact of COVID-19 on AMR outside the US is warranted.

 All requests for interviews with the study authors please contact Deb Wambold  in the MSD Media Office T) +1 (215) 779-2234 E)

Alternative contact in the ECCMID Press Room: Tony Kirby T) + 44(0)7834 385827 E)

Notes to editors:

[1] Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis – The Lancet
[2] no-time-to-wait-securing-the-future-from-drug-resistant-infections-en.pdf (

This press release is based on oral presentation 4960 at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID). All accepted abstracts have been extensively peer reviewed by the congress selection committee. There is no full paper at this stage, but the authors are happy to answer your questions. The research has not yet been submitted to a medical journal for publication. 


Conflict of interest statement: KAB, KPK, PAM, and LF are employees and shareholders of Merck & Co., Inc., Kenilworth, NJ, USA; LAP is an employee of Pfizer, Inc; and KCY, JW and VG are employees of, and also own stock in, Becton, Dickinson & Company.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Beginning of the End? Some Experts Predict COVID-19 Will Recede

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September 23, 2021

Frank Diamond

Suppose children get vaccinated, and no new variant emerges. In that case, new infections will drop from 134,000 a day to about 9,000 a day by March, according to 1 scenario. As a result, deaths would fall to about 100 a day.

It’s not like some health care experts didn’t see this coming. Of course, no one but no one will say it’s a lock—not after all the nasty surprises COVID-19 has sprung on us—but some indicators point to a steady and steep decline in SARS-CoV-2 over the fall and winter.

The better of the predictions hinge on 1 development and 1 nondevelopment. The former being the creation and launch of a COVID-19 vaccine for children (which could happen in the next few weeks), and the latter being the non-appearance of any new COVID-19 variant as infectious as the Delta variant fueling the current surge.

About 134,000 new cases of COVID-19 per day have been reported over the last week, about a 10% drop from the past 2 weeks. And while infections are rising in 27 states, they are falling in 23, according to Johns Hopkins University.

Mortality rates of 33% over the last 2 weeks (about 2000 people a day) tempers this hopeful news, but deaths are a lagging indicator.

One of the rosier scenarios comes from the COVID-19 Scenario Modeling Hub, which uses data from 9 different research groups. Justin Lessler, Ph.D., an epidemiologist at the University of North Carolina, associated with the hub, tells NPR if children get vaccinated. Then, new infections will drop from 134,000 to about 9,000 a day by March, with no new highly infectious variant emerging. As a result, deaths would fall to about 100 a day by March.

Source: COVID-19 Scenario Modeling Hub


Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, says that “many were talking” about the chart above, but not everybody had the same interpretation.

“The graph appears to be an old model which was entirely not correct,” Kavanagh tells ICT®. “It predicted that COVID-19 would be gone by this August. This did not happen. Instead, we got Delta. Predicting the future of COVID-19 is like predicting the stock market. Unfortunately, you have two unknowns; one is future human behavior, and the other is viral mutations. The wide range of future projections from IHME illustrates this dilemma.”

Source: Institute for Health Metrics and Evaluation (IHME)

Cécile Viboud, an infectious disease epidemiologist at the National Institutes of Health’s Fogarty International Center, tells STAT that new cases by the end of November will be down to about where they were in late June and early July: between 7500 to 15,000 per day.

She tells STAT that “we’re probably going to stay there because there is quite a bit of immunity in the population.”

However, both Lessler and Viboud do not seem willing to bet their house just yet that the worst is over.

Vibound: “That assumes that no new variant comes in. Because if you get a new variant that either has higher transmissibility or immune escape potential, then we will see a resurgence.”

Lessler: “Any of us who have been following this closely, given what happened with Delta, are going to be really cautious about too much optimism. But I do think that the trajectory is towards improvement for most of the country.”

Maria Van Kerkhove, PhD

Anti-SARS-CoV-2 Monoclonal Antibodies

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By Don M. McNulty ~ Summary of NIH Covid-19 Treatment Guidelines
Released August 4, 2021

What is Monoclonal Antibody Treatment?

With all the Covid fears continuing to swirl around us today, we must stay on top of all the avenues of treatment afforded the American people. Crime Scene Cleaners who serve Missouri and Kansas for all things biohazard, including Covid cleaning and disinfection processes, are constantly searching for official clinical studies and research to pass along to the public to keep you well informed in this ever-changing environment about Covid infections and the variants.

