28 August 2020
Jenna Denyes discusses whether we are still in the first wave of Covid-19 infections and what progress has been made in finding a vaccine.
Are we still in the first wave of Covid-19 infections?
I think there are a few dates which are important to keep in mind when we look at where we are in the pandemic. We have gone from December, having a startling rise in cases of pneumonia with an unknown cause, to March, the declaration of a global pandemic, to today more than 17 million cases; and all of this has happened in about eight months. For reference the Spanish Flu in 1918 had approximately 300 to 500 million cases over the course of more than two years. So this is something that that is happening very quickly. Unfortunately it looks pretty definitive that we are still in a first wave because at no point have we really seen any reduction in the rise in the number of infection cases. Some places might have experienced some degree of local control, but what you really saw was a reduction in severe cases and the virus was still spreading in the population just asymptomatically. For there to be a second wave, the first wave needs to have been brought under control and unfortunately even the summer temperatures do not seem to have allowed us to do that. It looks like this virus is going to continue to cause infections in one big wave and it is not going away any time soon.
Is it possible to put a timeframe on the virus?
It does look like at this point in time we can expect the Covid-19 virus to be staying with us for at least the foreseeable future. Experts are predicting it will stay more or less indefinitely; it is going to join the seasonal rotation of infections, if you will, along with influenza and the four other coronaviruses which regularly circulate in the population. To eradicate a pathogen completely a few criteria have to be met; the most important is that the pathogen only infects people. If you are spending all your time and effort keeping it from infecting people, unfortunately if the virus is spending its time also infecting bats, for example, then jumping back into people you are not going to be effective at removing it from the face of the planet. The other thing that you need to have to effectively eradicate a disease is an effective vaccine or treatment and unfortunately we currently do not have either, although promising progress has been made on both fronts.
What progress has been made in finding a vaccine?
We are currently experiencing a truly unprecedented pace of vaccine development. This pace has been made possible by exhaustive and extensive collaboration between experts in academic government research facilities as well as private industry and this has really been on a global scale. Currently there are two phase three clinical trials underway and we can expect one or two more to be starting imminently. These clinical trials are placebo controlled and they are going to be providing us essential answers to currently unanswered questions about the safety and efficacy of these trial vaccines. Some people are predicting we might have these answers as soon as October, which is possible as the structure of these trials means the more infections that the participants experience the quicker the trials finish, because they are event-driven rather than time-constrained trials. This also means if there are not that many infections happening in the population we might have to wait a little bit longer, but it is realistic to expect that we could see trial data from two or more of the different clinical programmes in the October to November timeframe. Do keep in mind that just because we would have trial data it does not necessarily mean that you or I would be getting a vaccine. After we have the data, a vaccine would still need to be carefully reviewed for safety and efficacy as well as approved and then produced, distributed and administered. And while a number of the different people involved in that process are already working very hard in finding solutions and developing plans it is still a pretty large global undertaking. But at this point all of the vaccine programmes are showing everything they need to show at this stage. There are no undue safety concerns; all of the efficacy data we have seen so far is promising and encouraging ; we are just going to have to be patient.
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