Chemistry and cooking are pretty similar, at least to Mike Natchus.
He walks through a lab in Atlanta and stops at a fume hood, a ventilated enclosure that sucks up dangerous gases, where he picks up a small glass container.
“A lot of what we do looks like you’re working in a kitchen,” Natchus, who works at the Emory Institute for Drug Development, says. “Instead of working with pots and pans, we’re working usually with little flasks and little vials.”
Natchus says, like cooks, chemists often take different ingredients and mix them to create something new.
‘No Virus, No Disease’
That’s how a drug called EIDD 2801 was made. Its name comes from that of the Emory Institute of Drug Development, the university-owned biotechnology company where it was created.
Natchus and others wanted to develop something that disrupted how viruses make more viruses. They took a key part of the viral genetic code and made minor changes.
“But that’s an error,” Natchus explains. “Now, [the virus] can’t replicate anymore. It doesn’t work. It’s broken. We just broke it.”
“It’s a very simple principle: no virus, no disease,” George Painter, president of the Emory Institute for Drug Development, says. “Or [EIDD 2801] limits the amount of virus on board to a level that’s not sufficient to cause clinical signs and symptoms.”
Fighting Different Viruses With One Drug
Painter says he started working on the antiviral drug in 2013 after he was approached by the Defense Threat Reduction Agency. At the time, the federal agency was looking for a way to fight Venezuelan equine encephalitis, a sometimes-fatal viral disease that causes brain swelling.
The FDA has already shown a willingness to fast-track tools for the current coronavirus outbreak. Earlier this month, it issued an “emergency use authorization” for a diagnostic test for the 2019 novel coronavirus developed by the Centers for Disease Control and Prevention.
Looking For ‘The Lowest-Hanging Fruit’
Testing out treatments that are already in development is likely faster than starting from scratch with a brand new drug, says Dr. Amesh Adalja, with the Johns Hopkins Bloomberg School of Public Health.
“The first thing to do is take the lowest-hanging fruit, which are other antivirals that may have activity against this virus,” he said.
“[These broad-spectrum drugs] can be useful,” Adalja says. “We have many different viral threats, and if something can work against more than one, it can serve multiple purposes.”
But antiviral drugs do have limitations, says Stephen Morse, who studies infectious diseases at the Mailman School of Public Health at Columbia University.
For one, you have to know who needs them.
“If you can target people who are infected and might be able to transmit to others, it could have a very large effect in reducing the epidemic,” he explains. “But it’s hard to diagnose everybody.”
Morse says antiviral drugs can be beneficial for people who get sick, but cautions they’re not preventative like vaccines. Quickly making enough medication to treat lots of people can also be a challenge.