After all we have been through since the beginning of the pandemic, it may be difficult to think of "good things" that occurred because of the virus. I remember seeing people in Italy leaning out of their windows and singing together in the early evening. Shortly after that, people in Manhattan did the same. People became much more friendly to elderly persons, with some major chain stores having hours reserved for them exclusively to do their shopping. Pollution in general reduced significantly worldwide. China's air pollution and nitrogen dioxide levels dropped significantly over 1 year. The famous canals of Venice, Italy, have never been clearer since the use of active water vehicles significantly decreased because of lockdowns and lack of tourists. And often overlooked people, such as teachers and nurses, are receiving shout-outs in social media and recognition in the streets.
However, the most important benefits have been due to Operation Warp Speed (OWS). OWS is a partnership with the Department of Defense (DoD), Department of Health and Human Services (HHS), and the private sector, charged with the goal of controlling the COVID-19 pandemic through the advancement of development, manufacturing, and distribution of vaccines. It was the support of OWS that facilitated the steps in obtaining approval or emergency use authorization from the Food and Drug Administration (FDA) for the Moderna, Pfizer, and Johnson & Johnson vaccines. To put things in perspective, OWS was announced on May 15, 2020, and vaccines were available for use to those at high risk by early 2021. Alexander Fleming accidently discovered penicillin in 1925 and clinical trials began in 1940. In conjunction with support from the US War Production Board, there were 2.5 million doses of penicillin available before the Battle of Normandy in 1944.1
How did OWS move so quickly? Relying on experience with the Zika Leadership group that was headed by the National Institutes for Health (NIH) and the Assistant Secretary for Preparedness and Response, an integrated structure was developed that additionally included the Centers for Disease Control and Prevention, the Biomedical Advanced Research and Development Authority, and the DoD.2 Included in the DoD were the Defense Advanced Research Projects Agency and the Joint Program Executive Office for Chemical, Radiological, Biological, and Nuclear Defense, along with experts in countermeasure research, development, manufacturing, and distribution.2 The overarching objective was to distribute millions of SARS-CoV-2 vaccines approved by the FDA to be given to people in the United States before the end of the year. What an ambitious scientific undertaking!
One of the reasons mRNA vaccine development was so fast is because mRNA vaccine technology had been developed prior to the pandemic and there had been available research using MERS-CoV and SARS-CoV.1 Knowing where to begin, scientists decreased the development of SARS-CoV-2 by months. Because the mRNA delivery system used lipid nanoparticles (LNPs), it was immediately available to be incorporated into the SARS-CoV-2 sequence, negating the need for massive amounts of cell lines to be produced, once again decreasing the time required to obtain the end result of an effective and safe vaccine approved by the FDA.1
The basic science and technologies used to develop the COVID-19 vaccines could not have been done without funding. The Department of Energy and NIH budgets increased by $11.25 billion in 2020, and National Science Foundation budget is thought to increase by $100 billion over the next few years.1 OWS maximized the phase 3 trials by investing heavily into companies that conduct clinical trials. Doing so facilitated testing because the companies' sites were already prepared so that as soon as an investigational new drug had the phase 1 study approved, phase 3 could immediately begin.2 OWS also supported industrial processes such as supporting/refurbishing facilities, raw material sourcing, technology transfer, staff hiring/training, and procurement of syringes, needles, and vials. The plan was to amass large quantities of the vaccine so it could be rolled out when FDA approval was obtained. The DoD and HHS collaboration designed the vaccine distribution network, prioritized the population at most risk for COVID-19, and provided logistic support.2
Because of the enormous collaboration between science, government, and industry, many advancements will continue long after the pandemic. For example, mRNA vaccines will continue to be researched for use to protect against other pathogens because the mRNA-LNP delivery system has proven tremendously effective.1 There is now a new attitude that involves convergence science, new approaches to examine complex challenges, and integration of multiple specialties. The achievements made during the pandemic will have positive impacts that will last for years.
-M. Terese Verklan, PhD, CCNS, RNC, FAAN
Professor and Neonatal Clinical Nurse Specialist
University of Texas Medical Branch
School of Nursing
Graduate School of Biological Sciences
Galveston, Texas
References