In the week since we published our overview of the healthcare industry’s counter attack on Covid-19, the situation has escalated rapidly. Death and infection rates across the world have soared, global governments have changed their guidance for dealing with the crisis, and western health systems are braced for a deluge of patients.
In fact, it may not feel as though the pharmaceutical industry is mounting a fightback at all given the painful acceleration of the total number of cases worldwide. In the 10 days leading up to 23 March, more than 233,000 new cases of Covid-19 were reported globally, compared with 145,000 cases in the previous 72 days – that is an immensely sharp increase in the curve that global governments are desperately trying to flatten.
Italy is evidence of why we need to halt the spread. The country has now reported more than 6,000 deaths – almost double the number in China. Spain, too, is spiralling out of control as its healthcare system becomes overwhelmed by patients. The UK – estimated to be just two weeks behind Italy in the spread of Covid-19 – could be heading that way if Brits don’t heed the government’s warning to stay indoors wherever possible.
Coronavirus is still far more significant for the old and vulnerable than it is for the young and strong, but there have been cases of patients being hospitalised with age on their side and without any underlying health conditions. More significant a problem is those young and strong patients who are contracting the illness, not showing any symptoms and passing the virus on to those who can’t shake it off. Preventing the spread by social distancing and self-isolating as much as possible is the right thing to do to overcome this.
But the policy of taking shelter at home to wait out the storm is only a temporary one. We can’t remain inside forever – the economic implications alone are huge. And even if we do manage to calm the spread, the virus will return once we venture outside again. The UK – like everywhere else – needs an exit strategy.
Eradicating Covid for good
There are currently three possible long-term solutions for curbing the Covid crisis. The first involves a permanent change in behaviour, which could mean repeated bouts of government-mandated isolation – not especially appealing – and a continuing need for decontamination, good for the likes of long-standing IC Tip Tristel (TSTL), which this week signed an important product development deal (see page 46). Countries such as Taiwan and Singapore, which appeared to have beaten the coronavirus, are now seeing a second wave of infection as feared, and reimplementing control measures.
The second solution is far more attractive, but requires a long wait: vaccination. If we can vaccinate around 60 per cent of the population we will build up herd immunity – without enough unvaccinated people to infect, the virus will struggle to spread.
On 18 March, Chinese group CanSino (HKG:6185) became the second biopharma company to begin studying its vaccine in a human population. Both CanSino and Moderna (US:MRNA) – which began its own study in the first week of March – are testing their vaccines in a group of healthy volunteers over the course of a month, which means early results will begin to emerge in April. But the wait for a vaccine will be a long one. Even if early-stage results are positive, it will take a year of safety and efficacy testing before either CanSino or Moderna’s vaccines can be launched.
The final exit strategy involves building up a herd immunity without the use of a vaccine. That means allowing enough people to contract the disease so that natural immunity is achieved in large populations. Humans have a natural immunity to seasonal flu – an illness that kills an average of 17,000 Brits a year, but less than 0.1 per cent of those affected.
Diagnostics is key
But natural herd immunity is a big call to make when the current death rate from confirmed cases is over 4 per cent. Disease modelling from a team at Imperial College London – which has helped dictate the government’s current lockdown policy – published earlier in March suggested that more than half a million Brits could die from the disease if infection rates kept accelerating.
But more recently, a different scientific team from the University of Oxford has produced research suggesting that the coronavirus could have infected far more people in the UK than previously believed – potentially as much as half the population. If the University’s modelling is correct (and for now there is no confirmed evidence that is the case), the mortality rate is far lower than expected, perhaps even as low as the seasonal flu. The modelling also suggests that far more of us might already be immune to Covid-19, having already contracted the virus unknowingly. But for now, this study – like all the others – is only a theory.
But to fully understand the disease and confirm the modelling from Oxford University, we need wide-scale testing. Including an antibody test that can detect whether someone has already had Covid-19, recovered from it and built an immunity.
In this arena, progress might be happening faster than many had expected. On 25 March, Professor Sharon Peacock, director of the National Infection Service for Public Health England confirmed that an antibody testing kit could be ready for general use within days “not weeks or months”, as previously believed. This might mean people will be able to order a kit from Amazon and test themselves for Covid-19 antibodies before the end of the week. The UK government has already ordered 3.5m of the testing kits ready for roll-out in pharmacies.
Widescale testing could help confirm whether the modelling by the University of Oxford is correct. If it is, the concept of natural herd immunity might become more realistic again.