The FDA Authorized the Emergency Use of the Anti-SARS-CoV-2 Monoclonal Antibody treatment. The treatment is intended for mild to moderate Covid-19 infections in nonhospitalized patients at high risk for progressing to severe disease and hospitalization.

There are two brands approved Casirivimab plus Imdevimab: These are recombinant human monoclonal antibodies that bind to non-overlapping epitopes of the spike protein RBD of SARS-CoV-2.

Sotrovimab: This monoclonal antibody was initially identified in 2003 from a SARS-CoV survivor. It targets an epitope in the RBD of the spike protein that is conserved between SARS-CoV and SARS-CoV-2.

The FDA also updated the EUA for Casirivimab plus Imdevimab as post-exposure prophylaxis for specific individuals who are at high risk of acquiring SARS-CoV-2 infection and, if infected, are at high risk of progressing to serious illness. See the for details.

Synthetic SARS-CoV-2 vs. SARS-CoV-2 to Discover new treatments

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Crime Scene Cleaners is always seeking to provide the public with a Complete Line of Services in Crime and Trauma Scene Cleanup, Biohazard Management, and Professional Cleaning Sanitizing for Bacterial and Viral Infections. We Service the entire States of Missouri and Kansas.

We also strive to not only keep ourselves up-to-date on the latest research we try to provide the public with this cutting-edge information on Covid Treatments.

The coronavirus disease (COVID­19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2), threatens global public health with total cases and deaths reaching over 212 million and 4.44 million, respectively.

Though vaccination efforts are underway in most countries, there are still limited options for treating COVID­19. Now, researchers at Penn State designed a new COVID­19 therapy that uses a defective synthetic version of the SARS­CoV­2 virus to interfere with the actual virus’s replication.

Published in the journal PeerJ Life & Environment, the study highlights the use of the defective virus that replicates three times faster due to its shorter size, interfering with the replication of the real virus. The defective synthetic version could be used as a self­promoting antiviral therapy, wherein the synthetic version replicates faster, the virus will assist in its own demise.

Defective genome replication

Versions of a viral genome with large deletions frequently emerge from most ribonucleic acid (RNA) viruses. Defective genomes lacking essential coding sequences can still replicate and packaged into virions in the presence of active viruses.

The full viral genome produces the essential proteins for replication, which can be exploited by defective genomes that retain the ability to bind to these proteins. Hence, these defective genomes are considered parasites of the full length virus since they compete for replication. Since they are shorter in length, they can replicate faster than their full­length parental genome in cells.

Common coronaviruses may contain these genomes, called defective interfering (DI) genomes. In SARS­CoV­2, long deletions have been reported, and DI genomes have been shown to emerge by recombination caused by sequence microhomology.

The Study

In the study, the researchers created short synthetic DI RNAs from parts of the wild­type SARS­CoV­2 genome to examine whether they could replicate in coinfected cells and be packaged into virions. They quantified the relative amounts of the DI and WT genomes in the cells over periods, showing the interference of the DI genome with the wild­type genome (WT).

Synthetic defective interfering viruses. (A) Three portions of the wild-type (WT) SARS­CoV­2 genome were used to create a synthetic defective interfering genome (DI1) and a shorter version (DI0) comprising only parts of the two terminal portions. Numbers delimiting the portions refer to positions in the SARS­CoV­2 genome. The first position is mutated (A →C) in both DI1 and DI0. Open rectangles show the position of the probes and primers used. (B) To produce synthetic DI particles, DNA constructs corresponding to the RNA sequence of DI1 or DI0 were transcribed into RNA in vitro using T7 RNA polymerase and transfected into Vero­E6 cells that were then infected with SARS­CoV­2. The supernatant from these cell cultures was used to infect new cells.

The study results showed that the defective synthetic genome replicates three times faster than SARS­CoV­2 in coinfected cells and interferes with it, reducing the viral load by about half in 24 hours. No differences between the packaging efficiencies of the two genomes were found, as transmission rates were the same. Hence, it can be concluded that the reduced amount of WT genomes was due to interference as a result of the faster replication of the DI genome. Significantly, amounts of DI genome so small they are undetectable via qRT­PCR can interfere with the WT virus.

