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Understanding Vaccine Science: A Primer
By Shlomo Maital
Here is my effort to understand where we stand, with regard to a COVID-19 vaccine.
There are several different types of vaccines, each with its own strategy.
- Live attenuated vaccines. These use the virus itself, weaken it, and inject it; the body’s immune system is alerted and springs into action, developing antibodies that can defeat the virus if and when it invades the human body. This is how vaccines against measles and mumps work. Measles vaccine has existed since 1950 and still is effective; measles has not mutated to defeat it.
- Inactivated vaccines. These use ‘dead’ viruses. Even though ‘dead’ the presence of the virus in the body activates the immune system. Vaccines based on this approach are effective against hepatitis and polio. Polio vaccine has been effective since the early 1950’s.
- Subunit vaccines. These vaccines use specific pieces of the virus, key pieces, to activate immunity and neutralize the virus if and when it invades the human body. Examples: vaccines against whooping cough and shingles.
- Toxoid vaccines. These use toxins produced by the germs, to trigger the immunity of the body that attacks the harmful toxins. E.g. vaccines against diphtheria and tetatnus.
- DNA/ RNA vaccines. These are the newest types of vaccine.
At Emory University, in Atlanta Georgia, for example, a new type of mRNA vaccine against COVID-19 is now being tested in humans (an Emory medical student). Here is how it works: “messenger RNA” is the protein made by the virus, found on those spikes you see in cartoon illustrations, these spikes poke through the cell walls to invade the cell and use its DNA to reproduce. mRNA vaccines teach the body to produce, identify and attack those key proteins, neutralize them and hence prevent the virus from poking through cell walls.
All over the world, desperate races are underway to develop a COVID-19 vaccine. All these different approaches are being used. Many labs are trying to use existing vaccines against related illnesses and adapt them.
A major problem: There has not yet been a vaccine effective against coronavirus (e.g. the common cold, which is a variant of corona). And the DNA/RNA approach is relatively new and untried.
With so many bright hard-working scientists at work day and night, there will be a breakthrough. And I believe it will come sooner rather than later. One of the key sparkplugs of creativity is desperation, and the world today is desperate for a vaccine. Add to that the profit motive – many billions of doses will be needed.
University Labs – to the Rescue! Paul Romer’s Plan
By Shlomo Maital
Nobel Laureate Paul Romer, NYU
I am collecting material on “emergence strategies” – how nations will release citizens from lockdown and isolation, and my sense of doom is growing. In the 1918 influenza pandemic, the second wave killed far far more people than the first, after the first wave subsided and everyone went back to business as usual.
Muddying the picture further are politicians, who pander to the ignorant and think doing so will get them re-elected. If they are, they will mount the victory podium by stepping on the bodies of hapless victims – a lot of them.
This is why I believe we should all listen carefully to Nobel Laureate in Economics Paul Romer, NYU, and his plan. (See “Roadmap to Responsibly Reopen America” available at https://roadmap.paulromer.net). ) The bottom line: Employ university labs to produce COVID-19 tests, at scale — millions of them. It IS do-able!
Romer writes, in the introduction to his Roadmap: “America is confronting two crises: an economic crisis laying waste to our livelihoods and a health crisis threatening our lives. The twin crises are deeply intertwined: our economy cannot be re-opened without credibly addressing fears of infection and resurgence. The immediate reaction, a national lockdown, was successful in slowing the virus. We must now shift to a plan that balances the need to protect our health and reopen our economy by locking down only those who are infectious. This paper presents a simple, scalable, and credible solution: introduce a comprehensive “test and isolate” policy, making it safe for Americans to return to work and keeping the infection rate below 5% of the population. Until a vaccine is developed and deployed, the simplest and safest path to this outcome is a national testing strategy that marshals our existing resources to test everyone in the U.S. once every two weeks and isolates all those who test positive. It does not rely on any new technologies, is far less disruptive and costly than our current policy, and will work even in a worst-case scenario. Below is a roadmap to a future in which the American people are confident that their health and our economy’s future are protected against this virus.”
