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May 30: Warning of the tightrope walk ahead as governments battle the coronavirus crisis, Nobel laureate Peter Charles Doherty has expressed concern about densely populated countries such as India relaxing lockdown norms while also describing a complete shutdown as “an economic and social impossibility”.

The Australian immunologist, who cautioned that the number of COVID-19 cases will rise in the coming days, said the earliest time frame for an effective vaccine “going into large numbers of people” is nine to 12 months.

"If all goes well with testing, we could know if some of the candidate vaccines are both safe and effective as early as September/October. Then, rolling a vaccine out will depend on the type of product and how quickly it can be made, put in vials and so forth," Doherty told PTI in an email interview from Melbourne.

The novel coronavirus, he added, does not change fast like influenza and, from what is known so far, “the same vaccine should work everywhere”.

Doherty, who is with the Department of Microbiology and Immunology at the Doherty Institute, University of Melbourne, won the Nobel Prize for Medicine in 1996 for his discovery of how the body’s immune system distinguishes virus-infected cells from normal ones.

Discussing the lockdown, he said, "If it was purely a matter of hard science, everywhere should stay locked down. But that’s pretty much an economic and social impossibility.”

The expectation, he said, is the numbers will rise and limiting spread will depend on people acting responsibly and the capacity for rapid response and extensive contact testing.

“And in a densely populated country like India I think that it will be very difficult," the scientist said.

Several countries, including India, began relaxing lockdown norms in mid-May despite the WHO’s warning about a second wave. India’s lockdown began on March 25 and has since been extended. The fourth phase ends on Sunday.

Asked whether there are any alternatives to a lockdown, the 79-year-old said, "There is no other option other than closing borders. South Korea, for example, conducted massive, intensive testing and contact tracing in a wealthy country with a very disciplined population. Otherwise, not till we have effective vaccines."

He added that he personally doesn’t see the point of closing borders for people coming in if there’s already a high incidence of disease in the community, “unless it’s to avoid the need to care for them and use scarce hospital beds".

According to Doherty, the coronavirus "is a new virus which has come straight out of nature".

“It (the virus) has moved so rapidly across the world because of people travelling on international planes as well as tourist ships," he added.

The immunologist also warned against the use of hydroxychloroquine to treat COVID-19, and said current and planned trials of the anti-malaria drug should be stopped.

“My understanding is that the use of the drug in severe disease is definitely contra-indicated, but it’s not yet clear whether, if taken under medical supervision, it could have some useful effect if taken early on, or as a preventive. Those trials just haven’t been done properly," Doherty noted.

The Indian Council of Medical Research (ICMR) has backed the use of hydroxychloroquine as a preventive against COVID-19 even after the WHO suspended clinical trials of the drug citing safety concerns.

Asked whether plasma therapy can be an effective treatment for COVID-19, Doherty said, "We lack good properly controlled trials but, especially if the plasma has been tested for antibody levels and there’s evidence of good activity, it could be helpful. If I had the disease and was offered plasma therapy I would certainly accept, but I would not take hydroxychloroquine."

Doherty is also very optimistic about herd immunity developing against the SARS-CoV-2 infection.

"We think that (herd immunity) will cut in and have an obvious effect when, say, 60 per cent of people have been infected. Best hope is to boost herd immunity with a vaccine," he stated.

Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, whether through vaccination or previous infections.

The number of COVID-19 cases have crossed 5.9 million and the fatalities 3,65,000, according to the Johns Hopkins University on Saturday. 

In India, the death toll has risen to 4,971 and the number of cases to 1,73,763, according to the Union Health Ministry on Saturday.

Several states, including Bihar, Uttar Pradesh, Madhya Pradesh, Jharkhand and Chhattisgarh, have reported a rise in number since lockdown norms were relaxed in early May and migrant workers reached home.

In Uttar Pradesh, for instance, the number of infections rose from around 3,000 on May 4 to 6,532 on May 26. Similarly, Bihar’s numbers increased from around 500 to over 2,700 in the period.