DI1 reduces the amount of SARS­CoV­2 by half; it replicates 3 times faster; and it is transmit­ ted with the same efficiency. (A) Growth rates (absolute amount relative to the amount at 4 h) of WT in controls (gray) and in coinfections with DI1 (blue) or DI0 (green); growth relative to controls at the same time point; and detail at 24 h. (B) Transmission efficiency of WT (blue) and DI1 (yellow) in coinfections: the amount, measured by qRT­PCR, immediately before passaging divided by the average amount mea­ sured almost immediately (4 h) after passaging (using the supernatant to infect new cells 24 h after initial infection). DI0 was detected inside the cells but not in the supernatant. (C) Growth rates (absolute amount relative to the amount at 4 h) of WT in controls (gray) and in coinfections (blue); growth relative to con­ trols at the same time point; and detail at 24 h. Growth rates (absolute amount relative to the amount at 4 h) of WT (blue) and DI1 (yellow) in coinfections; growth relative to that of WT in coinfections at the same time point; and detail at 24 h.

Indeed, DIs could be used as antivirals since they replicate faster in cells and interfere with the real virus. Meanwhile, the team explained that as the DI genomes increase in frequency among the virus particles pool, the process becomes more effective until the decline in the amount of the wild type SARSCoV­2 leads to the demise of both the virus and DI. A similar approach can be used in bacterial infections and cancer.

"We have established a proof of principle that a synthetic defective interfering SARS­CoV­2 can replicate in cells infected with the virus and interfere with its replication," the researchers concluded in the study.

Suicide and Its Warning Signs of Risk

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Suicide is such a dirty word to most people; they won’t even utter the word. But, the other day, an acquaintance of mine here in Kansas City, let me know that his son decided to check out of this world earlier this year. Like most people I know, when they receive news such as this, they say how sorry they are for the loss and quickly change the subject because it is very uncomfortable to have a conversation.

It’s just one of the reasons we have survivor support groups. No one wants to talk about it because they don’t understand it. Frankly, I doubt I could find experts who study in this field of psychology who would say they fully understand it.

When I first met my friend well over a year ago and learned of my work, we had a long conversation about my work in trauma and death scene remediation — what most people call Crime and Trauma Scene Cleanup — including suicide.

During this meeting a year later, he acknowledged that as he was going through this with his family, he turned his thoughts to our previous conversation and drew strength on some of what we discussed that day.

One of the biggest lessons I learned over the years is not struggling to comprehend

why someone would commit suicide?

Imagine if you had a chance to speak with those who commit suicide, they might tell you why they did this to themselves. Then, being a loving relative, friend, or concerned individual, every excuse they may present to you as the driving force behind that act, you would be able to counter it with a way out or an answer to the problem. The trouble is that most of these victims won’t hear you, and they won’t or can’t hear you because they are too focused on their perceived pain.

In my class, I show a video on YouTube called “An Awareness Test,” using basketball players passing a basketball between each player wear white —the audience is instructed to count how many passes occurred. So, the audience focuses on the task and comes up with the correct answer. Then the voice-over answers the initial question and adds, “but did you see the moon-walking bear?” Next, they fast rewind the video and play it forward in slow-motion. Indeed, there is a Moon-walking bear who strolls through the players on the video, and my audience is always astounded.

Then I tell my students why many times, no one pays attention to the logic you might present. They are too focused on the pain to hear what is being said to them.

Think back to a time when you slammed your fingers in a door or hit your thumb with a hammer. You probably danced around the room, otherwise known as writhing in pain, cussing, or yelling; you have not focused on anything else but the point of physical pain. But, honestly, I could put a Moon-walking bear strolling through the room, and you wouldn’t even know it.

I’ll give one more example. A middle-aged wife and mother came home to find her husband had committed suicide in their bedroom while she was away grocery shopping. According to her friend at the home when I arrived, she had no inkling those thoughts ever came to his mind. To say she was devastated would be an understatement. When I arrived with my crew, all this poor woman could do was cry. There were only a few moments of silence between her sobbing as she tried to catch her breath. It was one of the most challenging meetings I have been through in my career. She was so hurt she really wasn’t present to what was going on around her. Fast-forward about nine months later, and while I was out shopping, she and her friend came up to me. Her friend introduced me to this wife, explaining that I was the one who came to the residence that day to clean up the bedroom.

Now, why am I telling you this story? Although this woman thanked me for being there in her time of need, she has zero recollection of that day or the following two weeks after — her friend added and several more weeks, her memory is sketchy at best. My point being — mental pain and anguish can override any sanity or logic you would expect an individual to have.