Here are the main elements of his plan: 1. Expand the pool of testing capacity, mainly by establishing a network of university labs, which DO have the capacity to scale up and test effectively; 2. Find a revenue stream that can be used to find those who are spreading the disease; 3. Starting testing essential workers (e.g. healthcare), and expand to, e.g. grocery clerks; 4. Expand to those who need urgently to return to work. 5. Finally, offer tests to everyone…EVERYone!
The plan calls for testing every person in the U.S., with essential workers taking priority. Anyone who tested positive would be isolated. Tests would be administered “regularly,” with every two weeks the recommendation. That would mean 25 million tests per day.
In order to get testing to those levels, Romer advocates for removing regulatory barriers and establishing a network of university and national labs. It would also require substantial funding – about $100 billion altogether, including the costs of infrastructure and training. Those funds would be issued in block grants to the states. $100 b. is a lot – but a drop in the bucket, compared to the trillions the US is spending now on emergency bailouts.
Romer notes there are hidden costs in NOT testing widely. Under lockdown, Romer says,”the U.S. economy loses $500 billion per month. Lifting the lockdown without mass testing to ease that fear may only reduce losses by about $100 billion.”
The US has many Nobel Laureates in Economics. Why not bring them to Washington, put their heads together, and work out a well-considered strategic long-range plan for emergence? Including Romer’s? The economists now serving in the Trump administration are either Wall St. rapacious capitalists (Mnuchin) or low-level cranks (Kudlow). This does not bode well for the US.
In the Eye of the Corona Storm: A Drug That Works
By Shlomo Maital
Yaky Yanay
My good friend Dr. G. N. Rao, founder of the L V Prasad Eye Institute in Hyderabad, India, drew my attention to this: A coronavirus drug that works.
According to Maayan Jaffe-Hoffman, writing in the Jerusalem Post:
“Israeli-based Pluristem has treated its first American patient suffering from COVID-19 complications under the country’s compassionate use program.
The news comes days after a report by the company showed that six critically ill coronavirus patients in Israel who are considered high-risk for mortality were treated with Pluristem’s placenta-based cell-therapy product and survived, according to preliminary data provided by the Haifa-based company.
Let me provide some background.
Researchers report: “When it comes to COVID-19, recent research has suggested about 20% of people get the severe form of the disease. Many in this group become critically ill because of their advanced age or underlying health conditions. But those who were previously healthy and are in their 30s, 40s, 50s are very likely experiencing a cytokine storm.”
A small but significant fraction of COVID-19 patients, mainly younger ones, die not from the ravages of the virus on their lungs, but because their body over-reacts, as their immune system kicks in violently and creates this “cytokine storm”. It turns out that an overly strong immune reaction is just as bad, or worse, than a weak reaction.
How does Pluristem’s drug work? Here is how CEO Yaky Yanay explains it:
“Patients who are in severe condition and dying are actually dying from a severe respiratory condition. What is actually happening is there is a very high level of inflammation and at a certain point the immune system of the patient will attack [the patient], mostly in the lungs. Until now, Pluristem’s technology has been largely used to treat people suffering from poor blood flow to the legs, but the company’s scientists were able to quickly repurpose the cells to treat coronavirus patients. “We take cells from the placenta after full-term delivery and we have developed technology to expand the cells to very large numbers, in an environment that mimics the human body,” Yanay said. “The technology allows us to treat more than 20,000 people from a single placenta.”
His team “programs” the cells, which then have a wide range of proteins they can secrete. The cells don’t just deliver the proteins but also “adjust the level of secretion based on signals they receive from the body.”
The US FDA allows using the drug on compassionate grounds for very seriously ill patients. But for widespread use, full-scale three-phase clinical trials are necessary, and are already well underway.
