Coronavirus - Parts
1,2, 3 and 4 can be
accessedhereandhereandhere
and here
People
often say, ‘Avoid this or that like the plague.’
Yet when the plague
arrives, millions of people do very little to avoid it.
The first lockdown anniversary
It was last year, on Monday 23 March 2020, that Boris Johnson
ordered people to ‘Stay at home, protect the NHS and save
lives.’ One year later, on Tuesday 23 March 2021, was
regarded by many as a day of reflection, to remember
especially the126,172 people, who had died in the UK with
Covid-19, as well as the ‘grief and loss felt by so many’, as
acknowledged by the Queen.
Then Boris Johnson went and spoiled it. At a Zoom
meeting of the 1922 Committee of MPs later that evening, he
explained why the UK's speedy vaccine roll-out had beaten
Europe’s. He said, ‘The reason we have the vaccine
success is because of capitalism, because of greed, my
friends.’ OK, he immediately tried to retract his
comments, but once out …. ‘Greed’ and ‘capitalism’ – not
seemly topics for a day of reflection. That PM and his
loose tongue!
The Covid-19 numbers
The good news for the UK continues, sort of. During most
of March, Covid-19 cases, hospital admissions and deaths
continued to fall and vaccinations continued to rise.
But at the end of March, new case numbers started to plateau,
or even rise in some places. Why? Certainly there
were increasing cases among the 5 to 15 year olds as they
returned to school. And their under 50-year-old parents
were still vulnerable because they have not been vaccinated
yet. Could these latest trends of levelling data be the
harbingers of a third wave?
Yet overall, March has been a time of remarkable
advance. A month ago, at the end of February, 15,000 UK
people were hospitalised and 2,000 were on ventilators.
Now, at the end of March, those figures have plummeted to
approximately 4,000 and 600, respectively.
However, there are two stubborn statistics. First, the
number of new cases now remains seemingly stuck at around
4,000 per day. Second, the UK's current death rate from
Covid-19 is still about 1,800 deaths per million population,
still the worst in the world. This pandemic is far from
over.
News on the vaccination roll-out is good, or even
better. By the end of March, 31 million UK residents had
received one dose – that is equivalent to 45% of the
population, and is the second highest in the world, behind
Israel’s 60%. And another 4 million in the UK had had
their second dose. These figures are in contrast to the
roll-out shambles in the EU, where most countries are yet to
achieve vaccination rates of 10% or even the 25% of the USA.
Another welcome datum came on 23 March from the Office for
National Statistics (ONS). Deaths in the UK have fallen
below the five-year average for the first time since the
summer. In the week up to 12 March, 14% of all deaths
involved Covid-19, compared with 44% at the 22 January
peak. Lockdowns and vaccine roll-outs are indisputably
saving lives.
The Coronavirus Act 2020
The Coronavirus Bill was presented to Parliament on 19 March
2020 and on 25 March 2020 it received royal assent.
Government ministers promised to use the emergency measures of
this Coronavirus Act 2020 only ‘when strictly
necessary’. This legislation is time-limited for 2 years
with renewal required every six months. In its efforts
to contain the spread of the virus, the new law gave the
government wide-ranging powers, from shutting down pubs, to
detaining ‘at risk’ individuals, to introducing furlough and
statutory sick pay measures for those self-isolating.
One year later, on 25 March 2021, MPs voted by 484 to 76 to
extend these emergency powers for another six months, or ‘only
as long as necessary’. The next scheduled renewal date
is in late September 2021.
Covid-19 vaccine shortages
Vaccination programmes need two things – willing arms and
loaded syringes. Supplies of vaccines are essential but
they are very susceptible to logistical failures. And so
it was, on 17 March 2021, that NHS England announced that
weekly vaccine supplies in the UK would be ‘significantly
constrained’ from 29 March for four weeks, ‘as a result of
reductions in national inbound vaccines supply.’
This is a bump in the roll-out road. What, why and
how? Who can tell? The saga is confused and
confusing. First, it was blamed on the EU’s threatened
ban of exports of the Pfizer-BioNTech vaccine to the UK.
