Apr 30, 2020

Axios Science

Welcome back to Axios' special report about the science of pandemics. This week we look at collaborations between scientists in the U.S. and China, thorny questions about distributing a vaccine, the double whammy of the flu and COVID-19, and more.

1 big thing: As U.S. and China fight, their scientists collaborate

Illustration: Aïda Amer/Axios

All the tough talk and finger-pointing between officials in the U.S. and China about this pandemic belies cooperation among scientists in the two countries who are racing to understand the deadly virus.

Why it matters: Pandemics are a global problem that scientists say require a global solution. But scientific advances are increasingly seen as a national competitive advantage, creating tension that some experts warn could undercut global efforts to defeat COVID-19.

What's happening: Scientists in the U.S. and China are working together on testing COVID-19 treatments and drug candidates, developing vaccines, and understanding the origin and spread of SARS-CoV-2, the virus that causes COVID-19.

  • A new analysis for Axios by Pedro Parraguez of Dataverz, a data analytics startup in Copenhagen, found about 407 papers published so far this year are co-authored by researchers at institutions in the U.S. and China, out of roughly 7,770 published by researchers in the two countries. (The analysis was run using the dataset Dimensions.ai.)

The big picture: There are stark warnings of "vaccine nationalism" because if a COVID-19 vaccine becomes available, there won't be enough at first to immunize the global population.

  • The World Health Organization last week launched Access to COVID-19 Tools (ACT) Accelerator, an agreement of governments, companies and other organizations to collaborate on COVID-19 diagnostic testing, treatments and vaccines with an emphasis on making sure "no one is left behind."
  • Political leaders from the U.S. and China did not participate in the launch but there is a rolling campaign to join.

The bigger picture: Atoms, bits and base pairs fuel the Great Powers race. The U.S. is trying to keep its top spot as China tries to establish scientific prowess.

  • The next 5G, artificial general intelligence, quantum computing and now a vaccine for COVID-19 are seen by leaders as strategies for national security.

Yes, but: The country's scientific enterprises are intertwined.

  • The U.S. collaborated most frequently with authors from China — about 26% of U.S. internationally co-authored articles in 2018, according to a report earlier this year from the National Science Board.

The U.S. and China both benefit from their collaboration, says Jenny Lee of the University of Arizona.

  • China brings financial investment, and the U.S., with its established scientific heft, extends the global reach of China's research, says Lee, who studies global higher education.
  • At the same time, there are long-running concerns about IP theft and foreign influence in U.S. research, and some U.S. lawmakers have proposed limiting the areas of science that Chinese students can study.

The two countries worked together during the SARS outbreak in 2003, the Ebola outbreak in West Africa in 2014 and other epidemics over the past 20 years.

  • The U.S. Centers for Disease Control and Prevention says it offered to help its parallel institution in China when the COVID-19 outbreak began but, the FT reports, hasn't asked them to collaborate formally on research.
  • China's initial communication of the emerging epidemic, which included delays and inaccuracies, led to criticisms and concerns about how much the U.S. and the rest of the world could trust Beijing.

For some, those concerns are even more reason to collaborate.

  • "The more engagement we have, the more opportunities we have to build relationships and inform our understanding of this emerging infectious disease threat," says Margaret Hamburg, foreign secretary of the U.S. National Academy of Science and a former FDA commissioner.

What to watch: "Nationalism and attacks can erode even good collaborations [among international colleagues]," says virologist Richard Kuhn of Purdue University, who is also the editor-in-chief of the journal Virology.

  • "This can have a big impact on the advancement of science," he says.

The bottom line: Scientists are already multipolar, says Rajneesh Narula, a professor of international business regulation at the University of Reading in the U.K. "There can be three poles, which is what is happening: the U.S., Europe and China. Everyone is willing to accept that, except perhaps the poles themselves."

Read the full story.

2. The clash over who gets a vaccine

Illustration: Eniola Odetunde/Axios

Global demand will be high for a successful COVID-19 vaccine, even if it's years down the road before any become available, Axios' Eileen Drage O'Reilly reports.

State of play: There will not be enough vaccines to meet initial demand, experts say. That's left nations racing to secure future supplies and international organizations scrambling to make sure there is equitable access to any vaccines for the novel coronavirus.

What's happening: The COVID-19 vaccine race is underway, with at least 92 in development and more expected. They're based on different approaches that have different manufacturing processes.

  • There are a limited number of facilities that are large enough for massive scale-ups and/or are flexible enough to switch to a different type of vaccine than they were originally intended to produce.

Beyond the logistical problems is the likelihood that nationalism could stymie the process.

