That pot candy show with Marter, private trust, Ireland's leading private hospitals with locations nationwide, including Dublin, Cork and Limerick. This is News Talk. It's good morning to Look O'Neil, professor of biochemistry at Trinity College, Dublin. Good morning. Good morning. A number of things on our agenda, but I suppose the most startling headline is that Britain is going to run its first coronavirus vaccine trials that actually infect the volunteers deliberately with the coronavirus. That's right.
They got permission for this. This was suggested a few months ago, as you may remember. And it's been done before by way of malaria, for example, where you gave some of the vaccine and then purposely infect them and see if it protects them. And they were looking for this for a few months. And there was hesitation because, you know, you're giving someone covid-19, basically, but they've decided to go ahead with it because obviously it's a quick way to see if a vaccine is working or not.
So it's actually a very good development in many ways.
Now, do we know which vaccine they're going to use? That, as you have told us, hundreds of candidates perhaps between China and the United States and Europe and all the rest of it. Which one are they going to use for this human volunteer test?
They've got to guess. I think that it's bound to be the Oxford, although I think the AstraZeneca, of course, think of the U.K. vaccine, isn't it? But remember that center in Oxford, the Janner Institute and Adrian Hill, we remember you spoke to him. I mean, he's run these kinds of trials on malaria in the past, you see, so he knows what he's doing. I think the reason why they've got permission, Pat, is there is a kind of a treatment now, because obviously, if someone is given a live virus and disease develops, you've got to be able to help them, haven't you?
And because those drugs like Ramdas Xavier Parasitically that we discussed last week, dexamethasone, in other words, it's not as if you're taking a huge risk here. Secondly, it's young people, of course, and we know that they're at low risk anyway. But it is a way to see if a vaccine is working basically. I mean, obviously you give the group one group the vaccine, you give another group a placebo or whatever, and then you'd actually infect them and see how much disease they get.
So it's sort of a scientific thing in a way. Mm hmm.
And I presume you have to load them up with the kind of viral load that they would get if they came in contact with a seriously infected person. And we're up close and personal, but you don't want to overdo it either.
It's a bit hit and miss that. That's one of the unknowns, because exactly if you give them too much, that might be too bad. If you give them too little, it won't recreate like infection in the wild. I guess they'll be picking their doses based on the monkey trials because they know how much to give monkeys to cause disease. You see. I guess so. So that's one thing they can they can take a lead from that, I suppose.
But it should go quite quickly because you can imagine if this is an emergency situation in the world, obviously. And that kind of justifies the thing, I think, to some extent as well.
I guess now the question is, are these volunteers altruistic individuals or are they being paid?
They're being paid. And that's standard that anybody in a clinical trial is usually paid because obviously they're giving up their time and potentially their health. I suppose very often students volunteer for this because because it's a good source of income for them. But remember, they'll be in very controlled environments. It'll be like an ICU effectively, you know, and they'll be monitored very, very carefully. So the risk, the risk of something going wrong is extremely low. Is this is what they're saying?
And I think I'd agree with that.
Now they're going to get something around four grand or whatever, but they will be holed up in Whitechapel, which, you know, they'll be mind at hand on foot as they watch how the infection develops or doesn't.
I mean, if this thing is working, they'll be sitting there watching the television, eating crisps and enjoying themselves.
Yeah, at least on friendly side effect, maybe a sore arm, but that's it. Easy money, is it? But what would you do it it's easy money in the sense you're right. But I mean, the ones who are vaccinated, hopefully a reasonable percentage will be protected. And the one minute disease, by the way. So of course the other it'll be randomised. So you don't know which group you're going to go in. And remember, the physicians will be monitoring everything about these people.
They learn a bit about the infection as well, by the way, because you're actually infecting people and looking at what happens to them over time and they'll be measuring their immune system and all kinds of things. So we're going to get some scientific knowledge about this. But remember, I think it's because they're young. And as you know, the risk of anything going wrong for young people is very, very low. Across the criticism is, if not like in the wild, is that it's not as if it's a whole load of random people getting vaccinated.
That's one concern, I guess, about it, but certainly have to get useful information from it ethically.
