HEALTH

The COVID-19 Pandemic and Why the Situation is Unlikely to Improve Before December 2021

The following article looks at trends and developments in the vaccine development sector to find out the possible timeframe for the creation of a virus free world.

Shamsuzzaman Ansari

14/09/2020

The question that seems to be occurring time and again, in everybody’s minds is regarding when the coronavirus pandemic will finally be over. Healthcare experts and analysts can only attempt to estimate the timeline by analyzing trends in the observed data, however, there is no definite answer to the question. Countries like New Zealand, Singapore, Malaysia and Taiwan have achieved the elimination of COVID-19 cases to some extent, indicating that the elimination of the virus is feasible. Many sources reveal that New Zealand remained free of the virus for more than 100 days.

Tedros Adhanom Ghebreyesus, head at the World Health Organization, guesstimates that the COVID-19 pandemic might end within two years if resources are strategically pooled across the globe. Prof. Dr. Lothar Wieler, from Robert Koch Institute, Berlin, Germany, also predicts that the pandemic is likely to last for 2 years, and by then, approximately 60% to 70% of the world’s population would have tested positive for COVID-19, and develop immunity against SARS-CoV-2. Microsoft co-founder and co-chair of the Bill & Melinda Gates Foundation, Bill Gates predicts the end of pandemic in the rich world by the end of 2021, and for the poor world, by the end of 2022.

Bhaskaran Raman and his team from IIT Bombay whose analysis is based on Nobel laureate Prof Michael Levitt’s model, had claimed in July that the COVID-19 pandemic will not end in India before October,2020. With the term ‘pandemic-end’, he didn’t mean the disease will vanish completely, but rather will be sporadic while the number of mortalities would be considerably low.

According to the Times Fact-India Outbreak Report, a collaborative research and analysis by the Times Network and California based consulting firm, Protiviti, the end date of the pandemic is anticipated to be the first week of December 2020. As per this research study, India is set to hit its peak of 7.87 lakh active cases as early as September 2, after which the curve may hit a plateau till September 16, following which the cases are projected to show a steady decline. The report claims that some Indian states have already started to peak out and some might come out of it during the later part of August to early September while some highly infected ones may take a month longer. According to Dr. T Jacob John, professor emeritus and former head of virology at Christian Medical College, Vellore, across India, the COVID-19 cases have peaked mainly in highly urbanized and medium urbanized areas. The Rural areas are yet to witness the peak.

How will the COVID-19 Pandemic Come to an End?

Scientists believe that 60-70% of people are needed to acquire herd immunity in order to stop spreading of the SARS-CoV-2 virus. Herd immunity is an epidemiological concept that describes a situation where a significant portion of a population becomes immune to a disease and it stops spreading in the population. As per this concept, if 70 people out of 100 are immune against a disease then the remaining 30 people will hardy be exposed to the disease and thus any further spread of the infection would vanish in this scenario. Herd immunity can be acquired either by a safe and effective vaccination or through natural infection. The idea of acquiring herd immunity entirely through natural infection would be a disastrous strategy. It’s mainly because a large number of people will become severely ill and as a result sudden spike in sick people needing intensive medical care and hospital beds will overwhelm the healthcare system. Hence, the herd immunity, without a vaccine, is not an effective way forward.

COVID-19 Vaccine Development Status

Researchers across the globe are working day and night to find an effective vaccine against SARS-CoV-2. A vaccine would provide protection to people by triggering their immune systems to fight the virus so that they do not become sick. According to an article published in the National Geographic, more than 150 coronavirus vaccines are in development across the globe. Till date, there is only one approved COVID-19 vaccine i.e. Sputnik V. This Russian vaccine has been developed by the Gamaleya Research Institute of Epidemiology and Microbiology in collaboration with the Russian Direct Investment Fund (RDIF). However, the researchers from the west and other countries are skeptical about the efficacy and safety of the new vaccine owing to limited data available in the public domain.

The other key vaccines in the late stage of clinical trials are AZD1222 by AstraZeneca and Oxford, mRNA-1273 by ModeRNA and National Health Institute; BNT162 by Pfizer and BioNtech; Adenovirus Type 5 Vector vaccine by CanSino Biologics and Ad26.COV2-S by Janssen. According to Pfizer’s CEO Alberta Bourla, they could have results from their late-stage coronavirus vaccine BNT162 trial as early as October 2020. AstraZeneca and researchers from Oxford decided to halt the phase III trial of AZD1222 after one of the UK participants suffered a “potentially unexplained illness”. Though this incident might not be a bid deal and might not have a significant impact on AZD1222 development status, an unprecedented event like this highlights the significance of the results from a large, properly designed trials to assess vaccine safety before allowing it for mass use. While the US President Trump claims to have a vaccine in the US ready by October-November, healthcare experts anticipate first half of 2021 as the most feasible timeline for the same.

Many are hoping with the advent of COVID-19 vaccine, the pandemic will end. However, Dr. Anthony Fauci, coronavirus adviser to President Trump, says the virus will never fully disappear. Though vaccination will play a vital role, it won’t be able to control the pandemic on its own, instead, it would be achieved by a combination of safe and effective vaccination, a degree of herd immunity as a result of natural immunization, and appropriate public health measures.

Even if a vaccine works perfectly and is approved by the regulatory body, there will be other challenges when it comes to manufacturing and distribution. There may also be challenges with respect to demand and supply and in deciding which population/country/region should get the vaccine first. Billions of people needed to be vaccinated across the world in order to achieve herd immunity, and this will require massive scale of manufacturing capacity. Within a country, there likely won’t be enough doses to give to everyone at once, indicating government officials will have to prioritize who gets it first. Though the WHO says it is working on a plan to ensure the equitable distribution of vaccines, however, in reality how that plan would be enforced is not clear. Researchers have already warned that it might not be feasible for pharma companies to produce enough vaccine for everyone, and hence in this scenario rich countries might hoard stocks with them, leaving poor countries with limited supplies.

It’s not easy to predict the exact timeline of the end of COVID-19 as there are multiple factors which directly-indirectly influence the course of this pandemic. Considering the current development status of key corona vaccines, none of these vaccines are going to be available for mass use until early 2021. Once a safe and effective vaccine is approved and becomes available, a combination of mass vaccination, herd immunity as a result of natural immunization, and appropriate public health measures will lead the situation to improve by December 2021. Till then the world should learn to live with restrictions.

Shamsuzzaman Ansari is a Healthcare Consultant with several years of experience in Pharmaceutical Consultation and research. He is based in Gurgaon.

COVID-19 Vaccine Development Status

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