COVID-19: HOW CAN WE ACCELERATE THE BENEFITS OF VACCINES?

Today has heralded the real prospect of light at the end of the COVID-19 tunnel, with approval in the UK of the first vaccine, from Pfizer BioNTech.

Possibly getting back to a near-normal life by the middle of 2021.  But is there any way of accelerating that?

 

NEWS FROM THIS MORNING'S PRESS CONFERENCE

Dr June Raine of MHRA

It really is great news.  As the vaccine specialists said in this morning's press conference led by Dr June Raine, Chief Executive of the MHRA which authorised the vaccine:

• On safety "no corners have been cut" in their assessment, 
• With effectiveness "across all groups". 

Albeit testing on only about 20,000 people receiving the vaccine (with a similar number receiving a placebo).  

There's no serious adverse reaction even for people who have had COVID-19 before, which could have been a problem given how the body responds to other viruses.  That allows vaccinations to take place without a pre-test, simplifying an already complex roll-out.

 

BUT THE BIG BUT

But then there's a big but.  The roll-out of this specific vaccine will take weeks if not months to reach everyone that's needed for us to reduce the public's general restrictions.  The danger is that people will feel they can relax far too soon.  There's light at the end of the tunnel, but it's still a long tunnel.  We can't relax too early.  

The Prime Minister made that point strongly in the press breifing this evening, 2 December "It will take some months before all the most vulnerable are protected".

We have to remember:

• The Pfizer BioNTech vaccine only becomes properly effective 7 days after the second jab, 21 days after the first.  In other words a month's delay from the first jab.  The first people expected to be vaccinated before Christmas, but not immune until the new year
  
• The UK Government has purchased 40 million doses, enough for 20 million people.  Enough for about a third of the adults over 16 for which this is being licensed.  Assuming no doses are wasted, especially given it has to be stored at minus 70 degrees centigrade, and the very careful way it must then be handled whilst it thaws before injection to remain effective.  Manufacturing that quantity will take some time, let alone distribute it.
  
• No forecast as to when the Moderna or Oxford/AstraZeneca vaccines might be approved, although an indication from Dr Raine that not before the new year
• When there is a mass roll-out to tens of thousands of people, the monitoring may disclose safety or effectiveness concerns, especially in the more vulnerable groups

 

SO WHAT TIMESCALES TO BE EFFECTIVE ACROSS THE POPULATION? 

Vaccines for a substantial proportion of the population will take weeks if not months.  Assuming further vaccines are authorised early in the new year, my estimate would be sometime next summer 2021.  Meaning general restrictions would still be needed for a few months into the new year.

That estimate has been confirmed by experts at London School of Hygiene & Tropical Medicine in a public statement this morning:

• Stephen Evans, Professor of Pharmacoepidemiology, says "We will not be able to change distancing, mask wearing etc for quite some time- months at least, and we don’t yet know when or whether that will stop"
• Liam Smeeth, Professor of Clinical Epidemiology, says:
• "A further circuit breaker in January or possibly February is likely to be needed."
  
• "But, it is realistic to hope that by March or April the vast majority of older people, care home residents, and those with severe conditions will have been immunised."
• "We can then work towards wider immunisation – with ideally much of the population covered in time for next winter."
• In other words, realistically months
  

WHAT SHOULD THE GOVERNMENT DO?

Firstly the Government must be straight with the public about the timescales.  A point also made by some MPs in yesterday's debate on the new three tiers. 

Secondly they need to encourage "the great British public" to continue to follow rules and guidance right through until next summer.  A real challenge.

Fortunately the press briefing this evening Wednesday 2 December made those two points very strongly.  Professor Van Tam, the Deputy Chief Medical Officer talked about "being realistic about it being months not weeks" and "please stick to the guidance until we say it is safe to stop".  Next Spring was mentioned, but that is probably a little early.

But what about accelerating the benefits of very low infection rates arising from vaccines any earlier?  That would also help to address the risk of people relaxing too early.

As Liam Smeeth suggested above, a circuit breaker is needed early in the New Year.  Or preferably to leverage the virus's short natural lifecycle wth a short sharper Enhanced Firebreak in early January could get infection rates down to #NearZero levels until around Easter, when it could be repeated to get through to the summer:

 

Click here for details.  That would achieve these benefits earlier than waiting for the rollout of vaccines:

Wouldn't these benefits be fantastic to improve our lives and livelihoods?!