It would be best if you recognized in this whole situation — Suicide is an irrational act, and you and I are trying to understand it with a rational mind. However, a rational mind cannot understand an irrational act.

Those of us who can grasp this concept find mental relief while processing our grief and moving forward.

As stated above, there is an entire industry built around trying to understand suicide fully, its causation, warning signs, and hopefully, one day, finding the elusive magic that would prevent and solve the issue. I doubt it exists, but one can dream of it.

The following is curated from the American Association of Suicidology. You can locate them at
If you need help or know someone who does, you can call 1-800-356-5395 to get in touch with counselors 24/7.

Here are the Warning Signs of Acute Suicide Risk

The following are not always communicated directly or outwardly:

-Threatening to hurt or kill themselves, or talking of wanting to hurt or kill themselves; or
– Looking for ways to kill themselves by seeking access to firearms, available pills, or other means; or
– Talking or writing about death, dying or suicide, when their actions are out of the ordinary.

Additional Warning Signs:

  • Increased substance (alcohol or drug) use
  • No reason for living; no sense of purpose in life
  • Anxiety, agitation, unable to sleep or sleeping all the time
  • Feeling trapped — like there’s no way out
  • Hopelessness
  • Withdrawal from friends, family, and society
  • Rage, uncontrol anger, seeking revenge
  • Acting reckless or engaging in risky activities, seemingly without thinking
  • Dramatic mood changes
  • Giving away prized possessions or seeking long-term care for pets

Crime Scene Cleaners Kansas City coverage area includes the States of Missouri and Kansas. Although others may see this article outside our coverage area, I will only provide the rate of Suicides. The information below is based on the latest information compiled by the US Federal Government and Prepared by Christopher W. Drapeau, Ph.D., and John L. McIntosh, Ph.D. for AAS, and covers the years up to 2019 and 2020. All rates are stated as Suicides Deaths per 100,000 in population. Please note that these figures include the entire State. Therefore, when investigating a small, more rural area, the number may be skewed and inappropriate for those areas.

The Overall National Suicide Rate is 14.5/100,000. This number represents 47,511 per year.

Missouri Suicide Rate is 18.6/100,000 — representing 1,141 deaths per year — and ranks 15th in the nation.

Kansas Suicide Rate is 18.0/100,000 — representing 523 deaths per year — and ranks 18th in the nation.

For the complete list, Facts and Statistics – American Association of Suicidology

Crime Scene Cleaners of Kansas City is a company that helps families and businesses by remediating traumatic death scenes and also offers services for Hoarding Houses, Unsaniatary Dwellings, and Infection control services.

If anyone you know needs our services in Missouri or Kansas, we stand ready to help restore the structure. We service residential, apartments, commercial, industrial, and construction industries 24 hours per day, 365 days per year.


Direct-acting antiviral to treat COVID-19

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An international team of scientists from the Menzies Health Institute Queensland (MHIQ) at Griffith University and from City of Hope, a research and treatment center for cancer, diabetes, and other life-threatening diseases in the US, has developed an experimental direct-acting antiviral therapy to treat COVID-19.

Traditional antivirals reduce symptoms and help people recover earlier. Examples include Tamiflu, zanamivir and remdesivir.

This next-generation antiviral approach used gene-silencing RNA technology called siRNA (small-interfering RNA) to attack the virus’ genome directly, which stops the virus from replicating, as well as lipid nanoparticles designed at Griffith University and City of Hope to deliver the siRNA to the lungs, the critical site of infection.

“Treatment with virus-specific siRNA reduces viral load by 99.9%. These stealth nanoparticles can be delivered to a wide range of lung cells and silence viral genes,” said co-lead researcher Professor Nigel McMillan from MHIQ.

“Treatment with the therapy in SARS-Cov-2 infected mice improved survival and loss of disease. Remarkably, in treated survivors, no virus could be detected in the lungs,” Professor McMillan said.

Professor Kevin Morris, a co-lead researcher from both City of Hope and Griffith University said: “This treatment is designed to work on all betacoronaviruses such as the original SARS virus (SARS-CoV-1) as well as SARS-CoV-2 and any new variants that may arise in the future because it targets ultra-conserved regions in the virus’ genome.”

Professor McMillan added: “We have also shown that these nanoparticles are stable at 4°C for 12 months and at room temperature for greater than one month, meaning this agent could be used in low-resource settings to treat infected patients.”

