Tuesday 10 November 2020

A Vaccine To The Rescue?

Yesterday, there was huge excitement over the prospect for a COVID vaccine. Stock markets soared, by around 4%, as they saw the prospect that lockdowns would come to an end, and economic growth would return. That in itself is an expression of irrational exuberance, because, even if the vaccine works, its not going to be rolled out on a mass scale for months, and, in the meantime, governments are likely to continue their idiotic lockdowns, cratering economies, and wreaking carnage. But, its also an act of desperation, hoping that a vaccine can be introduced quickly. Of course, we all hope that a vaccine will be introduced that is effective, but is this new mania really the solution? 

Pfizer, together with bio-tech company BioNtech, based in Mainz, Germany have produced a vaccine that is based upon a new type of vaccine technology that uses genetic engineering to manipulate RNA. The vaccine consists of molecular instructions — in the form of messenger RNA (mRNA) — for human cells to make the coronavirus’ spike protein, the immune systems’ key target for coronaviruses. This is part of a new era of therapeutics based upon the use of biotechnology, and genetic engineering that is going to be the basis of a whole series of new medical advances in the decade ahead. I have been saying for some years that such developments are going to advance considerably in the next decade, as medical science advances, and forms a large and growing area of commodity production, and capital accumulation. It brings together a range of base technologies developed in the last Innovation Cycle. The growth of computing power is an important part of it, and now the development of Artificial Intelligence will make such development even faster and more revolutionary. These new types of therapeutics are likely to provide remedies for a range of illnesses including cancers, brain diseases like Alzheimer's, and so on, in the years to come. 

However, all such therapeutics, because they are so revolutionary, and utilise genetic engineering, manipulating the very coding of human cells, require great caution, and testing to ensure their safety. Yet, where vaccines usually require five years of such development and testing, this one is being rushed out in just a year. The dangers of that are obvious. If it turns out that the vaccine is not what all of the current hype cracks it up to be, let alone, if it were to be found to have negative side effects, it would only give ammunition to the wacko anti-vaxxers, and conspiracy nuts. That would set back not just the development of this vaccine, but potentially this whole line of development of new medicines. 

Pfizer are not yet even releasing the actual data on their testing, from which they are claiming 90% efficacy. What we have been told is this. They had a sample of 43,538 people participating in the test. Of these, some (I presume half) were given the vaccine, and the rest were given a placebo. These participants were then monitored for the duration of the trial, to see who contracted the virus. Some media reports have said that 94 people contracted the virus, and of these 90% were people who had been given the placebo. However, according to the magazine Nature

“The companies did not indicate how many of those cases were in the placebo group or among those that got the vaccine. But they said that the split of cases between the groups suggested that the vaccine was more than 90% effective at preventing disease, when measured at least one week after trial participants had received a second vaccine dose, three weeks after the first. The trial will continue until a total of 164 COVID-19 cases are detected, so initial estimates of the vaccines’ effectiveness could change.” 

Without sight of the actual trial data, its impossible to verify this claim of 90% efficacy. If 94 people were infected, for example, and, as some media reports claimed, 90% of these were people in the placebo category, that is not the same thing as the vaccine being 90% effective. It would be necessary to know that the trial was divided half and half between those receiving the vaccine and those the placebo, as well as knowing that the people in each group were broadly similar. But, its necessary to know, also, the behaviour of all the people in the trial. After all, according to this data, only 94 people, in total were infected, meaning that more than 43,000 were not. If the trial was comprised of 20,000 people in each group, and even if all of the 94 infections were in the placebo group, it would mean that 19,906 people in that group did not become infected, or close to 99%. One conclusion then might be that the most effective means of preventing infection, was not from a vaccine, but simply isolating yourself from contact with it! The only way of knowing how effective the vaccine itself is, in preventing infection, is to ensure that everyone in the trial is actually brought in contact with the virus, and then to see how many of those who have had the vaccine become infected, as against those that had the placebo. 

