The pandemic is also accelerating the development of new vaccine platforms, including RNA- and DNA-based vaccines, as well as platforms that use attenuated virus or bacteria to introduce microbial DNA into cells.
This worldwide laser focus on Covid-19 is providing hugely valuable learnings that can expedite research already underway pairing omics data sets (genomics, proteomics, metabolomics, etc.) with machine learning to identify why people get sick, why we age, which pathways to target, and which drugs to use. In addition to the known risk factors for Covid-19, there may be a genetic reason why some people experience a life-threatening reaction. That would help pinpoint the people who critically need a vaccine, sparing us the gargantuan task of trying to inoculate most people on the planet in the next two years.
Some people don’t want to know about their genetic predisposition for disease. But from a public health point of view, this is invaluable information. Sequencing everyone—with proper safeguards to insure privacy and nondiscrimination, of course—would advance clinical practice as well as scientific knowledge, and accelerate our progress toward true precision medicine.
Our ability to manipulate RNA and DNA, bacteria, viruses, algae, and fungi gives us the power to engineer life. Advanced imaging technologies allow us unprecedented views inside the body while big data sets, machine learning, and AI are helping us read those images and giving us correlations and predictions … and ultimately root causes. The only problem is, as Edward O. Wilson so succinctly put it, “we have Paleolithic emotions, medieval institutions, and godlike technology.” So how do we overcome our Paleolithic emotions (like fear, jealousy, and greed) and our medieval institutions (US health care, anyone?) to deploy our godlike technologies?
In 2018, a Chinese scientist claimed to be the first person to have created human babies with Crispr-edited DNA . But some couples using IVF had already been selectively editing their families for years. As more couples elect to freeze embryos, they will turn to preimplantation genetic screening to determine which embryo is the most viable. You can imagine a parent-to-be not selecting one that was genetically predisposed to mental illness, for instance. But what would our future civilization be like if it didn’t include people such as Isaac Newton, Beethoven, Van Gogh, Ada Lovelace, Winston Churchill, and Norbert Wiener? These are the difficult questions this next phase will force us to reckon with.
Of course, we are curious by nature, and it is in our nature to make tools. So we will pursue these lines of research and we will develop these tools. Through technology, we have already extended our locomotion, senses, cognition, and even asserted control over the very creation of life with birth control, advanced reproductive technologies, and now gene editing. This is possibly the ultimate definition of progress, like it or not.
If we move too fast, we increase the risk of unintended consequences, and a backlash from patients, consumers, regulators, religious groups, and more. But what if we move too slowly, or choose not to pursue these possibilities at all? Eliminating genetically inherited diseases is our obligation, isn’t it? To not do so seems like a crime against humanity. Imagine the day when your great grandchild sues her parents for not genetically engineering her to protect her from cystic fibrosis, or thalassemia, or sickle cell anemia. Or maybe she could sue because they failed to enhance her in order to compete effectively.