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2020: A Year In Review

A rapidly spreading and aggressive virus that infects humans, that has no known treatments, and that doesn’t believe in international boundaries! This sounds like the plot of a science fiction movie. Unfortunately for humanity, this became reality in 2020, an unforgettable year dominated by a global pandemic that crippled the world through disease, death, and untold hardships. In spite of these challenges, biomedical science succeeded in developing, in record time, immunization against this virus before the year ended. Additionally, though COVID-19 dominated the news in 2020, there were other significant developments in the field of science. Here we look at some of the notable stories from 2020.


COVID-19

Of course, the biggest story of 2020, possibly of the century, has been the COVID-19 pandemic. First detected in December 2019, this infection was traced to the SARS-CoV-2 virus. At its early stages, in January, this disease was described in a Nature editorial as an “outbreak of a mysterious pneumonia-like coronavirus”. By that time, there were a mere 300 reported cases of this illness. While the terms COVID-19 and SARS-CoV-2 were yet to be penned, this virus was called 2019-nCOV. In January 2020, the virus genome was sequenced and used to study the virus.


By March 2020, the rapid spread and severity of this virus was obvious and the World Health Organization (WHO) declared COVID-19 as a pandemic. At this point, almost 125,000 people were infected with this virus and more than 4,000 had died. The rising numbers of cases were overwhelming the medical facilities. People started social distancing, wearing masks, and working from homes, schools shut down and went online, and life was completely different for most people. The research community was scrambling to find a cure for this disease, and develop a vaccine.


Doctors and scientists were exploring current therapeutics that could be repurposed for COVID-19, while new drugs were being tested in studies. Additional technologies were being developed ranging from novel varieties of masks, to stop the spread of virus and prevent infections, or innovative ventilator designs such as a ventilator called VITAL developed by NASA for patients with respiratory insufficiency due to COVID-19 disease. Also, multiple companies started working on potential vaccines. By December 2020, there were 162 vaccine candidates in development all over the world, of which 52 were being tested in humans in clinical trials. And by the end of the year, in record-breaking time, the world had several of these approved for use with many additional promising candidates in the pipeline.


In spite of these positive developments, it remains a grim reality that to date, the world has seen over 101 million confirmed COVID-19 cases, with more than 2 million deaths. The Centers for Disease Control (CDC) reports that there are a mind-numbing 25.8 million total cases and more than 435,000 deaths in the US so far.


CRISPR In Therapy

A major biomedical breakthrough in 2020 was development of the first successful therapies using CRISPR technology. These therapies target two inherited blood diseases, beta-thalassemia and sickle cell disease.


For sickle cell disease, researchers deployed CRISPR to disable an “off” switch that stops production of fetal hemoglobin, which can attenuate effects of the sickling mutation. When injected into patients, these cells prevented the effects of sickle cell disease. These cells were also administered in patients who normally require blood transfusions for beta-thalassemia, and this treatment attenuated the need for transfusions. More detailed studies for both these conditions are ongoing.


Ultrasound Targeting Cancer Cells

Cancer remains a significant unmet medical need that necessitates development of new, effective therapies. A study from 2020 represents a step in this direction – this study from researchers at Caltech showed that low-intensity pulses of ultrasound can selectively kill cancer cells while leaving normal cells unharmed. The researchers termed this process as “oncotripsy” – selectively killing cancer cells while sparing normal cells. Additional studies are being carried out to better understand the mechanisms involved and improve targeting.


Structural Biology

A newly developed technique was able to image molecules, and take crisp pictures of individual atoms in a protein and map its 3D shapes. This technique is cryo-electron microscopy, and is likely to prove to be a ground-breaking breakthrough in structural biology. It will help understand how proteins work in health and disease, and will facilitate drug discovery targeting different proteins.


Mars Missions

In July 2020, three nations, the United States, China, and the United Arab Emirates launched missions to Mars to explore the planet and looks for signs of past life. This was the first interplanetary mission for the United Arab Emirates that will orbit Mars. China’s mission includes a rover and is their first attempt to land on Mars. The United States mission includes a rover named Perseverance, to drill and gather rock samples near the Martian equator.


Forest Fires

Continuing its trend of devastation, 2020 saw a record level of wildfires. Southeast Australia recorded blazes and bushfires that burned 46 million acres of land, and killed at least 34 people and over a billion animals, including many wildlife species driven to extinction.


Similarly, the 2020 wildfires in California were the worst recorded in history. In 2020, California had more than 9,000 fires that burned 4,397,809 acres, which is more than 4% of the state's land.


Conclusion

So, as the medical community stared down a mighty foe in COVID-19, scientific advances in other areas were happening albeit at a slower pace. While 2020 saw unprecedented challenges in public health with far-reaching economic implications, we also witnessed untold courage, commitment, resilience of healthcare and frontline workers, and exemplary innovation from the scientific community. As we have turned the page on this year, we start 2021 with a sense of cautious optimism and hope that we can relief from the pandemic and restore a sense of normalcy in our lives.


Written by: Sandeep Pingle, M.D., Ph.D.


Keywords: Covid-19, Forest Fires, Sickle Cell, Structural Biology, ultrasound, cancer cells

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