WASHINGTON – Americans struggling to worsen the coronavirus outbreak received some rare good news this week when researchers released encouraging updates on possible vaccines. Even Dr. Anthony Fauci, whose grim warnings have frustrated President Donald Trump, has consistently been enthusiastic about the prospects.
It is an encouraging thought that even though the country has failed to contain the virus or implement the kinds of public health measures that experts have asked for, there is a deus ex machina who comes to our rescue if we can resist long enough.
But some experts worry that Americans are getting too used to the idea that a miracle vaccine or treatment is just around the corner. While there is broad agreement that the latest news is promising, some are concerned that the prospect of future relief may bring complacency amid violent outbreaks that kill hundreds of people every day.
“I think we absolutely have to have a backup plan,” said Carl Bergstrom, a biologist at the University of Washington. “It is something that is not talked about enough.”
Even in the best case, the country can be six months or more away from widespread vaccines. And we may not be at best, which could require policy makers and the public to develop long-term plans.
“Until now, the history of vaccine development seems to be that none of the things that could have gone wrong went wrong,” Bergstrom said. “That doesn’t mean we are free at home in any way.”
If there is a Plan B, it is not clear what it is at this time. The White House and its allies in Congress are struggling to negotiate even the next temporary relief bill, and Trump has repeatedly speculated that the United States will soon find a vaccine or cure, or that the virus will “go away” on its own.
That has some nervous people. Ken Frazier, CEO of pharmaceutical giant Merck, recently warned that anyone promoting a medical breakthrough before 2021 was “seriously harming the public” given the inherent challenges of developing and administering a vaccine.
“The reality of the world is that this time next year it may very well resemble what we are experiencing now,” Frazier said in an interview with Harvard Business School professor Tsedal Neeley. “I think when we tell people that a vaccine is coming right away, we allow politicians to tell the public not to do the things the public should do, like wear the damn masks,” he added.
While candidates for various vaccines in the UK, China, and the United States are making good progress, the next phase of larger trials may reveal more serious side effects or limit their effectiveness. And if public expectations are too high, some fear it may pressure officials, especially in an election year, to authorize its use too quickly. (The FDA chief has insisted that it will not “cut through” safety.)
Even if a vaccine meets all the marks of safety and effectiveness, there is a possibility that governments may have difficulty distributing it quickly. The Trump administration is buying hundreds of millions of doses of candidate vaccines in advance in hopes that it can move quickly if approved, but obstacles may still arise.
Topher Spiro, vice president for health policy at the left-leaning Center for American Progress, has spent months researching the logistics of inoculating the public against the coronavirus once a vaccine is approved.
Possible problems he has analyzed include not producing enough glass vials to avoid red tape on who administers the vaccine, or simply fighting to convince enough people that it is safe to get vaccinated. An Associated Press poll this week found that 20 percent of respondents said they did not plan to get vaccinated if it was available, with another 31 percent unsure.
“We should not go ahead and we should start preparing for the possibility of having a vaccine, but that does not mean that we should stop looking for strategies to contain the virus in the meantime,” said Spiro.
Avik Roy, president of the conservative Equal Opportunity Research Foundation, co-wrote a coronavirus response framework in April that argued that officials should assume for planning purposes that advances in vaccines or treatments do not materialize.
“I spent a dozen years as an investor in biotech companies,” said Roy. “When you are close to the ground in developing new treatments, you are very aware of how often they fail, how often the data that looks promising in the early stages does not work in the later stages.”
According to Roy, accepting the possibility of no vaccine as an organizing principle could give more urgency to install security measures such as temperature scanners, protect vulnerable populations such as the elderly and advance plans to reopen schools safely.
“If we are going to say that it is okay to close the economy and keep schools closed because we will have a vaccine in six months, that implies many premature assumptions,” he said.
Many expert suggestions involve redoubling current efforts to tackle the virus.
Improving the availability of tests and response times, in which the White House has been reluctant to invest more federal dollars, could help detect outbreaks before they get out of control. Hiring and training more contact trackers, and maybe even experimenting with apps to help them, could help track the spread of the virus. Finding effective treatments that speed recovery and increase survival could make the pandemic easier to manage as an everyday threat. Former Obama health official Andy Slavitt has called for a national push to produce high-quality N95 masks for daily public use, rather than the more common cotton masks.
Any fight on the vaccine front could also affect the economic response. The longer the crisis persists, the more temporary changes such as virtual offices or higher e-commerce sales could become ingrained habits. That could make aid programs like Paycheck Protection that are based on maintaining existing businesses, no longer viable in a world devastated by coronavirus, more difficult to maintain. As it is, many companies are already closing their doors permanently.
“The CARES Act was based primarily on the premise that we would freeze jobs and businesses in place and then everyone would return,” University of Chicago economics professor Steven Davis told NBC News. “There is a lot of evidence that the post-pandemic economy will look significantly different and that many of the lost jobs will not return.”
Then there is the less desirable backup scenario: the virus wins.
If enough people are infected waiting for a vaccine to emerge, the country could move closer to herd immunity and get at least a temporary respite from major outbreaks. Some experts have estimated that reaching that point would require between 60 and 70 percent of the population to become infected, while others see a potentially lower threshold. According to a CDC study this week, the United States is still a long way off by any means, with only 24 percent of the hardest-hit New York City believed to have antibodies to the virus.
But some argue that we are more likely to get to that point sooner than we might think if current outbreaks worsen.
Former FDA Commissioner Scott Gottlieb, a CNBC contributor who sits on Pfizer’s board of directors, predicted that in early 2021, “we will have a vaccine or we will have collective immunity.”
However, the country will probably not celebrate in any way.
“We are a long way from that now, and many deaths and illnesses until we get there,” said Gottlieb.