How Israel Is Handling the Nursing Home Crisis
By Shlomo Maital
In the novel coronavirus pandemic, nursing homes have been a disaster, with many tragedies. This is just one terrible example, in New Jersey:
“29 Dead at One Nursing Home From the Virus. Or More. No One Will Say.] By Monday, the police in a small New Jersey town had gotten an anonymous tip about a body being stored in a shed outside one of the state’s largest nursing homes. When the police arrived, the corpse had been removed from the shed, but they discovered 17 bodies piled inside the nursing home in a small morgue intended to hold no more than four people. “They were just overwhelmed by the amount of people who were expiring,” said Eric C. Danielson, the police chief in Andover, a small township in Sussex County, the state’s northernmost county.
In Israel, too there have been nursing home tragedies. Family are banned from visits; and caregivers bring in the virus and the elderly are afflicted.
After several such scandals, Israel has taken action. A former Director-General of the Ministry of Health, Dr. Ronnie Gamzu, now head of a large Israeli hospital, was asked by the Ministry of Health to shape a comprehensive plan for protecting Israel’s nursing home residents. His 100 page document is revealing.
It calls for 600 Home Front soldiers to monitor entry to the homes. Notice that a former Health Ministry senior official does not trust the Ministry itself to handle the problem, but instead appeals to the Army. And those 600 can be increased to 1,000, if needed. Many in Israel believe that the overall management of the pandemic should have been placed in the hands of an interdisciplinary team led and run by the Israel Defense Forces.
Nursing homes are vulnerable. The elderly in them need caregivers. And the caregivers need the work, because they are poorly paid. So, you cannot quarantine or exclude the caregivers, despite the risk. Testing every single one is a possible answer, but you would need to do this very often – Caregiver A could be ‘clean’ today, but infected tomorrow.
Better late than never? Hard to say that, when it comes to the elderly, many of whom survived the Holocaust. Let us protect and care for them properly, and not make excuses.
Doctors Share, Globally: So Should We!
By Shlomo Maital
Doctors all over the world are using social media to rapidly share information about the coronavirus. And this is saving lives. Here is an example.
An emergency room doctor at Lincoln Hospital, in the Bronx, New York City, reports on the BBC that some distressed COVID-19 patients are NOT being intubated, with ventilators. And the results are good. Why? What is going on?
An Italian doctor published, on social media, the following insight: There are two types of coronavirus patients: L type and H type. L type have poor oxygenation, 60-70% oxygenation of their blood, or even 50% (normal is 95%). But they show no distress, are hungry and have good clinical presentations. Hmm. The H types have similar lack of oxygen, struggle to breathe – and they definitely need intubation.
Intubating L type patients can be harmful, and actually make them worse. Besides, with ventilators very scarce, misusing them can actually cost lives, by depriving those who need them. The Lincoln Hospital doctor read this and acted on it, with success. Well done!
There is a desperate need to learn more about the novel coronavirus, and because this is a pandemic, it is vital to share knowledge rapidly, efficiently, candidly and truthfully, among countries. And doctors are doing this. They are sharing insights on-line and other doctors, despite long desperate work days, are tracking this literature and learning and applying what they learn. As they are in Lincoln Hospital, Bronx.
We can all learn from this. Why just doctors? We all can share ideas, creative solutions, and information. There is a catch. There are evil people out there, spreading rumors, fake news, conspiracy theories…and muddying the water, fogging the insights. And there are miscreants who are inserting pornography into Zoom conferences, some of them important.
Twitter has been effective in preventing and punishing fake news. You get a warning, then removal, and have to meet conditions to get back on. Facebook has been delinquent and unwilling, for the most part. With social media playing a crucial role today, we cannot afford to have them act as delinquents, like Facebook. If needed, regulators should step up and put their feet to the fire.
Closing in on a Vaccine: The Not-so-simple Mechanics
By Shlomo Maital
Tel Aviv University Professor Jonathan Gershoni claims his lab is “two-thirds of the way” to creating a COVID-19 vaccine, according to a report in today’s Jerusalem Post, by Tamar Beeri.
