Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious Diseases
As we enter the new year, optimism is increasing that the end of the COVID-19 pandemic is within our reach. Nearly 70 vaccines against COVID-19 are being tested in human clinical trials, and millions of people – starting with those at highest risk – have already been vaccinated. Nonetheless, there are challenges to vaccine rollouts everywhere.
Greater focus on collaboration to ensure fast and equitable distribution of vaccines is more important than ever as the world approaches an inauspicious milestone: 100 million reported cases. Just today, Friday, January 15, there have been a reported two million deaths from COVID-19, globally.
This week’s edition of Rabin Martin’s COVID-19 Briefing focuses on the current – and shaky – status of vaccine distribution in key regions around the world. Are health systems prepared to lead mass vaccination campaigns? And is the public willing to accept COVID-19 vaccines? Will countries – even those with well-established health systems – get access to vaccines in time to prevent further damage? Our earlier COVID-19 Briefings are available here.
The U.S. accounts a quarter of global cases, reporting 23,362,050 cases and 389,581 deaths. The situation continues to worsen, with over 4,000 deaths reported in just one day for the second time on Wednesday, January 14.
Early hopes of containing the virus within a year are gone. With the arrival of the new year, most of the world is still facing an uphill battle against COVID-19. Countries are contending with deluges of new cases and enforcing strict regional lockdowns. Last week, U.K. Prime Minister Boris Johnson announced a series of new restrictions across England, seeking to quell transmission of the more infectious variant of COVID-19, which has been overwhelming hospitals. New modeling suggests that one in five people (equivalent to 12.4 million people) in England may have had COVID-19.
In Canada, Quebec is facing its highest number of cases, and authorities implemented a near-total lockdown, referred to as “shock measures,” including nightly curfews. Officials in the neighboring province of Ontario declared an immediate state of emergency, imposing a stay-at-home order that went into effect Thursday, January 14, in an effort to curb a new surge of cases.
As outbreaks grow in provinces around Beijing, China this week moved to lock down 22 million people across multiple cities – double the number of people affected by the Wuhan lockdowns last January. Though the outbreaks have raised China’s incidence rate only to 109 new cases per day over the past week, the rates are the highest the country has seen since last summer.
On Friday, January 8, Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization (WHO), warned against complacency: “This is a very dangerous time in the course of the pandemic, and I do not want to see people become complacent as vaccines are starting to rollout.” Noting that the world has seen “some of the highest numbers of deaths recorded at any point in the pandemic,” Dr. Tedros went on to discuss the new COVID-19 mutations and their potential to upend progress.
New COVID-19 strains are emerging in South Africa, Japan, and the U.K., raising alarm over currently approved vaccines’ efficacy against the new variants. These more infectious strains are making their way around the world, with the B.1.1.7 variant, discovered first in the U.K., picking up speed in the U.S. and nearly 50 other countries. While these strains are not proving to be deadlier than the original SARS-CoV-2, public health officials are warning that the more infectious profiles could result in more hospitalizations. Dr. Michael Ryan, Executive Director, Health Emergencies Program, WHO, noted that the global community must “redouble our efforts” to contain the virus.
Scientists are working quickly to determine whether currently approved vaccines will be effective against these new strains. One note of optimism: the COVID-19 vaccine produced by Pfizer and BioNTech is proving equally effective regardless of strain.
In particular, the global community is concerned with how these new strains will affect containment in low- and middle-income countries. On Sunday, January 10, the African Centers for Disease Control (CDC) reported over three million cases (across variants) on the continent – with more than 30 percent of them concentrated in South Africa – and more than 72,000 COVID-19 related deaths. A more infectious variant of the virus, 501Y.V2, may be driving the resurgence of cases in the country, pummeling an already over-burdened health system. South Africa is expected to receive its first delivery of a vaccine (one million doses of AstraZeneca/University of Oxford’s vaccine produced by the Serum Institute of India) by the end of the month, with additional vaccines to be delivered through the WHO’s COVAX facility in the Spring.