Second, it was attributed to Oxford-AstraZeneca having
production issues both in the UK and across Europe.
Third, the problem was said to be with the Serum Institute
based in Pune, India.
The political squabbles with the EU rolled on. For
example, on 24 March, the European Commission announced
proposals to toughen controls on Covid-19 vaccine
exports. These would stop short of an export ban, but
instead measure each shipment on the recipient country’s
vaccine rate and exports. The controls will assess
‘reciprocity’ and ‘proportionality’. It was befuddling
stuff and the EU-UK bickering continues.
But on 18 March, Boris Johnson stated that the supply problems
were caused by a delayed shipment from the Serum Institute and
because a batch currently in the UK needed to be
retested. Apparently, 10 million doses of the
Oxford-AstraZeneca vaccine had been ordered from the Serum
Institute. Of these, 5 million had already been
delivered, but the additional 5 million had been delayed.
Adar Poonawalla, chief executive of the Serum Institute of
India, said that the delay, ‘… is solely dependent on India,
and it has nothing to do with the Serum Institute of
India. It is to do with the Indian government allowing
more doses to the UK.’ The Indian government is thought
to be considering whether it needs to stockpile more vaccines
to expand its vaccination programme to its own 1.4 billion
population. However, Boris Johnson denied that the
Indian government was responsible. He told journalists
that, ‘The Indian government hasn’t stopped any export’ and
blamed the delay on ‘various technical reasons’. Neither
the Serum Institute nor the Indian government would comment
further.
Also on 18 March, Matt Hancock, the health secretary, told MPs
in the House of Commons that 1.7 million doses already in the
UK were being retested to check their stability. And a
spokesperson for AstraZeneca confirmed, ‘Our UK domestic
supply chain is not experiencing any disruption, and there is
no impact on our delivery schedule.’
And the upshot? The delayed 5 million doses would have
enabled vaccination of people under 50 to begin by the end of
March. This will now not happen. Instead, existing
vaccines will be prioritised for the top nine priority
high-risk groups and those requiring their second doses.
In addition, vaccine centres will not book any new
appointments for April. Nevertheless, the prime minister
reiterated that the UK would meet its targets – offering a
first dose to all over 50s and clinically vulnerable people by
15 April, and one to every adult by 31 July. Whatever
the truth behind the announced delay, the boast that every UK
adult will receive their primary dose by the end of July
remains central to the roll-out plan.
Two supplementary questions arise. First, will this
vaccine delay slow the easing of the lockdown? The prime
minister has said, ‘No. There is no change to the next
steps of the roadmap.’ Second, will this vaccine delay
hold up second doses? The prime minister has said,
‘No. We will have the second doses that people need
within the 12-week window, which means around 12 million
people in April.’
A third wave?
While the UK has recently seen less cases, less
hospitalisations and less deaths, continental Europe has had
more of each. Numbers of cases in Germany, Italy, France
and Poland, for instance, have been increasing almost
exponentially. A third wave is nigh. Will it reach
the UK? Of course, no-one knows. However, what
seems more certain is that we will experience some imminent
increase in cases for at least two reasons.
First, as the UK lockdown measures are relaxed, more people
will mix and therefore more cases will occur with consequent
rises in hospital admissions and deaths. It is a tough
price to pay for extra freedoms. Second, there is the
additional negative factor of border control, regulating
incoming visitors. OK, we know about border tests,
passenger locator forms, tests on days 2 and 8, hotel
isolation for 10 days and red list countries, but these
measures are neither foolproof nor virus-proof. Just a
few Covid-19 visitors, asymptomatic or otherwise, slipping
through the net, accidentally or intentionally, could cause
Covid-19 havoc across the UK again.
What else lies ahead?
On 23 March, the Royal Academy marked the anniversary of the
first lockdown by publishing its 172-page report entitled, The
COVID Decade: understanding the long-term societal impacts
of COVID-19. It was commissioned by the Government
Office for Science.