Gershoni, who holds USPTO vaccine patents, is very good at explaining how his vaccine will work. Probably other vaccines against COVID-19 will adopt similar strategies. So, here is his not-so-simple explanation, according to Beeri:
“[Gershoni] explained that the vaccine intends to target the virus’s Receptor Binding Motif (RBM), a critical weak point which allows the virus to attach itself and infect a target cell. The RBM is a small feature of the virus’s “spike” protein, meaning that the virus uses many different proteins to replicate and invade cells, but the “spike” protein is the “major surface protein that it uses to bind to a receptor – another protein that acts like a doorway into a human cell.” [Those spikes you see on cartoon drawings of the novel coronavirus are how it pokes into a human cell and uses the cell’s DNA to replicate itself].
“Once this protein binds to the cell receptor of a human cell, the viral membrane fuses with that of the human cell, which allows the genome, or genetic blueprint of the virus to enter human cells and begin infection. “The idea is to recreate, to reconstitute, to construct an RBM [receptor binding motif] of COVID-19 virus and use it as the vaccine,” he told the Post. “That is to say, you would inject a small 50 amino-acid sequence and it would allow our immune system to focus on it and create antibodies that would directly target the virus at its weak spot.”
“Due to the size of the RBM, which is a highly complex three-dimensional structure and only 50 amino acids long, it will be very challenging for it to be functionally reconstituted. It would, however, be extremely effective as a basis for a possible vaccine.
“The smaller the target and the focus of the attack, the greater the effectiveness of the vaccine,” Gershoni said. “The virus takes far reaching measures to hide its RBM from the human immune system, but the best way to ‘win the war’ is to develop a vaccine that specifically targets the virus’s RBM.”
“Gershoni originally developed the design of the vaccine which targets the RBM in response to SARS CoV, which broke out in 2004, and later for MERS CoV. “What we found was that we were able to reconstitute, to create a functional Receptor Binding Motif, and that’s when we filed for patent in 2015,” he explained to the Jerusalem Post.
“We are now currently working on implementing the design of the vaccine that we were able to construct for SARS and MERS and to apply it to the current virus, the SARS coronavirus 2,” he continued. “This is a multi-step process. We’ve completed, I would say, about two-thirds of the way.”
Best-Practice Virus Management: Look to Germany
By Shlomo Maital
Angela Merkel
Sometimes, something happens and – we know exactly why we were put on this earth. Take Angela Merkel. Americans would call her a ‘lame duck’ chancellor, as she has indicated she will not run for re-election as head of her party, and a successor was already chosen (and then, resigned, and a new successor emerged). But meanwhile, she is still Chancellor, leading Germany at a critical time – and guess what – she gets it. [She obtained a doctorate in quantum chemistry in 1986 and worked as a research scientist until 1989]. Listening to an ignorant, spiteful, uneducated draft-dodging American President who does NOT get, focused solely on his rapidly-decreasing chances for re-election, it is very painful, after hearing Merkel.
In part because of Merkel’s leadership, and in part because Germany is a very well-run organized country strong in science and technology, Germany today is best-practice in emerging from the coronavirus lockdown. New York Times’ Berlin bureau chief Katrin Bennhold explains why:
“….3,000 households [were] chosen at random in Munich for an ambitious study whose central aim is to understand how many people — even those with no symptoms — have already had the virus, a key variable to make decisions about public life in a pandemic. The study is part of an aggressive approach to combat the virus in a comprehensive way that has made Germany a leader among Western nations figuring out how to control the contagion while returning to something resembling normal life.”
Bennhold continues: “Other nations, including the United States, are still struggling to test for infections. But Germany is doing that and more. It is aiming to sample the entire population for antibodies in coming months, hoping to gain valuable insight into how deeply the virus has penetrated the society at large, how deadly it really is, and whether immunity might be developing The government hopes to use the findings to unravel a riddle that will allow Germany to move securely into the next phase of the pandemic: Which of the far-reaching social and economic restrictions that have slowed the virus are most effective and which can be safely. The same questions are being asked around the world. Other countries like Iceland and South Korea have tested broadly for infections, or combined testing with digital tracking to undercut the spread of the virus.
