The editors of the Washington Post urge the creation of a vast, new government program to deal with the Wuhan coronavirus:
WHETHER CHINA’s draconian quarantine measures will contain the new coronavirus infecting thousands of people is not yet known. But the latest outbreak underscores an inexorable reality: New viruses will arise from contacts between humans and animals, and humans need to prepare for pandemics, just as for terrorism or tornadoes. If China’s containment fails — a worse-case scenario — the stress on health and economic well-being could be intense in the United States and even more so elsewhere. We ought to do more than wait and hope.
Because it now appears this virus is transmissible from one person to another, the goal must be to break the chain. China’s quarantine of 50 million people in the center of the country is a crude and uncertain tool. Such roadblock-style methods may have a legitimate rationale; China’s vast Lunar New Year travel, if unchecked, could accelerate the transmission. But this is stopgap, not full stop. Viruses do not halt at passport control.
The first priority should be a crash effort to develop an effective vaccine. The ability to create just-in-time medical countermeasures — a rapid response capability for pandemic — is still not a reality. As Tom Inglesby, director of the Johns Hopkins Center for Health Security, has pointed out, multiple vaccine candidates should be pursued at the same time, rapid clinical trials prepared and planning set in motion for mass manufacturing when an effective vaccine is found. After the swine flu pandemic a decade ago, an effort was made to improve U.S. flu vaccine manufacturing capacity, but more needs to be done. If a vaccine is created, production ought to be strategically placed around the world. It won’t do if just the United States has a vaccine needed by millions elsewhere.
They also want better diagnostics and “hard thinking”.
Fortunately, the private sector is ahead of them. Moderna, Johnson & Johnson, and Gilead all have active programs to develop a vaccine. As to distributed production, the biggest impediments to that are governments in India, China, and the EU which control what companies can have production facilities in their countries. And world government is far in the future if such a thing will ever happen. Common government requires shared values and if there is one thing we have learned over the last couple of decades it is that there are grave differences among the values held in different places in the world.
Just so you know, Moderna is working with NIH and is receiving funds from CEPI to develop the vaccine. That is a private-public coalition with some very large public trusts (like Gates) and about 6 different countries. The more accurate way, I think, to look at it is that there were already ongoing efforts with the private and public sectors working together. I dont know if there are any ongoing purely private efforts. According to your article J&j and Gilead are only contemplating working on a vaccine, and it says J&J would use the same tech it used for an Ebola vaccine, which was heavily funded by govt institutions.
“Johnson & Johnson has made a significant investment in Janssen’s Ebola vaccine regimen since its decision to accelerate the development program in 2014 in response to the widespread outbreak that occurred in West Africa that year. The company is grateful to its global partners who have helped to support and co-fund these efforts. Janssen’s investigational Ebola vaccine regimen originates from a collaborative research program with the NIH and received direct funding and preclinical services from the National Institute of Allergy and Infectious Diseases, part of NIH, under Contract Number HHSN272200800056C. Further funding for the Ebola vaccine regimen has been provided in part with federal funds from the Office of the Assistant Secretary for Preparedness and Response, BARDA under Contract Numbers HHSO100201700013C and HHSO100201500008C.”
https://www.prnewswire.com/news-releases/johnson–johnson-announces-donation-of-up-to-500-000-regimens-of-janssens-investigational-ebola-vaccine-to-support-outbreak-response-in-democratic-republic-of-the-congo-drc-300948746.html
Steve
I come at it from a different angle.
What if despite a crash course program and unlimited resources, an effective vaccine is found to take years?
That’s a real possibility given there is no 100% or even 75% effective vaccine for the flu after 50 years. There is no vaccine for HIV after 40 years. They don’t have one for SARS after 15 years.
In that case, we do exactly what we have done now – invest in detection and traditional prevention programs. This time, researchers created a diagnostic test in 2 weeks. And the prevention measures like quarantine, wearing masks – should prove effective in perhaps a week or so. The WHO is following the procedures developed after SARS and they are saying the Chinese government has been pretty open about what is happening.
