A common question on people’s minds in New Zealand and around the world is “when can we get back to normal?”. A key variable in answering that question is how and when advancements in a vaccine or treatments for Covid-19 will occur. Progress in the advancement of either a vaccine or therapeutic is critical for the both the health of a nation’s citizens and economy. This is especially the case in New Zealand where the flow of people into the country critically supports service-based businesses. The investment team at Generate has been spending time talking with industry professionals and below we summarise some key points for you.
There are two important channels of focus; 1) developing a vaccine capable of providing broad population immunity, and 2) therapeutics, which involves the development of drugs able to provide treatment to Covid-19 patients.
Beginning with vaccines, there is a global race occurring which involves some of the largest names in the pharmaceutical industry trying to find a vaccine for Covid-19. To date, more than 100 vaccines are in various stages of development globally with 8 of those already in early-stage human clinical trials. Vaccines are notoriously difficult to develop owing to a multitude of complexities that must be overcome. One of these hurdles is conducting the large-scale human trials that are required to prove a vaccine’s safety and efficacy. These trials need to ensure that any developed vaccine is equally effective across gender types, age groups, ethnicities, and different virus strains. Governments of major countries such as the United States and the United Kingdom are pouring vast quantities of resources into accelerating the development process and ensuring that manufacturing capacity exists for a rapid scale up of production. Notwithstanding this, many industry professionals estimate that a vaccine being readily available to the broad population is at least some 18 months away, even under the most optimistic circumstances.
Among the frontrunners in the vaccine race to date are Moderna, Sanofi, Johnson & Johnson and a collaboration between AstraZeneca and Oxford University. If human trials are successful, best-case estimates suggest that emergency use of the Oxford/Astrazeneca vaccine could begin later this year, and Moderna’s at the beginning of 2021. Developing a vaccine is just one piece of the puzzle. Equally complex is manufacturing the vast volumes required to make the vaccine widely available to the population and in an equitable way. This is of particular interest to small countries like New Zealand who don’t have large pharmaceutical companies to lean on for access. According to Credit Suisse research there is a requirement for 1.5 billion vaccine doses to cover the most at-risk people in our society including over 60-year olds, and those with medical conditions such as respiratory illnesses and diabetes. In the optimistic scenario that all major vaccine programmes currently in development are successful, Credit Suisse estimate that by the end of 2021 there may still only be enough vaccine doses to cover this at-risk portion of the population.
Alongside the attempt to rapidly develop a vaccine, sits a similarly urgent attempt to develop an effective treatment for Covid-19. There are currently more than 100 studies underway into potential therapeutic solutions to Covid-19. These studies involve the creation both of new drugs, and drugs that have been created in the past to fight other viruses. Covid-19 is unique in the manner in which it attacks the human respiratory system, which consequently makes it very challenging to develop a therapeutic that can be easily administered, for example in pill form, to an infected patient. Gilead Sciences is currently dominating therapeutic headlines with its drug named remdesivir. Remdesivir was formerly designed and trialled as a drug in the fight against Ebola, which was ultimately unsuccessful. It is a complex drug that has proven difficult to manufacture and therefore is only able to be administered intravenously in a hospital setting. In the United States, remdesivir has been approved for emergency use after test results showed hospitalised patients that were administered the drug recovered faster than those who did not. Remdesivir is seen as a band aid solution and is not the therapeutic silver bullet currently required to dramatically lower mortality rates.
There are of course other options in the therapeutics space, one of which has recently made the headlines thanks to President Trump. Hydroxychloroquine is a generic drug which was first developed to treat malaria. There is little evidence to date as to whether this may be successful against Covid-19, and has also been associated with uncomfortable side effects such as heart rhythm abnormalities and psychosis.
Interestingly, progress (or a lack of) in therapeutics may in turn have an impact on the development of vaccines. In the case that a highly effective treatment is found for Covid-19, the changed economics for vaccine development may be a deterrent for some manufacturers.
While positive steps have been made to date, in the next six months the rollout of a large-scale vaccine programme appears unlikely. Nations will need to rely on strict contact tracing and case isolation in the interim, especially in the northern hemisphere where the potential this coming winter for seasonal influenza and further outbreaks of Covid-19 may result in further lockdowns.
The Generate team