More broadly, WHO noted that COVAX will begin delivering COVID-19 vaccines to countries this month. “We need about $7 billion in order to deliver enough vaccine to these countries through the end of 2021. The facility has already raised about $6 billion,” said Kate O’Brien, Director, Department of Immunization, Vaccines and Biologicals, WHO. COVAX currently has access to over two billion doses of vaccine and will begin delivery “by the end of January, and if not, then certainly by early February.”
Vaccine Distribution: “Vaccines don’t save lives. Vaccinations save lives.”
As scientists continue to uncover new mutations of the virus, expediting vaccine rollout is critical. Although researchers are hopeful that all approved vaccines will be effective against the new strains, the race is on to accelerate vaccination and rein in the pandemic. The more time the virus has to spread and the more people infected, the more opportunities it has to mutate and adapt to countermeasures.
In the U.S., inconsistent approaches – like much of the country’s COVID-19 response – have plagued vaccine rollout. The U.S. CDC established guidance for vaccine prioritization following extensive evidence-based and ethical debate. Healthcare workers and long-term care facility residents are the top priority group, followed by those 75 years and older and frontline essential workers. Those considered third priority are people between 65 and 74 years old as well as those 16-64 with high-risk medical conditions, and any other essential workers.
However, some states are complaining that the “rigid” system of prioritization limits their ability to distribute the vaccine quickly. Several states have developed their own systems which vary widely and do not necessarily follow CDC guidance. Secretary of Health and Human Services Alex Azar further complicated the CDC guidance on Tuesday, January 12, by calling for states to now include individuals 65 and older as a first-tier priority. At the same time, hospitals report discarding viable vaccine doses due to FDA labeling confusion. Dr. Drew Altman, President and CEO, Kaiser Family Foundation, criticized the U.S. rollout, saying, “The system we have makes sense on paper, but it’s too complex to be effectively implemented by our fragmented, multi-layered health system.”
Vaccine distribution remains slow and varies widely state by state. It will be important to glean best practices from those health systems that have been successful thus far in their work to vaccinate their populations quickly and equitably. (Axios, January 6, 2021)
In other regions, like Israel, governments have overcome logistical challenges. The country is on track to vaccinate 25 percent of its population by the end of the month, but has been criticized because its strategy leaves out a key population: Palestinians living in the West Bank and the Gaza Strip. According to Our World in Data, the United Arab Emirates is leading the second most successful vaccination campaign, having administered vaccines to 8.35 per 100 people. The UAE is one of few countries to approve Sinopharm’s vaccine and has access to uncontested local supply.
- On Wednesday, January 6, the European Medicines Agency granted conditional authorization to Moderna’s mRNA COVID-19 vaccine. The authorization allowed Moderna to begin supplying the 160 million doses of the vaccine ordered by the European Commission in late 2020. The E.U. joins Canada, the U.S., U.K., Israel, and Switzerland in authorizing use of Moderna’s vaccine.
- Johnson & Johnson, having completed enrollment for its 45,000 person trial last month, expects to unveil initial trial results “very soon.” The adenovirus-based vaccine candidate could prove an important tool in the fight against COVID-19 since the vaccine requires only one dose and can be refrigerated safely for up to three months, making it more accessible for some resource-limited regions. If approved, J&J intends to produce nearly 1 billion doses of the vaccine by the end of 2021.
- On Tuesday, January 12, GSK and Vir Biotechnology announced a partnership with the U.K.’s National Health Service to evaluate the companies’ antibody treatment, VIR-7832, in patients with mild to moderate COVID-19. The Phase 1b/2a trial joins two other global Phase 3 trials studying the safety and efficacy of another GSK/Vir antibody treatment, VIR-7831.
From the Experts
“Science has delivered, let’s not waste the opportunity to protect lives of those most at risk and ensure all economies have a fair shot at recovery.”
Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization
Friday, January 8
“[Current vaccine launches will] help us to end the acute phase of the pandemic, [but] we also need to plan for longer-term management of the disease.”
