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Dissing the scientists

I’ve written before about how science in this country has been murdered to within an inch of its life. This topic deserved more attention in the past and now that the viral apocalypse is upon us, it’s time we scientists had a louder voice. No one has been listening to us.

The Washington Post has a front page article about the problems developing a coronavirus vaccine and the impossible timeline Trump and Alex Azar expect to meet.

This paragraph makes me extremely nervous:

I would prefer to see the FDA at more arms’ length,” Lurie said. “I think it’s appropriate for the FDA to engage with manufacturers with vaccine candidates to explain what they will need so reviews can be expedited. But I think it’s a bad look for the FDA to be in the same room with a project that emphasizes speed.”

That remark deserves its own post. Trust me, we should all be horrified by that attitude if for no other reason than it feels like yet another attempt to deregulate.

Moving on.

Before I talk about how hard it will be to create a coronavirus vaccine, I’d like to remind everyone that we’ve been dealing with HIV for more than 30 years and we still don’t have an effective vaccine. That’s in large part due to the specific cells that HIV attacks- T cells. T cells are a critical part of the immune system. They need to be trained to recognize the virus protein on the surface of our cells. That’s basically how vaccines work. Your body is taught to recognize self from non-self. So if the virus you are trying to vaccinate against goes after a major component of the immune system, you’re going to have problems getting those rapidly diminishing T cells to do their job. If you do a thought experiment on that, it’s actually pretty depressing. Let’s just say that an HIV vaccine is probably going to be very difficult to create even 30 years later.

The way we keep HIV in check is through small molecule drugs like aspartyl protease inhibitors. I used to work in the area of small molecule drug discovery. There used to be a lot of medium sized pharma R&D companies strewn along the length of the Northeast Corridor that did small moleculr research. We used to work in many therapeutic areas such as antibiotics, to cardiovascular, central nervous system, women’s health as well as cancer.

In the 2000s, many of those drugs went off patent. With the loss of so many blockbusters, the industry laid off hundreds of thousands of career scientists, shuttered labs and switched to biologicals that didn’t have as many patent issues. Also, the portfolios switched to cancer and orphan diseases because they could be fast tracked and if there were awful side effects, well, desperate patients aren’t likely to sue. They’ll put up with a lower safety profile to eke out a few more months.

I just have to insert here that although chemo can be harsh, it’s not nearly as bad as it was 23 years ago. Some of that has to do with the drug cocktails we use these days that are effective and less likely to make you feel sick. Some of it has to do with a class of small molecule drugs called kinase inhibitors that are just hitting the market now. That’s what I used to work on.

Biologicals are great and show amazing promise. But they are just one weapon in the arsenal. Well, they used to be one weapon. With the destruction of the small molecule drug industry in the last 20 years, research has shifted disproportionally to biologicals.

Ah, you say, but don’t you want the most up to date science and technology? Yes. We do. But that doesn’t mean we have to abandon one avenue of discovery in order to chase profits. Someone should have been studying the effects of the patent cliff on medicine. Ok, the scientists who lost jobs can write papers on it now but there’s no mystery about this. No one gave a fuck about scientists. If you say “pharma” your mind immediately turns towards the shareholders who are making obscene profits on your misery. And I completely understand that. But it was our collective inability to distinguish between the financiers and greedy executives from the researchers that allowed the feeding frenzy on small molecule research to go on without any checks. And this is why we are partly in trouble right now.

Because people like myself were forced to find second careers at vastly lowered salaries. We had to shelve our knowledge, experience, skills and continuous training and are now sitting on the sidelines watching this catastrophe unfold, pretty much helpless to do anything about it.

Instead of working in IT in an entry level job, which is fine, I should be using my years of computational chemistry and structural biology experience to sift through millions and millions of possible drug compounds looking for hits against the coronavirus protein targets. BiFF should be writing code for combinatorial library generation and analysis. We should be working with med chemists, biologists, pharmacologists and animal model researchers to evaluate lead molecules. Some of us were at the height of our abilities and had just hit our zone when we were laid off.

The industry has been fragmented. The experienced lab rats were sidelined or shunted to small startups where they faced lay offs every couple of years as early discovery stage staff had to be let go due to lack of funding.

Anyway, I’ve gone over this before in many posts that most of you ignored because It was just not important at the time. Now it’s important.

Because there are two paths that I can see to getting coronavirus under control. 1.) A vaccine. 2.) Drug therapy, either biological or small molecule.

Vaccines can be tricky. They need to show efficacy, we need to know for how long they’ll be effective, we need to evaluate safety and we need to know about unintended consequences like triggering autoimmune responses. This takes time. It could take a couple of years or decades or maybe never.