The results suggest that siRNA-nanoparticle formulations can be developed as a therapy to treat COVID-19 patients, as well as used for future coronavirus infections by targeting the virus’s genome directly.

“These nanoparticles are scalable and relatively cost-effective to produce in bulk,” Professor Morris said.

“This work was funded as an urgent call by Medical Research Futures Fund and is the type of RNA medicine that can be manufactured locally in Australia,” Professor McMillan said.

The research has been published in Molecular Therapy.

Below is the curated article by

Source –

Image: Shutterstock – ker_vii

covid-19 cleaning

COVID-19 – The Revolutionary Power of Bio Platforms Vaccines

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Moderna designed the final version of its vaccine within 48 hours of analyzing the virus genome on January 11, 2020. Phase 1 trials began 60 days later (in comparison, it took 20 months of conventional vaccine development for the SARS vaccine to reach Phase 1). This vaccine was approved by the FDA on December 17, 2020 (the 11 months until approval were spent with testing and regulatory formalities). In a similar vein, BioNTech was able to rapidly redirect its mRNA technology platform from cancer to COVID-19 in a matter of weeks.
And they did all that entirely on a computer using a digital copy of the virus (Chinese scientists had already sequenced its genome), without having access to the physical virus. Quite intriguingly, this means that a digital copy of the virus reached the U.S. and Europe before the actual virus emerged there.

How is that possible? Well, the answer lies in the revolutionary nature of new industrialized biotechnology platforms that exploit breakthroughs in biological engineering and artificial intelligence.
Rather than growing vaccines in bioreactors, a new generation of biotechnology companies designs instructions that the body then can use to produce its own therapy.
These novel vaccines exploit the process by which cells build proteins from the information encoded in a single-stranded molecule called messenger RNA (mRNA).

Once the COVID-19 vaccine enters a cell, the mRNA molecule tells it exactly how to build a piece of the SARS-CoV-2 virus. By exposing the body to this piece of virus induces its immune system to mount a response, thereby training the body to fight the real deal if it gets infected by SARS-CoV-2.

Using mRNA as a vaccine – or any mRNA medicine, for that matter – is a fundamentally different approach than conventional vaccines.
Traditional vaccines usually contain weakened or inactivated disease-causing organisms or pathogen proteins (antigens) to stimulate the body’s immune response. These conventional viral vaccines are manufactured in large bioreactors through a lengthy and cumbersome process – that can take many months – that involves numerous steps like preparation of the seed virus, fermentation, harvesting and purification. It also necessitates the handling of large volumes of live viruses grown in chicken eggs or mammalian cells.

Take the example of the annual ritual of developing a vaccine against seasonal flu, which commonly takes about half a year from identification of the prevailing influenza virus strain to producing a vaccine. The candidate flu vaccine virus is grown for about three weeks to produce a hybrid virus, which is less dangerous and better able to grow in chicken eggs. The hybrid virus is then injected into a lot of fertilized eggs and incubated for several days to make more copies. Then the fluid containing the virus is harvested from eggs, the vaccine viruses are killed, and the viral proteins are purified over several days.

mRNA vaccines eliminate pretty much all of this conventional manufacturing process.
In contrast, mRNA vaccines are based on just sets of instructions – like a software code – that direct cells in the body to make proteins to prevent or fight disease.

This makes mRNA vaccines very safe – they do not interact with the genome but just carry the information required for expression of the encoded protein.

The millions of proteins in our body are all made by piecing together different combinations of amino acids. And in this process mRNA plays a crucial role: It carries genetic code from DNA in the cell’s nucleus (composed of four different building blocks – the nucleotides adenine, cytosine, guanine, and thymine) to the cell’s protein-making machinery. These biological machines are called ribosomes and in some mammals every cell carries millions of them. Ribosomes read the mRNA and, based on the instructions (which contain hundreds or thousands of nucleotides linked in a unique order), synthesize a set of amino acids that are then folded into a specific protein.
In short, without mRNA, the body wouldn’t be able to use the genetic code contained in DNA. Proteins would never get made. Basically, your body wouldn’t function.

