At the beginning of the COVID-19 pandemic, many physicians were at a loss about how best to treat patients with a disease that had never been seen before. As the growing number of people admitted to intensive care units stretched hospital resources thin, researchers around the world scrambled to find effective therapeutics against the deadly disease.
Last summer, the Canadian government launched the COVID-19 Therapeutics Task Force to assess treatments under development and provide expert advice to the government about which drugs to procure and which scientific projects to support. This is one of three COVID-19 advisory groups created at the federal level—there is also the Vaccine Task Force, which evaluates vaccines, and the Immunity Task Force, which tracks the spread of the virus.
The Therapeutics Task Force consists of seven core members and 11 science advisors from across Canada and with various backgrounds, including drug development, health care and business. At least six are McGill alumni. “I’m proud, and also humbled, to serve my country by being part of a group of such amazing scientists, clinicians and businesspeople,” says Cédric Bisson, MDCM’91, co-chair of the Therapeutics Task Force and a partner at the venture capital firm Teralys Capital.
Dr. Makeda Semret, BSc’88, PGME’01, one of the scientific advisors on the task force, an associate professor in the Department of Medicine at McGill University, and an infectious disease specialist and medical microbiologist at the McGill University Health Centre (MUHC), describes the experience of being on this task force as “intense.” When the task force first convened, they met virtually two to three times a week, and for several hours each time. “Everybody was incredibly engaged—the frequency of our meetings has normalized, but the engagement is still there,” she says.
Making a decision about whether or not to recommend a therapeutic involves balancing many different considerations. In addition to examining the efficacy of a treatment, issues such as whether it will be feasible to mass produce and distribute are also key, explains Youla Tsantrizos, BSc’77, MSc’79, PhD’90, a core member of the task force and a professor of chemistry (and associate member of the Department of Biochemistry) at McGill University. “It doesn't matter how great a compound is, if you cannot manufacture it in multi-kilo quantities efficiently, economically, and in a safe manner environmentally, it will never be a drug.”
Bisson says one of the benefits of having such a diverse group of individuals meant having different points of view at the table. “It’s quite a collegial group, but of course, we don't always agree,” he adds. “People voice their opinions, we discuss, and then typically arrive at a consensus.”
One of the biggest challenges, Bisson says, was the speed at which the therapeutics needed to be assessed, a complicated task given limited or conflicting data. According to Bisson, the team felt they had the duty to act as rapidly as possible due to the magnitude of the public health crisis.
To ensure that the country procures treatments early enough to provide Canadians access to effective drugs, the group often needs to make decisions before all the studies for a given treatment are complete—meaning that there is always some degree of uncertainty that they need to deal with, Semret says. “There’s definitely the sense of responsibility to make the right decision,” she adds. This decision-making process “involves a combination of a range of expertise around the table, deep discussions, and a climate of transparency.”
Currently, there are more than seventy COVID-19 therapeutics in clinical trials in Canada. These include antiviral drugs, antibodies designed to block the spike protein—structures on the surface of the virus that enable it to enter human cells, treatments that modulate interleukins—key regulators of the immune response, corticosteroids, a class of anti-inflammatory drugs, and a multitude of other compounds.
As the research and development of these therapeutics continue to move forward in 2021, people can expect a significant influx of results from the many ongoing clinical trials, according to Bisson. “Hopefully, some of that data will be positive or confirmatory and will give us more tools to treat infected patients or to prevent outbreaks in certain settings.”
At the end of 2020, the tide of the pandemic finally began to turn when the first vaccines against SARS-CoV-2, the coronavirus that causes COVID-19, started to get approved by governments around the world. Canada approved its first two vaccines—from Pfizer/BioNTech and Moderna—in December.
Even with vaccination initiatives now underway, identifying effective treatments for COVID-19 remains a crucial task. This is because it will take some time for the vaccines to be distributed and administered both to patients across Canada and around the globe, Bisson says. At the same time, there are open questions that remain about the vaccines, such as how long effective protection from the inoculation will last and whether they will be effective against emerging strains of the virus, such as those identified in the United Kingdom and South Africa.
“We’re hopefully heading towards the end of the pandemic, but I don’t think it’s the end of the virus,” Semret says. Even after the public health crisis passes, patients with COVID-19 will continue to arrive in the clinic—possibly for years to come, if SARS-CoV-2 becomes a seasonal virus like the common cold—and physicians will need therapeutics to help them.
“Most likely, there will always be a need for antiviral drugs that can treat the viral infection as opposed to preventing the disease, which is what vaccines are meant to do,” says Tsantrizos.
The task force is also looking ahead to the future in order to ensure that Canada is better equipped for future pandemics. One of the benefits of antivirals that target specific coronavirus proteins, in particular, is that they may be effective against more than one type of coronavirus—so pinpointing potentially useful drugs now could be beneficial to viruses other than SARS-CoV-2, Tsantrizos says. “We are learning, like every country around that world, that we need to be better prepared for the future.”
Addendum: McGillians Don Vinh, Don Sheppard and Maha Katabi also serve on the task force.