“Germany, which produces most of its own high-quality test kits, is already testing on a greater scale than most — 120,000 a day and growing in a nation of 83 million. Chancellor Angela Merkel, a trained scientist, said this week that the aim was nothing less than tracing “every infection chain.” That high level of testing has helped her country slow the spread of the virus and keep the number of deaths relatively low. More people in Germany now recover from the virus every day than are infected by it. Every 10 people infected with the virus now pass it to seven others — a sharp decline in the infection rate for a virus that has spread exponentially.”
“Nationally, the Robert Koch Institute, the government’s central scientific institution in the field of biomedicine, is testing 5,000 samples from blood banks across the country every two weeks and 2,000 people in four hot spots who are farther along in the cycle of the disease. Its most ambitious project, aiming to test a nationwide random sample of 15,000 people across the country, is scheduled to begin next month.”
“In the free world, Germany is the first country looking into the future,” said Prof. Michael Hoelscher, who heads up the Munich study, noting that a number of countries had already asked him for the protocol to be able to replicate it. “We are leading the thinking of what to do next.” Mr. Hoelscher was co-author of what has become a widely influential research paper about how the virus can be transmitted before someone develops symptoms. “There’s no doubt after reading this paper that asymptomatic transmission is occurring,” Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases in the United States, told CNN on Feb. 1, three days after the paper was published. “This study lays the question to rest. Asymptomatic transmission is what has made containment so difficult because a large number of infections are not detected.”
The Race to a COVID-19 Vaccine: Q&A
By Shlomo Maital
Where do we stand in the quest for a safe effective COVID-19 vaccine?
More than 2.2 million persons worldwide have contracted the virus and of those, 154,783 have died. That is a 6.8% death rate. But wait – there are far far more cases worldwide than those we know about. Deaths are certain; cases are a guess. If we use a 1% to 1.5% death rate, we can guess that between 10 million and 15 million persons worldwide have contracted the illness. Only an effective vaccine will put a clear end to this crisis, in which COVID-19 is already the #1 cause of death in the US.
This Q&A is based on an informative survey published in a reputable website, livescience.com, by staff writer By Nicoletta Lanese, two days ago: (Warning: this blog is long, 1895 words…sorry).
* https://www.livescience.com/coronavirus-covid-19-vaccine-timeline.html
When will a vaccine be ready?
“Here’s why it probably can’t be developed any sooner than 12 to 18 months.
“More than 60 candidate vaccines are now in development, worldwide, and several have entered early clinical trials in human volunteers, according to the Some groups aim to provoke an immune response in vaccinated people by introducing a weakened or dead SARS-CoV-2 virus, or pieces of the virus, into their bodies. The vaccines for measles, influenza, hepatitis B and the vaccinia virus, which causes smallpox, use these approaches, according to the U.S. Department of Health & Human Services. Although tried-and-tested, using this approach to develop these conventional vaccines was labor-intensive, requiring scientists to isolate, culture and modify live viruses in the lab.
That initial process of just creating a vaccine can take 3 to 6 months, “if you have a good animal model to test your product,” Raul Andino-Pavlovsky, a professor in the Department of Microbiology and Immunology at the University of California, San Francisco, told Live Science. “
Are there short cuts? How fast is the US working on a vaccine?
“The first COVID-19 vaccine to enter clinical trials in the United States, for example, uses a genetic molecule called mRNA as its base. Scientists generate the mRNA in the lab and, rather than directly injecting SARS-CoV-2 into patients, instead introduce this mRNA. By design, the vaccine should prompt human cells to build proteins found on the virus’ surface and thus trigger a protective immune response against the coronavirus. Other groups aim to use related genetic material, including RNA and DNA, to build similar vaccines that would interfere with an earlier step in the protein construction process. But there’s one big hurdle for mRNA vaccines. We can’t be sure they will work. As of yet, no vaccine built from a germs’ genetic material has ever earned approval, Bert Jacobs, a professor of virology at Arizona State University and member of the ASU Biodesign Institute’s Center for Immunotherapy, Vaccines and Virotherapy, told Live Science. Despite the technology having existed for almost 30 years, RNA and DNA vaccines have not yet matched the protective power of existing vaccines, National Geographic reported.