Building mRNA vaccines for COVID-19

Coronaviruses invade cells through surface molecules called spike proteins (named for the fact that they physically jut out from the rest of the virus), which take on different shapes in different coronaviruses. The SARS-CoV-2 specific spike protein is therefore a crucial antigen – i.e. a substance that induces the immune system to produce antibodies against it – that can be exploited for vaccine design.
And this is how an mRNA vaccine against COVID-19 works: Once the virus genome is sequenced – that means it is available as a digital copy – researchers can design an mRNA sequence that encodes the blueprint for the virus spike protein. Once tested for efficacy and safety in clinical trials, the mRNA molecule can then be synthesized on an industrial scale in robotic factories.
This mRNA molecule is wrapped with a lipid nanoparticle envelope, which protects it from degradation, and then directly delivered into cells. There, ribosomes get to work and read the mRNA as just any other blueprint – only this time they synthesize the spike protein. The finished spike proteins are then attached to the surface of cells where they are recognized by the immune system, eventually triggering the desired immune response against the virus.

In other words: Once you get your vaccine jab, the genetic instructions contained in the mRNA molecules are injected into the upper arm and the ribosomes in the muscle cells translate them to make a critical fragment of the viral protein directly inside your body. This ‘preview’ of what the real virus looks like gives the immune system time to design powerful antibodies that can neutralize the real virus if it ever gets in contact with it.
The protein production inside the muscle cells initiated by the injected mRNA injection reaches peak levels for 24 to 48 hours and can last for a few more days. Thereafter, the mRNA molecules get disassembled by the body.
The revolutionary impact of mRNA technology
mRNA COVID-19 vaccines have demonstrated in a very convincing way that biotechnologies have entered the industrial age. What we are seeing here is nothing less than the rise of bio platforms that give us the ability to engineer bits of biology, such as mRNA, to create programmable medicines and vaccines.

More generally, if it is indeed possible that mRNA can be used to make the full set of proteins in life, then it becomes possible to treat an incredible broad range of human diseases. This is at the core of the industrialized platforms that Moderna, BioNTech and others are building.
Essentially, an mRNA technology platform functions very much like an operating system on a computer. It is designed so that it can plug and play interchangeably with different programs. In this case, the ‘program’ or ‘app’ is the unique mRNA sequence that codes for a specific protein.
mRNA as the technological basis for therapeutics and vaccines is characterized by a great flexibility with respect to production and application. In essence, mRNA is an information-carrying molecule that can be industrialized – as opposed to traditional therapeutic molecules that have to be elaborately designed and synthesized from scratch for each application (i.e. medicine).
For starters, mRNA molecules are far simpler than proteins. mRNA is manufactured by chemical rather than biological synthesis, so it is much quicker than conventional vaccines to be redesigned, scaled up and mass-produced.
An excellent primer on the development of mRNA-vaccine technologies explains why: “Any protein can be encoded and expressed by mRNA, in principle enabling the development of prophylactic and therapeutic vaccines fighting diseases as diverse as infections and cancer as well as protein replacement therapies.”

And this is very the disruptive effect of the mRNA platform happens: If a therapy requires a certain protein to be encoded, only the sequence of the messenger RNA molecule needs to be changed, leaving its physico-chemical characteristics largely unaffected. In the above computer analogy, that is like writing a new piece of software that runs on the same operating system.

The disruptive force of emerging bio platforms

This means that diverse products can be manufactured using the same established production process – the same equipment, the same operators – without any adjustment and thereby saving massive amounts of time time and money compared with other vaccine or therapeutics platforms.
Having a library of genomes of potentially dangerous viruses, combined with the ability to quickly generate digital copies of emerging viruses thanks to powerful sequencing techniques, makes it possible to rapidly generate digital vaccine designs on a computer.
In the case of BioNTech and Moderna, these two companies spent a decade building their platforms to design and produce mRNA therapeutic candidates at massive scale, although originally targeted towards cancer medicines.
Moderna designed the final version of its vaccine within two days the first SARS-CoV-2 genome sequencing was made public – a matter of swapping out the ‘4 letters of life’ (the four nucleotides), according to CEO Stephane Bancel: “In 48 hours, we designed and locked down the entire chemical structure of the vaccine.”

This same dynamic allowed BioNTech to rapidly redirect its mRNA technology platform from cancer to COVID in a matter of weeks; the company estimates it can manufacture updated versions against emerging mutant strains in as little as six weeks.
What this all boils down to is that in the future every disease or infection can be described as a data sequence and every biological cure as an algorithm. As BioNTech states it: “Considering that all mRNA is generated with four different building blocks, but with unique sequence order, all therapeutic mRNAs have highly similar compositions, while having the capacity to encode a variety of different proteins. These characteristics allow for rapid development of mRNA therapeutics that are broadly applicable for treatment of many diseases, including cancer, infectious diseases and rare diseases.”