The review makes for grim reading. It concludes that
major long-term changes will be needed to reverse the profound
social, educational and economic damage caused by
Covid-19. And it predicts that the pandemic will cause a
decade-long shadow with declining public trust in government,
worsening mental health and widening social
inequalities. For example, it expects young people to
suffer disproportionately in terms of their mental well-being
and their educational losses caused by school closures.
The take-home message? We need to think way beyond 2021.
Oxford-AstraZeneca troubles
It is said that troubles often come in threes. First,
several European countries, such as Germany and France, banned
the use of the Oxford-AstraZeneca vaccine for the over-65s
ostensibly because of limited data. That precautionary
stance has now been lifted. Second, there was – and
still is – a hoo-hah concerning supply, and threats of
embargoes, of the vaccine from EU countries to the UK.
Third, there was concern that the Oxford-AstraZeneca vaccine
was causing blood clots – at least 15 countries, including,
France, Iceland, Germany, Spain, Latvia and Italy, halted its
use as a precautionary measure. Has the EU been playing
politics? Certainly, president Macron of France claimed
that the Oxford-AstraZeneca vaccine was ‘quasi-ineffective’
for the over-65s just hours before it was approved for all
adults across the EU. Similarly unhelpful have been
those who have derogatorily nicknamed it the ‘Aldi vaccine’ as
some sort of budget option.
Consequently, EU and UK regulators dug deep into the available
clinical data. On 18 March, both the European Medicines
Agency (EMA) and the UK’s MHRA (Medicines and Healthcare
products Regulatory Agency) confirmed, after a ‘thorough and
careful review’, that there is no evidence the
Oxford-AstraZeneca vaccine is unsafe and specifically that it
is not linked to an increased risk of blood clots. Most
countries promptly resumed their roll-out of the jab.
The scare was based on reports that a very small number of
recently vaccinated people had suffered an extremely rare form
of blood clot in the brain known as, cerebral sinus vein
thrombosis (CSVT). There had been 13 cases across Europe
and five cases in the UK – one of them fatal. Five
cases, in men aged between 19 and 59 years old with low blood
platelet counts, among 11 million vaccinated people is
considered to be extremely uncommon. In addition, it was
noted that CSVT can occur naturally and that Covid-19
infections themselves can make clots more likely. In
other words, the benefits of the vaccine, with an 80%
reduction in hospitalisation and death, far outweigh any
possible risks of serious side effects. However, as a
precaution, the situation will be closely monitored and after
being vaccinated, anyone with unusual bruising or a persistent
headache for more than four days, should seek medical advice.
Whether this information and these data reassure the EU
counties and others to resume their roll-outs of the
Oxford-AstraZeneca vaccine and whether their citizens will
queue up to use this particular vaccine is another issue.
Oxford Astra-Zeneca trial in the USA
On 22 March, Oxford Astra-Zeneca published results from a
Phase 3 trial of its Covid-19 vaccine that confirmed it to be
safe and effective. The trial, conducted by scientists
at Columbia University and the University of Rochester in
collaboration with AstraZeneca, involved 32,449 volunteers
from America, Chile and Peru, who were given two doses, four
weeks apart. The key results were that the vaccine was
79% effective at preventing symptomatic Covid-19 disease and
100% effective against severe or critical disease and
hospitalisation across all ethnicities and age groups.
In addition, there were no safety issues regarding blood
clots.
An extra feature of this US trial was that approximately 20%
of the participants were 65 and over. Yet the vaccine
was found to provide as much protection for them as to the
younger age groups, namely 80%. This is an important
finding because of those countries which initially refused to
authorise the vaccine’s use in adults over 65, citing a lack
of evidence.
On 25 March, Astra-Zeneca published updated results from this
US trial. The general efficacy rate of its vaccine was
adjusted from 79% to 76% and from 80% to 85% for the over 65s
age group. The previous and these amended results should
allow the US regulator, the FDA (the Food and Drug
Administration), to approve its use in the USA within the next
month or two.
