On Thursday, the Columbia Public Health Club held its inaugural event, “What’s going on with the COVID-19 vaccine rollout?” featuring Dr. Stephen Morse, a professor of Epidemiology at Columbia Mailman School of Public Health. Beyond discussing action items for this limbo between the despair of the pandemic and the hope vaccines offer, he explained why coronaviruses may be an increasingly prevalent part of our lives and how we can learn from this experience to prevent future pandemics.
Before getting into the details of the vaccine distribution, Dr. Morse walked the audience through a presentation on what coronaviruses are, past coronaviruses, and the current state of the vaccine rollout. Coronaviruses, he explained, are a family of viruses that have crown-like spikes on its surface. While they often circulate among other animals such as camels and bats, they could also evolve and affect people, often causing respiratory infections. Prior to 2003, most known coronaviruses that affected humans caused mild symptoms similar to those of the common cold. From observations of coronaviruses in other animals such as the mouse hepatitis virus, however, it was quickly found that coronaviruses were often hard to eliminate and could have serious effects on those who got infected.
However, because coronaviruses had been thought to be a veterinary problem that was largely only transmissible between animals, prior to the SARS and MERS epidemics, hardly any scientists were interested in coronaviruses. After the 2003 SARS epidemic which was caused by a coronavirus thought to have originated from horseshoe bats and other livestock, people were able to find about a dozen other closely related coronaviruses. “That should have been a “wake-up call,” Dr. Morse said. “It really should have told us that there were a lot of other coronaviruses out there, that it wasn’t just going to be a one-off, that we could expect to see these coming in the future if the opportunity arises.” While they used to circulate largely among animals and were largely considered a veterinary problem, coronaviruses, as we are gradually seeing, are slowly getting to be more relevant to the health of humans.
While technology and our scientific knowledge of coronaviruses have made great strides since they were first discovered, our main forms of non-pharmaceutical interventions have remained the same—social distancing, mask-wearing. The increased threat of coronaviruses to humans suggests that even after enough people get a COVID-19 vaccine, we need to constantly be on the lookout to prevent future pandemics, Dr. Morse explained. Surveillance systems like ProMED, a prototype outbreak reporting system with about 70,000 subscribers over more than 185 countries, as well as awareness and willingness to engage in non-pharmaceutical interventions when needed would greatly improve prevention and intervention efforts.
Dr. Morse said that ongoing research on coronaviruses, vaccines, and improvements in other areas have allowed us to have enough research and background information “that had been on the lab shelf for years” that allowed scientists to make a vaccine with unprecedented speed and efficacy. This is “the most advanced technology we have, but people have been working on refining them for years. What wasn’t there was any incentive economically to produce a new kind of vaccine,” Dr. Morse said.
Despite the efficacy of the vaccine, we must not let our guards down. For vaccines to be most effective, a large number of people need to be able to get it. Furthermore, transmissions need to be limited as we wait for everyone to get vaccinated to prevent the virus from mutating in ways that make it more dangerous and transmissible in ways that might render the vaccine less effective.
“Things are getting better, but it is no time to be getting complacent,” Dr. Morse urged. “We have a vaccine, but not everyone can get them yet.” Currently, some of the unresolved issues involve inconsistent supply of the vaccine, different priority groups across states, and the scheduling and distribution process. These challenges, among others, currently make it difficult for equitable and widespread vaccination—sign-ups for vaccination websites tend to be difficult to navigate, leaving those who are less tech-savvy lost and unable to register. While New York has started using POD sites—“point of dispensing” flexible vaccination sites that can be set up anywhere, pharmacy chains for long-term care facilities, and hospitals to help speed up vaccination, inconsistent supply, mistrust in the healthcare system, and other logistical issues with transporting the vaccines and distributions create hurdles that slow down the process.
As weary as we are, for the vaccine to be as effective as it can, we need to continue to play our part to stop the spread. “As long as this virus keeps being transmitted, it keeps mutating,” Dr. Morse reminded us. As such, even as efforts to distribute the vaccine increase, we need to maintain non-pharmaceutical interventions such as wearing a mask and trying our best to maintain social distancing measures to protect those who are unvaccinated and prevent mutations that could render a vaccine less effective.
Image via Columbia Public Health Club Facebook