Three Ways the Pandemic Has Made the World Better - The Atlantic
▻https://www.theatlantic.com/health/archive/2021/03/three-ways-pandemic-has-bettered-world/618320
par Zeynep Tufekci
This has been a year of terrible loss. People have lost loved ones to the pandemic. Many have gotten sick, and some are still suffering. Children have lost a year of school. Millions have lost a steady paycheck. Some have lost small businesses that they’d built for decades. Almost all of us have lost hugs and visits and travel and the joy of gathering together at a favorite restaurant and more.
And yet, this year has also taught us much. Strange as it may sound, the coronavirus pandemic has delivered blessings, and it does not diminish our ongoing suffering to acknowledge them. In fact, recognizing them increases the chance that our society may emerge from this ordeal more capable, more agile, and more prepared for the future.
Here are three ways the world has changed for the better during this awful year.
1. We Now Know How to Code for Our Vaccines
Perhaps the development that will have the most profound implications for future generations is the incredible advances in synthetic messenger RNA (mRNA) biotechnologies.
But amid all this came historic developments. The new mRNA technology, on which several vaccines—notably Pfizer-BioNTech’s and Moderna’s—are based, is an epochal scientific and technical breakthrough. We are now coding for vaccines, and thanks to advances in science and industrial production, we can mass-produce them and figure out how to deliver them into our cells in a matter of months.
This is all new. Neither Moderna nor BioNTech had a single approved product on the market before 2020. Each company essentially designed its vaccine on a computer over a weekend in January 2020—BioNTech’s took just a few hours, really. Both companies had vaccine candidates designed at least four weeks before the first confirmed U.S. COVID-19 fatality was announced, and Moderna was producing vaccine batches to be used for its trials more than a month before the World Health Organization declared a pandemic. In 2021, the companies together aim to produce billions of stunningly efficacious vaccine doses,
The mRNA vaccines work differently. For these, scientists look at the genetic sequence of a virus, identify a crucial part—such as the spike protein, which it uses as a key to bind onto cells’ receptors in order to unlock and enter them—produce instructions to make just that part, and then send those instructions into our cells. After all, that’s what a virus does: It takes over our cells’ machinery to make more of itself. Except in this case, we instruct our cells to make only the spike portion to give our immune system practice with something that cannot infect us—the rest of the virus isn’t there!
Until this year, that was the dream behind the synthetic mRNA technologies: a dream with few, scattered adherents, uphill battles, and nothing to show for it but promise. This year, it became a reality.
In 2020, we figured out how to make messenger RNA with precision, by programming the exact code we wanted, producing it at scale (a printing press for messenger RNA!), and figuring out a way to inject it into people so the fragile mRNA makes it into our cells. The first step was pure programming: Uğur Şahin, the CEO of BioNTech, sat at his computer and entered the genetic code of the spike protein of the mysterious virus that had emerged in Wuhan. Moderna employees had done the same thing the weekend after the genomic sequence was released on January 10. The Moderna vaccine candidate was called mRNA-1273 because it encoded all of the 1,273 amino acids in the SARS-CoV-2 spike protein—the code was so small that it could all be represented with little less than half the number of characters that fit on a single-spaced page.
The rest of the process relied on key scientific and industrial innovations that are quite recent. Messenger RNA are fragile—they disintegrate easily, as they are supposed to. The lipid nanoparticles we envelop them in to use as delivery systems were approved only in 2018. Plus, the viral spike protein is a notorious shape-shifter. It takes one form before it fuses with our cells and another one afterward. The latter, postfusion form did not work well at all for developing vaccines, and scientists only recently figured out how to stabilize a virus’ spike in its prefusion form.
This may allow us, finally, to transition from a broadcast-only model of medicine, wherein drugs are meant to be identical for everyone in a particular group, to targeted, individualized therapies. Plus, these technologies are suitable for small-scale but cheap-enough production: a development that can help us treat rare diseases that afflict only a few thousand people each year, and are thus usually ignored by mass-market-oriented medical technologies.
It’s also no coincidence that these two mRNA vaccines were the fastest to market. They can be manufactured rapidly and, crucially, updated blazingly fast. Şahin, the BioNTech CEO, estimates that six weeks is enough time for the company to start producing new boosters for whenever a new COVID-19 variant emerges. Pfizer and Moderna are both already working on boosters that better target the new variants we’ve seen so far, and the FDA has said it can approve these tweaks quickly.
2. We Actually Learned How to Use Our Digital Infrastructure
The internet, widespread digital connectivity, our many apps—it’s easy to forget how new most of this is. Zoom, the ubiquitous video service that became synonymous with pandemic work, and that so many of us are understandably a little sick of, is less than 10 years old. Same with the kind of broadband access that allowed billions to stream entertainment at home and keep in touch with family members and colleagues. Internet connectivity is far from perfect or equally distributed, but it has gotten faster and more expansive over the past decade; without it, the pandemic would have been much more miserable and costly.
Technology also showed how we could make our society function better in normal times.
According to the CDC, telehealth visits increased by 50 percent in the first quarter of 2020, compared with the same period in 2019. Such visits are clearly not appropriate for every condition, but when warranted, they can make it much easier for people to access medical help without worrying about transportation, child care, or excessive time away from work. Remote access to medical help has long been a request from people with disabilities and people in rural areas, for whom traveling to clinics can be an extra burden.
Work, too, has been transformed. Suddenly, hundreds of millions of people around the world had to figure out how to get things done without going into the office. It turns out that for many white-collar jobs, this is not just possible; it comes with a variety of upsides.
3. We’ve Unleashed the True Spirit of Peer Review and Open Science
On January 10, 2020, an Australian virologist, Edward Holmes, published a modest tweet: “All, an initial genome sequence of the coronavirus associated with the Wuhan outbreak is now available at Virological.org here.” A microbiologist responded with “And so it begins!” and added a GIF of planes taking off. And so it did indeed begin: a remarkable year of open, rapid, collaborative, dynamic—and, yes, messy—scientific activity, which included ways of collaborating that would have been unthinkable even a few decades ago.
Well, no more. When the pandemic hit, it simply wasn’t tenable to keep playing the old, slow, closed game, and the scientific community let loose. Peer review—the real thing, not just the formal version locked up by for-profit companies—broke out of its constraints. A good deal of the research community started publishing its findings as “preprints”—basically, papers before they get approved by formal publications—placing them in nonprofit scientific depositories that had no paywalls. The preprints were then fiercely and openly debated—often on social media, which is not necessarily the ideal place for it, but that’s what we had. Sometimes, the release of data was even faster: Some of the most important initial data about the immune response to the worrisome U.K. variant came from a Twitter thread by a tired but generous researcher in Texas. It showed true scientific spirit: The researcher’s lab was eschewing the prestige of being first to publish results in a manuscript by allowing others to get to work as fast as possible. The papers often also went through the formal peer review as well, eventually getting published in a journal, but the pandemic has forced many of these companies to drop their paywalls—besides, the preprints on which the final papers are based remain available to everyone.
Working together, too, has expanded in ways that were hard to imagine without the new digital tools that allow for rapid sharing and collaboration, and also the sense of urgency that broke through disciplinary silos.
The pandemic happened at a moment of convergence for medical and digital technology and social dynamics, which revealed enormous positive potential for people. Nothing will erase the losses we experienced. But this awful year has nudged us toward dramatic improvements in human life, thanks to new biotechnologies, greater experience with the positive aspects of digital connectivity, and a more dynamic scientific process.
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