Moderna is on its way
Sometime during April, Moderna, the US biotech company,
expects to deliver the first batch of its vaccine to the
UK. Moderna will therefore become the third supplier to
the UK, alongside Oxford-AstraZeneca and Pfizer-BioNTech –
this may help alleviate future supply problems.
On 18 December 2020, the USA’s Food and Drug Administration
(FDA) approved the Moderna vaccine for individuals 18 years of
age and older, with each person requiring two jabs, 28 days
apart. On 8 January 2021, the UK’s Medicines and
Healthcare products Regulatory Agency (MHRA) did the
same. The UK government has already ordered 17 million
doses.
In a large clinical trial last year in the US, Moderna
reported that its vaccine was 94.1% effective against
preventing Covid-19 and it showed no signs of being less
effective against the Kent variant, now the dominant Covid-19
variant in the UK. In laboratory tests, the vaccine was
less effective against the South African variant, but Moderna
reported that the response was still, ‘above levels expected
to be protective’ even though immunity may not last as long.
Moderna is already working on a modified version. And it
has also begun clinical trials to assess whether its vaccine
is safe for children aged between six months and 11
years. As the first western company to test a vaccine on
infants, it plans to enrol 6,750 children in America and
Canada for that trial.
Based in Cambridge, Massachusetts, Moderna was founded in 2010
and now employs about 1,000 staff. Since the proven
success of its vaccine the company’s market value has rocketed
to $62 billion. Its vaccine development and production
has been financed by the US government, plus a $1 million
donation from the singer Dolly Parton.
As an mRNA (messenger RNA) vaccine it is based on novel
technology, similar to that of the Pfizer-BioNTech
product. The Moderna vaccine, like all other
currently-available vaccines, comes with
bioethically-questionable baggage. During its production
the HEK-293 cell line is used in laboratory quality testing of
the final product, but not as a component of the
vaccine. The original HEK (Human Embryonic Kidney) cell
line was obtained from an abortion performed in 1972 in the
Netherlands. For more details of bioethical concerns see
Coronavirus Part 1 (October
2020).
Both Moderna and Pfizer-BioNTech have been criticised for
charging, respectively, £26 and £15 per dose for the required
two shots. These are expensive compared with the
Oxford-AstraZeneca vaccine, which costs about £3 per dose, and
which the company has committed to selling on a not-for-profit
basis during the pandemic.
Novavax and Janssen vaccines waiting in the wings
So far the UK has deployed two vaccines from
Oxford-AstraZeneca and Pfizer-BioNTech, with a third, Moderna,
on its way. But there are two others, namely from
Novavax and Janssen, waiting in the wings for approval by the
MHRA.
The Novavax vaccine is a protein-subunit type engineered from
the genetic code of the spike protein, which is inserted into
an insect cell to produce the spike proteins. These are
harvested, mixed with synthetic soap-like particles plus an
adjuvant to stimulate the immune response once injected.
During mid-March, the American company, Novavax, released
revised data from a UK-based Phase 3 trial with 15,000
participants, aged between 18 and 84, and including 27% over
the age of 65. After primary and booster doses, the
vaccine was shown, to be 96.4% effective against the original,
non-variant form of the coronavirus in preventing
mild-to-severe Covid-19 effects. And it was 86.3%
effective against the Kent variant. In a smaller trial,
conducted in South Africa, the Novavax vaccine showed an
efficacy 55.4% against that country’s variant. Across
both trials, the vaccine demonstrated 100% protection against
severe disease, including hospitalisation and death.
The Novavax vaccine is stable and can be stored in a domestic
refrigerator. The UK has 60 million doses on order of
this two-shot vaccine. Its UK production began in
February at a site in Billingham, Co Durham.
Authorisation by the MHRA for its use in the UK is awaited.
The other vaccine waiting in the wings is made by Janssen,
which is owned by the American pharmaceutical giant, Johnson
& Johnson. Incidentally, the parent company states
on its website that, ‘We are blending our heart, science and
ingenuity to profoundly change the trajectory of health for
humanity.’ Nice schmaltz!
