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Forget the ‘beginning of the end’, Covid is a permawar

San Francisco usually experiences an eerie change in January. The city’s casually dressed residents are suddenly infiltrated by thousands of suits, delegates at the annual JPMorgan healthcare conference.

This year the conference was held online but the dissonance remained. In the real world, politicians assure us that vaccines herald the beginning of the end of the pandemic. We can hope to see relatives soon. Summer holiday bookings in Europe have surged.

Yet in the virtual world of the conference, the healthcare industry was preparing for an enduring war on Covid. “We do believe more so than we did, let’s say four to six months ago, that there will be a level of testing that will continue certainly through FY ’22,” said Tom Polen, chief executive of Becton Dickinson, the New Jersey-based manufacturer of syringes and tests. 

Another two years of this? If anything, that is optimistic, according to Stephen Tang, chief executive of OraSure Technologies, a rival diagnostics company. “The need to have tests available to continue to test for Covid-19 will last well beyond 2022, certainly in the sophisticated economies,” said Mr Tang. “And then for the low- and middle-income countries, perhaps well into 2027 or 2030, unfortunately. But I think that’s the state of play for this virus and the world populations.”

Perhaps there is more cheer to be found from the vaccine makers, the companies transformed in the public imagination from greedy patent exploiters to the saviours of humankind. The extraordinary achievements of the likes of BioNTech, Pfizer, Moderna, Oxford university and AstraZeneca surely offer a speedy return to normality?

Not so fast. “We know that it’s changing and whether it’s changing a little or a lot, that is something that we’re anticipating,” said Angela Hwang, a Pfizer executive, pondering the virus’s ability to mutate. “So we may be in a place where we may need a new vaccine.” 

The current crop, despite their remarkable development speed and efficacy, are vulnerable to being rendered useless. Scientists expect a mutant strain to escape their grip. Pharmaceutical companies are confident they can respond but that requires adapting the vaccines, winning regulatory approval (ideally without another set of full-blown trials) and ramping up manufacturing all over again. 

In a positive scenario, this becomes as smooth as the annual flu vaccines, or an inoculation for all strains is developed. In a worst case, we are always a step behind the evolving virus.

Even if vaccines can deal with variants, there is a huge selection of the population ineligible for current vaccines, an impediment to herd immunity.

Stephane Bancel, Moderna’s chief executive, told the conference that the company would soon start to address this by testing its vaccine on young children “but this will take much longer” as scientists proceed carefully with low doses. We should not expect trial data until next year.

There is at least some positive news for investors. JPMorgan’s analysts worried about the “durability of the vaccine tailwinds” to pharma company profits. Fret not. “From where we sit here at Pfizer, we see this as a durable business,” said Ms Hwang. “And it’s a business and a piece of research that we’re going to have to continue to do for a long time.”


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