Bloomberg (paywall) has an interview with Richard Hatchett, who worked to develop a pandemic plan for George W. Bush, on the advent of omicron, vaccine strategy and what’s still ahead. Hatchett is now based in London, and runs the
Coalition for Epidemic Preparedness Innovations, headquartered in Oslo, which, among other things, helped to fund early production of the new mRNA vaccines.
A Q&A with Richard Hatchett, who worked to develop a pandemic plan for George W. Bush, on the advent of omicron, vaccine strategy and what’s still ahead.
www.bloomberg.com
Found some of his comments interesting, extracted below. Highlights mine.
ML: So rich countries don't have a supply problem, they have a demand problem, and lower-middle-income and lower-income countries have a supply problem.
RH: We have had a supply problem, but that has shifted very recently. Lower-middle-income countries were behind the upper-middle-income countries but had greater access to vaccines than low-income countries. The low-income countries were the ones who really fell off the cliff. In the last few months, the number of doses becoming available through Covax has increased. In November, we delivered close to 200 million doses. The first week of December, we delivered 11 million doses in a day. That’s how much supply picked up. ...
ML: So we create these vaccines, we administer them unevenly across the global population, and it creates pressures on the virus to change in certain ways. If we were to set out to create conditions in which the virus was most likely to learn how to evade a vaccine before we're all vaccinated, how different would it be from what we've done?
RH: It would look pretty much like what we've done. ...
ML: If I make you God at the beginning of this pandemic, how do you distribute the vaccine to minimize the likelihood that some mutation doesn't end-run the vaccine?
RH: Theoretically, the best answer is to prevent the pandemic altogether. Once you're in a pandemic, the deck is stacked against you. The next answer is you want vaccine manufacturing everywhere, and you want to reduce that period of scarcity to the shortest possible period, and you vaccinate the world in two months, not in two years. But even before that, if I'm really God, what I want to do is this: New scary virus pops up and it's picked up by surveillance and it's sequenced and the world goes, “Oh, my God, we’ve got a scary virus,” and we clamp down in the area where the virus has emerged with non-pharmaceutical interventions to reduce transmission and spread while we rapidly develop a vaccine.
ML: And everybody knows it's only going to be 100 days, so they live with it for 100 days to avoid a pandemic.
RH: Yeah. Live with a severe clampdown in the first areas of transmission and then saturate those areas with vaccine as soon as you've got vaccines and prevent a potential pandemic from becoming a true pandemic. That’s the answer. …
It’s pretty hard — if you've got a scarce supply of vaccines — not to protect the person who's at risk of dying. You’re trapped, as long as things are driven by scarcity. The long-term solution is to create the conditions that let you eliminate scarcity as quickly as possible. Fortunately, with Covid, the period of scarcity of vaccine has basically come to the end.
The supply of vaccine has ceased to be the rate limiter.
ML: So we no longer have a supply problem?
RH: Let me put it this way. The rate-limiting factor of getting people vaccinated is the ability of countries to receive and distribute and dispense the vaccine rather than the supply. ...
This is definitely not a once-in-a-century problem. Covid-19 is the seventh global infectious-disease crisis of the 21st century: SARS, avian influenza, swine flu, MERS, Ebola and Zika preceded it.
It looks like roughly every three years you're going to have a global infectious-disease crisis, and that tempo is probably increasing. Creating dedicated biodefense organizations might have sounded crazy 30 years ago. It's not crazy now. …
RH: I think it's much more likely that Covid is going to be like flu and we're going to have annual Covid seasons. Periodically we're going to have mutations emerge and these may give rise to new Covid pandemics. …
If you could create something that was stable, highly transmissible, not lethal that essentially displaced the current strain of Covid, that might be the most efficient way to create immunity.
RH: That's essentially what happened with the 2009 pandemic flu virus. It was a super-mild flu virus. It had a higher reproductive number than the other flu viruses that it displaced and had a comparatively minimal impact. It knocked the other, more severe flu viruses out of play for a couple of seasons. But I'm not aware of us ever adopting that strategy deliberately.