Like the Oxford-AstraZeneca vaccine, the Janssen jab is based
on an adenoviral vector, as opposed to the mRNA products
produced by Pfizer-BioNTech and Moderna. It also has
distinct advantages – chiefly, it requires only one
dose. And it can be stored at 2 to 8⁰C in a domestic
refrigerator for up to 3 months.
On 27 February 2021, the FDA issued emergency authorisation
for the Janssen vaccine to be distributed in the USA for
individuals 18 years of age and older. That permission
was based on results from clinical trials published by Janssen
on 29 January 2021. They involved more than 44,000
people across 10 countries with 34% of participants over the
age of 60. The vaccine proved to be safe and effective.
More specifically, 28 days after vaccination, it was 85%
effective in preventing severe and critical Covid-19 that does
not require hospitalisation. Overall, it proved to be
72% effective in the US against moderate and severe Covid-19,
and 66% effective when figures from all the test countries are
included. However, it was less effective at 57% in South
Africa where that variant is widespread. Even so, the
vaccine was 100% effective in preventing hospitalisation and
death.
Trials are currently being conducted by Janssen to test the
efficacy of a two-dose regimen. The UK government has
already ordered 30 million doses even though it has yet to be
approved by the MHRA.
Variants and vaccines now and later
Kent, South African and Brazilian, or B.1.1.7, B.1.351 and P.1
are now old news. News of new variants has seemingly,
though undoubtedly not for too long, gone off the boil –
thankfully. Nevertheless, UK health authorities are
currently reported to be tracking at least four Covid-19
‘variants of concern’. In addition, widespread genomic
sequencing is continuing to hunt down other possible variants.
Moreover, aware of the looming threats created by new and old
variants, biotech companies are busy modifying their current
vaccines. For example, this month Moderna initiated a
clinical trial of updated versions of its vaccine,
specifically developed to combat the vaccine-resistant South
African variant.
And the quest is now on for so-called ‘universal vaccines’ or
‘broad-spectrum vaccines’ that would protect against all or
most variants of a particular virus. The existing
Covid-19 vaccines work by targeting the specific spike protein
on the surface of the virus. Though this strategy is
currently successful, the spike protein is prone to mutate
creating new variants which may render present-day vaccines
less effective. A ‘universal vaccine’ requires a
different approach. For example, ConserV Bioscience is a
European biotech company targeting the non-mutating parts of
the virus, known as conserved regions, usually found in
internal or structural proteins. The company has
identified several conserved regions that can stimulate the
immune system. Further, it has produced a cocktail of
these antigens and formulated them in mRNA. And
furthermore, it has started preclinical studies in
animals. Phase 1 human trials are expected to start in
early 2022.
Even though unprecedented financial and novel regulatory
hurdles remain, these examples of innovative science are
exciting. Could the next-generation of vaccines be
variant-proof, universal vaccines? And could these
pioneer the next leap forward in fighting Covid-19?
Vaccine hesitancy
The needle on the ‘jab-o-meter’ now appears to be swinging in
favour of taking the needle. For example, researchers at
University College London tracked the responses of 14,713
adults in England and Wales over a recent two-month
period. Last December, they identified a cohort of 1,432
from among all the respondents who were vaccine hesitant –
uncertain about or intending to refuse a Covid-19
vaccination. But two months later, by February, 86% of
this cohort, had changed their minds and had either had a jab
or were planning to. This shift from hesitancy was
consistent across all levels of social deprivation and across
all ethnic groups. These results are encouraging because
deprived and BAME communities have been the most vaccine
hesitant and also the hardest hit by the Covid-19 pandemic.
Results from global surveys show similar trends. A study
of 13,500 people across 14 countries by Imperial College
London’s Institute of Global Health Innovation (IGHI),
conducted between November 2020 and February 2021, found that
58% of respondents would take a vaccine if offered.
People in the UK were the most willing at 77% in February, up
from 55% last November. Whereas France, Singapore and
Japan are among the least willing at 40%, 48% and 48%,
respectively. However, even these countries have all
become less hesitant since November when only 25%, 36% and 39%
of individuals were willing, respectively.
