Viral immunologist says a vaccine in NZ will be “late, limited and last”

Media Release

16 August 2020

A University of Guelph viral immunologist, commissioned by the Government of Ontario to develop a COVID-19 vaccine, says New Zealand could be in isolation for years if it sticks to its suppression strategy and waits for a vaccine.

“The race to develop a vaccine for the coronavirus is certainly on, but the timelines being reported by media, and hopeful virologists, have been greatly overstated,” said Dr Byram Bridle.

“The world record for a vaccine is four years from the start of a phase 1 clinical trial to safety-tested availability. This does not include the several years that are needed for the preceding discovery phase. Further, timelines for manufacturing, quality control-testing and distributing a vaccine could be very protracted. The promises being made of a vaccine within a year are very, very unlikely.”

Dr Bridle noted that it is troubling to see world governments re-define a successful COVID-19 vaccine as one that merely reduces the severity of Covid19 in an individual as opposed to preventing the spread of the disease.

“The quickest solutions, using a killed virus or parts of the virus as the base, probably won’t trigger the body’s proper immune response.”

The other challenges for New Zealand were getting access to any version of a vaccine ahead of rich or very poor countries ravaged by the disease, and public take-up.

Other countries have more money, and greater need, than New Zealand. All countries will be faced with the long time it takes to roll out a vaccine, and the large part of their population which will be reticent about the vaccine’s efficacy.

“New Zealand would be unwise to rely on elimination of the virus until a vaccine appears – because a vaccine will be late, and its availability will be limited. It’s arguable that by being free of the disease, New Zealand will be last in the queue for a vaccine,” he said.

Dr Bridle explained that given the challenges facing a vaccine, his team had decided to focus not on a specific vaccine for Covid19, but to adapt their existing work in cancer therapies to create a “plug and play” format for future coronaviruses.

“We can use live vectors to deliver the vaccine directly into cells to ensure an appropriate immune response. We’re trying to prove the viability of this approach so, unlike other “one-off” approaches, our platforms can be adapted to develop vaccines for future versions of a coronavirus. That means future vaccines might be made more quickly and cheaply.”

Dr Bridle is one of the international speakers at the COVID-19 Science and Science Symposium Webinar on Monday.

Joining the webinar, Dr Bridle will present on what a realistic vaccine development timeline looks like and briefly on his current research project to develop a versatile vaccine strategy that can be rapidly mobilised for the next major coronavirus outbreak.

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Do we really need yet another lock down?

By Ananish Chaudhuri and Simon Thornley

The authors are members of the Department of Economics and School of Population Health respectively at the University of Auckland. The views expressed are their own.

During the Vietnam war, the well-known (and Kiwi-born) journalist Peter Arnett is supposed to have quoted a US Major as saying “We had to destroy the village in order to save it.”

Regardless of whether anyone actually said this or not, we cannot help reflecting on the idea behind this as we go into yet another lock-down.

Back in March, when we entered our first lock-down, the evidence was not so clear. Reasonable people could have disagreed about the sagacity of the lock-down. Some of us did but on the whole most were willing to abide by the government’s decision.

But the evidence is clear now. Lock downs are not a panacea. There is, at best, weak if any correlation between lock downs and the spread of the disease. At best, they merely postpone the spread of the infection.

When the Swedish authorities said this, the rest of the world sneered at them.

Now, there is increasing recognition that maybe the Swedes did get it right. Certainly not all of it; they did experience a failure to protect the frail and elderly. But, on balance, it appears they will emerge from the pandemic stronger than their neighbours and that in the current globalized world, lock downs are not and cannot be a sustainable solution.

A recent report from the Productivity Commission now provides support for this Swedish view by asking questions about the relative costs and  benefits of prolonging our earlier lock down. The conclusion: the costs conservatively outweighed the benefits of an extended lockdown by 95:1.

And the Swedish approach has been reiterated by Camilla Stoltenberg, Director General of the Norwegian Institute of Public Health; that Norway could have handled the disease without locking down.

There is no vaccine and if there is one, it is still some time away. The fastest vaccine ever developed, for mumps, took four years. In any event, even with a vaccine there is no way of guaranteeing that every Kiwi will take it. In fact, unless we keep our borders closed forever, we need everyone else in the world to take the vaccine too. Diseases we thought had been eliminated, like measles, have made a come-back.

Consequently, in an earlier article we pointed out that elimination is not and never was a realistic strategy and suggested ways of moving forward and resuming normalcy including opening our borders.

It was certainly inevitable that the disease would recur. What was not inevitable was the steps we took along the way and the economic and social costs of those steps.

Did we really need to spend the time, effort and resources to force people into quarantine? Could we not trust them to self-isolate like we did earlier with prosecution of violators? Like Sweden, New Zealand is a high trust society. Why does our government have such little faith in its citizens? Why does it claim for its police the right to enter people’s home without warrants to enforce quarantine?

And if a government does not trust its citizens, then why and how long should the citizens continue to trust the government?

Even with preponderance of evidence that lock downs are mostly useless, our government has responded to an outbreak with another lock down. The initial rationale for a lockdown was protecting our hospitals, but now with cases linked to only one household, the threshold for pulling the lockdown trigger has dropped considerably.

