Organised by NatHealth as part of its Thought & Leadership series, the session saw a riveting discussion on the future of biotech and the evolving global landscape with the Covid vaccines.
Moderated by Dr. Sudarshan Ballal, Chairman, Manipal Hospitals, the session centred on the novel coronavirus and ways to tackle it, in addition to discussing the Covid vaccines. The session also saw the participation of Mr Siddhartha Bhattacharya, Secretary General, and Preetha Reddy, President at NatHealth and Vice Chair at Apollo Hospitals, who began by saying, “The past ten months have been tumultuous for humanity. Genomics has been the key word and has made a huge difference with the vaccines. Bill Gates said that what we have done in two months could have taken two decades to achieve.”
Dr. William Haseltine, President at Access Health International, was then welcomed and asked to shed light on what would be the right thing to do, whether in the space of innovation, research, genomics or biotech. He said, “We know this is a new virus, which probably started circulating as early as October 2019. It manifested as an outbreak in Wuhan in a demonstrable way in December. Once it was recognised, the Chinese authorities took very strong measures to control the spread by instituting standard public health measures, which is a tribute to the Chinese government as they had sent people to Harvard School of Public Health for ten years to understand how to control a pandemic. They understood that SARS not only destroyed lives but had the potential to destroy economies. So, they had studied in great detail and implemented almost a textbook case of what to do and it worked in a spectacular way. China is the only country, apart from a few island countries, that instituted that kind of control and managed to quarantine 11 million people. That should’ve taught the world a lesson but it did not.”
Continuing on the topic, he said, “We are still minimising the danger. As a virologist, I’ve learned to look at what actually happens. The lesson from SARS and MERS is that viruses are out there and can adapt to humans. We didn’t do our research on those viruses and we weren’t prepared for the next one. Scientists got everything done, the vaccines were ready, but the money wasn’t there. Another thing we should’ve paid more attention to is that coronaviruses aren’t new and each of us has it every year – we call it the common cold. They keep coming back, like the flu, which is why I said that don’t count on population immunity because it doesn’t exist for these coronaviruses.”
Speaking about the early development of the vaccine and the role of innovation and technology in the process, Dr. Haseltine opined, “Everyone is celebrating how great science is, how we’ve solved this, but we haven’t. These kinds of vaccines work, but our emphasis on high science has led to some problems. For America, it has been a disaster to not rely on public health but high science. The same goes for diagnostics: we felt that we needed fancy ones whereas lateral flow anagen diagnostics work far better and the world still doesn’t have access to tests that we need. That was a fundamental mistake made.”
Elaborating on how he felt that testing for the coronavirus could have been different, Professor Haseltine expressed, “In the early days of detection, the CDC tests didn’t work, they were PCR-based tests. Once the virus was understood, simple antigen tests could have been developed, measuring the concentration of protein in saliva and nasal fluids. But we relied on a test which broke down and is very expensive. Antigen tests are very simple and cheap and can be self-administered and know who’s contagious. This should have been followed by making sure those people are isolated, but this is difficult as people avoid this due to lack of economic support. I believe if the tests are done, you pay people to stay home and have a realistic policy – or ensure that the country’s social system works for everybody.”
Giving an overview of the types of vaccines, their safety, efficacy and which one he would choose if given a choice, Professor Haseltine said, “I would take the simplest one, the killed vaccine, because, one, it has a huge safety record, and, two, it’s a whole virus ,which changes when it’s trying to escape and how the body reacts. The mRNA vaccines are unreliable and we don’t know the full story and adverse reactions. After this, I would prefer subunit vaccines, where you produce a piece of the virus and use it as the antigen. The vaccine I would not prefer is the adenovirus vaccine because it’s usable only once.”
Talking about the logistics, production and distribution across the globe, Dr. Haseltine said, “We know that in the global vaccine business, the two problems are cold chains and multiple doses. Another important component is whether you can get it to every community and to work with trusted community leaders. If this is lacking, people will be afraid to take it.”
Talking about the mutation of the virus, Dr. Haseltine said, “One thing we learned is that the cold coronaviruses come back every year, like the flu. Natural immunity doesn’t last long for these viruses, especially mucosal immunity, the type which stops things from getting into you and you passing it on. The Chinese were lucky because they got the weakest version of this virus. But by February it mutated and transferred across the world. Over the summer, it changed again in different ways to become more transmissible. The mutations are escaping our immunity and becoming more infectious. Another lesson is that vaccines will have to adapt. The virus is like a tree with branches: to deal with it, cut down the tree at the root with public health. This is a lesson we need to push pretty hard if we don’t want to get hit again and again by this tricky virus.”
On being asked about the equitable distribution of the vaccine between the haves and have-nots of the world, Professor Haseltine said, “This is very important. The lesson from all these viruses is that, if we don’t eliminate it everywhere, we don’t eliminate it anywhere. The world has now become small and we’re all connected but more people are required to help each other out.”
Speaking of when people will be able to breathe easy, Dr. Haseltine said, “I have teams of people in China who’re travelling, enjoying life, but they can’t leave the country. Unless countries put in the effort to control the pandemic through public health measures, they won’t get back to normal in the foreseeable future because the vaccine will not do it. There’ll be other variants. Medicine can help the problem but not solve it. To cut it off from the root, we need to combine public health with other measures so it doesn’t exist on the planet anymore, not just in one country. We’re entering a period of vaccine euphoria, but next year it’ll be back like the flu. Another lesson is to pay attention when nature warns us. To get back to normal life, we need to do our best to take the institutions, our leadership, our governance, our social solidarity and science to tune them to their maximum efficiencies in order to have a normal life.”