Last week, the Government unveiled its battle plan should Covid-19 cases surge in the coming weeks.
Worst-case scenarios suggest that one in five workers – more than six million people – could be asked to self-isolate in order to stem the spread of infection.
Undoubtedly, Ministers, health chiefs and scientists will also be locked in talks this weekend, working out how best to tackle the looming epidemic. I can picture the scenes in the Department of Health ‘bunkers’ beneath Whitehall – because I’ve been there.
It was 2009 and worrying reports had been emerging from Mexico about a new type of flu. I was on the Joint Committee on Vaccination and Immunisation, providing independent scientific advice to the Government. Was this ‘the big one’ – the killer pandemic we had long feared? It looked like it.
Last week, the Government unveiled its battle plan should Covid-19 cases surge in the coming weeks. Worst-case scenarios suggest that one in five workers – more than six million people – could be asked to self-isolate in order to stem the spread of infection. Above (l to r), Chief Medical Officer for England Chris Whitty, Boris Johnson and Chief Scientific Adviser Patrick Vallance at a press conference on March 3
Researchers made some headway into finding a human coronavirus vaccine after the SARS pandemic in 2003. But, due to the huge international effort to track and isolate those infected, the disease disappeared. And funding for trials for the vaccine dried up. (Pictured, a computer-generated image of a type of coronavirus)
H1N1, or swine flu, as it became known, was spreading quickly. It was mainly in younger people – unlike normal flu – with a high death rate.
But we knew flu vaccines could be tweaked to protect against the new strain – and so we quickly worked out how many we would need to order.
In fact, swine flu turned out to be relatively mild. It still caused nearly 200,000 deaths worldwide, but that’s nothing compared to the 50 million-plus victims of Spanish flu in 1918.
Preparing for Covid-19 won’t be so simple, however. The disease is caused by a coronavirus, a family that also includes common cold viruses, but also SARS and MERS, two recent deadly outbreaks.
And currently there are no vaccines to protect against them.
HOW FIRMS ARE LOCKED IN A RACE TO DEVELOP A JAB
When we catch a virus that we’ve never had before, it can make us ill – as we all know. Our immune system works by attacking, and destroying the invader.
And, generally, the next time we come into contact with that same virus, the immune system ‘remembers’ it, and can kill it off before it can take hold and cause illness.
Vaccines contain a bit of a virus that has either been weakened, modified or killed off completely – meaning they are essentially harmless. But it still stimulates the immune system, so that should it then come into contact with the live virus, it’ll ‘remember’ it – just the same as if we had actually had the illness – and protect us.
For some viruses, like measles and flu, scientists have been able to make effective vaccines.
But not so for coronaviruses, the family that Covid-19 belongs to.
For some viruses, like measles and flu, scientists have been able to make effective vaccines. But not so for coronaviruses, the family that Covid-19 belongs to. Above, the Prime MInister meets staff at a laboratory at the Public Health England National Infection Service in Colindale, northwest London on March 1
Efforts to create them have run in to difficulties. There have been trials of a vaccine for feline coronavirus, for instance – but it caused immune reactions that made the cats sicker.
Researchers made some headway into finding a human coronavirus vaccine after the SARS pandemic in 2003.
But, due to the huge international effort to track and isolate those infected, the disease disappeared. And funding for trials for the vaccine dried up.
So with this new coronavirus, researchers were starting almost from scratch. Despite this, they have made remarkable advances.
Back in January, the Chinese shared the genetic sequence inside Covid-19 with scientists around the world.
This was a vital first step for creating any new vaccine.
A collaboration of developers hope to have three or more in production by next year.
Pioneering technology means scientists no longer need to work with the actual virus.
Instead, they can create digital versions of the virus and a ‘virtual’ vaccine in a matter of hours, which can be made in a laboratory in weeks. Some that appear to work against Covid-19 in the laboratory have already been discovered.
If and when one is found to work, it’ll be the first ever coronavirus vaccine.
But any new drug can’t just be given to millions of people straight away – as promised by Donald Trump, who has said he wants one ready before the November US elections. That would just not be possible.
VACCINE MIGHT NOT BE THE MAGIC BULLET
Two American firms, a Chinese company and a team at Imperial College London all claim to be nearly ready to begin small-scale safety trials of a Covid-19 vaccine in humans.
But the next stage, which will involve hundreds of volunteers, is slower.
First of all, they will all have to be tested, to check they have not yet been exposed to coronavirus – and afterwards, to see if the vaccine has induced antibodies and might have potential.
Any new drug can’t just be given to millions of people straight away – as promised by Donald Trump, who has said he wants one ready before the November US elections. That would just not be possible. (Above, Trump with a photo of Covid-19 at a CDC lab in Atlanta on Friday)
As more people are exposed to the virus, it will become more difficult to get recruits who do not have existing antibodies against it. This is already a problem in China.
There will also have to be dosing studies to check whether one shot of the vaccine is enough, or if two might be needed.
Next comes the final, and perhaps most important, stage.
The vaccine has to be tested on thousands of people to check whether it can stop healthy people from catching the virus.
Getting past this stage isn’t easy at all. Unwanted side effects may be discovered – or some vaccines might work, but just not in enough people.
The whole process can take years – and failure is possible at any stage. Chris Whitty, the Chief Medical Officer for England, has admitted we would be lucky to get a vaccine for Covid-19 within the next year. But even when we do, there’s the next obstacle – getting hold of enough of it.
Two American firms, a Chinese company and a team at Imperial College London all claim to be nearly ready to begin small-scale safety trials of a Covid-19 vaccine in humans. But the next stage, which will involve hundreds of volunteers, is slower. (Above, Shanghai railway station on March 7)
The UK orders about 14 million seasonal flu doses each year. So if two doses of the Covid-19 vaccine were needed for it to be effective, that’s already 28 million doses – just for at-risk groups.
‘Every other country will be ordering similar quantities,’ says Professor David Salisbury, a former UK immunisation director. ‘No country will get all the vaccines it wants or even all the vaccines it needs because there’s not enough global manufacturing capacity.’
Even once doses of the vaccine have been secured, it will take more time for them to be distributed to GPs – and for them to be given to at-risk patients. In any case, vaccines might not be the magic bullet we think.
COULD DRUG USED TO TREAT HIV HOLD THE KEY?
Finding a drug that can relieve the symptoms of Covid-19 might be a better option.
Trials are already under way to see if a drug originally developed to treat the ebola virus, but which proved unsuccessful, could help treat symptoms of Covid-19.
Meanwhile, a drug used to treat people with HIV is being tested as a possible treatment.
But until we know more, doctors treating patients who are more severely affected by Covid-19 will have to rely on providing standard medical support – administering fluids and breathing assistance where needed. I certainly don’t envy those experts who are trying to solve these conundrums.
For now, I’d say don’t hold your breath for a vaccine – and keep washing your hands.
