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Good News about the Pfizer Vaccine

A medical staff member receives the Pfizer/BioNTech COVID-19 vaccine at Jackson Memorial Hospital in Miami, Fla., December 15, 2020. (Marco Bello/Reuters)

On the menu today: some really good news about the effectiveness of the Pfizer vaccine against the Brazilian, U.K., and South African variants; a reminder that the more partisan a claim about the pandemic was, the less likely it was to be accurate; and the Lincoln Project tries to pull a Northam.

In Your Face, Variants!

In the tug of war between pandemic optimism and pandemic pessimism, one of the recurring arguments from the side of pessimism is that the virus is always mutating, mutated versions have in some cases become more contagious and more virulent, and our vaccines either may not work as effectively or, God forbid, may not work at all.

One lab experiment offers evidence that variants can slow the antibodies generated by the Pfizer vaccine, but they can’t stop it:

The Covid-19 vaccine from Pfizer Inc. and BioNTech SE showed a high ability to neutralize coronavirus strains first detected in Brazil, the U.K. and South Africa, according to a new study.

In lab experiments, the shot demonstrated “roughly equivalent” levels of neutralizing activity against the Brazil and U.K. strains compared with a version of the virus from early last year. It also showed “robust but lower” activity against the South Africa variant, according to a letter to the New England Journal of Medicine.

While the research needs to be validated with real-world data, it offers another reason for optimism that the Covid vaccines are generally performing well against variants of the virus.

The letter states, “All the serum samples efficiently neutralized USA-WA1/2020 and all the viruses with variant spikes.

And even if a variant comes along that proves immune to the current vaccines, development of a new vaccine or booster will not be starting from scratch:

How worried should we be about the variants? They pose a challenge, but, compared to the original vaccine-development effort, it’s small. Pfizer-BioNTech and Moderna have said that they can develop booster shots within six weeks that work against these variants; Moderna has already started working on one that targets the South African version. From a scientific perspective, developing variant-specific vaccines is a straightforward proposition—one simply swaps the new genomic material for the old. Testing, manufacturing, and distribution could still take months. But the F.D.A. has released guidance designed to streamline the approval process for coronavirus boosters, indicating that it will review them using roughly the same approach it employs for annual flu shots. This means that the new vaccines will likely be tested in small trials of several hundred people, as opposed to the larger randomized trials that were needed for initial approval of the vaccines. Instead of following trial subjects for months to see if they develop covid-19, researchers will be able to use a blood test to determine if they are mounting an adequate immune response to the variant. The U.S. regulatory apparatus is evolving with the virus.

That’s from a New Yorker article by Dhruv Khullar which not only illuminates the nature of the fight against the variants, but also offers a realistic argument that the virus will, in the long run, lose more and more of its battles against the human immune system.

Like all viruses, sars-CoV-2 will continue to evolve. But McLellan believes that it has a limited number of moves available. “There’s just not a lot of space for the spike to continue to change in ways that allow it to evade antibodies but still bind to its receptor,” he said. “Substitutions that allow the virus to resist antibodies will probably also decrease its affinity for ace-2”—the receptor that the virus uses to enter cells. Recently, researchers have mapped the universe of useful mutations available to the spike’s receptor-binding area. They’ve found that most of the changes that would weaken the binding ability of our antibodies occur at just a few sites; the E484K substitution seems to be the most important. “The fact that different variants have independently hit on the same mutations suggests we’re already seeing the limits of where the virus can go,” McLellan told me. “It has a finite number of options.”

Over time, sars-CoV-2 is likely to become less lethal, not more. When people are exposed to a virus, they often develop “cross-reactive” immunity that protects them against future infection, not just for that virus, but also for related strains; with time, the virus also exhausts the mutational possibilities that might allow it to infect cells while eluding the immune system’s memory.

That description of a virus mutating to less and less virulent versions reminded me of a passage near the end of John Barry’s The Great Influenza: The Story of the Deadliest Pandemic in History:

The 1918 pandemic reached an extreme of virulence unknown in any other widespread influenza outbreak in history.

But the 1918 virus, like all influenza viruses, like all viruses that form mutant swarms, mutated rapidly. There is a mathematical concept called “reversion to the mean”; this states simply that an extreme event is likely to be followed by a less extreme event. This is not a law, only a probability. The 1918 virus stood at an extreme; any mutations were more likely to make it less lethal than more lethal. In general, that is what happened. So just as it seemed that the virus would bring civilization to its knees, would do what the plagues of the Middle Ages had done, would remake the world, the virus mutated toward its mean, toward the behavior of most influenza viruses. As time went on, it became less lethal.

