Why the COVID-19 vaccine cannot be expected to save us

Most experts agree that the COVID-19 vaccine will be available sooner or later.But as the number of new cases soars and the reopening summer begins to give way to new restrictions and malaise, the urgency to find an antidote is urgent. Pandemic of our time It is rising.

The pursuit of treatment continues, but the most promising human trials to date have had to be suspended. Scientists knew that tame the virus was more difficult than it had ever encountered.

But the crazy scramble to embark on the other side of this pandemic also raises ethical and political issues.

It’s still a very moving target. We have been on the illness track of being with us for two years, most experts for nine months.

Optimistic predictions are that the vaccine will be ready by January. There are about 200 trials worldwide, only a handful of which are in stage 3 human trials. However, they will not be completed until 2022 or 2023. And the two most promising research studies had to be “paused” due to adverse side effects.

David N. Professor of Epidemiology at the University of Toronto’s Dalla Lana School of Public Health. Fisman states that, at least in the short term, the best scenario is a vaccine that is “somehow” effective by spring or summer.

The big problem from a scientific point of view is that the most promising vaccines to date are better at preventing disease than infection, says Fissman. “People who are sick and dying [from COVID-19] They are also usually the least responsive to vaccines. ”

Whatever the predictions, the development of vaccines to treat the virus will have to be done sooner or later (if not finished). We can deal with another tension in the coming months.

And with simple logistics, it takes about six months from the time a vaccine is developed to the time it is mass-produced and reaches the general public.

Adding to the complexity is that the most promising vaccines must be stored at temperatures between -20 and -80 degrees Celsius. It will make transportation difficult, not to mention distribution in developing countries.

The answer is not that simple. Traditional wisdom is to prioritize those at risk (healthcare professionals and those over 65).

However, more and more research suggests that this is not the case.

According to modeling that has not been published yet Implementation Vaccination of people who are likely to spread the virus (ie, especially young people between the ages of 15 and 19) is sufficient for the general population to avoid high mortality, according to researchers at the University of Waterloo. You are more likely to reach immunity. However, it is only when the vaccine becomes available later in the pandemic (July 2021). The scenario is reversed if the vaccine becomes available early (January 2021).

There is also politics to consider near the house. The Government of Trudeau has signed a World Health Organization (WHO) effort to prioritize the distribution (finalization) of vaccines in developing countries.

Canada’s participation in this initiative will allow Canada to purchase an additional 15 million doses of vaccine. But if the United States, China, or Russia first develops a vaccine, it is an open question for us to rank. None of these countries have signed WHO efforts.

That’s a $ 1 trillion question.

It is unclear how much the two recently suspended trials (reported to be due to inflammation around the spine in one subject) will retreat efforts.

“But obviously scientists are seeing something they didn’t expect,” says Thomas Tencate, an associate professor of occupational public health at Ryerson University.

Experts agree that it is not uncommon for trials to be suspended due to side effects. But the political pressure to develop a coronavirus vaccine is unprecedented. The approval process is proceeding quickly. In Canada, Health Canada has launched its own “rolling review” of vaccine candidates.

However, the extent to which scrambling to find a cure jeopardizes safety and may bring the vaccine to market before it is ready is one of the many ethical issues raised.

The number involved in the largest trial (approximately 30,000-60,000) far exceeds the 3,000 accepted by the US Food and Drug Administration FDA.

But experts warn that hundreds of millions of people expected to get the COVID vaccine could have harmful side effects.

For example, at what point do these side effects become unacceptable? The standard set by the FDA, which other countries are taking clues to, is that the COVID-19 vaccine must protect at least 50 percent of vaccinated people in order to be considered “effective.”

Transparency is the key to building public confidence in vaccines.But a recent poll by Angus Reid suggest Canadians are wary of safety issues. Less than half of the people surveyed, about 39%, said they would like to be vaccinated as soon as the vaccine becomes available.

This is lower than in the United States, where about 50% said they would be vaccinated.

The recent decline in Canada is most pronounced in Alberta and Quebec. These are also the two states with the highest per capita cases of COVID-19 infection in the country. And, not coincidentally, the movement to prevent masks and anti-boxers is ruining the public security message.

In Alberta, the percentage of residents considering vaccination as soon as possible has decreased by 13 points since July. In Quebec, that number has dropped 11 percentage points. However, it is not only the blockade prevention type and the boxer prevention that are moving the needle to public opinion. Overall, 7 in 10 (69%) of Canadians said they were concerned about safety issues.

The simple answer is no. The innate immunity of people infected with other coronaviruses such as SARS and MERS can last up to 5 to 6 years, but the window for COVID-19 is much narrower.

