The Search for the Lost World

Despite the development of three Covid-19 vaccines, the effects of the 2020 pandemic will be felt for a long time. The most promising vaccines will take months to roll out, even in the countries of their manufacture and the loss of faith in institutions means administering them could be a hard sell. “The man leading Operation Warp Speed said there is one thing that keeps him up at night: ‘We get vaccines to the people and then they don’t take them,’ Gen. Gus Perna said.”

“We get vaccines to the American people and they don’t take them,” Gen. Gus Perna told CBS “60 Minutes” of his worst nightmare in November. “Shame on us. ‘Hey, I was already sick, I don’t need it.’ Shame on us. ‘Hey, I don’t believe in vaccines.’ Shame on us.”

It’s not just anti-vaxxers who are hanging back. Australia is watching Britain’s experience because there are genuine unknowns left to be resolved.

Head of the Therapeutic Goods Administration, John Skerritt, told ABC RN Breakfast the UK and US were operating on a very different timeline to the Australian Government because of the stark contrast in the coronavirus caseload.

“They’re not approvals that those two countries are talking about, they’re emergency use authorizations, and they’re really reflecting the desperate situation of those countries,” Adjunct Professor Skerritt said.

There is still much about Covid that is unknown. As one Australian virologist explained, if there’s no need to rush, it will be better to wait for more data.

But experts have warned a vaccine cleared for emergency use is still experimental and the final testing must be completed.

That’s where phase 4 of Pfizer’s clinical trial comes in. This is when — after a vaccine has been rolled out — ongoing surveillance is carried out to make sure the vaccine is safe, said Kirsty Short, a virologist at the University of Queensland.

“The effects that we’ve studied thus far in phase 3 are only the short-term effects. We don’t see any adverse short-term effects but we’ve still got to check and make sure [the vaccine] is safe in terms of long-term effects,” Dr Short said.

So far, Pfizer has reported no serious side effects, although vaccine recipients may experience temporary pain and flu-like reactions immediately after injections.

In any case, many Third-World countries may have to wait till 2022 to get any vaccines at all due to supply issues and these have to be separately validated.

Through negotiations with vaccine development and pharmaceutical companies, government officials have mentioned at least 14 specific COVID-19 vaccines being eyed for use in the Philippines.

Negotiations for most are ongoing, while vaccine czar Carlito Galvez Jr earlier said the soonest a vaccine could arrive in the Philippines would be sometime between May to June 2021 at best, if not late 2021 to early 2022.

Indonesia will start mass vaccination with an assortment of drugs, including Chinese Sinovac and Sinopharm. Each vaccine involves a separate set of risks.

Vaccines produced by China’s Sinovac and Sinopharm are slated to be used in the early stages of the campaign. This year, the companies will provide 18 million vaccines, including 15 million that will be manufactured by Indonesia’s state-owned pharmaceutical company Bio Farma. All up, Indonesia has deals for more than 250 million doses until the end of 2021. This includes 30 million produced by the U.S. company Novavax.

The CEO of China’s Sinovac, which aims to sell their coronavirus vaccine globally, paid bribes for previous vaccine approvals, according to the Washington Post.

Chinese coronavirus-vaccine maker Sinovac Biotech is good at getting its products to market. It was first to begin clinical trials of a SARS vaccine in 2003 and first to bring a swine flu vaccine to consumers in 2009.

Its CEO was also bribing China’s drug regulator for vaccine approvals during that time, court records show.

Sinovac is now seeking to supply its coronavirus vaccine to developing nations, from Brazil to Turkey to Indonesia. While graft and weak transparency have long plagued China’s pharmaceutical industry, seldom has the reliability of a single drug vendor from the country mattered this much to the rest of the world.

Experience will determine which of the many vaccines will emerge as an acceptable standard. Tass suggests the Russian Sputnik V will be among them. But who knows? If 2020 demonstrated one thing it was that the unexpected could happen. “The race is not to the swift, Nor the battle to the strong, Nor bread to the wise, Nor riches to men of understanding, Nor favor to men of skill; But time and chance happen to them all.”

Time and chance have proved capable of overturning the Davos agenda, whose adherents admitting to their setback, now speak of the Great Reset. “There is an urgent need for global stakeholders to cooperate in simultaneously managing the direct consequences of the COVID-19 crisis. To improve the state of the world, the World Economic Forum is starting The Great Reset initiative.”

But as the organizers of Operation Warp Speed are discovering, finding the institutional credibility to sell giant social programs may be difficult these days. The pandemic’s psychological and economic damage to the global world has been profound. Apart from skyrocketing unemployment and idled production, much of the world has been plunged into debt, according to the IMF.

The riskiest period may still lie ahead. … Even in the best-case scenario, international travel will face roadblocks, and uncertainty among consumers and businesses is likely to remain high. World poverty has risen sharply, and many people will not be returning to work when the crisis passes. The political ramifications of the crisis in advanced economies are also still unfolding. The backlash against globalization, already rising before COVID-19, may intensify.

Even the West may be reaching a debt limit. “CBO projects a federal budget deficit of $3.3 trillion in 2020, more than triple the shortfall recorded in 2019. At 16.0 percent of gross domestic product (GDP), the deficit in 2020 would be the largest since 1945.”

But the deepest damage inflicted by the pandemic could be to elite prestige. The crisis showed they didn’t have all the answers. The parallels to the Black Death, which arrived in 14th-century Europe from the East are obvious, though Covid’s effects are much smaller. The plague humiliated authority, made cities dangerous, and assailed the unassailable.

