You’re certain an asteroid will strike the United States. You even know where. On January 28h, 2020, your Deputy National Security Advisor explains it could kill hundreds of thousands, perhaps millions. It may wreck the economy for years and diminish national power for decades.
Your response is to do nothing. You tell the public “things are fine.“
After all, you don’t want them to panic.
An asteroid would have a finite effect. Instead, our pandemic is part of the national, fictional world of Covid-19. It is a world where hydroxychloroquine, good for Sjogren’s syndrome but a cause of arrhythmias in COVID sufferers, is touted as a miracle cure. It’s a confected world where ingesting bleach will prevent the virus from causing illness. A place where tanning beds will annihilate COVID pneumonia and vasculitis. Where the head of the FDA is co-opted to say experimental convalescent plasma “saves 35% of the people it’s given to.“
This from a “study“ which does not involve a control arm, let alone a double-blinded one. A study where the most optimistic read of the data is that there might, might have been a 3% decrease in overall mortality. That’s what you normally get with a placebo.
Into this fictional world, our next, best chance of preventing further mass deaths, our new COVID-19 vaccines, must now make their way.
The Good News
Nearly 8,000,000,000 people on the planet want a vaccine, now. Vaccines are gnarly creatures. The immune system is nearly as complicated as the brain, and almost as poorly understood. Yet vaccines, like those for measles, have saved hundreds of millions of lives over the past century. Chances are good they will do so again.
COVID-19 has provoked the creation of many new vaccine platforms. These are entirely new ways of potentially initiating an effective immune response. We have vaccines that work through mRNA. We have vaccines that are boosted with adjuvant and opened to our immunity by supposedly harmless viruses. We have vaccines attached to nanoparticles that challenge our immune system with millions of juicy targets. We have good data these vaccines work in apes.
We also possess a newly possessed pharmaceutical industry. Long criticized, they wish to become heroes. Their scientists are excited at the prospect of doing something truly important. Their CEOs know that they can’t go back to their old profitable ways, charging hundreds of thousands, even millions of dollars for individual specific chemotherapies or gene therapies, until COVID-19 is controlled. These leaders know they may not see their pay and retirement packages of 100-200 million until all human business returns to some form of normal.
Numerous countries, with unfortunate local exceptions, are actively combining forces to stop a foe contesting all of humanity.
There are approximately 200 vaccines in development, perhaps a bit shy of 100 of them serious candidates. Some should work.
But there are obstacles.
The Bad News
The highly touted Oxford Vaccine trial now has a patient with transverse myelitis. An autoimmune illness that can leave people paralyzed, this is not good news. The transverse myelitis may have been provoked by the vaccine’s use of a special chimpanzee adenovirus. Or it may be a fluke. Lots of the new vaccine platforms rely on different adenoviruses. If they provoke similar responses, many may provoke unacceptable side effects.
The way to handle this problem is time tested and universally acknowledged, at least in the scientific community. You do double-blind clinical trials with tens of thousands of people. You watch for side effects, some of which may take months or years to appear. You wait. You watch. You do that studies the way they’re meant to be done.
You do not tell the public, as the FDA just did, that a new vaccine should be ready just before the election. You do not speed up the process which can lead, as the original polio vaccine did, to mass death. You let scientists and pharmaceutical companies do the job they’re pledged to do. You let independent researchers from across the globe probe and assess the results. Only then do you act.
For the first effective vaccines may not prove the most effective. Some will be hard to make, others to distribute. They may work well with one population, like old folks, less well with the young.
To find out what works best you wait. You watch.
For long and highly dangerous months, our president and his political supporters have told the virus, and Mother Nature, what to do. The virus responded with evolutionary ruthlessness. It has increased its viral reservoir, spurring its chances to mutate in ways that will prevent us from controlling it.
Telling Mother Nature how to act, with viruses or climate, does not work. It may lead, as it has with COVID-19, to countless unnecessary deaths. We should pledge to let scientists do their job.
Vaccine makers have a century of experience. They know what works. Public health people also know what to do. Some politicians have to get out of the way so that the rest of us will live.