I can see where Trump et al thought that whipping up a coronavirus vaccine was going to be as easy as making a flu vaccine. There’s a new one every year. We can track sequence mutation in publicly available databases. Piece of cake! But the influenza protein targets are well known. Flu vaccine production has been around for a long time. We know what we’re doing.

The ridiculous timeline that Trump proposes shows his profound ignorance of science in general. I really wish he’d just shut up. Every time he opens his mouth on the subject is infuriating. He makes it sound as if the long timeline is due to scientists not appreciating the urgency. They’re all sitting around on their elitist asses and if someone like Trump just applied right amount of pressure, whipping and humiliation, they would come down from their ivory towers and get to fucking work to save his bacon by Election Day. You can bet if there’s not a vaccine by then, it will be all the scientists’ fault.

Nevermind the years of neglect, underfunding of the NIH, lack of preparation or foresight on the part of Trump’s administration. Forget that the small molecule industry hit the patent cliff hard under Obama but was allowed to be picked to death by financiers, vulture capitalists and chided by smug Silicon Valley types who can’t understand why methods of innovation of man made products can’t operate just as well in incompletely understood natural systems.

We see through a glass darkly. That is the problem. Science on the level that Trump is demanding is not possible. Sure, we can have a Manhattan project. It’s still going to take time. It’s going to take drug therapy in case the vaccine stalls.

We are not data operators or factory workers whose productivity can be optimized. We could work our bodies to exhaustion, you could chain us to our hoods, make us work 18 hours a day. You’d be surprised at how much some of us find that scenario attractive. Science is the ultimate intrinsic reward system. It’s intoxicating and addicting when you’re onto something. But to be thorough, careful, rigorous, and to uphold our own natural instincts to share information, truthfully, not slanting data to fulfill some loyalty oath, goes against almost everything Trump stands for. And, no, big monetary rewards to single individuals as incentive does not make discovery go faster. This kind of work depends on collaborating with each other. Jack Welch type work structures are counterproductive.

I have no doubt that American scientists can accomplish what may look miraculous. I honestly believe that because our culture is so open, optimistic and non-hierarchical that we pay less of a cost to try things out and innovate. We do this better than any nation in the world.

But we can’t do it without the “means of production”. We can’t do it if we’re sidelined and sacrificed for shareholder value. And we can’t do it with criminally incompetent and stupid presidents breathing down our necks and throwing hissy fits because he has no fucking clue what he’s dealing with.

18 Responses

  1. “Anyway, I’ve gone over this before in many posts that most of you ignored because It was just not important at the time. Now it’s important.”

    RD, I don’t think it’s that we don’t recognize the importance.

    I can’t speak for anyone else, but since I’m not a scientist, I don’t feel qualified to comment on posts like this one. That may be why you don’t get many comments when you post this sort of essay.

    On a related topic, it’s not just Don Donnie Two Scoops and his capos. The whole GOP has become an anti-scientific party, thanks mainly to its courting of the fundagelicals.

    https://thebulwark.com/the-pandemic-and-the-gops-science-problem/

    • Golly, that doesn’t stop Trump from giving his opinion and I’m POSITIVE that you are smarter and better informed than trump.
      I’m no rocket surgeon, BTW. I never got my PhD even though I worked at that level. So I don’t know everything. But If you guys wanted nice explanations for things, I’m sure I can find some.

      • Yes, but because I am almost certainly smarter and better informed than Benedict Donald, I recognize my limitations; hence, I am reluctant to talk about subjects I don’t know much about.

        It’s the opposite of the Dunning-Kruger effect.

  2. I am not a scientist, either; but I understand enough to be very worried.

  3. To me the issue is that starting in the 80’s the MBA became almighty, and all they know about is maximizing profit at warp speed. This has happened in IT as well as your industry. There was something to be said for 1 or 2 updates to MVS a year, and a major upgrade every three. Sadly, the business people thought they could do everything with spread sheets on PCs. You can teach MVS how to run software made for PCs but you cannot put into PCs the very close to bullet proof OS that mainframes have run decades

    • I’m in IT and can’t believe how retro it feels compared to pharma. People are still doing data analysis with EXCEL. OMG, unbelievable. They make paper copies of regulations. They leave valuable applications on Mainframes. Sorry, I realize there are reasons for this and I’m still adjusting. But I’m floored at the number of people who still think the ability to create a pivot table is an indication of advanced thought processes.

    • I went back to school for an MBA in the mid-80’s. and business was not something i was versed in. I remember a class, maybe it even was in Marketing, where we read about HMOs, which were just starting., and we had to write out opinions on it. The economic analyses laid out were not easily understandable for me, but i managed to cut through that to understand that they were going to construct a model where profit took precedence over anything else. So I just wrote about how I did not like the model, I thought it sacrificed caring medical practice for cost-effectiveness; and I got an “A” in the course, so maybe i actually. understood this better than the typical MBA students there who were looking for ways to obtain the highest profits.

