Cherchez le fric

You cannot expect most mortals to excel in the über-byzantine ways of Modern Politics.

Except for the Brits. The inhabitants of a little island managed to rule the planet with wits.

Their top diplomats used few words adorned with plenty of elegantly suggested threats.

Why did the British born and raised CEO of Sanofi open his mouth a little bit too much?

In an interview with Bloomberg News on May 13, 2020, CEO Paul Hudson said: “The U.S. government has the right to the largest pre-order because it’s invested in taking the risk…(the U.S. expects) that if we’ve helped you manufacture the doses at risk, we expect to get the doses first.” The American government had expanded a public—private partnership by injecting U$ 400 to develop a safe vaccine faster; the company has a vaccine development facility in Waltham, Massachusetts.

The not-so-subtle words of someone that should know better than ruffling the already-excessively-ruffled feathers of the public servants assailed by the clamor of their constituents to bring a vaccine to the market that will deliver us all from this ordeal, landed as a cluster bomb in the elegantly baroque hallways of the French government. Président François Macron expressed outrage at that statement and countered that a good vaccine should benefit all Mankind and should not be sold in a private market.

We watched in Le Journal of France 2—the most popular news program in France—on May 14, 2020, as Serge Weinberg, President of Sanofis-Aventis, made a special appearance to calm the public uproar that his subaltern had maladroitly produced a day earlier. He said: “there will be no particular advance given to any country.” He explained that his company has a small vaccine facility in Waltham but a much larger one near Lyon. They are making arrangements already to produce the vaccine in those two facilities plus several other ones to meet demand in other parts of the planet.

In a Washington Post article, Christopher Rowland, Carolyn Y. Johnson and William Yan said: “Johnson & Johnson’s race to manufacture a billion doses of coronavirus vaccine is ramping up in a small biotechnology plant near Interstate 95 in Baltimore. But even as technicians prepare to lower 1,000-liter plastic bags of ingredients into steel tanks for brewing the first batches of experimental vaccine, international concern is bubbling about what countries will get the first inoculations.” That Baltimore facility is the first one of four company planned ones as the production of a vaccine for the whole of Mankind will take an unprecedented manufacturing effort.

Designing and manufacturing a reliable, safe vaccine for the SARS-CoV-2 virus is a task of biblical proportions with no margin of safety errors for three major reasons:

a) It’s a novel virus that produces multiple effects in various body systems, for which scientists and physicians are still learning “sur le champ” in a paranoid environment.

b) Pharmaceutical companies are developing new biotechnology techniques that had not been tested before and demand caution as there is hardly any long-term safety data.

c) Unlike other pharma products that are eventually consumed by sick people, an approved vaccine(s) will be given to millions of healthy people all over the planet.

Herd Immunity is the indirect immunological protection that is afforded to an entire population by the presence of a sufficient number of immunized individuals in their midst—after they had been infected; this has occurred for measles, mumps, polio and chickenpox due to the massive vaccination campaigns promoted by authorities. As long as the number of immune individuals does not go below a certain threshold, the whole population is safe. If there is a community with lower coverage—like it happened with measles in Disneyland in 2019—there might be an outbreak. Some viruses like the Flu mutate frequently and its immunity only lasts a few months, requiring almost yearly updates. So far, the SARS-CoV-2 virus has not shown that propensity to change frequently, which would extend immunity to several months or years. However, we still do not know much about it and we should be prudent.

There are two ways to develop the Herd Immunity: option A and Option B.

Option A

If we do not enact Physical Distancing and Social Isolation measures, the virus will infect millions of people in just a few months; experts agree that at least 70% of the population must be immunized in order to get the necessary Herd Immunity. This is the approach taken by Sweden, which has not put up any radical measures. We must consider that it is a small country of only a few million people, living apart both from a physical and social standpoint. Have you seen Swedes holding hands in the street? This approach can overwhelm the care facilities and exhaust the available material needed to take care of a surge of critically ill patients in the large urban centers.

Option B

If we do enact those drastic Public Health measures, the incidence of new infections will slow down, which will not overwhelm the already existing facilities and allow authorities to increase their resources, both human and material; this is what is commonly referred as “flattening of the infection curve.” New cases will rise slowly, then plateau over a period of weeks or months before finally coming down. This is the approach that has been taken by most countries in the world at the present time.

For both societal alternatives, the arrival of one (or 2,3) useful and safe vaccines will accelerate dramatically the attainment of a protective immunity shield for all people. That is precisely why many governments (especially if they have vaccine producing facilities in their territory) are fighting a sordid war of words and elbows to be in the pole position once the  frantic race for massive vaccination starts in the near future.

Development of an effective and safe vaccine for millions of people is usually a process that takes many years, even decades. The design of one ( or maybe two or three) vaccines for the SARS-CoV-2 virus is being fast-tracked by several teams around the planet, sometimes carrying out animal experiments and the initial phase of clinical trials at the same time. There are at least four major techniques to achieve that feat in record time:

a) Use of harmless viruses to deliver their genetic material inside the cells so they can form proteins, which will eventually alert the immune system to produce antibodies.

b) Use of killed or inactivated fragments of the virus to engage the immune system.

c) Use of a novel technique of viral messenger RNA in order to stimulate the human cells to produce the viral proteins that will trigger a response.

d) Use of viral DNA to produce the same effect as the above-mentioned technique.

The use of viral DNA or DNA is a completely new scientific approach and there is not any industrial experience about how to manufacture that kind of vaccine in a large scale; if we consider that in order to reach complete immunity, humans might need two doses of the vaccine, we are facing the real need of producing billions of doses on short order. Experts believe that eventually there will be more than one candidate, which will facilitate the tackling of this colossal production of good vaccines in a few months.

In order to dramatically speed up the arrival of an effective vaccine, the American government—breaking all the conventional wisdom and past experiences on vaccine development—has created a special project called Operation Warp Speed. In an article in Science, Jon Cohen said: “The project, vaguely described to date but likely to be formally announced by the White House in the coming days, will pick a diverse set of vaccine candidates and our essentially limitless resources into unprecedented comparative studies in animals, fast-tracked human trials, and manufacturing. Eschewing international cooperation—and any vaccine candidates from China—it hopes to have 300 million doses by January 2021 of a proven product, reserved for Americans.”

On May 21, an article in Bloomberg News detailed the U.S. administration whooping investment of 1.2 billion U$ in the joint AstraZeneca-University of Oxford project to develop a vaccine for SARS-CoV-2, which will start a large clinical trial in 15 days. The details are still coming out but there is already talk of a compromise for 1 billion doses.

If you are trying to guess which country will get the vaccine first, you must remember the answer of veteran sleuths to the question of what the motive of a heinous crime was.

Cherchez la femme!

Cherchez le fric!

Note – We have a little theory why Mr. Hudson committed perhaps the worst mistake of his life: he has spent too much time in the USA, the land of the brutish spitters of “truths.” Except for highly educated regions like New England and well-behaved ones like the Midwest, there are far too many spontaneous sauvages in this country who sincerely yet naively believe that just because something might be “correct”, it necessarily has to be “right.” We respectfully propose to the honorable Sanofis-Aventis board that they should grant their Demolition Paulie a leave of absence for a refresher stint in an English boarding school—with mandatory wearing of a good muzzle at all times, except in the refectory.

Stay distant. Stay safe. Stay beautiful.

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