Inside Covid-19: Meet 32-year-old SA scientist at forefront of global research into variants; big pharma retools vaccines

In this episode of Inside Covid-19, we speak to Sandile Cele, a 32-year-old researcher at the Durban-based African Health Research Institute who has made global headlines for an important breakthrough in the fight against Covid-19. Cele found a new way to grow the 501.V2 variant and in so doing, reports the Financial Times, helped show scientists that the variant can escape antibodies and lead to reinfection. Also in this episode, we hear from our partners at Bloomberg about how pharma companies are racing to retool their vaccine strategies as fast-spreading and potentially dangerous mutations of the virus emerge. Plus the Covid-19 headlines – and an update on vaccine roll-out from Discovery’s Adrian Gore. – Jackie Cameron

Covid-19
Sandile Cele. Photos by: Qiniso Dladla

Inside Covid-19 headlines

  • As of this week, nearly 110m cases of Covid-19 have been recorded around the world, nearly 2.5m people have died of the new disease, according to the Johns Hopkins Coronavirus Resource Centre. The US is the hardest hit, with not far off half-a-million Covid-19 deaths recorded from 28m cases. Brazil, Mexico, India and the UK are also among the countries with the highest number of deaths from Covid-19. About 120k have died in Britain. South Africa has the highest number of deaths recoded on the continent with about 48.5k people dying from Covid-19, according to government figures.
  • South Africa’s muddled acquisition AstraZeneca vaccine from India, found on delivery to have an April expiry date and not the normal six-month one, continues, writes MedicalBrief. After India refused to exchange the vaccine or give a refund, the Health Department said it would on-sell the consignment to the African Union (AU) at cost but now, reports the Mail & Guardian, it appears that South Africa is having to sell at half-price. Contradicting official accounts that South Africa would on-sell the AstraZeneca vaccine to the AU “at no cost to the fiscus”, Mail & Guardian reported that that government is planning to sell its AstraZeneca Covid-19 vaccine consignment to the AU or an associated body on the cheap, at almost half the price it originally paid for it. More than half of South Africans probably have already been infected with SARS-CoV-2, with blacks three-to-five times more likely than white people to have antibodies to the virus, found a SA National Blood Service study. Despite this, “As has been seen in other areas, even such high seroprevalence does not guarantee population-level immunity against new outbreaks – probably due to viral evolution and waning of antibody neutralisation,” reports the study, which extrapolates to the entire population an analysis of blood donors.

In a Business Insider report, Discovery Group CEO and founder Adrian Gore agrees with the SANBS conclusion, saying that South Africa’s sky-high “excess” death number indicates that more than 50% of population had already been infected with COVID-19. Based on the excess death rate, Discovery estimates the country’s true infection rate must be above half of the population.

“The number of people who have been infected in our view is probably over 50% of the country. This pandemic has had a traumatic effect on people, on the economy. You have to fight it with everything you can,” Gore said in a statement published on the Discovery website.

“I need to stress the importance of helping to make the national rollout a success, given the scale of the pandemic and its tragic impact. There have been over 2.3 million deaths globally, and approximately 120,000 excess natural deaths in South Africa during the period of the pandemic – most of which are almost certainly attributable to Covid-19.

We have also experienced the tragic Covid-related deaths of almost 5,000 Discovery Health administered scheme members, and of 12 of our own staff. We are acutely aware of our responsibility in this pandemic and the crucial role we need to play in ending it. I assure you that we have not and will not shirk our responsibility. In this context, we are often asked why we don’t just procure the vaccines ourselves for our DHMS members, and rapidly vaccinate them. There are two important constraints that make this narrow approach problematic.

First, there is a global shortage of vaccines, and the pharmaceutical companies manufacturing the vaccines will currently sell only to national governments, and not to any other entities. Second, there are specific risk factors that make some people more susceptible than others to severe illness and death should they contract Covid-19. This means that to be both fair and effective, the vaccination programme must be planned and implemented at a country level, according to a schedule that prioritises high-risk individuals first, and matches appropriate vaccines to at-risk groups according to clinical and scientific guidelines.

Not following this process would mean low-risk people get vaccinated before the clinically vulnerable, resulting in unnecessary illness and death. This cannot and should not happen. Ensuring appropriate clinical prioritisation across the nation is therefore critical. We need social solidarity; but in return, we need to make sure that this coordinated approach is implemented as quickly and as effectively as possible.

In this regard, I want to assure you of Discovery’s deep involvement in these processes. We have been working closely with the National Department of Health (NDoH), Business for South Africa, Business Leadership SA, and other stakeholders, on many aspects of the national vaccination programme. Our team has been involved in supporting the population analytics, research-supported procurement processes, distribution planning and system development that has been taking place.

