Trump attempt to rush treatments and vaccine is a reckless gamble
The news that Donald Trump wants to fast track the Oxford vaccine in October is just another example of how politics is intruding in the difficult work of finding a long-term solution to the problem of COVID-19.
This latest story comes from The Financial Times, who suggest that the “administration is considering bypassing normal US regulatory standards” to make the vaccine available ahead of the November election. The politics of this are obvious as they are crass; the science and broader rationale is worrying, if not frightening.
Vaccines work because they help develop the often-discussed “herd immunity” more rapidly than can ever be achieved through the normal process of community spread and recovery. This does mean, however, that a majority of the population needs to be vaccinated and that percentage is determined by how contagious the virus is. In measles, it’s 94% but in other diseases the number can be as low as 40%.
Yet, to persuade so many people that a vaccine is safe, those of good standing need to advocate for their use. That role is usually played by scientists who are guardians of the process. Politicians? Their involvement should be the first and last taboo of science.
As we’ve seen around masks, the ability to convey even simple science effectively is often beyond most governments. How many times a day does somebody still say “it’s okay, I’ve got my mask on” as if it gives them immunity? Face masks do not prevent Covid-19 and the protection they offer is minimal (for example, it’s suspected the virus can also enter via the eyes). They do, however, provide a considerable barrier to transmission, which is particularly effective with a disease that is often asymptomatic in carriers.
So much for the “simple” science of masks. The science around vaccines is infinitely more complex. This is the problem all governments now face and why Trump’s continued intervention in the scientific processes is not just misguided but dangerous.
The anti-vax movement was always going to be problematic come the end of 2020 and going into 2021. A poll in January this year showed that only 45% of Americans didn’t believe that vaccines cause autism in children, a ten percent drop since 2001.
Meanwhile, in a poll conducted in July here in the UK, only 30% of people said they would definitely take a vaccine, with 43% likely or fairly likely.
Trump seems to care little for the safety of a vaccine. He is looking for quick wins after months of failing to control a virus that will have probably killed more than 200,000 Americans by the time the country votes.
Late on Saturday, the White House Press Secretary, Kayleigh McEnany, tweeted out that the President would announce “a major therapeutic breakthrough” on Sunday. That breakthrough was “convalescent plasma”, a treatment that had been used during the 1918 flu epidemic and might even have been used as early as 1906 when Francesco Cenci used it to treat an outbreak of measles in the Campello sul Clitunno area in Italy. A “major therapeutic breakthrough” in 2020 it most certainly isn’t.
What it was, however, was a Fox News headline last week after high-level government scientists, including the Director of the National Institute for Allergy and Infectious Diseases, Anthony Fauci, stepped in to stop the FDA from issuing the authorisation.
Their argument against the therapy was one solidly based in careful scientific reasoning: the treatment hasn’t been proven to work for COVID-19 patients. It is widely believed to work, but without proper trials, the efficacy of convalescent plasma is unknown. Yet, for it to be properly trialled, scientists require a control group, where some patients are given the plasma and others are given a placebo. Obviously, when people already believe this is a miracle cure, no family is going to agree to their loved ones being given the placebo.
Trump is looking for easy answers. Back in April and under intense pressure from the White House, the FDA approved the emergency use of the anti-malarial drug, hydroxychloroquine, for COVID-19 patients. “What do you have to lose?” asked Trump (echoing his question to black voters in 2016). The answer became obvious in June when the FDA revoked the authorisation after increasing evidence of adverse effects including patient deaths.
One might have thought the President would have learned his lesson but, just last week, a high profile Trump donor, Mike Lindell, claimed that the President is now excited by the news of Oleandrin, an extract from oleander, which has been shown to kill the coronavirus in-vitro (i.e. inside a test tube). “This thing works”, Lindell told Anderson Cooper in a heated exchange on CNN. “It’s the miracle of all time”.
To unpack that a little: Mike Lindell is known in the US as the “My Pillow guy”, a sharp-talking pillow salesman with a history of controversy. He is also reported to have a financial interest in this “miracle” drug, which would more accurately be described as a deadly poison with no known medical uses. The fact it kills the virus in a test tube is meaningless. Bleach would do the same. So would many chemicals, none of which you would be wise to inject into your body.
Trump hasn’t yet advocated for Oleandrin but has said “we’ll look at it”, which is an indicator of where we’re at.
Hydroxychloroquine, convalescent plasma, Oleandrin, UV light (“I think it’s a great thing to look at”), it’s clear the President looks at treatments in political rather than medical terms. He has already accused the FDA of holding up treatments simply because they want to hurt him politically.
Whether the Oxford vaccine offers protection or even immunity to COVID-19 now appears less important than whether Trump can make a victory announcement in October. The Oxford vaccine would then be no more than a political placebo making the American public enter the voting booths on November 3rd believing their president had delivered a cure.
Needless to say, his interest would wane on November 4th. As with everything in Trump world, things are “the greatest” until they’re “the worst”.
Researchers would be wise to continue working to their own timeline, remembering that it’s not just lives that are at risk here but people’s faith in science. They need to get this right.