But, there are many more questions, such as what effect the vaccine might have on the elderly, as opposed to the younger healthier members of the population. A safe vaccine will be of greatest benefit to the elderly, because it is they that are at serious risk from infection. The rest of the population could simply obtain immunity by natural infection, and, thereby, at no cost, as against the very high costs that will be involved in a vaccine. But, we do not know yet, whether the vaccine will be safe when administered to the elderly and vulnerable, which would require far more testing within that cohort to determine. If it turned out that it was only really safe to give the vaccine to younger, healthier people, what would be the point of that, because they could just get immunity for free, by natural infection. In fact, a sensible strategy of focused protection, and development of herd immunity would have been doing that for the last 8 months anyway. If we find that the vaccine is only safe to give to younger members of the population, then it would offer no immediate solution to the elderly, who are the only people actually at serious risk. It would be yet more evidence that the whole process has been driven by the financial interests of the medical-industrial complex. 

A lot has been made of the fact that the vaccine requires two-doses to be effective. That is not really an issue, because other vaccines also require two doses. This seems to confirm the other data that has been collated, which suggests that active antibodies remain in the body for around 3 months. Some of those that have opposed the strategy of herd immunity, made a great deal of that, but the fact is that this is normal. The body's immune system does not keep large numbers of antibodies active over long periods when they are not required. That would be a wasteful use of the body's resources. Rather the immune system retains the memory of what antibodies are required to fight off various pathogens, and then produces them, only when the body is again attacked by such bacteria or viruses. This is what occurs with the acquired immunity to a number of coronaviruses that cause the common cold, for example. We acquire the ability to produce the required antibodies, and each time the body comes into contact with that coronavirus, or one close to it, its like having a booster jab, as the body springs into action, producing the required antibodies. 

The particular nature of the Pfizer vaccine also requires that it be kept at temperatures below -70. Again, this is not necessarily a serious problem, and Pfizer are producing a “suitcase” in which the vaccines can be transported. It does mean that the logistics of administering it may be more problematic in hot countries, and where populations are widely dispersed. 

Its also not known whether the vaccine prevents people who it might protect from serious illness, and who are then asymptomatic, from still being infectious to others. 

In short, in desperation, the same media that encouraged governments to destroy economies by introducing idiotic lockdowns, and now launching into a new mania over the news of this potential vaccine. Yet, many questions remain over its efficacy, and even if, as we hope, it does prove to be effective, there are many months of necessary testing ahead, before it could be rolled out on a mass scale. It makes sense to roll it out first to front line workers in the health and care sector, so that they can be protected, but without knowing whether they might still be infectious, it would not remove the requirement for them to have PPE, and contact protocols etc., to prevent them spreading the virus to those in their care. It would make sense to next give it to the elderly and sick, to provide them with protection, but we would need to be sure that the vaccine is safe for these vulnerable groups to take. Its quite rightly being said that there are no plans to give the vaccine to the young, because, at least now, its being admitted that COVID19 poses no threat to these groups, but in that case, why not also admit that it poses no real threat to anyone under 60, who has no underlying medical conditions either? 

But, in that case, why spend billions of Pounds on a vaccine for this large bulk of the population, who were never at serious risk from COVID19? Why not have simply allowed all those in that age range to have gone about their lives and work normally for the last eight months, and, thereby to have acquired immunity against COVID19 safely, and for free? That way, society would have already developed herd immunity against the virus at no cost, with no destruction of the economy, and the elderly and vulnerable would then have been protected from it too. The reality is that all this hype is being engendered out of desperation by those that promoted lockdowns as the only way of dealing with the pandemic, and who have seen, that the result has been instead that tens of thousands of elderly people died from it, because governments failed to isolate and protect them in hospitals and care homes, and in the process, by focussing on tying to isolate the whole of the population, achieved neither, whilst creating the worst economic slowdown in 300 years. 

