At Davos, a ‘good news, bad news’ message emerges about Covid-19

As the coronavirus continues to wreak havoc, an expert panel at the World Economic Forum delivered a mix of good news and bad news on Monday: More variants will emerge, but vaccine production is accelerating and research is progressing toward a combined shot that may be able to attack these different variants.

On one hand, the world needs to prepare for newer strains that could be more vexing, or the “worst case scenario,” said Annelies Wilder-Smith, a professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine. “Omicron will not be the last variant. There’s a high probability we will have another variant coming up. The question is when and will it be less dangerous?”

Her sobering reminder was made as part of a discussion about the path the coronavirus is taking and the outlook for its transition from pandemic to an endemic threat. For that to happen, the world has to take control in ways that still are not happening, which makes it difficult to predict that such a transformation can occur this year, according to Anthony Fauci, chief medical adviser to President Biden.

“We don’t know, and we have to be openly honest about that,” he said. At this stage, the near-term goal is to control the virus to the point where it is not disrupting society. But the current outlook depends on whether still another variant emerges that eludes the immune response to the Omicron variant. As a result, this remains “an open question.”

Tempering the uncertainty was a strain of optimism over vaccines. Moderna (MRNA) chief executive officer Stéphane Bancel noted that production is ramping up to meet global demand and that his company expects to makes two to three billion doses this year. He added that work is also under way to make a single, annual booster shot for Covid-19, influenza and RSV, a respiratory virus, and an answer may be known by the fall.

Meanwhile, though, the panelists acknowledged the inability to better address vaccine inequity, or whether vaccine supplies are sufficiently available across the globe. As the pandemic emerged two years ago, many wealthy nations raced to secure vaccines, leaving poor and middle income countries behind.

Public health experts and patient advocates have warned, however, this type of horserace only prolongs and worsens the pandemic because it allows new — and possibly, more dangerous – variants to emerge. And as such a scenario plays out, the number of infections and subsequent deaths continues to increase — making it harder to recover global health and the global economy.

But some panel members maintained progress is being made as an increasing number of doses are being delivered to lower-income countries. Richard Hatchett, who heads the Coalition for Epidemic Preparedness Innovations, noted that a World Health Organization donation program called COVAX has delivered 1 billion doses to mostly poor countries, as of this past weekend.

This is “an important milestone,” he said. But Hatchett, whose nonprofit works with the WHO and the GAVI vaccine alliance in managing the COVAX program, also indicated that he does not think a proposal before the World Trade Organization to temporarily waive intellectual property rights for Covid-19 medical products is a key answer to greater production or distribution.

In theory, such a waiver could make it easier for countries that permit compulsory licensing to allow a domestic manufacturer to export vaccines. But many wealthy nations, including several that are home to some of the world’s biggest drug makers, have objected to the idea, although the Biden administration last spring agreed to support the effort.

The “waiver may have a role in that, but there are other paths to pursue too, and we really need to explore all of them,” said Hatchett. “I don’t think it’s necessary right now in terms of making vaccines available. I think it’s the last option.”

Instead, Hatchett maintained a key issue right now is what he called “the last mile,” a reference to ensuring that vaccines sent to low and lower-middle-income countries find their way into arms. Beyond sufficient supplies, there are concerns that many countries lack logistical and medical resources to vaccinate their citizens.

Bancel indicated that, on any given day, his company has 50 million to 100 million doses waiting to be shipped to COVAX and argued that wealthy nations should be doing more to ensure supplies are made available. For his part, Fauci noted the Biden administration has increased its donation program to poorer countries.