Searching for the magic bullet
An infectious lung disease spreads across Europe. The disease can be transmitted through the air – you can catch it if the person next to you coughs or sneezes or just talks.
Nope, not Covid-19.
Tuberculosis in the 19th century.
Tuberculosis has been around for as long as humans existed. But after the industrial revolution, the disease tightened its grip on newly urbanized Western Europe, until it turned into a real pandemic. While there was some air of tragic heroism created around the victims of the ‘romantic disease’ – how can you not cry when Mimi dies in La bohème - in the end there is nothing heroic about it. Tuberculosis was (and in many parts of the world still is) nothing but an ugly, life-threatening lung disease.
Just like we hope to find a drug or a vaccine for Corona virus/ Covid-19 – a magic bullet that will rid us of the threat the disease poses to our lives, our livelihood and our freedom once and for all - the people of the 19th century were hoping for a cure for tuberculosis. And like us today, they wanted their magic bullet sooner rather than later.
Lucky for them, the scientific world had just been turned upside down by the discovery that many diseases are not caused by internal imbalances of the bodily humors but by tiny, hostile invaders – microorganism. In the 1880s, the German microbiologist & physician Robert Koch found the bacterium which causes tuberculosis - Mycobacterium tuberculosis (for some reason we scientists can’t resist writing the Latin species names in italics, since that’s the way we learn it at university).
A little competition is good for business
In the newly founded field of microbiology, there were two titans, the French Louis Pasteur and the aforementioned Robert Koch. The two men were locked in a scientific wrestling match for large parts of their careers, trying to trump the other’s successes, trying to be the first to make the discovery. If you want to win a race, sometimes you have to take risks.
They did.
Pasteur vaccinated children with an untried rabies vaccine. He was lucky, it worked.
Koch developed a supposed wonder drug to treat tuberculosis and in 1890 let it loose on the public. He wasn’t as lucky as his French colleague, the concoction he sold under the name tuberculin didn’t cure Tuberculosis.
History forgave him this epic failure. He was awarded the Nobel Prize in 1905 and he is remembered for his successes and not for this one big screw-up. The question is if his contemporaries, who’d been treated with the ineffective drug forgave him so easily.
Giving him the benefit of the doubt, I would say that Koch meant well. His biography does not give the appearance of a mountebank, a scientific scam artist who’d set out to cheat his patients. He had good intentions. But he became impatient.
The Principle of Hope
Good intentions can take you a long way.
Hope and daring can take you a long way.
But they can only take you so far.
If you read the news today you see scientists and pharma representatives and politicians (and plenty of other people who feel the need to voice their opinion) speculate passionately about the earliest release date of a vaccine and about the potential miracle drugs (and some other scary ideas we’d rather not discuss here).
Vaccine development usually takes years up to decades. To show the vaccine works, you have to vaccinate a healthy person and wait until that person encounters the pathogen in the wild. An alternative are so-called challenge trials – in which volunteers are exposed to the pathogen in an experimental setting. In the case of Covid-19, with its unpredictable effects in different individuals, this approach is ethically questionable.
And, there is no guarantee that any of the vaccines candidates under scrutiny will work. Two of the most promising candidates are the vaccines from moderna and BioNTEch/ Pfizer. Both companies rely on the so-called mRNA technology and have seen a hype even before the Covid-19 pandemic, reflecting the hopes set in the technology.
But hope doesn’t have to mean success.
Another contester is a DNA vaccine from the University of Oxford, which like the other candidates is still in early stage development. Nevertheless, the ‘Vaccine king of India’ (to be honest, anyone who’s called the King and who isn’t Elvis makes me suspicious) is starting mass production of the basically untested vaccine.
Hope is good. Hope is necessary. But hope isn’t enough to will a miracle drug or vaccine into existence. And there is a fine balance between necessary daring, and using people as guinea pigs for untried concepts, as Koch and Pasteur did.