In this high-stakes competition, is there also collaboration?
“Assuming these unconventional COVID-19 vaccines pass initial safety tests, “will there be efficacy?” Jacobs said. “The animal models suggest it, but we’ll have to wait and see.” “Because of the emergency here, people are going to try many different solutions in parallel,” Andino-Pavlovsky said. The key to trialing many vaccine candidates at once will be to share data openly between research groups, in order to identify promising products as soon as possible, he said.
Could a COVID-19 vaccine be potentially dangerous and do damage?
For sure.
“Designing a vaccine that grants immunity and causes minimal side effects is no simple task. A coronavirus vaccine, in particular, poses its own unique challenges. Although scientists did create candidate vaccines for the coronaviruses SARS-CoV and MERS-CoV, these did not exit clinical trials or enter public use, partly because of lack of resources, Live Science previously reported. “One of the things you have to be careful of when you’re dealing with a coronavirus is the possibility of enhancement,” Fauci said in an interview with the journal JAMA on April 8. Some vaccines cause a dangerous phenomenon known as antibody dependent enhancement (AED), which paradoxically leaves the body more vulnerable to severe illness after inoculation. Candidate vaccines for dengue virus, for example, have generated low levels of antibodies that guide the virus to vulnerable cells, rather than destroying the pathogen on sight, Stat News reported. Coronavirus vaccines for animal diseases and the human illness SARS triggered similar effects in animals, so there’s some concern that a candidate vaccine for SARS-CoV-2 might do the same, according to an opinion piece published March 16 in the journal Nature. Scientists should watch for signs of AED in all upcoming COVID-19 vaccine trials, Fauci said. Determining whether enhancement is occurring could happen during initial animal studies, but “it is still unclear how we will look for AED,” Jacobs said.
Are there specific dangers in developing a COVID-19 vaccine?
A successful coronavirus vaccine will snuff the spread of SARS-CoV-2 by reducing the number of new people infected, Andino-Pavlovsky said. COVID-19 infections typically take hold in so-called mucosal tissues that line the upper respiratory tract, and to effectively prevent viral spread, “you need to have immunity at the site of infection, in the nose, in the upper respiratory tract,” he said. These initial hotspots of infection are easily permeated by infectious pathogens. A specialized fleet of immune cells, separate from those that patrol tissues throughout the body, are responsible for protecting these vulnerable tissues. The immune cells that protect mucosal tissue are generated by cells called lymphocytes that remain nearby, according to the textbook “Immunobiology: The Immune System in Health and Disease” (Garland Science, 2001).
“It’s like your local police department,” Andino-Pavlovsky told Live Science. But not all vaccines prompt a strong response from the mucosal immune system, he said. The seasonal influenza vaccine, for example, does not reliably trigger a mucosal immune response in all patients, which partly explains why some people still catch the respiratory disease after being vaccinated, he said.
“Even if a COVID-19 vaccine can jumpstart the necessary immune response, researchers aren’t sure how long that immunity might last, Jacobs added. While research suggests that the coronavirus doesn’t mutate quickly, “we have seasonal coronaviruses that come, year in [and] year out, and they don’t change much year to year,” he said. Despite hardly changing form, the four coronaviruses that cause the common cold keep infecting people — so why haven’t we built up immunity?
Could the COVID-19 virus pose special problems?
“Perhaps, there’s something odd about the virus itself, specifically in its antigens, viral proteins that can be recognized by the immune system, and that causes immunity to wear off. Alternatively, coronaviruses may somehow fiddle with the immune system itself, and that could explain the drop-off in immunity over time, Andino-Pavlovsky said. To ensure a vaccine can grant long-term immunity against SARS-CoV-2, scientists will have to address these questions. In the short term, they’ll have to design experiments to challenge the immune system after vaccination and test its resilience through time, Jacobs said. In a mouse model, such studies could take “at least a couple of months,” he said. Scientists cannot conduct an equivalent experiment in humans, but can instead compare natural infection rates in vaccinated people to those of unvaccinated people in a long-term study. “When you have the luxury, you look at this for five years, 10 years to see what happens,” Andino-Pavlovsky added.