Dr. Swati Gupta, Vice President, IAVI
Monday, January 11
“We have no other choice: In the absence of any real federal coronavirus response, all that remains is the hope to vaccinate the nation. Averting a humanitarian catastrophe and possibly the worst public health disaster in modern U.S. history requires the immediate implementation of a new program to immunize millions.”
Dr. Peter Hotez, Dean, National School of Tropical Medicine, Baylor College of Medicine
Monday, January 11
“Our collective goal is to get ahead of the game and have a global mechanism to quickly identify and study variants of concern and understand their implications for disease control efforts.”
Dr. Ana Maria Henao Restrepo, Head, WHO, R&D Blueprint
Tuesday, January 12
What We’re Reading
- The World is Desperate for More COVID Vaccines – James Krellenstein, Peter Staley, Wafaa M. El-Sadr, The New York Times
- Vaccines Were A Chance to Redeem Failures in The U.S. Coronavirus Response. What Went Wrong? – Lena H. Sun, Isaac Stanley-Becker, Frances Stead Sellers, Laurie McGinley, Amy Goldstein, Christopher Rowland, Carolyn Y. Johnson, The Washington Post
- Dollar General Will Pay Workers to Get a COVID-19 Vaccine – Sarah Krouse, The Wall Street Journal
- This Is What An ‘Overwhelmed NHS’ Looks Like. We Must Not Look Away – Christina Pagel, The Guardian
- Billions Will Not Receive a COVID-19 Vaccine in 2021 – International Rescue Committee
- The Health 202: Recovered Coronavirus Patients Should Still Get the Vaccine, Experts Say – Alexandra Ellerbeck, The Washington Post
- It’s Essential to Understand Why Some Health Care Workers Are Putting Off Vaccination – Katherine Harmon Courage, Vox
- We Need A Better Way of Distributing the COVID-19 Vaccine. Here’s How to Do It. – Drew Altman, The Washington Post
Reports from International Governments and Bodies
- WHO COVID-19 Information and Guidance
- WHO Weekly Epidemiological Update: January 12
- WHO Weekly Operational Update: January 11
- CDC Coronavirus Resource Page
- COVID-19 Health Systems Response Monitor
- NCD Alliance COVID resources relevant to NCDs
Funding and Policy Trackers
- International Monetary Fund Policy Tracker
- Kaiser Family Foundation Coronavirus Policy Tracker
- U.S. Chamber of Commerce Foundation Corporate Aid Tracker
- Devex Interactive Funding Tracker
Resource Pages and Market Research Literature
- JAMA Resource Center
- The Lancet COVID-19 Resource Centre
- 2019 Novel Coronavirus Research Compendium (NCRC)
- National Academy of Medicine COVID-19 News and Resources
- WIPO COVID-19 IP Policy Tracker
- The COVID Tracking Project
- PharmaIntelligence: Coronavirus – What will the Impact Be?
- Health Affairs Resource Center
- STAT News COVID-19 Tracker
- Global Health NOW’s COVID-19 Expert Reality Check
- International Association of National Public Health Institutes COVID-19 Resources
- Center for Strategic and International Studies The Reopening and Take as Directed Coronavirus Crisis Update Podcast
- Primary Health Care Performance Initiative Forum
- U.S. Global Leadership Coalition COVID-19 Issue Briefs
- Prevent Epidemics Weekly Science Review
- COVID-19 Watch Weekly Updates
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About Rabin Martin
Rabin Martin is a global health strategy firm working at the intersection of private sector capabilities and unmet public health needs. Rooted in our mission to improve health for underserved populations, we design strategies, programs and partnerships that both deliver public health impact and drive business results. We leverage our deep knowledge and networks across a wide range of geographies and health areas to develop tailored solutions for every client engagement. We have helped many clients create bold global health initiatives and innovative multi-sector partnerships. Our specific areas of expertise include infectious disease and vaccines, non-communicable diseases, rare diseases, maternal and child health, and universal health coverage. Our clients and partners include multinational health care companies, multilateral institutions, government agencies, large foundations and leading NGOs. Rabin Martin is part of the Omnicom Public Relations Group.
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