The other side of the vax


(First of two parts)

At the beginning of August, 2020, we wrote in this column the imperative to think and act outside the vax. If other nations’ authorities managed to mitigate the pandemic’s ruthless consequences on their people’s lives and livelihood, keep recession relatively mild and prevent joblessness from leading to suicide without vaccines, it is difficult why the Philippines has failed to do it.

This is not to propose that there is no progress.

We see progress in the drop of new cases from 4,063 at end-July to only 1,773 at end-November. But while recoveries have risen, total cases continued to climb from 93,354 on 31 July to 431,630 on 30 November. UP’s OCTA Research Group estimates COVID-19 cases to hit between 470,000 and 500,000 by the end of December, 2020. The incidence rate has slowed down, but it keeps on rising.

With OCTA Research’s explanation that the increase in new cases derives from the “largely community transmission exacerbated by the rise in mobility due to the opening up of the economy,” the current positive trends “are very tenuous and can easily be reversed.” Vigilance and collaborative efforts among us are indispensable.

What is tricky about the virus, and by this time this should already be of common knowledge, the carriers are innocently asymptomatic.

The strategy, and we are glad this is broadly shared, is to strengthen the observance of health protocols, avoid crowded places and congregations, and equally important, “strictly monitor and enforce compliance with minimum health standards.” Testing and tracing, quarantining and treatment remain the pillars of successful management of the pandemic. Vietnam, South Korea, Singapore, and other truly resilient economies succeeded in suppressing the virus, despite the occasional upsurge.

We differ with Health Secretary Francisco Duque’s position that he is “not in favor of shifting the lockdown status in NCR from general community quarantine to moderate GCQ, as doing so could only trigger more cases.” What happened to the government’s program to dance with the virus on face masks, face shields, with sufficient physical distancing?

By this time, we are already past that trade-off between life and livelihood. We continue to give priority to flattening the pandemic because that is the only means by which we can inspire confidence among consumers and business, and in the process hope to restart economic activities. The deepest recession of the first three quarters of 2020 was the direct outcome of the weak public health management. The green shoots we are seeing are essentially transitory, isolated indicators of one good episode that may not be sustained.

We refuse to believe that we were rather reluctant to take the virus by the spikes because we hoped against hope the vaccines would be made available shortly after the Wuhan incident. This is risky.

The National Geographic last week reported that there are over 150 coronavirus vaccines in various stages of development today. Everyone is racing against time because the pandemic has already claimed one and a million lives around the globe. The US government, for instance has launched its Operation Warp Speed initiative covered by a pledge of $10 billion to deliver 300 million doses of a safe, effective coronavirus vaccine by January, 2021. The World Health Organization is coordinating global efforts to develop a vaccine with two billion doses by the end of 2021.

Medical experts agree that vaccines take 10 to 15 years before they could be made safely available in the market. The vaccine for mumps was the quickest vaccine put on stream but it took all of four years in the 1960s. We are not about to dispel the optimism of some of our health experts but they should be the first to know that vaccines go through a three-stage clinical trial process before they are able to secure regulatory approval, a protracted process in itself.

Beyond the vaccines’ approval for use, there could still be logistical nightmares. Production and distribution are scalable but politics could get in the way on who gets the vaccine first. Politics could also decide whether the vaccine, quickly developed and launched, could stand the tests of effectiveness, safety, and affordability. Stage 4 will definitely add more time for this would involve constant review of the vaccine as it is put into popular use to ensure continued social usefulness.

There can only be guarded jubilation over the recent tripartite agreement last November 27 among the Presidential Adviser for Entrepreneurship Joey Concepcion, AstraZeneca executive Lotis Ramin and National Task Force Against COVID-19 chief implementor Carlito Galvez, Jr. This agreement will benefit 1.5 million Filipinos or 1 percent of our 108-million population.

Based on the media report, the vaccine could pass the criterion of affordability because it is expected to set one back by only $10 or P500 for two doses. As to effectiveness and safety, we note from the same report that “the government’s medical experts… are seeking more details about the vaccine amid doubts over the data coming from the multinational company that worked in tandem with Oxford University.”

With donations coming from the private sector, the initial doses will be given to government front-liners screened by the DOH and employees of private companies. Owners of these companies that participated in this initiative believe that “if they can show they have vaccinated maybe not all but majority of their workers, then more people will shop in these stores rather than those on areas that are not being vaccinated.”

In the words of Galvez, “this is something better than nothing. It’s a chance to really open up the economy. It’s a chance to really bring back confidence.”

Is this true?

This is the other side of the vax.

Last Monday, another broadsheet reported that the UK, with a population of only 67 million, secured two million more doses of Moderna’s COVID-19 vaccine, bringing its access to 357 million doses from seven developers. They include Germany’s BioNTech SE and Pfizer, Inc., of the US which boasts of 95 percent effectiveness. On the issue of effectiveness, Moderna’s experimental vaccine claims 94.5 percent effective. AstraZeneca is also supplying UK’s need for 100 million doses with an average 70 percent effectiveness. These are rather high rates that require full validation.

Beyond effectiveness, are these vaccines safe, given the short vetting?

We therefore find the message of the G-20 heads of states on the pandemic rather tangential. They pledged fair vaccine distribution with no assurance it is effective and safe. President Duterte also sounded the call during the last APEC leaders meeting for a “free flow of vaccines.” It was correct for the President to have described the vaccine as a global public good. That should pass for a defining statement if the vaccine was qualified as effective and safe, as it is free flowing.

Both G-20 and APEC leaders should continue to hammer on global coordination and mutual support to manage the pandemic.

An effective, safe, and affordable vaccine is not a global public good for nothing.