Saudi Arabia: Coronavirus Adds Momentum To Search For MERS Treatment

By Jumana Khamis

The race is on like never before in human history. As the number of confirmed coronavirus disease (COVID-19) cases continues to climb around the world, the urgency to find a vaccine is greater than ever.

Last month, Saudi Arabia pledged $2 billion to the ACT Accelerator initiative launched by the World Health Organization (WHO) to help develop a vaccine for the fifth and most contagious strain of the novel coronavirus.

The global initiative will draw on the expertise and infrastructure already put in place by nonprofits, including Gavi (the Vaccine Alliance), the International Federation of Red Cross and Red Crescent Societies, and Unitaid.

More than 80 groups of researchers and scientists around the world are working on a COVID-19 vaccine.

Many have even skipped the animal-testing phase and begun clinical trials on humans as the number of infected people crosses 4 million globally, of which close to 91,680 cases are spread across the Gulf Cooperation Council (GCC) countries.

Amidst the mounting pressure to find a cure for COVID-19, the lessons learnt from encounters with other strains of coronavirus are invaluable.

Coronaviruses are a large grouping that can cause diseases ranging from the common cold to COVID-19. Some strains are deadlier than others.

Take the Middle East Respiratory Syndrome (MERS) coronavirus (MERS-CoV).

The viral respiratory disease caused by MERS was first identified in Saudi Arabia in 2012.

According to the WHO: “Current scientific evidence suggests that dromedary camels are a major reservoir host for MERS and an animal source of MERS infection in humans.

However, the exact role of dromedaries in transmission of the virus and the exact routes of transmission are unknown.

In any event, Saudi Arabia’s 2012 experience with MERS set the stage to not only control it quickly and effectively, but also to try and find a vaccine for it.

This push is of relevance even now as the Kingdom continues to battle MERS, though at a slower rate.

The most recent outbreak was reported between Dec. 1, 2019, and Jan. 31, 2020, when the National IHR Focal Point of Saudi Arabia confirmed 19 additional cases of MERS, including 8 associated deaths.

The WHO reported the cases from the regions of Aseer (7), Riyadh (6), Al-Qassim (2), Eastern (2), Madinah (1) and Aljouf (1).

Which brings us inevitably to the question: How successful has the Kingdom been in its pursuit of a vaccine for MERS?

Several versions are in the experimental phase, with “a number of promising candidates in different stages of development,” Dr. Abdullah Algaissi, assistant professor of virology and a coronaviruses researcher at Jazan University, told Arab News.

A front-runner is the “ChAdOx1 MERS vaccine” which, he said, is a result of a joint collaboration between the Jenner Institute at the University of Oxford in the UK and the King Abdullah International Medical Research Centre (KAIMRC) at the Ministry of National Guard in Saudi Arabia.

Dr. Algaissi said the vaccine must successfully complete phase one of the clinical trials under way in Saudi Arabia and in the UK, followed by phase two and three before being approved for use.

“This process may take up to three years,” said Dr. Algaissi, who believes that any progress made in creating a vaccine for the MERS virus will automatically aid the development of a cure for SARS-CoV-2, the virus that causes COVID-19, in a shorter time frame.

This may be possible due to the similarities in the structure of the two coronaviruses, which belong to the same family and group of viruses, the “coronavirus and betacoronavirus,” he said.

He referred to a spike protein present on the surface of these viruses, which they use to enter cells in order to replicate and this protein could be “a major target for vaccines.”

Essentially, this would mean that if the spike protein is disabled, the virus loses its ability to penetrate cells.

Dr. Algaissi noted that researchers in Saudi Arabia and around the world are currently using the spike protein found in the SARS-CoV-2 virus to find a vaccine for COVID-19.

Incidentally, Saudi Arabia’s Ministry of Health has joined global solidarity trials to test the most advanced treatment for COVID-19, while several offers have been made to help Saudi scientists fund their research on vaccines and treatments.

Ahmed Alaskar, executive director of KAIMRC, said the institute began clinical trials for MERS shortly after the 2015 hospital outbreak in the Kingdom.

“We entered into agreements with local and international partners to build capacity internally, and we have the government’s support,” he said.

Phase 1 of the clinical trial, Alaskar said, has received approval at the national level and the testing of a potential MERS vaccine is in progress with the permission for conducting human clinical trials granted after three years of hard work.

Also, successful pre-clinical trials on camels in Saudi Arabia helped virologists, epidemiologists and infectious disease researchers at KAIMRC build knowledge about COVID-19, enabling the KAIMRC to join the global race to find treatment and vaccines for COVID-19, he said.

Researchers at KAIMRC have successfully isolated the new virus from clinical samples and sequenced its whole genome, said Alaskar.

“Whole genome sequencing would eventually lead to the identification of certain targets for therapeutics and for tracking the virus if it develops resistance or transforms,” he said.

KAIMRC is also working on two rapid diagnostic tests that were initially developed for MERS and replicated for COVID-19, said Alaskar.

However, he cautioned that attempts to develop a vaccine in a matter of weeks or months would carry their own risks.

While a country’s contagion-preparedness is a “continuous process,” Dr. Algaissi believes that COVID-19 is not the first pandemic and it certainly will not be the last.

“I think some of the things that we need to do to improve our preparedness is to invest more in basic and translational research in the areas of infectious disease and outbreak. We may also need to think of establishing a national stockpile of essential medical equipment.”

He said there was a need for more graduate programs in the Kingdom’s universities that focus on areas such as public health, epidemiology, infectious diseases and crisis management, and vaccines and drugs development for infectious diseases.

Dealing with a virus outbreak is not a new phenomenon for a country like Saudi Arabia, said Dr. Algaissi, adding that measures such as stringent lockdowns are being replicated to contain the current coronavirus pandemic.

Meanwhile, the WHO warns that as a general precaution, anyone visiting farms, markets, barns, or other places where dromedary camels and other animals are present should practice general hygiene measures, including hand washing before and after touching animals, and avoiding contact with sick animals.

According to the WHO, the consumption of raw or undercooked animal products, including milk and meat, also carries a high risk of MERS infection.