      And in something that must be related to it, we now see endless ads on TV from big pharma, some seeming to invent ailments so that they can sell medications for it. The pursuit of profit has infected this profession just like the others, so that now we do not even trust much of what we hear from the pharmaceutical conglomerates.. And we now hear social darwinist themes about how we must reopen the economy, boost the revered stock market; and as trump typically said without one drop of human empathy, “you just have to fight you r way through it,” meaning that a few hundred thousand more deaths are fine, as long as the goal of Republican corporate socialism is continued, and there are many profit-making scams along the way. “They are OUR masks!,, said Jared Kushner.

  4. THANK YOU!
    Again an excellent post.
    Sorry that you’ve been pushed down from you cognitive and academic capacities for the value of profits.

  5. I think that if some kind of vaccine somehow comes out at the end of the year, I will not take it, because it will be tainted with the evil of Trump; it will be something rushed out without enough testing, and it will not only not work very well, it will kill people by infecting them with the virus. The only way I would take it, is if it came out in someone else’s administration, and if scientists who have earned the highest respect, vouch for it. That is the way it should work; we should believe that our government cares about the health and welfare of its citizenry. But Trump’s regime does not have any interest in anyone but the Trumps and a few of its corporate donors.

    I had an image today of an imagined Twilight Zone episode where a carnival barker somehow took over the country, and so everyone heard his spiels about magical potions and great things inside the tent, except that now it was not amusing, or something you went along with for a few dollars of admission. It was a world where no one could believe anything the barker said, but there was no other option, nowhere else to go; the spiel went on endlessly; you had no way of knowing what was right, what was not; you could either try to run away from all of it, or you just had to keep listening to the barking, while others around you gave into it, and drank the bleach, took the hydroxychloroquine, put their arms out to be injected with the vaccine they were told would grow their hair back, make them potent; we have prevailed, we are winning, we are back, big rally tonight.

    BTW, did you see that Trump’s closest comparative in evil in the Americas, Bolsonaro of Brazil, is seeing his medical chiefs resign because they do not agree with his efforts to force hydroxychlorquine on the Brazilian public? Those who have hypothesized that there are a few incredibly rich entities which work together to run the entire world, may be more accurate than I had thought. How could both Trump and Bolsonaro be pushing the same unproven and dangerous drug? Who is pulling the strings?

  6. 😈

  7. You write a post talking about the destruction of pharma research in the US but you don’t even mention the fact that the entire industry was outsourced/off-shored to China. This was done with the blessings of the Democrats and took place BEFORE Trump ran for POTUS.

    When JFK promised to put a man on the moon by the end of the decade people thought his timeline was ridiculous too.

    • 😛

    • Hi Niles! The history of pharma is not as simple as “your job got shipped to China. And India!” It can’t be boiled down to trade deals. Maybe you should go learn about the Patent Cliff before you say another irrelevant thing.

    • BTW, living organisms behave quite differently than rocket boosters, transistors and code.
      Go work in a lab for a few years. You’ll see what I mean. It’s a completely different set of problems to solve.
      Don’t repeat Trumps jingoism on science here unless you like to look silly and childish.

  8. In the years when I was a front line RN, and then as a Nurse Manager, I saw multiple epidemic scenarios, as well as local outbreaks of everything from HIV to Pertussis to Hepatitis A (which was embedded in organic frozen smoothies.)

    I managed large scale delivery of influenza immunizations and maintained an international certification for administering Yellow Fever vaccine. I was the Ebola response leader in a medical office building which saw 2,000 patients a day.

    I focused on communicable diseases within the ambulatory care health care delivery system and the systemic approaches to treating and tracking ILI (influenza like illness) , among other locally infectious diseases. We had Legionnaire’s pop up at a local health club’s hot tub area, for instance.

    I only know science. You, and your colleagues, have delivered cures and treatments and prevention and I can’t thank you enough.

    I retired super young (well perhaps younger than then those who generally retire, lol) and was happy to do so.

    I kept my license active and then just recently certified to teach BLS and ACLS . And, then COVID and so on and so forth. No one is teaching these classes right now.

    I am mostly horrified to see this “reopening” BS from GOPers.

    And, I am doubly distressed that credentialed scientists, like you, have been removed from the community for many years.

  9. I came across this cogent remark a couple of days ago:

    Trumpians believe in life before birth and life after death. But not in between.

  10. “Dear” re-openers:

  11. Another reason Why We Can’t Have Nice Things:
    https://theweek.com/articles/914220/conservative-victimhood-complex-made-america-impossible-govern

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