Vaccine for Poor Countries will Save $466 billion in Ten Wealthy Countries

Vaccine Efficacy May Be Short Term

New Virus Variants in Many Countries

Holistic Plan to Battle COVID for 1.7 Billion Students

____________________________________________________________________________

Vaccine for Poor Countries will Save $466 billion in Ten Wealthy Countries

There are major negative economic consequences for wealthy countries if poorer ones do not get the vaccines they need. Global equitable access to COVID-19 vaccines is estimated to generate economic benefits of at least $153 billion in 2020–21, and $466 billion by 2025, in 10 major economies. This is the conclusion according to new report by the Eurasia Group

It finds that leaving low-and lower-middle-income countries (LLMICs) without access to vaccines amid the COVID-19 pandemic will cause significant economic damage that puts decades of economic progress at risk – for both LLMICs and advanced economies alike. 

The report by the Eurasia Group analyses ten major economies – Canada, France, Germany, Japan, Qatar, South Korea, Sweden, United Arab Emirates, United Kingdom and the United States – to assess the economic benefits to advanced economies of contributing to the work of the Access to COVID-19 Tools (ACT) Accelerator.

The ACT Accelerator, led by WHO and partnering with the world’s leading international health organizations, is a unique global collaboration which supports the development and equitable distribution of the tests, treatments, and vaccines the world needs to fight COVID-19. However, the programme still has a significant funding gap of $28.2 billion – with $4.3 billion needed urgently to fast-track critical areas of work. If that shortfall isn’t met, low- and low-middle income countries will have delayed access to these vital tools in 2021, which will result in a protracted pandemic, with severe economic consequences, not just for these countries by also for the wider global economy.  

The report, which was commissioned by the Bill & Melinda Gates Foundation, finds that the economic benefits of a global equitable vaccine solution alone for the 10 countries included in the analysis would be at least $153 billion in 2020-21, rising to $466 billion by 2025. This is more than 12 times the $38 billion estimated total cost of the ACT Accelerator. This figure was compiled using the expected negative effects of sustained coronavirus outbreaks in LLMICs, based on the downside and baseline scenarios of the IMF’s October 2020 World Economic Outlook forecasts.

So far, the 10 countries featured in the report have contributed $2.4 billion to the work of the ACT Accelerator, with the United Kingdom committing just over $1 billion, and Germany, Canada, Japan and France committing $618 million, $290 million, $229 million and $147 million respectively.

In just seven months, the ACT Accelerator’s progress has been significant: over 50 diagnostic tests have been evaluated and new rapid antigen diagnostics have been developed and being made available for LMICs; life-saving Dexamethasone treatments are being rolled out, research into monoclonal antibody treatments is advancing; and through the Health Systems Connector, the health system requirements for delivery of COVID-19 tools have been mapped in 4 out of 6 world regions.

COVAX, the Vaccines Pillar of the ACT Accelerator, has the world’s largest and most diverse portfolio of vaccines. It aims to accelerate the development and manufacture of COVID-19 vaccines, and to guarantee fair and equitable access for every participating country. Working with 189 countries, COVAX is supporting the development of nine vaccine candidates through CEPI, 8 of which are in clinical trials. COVAX has secured hundreds of millions of doses of three promising candidates, including at least 200 million doses for LICs, with the support of the Bill & Melinda Gates Foundation.

This new report emphasizes the funding urgency and the return on investment for donor countries of the work of the ACT Accelerator, which published its Urgent Priorities and Financing Requirements on 10 November.

Dr Tedros Adhanom Ghebreyesus, WHO Director-General, called on countries to commit to the work of the ACT Accelerator, stating that, “The ACT Accelerator is the global solution to ending the acute phase of the pandemic as quickly as possible by ensuring equitable access to COVID-19 tools. Contributing to the ACT Accelerator it is not just the right thing to do – it’s the smart thing for all countries – socially, economically and politically.”

