A perspective on SARS-CoV-2 and COVID-19, on what I consider a positive day in the pandemic:

Firstly a reminder; this virus is highly infectious and causes a severe, often fatal, disease in a subset of the population, mainly the elderly. Left unchecked many people will die from this disease worldwide.

We will not change the fundamentals of this pandemic until we change infectivity of people or severity of the disease; the former mainly via vaccines, the latter via treatments. Until we have good enough vaccines and/or good enough treatments we have to learn to live alongside it

Today we saw published two papers on early trials of vaccines. Both took the same broad approach; engineering a harmless virus that infects chimpanzees (in one case) or humans (another) with the key part of the SARS-CoV-2 virus to trigger a "safe" immune response.

These papers aren't the final word in whether these vaccines work, but broadly they are the best one can expect for this stage, and it is unheard of to be at this stage only 7 months after the discovery of the virus. Hats off to the Oxford Jenner team and the Nanjing Team.

(Many other vaccines are in development, many of them using other modalities, so we have many shots on target here).

Previously, last month, the Oxford lead RECOVERY trial in the UK showed that dexamethosome was an effective treatment via a clinical trial; it joins Remdesivir from a NIH trial as two treatments that improve outcomes.

Other aspects of clinical care (anti-clotting etc) and how to manage the disease COVID19 mean less people who catch the disease die, though many are still severely ill. Today also saw an interesting (but underpowered) phase I result on nebulised interfon as a treatment

It joins tocilizumab as two promising potential treatments to be tested further in clinical trials, along with convalescent plasma. We need more simple, robust, multi-arm trials such as RECOVERY worldwide.

Testing depth is improving, with new technologies such as LamPORE, SHERLOCK and pooling with RT-PCR provides more - probably at least another order of magnitude possible testing.

Lots of logistical problems here; many countries are not using their testing capacity now and it is a bit eye-watering how big a net of negatives one needs to cast to catch positives in low incidence settings.

Added to this is the potential of sewage testing - nature's natural pooling scheme - for situational awareness. This I feel can really augment broad individual testing. It's not perfect; it is likely to be useful.

This virus transmits in a over-dispersed (clustered) manner, with high risk environments (the "3 c's" from Japan a catchy way to remember) responsible for much of the transmission. This makes trace+test *more* efficient by back-tracing to points of infection.

Finally from studies in France, Germany and Denmark it looks like young children do not transmit the virus. A saving aspect of this pandemic has been that children are spared, and the concerns is more about transmission than disease.

Broadly, we (humans) can beat this virus; each month you can feel the progress we make; that progress is made in many different countries and in different disciplines.

I know that COVID19 has intensified many national discourses - and the economic impact is another topic out of my scope - but this is, in my view, a day to look forwards and upwards. There is a positive, post SARS-CoV-2 future possible for us all. Let's make that future real.