UC San Diego's chief of infectious diseases thinks a coronavirus vaccine is at least a year away

Dr. Davey Smith is a translational research virologist, shown in the lab at UC San Diego on June 2.

San Diego Union-Tribune

June 11, 2020 12:06 PM PT

The workday is never short for Dr. Davey Smith, chief of infectious diseases at UC San Diego.

He’s part of the Herculean effort among scientists to find ways to slow and eventually stop the spread of the COVID-19 coronavirus, which has killed more than 4,600 people in California.

It’s a daunting situation.

“I have a great sense that the public has a hard time figuring out what’s going on because I also have a hard time figuring out what’s going on,” said Smith, 47. “It’s something [I’m] doing 10, 12 hours a day — going through the literature as much as I can and generating my own data and still being stuck.”

Smith discussed where scientists are in the fight against the virus and what might come next.

Q. How well do scientists understand this coronavirus?

A. “We’re about six months into this virus infecting humans and causing disease and scientists don’t quite understand all the nuances. How does it cause illness in some people and not in other people? How do people stay asymptomatic but able to spread it to a whole bunch of other people? Some people don’t have a lot of virus but still get very sick and end up in the hospital and even pass away. ...

“We’ve tried getting vaccines for coronaviruses before, particularly SARS and MERS. We just haven’t done it yet. We think this is going to be a hard effort.”

Q. The University of Oxford is getting a great deal of publicity about the vaccine it is developing. What feels plausible about the Oxford effort?

A. “The Oxford effort is a great one. They started right off the bat. They’ve known how to make that type of vaccine for a while. It is very encouraging that as soon as they got it together they started pushing for clinical trials and getting it into humans to see the immune response. Kudos for them.

“If they strike a home run right off the bat, that is great for mankind. But in vaccine development, many times the first at-bat doesn’t work. It requires some iteration for it to get better.”

Q. Would it be accurate to say that while there are a lot of scientific efforts underway, the number of experimental coronavirus vaccines that have actually gone into humans is pretty small at this point?

A. “I think there’s 130 different types of vaccines possibly out there, in various stages. Some are still in the petri dish, some are in the test tube, some are getting into mice or hamsters and some have made it into humans. There’s just a handful. I think two or three.”

Q. Is it possible that we can get vaccinated and it’s good for a while but then it wears off?

A. “It is possible. The first time that we get a vaccine it might last a couple of months. Then the immune system response sort of wears off. We might need a booster.”

Q. When are we likely to have a vaccine that’s been tested, that’s safe, that works and can be manufactured and distributed?

A. “I really think that it is going to be another year, if not longer, before I can get [a vaccine] at my pharmacy or doctor’s office. It’s not only that we are testing it in people, we have to go and see if it works. That means that the people who got that vaccine have to be exposed and that there’s enough of them to know whether the vaccine protected them from getting infected.”

Q. Does it look like a lot of therapeutic agents will be coming out before the vaccine that could help cut down on the number of people who die?

A. “Yes. So at the start of the pandemic it is important to have multiple things in line. The first thing that we worked really hard at is trying to get testing figured out. How do you diagnose it? How do you make sure that someone really does have [the virus]?

“The next thing that we need are treatments. What are the drugs? What is the drug that will keep people out of the hospital? What are the drugs that keep people off the ventilator or keep from dying? And those seem to be different types of drugs. And all of those need to be tested.

“The next stage, which happens at the same time, are the vaccines.”

Q. Where are we with testing? Are there good tests, or are they evolutionary?

A. “Where we are in testing is a very good question. And at the moment there are so many different people trying to solve that problem — which is a good thing, having lots and lots of platforms and machines to run all these tasks is exactly what’s needed.

“But the next step is to figure out which ones are the best. Which ones are the most cost-effective? Which ones are the ones we’re going to need to screen someone who may be asymptomatic or someone who might have had an exposure? All of those things still need to be clarified.

“The good news is that we have tests. We have tests that work. They’re not always 100 percent. But no test is. We have to understand the limitations of those tests. And if people are worried that they might have been exposed or get sick, they need to go get tested. ◆

-- Gary Robbins is a reporter for The San Diego Union-Tribune