Canadian researchers are developing a DNA vaccine for SARS-CoV-2, the coronavirus that causes COVID-19 and has currently infected nearly 5,00,000 people worldwide and crippled the global economy.

Entos Pharmaceuticals, a health-care biotechnology company headed by a University of Alberta researchers, develop new therapeutic compounds using the company's proprietary drug-delivery platform and has begun manufacturing vaccine candidates against the novel coronavirus.

"Given the urgency of the situation, we can have a lead candidate vaccine within two months. Once we have that it's a race to get it into clinical trials," said John Lewis, CEO of Entos and a Professor at the University of Alberta in Canada.

Lewis said in comparison to a traditional vaccine, DNA-based vaccines hold several advantages.

Nucleic acids are introduced directly into the patient's own cells, causing them to make pieces of the virus--tricking the immune system into mounting a response without the full virus actually being present, the researcher said.

According to the company, the approach is recognised as being easier to move into large-scale manufacturing, offers improved vaccine stability and works without needing an infectious agent.

In the current absence of a vaccine for COVID-19, several companies around the world are mounting efforts to begin similar work.

The first clinical trial using a DNA-based vaccine developed by Moderna Inc.in the US on March 13.

Their approach allows for antibodies to be made in the human trial volunteers against a specific protein on the surface of the coronavirus that lets the virus enter human cells.

The hope is that the antibodies will stop the interaction.

Though this approach is designed to be effective against COVID-19 specifically, Lewis said Entos is taking a different tack.

The company plans to use plasmid DNA to amplify the production of key coronavirus surface and structural proteins with each injection, with an eye to the bigger picture.

"Many of the structural proteins in the virus are pretty well conserved across all the coronaviruses, including SARS and MERS," said Lewis.

"We're hoping that if we express more of the structural proteins that are common to most coronaviruses, we can inhibit the current COVID-19, and also potentially protect against all coronaviruses both past and future," Lewis added.

To move the project forward quickly, the company is seeking financial support from both provincial and federal levels of government.

"We have the opportunity to save a lot of lives, and I think it's really upon us and governments to find solutions for that," Lewis said.

Beijing, Jan 25: The death toll due to the novel coronavirus (2019-nCoV) outbreak in China has soared to 41, while the number of infected persons were 1,287, the National Health Commission said on Saturday.

The Commission said that 444 fresh cases were reported since Friday, with 237 patients in serious conditions, while 38 had been cured and discharged from hospitals, reports Efe news.

Health authorities have carried out check-ups on 15,197 people who have come into close contact with the infected persons. Nearly 14,000 of them continue to be monitored for symptoms.

The others cases outside of China were reported in France (two), Australia (one), Thailand (four including two cured), Japan (two including one cured), South Korea (two), the US (two), Vietnam (two), Singapore (three), Nepal (one), Hong Kong (five), Macao (two) and Taiwan (three).

The symptoms of the new coronavirus, provisionally designated by the World Health Organization as 2019-nCoV, are similar to those of cold but may be accompanied by fever and fatigue, dry cough and dyspnea (shortness of breath).

The WHO has so far to declared the outbreak as an international health emergency.

Strict measures were being carried out in China, which include complete suspension of transport in around a dozen cities in Hubei province and also cancelling Chinese New Year celebrations.

Traditional events at Lama Temple and Ditan Park in Beijing were cancelled due to the risk of spreading the virus, authorities reported Friday, while the famous Forbidden City has also been closed indefinitely.

Wuhan, the capital of Hubei, where the virus was first reported, has been on lockdown since Thursday to prevent further spread of the virus and the city's authorities have begun to build a "special hospital" with 1,000 beds for infected patients.

"Construction of the special hospital with a capacity of 1,000 beds for patients with #nCoV2019 has begun in Wuhan," official China Daily said on Twitter.

The hospital in Wuhan will be based on the model of a similar facility that was built in just seven days in Beijing to deal with SARS in 2003.