Additional results from the USA demonstrate a widely hesitant
population with fluctuating responses. According to the
latest figures released by the Pew Research Center, 69% of US
adults said in mid-February 2021 that they would definitely or
probably take a coronavirus vaccine. In May 2020, that
figure was 72%, though this plummeted in September 2020 to 51%
before rising in November 2020 to 60%. Of course, the
converse is that 30% of Americans in February 2021 said they
would definitely or probably not get a jab. The main
groupings among these decliners were the young, the poor,
black citizens and white evangelicals.
Vaccine passports
Here is another controversial proposal – so-called vaccine
passports. After a moment’s thought, up pop at least
four complex legal, ethical and logistical questions.
For instance, would they be compulsory for some, or for
all? What form would they take, paper or phone
app? Would they be needed for all/some employment and/or
to attend say, a football match, or even a church? How
and when would they be updated? See what I mean?
Past governments have shilly-shallied about the need for
identification cards, now the current government has bitten
the bullet and launched a two-week consultation on the issue
on what it calls ‘COVID-status certification’. It closed
on Monday 29 March. In the near future, Michael Gove,
the prime minister’s appointee to lead a review into the need
and style of such documentation, will no doubt reveal
more. The consultation contained just three questions,
the issue raises many more.
The NHS Test and Trace service in
England
On 28 May 2020, Boris Johnson announced the launch of the NHS
Test and Trace (NHST&T) service for England – ‘a
world-beating contact tracing programme.’ Its aim was to
enable mass testing for Covid-19 in England with the
capability to trace the contacts of those testing positive, to
isolate them, to thereby break the chains of transmission and
to enable people to return to a normal way of life. The
service, headed by Baroness Dido Harding, had an initial a
budget of £22 billion plus an extra allocation of £15 billion
– a total of £37 billion over two years.
From the start it was a scheme riddled with doubt and
controversy. For instance, the means of mass testing
were contested. Depending on the make and brand used,
the lateral flow test (LFT) can be cheap – less than £10 per
kit. It can be fast – between 15 and 30 minutes.
But it can be flawed – in some reported instances giving up to
50% false negative results. The more reliable PCR
(polymerase chain reaction) test can be expensive – up to
about £100 per test. But it can be slow – about 48
hours. Then there were grumbles about the 2,500 overpaid
and underworked ‘consultants’ on an average daily rate of
£1,000 with some being paid £6,624 a day. And with its
huge ambitions to test between two and four million people
each day and to track their contacts, and its eye-watering
costs, the service was always going to be open to harsh
criticisms.
Moreover, NHST&T seemed to be beholden to no-one.
Except that on 10 March 2021, the service was the subject of a
report by the House of Commons Public Accounts
Committee. It was damning. Nevertheless, the
Committee did recognise that the service was ‘… set up and
staffed at incredible speed’. And it praised some of
NHST&T’s achievements, such as contacting over 2.5 million
people testing positive for COVID-19 in England and advising
more than 4.5 million of their associated contacts to
self-isolate, in the 10 months since its inception.
However, the Committee stated that NHST&T, ‘… now needs to
wean itself off its persistent reliance on consultants and
temporary staff.’ And, ‘There is still no clear evidence
to judge NHST&T’s overall effectiveness. It is
unclear whether its specific contribution to reducing
infection levels, as opposed to the other measures introduced
to tackle the pandemic has justified its costs.’
Or as Meg Hillier, the Committee’s chairwoman, put it,
‘Despite the unimaginable resources thrown at this project,
NHS Test and Trace cannot point to a measurable difference to
the progress of the pandemic, and the promise on which this
huge expense was justified – avoiding another lockdown – has
been broken, twice.’
The Committee’s report also detailed a number of other serious
failings, such as a lack of clear planning and poor control of
costs. Nevertheless, the Committee welcomed NHST&T’s
increasing collaboration with local authorities and it
encouraged partnerships with the wider public health
establishment and other sectors including local government,
schools, and the hospitality industry. In addition, the
Committee called for better data handling and publication of
results so that people can assess NHST&T’s effectiveness
in, for example, the time taken to trace the contacts of an
infected person – the so-called ‘cough to contact’ period –
and the degree of compliance with self-isolation.