Alexander Kazan, Managing Director for Global Strategy at Eurasia Group and one of the authors of the report said, “There is a clear humanitarian and ethical case for supporting the ACT Accelerator and the Covax facility, along with the obvious economic gains it would bring to developing countries; doing nothing risks reversing years if not decades of economic progress. But our analysis shows that the program is likely to yield economic and other returns for major donor countries as well. The ACT Accelerator is a unique opportunity to save lives, repair the global economy, and build diplomatic capital that will last a generation.”

Hassan Damluji, Deputy Director at the Bill & Melinda Gates Foundation, commenting on the report’s findings said, “The moral case for an equitable global solution to the COVID-19 crisis has always been clear, but with high-income countries reeling from a huge shock, their governments are increasingly focusing on investments that can help their own economies to rebound. This report adds to the body of evidence that shows that the ACT Accelerator is precisely one of those investments. It is both the right thing to do, and an investment that will pay dividends by bringing the global economy back from the brink, benefiting all nations.”

Vaccine Efficacy May Be Short Term

A new study by the New England Journal of Medicine (NEJM) and reviewed by William Hazeltine in Forbes  suggests that the long-term efficacy of Moderna’s mRNA-1273 vaccine, specifically the neutralizing antibody count, may be less than we were hoping for.  This potential adds to the urgency to make CATER masks widely available and utilized.

Neutralizing antibodies bind to invading pathogens, like all antibodies do, but they bind in a manner that stops infection. That is why pharmaceutical companies stress neutralizing antibody counts as an essential measure for their vaccines’ success.

The NEJM study followed a group of 34 patients who had taken both doses of mRNA-1273 and analyzed their antibody counts from the administration of the first dose for 119 days. Neutralizing antibodies were monitored in subgroups of 18-55 years of age, 56-70, and 71+, as shown below.

A significant determinant of vaccines’ effectiveness in controlling a pandemic is antibody duration—how long the antibodies last in a person’s system. For those 18-55 years old, the majority only show a slight decrease in neutralizing antibodies in the three months following their second vaccine dose. Two of the 34 patients in this age group saw a significant drop in neutralizing antibodies. Due to the limited number of participants in this study, we cannot draw conclusions from these outliers until further data becomes available.

However, sustained antibody counts are not the case in the 56-70 and 71+ age groups. In these subsets, the neutralizing antibody counts fall anywhere between 50 and 75 percent. This suggests that in these age groups, the duration of neutralizing antibodies from the Moderna vaccine will be relatively short, potentially less than a year. That is particularly troubling as these are the age groups most affected by severe Covid-19. It may well be that the levels of antibodies after three months, if maintained, are sufficient to protect these age groups, but it is unlikely they will continue to protect if levels fall still further.

Moderna is simultaneously producing vaccines for avian influenzas H10N8 and H7N9. These two vaccine candidates show similar drops in neutralizing antibody counts to mRNA-1273 after three months. According to data from Science Direct, antibodies persisted up to six months after injection, but dropped as much as 90% in that time. Sustained protection from the virus requires sustained neutralizing antibodies, yet the patterns indicate that Covid-19 vaccines may be more than a one-time occurrence.

In addition to Moderna’s bird flu vaccines presenting similar antibody trends to that of the Covid-19 vaccine, early trials required them to discontinue their 400 microgram dose due to patient side effects like injection site irritation and headaches. The mRNA-1273 vaccine will be two doses of .5ml each, according to the CDC. While Moderna trials did not note significant side effects from vaccine administration, some effects may arise in the general population.

This is all not to say Moderna’s vaccine is not effective. Even at these low numbers, antibodies may still be fully or partially protective. That remains to be seen. Additionally, the NEJM study only analyzes 34 patients, most of whom are in the 18-55-year-old age group. Conclusions drawn from such small data sets must be taken with a pinch of salt, but we still need to take the results seriously—this data may be the first of many indicators that vaccines don’t last as long as we would hope.