How will they ensure that a COVID-19 vaccine is safe?
“Unlike an antiviral treatment for COVID-19 that can be given to patients already infected with the virus, a vaccine must be tested in diverse populations of healthy people. “Because you give it to healthy people, there’s an enormous pressure to make sure it’s absolutely safe,” Andino-Pavlovsky said. What’s more, the vaccine must work well for people of many ages, including the elderly, whose weakened immune systems place them at heightened risk of serious COVID-19 infection. “Initially, safety studies will be done in small numbers of people,” likely fewer than 100, Jacobs said. A vaccine may be approved based on these small studies, which can take place over a few months, and then continually monitored as larger populations become vaccinated, he added. “That’s just my guess.”
[Note: The high and growing death toll from COVID-19 may justify some speed-up and short-cuts].
So what are the various stages that a vaccine must undergo, before it can be mass produced?
“Any potential vaccine will need to pass a safety trial, known as a Phase 1 trial, which also helps determine the needed dose. The next step is a larger trial in 100 to 300 people, called a Phase 2, which looks for some biological activity, but can’t say for sure if the drug is effective. If a vaccine candidate prompts a promising immune response in Phase 2 clinical trials, after passing safety tests in Phase 1, it’s possible that the FDA could approve such a vaccine for emergency use “before the 18-month period that I said,” Fauci said in the JAMA interview. “If you get neutralizing antibodies,” which latch onto specific structures on the virus and neutralize it, “I think you can keep moving forward on it,” Jacobs said. Normally, a vaccine would then enter Phase 3 clinical trials, which include hundreds to thousands of people.
“So adding up these steps, each of which will likely take 3 to 6 months, it’s very unlikely we would be able to find a vaccine that is safe and effective in less than 12 months — even if many of these steps could be done in parallel.
Can it be mass-produced? How?
“Then comes the issue of manufacturing billions and billions of doses of a new vaccine whose ingredients we don’t yet know. Bill Gates has said that the Gates Foundation will fund the construction of factories for seven coronavirus vaccine candidates, equipping the sites to produce a wide variety of vaccine types, Business Insider reported.
[Neanderthal Conservative groups have attacked Gates, making false and inflammatory claims about him].
“Even though we’ll end up picking at most two of them, we’re going to fund factories for all seven, just so that we don’t waste time in serially saying, ‘OK, which vaccine works?’ and then building the factory,” Gates said. Even if a fairly promising vaccine surfaces by 2021, and can be mass-produced, the search won’t end there. “Especially with trying to get something out this quickly, we may not get the best vaccine out there right away,” Jacobs said. Ideally, an initial vaccine will grant immunity for at least one to two years, but should that immunity wane, a longer lasting vaccine may have to be deployed. Historically, so-called live attenuated vaccines that contain a weakened virus tend to perform most reliably over extended periods of time, Andino-Pavlovsky said.
“That may be what we need in the long run,” he said. And research into coronavirus immunity should continue, regardless, “not only for COVID-19, but for the next coronavirus that comes.
Compassionate Capitalism: Filling in the Details
By Shlomo Maital
In an earlier blog, I proposed that businesses adopt a new formula for free-enterprise capitalism: Price at cost. I called this “compassionate capitalism”, suitable for this new era of unprecedented unemployment, hardship and economic collapse. The goal: Preserve jobs, keep businesses alive, but help the people stretch their diminishing incomes.
My close friend in Vietnam, Tran Luong Son, reports that the idea is resonating in his country, but there remain many practical questions. Let me try to answer some of them. In general, I propose to launch a voluntary group of visionary business leaders, willing to embrace C c (the capital C is for compassion, the small ‘c’ is for capitalism), and to commit to a small number of Cc principles.
