Contradictory statements make it hard to understand the status of a new vaccine
On the world stage, we observe with amazement, a farcical drama being played at the highest level with pretentious rhapsody, Philippic invectives against an enemy portrayed as a weakling by the so-called leader of the free world who appears to be inflicted by this biological agent, one of the most murderous adversaries humankind has been exposed to during the existence of the modern human, the homo sapiens, over the 300,000 years on Earth.
And this spurious commander-in-chief then miraculously recovers without the slightest of ramifications, to continue his enigmatic charade. He continues his energetic play and mocks humanity whence the cause of his pretentious infliction, this infinitesimal microbe, has opportunely infected 37.5 million people globally, causing 1.08 million fatalities in less than a year.
Though the elderly and people with complex co-morbidity are more susceptible and particularly vulnerable, no human is exempt from the devastation brought on by the virus, unknown to the scientific community until the last millennium, and the knowledge of vulnerability of the human health to its desolation is relatively extant, and has been observed only after the debut of the present millennium.
Confusion rises even higher due to the contradictory thoughts of the prominent international scientific groups advocating “focused protection,” and their opponents critical of such a strategy defining the so-called focused protection as wishful thinking. Scientists from Cambridge, Oxford, Nottingham, York, and Edinburgh, only in the past week, advocated the achievement of “herd immunity” through selective natural infection of the healthy and young, who are least susceptible to death from the virus while simultaneously protecting those who are highly vulnerable to the adverse impacts of the virus, including death.
The opposite view is held by other renowned scientists, who dispute that protecting the vulnerable while safely building up herd immunity in the rest of the population is an impossibility. Defining the vulnerable of the population is extremely difficult, and as such, an unknown proportion of them would inadvertently be exposed to the virus; for the sake of argument, even if it is possible to identify the vulnerable, isolating them from the rest of the population, who would deliberately be exposed to natural infection, would be next to impossible.
The proponents of herd immunity through natural infection are concerned about the impact of lockdowns on short and long-term public health effects; catastrophic reduction in childhood immunization, worsening of cardiovascular disease detection and management, disruption in cancer screening, detection, and treatment; deteriorating mental health of the population, all leading to unacceptably higher long-term mortality, particularly affecting the young and the working class.
They advocate selective protection of the elderly and vulnerable, who are a thousand times more susceptible than the young. The disease, they believe, is mild, and much less dangerous for the young.
The opponents, on the other hand, postulate that immunity gained through natural infection is transient, unable to provide lasting protection, re-infection in the same individuals is not unheard of, and therefore herd immunity is a phenomenon not achievable by natural infection without the support of an effective and safe vaccine.
These scientists conform with the view that the vulnerability and fatality of the old and infirm may be a thousand times higher than the young and the robust, but the proponents of herd immunity with natural infection appear to ignore the growing evidence of continued debilitating symptoms for prolonged periods in the young after apparent recovery from coronavirus infection, even when the original infection was of mild nature.
To date, the World Health Organization has been tracking around 170 vaccines. No vaccine so far has officially been recognized for general use. There are about 11 vaccines progressing through their phase III trial of large-scale efficacy research, and 19 are in expanded safety trial of phase 2. Confusion regarding the safety, efficacy, and availability of a safe and effective vaccine is a huge concern for global political and medical leadership.
Two of the front-runners in Covid vaccine development, Oxford-AstraZeneca and Johnson & Johnson, had to pause in their trials due to safety concerns. Though Oxford-AstraZeneca restarted their trial in the rest of the world, their vaccine trial and that of J&J’s have been disrupted in the US, and there is no guarantee that the US trial of these vaccines are going to be re-started soon.
This uncertainty with vaccines enhances anxiety and confusion, particularly when there is a substantial threat to the population of Europe and the US, who have been mercilessly exposed to the next wave of the viral pandemic.
The confusion runs supreme, as the scientists are zealously awaiting encouraging announcements of the results of the phase III trials of the leading vaccines by the middle of the next month, and many vaccine developers are hoping to roll out millions of doses of vaccines for general consumption by the start of the new year. Soumya Swaminathan, the chief scientist of the World Health Organization, announced that the majority, particularly the young and healthy, may have to wait until 2022 to have access to Covid-vaccines and even health care, and front line workers may have to wait their turn to have access depending on their magnitude of risk they are being exposed to.
Raqibul Mohammad Anwar is Specialist Surgeon, Global Health Policy and Planning Expert, and Retired Colonel, Royal Army Medical Corps, UK Armed Forces.