*By: Dr. Pashko R. Camaj, Doctor of Public Health Sciences –
We are entering the seventh months into the coronavirus pandemic. During this time, we have learned many things about the SARS-CoV-2 virus and the disease it causes. With the numbers of infections and fatalities still on the increase, some questions remain difficult to answer: when will the vaccine for Coivi-19 be ready, and will it be safe and effective? The answers to these questions are not easy, and certainly not simple, but from the standpoint of our desire to get back to immediate normalcy, the answer is no. However, from the standpoint of typical vaccine-development timing, yes, it will be ready and here soon.
Vaccine Progress: Developing a new vaccine can take years or even decades. That was true until now! The speed and progress in search for a viable and safe vaccine against Covid-19 have been inspiring. The early positive results can be attributed partly to the number of world-wide research teams working on it around the clock. In addition, relaxed restrictions on moving between stages of vaccine development, and the promise of new vaccine technologies that have been unleashed globally, have also played a role in this unprecedented progress.
Traditionally, vaccines have worked by introducing dead or weakened viruses into the body, which stimulate the body to preemptively produce antibodies that are ready to attack the intruding viruses. While this has been an effective approach, it has also been slow to develop, since there are a lot of safety concerns anytime we introduce a virus, dead or weekend to a human body. More recently, new vaccine approaches utilizing introduction of only a small portion of the virus, called an antigen, which acts almost like show-and-tell. The antigen typically prompts the body to make antibodies, without the safety concerns with introducing the entire virus. Now, in the most novel approach, scientists are working to get our own cells to produce the antigen; our body, in turn, produces the antibody. Vaccines made like this are potentially fast to produce. But this approach is largely untested, with potential many side effects and uncertainty if they will even work.
At the moment, researchers are working on all these approaches, and several are already in the process of testing for safety and efficacy. Some of that trials are well in their last stages and will be finished by the end of the summer. Concerns remain, that even with an approved vaccine, it will still take some time to manufacture and distribute large number of doses. Later in 2020 or early 2021 is probably an optimistic estimate for the first actual vaccines being administered to the larger populations. Logistics of how and where vaccines will go first, and who will get the priority of early vaccination are still to be ironed out. But that is a ‘problem’ we should all be happy to grapple with.
Effectiveness of a Vaccine and ‘Herd’ Immunity: Typically, for a vaccine to be considered a successful it will need to promote immunity in at least 60 percent of people. That is considered a minimum when we talk about achieving “herd” immunity. Some data suggests that we need 70-80 percent effectiveness for this immunity to take hold. There are those that say we should have left the virus run its course and build the immunity that way. But early original modeling estimated that without any changes in our behavior, and allowing the virus to run wild, the virus
may have killed 1 million to 2 million Americans-some estimates even double or triple that number. That was unacceptable! We also know that Sweden, which came the closest to letting the virus “run its course,” had much, much higher death rates than its neighboring countries. So, waiting for herd immunity to take hold, would have resulted in many more deaths, in addition to completely ‘flooding’ our health care system, which could have produced additional concerns, not only related to Covid-19.
Improvements in Health Care: While we look for news on the vaccine front, we have been seeing progress in the treatments for Covid-19. There has been some good news on the treatment front. Remdesivir and a steroid called dexamethasone have both been shown to significantly reduce mortality in seriously ill patients – in some cases by up to a third. In addition, RLF-100 or aviptadil, a synthetic form of a natural peptide that protects the lung has shown some significant progress treating critically ill patients. The therapy has been granted fast-track designation to develop the drug in the United States. Treatments to improve prognosis for patients with milder cases of the infections have been also on a research front-with improved outcomes. One important aspect of improved treatments has been that hospitals and health care providers in general are far better prepared now than earlier in the year. This is a result of increased capacities to treat and care for patients. Also, hospitals are getting better at treating the virus, thanks to a combination of experience and new treatments. A testament to this is relatively low and declining death rate compared to those of a few months ago.
So, the continued virus prevention methods such as good hygiene and social distancing, using face covers and masks will help lower the risk of spreading the virus or becoming infected and keeping us healthy. For those unlucky ones that get infected and require medical care, use of improved medication will be essential. These are the viable options in the fight against this enemy, until a safe and effective vaccine puts us on a path to returning to lives we knew before the Covid-19 shook our world!
**Vice-President of Pan-Albanian Federation of America -VATRA