The Future of COVID-19
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  • For this research, we focused on identifying scientific facts and statistics regarding the timeline for COVID-19. None of the scientific literature predicted the end of COVID in Australia. However, the predictive models for achieving herd immunity in the UK and USA have been quoted in this research; which can also be implied for Australia if confounders can be adjusted accordingly.
  • Our approach for this research was based on quoting facts and statistics from scientific literature rather than media sources for ensuring high-level credibility of the data. Our research indicated that the decision to produce vaccines, or invest/fund vaccine manufacturing plants depends on factors outlined below and superficially addressed in this research document.
    • (i) the time to achieve herd immunity through vaccination,
    • (ii) the duration of immunity,
    • (iii) how many people will need to be vaccinated to achieve herd immunity,
    • (iv) whether vaccination will be required annually,
    • (v) whether the current vaccine will be effective against new and emerging strains of corona viruses,
    • (vi) vaccine effectiveness data on the vulnerable population including children and pregnant females,
    • (vii) number and frequency of vaccine doses required to achieve total protection.
  • We conducted a high-level overview and addressed key factors that might help the government understand the need to invest in a new mRNA vaccine manufacturing plant. We would, however, recommend that scientific opinion and data on each of the aforementioned factors should be addressed in future research.
  • For future research, we would recommend:
    • (I) A cost-benefit analysis for achieving herd immunity by vaccine administration in Australia within one-year, as opposed to the conventional approach.
    • (II) Additionally, there is a huge and growing market for vaccine export to neighboring countries in the Asia-Pacific region, which might be a fruitful investment, this merits separate research to investigate potential markets and potential profits from the overseas sales of the vaccines.
    • (III) Research on the single-dose vaccine by J&J, which might be convenient, and at the same time cost-effective in mass country-wide vaccination in Australia.

Table of Contents

 Mckinsey’s Research on Vaccine Rollout, Herd Immunity, & Pandemic predictions:

  • According to Mckinsey’s Research (published on 20th January 2021) on the efficiency and the impact of vaccine rollout in the USA, has been outlined below. This research covers various factors and possible challenges involved in achieving herd immunity.
  • The initial rollout of vaccines has been slower than hoped in many places; while many more-infectious strains of the COVID virus have been detected in South Africa, the United Kingdom, and have demonstrated spread across the globe with a number of countries reporting incident cases. The net impact of more-infectious strains means that a higher population needs to be vaccinated, which may take more time.
  • Herd Immunity: is achieved through a mass vaccination program. Herd immunity makes it possible to protect the population from disease, including those who can’t be vaccinated, such as newborns, pregnant females, or those with the compromised immune system.
  • More-infectious strains raise the bar for herd immunity: More-infectious strains of SARS-COV2 have raised concerns over its high transmission rate and associated morbidity and mortality.
    • The transmissibility rate of the UK strain is 40-80 percent-times higher than the original SARS-COV2 virus.
    • The growing concern amongst the scientific community is the possible inefficacy of the vaccine towards ongoing vaccination campaigns. The fear is that new strains may affect the binding capability between the antibody to the virus, which may reduce the efficacy of vaccine or antibody treatment developed over the past few months.
    • If new strains become dominant, this factor might cause a huge delay in reaching herd immunity. The new viral variant with higher transmissibility could impact in major two ways: (i) the proportion of people required to achieve herd immunity will increase by 10-20%; and (ii) the vaccine coverage levels needed to achieve herd immunity would require 65-80% of the total population; or 78-95% of the population over the age of 12 years and above.
  • Predictions for Herd Immunity: McKinsey has predicted that herd immunity in the UK and the USA, will be achieved most likely in the 3rd or the 4th quarter of 2021. However, the chances of delays until the 1st quarter of 2022 or beyond has increased.
  • Prediction of Herd Immunity in the USASource
  • The transition toward Normalcy: would be driven by a combination of factors including (i) the early vaccine dose administration, (ii) the decline in the number of cases, and (iii) the herd immunity. The herd immunity is strongly dependent upon vaccine effectiveness in reducing transmission of SARS-CoV-2, not just in protecting vaccinated individuals from getting sick.

Expert Opinions:

FOR:

  • According to Dr. Anthony Fauci (dated 9th December 2020), who is the Director of the U.S. National Institute of Allergy and Infectious Diseases, “If 75-80% of Americans are vaccinated in broad-based campaigns likely to start in the second quarter of next year, then the U.S. should reach the herd immunity threshold months later. However, if the vaccination levels are lower i.e., the vaccine is reaching out to 40 to 50% of Americans, it could take a very long time to reach that level of protection.”
  • According to a publication from The Lancet Journal (Anderson R. et. al., Nov 2020), that investigated how many vaccines will be required by any given country year-by-year, to create herd immunity, and to block the SARS-CoV-2 transmission. The article discusses challenges and statistics regarding achieving herd immunity through vaccination, the relevant pointers are mentioned below:
    • The vaccine delivery will scale-up gradually, as manufacturing capabilities develop over 12–24 months post-licensure of a COVID-19 vaccine. The impact of vaccination on the COVID transmission will start slowly and build up over a few years to reach target coverage levels.
    • The amount of vaccine required for a defined population will depend on (i) the evidence from phase 3 COVID-19 vaccine trials on efficacy, and (ii) the average duration of vaccine protection
    • Until the results from Phase-IV clinical trials on (i) the duration of protection against infection, and (ii) protection against severe COVID infection; it will be unclear about the average duration of vaccine protection or long-term immunity.
    • For a vaccine with 100% efficacy that gives life-long protection, the level of herd immunity as a proportion of the population, pc, required to block transmission is [1 – 1 / R0], where R0 is the basic reproduction number. Given an R0 value before lockdowns in most countries of between 2·5 to 3·5, we estimate the herd immunity required is about 60–72%. If the proportional vaccine efficacy, ε, is considered, the simple expression for pc becomes [1 – 1 / R0] / ε. If we assume ε is 0·8 (80%), then the herd immunity required becomes 75–90% for the defined range of R0 values. For lower efficacies, the entire population would have to be immunized. These overall estimates ignore heterogeneities that can make these figures lower or higher in specific locations.

AGAINST:

  • According to Dr. Roy Anderson’s scientific publication in the LANCET medical journal, “most vaccine efficacies to protect against COVID infection above 80% are desirable.”
    • However, the protection offered may remain uncertain, unless more follow-up data is generated for a couple of years post-licensure of COVID-19 vaccines. The preliminary evidence indicates waning antibody titers in patients recovered from SARS-CoV-2 infection.
    • Further, the data on immunity to other coronaviruses suggest that immunity to SARS-CoV-2 might be short-lived, perhaps 12–18 months in duration.
    • It is still unknown whether past COVID infection could prevent severe COVID-19 on re-exposure to SARS-CoV-2.
    • As of November 2020, there were 45 COVID-19 vaccine candidates under human clinical trials, of these nearly 10 are in phase 3 clinical trials and nearing completion. If more vaccine candidates demonstrate positive results, more manufacturing might be required to meet the growing global demand for vaccine administration.
  • According to some experts, Dr. Lisa Maragakis, M.D., M.P.H., Senior Director of Infection Prevention, and Dr. Gabor Kelen, M.D., Director of Johns Hopkins Office of Critical Event Preparedness and Response, address common questions and explain how a vaccine could affect the current pandemic climate.
    • Information is still lacking regarding whether long-term protection is achieved (i) from getting COVID-19 (natural immunity) or from post-vaccine administration (acquired immunity)
    • Results from Moderna and Pfizer demonstrated that the vaccine is nearly 95% effective, which means that about 1 out of 20 vaccinated individuals may not have the protection from getting the COVID illness.
    • It is also unknown if a vaccine administration might prevent an individual from carrying the virus and transmitting it to others.
    • Given that the data is lacking about the duration of antibody response, there is a clinical equipoise that the vaccine might be repeatedly administered each year. Hence, vaccine developers are currently working on ways to boost the effectiveness of the vaccine so that it provides long-term immune protection to the coronavirus.
    • There is still insufficient data on the timing, safety, effectiveness, and practical aspects of vaccinating children for the coronavirus, especially children under 12 years. This information may not be achieved until late 2021 or even 2022. Currently, there is an ongoing trial investigating the safety and efficacy of the vaccines in a cohort of children aged 12-18 years. If the results are positive for the age groups (children between 12-18 years, and children less than 12 years old), then the vaccination of children might start by the end of 2021 and may last until 2023.
  • Dr. Roy Anderson (Imperial College London) addresses the main concern that what will happen if countries do not reach high vaccine coverage levels?
    • First, SARS-CoV-2 will become endemic but at a low level, the precise level depending on the degree of vaccine uptake, with peaks in winter and troughs in summer in the northern hemisphere.
    • Second, policy-makers will have to consider whether to mandate vaccination and to create a certificate to record immunization for school, college, or university, and the workplace. Given vaccine hesitancy, the creation of herd immunity by vaccination is likely to be challenging in many countries.
    • A further problematic issue for policy-makers and vaccine producers is to carefully track the molecular evolution of SARS-CoV-2.
    • Vaccine efficacy will depend on a stable virus target, unless we move to a situation such as that for influenza A vaccination where vaccine composition varies depending on which strains are predicted to be dominant in any given year. Research shows the continued viral evolution of SARS-CoV-2 and this aspect needs to be tracked carefully.
GLENN TREVOR
Glenn is the Lead Operations Research Analyst at The Digital Momentum with experience in research, statistical data analysis and interview techniques. A holder of degree in Economics. A true specialist in quantitative and qualitative research.

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