What are the limitations?

The limitations of mRNA technology are reached when the mechanism of a disease are not well understood, as for instance is the case with HIV, Alzheimer’s or many cancers.

However, as soon as you can pinpoint a specific protein, or several proteins in a certain ratio, as the root cause for a disease, then mRNA researchers can get to work on their computers and start designing the instructions for proteins that fix the problem.
Another complicating factor is to design the right delivery vehicle to get the mRNA into the targeted tissue and cells while evading the immune system. For vaccines it is relatively easy to inject it into muscle cells. It gets more difficult to get it to the brain, heart or the lungs.
Also, ribosomes have to think the mRNA was produced naturally, so they can accurately read the instructions to produce the right protein. Finally, the cells need to express enough of the protein to have the desired therapeutic effect.

The big picture

The emerging bio platforms will impact more than just industrialized vaccine development. They will transform all areas of biotechnology: areas like small molecule discovery, protein engineering, genome editing, gene delivery, and cell therapy.
By programming biology to allow a body to make its own medicine – programmable medicine – it will become possible to tailor diagnostics and therapies based on the genetic features of the disease-causing molecules. And because it is all based on the same underlying platform, it will be provided it in an easily reproducible, timely and cost-effective way.

Using mRNA as a platform technology – pretty much what Android or iOS are today for smartphones – will ultimately allow to create ‘apps’ for target groups such as allergy sufferers or smokers. It might even lead to bio agents that are synthesized for just a single individual, taking the term ‘individualized medicine’ to its logical conclusion.

Life with Covid-19 is Improving, but there are Six Things we still need to Practice

By Blog

We are now seven to eight months into the Covid 19 Pandemic here in the United States. I have now been through four pandemics. After my second pandemic, I developed a saying, the Center for Disease Control (CDC) actually stands for the Center of Dysfunction and Confusion.

I know it seems harsh, but it is not their fault. During these trying times at the start of a pandemic or epidemic, everyone is clamoring for information on coping with whatever bug is attacking humans or animals. The problem is science takes time. Data has to be compiled and researched, which leads to studies that have to be developed and conducted in a certain way, then those findings have to be analyzed to more refined studies to be conducted. Depending on their findings, they will then attempt to develop a scientific assumption that you and I can use to handle the disease facing humanity.

No matter what happens, there are six things you and I can do to reduce the likelihood of becoming infected. These six-steps are suitable to reduce the likelihood of catching a cold or flu too.

  • Washing your hands thoroughly and regularly. Well established studies have shown 80% of colds and flu transmit through hand contact, and 97% of adults do not wash their hands properly.
  • Clean and sanitize your surfaces. To clean, you need to use a product with a soap molecule, a product classified as a cleanser. Next, you need to use a disinfectant being both bactericidal and virucidal, using the proper dwell-time (wet contact time) on the surface before you wipe it off. (Do not use bleach), Why not bleach? Bleach is a strong oxidizer, not a disinfectant. Will it disinfect? Yes, when mixed with water at one part bleach to ten parts water, but no one tells you bleach damages every surface it touches, including your white clothes, and that it needs to be thoroughly rinsed after applying to any surface. Bleach will also begin to bleach out every surface where it is used. It takes the color out of Formica® (plastic laminate) and will bleach out almost every textile.)
  • Stay at home if you are sick. Every cold and flu will shed while you are feverish and symptomatic. Staying home will help keep others safe.
  • Avoid close contact. At home or work, we usually have close contact with family and co-workers. It’s this proximity, especially with longer contact times, that will spread the disease quickly.
  • Cover your mouth and nose while coughing or sneezing. As we’ve seen with Covid, coughing and sneezing spread the disease to other surfaces quickly. Depending on what virus or bacteria you’re shedding, it will be hard to contain since even speaking contains droplets we deposit everywhere.
  • Avoid wild or domestic animals. Why animals? Studies have shown that animals can carry and transmit diseases. Wild animals may be infected while domesticated animals like our dogs and cats and carry disease particles on their fur, and when we pet them, the disease can then transfer to us. (This is called a zoonotic transfer).

These six practices are a silver lining to the Covid Pandemic because these practices will give you and others healthier life.

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