COVID-19 acute respiratory disease has been with us since December 2019 and has caused many deaths and morbidity all over the world. It started off as a health crisis that turned into an economic crisis as well as governments tried through Lockdowns to control the spread of the disease and save lives. It has evaded all aspects of our lives: how we do things, how we connect with one another, how we work and travel. We have been forced to create a new Normal as the virus overwhelms us.
As of the 24 th November 2020, according to the Johns Hopkins University Corona Virus Resource Centre , the global confirmed cases were 59,814,726 and the deaths were 1,410,190
USA is the most affected country in the world. It has:
12,597,330 Confirmed cases and 259, 962 Deaths.
Followed by India with : 9,222,216 Confirmed cases and 134, 689 Deaths.
My country, Uganda, has reported : 18,406 Confirmed cases and 186 Deaths.
My second country,Botswana, has reported 9,992 Confirmed cases and 31 Deaths.
Since late October, Europe has been going through a second wave of the pandemic that forced countries like Britain, France and Portugal to shut down – a second Lockdown till early December.
Currently, we are focusing on the tried and tested public health procedures to control the spread of the disease.
1. Washing your hands with soap and water regularly and properly
2. Wearing a face mask properly in all public places or around people who do not live in your household.
3. Physical distancing – at least two metres between yourself and other people.
4. Being well informed about the disease.
Returning close to Nomalcy requires us to combine these four with the availability and access to a safe, effective and affordable vaccine against the COVID-19 coronavirus.
While the virus is raging havoc, researchers, funders and volunteers are getting together to develop a safe and effective and affordable vaccine. It is a race against time that started in March 2020.
Much as a vaccine is required urgently, it has to be developed following the rigorous Scientific testing of its potency, safety and purity because a vaccine is given to healthy people to prevent them from getting sick.
Safety is the priority. This is how it has been since the world’s first vaccine was developed by Edward Jenner, the English physician and scientist, in 1796. He used a relatively mild cowpox virus to immunize people against the deadly smallpox virus. Almost 200 years later, smallpox disease became the first disease to be eradicated from the world solely through vaccination in May 1980!
The standard model/process for developing a safe effective vaccine goes through 5 rigorous stages and requires huge investment from both the public and private sectors.
From the Wellcom.org website the process is made up of these stages:
- Discovery research- it is done in the laboratory to find ways of inducing an immune response at a molecular level. This stage normally takes 2-5 years.
- The Pre-clinical stage- the product is tested in animals to assess its safety and suitability as a potential vaccine for humans. It takes 2 years.
- Clinical development- the potential vaccine has to be tested in humans in three phases.
Phase 1– for any vaccine in development, its safety for use in humans is the priority. The potential vaccine is tested on small numbers of volunteers. It takes 2 years and requires 10-50 people.
Phase 2– this stage focuses on understanding the immune response induced by the vaccine in humans. It requires hundreds of healthy volunteers of the same age, gender and other laid down criteria to match the population segment for which the potential vaccine is being developed for. It takes 2-3 years.
Phase 3- To asses if the potential vaccine protects against that particular disease. Does it prevent the disease or does it prevent the development of the full-blown infection? How many doses are necessary to induce the appropriate Immune response? How long does the induced immunity last?
This phase takes 5-10 years and requires thousands of eligible healthy volunteers to take part in the trial.
4.Regulatory review and approval- the researchers have to submit the data and information gathered through the trials to the regulators to gain approval for the potential vaccine. This stage can take 2 years. Once the potential vaccine passes this stage it is considered as a vaccine candidate now ready for licensing with drug and vaccine authority like the Food and Drug Administration of USA or the National Drug Authority of Uganda.
5. Manufacturing and delivery- the developed vaccine is manufactured at selected specialist facilities which are highly regulated and monitored.
Following this model for development of a traditional vaccine could take more than ten years and costs huge amounts of money.
As the COVID-19 virus continues to cause havoc worldwide , there is an urgent need to develop a safe, effective and affordable vaccine to prevent its quick spread and reduce the severity of the disease so that health care systems and the frontline workers do not get overwhelmed by it. The earlier we return to normalcy , the quicker our economies would recover from the dire economic hardships induced by COVID-19 virus.
Thanks to the new technology innovations like Genome Sequencing- determining the complete arrangement/pattern of the germs’ genetic material- DNA at a single time.
These innovations can be safely used to develop the safe effective vaccine quickly: cutting the ten years to less than a year without compromising the safety, purity and potency of the new vaccine.
