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COVID-19 key questions: everything you need to know

Find out more about how close we are to finding a COVID-19 vaccination and more from a Cleveland Clinic expert.

While the world has accepted the harsh realities of COVID-19 and people have adjusted their lives accordingly, there are still have so many unanswered questions, such as why has COVID-19 taken such a detrimental toll and where are we in the process of finding a cure?

To get a better idea of where science is headed, below are some insights from Serpil Erzurum, MD, Chair of the Lerner Research Institute at Cleveland Clinic in the US.

How is COVID-19 different from viruses like Ebola, H1N1 (swine flu) or SARS?

These viruses are similar because they are encoded with Ribonucleic acid or RNA. They all infect the human host, but the difference between them and COVID-19 is this coronavirus is infectious before you become sick. It is infectious while you look very healthy and that is a very big difference.

If you’ve been infected with the coronavirus, can you become infected again?

This virus is very similar to the first SARS virus where immunity was very effective. Current data suggests that immunity occurs in people who have had the virus and that is effective for preventing them from getting infected again. The best evidence that we do have for effective immunity is the fact that we can take plasma from an individual who was infected, transfer that immunity passively to somebody who does have the infection, and it helps them recover. All those things strongly support that immunity does develop and is effective at neutralising the virus.

Why is COVID-19 antibody testing not the norm?

The problem is that there are a lot of coronaviruses – for example, the common cold is a coronavirus. Immune testing to diagnose COVID-19 is difficult to do because if you have had a common cold a few weeks before and we tested your body, it would look like you have immunity to coronavirus, but not necessarily to COVID-19, and not necessarily that you are protected from catching it. It would be a false reassurance to do immunoglobulin testing as a diagnostic strategy.

When do you think that we can expect to have a vaccine for COVID-19?

The usual strategy for making a vaccine is that you take the live virus, inject it into chicken eggs, allow the virus to grow, and then you deactivate it and inject that into people, so immunity develops. When the real virus comes along, you are protected.

That process can take 12 to 18 months. However, there are new strategies where we do not have to grow the virus. Instead, we can take the nuclear material that encodes part of the virus (the surface proteins) and inject them into the body. The body will recognise it as being foreign, antibodies will develop and attack the surface proteins, so they go away. Now, if the virus enters your body, your body remembers those proteins and the antibodies come and destroy the virus.

There are so many new technologies now that are using this type of strategy. Many studies are already in phase one and some are even entering phase two and phase three. Phase three means large studies and quicker paths to having something available for our community.

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Dr. Serpil Erzurum

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