  • It's not clear if drug companies have contracted out to governments at this point, but during a press briefing today, Gayle Smith, who is the CEO of nonprofit ONE and was an adviser to President Obama during the 2014 Ebola pandemic, called for transparency from drug companies to prevent a scramble similar to what happened during the 2009 H1N1 epidemic.
  • "Basically, the bulk of that vaccine was already owned before it even came on the market."

Yes, but: Already there are signs of protective measures, which experts also acknowledge are natural tendencies.

The top priority for the first round of vaccinations, Smith says, should be people like health care workers and those in regions where epidemiologists say it would be best to halt the spread of the virus.

  • Eventually, the world should be vaccinated, as this coronavirus could easily find a foothold and spread again.
  • "As much as everyone's concerned about their own personal situation and each country is concerned about that country's situation, because of the nature of the virus ... unless we're able to interrupt transmission, ultimately no one wins," Hannah Kettler, director of vaccine financing and partnerships at PATH’s Center for Vaccine Innovation and Access, tells Axios.
  • "Equitable access is so critical," Seth Berkley, CEO of GAVI, the vaccine alliance to increase supplies to developing nations, tells Axios.

Read the full story.

3. How to avoid dueling outbreaks

Illustration: Sarah Grillo/Axios

The seasonal return of influenza in the fall and winter is set to further complicate the ongoing response to the COVID-19 pandemic — but it doesn't have to be a double disaster, Axios' Bryan Walsh writes.

The big picture: Influenza kills tens of thousands of Americans each year. But the flu has a vaccine — and a dedicated plan to increase vaccination rates could avert a magnified disease crisis.

The same social distancing put in place to slow the spread of COVID-19 also seems to have brought an early end to this year's flu season. If those efforts continue into the fall and winter, "it's likely to help us somewhat with the flu as well," says William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center.

The catch: If social distancing in some form remains in place — as many experts believe it will — it may prove difficult to distribute the flu vaccine.

Regardless, it's almost certain COVID-19 and the flu will be circulating at the same time this fall, says Richard Besser, CEO of the Robert Wood Johnson Foundation. "That makes it important to plan now for how we will deal with both outbreaks simultaneously."

  • The flu on its own puts tremendous pressure on hospitals each year — last year's season resulted in nearly 500,000 hospitalizations, especially among the same elderly cohort that is most at risk from COVID-19.
  • The most important step Americans can take is to ensure they get vaccinated for the flu this year, which will offer them some individual protection and reduce the strain on the health care system.

What to watch: Assuming an effective COVID-19 vaccine can be developed, the world will need to produce hundreds of millions of doses, if not far more.

  • Some experts are worried that vaccine manufacturers may hit production limits that force them to choose between a new COVID-19 vaccine and existing vaccines for diseases like the flu.

The bottom line: Doctors will need to be on guard — and Americans will need to get their flu shots — to ensure that influenza doesn't make a bad COVID-19 pandemic even worse.

Read the full story.

4. Worthy of your time

What if immunity to COVID-19 doesn't last? (Antonio Regalado — MIT Tech Review)

  • There is early evidence that infection affords some immunity, but determining for how long is critical to knowing when and how this pandemic ends.

Why the coronavirus feels so risky (Bryan Walsh — Axios)

  • "Properly managing the pandemic on a social and personal level will require hard honesty about what we know and what we don't."

Why Romans grew nostalgic for the deadly plague of 165 A.D. (Edward Watts — Zócalo Public Square)

  • An ancient story of resilience and rebuilding offers some hope and perspective.

A sobering astronomical reminder from COVID-19 (Avi Loeb — Scientific American)

  • A different perspective from the chair of Harvard's astronomy department: "We should be thankful for the fortuitous circumstances that allow us to exist, because they will surely go away one day, with or without COVID-19."
5. 1 viral thing

Daniel Defoe's "A Journal of the Plague Year"

We live this pandemic by charts and graphs — case curves, peaks and plateaus, tweeted, printed and broadcast.

That wasn't always so.

  • During England's Great Plague (caused by a bacteria albeit not a virus) in the 1660s, there were hardly any newspapers.
  • It wasn't until 60 years later that English writer Daniel Defoe captured the drama of the time through tables and charts in the pages of "A Journal of the Plague Year."
  • "Thus does the regime of the numerical tableaus begin," writes Yale University's Rüdiger Campe.

Why it matters: Today there is a relative wealth of data in which we seek comfort, guidance — and even validation.

  • But like Defoe's data, today's is incomplete.
  • 9,000 more people may have died from COVID-19 than reported based on new CDC statistics of provisional deaths above the normal rate — and even that is partial data, per NYT.
  • With asymptomatic carriers of the disease, a lack of testing and inaccuracies in the tests, there are uncertainties in the charts and graphs that we take to accurately reflect reality.

The bottom line: Just like for the characters in Defoe's book, the question of where we are in this story is very much unknown.

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