The results of this contagion were, however, felt not in mortalities alone but in demographics and psychology, too. Grim experience quickly taught people in the day that Plague decimated cities more heavily than rural communities. … The result was that people fled the cities of Europe in large numbers … precipitating a trend toward de-urbanization far more catastrophic than that following Rome’s disintegration a millennium before …

the democratic nature of death, which steals away both rich and poor, nobleman and peasant, pagan and priest, opened the door wide to a general questioning of the culture on which the Medieval synthesis had rested …Offering little in the way of help—much less explanation or solace—these postulates began to crumble.

It resembles how today’s elite authority suffered. During the Black Death, many people stopped believing the church and secular authority which alike proved powerless to arrest or even explain the invisible menace. Similarly, as the Covid pandemic began, the Third World watched astounded as the coronavirus hit New York harder than Nigeria, London harder than Lagos, Milan harder than Monrovia, etc. The high officialdom of the global world — the American president, the British prime minister, the EU chiefs — proved momentarily helpless against the pandemic. Indeed they caught the disease themselves.

While medical science did not prove entirely defenseless before the coronavirus, it was initially less effective than hoped. This together with greatly sensationalized warnings by pandemic modelers that failed to materialize undermined trust in authority. A sense of fallibility, the feeling that the old certainties are gone fills the air.

The incalculable has displaced the growing certitude we were conditioned to expect of the 21st century. People in the 14th century may have sensed there was “something out there” they could not understand — but that was in the pre-modern age.

All in all, the bubonic plague is fundamentally a rat disease since it does not persist long in human communities where rats are absent. Rats, however, are not the cause of Plague—its pathogen—rather, just like human hosts, they are victims of the disease. The actual pathogen is a bacillus (a form of bacteria; pl. bacilli) called Yersinia pestis, which was first isolated and identified in 1894 by the French bacteriologist, Alexandre Yersin, after whom it is named. For all the destruction Yersinia pestis left in its wake, people at the time of the Black Death never knew this bacillus was the cause of the Plague. Thus, its invisible mechanisms combined with the extraordinary speed and violence with which it attacked contributed greatly to the terror and psychological damage it wrought upon late Medieval Europe.

But we were momentarily expecting the Singularity and the End of History. How come suddenly we could not go to a restaurant?

While 21st-century science is well aware that pathogens can cross from other species into the human population, it is less prepared to deal with dangers originating from science itself. Growing amounts of genetic information are stored, not just in nature but in biotechnology laboratories of great corporations and authoritarian states. In a reprise of the guns vs. armor race, the more biotechnology learns about stopping and manipulating pathogens the more deadly a pathogen it can potentially design.

Today, not only must one set a watch on the borders of nature and human populations, but between labs and nature and nature and labs. Each vertex of the deadly triangle can act on the other. While Covid-19 itself may be beaten back, there is less confidence in being able to master the newly escalated threat environment. The editors of the Lancet say getting back to normal will be far from easy:

“Yes. Yes. Yes.” That was the response of John Bell, Regius Professor of Medicine at the University of Oxford, when asked whether we could be confident that life will be returning to normal by spring. He was being interviewed by the BBC shortly after the announcement last week by Pfizer and BioNTech that their COVID-19 vaccine candidate had 90% efficacy in clinical trials. Similar announcements about the Russian Sputnik V and Moderna vaccines followed soon after.  … But although it is right to be hopeful and encouraged, we are far from ending COVID-19 as a public health issue. …

…questions will not be answerable for some time. For one, the duration of protection is unknown and will have a huge bearing on the practicalities and logistics of immunization (will boosters be needed? How often?). …

Pfizer and Moderna together project that there will be enough vaccine for 35 million individuals in 2020, and perhaps up to 1 billion in 2021. As a result, many millions of people at high risk of disease will not be immunized any time soon …

Vaccine hesitancy is also a clear threat to COVID-19 control. New data show that willingness to take a COVID-19 vaccine is far from universal. When even wearing a face mask can be painted as a political act rather than a public health measure, responsible leadership and careful public communications will be essential.

These concerns will be irrelevant in places where a vaccine is unavailable entirely. Leaving aside the huge logistical challenges of manufacturing and roll-out (including onerous cold-chain requirements for some candidates), vaccine nationalism remains a major threat to equitable access. COVAX, the GAVI-led financing mechanism to provide COVID vaccines to low-income and middle-income countries, has raised US$2 billion, but needs $5 billion more for 2021. Pfizer and Moderna have not yet reached agreements with COVAX to supply vaccines …

For the first time in decades, science has gone from continuous advance to a sudden defensive against a disease in which the most likely outcome is a years-long stalemate. Even that fragile stalemate can easily be destabilized by the outbreak of another disease, or perhaps famine, financial crisis, or war, as also happened in the 14th century. The Design Margin which so long seemed adequate against all contingencies has evaporated in a single year.

This suggests that the search for the Lost World faces deeper challenges than the mere recalcitrance of a handful of Deplorables. The top-down model of progress, which held sway for over a hundred years, may be running into trouble from complexity itself.

But perhaps disruption is the road to the future. Although the Black Death brought much destruction, it is often forgotten that the roots of much that was good lay in it. As the BBC notes, the collapse of the old order ended serfdom, ushered in “the age of yeomen,” reformed religion, established the principle of no taxation without representation, and much besides.

Those who are determined to recreate the world of 2016 may find they have neither the money nor capital to do it. The next few years will pose challenges of their own to which politics must adapt or face irrelevance. There’s a new world out there but it’s not the old lost one.

Books: The Price of Panic: How the Tyranny of Experts Turned a Pandemic into a Catastrophe by Jay Richards. The human cost of the emergency response to COVID-19 has far outweighed the benefits. That’s the sobering verdict of a trio of scholars—a biologist, a statistician, and a philosopher.

Follow Wretchard on Twitter or visit Wretchard.com