Crabs and Beer!

A few days ago I published a list of five areas that need attention from the incoming Biden administration. Number 5 on the list was ‘End the Pandemic’ but really that needs to be number one. Ending the pandemic is a critical prerequisite to getting much else done. Here’s what I think needs to be done.

• Simplify and Accelerate the Administration of the Vaccines.

We’re fortunate in that we have two vaccines, both based on mRNA technology that are shown to be highly effective and are being produced and distributed to the states. More are on the way. Here’s a rundown.

The Oxford University/AstraZeneca vaccine uses an engineered virus to carry certain coronavirus genes into cells and have them make virus proteins which generate an immune response. Based on Phase 3 trials it appears to have good efficacy – between 62 and 90%. In what appears to be a paradox, trial participants who got a lower first dose appear to have a better immune response. There is some thought that the larger first dose triggers an immune response to the vaccine itself. In any case the vaccine has been approved for emergency use in a number of countries and AstraZeneca is having discussions with the FDA about US approval. In contrast to Pfizer and Moderna, AstraZeneca has indicated that it can produce up to 2 billion doses a year. The US has pre-purchased 300 million doses.

Johnson & Johnson has developed a similar vaccine which showed good results in Phase 2 trials. Results from Phase 3 trials are expected within days. Unlike the vaccines above, the J&J vaccine requires only a single dose. The US has pre-purchased 100 million doses of the J&J vaccine and, while there have been some initial production delays, the company indicates it can produce 1 billion doses in 2021.

Novavax, a Maryland company, has developed a vaccine which sticks virus proteins onto microscopic particles to be injected. Preliminary and Phase 2 results have been promising and a Phase 3 trial was launched in August in the UK with results likely early this year. Novavax expects to deliver 100 million doses to the US in 2021.

There are dozens of other vaccines in testing or production, but mostly outside the US. Russia’s ‘Sputnik’ vaccine seems to be quite effective. But looking at just the vaccines above, the US should receive 900 million doses in 2021 – more than enough to vaccinate the entire population.

The trick, of course is to get the vaccine into our arms and not sit on the shelf while more people are infected an die. Here’s what we need to do:

1. Simplify the Priority List. Administer the vaccine to direct health care workers and then people 65 and over. Trying to set aside vaccines for nursing homes and front-line workers has proven too complicated for most localities. If we vaccinate as many as possible, those folks will get included.
2. Provide Additional Resources to Local Health Departments. Most have been struggling and need help, particularly in getting the vaccines to poorer neighborhoods. Send it.
3. Stop Trying to Persuade People. Some people are afraid of the vaccines. Don’t waste effort at this point trying to persuade them. There are plenty who eagerly want the vaccine. It will be easier after we see results.

• Shut Down Indoor Restaurants and Bars

There’s plenty of evidence showing that the virus spreads efficiently in poorly ventilated indoor areas. Because of the rapid spread of the virus, we’ve close schools and taken other steps that damage the economy and our well-being. We also need to compensate the restaurants and bars we shut down by paying their employees and their expenses until we can allow them to reopen.

• Consider Better Masks

There is strong evidence that high-filtration masks are much more efficient at reducing transmission of the virus. Consider using the Defense Production Act to produce large numbers of these masks and sending sets to every household.

So far around 20 million Americans have been infected and more than 10 million vaccinated. By mid-May we could see cumulative infections of around 25 million and about 100 million vaccinated and the transmission of the virus should slow dramatically. We just need to keep focused and take care of ourselves and others.