We have been engaging directly with several of the key vaccine manufacturers since Q3 2020 and remain in active contact with them. Should their position of selling only to governments change in the near future, we will rapidly engage with the NDoH to agree on a role for Discovery and other private sector players to become directly involved in procurement and distribution.we are optimistic that the priority groups identified for early vaccination will receive their vaccines during the first half of 2021.

  • Pfizer and BioNTech SE’s Covid-19 vaccine stimulated roughly two-thirds lower levels of neutralising antibodies against the South African variant of the coronavirus in a lab study. The Pfizer results are part of tests of its vaccine against a lab-created virus that had all the mutations found in the South African variant, which is thought to spread faster than earlier versions. The study released Wednesday showed reduced neutralisation of the South Africa-like virus by blood from people who had been immunised with the Pfizer-BioNTech vaccine. The companies believe their vaccine will still work against the variant.
  • The fast-spreading virus variant first found in the UK now makes up more than 20% of cases in Germany, Health Minister Jens Spahn said. “We must assume that it could also dominate here soon,” Spahn said in a tweet on Wednesday, citing data from the Robert Koch Institute. The share of variants from South Africa and Brazil is also rising, but is at a much lower level, Spahn said.
  • Two variants of the coronavirus first identified in the UK and in California appear to have combined into a heavily mutated hybrid. This could signal a new phase of the Covid-19 pandemic, as more hybrid variants may emerge. This is according to the New Scientist, which says that coronaviruses such as SARS-CoV-2 have an evolutionary superpower called “recombination” which allows two closely related viruses to mix-and-match their genomes into novel combinations. Unlike regular mutation, which proceeds slowly one change at a time, recombination can produce wholesale changes in a coronavirus genome in one single swoop. The publication asks: Has the hybrid been detected among actual viruses circulating in people? “No, although the sequence is from a virus taken from an infected person, so it is a plausible hypothesis that the recombinant virus is in the community. However, it could have already fizzled out after failing to transmit to other people. The US has relatively low rates of viral sequencing, so it is hard to say either way,” it says.
  • After a clash last month over whether EU countries would get their fair share of AstraZeneca’s vaccine shipments, fewer than one-tenth of the doses delivered to Germany have been administered in the initial days of the rollout, says Bloomberg. Some health-care workers also say they’re concerned about side effects amid reports about unexpectedly strong reactions. Germany isn’t alone: some French health workers are also pushing to get shots from Moderna and Pfizer-BioNTech instead.
  • The UK is set to carry out the world’s first study to deliberately expose volunteers to the new coronavirus to speed research, says Bloomberg. The human challenge study was approved by a research ethics committee and may eventually help accelerate development of vaccines and treatments and take on variants, the partners including Open Orphan Plc said. The trial involving as many as 90 people – due to begin within a month – is aimed initially at determining the smallest amount of the virus needed to cause infection.
  • Getting a Covid-19 vaccination in Indonesia will be mandatory for eligible citizens, the government said, with the country seeking ways to quicken its inoculation program to curb Southeast Asia’s largest outbreak, reports Bloomberg. The government will punish citizens who refuse the vaccine, including with fines and delaying or halting the provision of social assistance and administrative services.
  • People in New Zealand will have to wear a face covering on most public transport, the government announced after the end of a lockdown of Auckland ended Wednesday, says Bloomberg. There were no new positive Covid-19 cases in the community reported Thursday.
  • The Netherlands set aside €8.5bn in a multi-year support plan for the country’s education system, to help pupils and schools hit by the pandemic, according to Bloomberg. “To remove study delays caused by the outbreak, primary and secondary schools can use extra funds on targeted measures such as tutoring for pupils in small groups. About 6,600 primary schools will on average get €180,000 per school in the coming year, while the 650 secondary schools will receive more than €1.3m on average. Tuition fees for university students will be cut in half next year.”
  • Air France-KLM is poised to get a fresh government bailout after burning through €2.1bn ($2.5bn) in the final quarter of last year as a resurgent Covid-19 pandemic delayed any recovery in air travel, reports Bloomberg. Talks are ongoing between the carrier’s biggest shareholders, the French and Dutch governments, and the European Commission about a rescue package, according to Chief Financial Officer Frederic Gagey.
  • The value of Airbus’s order backlog fell by €98bn to €373bn at year-end, reflecting in part the longer-term damage wrought by the coronavirus pandemic on the health of the aerospace industry.
  • While case counts are coming down, new virus strains have created uncertainty about the timing of a global travel recovery. Passenger traffic may improve by only 13% in 2021 in a worst-case scenario, the International Air Transport Association said this month. That compares with an official forecast of a 50% rebound issued in December.
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