For some, who have lost their jobs as a result of that, the consequences will last for some time. Fortunately, with or without a vaccine, we are likely to see widespread immunity develop in most countries by the middle of next year, and we will see economies rebound strongly. Yesterday, as stock markets rose sharply on the prospect of such growth, bond markets got hammered. Only a few months ago, there was talk of the US Ten Year Bond joining many others in having a negative yield. The main reason for that is manipulation of the market as a result of the central bank printing money to buy bonds, and push up their price. But, yesterday, despite the central bank intervention, US Treasuries sold off heavily, with the Ten Year approaching a yield of 1%. As growth resumes strongly in the next months, and with all of the astronomical levels of borrowing producing vast amounts of new debt issuance, along with all of the inflation in the system caused by money printing to finance all of this unproductive consumption, interest rates are set to rise sharply, however much central banks try to play the role of Canute holding it back, with pronouncements on their official rates. That will cause an asset price crash on an unprecedented scale, taking down not just bonds, but also equities, property, their derivatives, crypto-currencies, and all the other asset classes whose prices have been blown into ridiculous bubbles. 

4 comments:

George Carty said...

And how much of a threat is it that it is likely that large numbers of people will refuse to have the vaccine because its accelerated development makes them doubt its safety?

Natural herd immunity (ie resulting neither from vaccination nor from deliberate infection in the manner of the "pox parties" of yore) isn't really a substitute for vaccination, not just because of the lack of direct protection for the at-risk population, but also because it is inherently fragile because the level of immunity is only just enough to prevent a renewed epidemic, and the relevant "herds" aren't static (this is why we get Freshers' Flu every October, as new "herds" are created by the start of the university year).

Boffy said...

We already know that lots of people have said they will not take it. I have always had a flu jab, but I will wait to see what happens with this, before volunteering as a guinea pig.

But, Covid isn't flu. The whole point about herd immunity is that it makes it impossible for the virus to obtain hosts in order to then be able to incubate and then be transmitted. As a result it dies out, in he same way that a forest fire, which cannot spread to unburned trees, because firebreaks have been created, dies out once its consumed its limited fuel.

The problem with flu is that its strains are continually mutating, and there is not enough acquired immunity either from natural infection, or from vaccination to prevent these new strains being able to infect new herds. If everyone was vaccinated for existing flu strains, then maybe over time, we would begin to limit it.

With coronavirus, because it is most often manifest as the common cold, lots of people from childhood get colds, and thereby build up natural immunity, including to similar strains. Over a lifetime, you come into contact with coronaviruses, and each time, its like a booster shot, because your immune system, remembers it from the time before, and kicks in producing the required antibodies, and so on.

With flu, everyone needs to be vaccinated, but with COVID, provided the vaccine is safe and effective, you really only need to vaccinate the elderly, and those at risk, because everyone else is pretty much asymptomatic, and would simply acquire immunity naturally. Of course, that is no fun for the medical-industrial complex, because that limits the number of vaccines etc. it can sell, and so severely limits the profits they can make from it.

George Carty said...

It looks like Sweden is now tightening its restrictions.

It has me wonder whether the Swedes went for a relatively light-touch approach back in March because they (unlike most other European countries) believed that whatever restrictions they did impose had to be maintained until herd immunity was achieved (either by natural infection or by vaccination).

However, the second wave which is now apparent (even if it hasn't yet gone on long enough for cases to translate into deaths) shows that Sweden has not attained herd immunity, and there is good cause to fear that it will be much worse than the first because Covid like flu is clearly strongly seasonal, meaning that the first wave was cut short because winter was almost over when the virus arrived.

Perhaps this (combined with the strong prospect of vaccination in about 6 months' time) has changed the relevant parameters in favour of lockdown?

Boffy said...

Maybe, or it could just be that politicians are feeling they have to respond to public opinion there just as here. I note the latest data shows an uptick in deaths, also, but nothing like the situation at the start of the year, and remains low relative to new reported infections.

My guess is that Swedish politicians with a vaccine only a few months away are playing safe. But, there is no indication that they intend to impose a lockdown, and nor should they.