A YEAR ago, nobody had even heard of SARS-CoV-2 and the disease it causes, covid-19. Today, they are household names all over the world, thanks in no small part to an unprecedented scientific heave.
“Doing research in an outbreak is really challenging,” says . “But it has moved super quickly. It’s been amazing.”
In just less than 12 months, scientists and medics have filled many of the urgent knowledge gaps, from basic virology and immunology to how to save lives in hospital. “Research scientists worldwide have generated an astonishing total of pandemic-related biomedical papers,” says , executive director of Cold Spring Harbor Laboratory Press in New York.
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According to an , more than 75,000 peer-reviewed research papers on covid-19 and SARS-CoV-2 have been published since January. About 10,000 more preliminary papers have been posted on the bioRxiv and medRxiv preprint servers, both co-founded by Inglis, with more elsewhere. Another database, the , lists more than 5000 active covid-19 projects with over $2.2 billion invested in them.
The research effort hasn’t just been big, it has also been clever. Much of the science has been guided by a to-do list written by the World Health Organization (WHO) in February. With confirmed cases in 28 countries but a pandemic not yet declared, it convened a panel of hundreds of experts on 11 and 12 February to agree a set of research priorities.
The resulting document – published on 12 March, the day after the pandemic was declared – identified the gaps in our knowledge and . According to Alice Norton, head of the , it is an “unprecedented galvanising document for global research collaboration”.
The road map is divided into nine major areas, each detailing a long list of unknowns. At the time it was compiled, a few urgent queries already had some answers. The disease-causing agent was known to be a novel coronavirus and its genome had been sequenced, while a market in Wuhan, China, had been identified as a possible ground zero, although that has since been called into doubt. Some basics of the illness, including its incubation period and R number – the average number of people an infected person goes on to infect – had also been estimated.
Yet there was still a stack of crucial questions. To name just a few: how is the virus transmitted? What is the mortality rate? What is the full range of symptoms? Are survivors immune? Is a vaccine possible?
According to Lang, who wasn’t part of the WHO team but keeps tabs on the road map, some of those urgent queries have now been ticked off. We know, for example, that the virus is spread mostly through airborne droplets and aerosols, and is transmitted more easily indoors. We also understand that most people who get the virus don’t fall ill but can still spread it, that people do have an immune response and so a vaccine is feasible and that a few existing drugs help but many don’t.
Yet we still don’t know exactly where the virus came from, how it is affected by temperature and humidity, how long immunity lasts, the precise fatality rate and which public health measures – such as face coverings and lockdowns – work best.
Some new questions have also been added and partially answered, including the disease’s health impacts. Other unexpected queries will probably arise too.
Overall, though, progress has been commendable. “The road map was written very early on,” says Lang. “But it was exactly what we needed to do.” Well, so far, so good. But there is still a long and hard road ahead.
