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The inconvenient truths and dirty little secrets of our COVID vaccine rollout

Opinion

Despite the appearance of everyone pulling in the same direction when it comes to the COVID-19 vaccine, there is no global strategy in place, writes Dennis Atkins

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American political strategist James Carville shot to global fame as one of the key players behind the come-from-nowhere rise of former US president Bill Clinton in 1992.

His most famous plea to campaign workers was scrawled on a whiteboard in the famed “war room” in Little Rock, Arkansas. “It’s the economy, stupid,” it read in unsparing, Louisiana directness.

This past week Carville has offered an equally blunt observation about handling the COVID-19 pandemic, especially the hopes and prayers surrounding the vaccination program in the US and throughout the world, including in Australia.

“Wish in one hand, shit in the other and see which one fills up first,” he said. It probably won’t achieve the fame of the “economy, stupid” line because of its earthiness but it should be noted and appreciated.

The dirty secret of the politics and policy of the SARS-CoV-2 virus at the beginning of what’s at best the second quarter of a long game is that the vaccine story is overhyped, spun within an inch of its existence and could go wrong on any day.

On a primary level, it’s been a great success and has the potential to become a wonder of the world.

Just consider the list of fastest-ever achievements: the mapping of the virus DNA, building a prototype for a vaccine, starting mass scale clinical trials, getting vaccines ready for regulatory approval and getting approval granted.

It was all done within 10 to 11 months.

On vaccines, one in 10 Americans have been vaccinated and almost one in five people in the United Kingdom have received at least a first shot. Israel is at the head of the pack with more than 63 per cent of its population having already had a dose of vaccine administered.

However, the vaccines are fighting a battle the parameters and objectives of which are still being finalised.

Pulitzer Prize-winning journalist and Council for Foreign Relations member Laurie Garrett said two inconvenient truths lurked behind the current global struggle with COVID and SARS-CoV-2.

The most alarming is that despite the appearance of everyone pulling in the same direction, this isn’t really happening.

“We have no strategy for tackling this virus,” Garrett said in a podcast at the end of January. “We have no global strategy, the World Health Organisation doesn’t have one, we have no national (US) strategy, even the 200-page-long COVID plan put out by the Biden administration is not a strategy, it’s a list of tactics.

“You don’t have a strategy unless you have an agreed-upon goal, a target. What are you trying to achieve?

“Some (scientists) say it needs to be eradicated like smallpox, it must be completely eliminated from planet Earth.

“Some would say we just have to buy enough time with vaccines and (we get) herd immunity and we add it to the pantheon of child vaccine schedules alongside measles.

“And some would say it’s like HIV and it will be a permanent threat on the human landscape that didn’t exist before.”

The other inconvenient truth is that we’ve only completed half of the vaccination task. We’ve got vaccines against the illness the virus causes – COVID-19 – but as yet we haven’t got a vaccine for the virus itself, SARS-CoV-2 . The hand that’s full of hope is based on the belief that the vaccines will also prevent transmission.

Anyone who wants to see a shuddering example of why this doesn’t always happen should read the two-stage history of the polio vaccines. Jonas Salk’s vaccine for polio caused jubilation but a rush to get people immunised caused problems (a small percentage were actually infected with the disease) and it was soon realised the medicine only guarded against the illness and not the virus that caused it.

A second, oral vaccine was developed to tackle and wipe out the virus behind polio. Right now we are in the first stage of the polio experience – and hopefully we will get past that quickly and successfully. But we should keep this in mind when celebrating every breathless government press release.

These whiplash reality checks are all the more relevant when you read the constant spin that passes for information and progress on Australia’s snail’s pace journey towards getting vaccinations available.

The other points to bear in mind are that no one has a real idea of what is happening with the virus and its many mutations into new strains.

Garrett said it’s like a high-stakes game of deadly roulette.

“We’re playing havoc with viral evolution,” she said. “We’re creating 100,000 Petri  dishes to sit around and offer limitless opportunities for the virus to evolve and mutate.”

In December, Dr Emma Hodcroft, a British scientist who was among the first to identify airborne transmission of SARS-CoV-2 last May, said the worrying thing for researchers is that we are only seeing those variants we recognise.

“The UK and South African variants are like friends who wear dark glasses and a hat,” Hodcroft told the Lancet podcast. “We still know who they are. What we’re really worried about is when the virus puts on a big overcoat and scarf covering its head. Then we’re in big trouble.”

Finishing on a parochial aspect of this doom vista, the vaccine rollout in Australia is due to start within three weeks, with a plan to use private logistics companies.

This means the tens of millions of vials of vaccine are going to be trucked around by companies such as Linfox, Allied Express and Cube, none of whom has significant experience in hauling pharmaceuticals, especially vaccines that need to be stored at minus-70 degrees Celsius.

As one pharmacy sector figure asked: “Why aren’t they getting the army to do this? They are supposed to be the best logistics operation in the public sector.”

If the Government doesn’t want to use the army – or they don’t want to do the work – there are established pharmaceutical distributors with annual experience in rolling out flu vaccines, being mindful of temperature, quantities and geography, who could play a role. They are being overlooked.

As it stands, what could possibly go wrong? After all, outsourcing hotel quarantine worked so well.

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