It's harder, though, to do this to people who might be in some way health compromised or people for whom the consequences may be the older people for whom the consequences would be catastrophic. So I presume that's why they have to go for young people who if they end up with the coronavirus covid-19 infection, they're going to come through it. Yeah, that's the theory precisely.
Now, the other vaccine trials, but there are vaccinating vulnerable people and people at risk and in the outside world, vaccine trials, if you will. So they have to do that because we've got to make sure the vaccines work in older people.
There's a risk that they're not infecting those people. You see that they're just taking their chances in the wild. They've been vaccinated and they're you know, they will come across infection like anybody else will. And the hope is that they won't get infected.
Yeah, precisely. And that's exactly the risk that is, you know, is different for that group. But it's important that vaccines are given to these vulnerable groups in the wild just to make sure that's going to work in these wonderful populations. And as I say, two of the other by. The trials are going after that, where the more vulnerable older category of pay up to you. Now, one of the worrying stats that's come out of a survey of 70000 British adults, more than a fifth said they would refuse to get a covid vaccine, covid-19 vaccine.
And in America, probably thanks to the carry on of President Trump, where he seems to be forcing the pace of vaccine development and trying to cut corners in terms of approval. I think it's well over 50 percent now are saying, no, we won't do it, won't have it.
Yeah, this is our next concern. And we've got to make sure that we get the message out there that the vaccine has to be used. This has happened through history. There's been, I think, a vaccine hesitancy. As we know, it's evident in people. And it's understandable, especially with this, because people are worried, aren't they, in any any mention of the virus unnerves them, you see. So that's kind of a case of public information.
I mean, remember, in the 50s, they used Elvis to promote the polio vaccine. He went into almost every state in America and he was vaccinated and there was already lots of publicity. You see, now, this was obviously the case that everybody so we're going to have to do things like that. I think once the vaccine is rolled out, would be vaccinating Lady Gaga or whatever the equivalent is, you say, just to encourage people to take up the vaccine.
Now, comparing the common cold to covid-19, we have talked about this and whether or not multiple infections of the common cold in GP's, for example, would convey some sort of immunity. What do we know about common cold immunity, those particular coronaviruses?
Yeah, it's really important because remember, this sars-cov-2 virus is very similar to the ones that some of them cause the common cold around four of them actually in humans. One in five colds we get are caused by coronaviruses and there's obviously a very much milder disease, but they're in the same family. But there's a huge number of similarities then between the viruses that cause the cold and the ones that cause covid-19. So it's an important question. Can you get reinfected with the same cold virus?
Anecdotally that seem to be the case? There was one or two studies, but now a big studies just come out suggesting, you know, sadly, I guess there is evidence for reinfection with the same virus. And what they've shown is that on average, about maybe nine to 12 months afterwards, you can pick up the same virus again and get reinfected. So there is a risk of a reinfection and then we would assume it's going to be somewhat similar with they were covid-19.
So that would mean that the vaccinations, it could be once a year, could be twice a year to keep the coronavirus at bay.
And moving on to the idea of having covid-19 testing any time anywhere. Now, that is the Holy Grail because in crashes at airports and workplaces and so on, if you could do it cheaply, you could make sure everyone is fit and healthy or else they go home.
Yeah, exactly. And in fact, this is your other front in the fight. Remember this this forefronts. Now we're running full pelt to beat this virus. Obviously, the vaccine, the therapeutic area is the second one, the social distancing and all the things we're doing. The third the fourth is testing. And there's a massive effort to get better tests, quick, rapid, reliable tests. Because if we can do that, that's a really great weapon to use, especially on asymptomatic, you know, because obviously we should already have a test every day, basically.
And then if you have the virus, you stay home. That's a great way to beat this virus, remember, because now the people who are have the virus on board are isolated and it doesn't spread, you see. So you have never seen I mean, as far as we know, the effort to make a vaccine, 100, 90 minute development, that's over a thousand therapeutics being tested. So this is like that. There's many, many tests being developed and one looks really good, but it's called detector.
Typical of, I suppose, but it takes less than an hour, very accurate. And you can do it anywhere. And that's going airports, as you say. You can do it at home. You can do in schools. Now, again, this is being developed as we speak. It's 70 cents per test and that makes it very reliable. You have to buy a little device. The cost you have to buy the ticket. It's a handheld disposable device is used.
