Post #777: Covid-19 Vaccine 1, revisited: Yes, the Russians have it right.

Posted on August 21, 2020

 

This is a followup to Post #773, contrasting how the Russians are approaching vaccine development compared to America (and presumably the rest of the world).  In a nutshell, the Russians are hurrying things along, while we aren’t.

Two things have come into the news stream since that time.

One was our own Dr. Faucci, wagging his fingers and tsk-tsking at the Russians, saying they didn’t have a “real” vaccine because they hadn’t jumped through all the hoops that the public health infrastructure traditionally requires.  He’s been doing that for the better part of two weeks now.  Seriously, he was quoted as calling the Russian vaccine “bogus”.

The other was that, per Newsweek, the Russian minister of health has explained  exactly what the Russians are doing, and why.  Putting aside the usual Russian paranoia, they are doing exactly what I had stated in Post #773.  They’re going to use it for high-risk populations now, after the vaccine has passed safety trials but before they know how well (or whether) it actually works in preventing COVID-19 infections.

Here are a few key quotes.  These, in a nutshell, are why I think the Russians are being smarter about this than we are.  If you read the details, what they’re actually doing is not hugely different from what we’re doing.  Except that they’ve licensed their vaccine for general use already.  If you’re a high-risk worker in Russia, you can try the Russian vaccine now.  But not if you’re a high-risk worker in the US.  These are all from the Newsweek article cited above.

1:  "Russian authorities and scientists say the vaccine .. is safe and induces a significant immune response against COVID-19, based on results from small-scale human trials over the past months."
2:" ... mass testing of the vaccine ... will begin next week ... will involve more than 40,000 volunteers ... will be randomized and placebo-controlled.  "That will be a very important trial that will go on in parallel to vaccination [of high-risk groups, such as health workers,]" Dmitriev said."
3:  Normally ... "Phase III" trials such as this are typically held before a given candidate is approved. However, Russian officials have decided to approve the vaccine early given the nature of the pandemic.
4:  At least four other COVID-19 vaccine candidates around the world have reached this stage, but are yet to be approved by regulators in their own countries.

Items 1 and 2 describe exactly where “our” vaccine (via Moderna) is now.  Except for the part in boldface.  Item 3 is what I’m harping on.  That boldface part — “given the nature of the pandemic” — is something that US regulators can’t quite seem to grasp is important.  And point 4 is just to say that the Moderna vaccine and three others could be used as the Russians are using theirs.  Now.

I’m still with the Russians on this one.  I think they are being vastly more rational about this than we are.  At present we have:

  1. Maybe  600 a day dying from this in the US.
  2. The near-complete disruption of the US educational system.
  3. The US economy on the edge of the next Great Depression
  4. Unemployment over 10%
  5. A Federal budget deficit of $0.8 trillion dollars in the last reported month, with no obvious way to reduce that, see point 3.

And yet, our regulatory bureaucracy keeps insisting that the only rational course is to ignore all of that, and proceed as if this were any other vaccine development situation.  In business, you’d call this situation “silo mentality”.  If and only if the only concern were to have a perfect vaccine, our bureaucracy has it right.  But true leadership would break open the public health silo in recognition of the full scope of the situation.  And if we ever get rational executive branch leadership again, I surely hope that’s the first thing about this situation to change.

Once again, I’ll lay out the logic.  If the vaccine is safe, but doesn’t work, you’ve lost nothing by giving it now.  If it’s safe, and it works, you’ve lost a huge opportunity by NOT giving it now.  Heads you win, tails you don’t lose.

The Russians are calling their vaccine Sputnik V.  But this really ain’t rocket science.