Governments are understandably desperate for anything that would forestall the deaths, closures and quarantines resulting from COVID-19. Hope for a speedy resolution for discovering and manufacturing a vaccine for millions of users were quashed when experts were warned that a vaccine could be more than a year away. The waiting time is usually attributed to extensive clinical trials needed to ensure it is safe on human test subjects before distributing to the wider public. Hot on the heels of such topic comes World Health Organisation chief Tedros Adhanom Ghebreyesus. Last month he cautioned that the struggle is far from over. Quoting his words "make no mistake: we have a long way to go".
In Malta, the number of infected persons seem to go down to single figures on a daily basis but the health authorities warn us not to relax and keep maintaining social distancing. Elderly people over 65 years and other vulnerable persons are strongly advised to stay at home. It is now almost seven weeks that a partial lockdown has paralysed the economy as all hotels, bars, gyms, shops, schools, university, the international airport and the central court are closed. One speculates that the apex of jobless totals will be reached by October this year, unless some relaxation of the lockdown is ordered by the health authorities.
The bleak situation hits aggressively a number of sectors (not on Annex A), which are not covered by an €800 monthly grant by Malta Enterprise. In fact, all professionals like accountants, auditors, consultants, lawyers, notaries, engineers, fund advisers and estate agents are branded as persons with deep pockets and consequently need no subsidy. One hopes a reality check hits the political team in Castille. The truth is that soon there will be multiple redundancies, if the partial lockdown is not lifted by the end of next month.
Still, it is not all doom and gloom since Malta succeeded to persuade the Commission to grant €5.3m to help kickstart local research into a vaccine against COVID-19. How effective this sum is, is somewhat doubtful, since Malta is one of the countries with the lowest amount invested in innovation and applied research. Ideally, a sum not less than €200m annually is the extra amount urgently needed to reach the standard rate of 2% of GDP as recommended by the EU.
More good news follows announcements that as infections in Europe gradually decline, countries are slowly lifting restrictions. Principally we notice how Germany has permitted small retail spaces to open while Poland has made parks and forests accessible to the public again. Lucky for children in Norway, they can now return to kindergarten, while it is encouraging to hear that open markets in the Czech Republic will be permitted to trade.
The race for a vaccine has been triggered and the president of the European Commission, Ursula von der Leyen, suggested that regulatory approval for an eventual vaccine might be expedited. The question follows that as the world is gripped in this pandemic and close to two million persons are infected, many ask: what is hindering laboratories in their quest to launch a successful vaccine? Let us talk a bit about what it takes to produce an effective vaccine that can be produced in sufficient numbers to be distributed globally. Normally, a vaccine is developed in the lab before being tested on animals. If it proves safe and generates a promising immune response in this pre-clinical phase, it enters human or clinical trials. These are divided into three phases, each of which takes longer and involves more people than the previous one. Phase 1 establishes the vaccine's safety in a small group of healthy individuals, with the goal of ruling out debilitating side effects. Phases 2 and 3 test efficacy, and in an outbreak like the present one, they are conducted in places where the disease is prevalent. The mystery thickens when various medical experts caution us to be patient since there is no scope in rushing to produce a defective cure.
Governments, who fund such expensive research ask... Can people who have recovered from the disease catch it again? Still, there has been encouraging signs coming from different countries. The beginning of March saw a major news item about Israel's major technology breakthrough. Enter Teva, one of the mega medical and drug companies in Israel. One of its recent discoveries is the hydroxychloroquine sulphate tablet drug. For readers with a medical background, one can add that according to Professor Didier Raoult, director of France's Institut Hospitalo-Universitaire, the hydroxychloroquine molecule could indeed have an effect on the elimination of the Coronavirus. The tablet was originally approved by the US Food and Drug Administration (FDA) for the treatment of malaria, lupus erythematosus and rheumatoid arthritis but not in the use for the treatment of COVID-19. Only this month, we received more good news that the FDA approved the use of chloroquine phosphate and hydroxychloroquine for emergency treatment of COVID-19 patients. The FDA is recommending only controlled clinical trials to test the drugs' effectiveness in treating COVID-19, but is allowing doctors to give to patients in cases in which they cannot participate in such a trial.
Equally promising are other giant research firms which joined in the race. A typical contender is the British pharma giant GlaxoSmithKline currently in collaboration with Vir Biotechnology. It hopes this antibody testing will be completed within the next three to five months. Another strong contender is Modena Therapeutics, a company based in Cambridge, Boston, which has successfully developed a potential shortcut to a laborious process that could shorten the time it takes to develop vaccines against the current Coronavirus. Last, but not least is Inovio, a company funded by Bill Gates. Inovio claims it has been well ahead of other pharmaceutical companies with regard to getting a Coronavirus vaccine into worldwide circulation.
In conclusion, as many persons are cooped up at home, trying to maintain their sanity and work offline, one appreciates that our health authorities are doing a sterling job by controlling the spread of the infection. On the other hand, as warm weather is approaching there is a natural drive for islanders to go out and enjoy a long-awaited moment of liberation.
Pray that the butterfly of deliverance will soon grace our balconies and windows.
George M. Mangion
The writer is a partner in PKF Malta, an audit and business advisory firm