Covid Chronicles XXIX

By lockdown_exit - 19th Feb 2021, 12:02 pm - Covid Chronicles

With an untrammeled run for the best part of a year, Covid-19 appeared close to being stymied with more than one vaccine appearing on the scene late last year. But it's clearly fighting a rearguard battle to stage a resurgence with variants appearing almost as fast as the vaccines. 

Two variants of the SARS-CoV-2 coronavirus that causes Covid-19 have combined their genomes to form a heavily mutated hybrid version of the virus. The "recombination" event was discovered in a virus sample in California. The hybrid virus is the result of the recombination of the highly transmissible B.1.1.7 variant discovered in the UK and the B.1.429 variant that originated in California and which may be responsible for a recent wave of cases in Los Angeles. 

B.1.1.7 - the variant first identified in Kent, UK - could be between thirty and seventy percent more lethal than previous strains, according to a report from the New and Emerging Respiratory Virus Threats Group. Concern over its potency has increased because the variant is highly transmissible. B.1.1.7 has spread to many other countries with 83 nations detecting cases, according to the World Health Organization. 

U.S. researchers published on Sunday a study 'reporting seven growing lineages of the novel coronavirus [...] all of them evolving a mutation in the same genetic letter.' Growing concerns over new variants are manifest in southern California, where new variant CAL.20C has been identified as infections surge there. The appearance of more and more mutants has cast a shadow of doubt over existing vaccines in use in various parts of the world. 

Under severe criticism for its tardy and chaotic response to the pandemic, South Africa has asked the Serum Institute of India (SII) to take back the one million Covid-19 vaccine doses the company had sent in early February. 

In the latest international Covid-19 developments, South African health officials announced they will share the country's AstraZeneca-Oxford vaccine with other African nations. Meanwhile in Europe, Johnson & Johnson submitted its request for an emergency use authorisation for its single dose Covid-19 vaccine. South Africa recently announced a pause in the rollout of the AstraZeneca-Oxford vaccine, following early study findings that it appears to have little impact on mild-to-moderate disease from the B.1.351 variant that is dominant in the country. South Africa followed that development with an announcement that it would temporarily switch to using the ironically unapproved Johnson & Johnson vaccine.

None of the vaccines in use so far and those imminently in the offing actually have the proven credentials to handle the numerous variants that are emerging. None of them have been cleared for use in children and few of them have proven efficacy amongst the old. In the race against the pandemic, therefore, it's become a case of half a loaf being better than none at all. The more people that get vaccinated the more the virus gets squeezed.

Pfizer and Moderna's vaccines may need to be updated to prevent against more aggressive Covid-19 variants, based on new research. Pfizer found its vaccine to be two-thirds less potent against the variant first identified in South Africa, while Moderna has said its vaccine's ability to neutralise antibodies against "a full panel of mutations" dropped sharply following tests. 

However, the one that appeared to be the first off the bat last year has since come in third after Pfizer and Moderna. It is now part of a ping-pong game, an apt description since the virus first surfaced in China: the Oxford University/AstraZeneca vaccine. Earlier, South Africa had shelved it in favour of others not necessarily efficacious against its variant. 

The World Health Organization on Monday listed AstraZeneca and Oxford University's Covid-19 vaccine for emergency use, widening access to the relatively inexpensive shot in the developing world. "We now have all the pieces in place for the rapid distribution of vaccines. But we still need to scale up production," Tedros Adhanom Ghebreyesus, WHO Director-General, told a news briefing. A WHO statement said it had approved the vaccine as produced by AstraZeneca-SKBio (Republic of Korea) and the Serum Institute of India. 

AstraZeneca, which set up a global supply network for its vaccine to deliver doses around the world, hasn't tapped regional producers to ease delivery shortfalls elsewhere as yet. But that could change soon. British regulators are inspecting one of the drugmaker's biggest production partners, the Serum Institute of India, which signed on to manufacture AstraZeneca's shot for its home country and other global markets. A green light from the UK's Medicines and Healthcare Products Regulatory Agency (MHRA) could clear the way for AstraZeneca to import the India-made shots to the UK and EU, which have struggled to beef up vaccine supplies after AstraZeneca said it would cut first-quarter deliveries last month.

In the search for the "perfect vaccine" there are many who have none at all. The United Nations chief has sharply criticised the "wildly uneven and unfair" distribution of Covid-19 vaccines, pointing out that just ten countries have administered 75% of all vaccinations. Addressing a high-level meeting of the UN Security Council on Wednesday, Secretary General Antonio Guterres said 130 countries have not received a single dose of any vaccine. Guterres called for an urgent Global Vaccination Plan to ensure people in every nation get inoculated as soon as possible. 

Squeezed out of the race for Western vaccines, developing countries are turning to China whose vaccines are still largely untried and not fully tested. As Peru is caught in the throes of a brutal second wave of Covid-19, millions of people are putting their faith in one country to turn the deadly tide. Peru has joined developing nations from North Africa to the Andes in counting on China for help. For these customers, the vaccines developed in Chinese laboratories and now being distributed globally could hold the solution to a massive problem: how to inoculate their populations after bigger and richer nations have pushed them to the back of the line for the more reliable vaccines developed in the West.

However, things could become better even as they appear to be getting worse. Covid-19 vaccine maker Novavax on Thursday unveiled a memorandum of understanding with Gavi, the Vaccine Alliance, to provide 1.1 billion doses of its coronavirus vaccine candidate to COVAX, a global effort to ensure equitable vaccine distribution. The Serum Institute of India will help produce doses under a prior deal between the company and Gavi.

Lalita Panicker is Consulting Editor, Views, Hindustan Times, New Delhi