But this looks really good. The reading now saying this could be the one it used, the technology called CRISPR. Right. So that's a technical term to measure the RNA and the virus and an enzyme as well. So technical. But but this looks really good. And if this is a reality we're looking at two, three months from now, by the way, the testing, any time, any place, anywhere, Israel is ahead of the game here.
They've really focused on this. And that may be the first country where everybody has a test that, you know, every couple of days or whatever. So we're going to see these of getting rolled out more and more, I think.
Yeah, because there is this attitude. And if you compare it to, say, drink driving, it's a bit crazy. I've been tested and I don't have er covid-19 therefore yipee. But that's like saying I stopped at a at the checkpoint and I didn't have a positive test so I can drive on and then I pull in and have a few pints. That's right, yes. And I consider myself immune from the Godlee for seven days. That's not the way it works.
Exactly. I think, I think it's Everhard. The most malicious thing about this virus is there's a symptomatic spread. You've got to assume you're infected when you go out and about and they'll be thinking about symptoms. I just imagine you're infected and then your behaviour should be different. Right. So that's what we need to test everybody. All the time, it's no point just testing the with symptoms, they're important, obviously they've got symptoms and they're going to spread it, but a lot, maybe as many as half the spread as people without symptoms.
So you've got to spot those. We got to able to measure the virus in everybody kind of all the time is going to be one one solution to this.
Now, look, if I had a euro for every time someone has said to me, oh, I think I had it back in January, I think I had it back in February. So I'm probably OK. I'm probably immune. I'd be nearly as rich as you.
Yeah. So now let's have this is the question.
So this is the question about trying to find out whether we've had it and whether we still have an immunity with an antigen test. What's this about artificial intelligence and its use in the home?
Yeah, this is another test that's being rolled out, I suppose, and it's very rapid and reliable. That's called an antigen test. And what you're measuring there is a protein in the virus. The PCR test measures the RNA, which is the genetic recipe to make a virus, the antigen test to measure the protein in the virus. And it can be done very quickly and you can use an antibody to detect the antigen. It's a bit like a pregnancy test, I guess, in a way.
And this is another hope because it's a very rapid test, I suppose, to show if you have the virus on board. It's also inclined to be more predictive if you're infectious because the PCR test can be too sensitive. And I think we discussed this before and you can detect it and you might be actually infectious at all, whereas the antigen test probably is a better predictor of you being infectious, I guess. And yet loads of antigen tests are coming out.
There's one by a company called Salix. And again, it's a kind of a little strip in a tube. But what makes it really good is you scan it into your iPhone or your Android and that reads it for you. In other words, it's not dependent on you trying to see if there's a band there or not, which can be a bit hidden. Yes. You see, so they're using I mean, it's quite a laboratory to scan this.
They said this device, I guess, into your phone and then the phone reads it. So again, it's a step up on the previous test that's much more reliable, I suppose, and says, yes, you have antigen in your system. So it's another example of a hopefully a reliable quick test.
But would I have antigen if I'd kind of recovered? That's the question I like, yeah.
Yeah. Because you see the RNA, you can linger, you can be remnants of the RNA. You can go on for weeks and weeks. And it's not actually the virus. It's just a bit of the virus. You're not infectious. If you have antigen, it's more than likely because the virus is alive and kicking in your body because it's the protein in the virus. You see, as I say, it's more reliable. It could be. I mean, this is a work in progress.
What they're saying this could be a better test to say someone is infectious and maybe the case numbers might switch to antigen testing, you see, and that would give us a better measure of how many people are infectious in the population.
Now, the next topic we have is vitamin D and covid-19. Now, you will remember Linus Pauling and vitamin C and the common cold and I'm not sure which way it went.
He was discredited and then he was created again and then he was discredited. He's now departed from us. Yeah. So we have to be careful about making wonderful claims for vitamins.
Vitamin C didn't didn't pan out, but there's no evidence that that protects against the cold. Again, back to our first topic. That was sadly Linus, we think got it wrong there. You know, the vitamin D, a different story because more and more and more evidence suggesting is a really good way to protect against covid-19. And lots of studies now. There's at least seven are correlating vitamin D levels with severity.