Can you outline a clear simple methodology for applying Cc?
- Open an Excel sheet for each of your products and services.
- Begin with variable costs (costs of production and distribution). Wages: lower than pre-plague but reflecting the needs and productivity of workers; senior management take proportionately bigger cuts. Materials: Take into account second sourcing – businesses that used a single source are, in many cases, in trouble.
- Cost of capital: This is an opportunity cost. The risk-adjusted return on capital has declined, but is recovering. Use again the principle of fairness: Owners of capital need a return on their money, but not as high as pre-plague. They too must take cuts, as do wage-earners.
- Fixed costs: Governments are part of this. They need to contribute as well, by reducing income and profit taxes and property taxes. Many governments have job-preservation schemes, to replace unemployment insurance with partial wage subsidies.
- Prioritize: Apply the McCabe principle. Tom McCabe was the legendary CEO of Scott Paper, making it a great global company. He had every senior manager put this plaque on the wall: Whom do we serve? 1. Customers 2. Our community 3. Our country 4. Our employees. 5. Our shareholders. Shareholders last???? McCabe had a simple answer. Of course. If you serve the other four well, you will best serve your shareholders, in the long run. This applies more than ever now. In Cc compassionate capitalism, serve your customers, your community and your country, and your employees. They come first. This is what capitalism should look like, if we are to sustain it.
- Use the “value sharing” principle. When I taught this to MBA students, there was blood on the floor. They were taught to profit maximize. This is more than obsolete, it is immoral in today’s plague-ridden world.
a) Estimate the value your product or service creates, by the average amount your clients would be willing to pay for it, if you ‘squeezed’ them at the maximum. ($). b) estimate the cost of providing the product or service, taking into account maximum productivity and hidden costs (opportunity cost of capital – see above). c) set the price as close as you can to cost, while sustaining the business and its jobs. To maximize client margin (the net value your clients get from your product). These days, ‘value’ is way down, for most products and services, because our income and disposable income are way down. If you still manage to generate ‘client margin’ (net value for clients), you will have loyal customers for three generations or for a century. We customers will not forget who served us (McCabe principle) and who ripped us off.
Capitalism can no longer afford to maximize ‘company margin’. The game today is to maximize ‘client margin’.
Does the Novel Coronavirus Mutate?
By Shlomo Maital
Writing in today’s New York Times, Nathaniel Lash and Tala Schlossberg try to answer the key question, does the novel coronavirus mutate? If so, how and when?
Here is why it is important for us to know this. The pandemic crisis will end only when we have a vaccine, produced in billions of doses. The vaccine will work by stimulating the body to produce antibodies that neutralize the virus by binding to it in a very specific way. If the virus can mutate to defeat the vaccine, then the vaccine will not stop working. The key is the “spike protein” – the protein the virus makes that penetrates the cell walls and lets the virus invade (and kill) it. Those are the spikes you see in the graphic illustrations of corona. Vaccines can defeat the spike.
Here is what the authors of the article have found:
“Among the thousands of samples of the long strand of RNA that makes up the coronavirus, 11 mutations have become fairly common. But as far as we know, it’s the same virus infecting people all over the world, meaning that only one “strain” of the virus exists, said Peter Thielen, a molecular biologist with the Johns Hopkins Applied Physics Laboratory. Only one of those common mutations affects the “spike protein,” which enables the virus to infect cells in the throat and lungs. Efforts to produce antibodies that block the spike protein are central to many efforts to develop a vaccine. Since the spike protein has changed little so far, some scientists believe that’s a sign that it can’t alter itself very much and remain infectious.”
So – we have a small piece of good news. The measles vaccine, for instance, was developed in 1950. And it is still effective. Measles hasn’t mutated in a manner that neutralizes the vaccine. Evolution is powerful – but apparently it cannot surmount EVERY obstacle. So hopefully the same will apply to the COVID-19 vaccine – and we will bid this insidious deadly enemy good-bye, with an effective vaccine… until the next one.
TIMnovate 