Where we are with Covid-19

Originally published in Dhaka Tribune on 6 October 2020

The World Health Organization has just approved a very sensitive, rapid, and relatively accurate antigen test produced by a South Korean manufacturer that could be used for mass screening and in schools, universities, and workplaces, at a time when the leader of the free world, the president of the United States has been diagnosed to be corona-positive.

Another antigen rapid test manufactured by the American company Abbott is soon to be approved for use. Both tests are to be rolled out for worldwide use in developed countries as well as developing nations. The diagnostic tests have the potential to add to the human armament in the on-going viral pandemic and successfully avert many a fatality, at a time when the entire developing world is struggling with death and economic destruction.

The approved diagnostic test is a rapid antigen test that is faster and easier, as well as cheaper. Both tests are being manufactured in South Korea, and are capable of delivering results within minutes rather than hours. Lucky for countries like Bangladesh, The Gates Foundation’s involvement has guaranteed availability of the test to low and middle income countries at a price less than $5 each.

The tests are part of the initiative launched by World Health Organization, the European Commission, the French government, and the Gates Foundation under the auspices of Access to Covid Tools Initiative (ACT accelerator). One of the tests produced by the South Korean Company SD BioSensor has been given emergency approval by the WHO and the one by Abbott will be approved shortly, both companies manufacturing the tests in South Korea.

Claimed to be 95% accurate in optimal situations, though likely to be 80-90% accurate in real situations, the partnership deal for access to the tests has also been secured by Africa Centres for Disease Control and Prevention, the Clinton Health Access Initiative, the Global Fund, and Unitaid. ACT Accelerator Initiative is also participating in bulk buying and distributing of Covid drugs and vaccines as and when they become available for use.

In the vaccine front against the on-going pandemic, the media world is full of eye-catching headlines such as “China prepares to declare victory in global vaccine race — and assures the world theirs is safe,” “Johnson and Johnson coronavirus vaccine shows response in 98% of test participants,” “Scientists to infect 24 people in the UK with genetically modified coronavirus to develop a live vaccine” and so on.

On the cautious side, the headline goes “Covid-vaccine results are on the way — and scientists’ concerns are growing,” “Covid vaccine tracker: When will a coronavirus vaccine be ready?,” “Coronavirus vaccine: When will we have one?” Finally, the headlines postulating terrifying effect of the vaccines: “Coronavirus: Half a million sharks ‘could be killed for vaccine,’ experts warn.”

The media world believes that humanity is almost at the very door of producing an effective vaccine as early as the beginning of next year. The leader in the pack, the Oxford vaccine, had a bad press last month when an isolated incident of neurological adverse effects was reported in a trial subject. They seem to have overcome the obstacle and appear to be going in full swing ahead with their phase III trial. It appears from the media that the final product will be marketed as “Covishield” in India.

The trial of vaccine Ad26.COV2.S, being developed by Johnson & Johnson, is the only Phase III vaccine trial in the US that is testing the efficacy of a single dose of a vaccine, and though, not yet peer reviewed, J&J researchers claim that 98% of participants in the study have developed neutralizing antibodies within about a month, after being inoculated by the vaccine.

The trial may confirm the vaccine’s uniqueness in initiating adequate antibody production response following a single dose injection, rather than in two doses, common with other vaccines being developed, reducing the time required to deliver the vaccine, simplifying its mass quantity production and distribution.

Chinese front-runner Sinovac was given emergency-use approval for vaccination in high risk groups in China by the Chinese government at the end of August. The company claims that the vaccine would be ready for mass vaccination by the beginning of next year worldwide, including the US, and the authority of Sinovac appears optimistic about manufacturing a few hundred million doses by February or March 2021.

The vaccine being developed by Moderna in the US started their phase III study soon after the Oxford vaccine, and is well ahead in its large-scale recruitment drive for volunteers. Though they are subject to tremendous political pressure to produce the vaccine before the election, they are in no way to be pushed into achieving a result early for political advantage without the proper rigour of the phase III study-protocol, announced the owners of Moderna in an attempt to distance themselves from the political saga being played out.

The way vaccine development has gone on, there is some reasonable concern for the safety and efficacy of the vaccines, as the final results are going to come out on many of the vaccine front-runners soon. Concern for human life has been the soul of vaccine development against coronavirus but geopolitics, socio-economics, the US election, Wall Street manipulations all seem to raise some worry among the scientific circle.

The most interesting and contentious issue has been raised by environmental scientists who believe nearly half a million sharks would need to be culled for the production of squalene.

Humanity is now at a crossroads, and until effective treatment and a vaccine are available against coronavirus, emphasis must be placed on the rigorous adherence to the recommended public health measures, which must religiously be followed.

—Dr Raqibul Mohammad Anwar is Specialist Surgeon, Global Health Policy and Planning Expert, and Retired Colonel, Royal Army Medical Corps, UK Armed Forces.