Vaccines and their outcomes are going to be one of the biggest sharemarket and business strategy forces during the next year. I do not believe Australians understand the likely new rules of the game. There are lots of experts but to help my readers understand the likely future, I have chosen Dr Anthony Fauci, the director of the US National Institute of Allergy and Infectious Diseases. He has a special alert to Australians and others contracting to use the AstraZeneca vaccine.
We must all brace ourselves for the likelihood of continued, albeit milder, restrictions for some years and cures for COVID-19 are just as important as vaccines.
Meanwhile the likely outcomes will also trigger deep community debates.
Before we start, readers need to understand two of the terms. The coronavirus disease is COVID-19 but the strain of coronavirus that causes COVID-19 is called SARS-CoV-2.
Looking at the overall vaccine development industry Dr Fauci warns that that the chances of scientists creating a highly effective vaccine — one that provides 98 per cent or more guaranteed protection — for the virus are slim.
Scientists are hoping for a vaccine that is at least 75 per cent effective, but 50 per cent or 60 per cent effective would be acceptable.
Given the slim chances of a 98 per cent effective vaccine, Fauci warns “you must never abandon the public health approach”.
And so here is the Fauci doctrine: “You’ve got to think of the vaccine as a tool to be able to get the pandemic to no longer be a pandemic, but to be something that’s well controlled”.
To support Fauci the US Food and Drug Administration has said it would authorise a coronavirus vaccine so long as it is safe and at least 50 per cent effective. Elaborating, FDA commissioner Stephen Hahn declares that it’s possible the US could end up with a vaccine that, on average, reduces a person’s risk of a COVID-19 infection by just 50 per cent.
I do not believe Australians understand the implications of the Fauci and FDA doctrines — that the first generation of COVID-19 vaccines may not prevent people from becoming infected with or transmitting SARS-CoV-2 virus. The best that COVID-19 vaccines may do is prevent people becoming severely ill and dying.
Regarding the AZD1222 vaccine being developed by AstraZeneca, Dr Fauci says:
“I would have liked to have had protection against infection. But then again, it depends on what you’re looking for with the vaccine. That vaccine doesn’t look like it’s a knockout for protecting against infection, but it might be really very good at protecting against disease.”
AstraZeneca CEO Pascal Soriot offers similar caution, saying that although it is unclear if AZD1222 would “completely clear the virus,” it could still be considered effective if it kept people from getting COVID-19 symptoms.
Soriot told the BBC: “The question around the vaccine is, will some patients need a second dose? And also, will the vaccine eliminate the virus from the body of the people or simply protect them against being sick? But being protected against being sick would already be a big plus.”
My conclusion from the Fauci and Soriot remarks is that it’s possible AZD1222 may allow people to be infected but not have the symptoms. That infection may pass to people who are not vaccinated and who will therefore suffer the consequences.
If that scenario proves correct, then while our Prime Minister backed away from demanding a 95 per cent inoculation rate, in fact he was right. If that’s how the vaccine develops it needs very high rates of vaccination to be effective.
A very important addition to knowledge of AZD1222 in Australia was the excellent commentary by Natasha Robinson and Jared Lynch.
In particular AZD1222 mimics a natural viral infection and prompts the body to produce viral proteins inside its own cells, triggering a T-cell response. Scientists believe viral vector vaccines have advantages over traditional protein-based vaccines in fighting COVID-19.
Of course given the large number of research efforts Fauci may be wrong about the sort of vaccines that will be developed. But if he is right about first generation vaccines then cures became as important as vaccines.
Fauci says that currently there are two solid treatment options for people with advanced COVID-19: Remdesivir and the corticosteroid dexamethasone.
But there are many more treatment options currently being tested. Fauci names four: direct antivirals, monoclonal antibodies, convalescent plasma, and hyperimmune globulin.
CSL is developing hyperimmune globulin by producing a small batch to develop tests to detect the presence of the antibodies that fight the SARS-CoV-2. The second phase will involve a larger batch that will be used in clinical trials in Australia’s hospitals to establish the safety of the product.
The hyperimmune globulin will be developed using donations of plasma made in Australia by people who have recovered from COVID-19.
And I know it is controversial but medical experts I respect believe that zinc is a cheap way of attacking SARS-CoV-2 if it is administered early. But zinc needs a material to help it penetrate the cells and the best known available is hydroxychloroquine, which itself is not a cure. Sadly it’s all mixed up with anti-Trump declarations and we may have to wait until after the US election before zinc and hydroxychloroquine are revisited.
Meanwhile, whether you operate an airline, a cafe, an aged care centre or any other business, look to find a way of operating in an environment where the virus continues but is contained and we live with a reduced impact.
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