It’s strange how progress against the disease has been so slow *except* in the one branch of medicine that might actually eradicate it, where it’s progressing at a breakneck rate. After nearly two months of firsthand observation, U.S. doctors still don’t know why some people develop severe cases while others develop mild ones or why some regions have ferocious outbreaks while others are barely touched. There’s no proven effective treatment except remdesivir, and early indications are that the effect from that drug is mild. Despite nearly two months of social distancing the number of daily deaths nationally is flat and we continue to see new infections at a clip of 30,000 per day. We’re in the soup.
Except that there are a dizzying array of vaccine candidates racing along in development. And the timeline for when one might be widely available seems to be getting shorter in experts’ estimation, not longer.
Case in point, here’s Scott Gottlieb yesterday on “Face the Nation.” Gottlieb isn’t sanguine about the disease or our toolbox for treating it, but he seems pretty confident that millions of doses of a vaccine will be circulating this fall — not enough to immunize the entire population but enough to deploy to a city on an emergency basis if need be, to stamp out an outbreak that’s raging there.
COVID-19 VACCINE: @ScottGottliebMD says that manufacturers could have a #coronavirus vaccine ready for trial by fall and could deploy it to cities with mass outbreaks to study its effectiveness pic.twitter.com/A2s2pCri5K
— Face The Nation (@FaceTheNation) May 3, 2020
Watching scientists brighten on the prospects for a vaccine while they turn grimmer on pretty much everything else is vertiginous. It’s like facing an enemy army when you don’t have enough armor, enough rations, or even enough bullets — and then being told that building a functioning nuclear weapon might be right around the corner.
Yesterday “Meet the Press” had on one of the leaders of Oxford’s COVID vaccine project, which (as far as I understand) is on the most aggressive timeline of any vaccine candidate in the western world. That’s because they had the good fortune of having developed a vaccine candidate last year for MERS which has already been proved safe for human beings, the first crucial step in bringing a vaccine to market. Their coronavirus vaccine is a variation on that. It’s already been administered to monkeys and other primates, and a small human trial is under way with a larger one soon to follow. The Oxford vaccine works by “teaching” the body to recognize spike proteins, the same mechanism COVID uses to enter cells, and to build defenses against them. If it works, it should work well:
This approach is appealing because vaccines that include genetic material from the virus they’re designed to protect people from seem to produce a particularly strong immune response. “Our cells are already adapted so that once they see the [DNA] sequence they’ll make a whole lot of the viral protein,” she says. “And the body is going to look at that and say, ‘That doesn’t belong here,’ and raise an immune response against it.”
Because the vaccine exposes the body to a large dose of the viral protein (which cannot cause COVID-19 on its own), it causes a more robust immune response, and the fact that your body is producing it gives it another edge. “Because it’s a protein being made inside your cells it triggers multiple arms of the immune response,” George says. This leads to more enduring protection than some other vaccines can create.
The major subplot to the “When do we get an effective vaccine?” storyline is “Which country gets to it first?” China really, really wants to be first, which would be really, really bad for a desperate world:
Being able to vaccinate its own population first, for example, would serve as a strong “economic rudder” for China and allow it to fully open its economy to global companies, said Dr. Ross McKinney, Jr., the chief scientific officer at the Association of American Medical Colleges.
It would also yield diplomatic leverage, said Matt Kroenig, a former Pentagon and CIA official who now serves as deputy director at the Atlantic Council’s Scowcroft Center.
“Often, Chinese offers of aid come with strings attached,” said Kroenig, whose new book examines American power competition with China. “So they could use it as a way to try to increase their influence and further push out the U.S.”
Not only would it be an economic coup for China, it’d be the biggest boost in international prestige the Chinese Communist Party has ever received. If China were “generous” in sharing with other nations, it might even short-circuit the growing global backlash to Beijing’s cover-up of the initial outbreak in Wuhan and the antagonistic nationalism it’s displayed ever since in trying to shift blame.
It wouldn’t be great for Trump’s electoral prospects either:
China’s Center for Disease Control and Prevention predicted that one of the vaccines could be in “emergency use” by September, meaning that in the midst of the presidential election in the United States, Mr. Trump might see television footage of Chinese citizens lining up for injections.
“It’s a scenario we have thought about,” one member of Mr. Trump’s coronavirus task force said. “No one wants to be around that day.”
European leaders are keeping an eye on China — but they’re keeping an eye on Trump too, worried that his “America First” approach might lead the U.S. to be less inclined to share the vaccine with poorer countries than a different president, or a different country, might be. (China could conceivably finish second in the vaccine race and still benefit prestige-wise by supplying the vaccine to countries that are low-priority for Washington.) From a European perspective, having Oxford win the race might be ideal. The west would have denied China its great propaganda victory while also denying Trump influence over how the vaccine gets distributed.
Here’s the “Meet the Press” interview. Note how soon we should have an indication of whether Oxford’s vaccine works or not. Just a month from now, initial data on how it’s working in humans should be available. Data on how it’s working in primates should be available this week.