So the more you have, the less severe disease is the fact is uncanny are great. One of my great colleagues, I mean, she's been part of this. She's been advocating for vitamin D is a thing. And the reason why it's good, but is there's a mechanistic basis. Vitamin D is really good for your immune system. It boosts your macrophages to eat the virus by a process called autophagy, which is an immunologist listening even will know what that is.
But it's a really good macrophage booster. And then it's also able to limit inflammation and limit damage. So in other words, there is a basis for this vitamin D activity, I suppose, and that's what's very important.
But as older people can't make enough because you only make it in your skin. So sunlight, sunlight shines on your skin and you can make vitamin D older people, their skin isn't as effective as they're inclined to be. Vitamin D deficient. This may be another reason why they're at risk anyway. So the advice now is keep your vitamin D levels up. And in fact, there's talk now of doing proper supplementation of vitamin D, especially in more vulnerable groups.
So the evidence around vitamin D got much stronger.
Now, do we know how much we have to take? Yeah, you got like, what's the dose? Any normal diet would have enough, actually, you know. And then secondly, if you have sunlight, even 10, 15, 20 minutes of sunlight on your skin, you make sufficient levels for you, you know, so you don't need to go too crazy with the amounts. But as I say, in these more vulnerable groups, the typical supplements you would get in your health food shop are going to top it off, you know, but if you eat sufficient amount of food stuffs that are rich in vitamin D, then you should be OK.
You see. So a good balanced diet and a bit of sunlight is good. This is why it's good to be out in the sun, because you've got to be careful not to get sunburned. There's a risk of, you know, skin cancer there. So we can't be recommending people getting get burnt basically to be careful. So but a tiny little bit of sunlight every day would suffice.
We need to make enough. Now, they've actually done some work on this in Spain, and we know Spain has a particularly intractable, intractable problem with the coronavirus at the moment. What have they discovered there?
Yes, what's happening? A little bit of studies are being done here and there. There's a huge studies being run. Of course, you need lots of numbers to prove this. You know, a proper double blind, placebo controlled trial is needed. But there was one study in Spain. It was only 50 patients. It's a bit limited, which which makes it slightly cautious. But certainly those who were given supplements had a much decreased need for an intensive care if they got infected.
You see, the ones that are supplemented basically had two percent risk of ending up in the ICU, whereas the ones that were deficient didn't have enough of a 50 percent chance that somebody big difference. It seems a bit too high to me. But but certainly that study is suggesting that supplementation will make you have a better course if you get infected as the idea. So that's that's one of the pieces of scientific evidence to suggest a supplementation might protect you.
OK, and now some of the questions coming in need to take my daughter for a test today only to public centers in or around Dublin. The Aviva and Saud's advice is not to take public transport or taxis. I don't have a car home test take up to five days unless I start walking now with my little girl. I don't know how to get there.
That's a challenge, isn't it? That's a tricky one. Yeah.
I mean, you really what choices do you have not to take taxis or public transport and you can't cycle from swords or wherever to the these testing centers.
I mean, what can you say to people except, you know, wear a mask to get a taxi, open the windows and the taxi, bring hand sanitizer with you. That's all you can do.
Exactly. That should be pretty safe. I would recommend taking a taxi. You wear the mask, make sure that good ventilation, you know, and keep the distance in the taxi as much as you can. That's all you can do because it's important to be tested in that situation, you see. So it justifies a little bit of risk there.
I think by taking a taxi, our listeners really try to test you. Look, how do we know that the asymptomatically are not false positives?
Oh, that's a great question. But actually, that's the biggest concern about testing. Is that any false positive or indeed false negative, you see. So they're very zealous. They're trying to look at that, I suppose, and make sure the test doesn't do that. You know, in a way. And I mean, the PSA test has a very low false positive rate, I think. I mean, the numbers are tiny. You know, something we don't really worry about, really.
I think that's why the test has to be validated. There's no point in rolling out a test that gives you twenty percent false positives, is it? Because that means one in five people are told, in fact, and they aren't. So it's a really important thing to keep an eye on.