Recent reports suggest that vaccines can immunize people from the virus for only about 18 months. Release British Medical Journal Lancet.. According to other surveys, the number is close to 6 months.

As Lancet “There is little knowledge of post-infection immunity to SARS-CoV-2, and the biological and genetic factors responsible for the severity of a wide range of diseases remain unknown,” the article points out.

Understanding the impact of vaccine potential on children and pregnant women remains a gap in current research. None of the ongoing trials are for subjects under the age of 18. Pregnant women also do not participate in human exams.

Trudeau government says vaccine Will be distributed free of charge In Canada. However, the international feeding frenzy to procure vaccines is already similar to the supply problems we saw in personal protective equipment during the early pandemics where the government was betting on numerous vaccine candidates.

So far, the federal government has dropped $ 1 billion in contracts to buy millions of vaccines from half a dozen manufacturers.

Despite the international good intentions of developing a vaccine, we still need to make a lot of money for those who first reach the finish line. And at this point, we don’t know how it will affect distribution.

There was a new story about herd immunity. The idea is that by allowing the virus to pass through the general public, eventually a sufficient number of people will see the virus develop immunity to disappear.

It is estimated that 75 percent of the population must be infected in order for herd immunity to occur. Others rate that number at 50 percent.

The death toll turned out to be a disaster in countries where it was attempted early.

But as the pandemic gets worse, the call to end the blockade and advance the disease is growing.

World Health Organization calls that option Unethical.. Tim Sly, an emeritus professor of epidemiology at Ryerson University, calls this idea “madness.”

“The cost of a huge number of deaths, especially the collapse of medical and hospital services, is unacceptable,” he says.

Most health professionals agree that trying to relax the restrictions on COVID-19 risks causing a larger second wave.

Obviously, we have testing issues that are hindering our efforts to track and track illnesses in the state. The fatigue of COVID-19 also begins. We are less afraid of the virus than in March, leading to a level of complacency.

But compared to the rest of the globe, we are far superior to most people, says Fissman. “People see what they are, but as an epidemiologist I see what they are not,” says Fisman.

Although the number of lives is higher in Ontario than ever before, Fissman said that the increase in “lagging indicators” (virus-related deaths and hospitalizations) is higher than the exponential growth we initially saw. It points out that it is “linear”. Pandemic.

Similarly, Dr. Bonnie, a British Columbia Health Officer Said At the BCCOVID-19 briefing on October 1, the increase in this state is linear rather than exponential. Nevertheless, she said the state needed to maintain health precautions.

“We have discovered this virus, which can sneak up on us and cause an explosive outbreak if we are not vigilant,” she said.

It is also clear that while the spread of the virus can be delayed, it is difficult to stop it completely. Some say it is impossible given the ability to spread asymptomatically.

Schools, for example, are new hotspots and account for an increasing number (and percentage) of new daily cases in Ontario.

“It’s just the tip of the iceberg,” says Anna Banergi, an infectious disease specialist at the University of Toronto. She says she sees daily cases of children who have flu-like symptoms that can only be achieved with COVID-19, but are falsely negative on the virus test anyway.

On October 29, Dr. Henry Said BC is in a “danger zone”, especially when heading to the respiratory virus season, and Victoria, CEO of Fraser Health, to address the pandemic “disproportionately affecting the Fraser Valley community.” Dr. Lee was added.

Some countries in the European Union are considering a second blockade as another wave of the virus flows over the continent.

Germany, Italy and France report 20,000 to 50,000 new cases of coronavirus per day. The United States reports 80,000 new cases daily. By comparison, Canada has about 2,300 new cases, but France, Italy and Germany have about twice the population of Canada.

In these countries, there is a risk of losing control of the virus without lockdown. We know what seems to work — pulling people apart. But not everyone can do it forever.

Dr. Henry of BC Said At the BCCOVID-19 update briefing on October 29, the state is not considering a blockade at this time and intends to keep as many companies, schools, basic services, and healthcare systems open as possible. Said.

She had again Mention At the briefing on October 26, the restaurant and cafe were not considered to be closed because the transmission was not seen at restaurants that follow the safety plan.

All you need is a crystal ball. What we know is that coronaviruses are very mutated. In other words, vaccination can continue to be toxic for some time.

On the one hand, Fissman says it can drift throughout the population and become like other seasonal flus that appear in drugstores each year for vaccination.

Fortunately, COVID-19 will eventually end. The bad news is that you don’t know when. In any case, it will be a chess game that precedes the virus.

Includes Craig Takeuchi files.

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