Among the Committee’s other recommendations was a call for the
government to plan for the integration of the NHST&T
service into the newly-formed National Institute for Health
Protection. And finally, the Committee said it intends
to follow the progress and performance of NHST&T later in
the year with a second report.
COVAX and the world
Here is a fact – the UK has a population of less than 70
million, consisting of about 50 million adults over the age of
18. Here is a question – so why have we ordered at least
400 million doses of Covid-19 vaccines? If every adult
were to have the recommended two jabs, we would still need
only 100 million doses. If an extra autumn booster
vaccination is required, which seems more likely as the weeks
go by, that still amounts to only about 150 million
doses. OK, so ‘vaccines ordered’ are not necessarily the
same as ‘vaccines produced’ and in storage, ready for use
right now, but why are we preparing to future stockpile
millions of doses?
But here are questions underlying the real issue. If we
in the UK have so far managed to vaccinate those at greatest
risk, our elderly, vulnerable and healthcare workers plus our
top 9 priority groups, what about those same cohorts in other,
particularly poorer, countries? Until there is a more
global dimension to vaccination, the wretched Covid-19 virus
will remain a threat. Should we not make some of our
stockpile available to others worldwide? Are we guilty
of a rather ugly case of self-interest and smug satisfaction
and vaccine nationalism?
Even when the entire UK adult population is vaccinated, the
virus will not disappear – it will be circulating somewhere
and it will return to infect us sometime, perhaps repeatedly,
for many years to come. And the longer it is allowed to
spread, the greater the probability that dangerous variants
will emerge. And until we are all safe, none of us is
safe. What we need is an altruistic sense of
‘enlightened self-interest’ and that is best served by
vaccinating the rest of the world.
Enter Covid-19 Vaccines Global Access, known as COVAX.
It was launched on 4 June 2020 and is co-led by Gavi, aka the
Vaccine Alliance, the Coalition for Epidemic Preparedness
Innovations and the World Health Organization. This
international partnership of over 190 countries aims to
distribute vaccines more equitably. It has an uphill
task. By mid-March, of all the global 191 million shots
so far jabbed about 75% were deployed in just 10 countries,
while about 60% or 130 of all the countries of the world,
accounting for 2.5 billion people, had so far received no
Covid-19 vaccines. High-income countries, like the UK,
represent only 16% of the world’s population, but they have
already purchased more than half of all global Covid-19
vaccine doses.
The COVAX primary strategy is to create a ‘buyers’ pool’ of
richer nations that can fund collective purchases of vaccines,
fund vaccine development and vaccine manufacturing and ensure
that vaccine supplies go to poorer countries. It is a
worthy plan, but COVAX is continually getting pushed to the
back of the queue. Rich nations are buying vaccines by
direct deals with manufacturers rather than through the COVAX
pool. Nevertheless, COVAX expects to secure some 2
billion doses by the end of 2021. Another possible COVAX
strategy is ‘vaccine tithing’. For every nine doses
administered by rich countries, one dose could be donated to
COVAX – a 10% tithe scheme. Though this would still be
far from ‘equitable’, it is perhaps possible.
True, the UK has already promised, though without specific
details, to share some of its vaccine surplus with
less-developed countries. Dominic Raab, the Foreign
Secretary stated in January 2021 that, ‘As one of the biggest
donors to COVAX, the UK is ensuring that more than one billion
vaccine doses will be sent to 92 countries so that no one is
left behind in this global fight.’ And the UK has
already pledged £548 million to COVAX. But promises,
warm words and cash alone will not help poor countries if the
rich ones continue to hoard vaccines. Nevertheless, by
late March, COVAX had managed to ship 32 million vaccine doses
to 60 countries. Is it time we moved towards sharing
vaccines more equitably around the world? Until we do,
we are prolonging the pandemic. And another question –
just who is ‘my brother and sister and mother’? (Matthew
12:50).