When the Jewish people ushered in the year 5780, little did they know that two months later a crisis of biblical proportion would plague the world.
The Hebrew year 5781 was spent mostly in lockdown. Israel lost 5,622 people between Erev Rosh Hashanah 2020 – September 18 – and August 24. Tens of thousands of Israelis became unemployed. Immigrants were torn apart from their families as the airport closed. And children became emotionally distraught and educationally challenged.
Now, we stand on the precipice of a new year – looking forward to what God might have in store for us this time.
It is not just a question of will there be a sweet year anymore. We know that it will be bittersweet for at least a while more, as poor- and middle-income countries struggle to vaccinate and the virus continues to spread and slay.
There are also more than 1 million Israelis who have not recovered from COVID-19 and who have chosen not to get inoculated, putting themselves, their loved ones and the entire country at risk.
We cannot just wonder “who will live and who will die.” If the last 18 months have taught us anything, it is that we must make a personal effort (“hishtadlut”) to protect ourselves. This is on a governmental level by investing in our health system and enforcing the rules it puts in place. It is also on an individual level by wearing masks, social distancing, washing our hands and not hosting mass events when we don’t need to.
Although we are not prophets, we can likely predict some of what 5782 will hold – what will change, get better, and what will undoubtedly stay the same.
Positive outlook: Vaccines
This year, we can expect to see higher percentages of the world get the jab.
The World Health Organization is pushing partner countries to help vaccinate at least 10% of the population of every country by the end of September, and its larger target is to have at least 40% of people in low and low-middle-income countries vaccinated by the end of 2021.
WHO officials have said it many times: “No one is safe until everyone is safe.”
This year, we can expect the number of vaccinated people to climb, saving lives and enabling the economy to slowly start recovering.
We can also expect the first Israeli vaccine to come to market.
The Israel Institute for Biological Research signed an agreement in July with Nasdaq-traded NRx to help fast-track its BriLife vaccine, which had been plagued by delays for more than a year. It recently kicked off its Phase IIb trial in the country of Georgia.
NRx chairman Prof. Jonathan Javitt told The Jerusalem Post that it expects to launch its Phase III trial as early as October, meaning that if the results are good, a blue-and-white (with a little red) vaccine could be available.
Preliminary studies are showing that the vaccine is powerful against variants and that with a high enough dose, a person’s neutralizing antibodies last longer than with the mRNA vaccines, meaning a third shot might not be needed – or certainly would not be needed as quickly as with Pfizer.
Hope: COVID-19 treatments
Over the past 18 months, scientists from around the world have been searching for a cure for COVID. While an actual “cure” may never be available, there are several treatments that can give us hope – including from Israel.
The goal is really not to eradicate coronavirus anymore, it is to stop the progression from mild to severe disease in order to prevent deaths and to keep our hospitals from breaking down.
Many new and old drugs have completed pre-clinical Phase I and II trials. Some are even in the midst of Phase III clinical trials, meaning they are truly en route to approval. Here are some treatments to keep an eye on.
Some existing drugs could stop COVID at almost 100%
In July, scientists from the Hebrew University said that they have identified several existing drugs that could potentially help treat people who develop COVID-19.
Prof. Shy Arkin, a biochemist in the Alexander Silberman Institute of Life Science, and his team culled through a library of more than 2,800 approved-for-use compounds, identifying 18 drugs they felt could be effective. In unpublished work, the researchers were able to show that several of these compounds “exhibited remarkable potency against the whole virus in in-vitro experiments.”
In fact, in lab tests in which cells infected with SARS-CoV-2 were placed together with the drugs for two days, “almost 100% of the cells lived despite being infected with the virus.” In contrast, without the preexisting drug compounds, around 50% of the cells died after coming in contact with the virus.
Arkin believes his team is set for in vitro and in vivo studies, and he is looking for a pharmaceutical partner to help carry these trials through. Because they are being repurposed, this will likely expedite any future regulatory steps.
Israel to expand use of COVID drug that gets 88% of patients out of hospital
Earlier this month, Israel’s Bonus Biogroup said that its drug, MesenCure, helped 15 out of 17 severe patients who took it to be released from the hospital one day after receiving their final dose.
The drug was being tested at Rambam Medical Center as part of a Phase I/II trial. The ministry has approved expanding the trial and allowing any interested Israeli hospital to take part in the Phase II trial and to use the drug for additional approved patients.
The data also showed a 40% decrease in lung inflammation from treatment – from 55% to 15%, as seen in chest X-rays – in the first five days after treatment. One month later, lung inflammation reached 1%.
Additionally, patients showed significantly improved respiratory function, with blood oxygen saturation increasing to 95% and lung functioning returning to almost entirely normal levels after only one month.
The final timeline is unclear, but the hope is that MesenCure could be available this year.
$15 drug gets COVID patients off oxygen support in under week
Another Hebrew University researcher, Prof. Yaakov Nahmias, has discovered that the FDA-approved drug TriCor (fenofibrate) could get severe patients off oxygen support in less than a week.
According to data that Nahmias shared earlier this week, 14 out of 15 severe COVID-19 patients who were treated in an investigator-initiated interventional open-label clinical study of the drug didn’t require oxygen support within a week of treatment and were released from the hospital.
In addition to the standard of care, the patients were given 145 mg/day of fenofibrate for 10 days. “The results,” said Nahmias, “were dramatic.”
“Progressive inflammation markers, which are the hallmark of deteriorative COVID-19, dropped within 48 hours of treatment,” he told the Post. When looking at the data on other similar severe patients, less than 30% of them on average are removed from oxygen support within a week.
The drug is already engaged in Phase III trials in South America, the United States and Israel. Those studies are placebo-controlled and double-blind., so we should have final results soon.
90% of patients treated with new Israeli drug, discharged in five days
The treatment that former prime minister Benjamin Netanyahu called a “miracle drug” has successfully completed its Phase II trial with 93% of 90 serious coronavirus patients who were treated being discharged from the hospital in five days or less.
The trial took place in Greece.
EXO-CD24, developed by Prof. Nadir Arber of Tel Aviv Sourasky Medical Center, is based on CD24-enriched exosomes and is meant to fight the cytokine storm, which overwhelms the immune system. Exosomes are responsible for cell-to-cell communication. In this case, they deliver the CD24 protein to the lungs, which helps calm down the immune system.
The CD24 protein is delivered by inhalation directly to the lungs.
The team is now ready to launch Phase III and Arber said he expects to complete it by the end of the year.
Despite these expected breakthroughs, it can be assumed that there will be more and more robust variants. We will still be wearing masks. And international travel will still not be the same, if it resumes at all.
If 5781 was the year of the COVID-19 crisis, 5782 will be the year that we learn to live alongside the virus. But while we struggle to find balance, we can be encouraged that a breakthrough is on the horizon.
The writer is senior coronavirus analyst and head of strategy for the Jerusalem Post Group.