The signs are good. Vaccines are coming and the early indications from clinical trials look promising. However, the COVID-19 pandemic will take time to tame.
In the meantime, a combination of measures will be needed. Here are some of the pieces of the ‘Vaccines Plus’ puzzle that will combine to make next year better than 2020:
- COVID-19 vaccines: prioritise healthcare workers and older people
- Testing and tracing: rapid tests could help identify cases
- Therapies: treatments are improving; more are on the way
- Masks and distancing: continue some restrictions until herd immunity is reached
If preliminary data are so encouraging, why can’t we exit the pandemic next spring?
First, no vaccines have yet been approved by regulators. It is simply too soon: vaccine development takes time and independent authorities will demand strong evidence that the vaccines are safe and effective.
Initial data show that the Pfizer/BioNTech COVID-19 vaccine could be more than 90% effective in preventing disease. The Moderna COVID-19 vaccine, which uses similar mRNA technology, reports initial effectiveness of 94.5%.
Trials of these and other vaccines are still ongoing and there are still plenty of things to learn about COVID-19 vaccines. Scientists do not yet know how well vaccines prevent the spread of disease or how long immunity will last, although BioNTech vaccine scientist Uğur Şahin is optimistic about reducing transmission of the virus.
Then the complex task of producing and distributing vaccines. Some of the vaccines in development require two doses. Several must be stored at very low temperatures (including during transit).
Millions of doses of vaccines will arrive in 2021 but it will not immediately end the crisis. Health professionals, frontline workers, older people, and vulnerable individuals living with underlying conditions will be among the first in line to be offered a COVID-19 vaccine.
It is vital the vaccines are delivered through strong vaccination programmes, supported by widespread public engagement campaigns to ensure uptake. (For more, read the European Commission’s paper on COVID-19 vaccination strategies and vaccine deployment.)
Over time, experts hope that enough people will be protected against COVID-19 to halt its spread in the population. If herd immunity (also known as community immunity) is achieved, the risks associated with mass gatherings or visits to vulnerable family members would plummet.
Vaccines alone will not end the pandemic in the short term. That’s why a vaccines plus approach is essential.
From the beginning of the COVID-19 crisis, the WHO message has been test, test, test. Several countries in Asia have recorded particular success with massive testing.
Now, much faster tests are becoming available. In general, speed often comes at the expense of accuracy. While these rapid tests may not be as accurate as the gold standard PCR tests, they could be used in certain settings (where people do not have symptoms and are not close contacts of an infected individual).
Antibody tests can also be used to check for an immune response. These could help individuals know whether they are protected, and will be important to learning more about how long immunity lasts.
In the early phase of the pandemic, when the disease was new and health professionals had no experience of how to best manage patients, the risk of admission to intensive care units (ICU) and death was significantly higher than it is today.
The improvement can be attributed to a combination of measures ranging from proning (turning patients on their stomach to help breathing), better use of existing treatments, and the emergence of new therapies. More new therapeutic options, such as cocktails of antibodies, are being tested to see if they can further change the outlook for people who are infected.
This is all very encouraging. However, we have not yet reached the endgame. Until we do, patience would be prudent. In practice, this will mean continuing to do the basics well: handwashing, mask wearing, social distancing.
It may feel as though we are in an interminable cycle of restrictions being tightened, lighted and tightened again. But the enormous scientific efforts of 2020 are bearing fruit. In 2021, ‘vaccines plus’ will ensure that the light at the end of the tunnel continues to brighten.