It is also vital to review similar data in the Pfizer and Biotechvaccines as it becomes available. The United States government and the governments of countries worldwide seem to be banking on the effectiveness of these vaccines. Hazeltine urges pharmaceutical companies to be forthcoming on their continued monitoring of these early patients and those who have received the vaccine more recently. As more data like this is released, the clearer the picture of these next several months of the pandemic becomes.

New Virus Variants in Many Countries

Japan, Spain, and France have found small numbers of infections involving a new, potentially more transmissible variant of the coronavirus, most linked to travel from the U.K., where it was first detected.

The rapid spread of the variant led to the lockdown of London and southern England this week, prompted a temporary French blockade of the English Channel and resulted in countries around the world barring travelers from the U.K. Because few countries have the level of genomic surveillance that Britain does, there is concern that the variant may have been traveling across the world undetected for weeks.

A recent study by British scientists found no evidence that the variant is more deadly than others but estimated that it is 56 percent more contagious.

So far, the British variant has been diagnosed in seven people in Japan, the country’s health ministry said. All had either recently traveled to the U.K. or been in contact with someone who had.

The discovery in Japan prompted the country to close its borders to all new entry by nonresident foreigners. The ban went into effect at midnight on Monday and will last through the end of January, the public broadcaster NHK reported.

In Spain, the variant was found in the capital region, local authorities said on Saturday. Antonio Zapatero, a regional health official, said that four cases had been confirmed in Madrid, while another three were being treated as suspicious. At least two of the cases involve people who had recently been to Britain and then tested positive in Madrid, as well as some of their relatives.

The first case of the new fast-spreading variant of the coronavirus was identified in France on Friday, according to the French health ministry. Officials said that the patient was a French citizen living in Britain who had traveled from London to Tours, a city in central France, on Dec. 19, a day before the British government imposed a lockdown following the emergence of the variant.

It is normal for viruses to mutate, and most of the mutations of the coronavirus have proved minor. The British variant has a constellation of 23 mutations, several of which might alter its transmissibility. Vaccine experts are confident that the available vaccines will be able to block the new variant, although that has to be confirmed by laboratory experiments that are now underway.

The European Union’s member nations are scheduled to begin vaccinating against the virus on Sunday with the Pfizer-BioNTech vaccine. Hungary began administering the vaccine a day early, on Saturday.

A few other concerning variants have also been identified, including one in South Africa and another in Nigeria. The U.K. said on Thursday that it would ban travel from South Africa after the British health secretary, Matt Hancock, said two people were confirmed to have been infected with the variant that emerged there.

Germany and Singapore have identified infections with the new variant. And Denmark, which has wider genomic surveillance than many other countries, detected 33 cases of the variant from Nov. 14 to Dec. 14, according to the Danish health authorities.

The U.S. has not yet reported any cases of the U.K. variant. But the country will require all airline passengers arriving from Britain to test negative for the coronavirus within 72 hours of their departure, the Centers for Disease Control and Prevention said Thursday. The rule will took effect Monday, December 28.

Holistic Plan to Battle COVID for 1.7 Billion Students

There are now nearly 1.5 billion children around the globe — or 87 percent of Earth’s student population — whose schools have closed because of the novel coronavirus pandemic, and more than 60 million teachers are home as well, according to a United Nations agency.

Schools in nearly 165 countries have shuttered,

There are 140,000 schools in the U.S.

Each school can be viewed as a potential bubble.  The big universities with 10,000 students would be large bubbles. The average school in the U.S. with 700 students would be a much smaller bubble. The universities in developed countries have all the technical capability to conduct fitness tests and monitor the use of them in their buildings.

Many of the 1.7 billion students are in environments where fitness testing and funds for masks will have to come from wealthy countries.  In the Alert yesterday we cited studies which showed that if  the 67 poorest countries do not contain the virus in the next year the cost to the 10 wealthiest countries will be $350 billion.  Mask programs for students can therefore be justified just on the selfish interest of the wealthy countries.