WEBVTT - A Cure in Survivors' Blood? 0:00:07.120 --> 0:00:12.080 Welcome to Prognosis. I'm Laura Carlson. It's day thirty seven 0:00:12.119 --> 0:00:16.640 since coronavirus was declared a global pandemic. Our main story, 0:00:17.720 --> 0:00:20.959 people who have recovered from COVID nineteen may be able 0:00:21.000 --> 0:00:23.720 to help others who have the illness in a bold 0:00:23.720 --> 0:00:27.280 new way. They can donate their blood plasma to have 0:00:27.360 --> 0:00:32.000 it injected directly into patients. But researchers first have to 0:00:32.040 --> 0:00:37.520 figure out exactly how to harness antibodies, those magical proteins 0:00:37.720 --> 0:00:42.720 in the blood of recovered patients. But first, here's what 0:00:42.800 --> 0:00:52.320 happened today. Just a few days after President Donald Trump 0:00:52.440 --> 0:00:56.320 insisted he had absolute authority to reopen the economy, he 0:00:56.480 --> 0:00:59.880 issued guidelines that put the onus on governors and businesses 0:01:00.120 --> 0:01:04.000 to make the tough calls. Trump released a brief document 0:01:04.240 --> 0:01:08.160 that suggested what state should consider as they decide whether 0:01:08.240 --> 0:01:12.839 to relax stay at home orders or other virus containment measures, 0:01:12.880 --> 0:01:16.640 but the difficult decisions were largely left to state houses. 0:01:18.440 --> 0:01:22.319 The president set no deadlines, demanded no particular action, and 0:01:22.440 --> 0:01:27.440 offered little federal assistance. Included in the guidelines is the 0:01:27.480 --> 0:01:31.560 instruction that state should plan to independently secure protective gear 0:01:31.840 --> 0:01:36.800 and medical equipment for their hospitals. The guidelines did not 0:01:37.040 --> 0:01:39.840 set out a plan for dramatically ramping up testing and 0:01:39.920 --> 0:01:44.399 contact tracing, something experts say should be a prerequisite for 0:01:44.520 --> 0:01:50.680 relaxing lockdowns. On the science front, there is promising development 0:01:50.720 --> 0:01:54.360 in the quest to return to normal life. A coronavirus 0:01:54.440 --> 0:01:59.120 vaccine could be in production by September. Researchers at the 0:01:59.200 --> 0:02:01.840 University of ox Heard are testing of vaccine they hope 0:02:01.840 --> 0:02:05.640 will show results by the fall, and manufacturing is already 0:02:05.720 --> 0:02:11.000 under way. And finally, a glimpse of the economic havoc 0:02:11.120 --> 0:02:15.760 the coronavirus has reaked on China. The country's economy shrank 0:02:15.840 --> 0:02:19.800 last quarter for the first time in decades, following almost 0:02:19.960 --> 0:02:24.680 seven percent from a year ago. With the disease spread 0:02:24.720 --> 0:02:29.000 around the world, China is counting on shaky local demand 0:02:29.400 --> 0:02:41.800 to prop up a recovery. Now to today's main story, 0:02:43.560 --> 0:02:45.800 there's a sliver of hope for people very ill with 0:02:45.880 --> 0:02:50.359 COVID nineteen. It's a bold new treatment that involves taking 0:02:50.360 --> 0:02:52.680 the blood plasma of people who have recovered from the 0:02:52.760 --> 0:02:56.400 disease and injecting it into people who are very sick. 0:02:57.919 --> 0:03:01.200 The secret is in the antibodies. A protein that is 0:03:01.240 --> 0:03:05.480 produced when someone's immune system has fought the virus, But 0:03:05.960 --> 0:03:09.680 using antibodies to treat the sick is more complicated than 0:03:09.800 --> 0:03:14.519 just transferring them from one person to another. Bloomberg Senior 0:03:14.639 --> 0:03:18.280 editor Jason Gale reports on what researchers are doing to 0:03:18.360 --> 0:03:21.760 sift through the many antibodies out there and find the 0:03:21.880 --> 0:03:31.200 right ones to help people recover from being infected. Dr 0:03:31.320 --> 0:03:35.400 Erica Ulman Sapphire says her job is like military intelligence. 0:03:35.920 --> 0:03:39.680 She's an immunologist and professor at the Lahoya Institute for Immunology, 0:03:39.920 --> 0:03:43.200 a nonprofit research center in San Diego, and her job 0:03:43.280 --> 0:03:45.520 is to find the weak spots in the most deadly 0:03:45.600 --> 0:03:49.200 viruses and exploit them using antibodies. So you know, when 0:03:49.200 --> 0:03:51.760 the military can figure out how to precisely drop a 0:03:51.760 --> 0:03:53.920 bomb and one particular bad guy is sitting in one 0:03:54.000 --> 0:03:57.600 particular chair, in one particular room, one particular compound without 0:03:57.600 --> 0:04:01.360 any collateral damage because somebody had a high resolution photographs. 