When the whole world seemed to be losing control over COVID-19 disease, the collaborative efforts of researchers, funders and volunteers started bearing some fruits.
Rainbows have started appearing in the sky giving us renewed hope.
They say ,“ Life is like a rainbow. You need both the sun and the rain to make its colours appear.”
The unprecedented COVID-19 crisis has demanded that scientists, medical doctors, funders and ordinary people form collective and collaborative partnerships to fight the pandemic.
9th November 2020- the New York –based drug company Pfizer and Biontech released the interim results of their phase 3 clinical trial. Their 2-dose vaccine was tested in over 43,000 enrolled volunteers. It was well tolerated and its efficacy was 92%. It is likely to cost 30-50 USD per dose and requires cold shipment and storage at minus 70 degrees Celsius.
11th November- Russia announced the completion of the phase 3 trials of its vaccine candidate Sputnik V, named after the world’s first satellite launched by the Soviet Union in 1957. It was tested in 40,000 volunteers and proved to be 92.5% effective. The data and the information are yet to be shared worldwide.
16 th November- Moderna Inc and NIH announced the completion of the phase 3 trials for its Covid-19 vaccine candidate conducted in 30,000 volunteers in USA. It was found to be 94.5 % effective but has to be kept at extremely cold temperatures of minus 20 degrees Celsius.
23rd November- Oxford University in partnership with the drug company AstraZeneca plc announced the interim data from its phase 3 trials for their vaccine candidate. A 2- dose vaccine whose efficacy ranged from 90- 62% tested in volunteers in UK, Brazil and South Africa. Its main advantage is that it is cheaper to manufacture and can easily be transported at temperatures of an ordinary refridgerator(2-8 degrees C) It is likely to be sold between 3-5 USD per dose. The two partners did not develop the vaccine for profit but as a contribution towards stemming the Coronavirus crisis.
The period from March to early November 2020 is too short to give us most of the answers we need to know about the new virus and these vaccine candidates. We do not know how long the vaccine-induced immunity lasts. The studies will have to be conducted in other countries too.
It is claimed that these vaccine candidates prevented the infection and those who went on to develop the infection did not develop the severe type thus cutting down on the need for hospital admission.
This is a remarkable achievement in our time and we thank and celebrate all the teams involved.
Many doses of the vaccines are required for the most vulnerable and the frontline health workers among the 7 billion people in the world. The more vaccines developed, the cheaper they become and the easier the distribution worldwide. According to the World Health Organisation, there are about 200 potential vaccines in development and at least 24 of them are in the human clinical trials phase. China, Russia , Germany, Israel are in this race too.
Developing the vaccine is half the job done ; manufacturing and delivering the vaccine to those who need it most in the developed and poor countries like mine, could be equally challenging. The vaccines have to be bought , transported to different countries and be administered to the most vulnerable and the frontline health workers including those in war zones or conflict areas. It has to reach those who need it most without losing its effectiveness from exposure to extreme heat or cold weather conditions.
This explains why the Oxford Univesrity- AstraZeneca vaccine which can be transported at temperatures of a domestic refridgerator holds more promise for those of us living in the least developed countries . Even at that level governments and health workers will have the challenge to educate their communities about the benefits and risks of the vaccine to boost its uptake.
We have come far since the Chinese scientists identified the COVID-19 virus and completed its genome sequencing from a patient with severe pneumonia previously working in the seafood market on the 7th January 2020. Never before has a vaccine been developed in such a short time!
As we are living in the age of pandemics, the knowledge and skills that we acquire and the partnerships we create as we try to control the COVID-19 pandemic prepares us to manage future pandemics better. Viruses like HIV, Ebola, SARS and COVID live in wild animals like monkeys and bats as their natural hosts but as huge forests are being cleared for timber, farming and new settlements, the animals’ natural habitat is being reduced. Wild animals have been forced to move and live close to human beings. This makes it easy for the viruses to move from these animals and jump into human beings thus causing diseases like Ebola and Covid-19.
If you want to go fast, go alone. If you want to go far, go together. African Proverb.
As we celebrate the best news about COVID-19 disease this year, each one of us has to remember the following:
Your health is you responsibility. You also have a role to play in stemming this pandemic.
Follow the public health safety and health guidelines.
Volunteer for the clinical trials when an opportunity presents itself.
Encourage members of your community to use the new vaccine when it becomes available in your country.
Have you identified your vital role in the control of the COVID-19 pandemic?
Are you just a passive bystander?
We are all in this together.