Is this really sustainable: To lurch from one from lock down to another with breaks in between?

Yes, resuming normal life will lead to more cases and there will be more deaths due to Covid-19; just as there will be more deaths from auto accidents, flu, pneumonia, respiratory illnesses, loneliness and self-harm. We also now appreciate that the age distribution of deaths from Covid-19 is indistinguishable from background mortality.

Maybe we need to better confront the idea of our own mortality. Such a conversation is topical given the upcoming referendum on euthanasia.

If we could shut down all motorized vehicles, then the reduction in pollution will save many lives that are lost from respiratory illnesses. But, no one suggests that since this is not a realistic proposition. Instead, we set emissions standards in such a way that the social benefit of driving or flying is equal to or higher than the social cost.

Contrary to the culture of fear besetting us, Covid-19 is hardly the threat it has been made out to be. Both the case fatality ratio (number of deaths divided by the number of reported cases) and the infection fatality ratio (number of deaths divided by the number of people potentially infected) is relatively low and much lower than say Ebola or other corona viruses such as Middle Eastern Respiratory Syndrome (MERS) or Severe Acute Respiratory Syndrome (SARS). It is now clear that lockdowns are a blunt instrument that is disproportionate to the threat posed by this virus.

Masks only useful in confined spaces

Media Release

14 August 2020

Epidemiologist Simon Thornley has reassured people that there has been no new information that concludes masks are warranted against COVID19.

“The trials are clear; there is no statistically useful safety gain in wearing a mask, although low quality observational studies show an advantage to wearing one in confined spaces.”

Thornley says he was moved to clarify the science because people advocating masks were claiming ‘things had changed’, leading to an increase in public mask-wearing since Wednesday.

“Nothing in medical science has changed since Ashley Bloomfield first told us months ago that there was no advantage to masks. What has changed is social and political advantage in advocating masks, and that’s not science.

“I will not be wearing a mask without symptoms, but anyone with compromised health could choose to carry a mask to wear in places like public transport.”

Thornley urged all public communicators, including media, to reference the latest science on masks so people could decide for themselves (see below).

On Monday, the Covid Plan B group is live streaming a COVID-19 Science and Policy Symposium, featuring international experts analysing the New Zealand situation. Find out more here.

ENDS

The Science on masks

A trial in Australia showed that in households exposed to children with respiratory symptoms and fever, there was no difference in outcome between households that wore either surgical or P2 masks with controls who did not wear masks. The incidence of laboratory confirmed infections were twice as high in the mask wearing groups compared to controls, but the difference was not statistically significant.1 About 50% of patients reported problems with the masks, and by day five, only 30% of participants were compliant with the mask use.

A larger trial in Thailand that compared control, to handwashing, and handwashing and surgical masks in households with influenza-like illness showed no difference between the three groups, in terms of reducing the incidence of secondary transmission from primary cases.2

Meta-analyses of observational studies have reported benefits of reductions in risk of using masks.3 A case-control study of H1N1 transmission following a prolonged flight between China and the US showed a very strong association between mask use and protection from infection. None of the 9 cases wore masks, compared to 47% (15/32) of control passengers.4

The World Health Organisation5 only recommends masks when individuals have symptoms compatible with Covid-19. In populations such as those with a high prevalence of Covid, immunocompromised patients or times where high population density cannot be avoided, such as mass gatherings, public transportation (including aeroplanes), masks are considered useful for ‘source control’, rather than ‘protection’.

References

  1. MacIntyre CR, Cauchemez S, Dwyer DE, et al. Face mask use and control of respiratory virus transmission in households. Emerging infectious diseases 2009;15(2):233.
  2. Simmerman JM, Suntarattiwong P, Levy J, et al. Findings from a household randomized controlled trial of hand washing and face masks to reduce influenza transmission in Bangkok, Thailand. Influenza and other respiratory viruses 2011;5(4):256-67.
  3. Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. The Lancet 2020;395(10242):1973-87. doi: https://doi.org/10.1016/S0140-6736(20)31142-9
  4. Zhang L, Peng Z, Ou J, et al. Protection by face masks against influenza A(H1N1)pdm09 virus on trans-Pacific passenger aircraft, 2009. Emerging infectious diseases 2013;19(9):1403-10. doi: 10.3201/eid1909.121765
  5. Organization WH. Advice on the use of masks in the context of COVID-19: interim guidance, 5 June 2020: World Health Organization, 2020.

New lockdowns are proof that they don’t work

Media Release

13 August 2020

Epidemiologist Simon Thornley says the new virus outbreaks and lockdown responses are proof that New Zealand must, as the WHO has recently said, learn to live with the virus.

“An outbreak was inevitable, and therefore lockdowns were never a viable repeatable solution – you pay a high price, repeatedly.”

“As we’re about to experience yet again, lockdowns harm everyone more than the coronavirus does.”

“Protecting the elderly, staying at home if you are ill and hand hygiene are the mainstays of reducing the spread of the virus.”

Thornley says it is ironic that the Government had now also decided to lock down all aged care facilities.