0:04:01.680 --> 0:04:03.920 So that's what we do for viruses. We take those 0:04:03.960 --> 0:04:07.440 incredibly high resolution photographs and three dimensions and figure out 0:04:07.960 --> 0:04:10.680 how do you work, what's your weak spot, where are 0:04:10.720 --> 0:04:13.440 you vulnerable? What happens if you put an animalty here. 0:04:17.120 --> 0:04:20.040 Erica has spent years in this field. In fact, she 0:04:20.240 --> 0:04:23.040 figured out a key step in how e Bowler invades cells. 0:04:23.640 --> 0:04:26.560 The discovery opened up a way for drug therapies that 0:04:26.640 --> 0:04:30.159 have greatly improved survival for people with a POLO with 0:04:30.279 --> 0:04:33.440 the coronavirus. Currently, no drug is being proven to work 0:04:33.480 --> 0:04:37.120 against it, and a vaccine maybe at least a year away. 0:04:37.200 --> 0:04:41.400 That's why Erica says antibody infusions from survivors may work 0:04:41.400 --> 0:04:44.279 out to be the fastest life saving option when someone 0:04:44.320 --> 0:04:47.920 has recently survived the disease, especially of really new disease 0:04:47.960 --> 0:04:50.839 for which there aren't any other treatments, the blood of 0:04:50.839 --> 0:04:54.400 those survivors could be something that helps somebody else. The 0:04:54.600 --> 0:04:57.919 survivors have those immune molecules in their blood, and the 0:04:57.960 --> 0:05:01.120 absence of any other medicine you can give somebody, you 0:05:01.160 --> 0:05:04.279 could offer them a survivor's blood and that gives them 0:05:04.400 --> 0:05:10.440 that immunity immediately but temporarily, but that could help. Erica says. 0:05:10.440 --> 0:05:14.680 Antibodies viruses by recognizing and latching onto them, and their 0:05:14.760 --> 0:05:17.640 job is to seek that out anchor onto it never 0:05:17.720 --> 0:05:21.160 let go. And when they do that, they can mechanically 0:05:21.240 --> 0:05:24.840 and activate the pat so by grabbing onto it, they 0:05:24.839 --> 0:05:27.400 do what we call they neutralize it, meaning they could 0:05:27.400 --> 0:05:32.080 prevent the virus from attaching to yourself. The base does 0:05:32.120 --> 0:05:35.560 other things. The base says, I am attached to something 0:05:35.560 --> 0:05:38.200 that must be destroyed, and so it signals all of 0:05:38.200 --> 0:05:41.120 your other immunes, cells and immune centuries to come to 0:05:41.160 --> 0:05:45.239 the side of infection and destroy the virus or destroy 0:05:45.320 --> 0:05:48.479 the infected cell. So it's no longer a virus factory. 0:05:48.560 --> 0:05:54.800 And those different kinds of activities are complementary. Knowing more 0:05:54.839 --> 0:05:58.560 about coronavirus antibodies will inform ways to make an optimal 0:05:58.720 --> 0:06:02.680 vaccine against it, but study results using antibodies to thwart 0:06:02.720 --> 0:06:06.159 the disease are still unclear. One such that he published 0:06:06.200 --> 0:06:08.880 in the Journal of the American Medical Association in March 0:06:09.279 --> 0:06:12.719 reported the results of five critically ill COVID nineteen patients 0:06:12.720 --> 0:06:17.040 in China. These patients received blood components from five adults 0:06:17.160 --> 0:06:20.000 who had recovered from the disease. The study didn't have 0:06:20.040 --> 0:06:22.320 a control lam, so there's nowhere to tell if the 0:06:22.320 --> 0:06:25.919 treatment made a difference. All five patients seem to improve, 0:06:25.960 --> 0:06:29.600 though Eric is working on a more sophisticated approach that 0:06:29.720 --> 0:06:32.400 will avoid some potential pitfalls and using the blood from 0:06:32.440 --> 0:06:36.200 just any survivor. The experiment in China was small and 0:06:36.480 --> 0:06:39.600 has some problems, she says. The first one is the 0:06:39.680 --> 0:06:42.400 risk it's blood from another human coming into your events. 0:06:42.880 --> 0:06:45.120 The other thing is that it's limited in quantity. You 0:06:45.160 --> 0:06:47.560 only got so much below the gift. The third thing 0:06:47.640 --> 0:06:50.240 is that it's really quite variable. Some people make a 0:06:50.320 --> 0:06:52.640 very strong immune response, are there is a very weak 0:06:52.680 --> 0:06:56.680 immune response. Erica's work involves coming through the millions of 0:06:56.720 --> 0:06:59.400 antibodies that people have made to find the very very 0:06:59.480 --> 0:07:02.560 best to three. The objective is to figure out what 0:07:02.720 --> 0:07:06.320 anybody treatments could best protect frontline healthcare workers and other 0:07:06.360 --> 0:07:09.200 people at risk of infection, as well as treat COVID 0:07:09.240 --> 0:07:14.440 maintained patients. My job is to be the clearing house 0:07:14.480 --> 0:07:17.680 of the world's antibodies, to gather them, to give them 0:07:17.680 --> 0:07:20.320 all code names, to make the study very fair, and 0:07:20.520 --> 0:07:22.600 organize an effort by which we compare them side by 0:07:22.600 --> 0:07:26.000 side to figure out what works, what's best, and why. 0:07:26.120 --> 0:07:28.360 And my group will also be solving the molecular structures 0:07:28.360 --> 0:07:29.760 to figure out what do they look like and how 0:07:29.800 --> 0:07:33.120 do we put the other complementary therapy. Erica says, antibody 0:07:33.160 --> 0:07:37.160 therapies might be applied differently depending on the patient. So 0:07:37.240 --> 0:07:39.240 the different kinds of people that might want an antibody 0:07:39.280 --> 0:07:42.600 therapy could be a perfectly healthy health care worker that 0:07:42.680 --> 0:07:46.400 wants to stay that way, so a preventative, or it 0:07:46.440 --> 0:07:50.560 could be a person who has been newly infected but 0:07:50.640 --> 0:07:54.040 they're vulnerable and so they really need a treatment. Or 0:07:54.080 --> 0:07:58.440 it could be somebody that's in full on serious disease. Okay, 0:07:58.440 --> 0:08:01.800 full on serious disease. You may want to control immune activity, 0:08:01.880 --> 0:08:04.720 but to prevent somebody from getting infected, it might want 0:08:04.720 --> 0:08:07.920 more of that activity, and so different antibody frameworks in 0:08:07.920 --> 0:08:10.400 different ways to engineer the antibody where you could dial 0:08:10.440 --> 0:08:13.200 that up and turn it off. The ultimate goal would 0:08:13.200 --> 0:08:17.320 be a treatment mixture, called that a cocktail, but probably 0:08:17.360 --> 0:08:20.320 two different antibodies that would command the virus in different 0:08:20.360 --> 0:08:23.120 ways and might do different things, and the goal is 0:08:23.160 --> 0:08:27.040 to inactivate the virus two ways at once. Dozens of 0:08:27.120 --> 0:08:30.640 research groups are racing the pandemic to collect and incubate 0:08:30.720 --> 0:08:34.040 thousands of antibodies. Erica says they'll send their best to 0:08:34.080 --> 0:08:37.440 her lab to evaluate in clinical trials, and the results 0:08:37.559 --> 0:08:40.920 should be no much sooner than parallel research into experimental 0:08:41.000 --> 0:08:44.560 vaccines dose take longer to develop because scientists need to 0:08:44.640 --> 0:08:48.200 first find a molecule that will safely and effectively trigger 0:08:48.240 --> 0:08:51.960 the kind of infection. Finding antibodies, Erica's lab is already screening, 0:08:52.720 --> 0:08:55.000 and the reason is faster is because an antibody is 0:08:55.000 --> 0:08:58.280 a natural human molecule. We understand how it works. We've 0:08:58.280 --> 0:09:01.200 made them before. When you've made them before, it's easy 0:09:01.240 --> 0:09:04.240 to scale them up again. We understand how to evaluate them, 0:09:04.240 --> 0:09:07.079 we understand their pharmaco kinetics, we understand how they behave. 0:09:07.880 --> 0:09:11.840 It's faster, easier, and more straightforward to mobilize an antibody 0:09:11.920 --> 0:09:15.000 right away than something entirely new. To make this happen 0:09:15.400 --> 0:09:18.600 means a lot of lab work. Yeah, it's a lot 0:09:18.600 --> 0:09:22.680 of coffee. Eric's lab was recently given almost two million 0:09:22.679 --> 0:09:25.640 dollars from the Bill and Melinda Gates Foundation to evaluate 0:09:25.679 --> 0:09:30.040 Canada antibodies in the fight against COVID nineteen. Patient studies 0:09:30.080 --> 0:09:33.280 will probably start within a few months after Eric's lab 0:09:33.320 --> 0:09:47.720 is identified the best ones to test. And that's our 0:09:47.760 --> 0:09:50.560 show for today. For more on the outbreak from one 0:09:50.640 --> 0:09:54.680 hundred and twenty bureaus around the world, visit bloomberg dot com, 0:09:55.000 --> 0:10:00.360 slash Coronavirus and one small favor. If you appreciate show, 0:10:00.800 --> 0:10:03.680 please leave us a review and a rating on Apple 0:10:03.760 --> 0:10:07.520 Podcasts or Spotify. It's the best way to help more 0:10:07.600 --> 0:10:12.160 listeners find our global reporting. The Prognosis Daily edition is 0:10:12.200 --> 0:10:16.040 hosted by Me Laura Carlson. The show was produced by 0:10:16.080 --> 0:10:21.800 Me tophor Foreheaz, Jordan Gospoure, and Magnus Hendrickson. Today's main 0:10:21.880 --> 0:10:27.240 story was reported by Jason Gale. Original music by Leo Sidrin. 0:10:27.679 --> 0:10:32.079 Our editors are Francesca Lead and Rick Shine. Francesca Levi 0:10:32.400 --> 0:10:35.679 is Bloomberg's head of podcasts. Thanks for listening.