Ask where are the bottlenecks in the testing system? Is it a shortage of reagent shortage of qualified testers, the training of testers, etc.? That's from Frank.
I think it's all of that and in fact, at the very start. But that's why we were shouting for a minister for testing, because there's many steps in the testing process. A minister could break through the roadblocks. You know, staffing was one, reagents is another, you know, logistics. All these things that can be done, though. I mean, the shame that in some cases other countries had fantastic testing, Iceland, you know, South Korea.
But that's our goal in a way. And we're getting there. I mean, we're not the worse than the class by any means. You see, we're not too bad, but certainly you've got to be zealous and make sure you have the an optimum testing system.
It's really important.
How long after taking the vaccine? Well, they will they in fact, the trial candidates. That's a good question, Bryan. I don't know.
That's a great question. Yeah, I would think it would be pretty soon, you know, like in other words, you're trying to recreate the situation in the wild, I suppose, in a way. So you'd give the vaccine and then imagine the person goes out for, you know, a day or two and then infect them. I imagine that's what they will do there.
Yeah. And I presume they can check whether the vaccine has generated those antibodies and they say, OK, they're there now.
We have a go and give them a shot of the coronavirus. Ah, yeah. This is the experimental immunology.
We call this because they're absolute they were vaccinated solman and begin to measure antibodies and T cells immediately, you see. And then at a time course we call that and the best vaccine will cause antibodies to be made very quickly. Within an hour or two, you might begin to make antibodies, you see. But it's a really good way to say how good the immune system is.
You think, ah, the lower rates of people dying because we've changed our habits, or is it possible the virus isn't as deadly as it was six months ago?
That's another. But that's in our minds all the time. That's the good news about the death rate has gone down usually as we know now. It's partly because as younger people getting sick and ending up in hospital and they're more inclined to survive. So the overall death rate is calculated based on total number of people in a hospital. I guess that's one reason. But the second more promising reason is they're getting much better at handling patients because the doctors are learning.
And we've had two examples. If you end up in a severe way, they give you dexamethasone and that's saving one in five or those who died. So we've got a 20 percent win there already, you see. And then there's other measures, anticoagulants, the way the way they handle the patient, the various ways are improving all the time. And and remember that the the goal is every week that should get better if we're lucky, either with different treatments are new treatments come in.
And by the time we get to, say, three, six months from now, the death rate should be even lower is the hope you see.
We can live with the virus, we cannot exist without spare acute bed capacity if the beds become nearly full and there will be an immediate and complete lockdown, that's probably likely if it gets to that point where our capacity is limited and everyone is saying there'll be chaos and flu season, but who's going to catch the flu when we're all washing our hands and wearing masks?
The flu rates are going to plummet in Australia.
I've had the flu right plummet if they have their winter ahead of us. And there was almost hardly any flu because of these measures. Exactly. So the things we're doing to stave off the flu as well.
Look, I tested negative for covid-19 in April, but an antibody test has identified, it looks like EGI. How long might the antibodies stay? That's from Mary.
Yeah, well, that, again, is variation. I mean, you see what's clear about this, but is the immune system kind of like everything else? And biology varies between people and some will have a sustained antibody. The Icelandic study, there was antibodies for a good, strong level for four months after infection. You see, other studies suggest that begins to wane. There's no doubt antibodies will have to weigh in because there's no point making loads of antibodies all the time if you don't need them, you know, so there will always be a range there.
But antibody should persist for a few months, we think, in people.
Yeah. And then they're ready to go if there's another attack. That's the theory. Is it safe to go to public swimming pools? This is our last one. Does chlorine provide enough defence against covid-19?
Well, the swimming is pretty safe, actually, as long as you're again observing the distancing rules. And it's great for your health. And of course, a bit of exercise boosts the immune system. The fear about swimming was if you're hanging around crowds outside the swimming pool or in the changing rooms, avoid that. So get in there and have a good swim, you know, and obviously, if the virus comes out and ends up in the pool, that won't last long, you know, because partly because of chlorine and also because of dilution.
So there's no risk of catching the virus in the swimming pool? I don't think so. That's that's a pretty safe thing to do.
All right, Luke, thanks again very much for joining us. Luke ONeil, professor of biochemistry in Trinity College in Dublin.