“This is precisely the solution we advocated three months ago. Proof has since mounted that those of us over 65 are the only people at real risk: the age of death with this virus is much the same as what we observed in people who died last year. The risk is extremely low for people aged less than 65. No one has yet died in their fifties or younger in New Zealand.

Even in apparently ‘hard hit’ regions of the world, people aged less than 65 without underlying conditions were very unlikely to die from the virus. They accounted for 0.7–3.6% of all COVID deaths in France, Italy, Netherlands, Sweden, Georgia, and New York City.

“Safe hygiene practices and protection of the elderly is the best solution.” Thornley said.

Thornley points out that the Government promised that the first lockdown was to eliminate the virus, and its four-day extension would ‘lock in the gains’.

“Yet here we are, with the virus, locking down again. Proof, if you needed it, that lockdowns only delay, or even magnify, the health and economic harm.”

On Monday 17 August, the Covid Plan B group is live streaming the COVID-19 Science and Policy Symposium, featuring international experts analysing the New Zealand situation.

The international speakers confirmed include founder of Yale University’s Yale-Griffin Prevention Research Centre Dr David Katz, who worked at the front line of New York hospitals dealing with patients, and viral immunologist Dr Byram Bridle who is part of a team commissioned by the Canadian Government to develop a COVID vaccine.

To find out more information about the COVID-19 Science and Policy Symposium, visit here.

ENDS

WHO highlights NZ border problem – International symposium to tackle dilemma

 

Media Release

28 July 2020

Several World Health Organisation officials have this week crystallised New Zealand’s border dilemma – saying that keeping national borders closed because of COVID-19 is now unfeasible.

Head of WHO’s emergencies program lead Mike Ryan said “it is going to be almost impossible for individual countries to keep their borders shut for the foreseeable future…. Economies have to open up, people have to work, trade has to resume.”

Simon Thornley, of the Covid Plan B Group, says this highlights a core problem the group had with lockdown; there was no exit strategy.

“New Zealand came out of lockdown well, but the suppression strategy has left us in an international and economic dead end.

“Other nations, although worse hit by cases and deaths, are now opening up borders and activity. New Zealand is in a bind; locked behind its border, fearful of even a single infection let alone a death.

“Yet the most recent infection fatality studies show Covid-19 is 0.65% – at most only a quarter of the deaths we expected, and probably far fewer.

“We need to open our borders to restore economic and social connections with the rest of the world.”

Thornley said New Zealand’s dilemma would be tackled by an international symposium at Parliament on 17 August, featuring several internationally respected experts. They will analyse the latest information on COVID-19 to offer possible pathways for New Zealand’s recovery.

“The main danger of the virus is that hospitals become overwhelmed and the virus spreads to frail patients. Most countries are now well beyond this, but New Zealand might not be. We need to cautiously open our borders and continue to monitor our health system’s capacity.”

The international speakers will present live by video link, followed by questions from the public. They include vaccine specialist Byram Bridle, Epidemiology Professor Sunetra Gupta of Oxford University, and Preventative Medicine specialist David Katz at Yale.

Interested parties can register for free tickets here. To find out more information about presenters at this event, please visit here.

ENDS

Oxford professor criticises NZ suppression strategy

Media Release

21 July 2020

An Oxford professor has criticised New Zealand’s Covid-19 strategy ahead of an international symposium on New Zealand’s policy options to be held in Parliament in August.

Professor Carl Heneghan from the Oxford Centre for Evidence Based Medicine said in an interview on the weekend that “If you follow the New Zealand policy of suppressing it to zero and locking down the country forever, then you’re going to have a problem… This virus is so out there now, I cannot see a strategy that makes suppression the viable option. The strategy right now should be how we learn to live with this virus”

Simon Thornley, of the Covid Plan B Group, has today announced plans to hold an international symposium on New Zealand’s policy options at Parliament on 17 August.

The COVID-19 Science and Policy Symposium will feature at least five internationally respected academics and scientists analysing the latest information of COVID-19 to offer possible pathways for New Zealand’s recovery, along with New Zealand-based experts.

Thornley says experts were keen to present at the symposium because New Zealand is receiving global attention for its handling of the pandemic and the situation it is now in.

“New Zealand’s approach is a hot topic internationally – experts are keen to discuss our unique position. Our low infection and death rate has created a difficult decision on when and how we open back up to the world.

“The risks and impacts of the virus are now becoming much clearer and more certain. This information is vital to New Zealand’s decision-making, but we’re not getting the full picture.”

The international speakers will join by video link, giving presentations on the latest data, and open to discussion and questions from the public.

Those confirmed include Dr David Katz, founder of the Yale-Griffin Prevention Research Centre and who worked at the front line of New York hospitals dealing with patients, and viral immunologist Dr Byram Bridle who is part of a team commissioned by the Canadian Government to develop a vaccine.

The COVID-19 Science and Policy Symposium will be held in Parliament’s Banquet Hall on Monday 17 August. Interested parties can register for free tickets here.

To find out more information about presenters at this event, please visit here.

ENDS

Grant Morris on COVID-19 law

Ananish Chaudhuri talks Plan B

Why do we need a Plan B?