7 January 2021

In the fight against Covid, it’s the quick or the dead

By Jon Moulton

Every person infected with Covid is a viral breeding ground, and we now have more people infected than at any point in the pandemic so far. The virus makes lots of errors in duplicating itself, and while most of those errors lead to non-viable variants or insignificant changes; some of these mutations will generate more dangerous offspring. Given the billions of virus replications happening every minute even thoroughly unlikely mutations will eventually happen. And the more breeding grounds – the quicker this will happen.

These more dangerous mutations have already surfaced. The recent UK variant is spreading much more easily. A South African strain is doing the same. The Danish “mink” variant has not proved to be a great threat, but recently another new form of coronavirus has surfaced in Nigeria.

Given the increase in infections we should expect more dangerous variants to turn up more frequently. So far it seems that the vaccines can still handle the nasty ones, but it is likely that eventually mutations will diminish or eliminate the protective effects of one or more vaccines.

The good news is that the vaccines being developed work in different ways, so it is unlikely that a variant will escape all the vaccines at once.

However, we should not brush this unpleasant possibility under a carpet – vaccines will become obsolete and new ones will be needed.

So, it would be prudent to get a pipeline of vaccines (even better a powerful drug treatment) and to develop technologies for the rapid development of vaccines than can be tailored to fresh mutations.

There has been much praise of the speed which which Britain got its vaccines approved, but the regulators could have been quicker.

Gathering data for review during trials is a welcome move by the MHRA, but it still took a full month after all the data was in for approval to be finalised. Surely the intellectual effort should have been done earlier and go/no go parameters (efficacy, side-effects etc) set so that as soon as those targets are met, implementation (or not) can go ahead?

We have yet to use ‘challenge trials’ where you get, say, 30 healthy volunteers and give half of them a drug or vaccine and a placebo to the other half. You then spray them all with virus and see if they get sick. There are obvious ethical issues, but the hard arithmetic is that the potential risk has to be measured against the thousands of lives potentially saved and the economic hurt avoided. These very speedy trials were instrumental in developing vaccines for yellow fever, typhoid, and malaria.

Speed really is of the essence – the economic effects of delay are horrible and every day that passes, more people die.

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Jon Moulton is founder and chairman of Better Capital.

Columns are the author's own opinion and do not necessarily reflect the views of CapX.