On June 16th, 2020 and as part of its Bicentenary the French Académie Nationale de Médecine organized an international seminar on “The challenges of COVID19”. The seminar addressed the issues of public policies and strategies, pathophysiology, therapeutic trials, and vaccine trials.

The first session on public policies and strategies gathered experts from France, Morocco, China, Germany, the United Kingdom and Sweden. The first presentation by Pr. Didier Houssin, president of The World Health Organization Emergency Committee on Covid-19 and president of AP-HP International (Paris Hospitals), particularly emphasized the need for preparedness and the timeline of the crisis in France. Lack of preparedness is a pattern identified in several countries and it was suggested that it is linked to the legacy of H1N1 pandemic when governments have been accused of “overreacting”. This point was also highlighted by Brian Mc Closkey, Director of Global Health for Public Health England; he also developed the role of science in such a pandemic, the expectations of the politics and the uncertainty. Among the other topics covered were the adaptation of national health systems, the international response and the importance of communication.

In the afternoon, the talks emphasized the pathophysiology of the virus. First, Dr Avelin Aghokeng, virologist at the Institute for Research and Development spoke about the place of SARS-COV-19 among other human coronaviruses. Professor Angelo Ravelli, Head, Division of Rheumatology, Giannina Gaslini Institute and Professor of Pediatrics at the University of Genoa, made a presentation about the Kawasaki disease similar syndrome observed among several children that have been infected by SARS-COV-19. He described the physiology of the disease and highlighted the debate on whether it was the Kawasaki disease or another disease with many similarities. Then Pr. Dror Mevorach, from Hadassah-Hebrew University Hospital, and Pr. Laurent Abel from University Paris Diderot and INSERM respectively spoke about the specificity of Covid-19 cytokine storm and the human genetics of Covid-19.

Followed a panel discussion on the Covid-19 therapeutic trials which started with the presentation of Professor Carlos del Rio at Emory University and Vaccine Center. He particularly spoke about the situation in the US with the trials of Remdesivir –an experimental antiviral drug, and of hydroxychloroquine which has been stopped due to the lack of results. After, Carole Jabet from FRQS (Québec Fund for Research in Health) proposed an update of the trials taking place in Québec. Finally, Pr. Yazdan Yazdanpanah from the INSERM presented some of the ongoing trials in France and Europe, in particular the Discovery trial in which Luxembourg and Austria are part of (and that Germany and Portugal will soon join). He emphasized the importance of international cooperation; one of the issues is the great number of small trials that are testing the same drugs. He also calls for more European funding through the Horizon 2020 framework program. He also presented two other trial realized in France: French COVID and CORIMUNO-19.

Finally the last topic was the current ongoing vaccine trials and research. The discussion began with the perspective of Pr. Stanley Potkin, emeritus professor of Pediatrics at the University of Pennsylvania and consultant for vaccine companies; he presented the high number of vaccine candidates (more than one hundred) and their diversity. Numerous candidates are focusing their action on the spike protein on the surface of the SARS-COV-19 or on the nucleocapsid proteins; and they can be divided in 4 categories regarding their action mode: direct targeting of the virus, DNA or RNA based, vector based or protein based – the category with the highest number of candidates. Potkin then briefly recalled the most advanced projects of Moderna (USA) and Curevac (Germany) as well as others from Sinovac (China) and Sanofi-Pasteur (France). National experts from the United Kingdom, France and Germany then shared their perspectives.

Léa Dubreuil