Get vaccinated when you’re able, and don’t be like the mayor of Detroit, getting picky about which vaccine you receive. Any vaccine will give you some enhanced protection against the virus, while not having a vaccine means you’re rolling the dice on your own immune system. Given a choice, you’d rather wear a bulletproof vest, right?

Learning a Lesson Requires Correct Information

My colleague Ramesh Ponnuru has a typically excellent column about what we’ve learned, roughly one year into the pandemic:

The more partisan the narrative, the worse it has fared. Liberals have spent much of the pandemic fretting about red-state irresponsibility. But the four states with the highest percentage of Covid deaths all vote consistently for Democratic presidential candidates. Florida, though a consistent target of progressive criticism, has a death rate well below the national average. Some conservatives, for their part, predicted that we’d stop hearing about the pandemic as soon as the election was over. Instead, the deadliest weeks came after it, and both politicians and the press kept talking about it.

I try not to push the “The national mainstream media does a terrible job and gets far too many things wrong” button too often, but it is hard to overstate just how important it was, during this national crisis and particularly in its earliest moments, to present accurate information clearly. If there was ever a time to put aside the hot takes, knee-jerk narratives, partisan axes to grind, instinctive spin, and rock-em-sock-em-robot dueling-pundit habits and just tell people what they need to know, this was it.

For example, if the media airbrushes a Michael Avenatti type into a noble crusader for truth and justice, that’s bad. But it’s not necessarily life-and-death bad.

You know what’s life-and-death bad?

January 23, 2020, Vox: “The evidence on travel bans for diseases like coronavirus is clear: They don’t work.”

January 26, 2020, Vox: “There are now five confirmed US coronavirus cases. Experts say it’s no cause for alarm.”

January 28, 2020, BuzzFeed: “Don’t Worry About the Coronavirus. Worry About the Flu.”

January 31, 2020, the Washington Post: “The flu poses the bigger and more pressing peril; a handful of cases of the new respiratory illness have been reported in the United States, none of them fatal or apparently even life-threatening.”

February 5, 2020, the New York Times: “Who Says It’s Not Safe to Travel to China?”

February 7, 2020, Time magazine: “‘It’s just amazing how quickly word about this [coronavirus] has spread, the intensity of the coverage,’ says Steven Miller, a professor at the Rutgers School of Journalism and Media Studies. ‘It seems to me that the coronavirus is being covered in more sensationalistic terms than Ebola in 2018.’”

February 29, 2020, Forbes magazine: “No, You DO NOT Need Face Masks For Coronavirus—They Might Increase Your Infection Risk.”

March 4, 2020, Time magazine: “Health Experts Are Telling Healthy People Not to Wear Face Masks for Coronavirus. So Why Are So Many Doing It?”

Keep in mind, by February 5, 2020, Chinese state-run media were showing those videos of vehicles spraying the empty streets of Wuhan with massive clouds of disinfectant. By February 10, 2020, the Chinese government put its two biggest cities, Beijing and Shanghai, on partial lockdown — check points to measure people’s body temperatures, compulsory mask-wearing, travel restrictions, a requirement that all visitors check with medical authorities upon arrival. No country does that for “just the flu.” Don’t watch what authoritarian foreign governments say, watch what they do.

The realization that we were confronting a contagious virus that could kill you — that SARS-CoV2 wasn’t like SARS-CoV1, or MERS, or Zika, or H1N1, and instead was more like something out of Contagion — should have been a signal that it was time for the grown-ups to act. And while the world of American journalism had plenty of examples of terrific, fact-based COVID journalism that was neither fearmongering nor Pollyannaish, far too many institutions succumbed to the temptations of clickbait, conventional wisdom, groupthink, and other bad habits.

ADDENDUM: Did you notice that, much like Andrew Cuomo, the disgraced Lincoln Project is “pulling a Northam” and just plowing full speed ahead, hoping everyone forgets about its scandals? The New York Times today reports:

The behind-the-scenes moves by the four original founders showed that whatever their political goals, they were also privately taking steps to make money from the earliest stages, and wanted to limit the number of people who would share in the spoils. Over time, the Lincoln Project directed about $27 million — nearly a third of its total fund-raising — to Mr. Galen’s consulting firm, from which the four men were paid, according to people familiar with the arrangement.

George Conway and Mike Murphy have called for the Lincoln Project to disband. Murphy concluded, “all credibility is gone.” Conway called for a full accounting of the group’s finances and concluded, “there’s simply too much money that hasn’t been accounted for, and, I fear, never will be.

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