Last week we had the great news that a safe and effective vaccine against SARS-CoV-2 should soon be available. Thanks to the work of Pfizer and BioNTech, we may have the opportunity to start vaccinating those at highest risk of severe disease towards the end of this year and into 2021. The interim analysis of their clinical trial has indicated that it is more than 90% effective in preventing COVID–19 in participants who haven’t been infected with SARS-CoV–2 previously, when participants received 2 doses of the vaccine 21 days apart. The trial continues and there remains much that is still unknown – how long will immunity last?Will it offer effective in those who have had prior exposure to SARS-CoV-2? And will it help reduce the transmissibility for those vaccinated, a vital element in reaching indirect protection (or herd immunity) through vaccination1?
Vaccination is an important part of what will be required for this country, and the world,to move past a series of lockdowns and travel bans, but it is just one part of what is required. Testing and isolating those individuals who are infectious with SARS-COV-2 to minimise transmission, as well as treatments for severe disease and long–COVID will also be required for those who still contract COVID–19. We are now fortunate to have a variety of sensitive and specific PCR based tests availablethat can detect if you currently have a SARS-CoV-2 infection. Gold standard PCR based testing, alongside the new rapid antigen and antibody tests which are proving to be less accurate2 but important because of their ability to give a rapid result, are a powerful toolbox to determine who is infected and who has previously been infected. There are many clinical trials investigating treatments for COVID-19 ongoing across the globe. Most treatments currently in trials are either antivirals to prevent the virus from multiplying, or immune modulators which help the immune system to create a response against SARS-COV-2 or prevent the immune system from dangerously overreacting against the virus. In the UK, the RECOVERY trial3 is currently testing low dose dexamethasone for use in children, Azithromycin (a commonly used antibiotic), Tocilizumab (an anti-inflammatory treatment), convalescent plasma (containing antibodies from donors who have recovered from COVID-19), REGN-COV2 (monoclonal antibodies directed against coronavirus) and Aspirin (used as an anticoagulant to thin the blood). Just last weekend, the NHS announced the start of 40 specialist long–COVID clinics to help the 60,000 individuals who have been left with longterm fatigue, breathlessness and pain as a result of SARS-CoV-2 infection.
With so many rapid advancements that the medical and scientific communities have provided to address the challenges that SARS-COV-2 has bought this year; we have much to be optimistic about longer term. It is important that we still recognise that it will take time to vaccinate the population and find the best treatments for those affected. The government has purchased 40 million doses of the Pfizer/BioNTech vaccine, enough to vaccinate 20 million people using the 2-dose regime. It is hoped that the first 10 million doses may be delivered this year but it takes 28 days after the first dose to be effective in 9 out of 10 cases, and even 40 million doses will be sufficient forjust under 30% of the 67 million population. With 25% of the UK’s population being classified as highly vulnerable, it is only correct that they will be prioritised for vaccination, but this will leave the large majority of the population at risk for the foreseeable future and especially through these next few crucial winter months.
We look forward to the day when we will be able to return to meeting our customers face to face, meet our colleagues again in person, and being with our family and friends once more, but until then we are looking after our team by offering staff and family COVID testing with our Clarigene® SARS-CoV-2 test in our own genomic services laboratory. We will continue to support our partners to return safely back to work through our workplace testing – which is available through Mediskills, ReCoVaand Caxtonamongst others. And for our own technical support team, testing services have been important to allow them to resume travelling to existing and new customer sites rolling out the new IONA®Nx NIPT test to sites across Europe and beyond.
1. Paul Fine, Ken Eames and David Haymann. CID 2020, 52 (7): 911-916. DOI: 10.1093/cid/cir007
2. RanyeMulchandani et al. BMJ 2020; 371: m4262. DOI: https://doi.org/10/1136/bmj.m4262