Friday, December 18, 2020

Modern Miracle?

We are witnessing an historical event in modern medicine, and yet the gratitude response for this "modern miracle" is sobering in its silence. Let's examine some of the facts and then break down the possible reasons for the towering silence.

In early 2020, the COVID-19 virus starts sweeping through the United States, and after a sluggish response from our national leaders, a plan is revealed in May 2020. Named, "Operation Warp Speed", President Donald Trump said that the effort would be focused on developing and distributing a vaccine for the virus before the end of the year. The media response was predictable:

  • MSNBC - "the President is living in Wonderland"
  • CNN - "totally preposterous"
  • Bloomberg News - "this plan is virtually impossible"
  • NBC News - "most experts say that the development, testing and production of a vaccine for the public is still at least 12 to 18 months off, and that anything less would be a medical miracle"
Fast forward to mid-December 2020, eight months after the announcement of OWS and front-line health care workers are receiving a COVID-19 vaccine.

How?

One of the main reasons for this success was the government's strategy of dividing up the investment money, over $10 billion dollars, between eight vaccine candidates. This enabled OWS to run the vaccine development in parallel rather than sequentially. This also enabled a fast-track path for all of the candidates, clearing away regulatory hurdles, and putting General Gustave Perna in charge of logistics and distribution. For example, the United States government pledged $1.95 billion for the purchase and nationwide distribution of 100 million doses of Pfizer's vaccine, which was rolled out this week. It also pledged almost $1 billion dollars to the development of Moderna's vaccine - which just received FDA approval and then received $1.5 billion dollars to support large-scale manufacturing and distribution of its vaccine. The U.S. government also pledged to purchase 100 million vaccine doses each from Astra Zeneca, Johnson & Johnson, and Novavax, all of which are in their final, Phase 3 clinical trials. 

This strategy was not without the failure, for instance, over $2 billion dollars was provided to Sanofi and GlaxoSmithKline for 100 million doses of their vaccine, both of which recently suffered severe setbacks. But the upside remains that because the government spent the money on the front end of this process it will now be able to distribute over 500 million doses of the vaccine over the coming months. All purchased before the economics dictated the vaccine's values. 

This event is without parallel in modern medicine. For instance, before this achievement, the fastest vaccine development in history was four years, which makes OWS a singular achievement without equal in history. 

So where are the accolades for this success?

I believe that a huge reason for the silence is buried in the partisanship which barely passes for politics in 2020. President-elect Joe Biden has been slow to credit the man who has yet to admit that he lost the recent presidential election. That environment does not tend to create a mutually respective situation. Add to the mix the tone-deaf response from President Trump in multiple national conversations and interviews regarding COVID-19 plus the division that he has encouraged in our lack of a national response to this pandemic. It was then left up to the individual states to navigate these waters and this passing of the baton has contributed even further to our national division. Factor in the extreme suffering this virus has caused, over 300,000 deaths, the unmeasurable losses and impact to so many families, the economic fall-out, and the education system and the upheaval that our children are facing on a daily basis. Our national mood of despair and hopelessness, represents millions of individuals and their personal struggles with anxiety and depression. When you consider our collective mental health, it just may be true that our country is not even capable of celebrating this achievement. And it may be that our country is incapable of anything that rises to a measure of national unity again, ever. 

But even with all those factors, there is a more important part of this story. 

Is this vaccine effective and safe?

With an accelerated timeline, political pressure from both sides of the aisle, the impact the virus is having on our national and international economy, and the rising infection rate, and let's be honest, the motivation of mountains of profits, is it any wonder that we suspect shortcuts were achieved in this process? Our FDA, which usually drags their feet on much less impactful potential medicines, has suddenly placed all of these vaccine possibilities on the fast-track. Do you truly believe that the long-term possible side-effects will be null when faced with obvious short-term testing? 

This may be the unraveling of this entire process. 

Imagine this, what if we roll out a vaccine - inoculate 70% or more of our population in the United States, but then discover after sixteen months that there are side effect(s) that in hindsight would throw into question the entire process. Or worse. (Anybody here seen "I Am Legend?")  

So yes, we got our "miracle". And yes, we have no idea if long-term this effort will be successful, (or safe). But the wheels are turning, and the might of the U.S. government and the partnership of the national media, will ensure that this vaccine will be produced, and promoted. It remains to be seen if the current trend of eroding trust in our national leaders, medical leaders, and media will have a negative impact on the assimilation of the general public and their acceptance of this new vaccine. Without a substantial portion of the population buying in will we still experience all of the issues that we currently face as a nation? Will peer pressure, along with state and local leaders, start mandating the implementation of this cure? Will free will become the next casualty in our growing list of dwindling freedoms? 

I truly feel that we are on the verge of discovering if the cure is worse than the disease.