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COVID-19 - Game Changer?

 

As the first doses of a vaccine against COVID-19 were rolled out in Canada and the United States, BMO guest medical experts Dr. John Whyte and Dr. Allison McGeer joined our client call to laud the development as a game changer in the 10-month battle against the pandemic.

The U.S. FDA authorized the Pfizer BioNTech vaccine on Friday, declaring it safe to use and 95% effective. Canada, the UK and certain Middle Eastern countries had already authorized it, but the first doses were administered on Monday in both the United States and Canada.

“This really is a game changer in our desire to crush COVID-19,” Dr. Whyte, Chief Medical Officer of WebMD, told the call. “It's going to be several months before we really see the impact of widescale immunization, but it really is light at the end of the tunnel.”

For the medical portion of the call, Dr. John Whyte, Chief Medical Officer of WebMD, and Dr. Allison McGeer, Senior Clinician-Scientist, Lunenfeld-Tanenbaum Research Institute, Sinai Health gave both the American and Canadian perspectives on where we are in terms of vaccines.

Vaccine rollout

Currently, there are 2.9 million doses of the vaccine in the U.S., with an expected 25 million doses due by the end of December 2020, and 100 million doses by March or April. Because this is a two-dose vaccine, that means 50 million people should be vaccinated by that point.

In Canada, there will be 294,000 doses by the end of December, Dr. McGeer, Senior Clinician-Scientist, Lunenfeld-Tanenbaum Research Institute, Sinai Health, told the call, representing about the same rate of doses per capita as the United States. Canadian health authorities expect to have around 6.4 million vaccine doses by the end of March, enough to vaccinate the country’s first high priority group.

In terms of how the dosing works, Dr. Whyte explained, “it's two doses, separated by about 21 days. We think you may have 50% immunity after the first dose and then that 95% immunity about a week after you have the second dose.”

Because the vaccine is still so new, experts are unsure how long immunity will last.

“We're hoping it's several years,” Dr. Whyte said. “We're hoping it's not like influenza and I don't think it will be, but remember these studies are going on for two more years, so we're going to continue to find out more information.”

The rollout

In the U.S., the CDC has recommended long-term care workers be the first to receive vaccinations; however, it will be up to state and local jurisdictions to make the final call. In Canada, the priority varies by province–in Ontario, long-term care workers and residents are the focus, whereas, in Alberta, acute care workers are the priority.

Dr. Whyte noted that the FDA hasn’t yet tested the vaccine on pregnant or lactating people, nor have they tested it on children under 16. Those trials will begin in January 2021.

Different vaccines, different methods for immunity

While the Pfizer BioNTech vaccine has led vaccine news, Dr. Whyte noted that, later this week, the FDA will be reviewing the Moderna vaccine for emergency use approval.

Both of these vaccines are mRNA, which differs from all previous vaccines in that a piece of genetic material is given which causes the patient’s body to create its own spike protein. When the patient is then exposed to COVID-19, their body mounts an immune response to protect itself.

The one drawback of mRNA vaccines is the extremely low temperatures they must be stored at. That’s why the adenovirus vaccines currently being tested by J & J and Astra Zeneca and not requiring the same storage temperatures, continue to be of interest. Sanofi and GSK are also working on a vaccine, but Dr. Whyte expects they won’t be ready until late 2021.

The tunnel before the light

Medical experts warned, however, that a vaccine rollout does not mark the end of the fight against COVID-19, noting that the holiday season will be a critical time to keep the spread of infection in check.

“I want to spend just a minute talking about the tunnel before we get to the light at the end,” said Dr. McGeer, a leading Canadian infectious disease specialist. “Because one of the things we need to be really careful about in the next three months is that we don't get so excited about the vaccine that we lose control of the pandemic in between.”

While the Atlantic bubble has been successful in staving off the second wave of the virus, other provinces are currently facing a far bigger second wave than in the spring.

Canada is sitting at a reproductive ratio of just over one, Dr. McGeer said, which means cases are climbing very slowly, but they are climbing.

“All of us are living in fear, that over the holiday time, people will just not be able to bear to maintain social distancing, and that the consequence of that is that we'll start to see cases increase,” just as vaccines roll out.

A bumpy ride

Dr. McGeer noted that, in all countries, we should expect a bumpy ride when it comes to vaccine rollout. There will be adverse events that may or may not link back to the vaccine, or drive the ebb and flow of demand for the vaccine.

“It’s going to be very heavily dependent on how well we do as a profession, in medicine and nursing, in communicating information about these vaccines and their efficacy and safety to people,” she said.

Both Dr. Whyte and Dr. McGeer agreed that the rollout of a COVID-19 vaccine after just 10 months is a worldwide triumph.

“This really is a success story of innovation, of science, of engineering,” Dr. Whyte said. “We should be celebrating the progress and the success that we have, not just in vaccine development, but also where we are in therapeutic actions as well, and testing.”

Read more

PART 1

COVID-19: Where We Are and What Comes Next

Brian Belski, Michael Gregory, CFA, Margaret Kerins, CFA December 14, 2020

COVID-19, BMO hosted a panel with in-house and external experts to discuss the implications from a health, markets and macroeconomic perspective,...





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