If I were looking for investments or investigations – less on “tech†and more on people / culture. Like spreading best practices to prevent viruses from jumping spieces, how to get people to practice good hygiene, etc.
Culture is really hard to change. Investing some effort into it is fine, bout dont expect it to happen quickly if at all. That should be one of the lessons we have learned from our forays into the ME.
As an example look at US culture. Suppose we get that virus that is communicable well before people display symptoms, and suppose it is a long time until they display symptoms. A quarantine is going to be difficult to enforce and work even if people are cooperative. Then add in the number of people in our culture who won’t believe anything the government tells them. Or anything that some professors are telling them. People who unquestioningly accept conspiracy theory over facts and science.
Remember that the experts in the field are often working with inadequate information when dealing with an outbreak of a new disease. They are going to make their best guesses, and most of the time they will be correct. But, they will sometimes be wrong. Then we will get to see claims about fake news, fake science, government is incompetent. People are going to run off and do whatever they want, or what some demagogue is telling them to do. So watch all those zombie movies if you want to prepare.
Steve
Where that investment should be made is China and, sadly, there is no amount of foreign investment that could have the desired effect. People living in very close proximity to farm animals, closer than has ever been customary in Europe or the United States, is a commonplace in rural China and that practice facilitates the spread of zoonotic diseases.
steve:
The remarks in your first comment are true but they don’t tell the whole story, either. By and large the federal government no longer produces products or performs services. In general it lets contracts and “private” organizations produce the products or perform the services. Just as an example the number of physicians actually employed by the federal government is quite small. Health care is provided to the poor and the elderly by paying private physicians to provide it.
Capitalizing on existing contracts is one thing but letting a new contract is a lengthy process—months or even years. The message to me is that, when fast response is needed, except for the military don’t expect it from the federal government. A Manhattan Project would be extremely difficult if not impossible today and would take a multiple of the time the original actually did. By the time we would have let the contract the Germans would already have developed their own bomb. That’s the consequence of a fully mature military-industrial complex, to use Eisenhower’s memorable phrase. Heck, we probably couldn’t have a Mercury Program. That was done by letting hundreds of contracts to small contractors. We just don’t operate that way any more.
When I think of investments, I wasn’t thinking of who would make the investments.
I agree that the American government can do very little about an epidemic that starts in China.
Dave- Yes. Read the history of penicillin. The government didnt have the capacity to produce large amounts so they turned to the private sector. So what happens with lots of drugs is that govt agencies, universities, NIH, etc, do the basic research then turn to the private sector to make them. It’s usually not the case of the private sector being out ahead, but rather they partner with the government agencies to decide what vaccines to make and often use govt funding to facilitate the development process.
Steve
The market advocates think that the private sector is always the answer.
Steve:
‘The market advocates think that the private sector is always the answer.’
And the government advocates believe that the public option is always the best.
I agree that the best results in these emergencies seem to be some sort of government/private collaboration. It takes a dedicated selfless true believer, or a bunch of true believers, to push a government project to fruition in a timely fashion. Unfortunately true believers too often are apt to get distracted or run down rabbit holes and are able to keep on going because it isn’t their money that’s being spent. That’s where the profit motive is useful in that it is better because of self-interest at preventing money being wasted (note, I said better, not best. If there’s a way to scam the taxpayer and get away with it, you can trust the private end of the collaboration to find a way to do it).
Tars- Think you get it. When it comes to marketing potatoes the private sector is the way to go. When it comes to other areas, like public health, it has been the partnership of private and public efforts that have given us a lot of success. In this partnership the private sector doesn’t actually lead very often. They depend upon the research provided by government funded efforts. Since you arent going to sell vaccines for $100,000 like the hepatitis drugs, it isn’t high profit so the money from the government makes them financially viable.
Steve