LETTER: In December last year, The New York Times reported that new strains of coronavirus were detected in the United Kingdom (UK) and South Africa, reportedly 70 per cent more contagious than other variants.
According to the Centers for Disease Control and Prevention (CDC), the UK strain is known as lineage B.1.1.7 while the one from South Africa is B.1.351. Both strains have notable mutations in the spikes.
The CDC reported that based on "preliminary epidemiologic indicators" the B.1.1.7 variant is linked with "increased transmissibility", but so far it doesn't seem to impact disease severity or vaccine efficacy. More data is needed but the currently observed increase in infectivity (but not severity/lethality) is in line with the 'reasonable' mutational trajectory postulated earlier.
In October last year, we highlighted how the coronavirus mutation may pose a risk to the future effectiveness of Covid-19 vaccines and the potential scenario of needing additional batches of the same vaccine-type due to low immunity retainment and/or updated batches of vaccines faster than expected (vaccine validity) due to virus mutations.
With the various vaccine options under the consideration of the government, combined with uncertainties surrounding virus mutation (particularly with vaccines that focus on the spikes only) and its impact of vaccine validity/effectiveness, duration of immunity retainment and potential long-term effects, the authorities may consider the following:
1. Ensure procurement deals include favourable provisions on effectiveness, safety, immunity retainment, validity of the procured vaccine versions and stagger purchase commitments with related milestones;
2. Conduct 'pilot-run' of vaccine roll-out using several types of vaccines. The pilot run should target smaller populations first but it's necessary to familiarise with logistics and handling;
3. Larger-scale of a 'first-batch' vaccination roll-out using different types of vaccines, taking lessons learnt from the pilot stage. This first batch roll-out may also be considered a phase to funnel future vaccine choices;
4. Monitor the first batch roll-out similar to a late-stage clinical trial. Results from the third phase of clinical trials from the leading vaccines mentioned earlier have shown to be promising. However, without a significantly longer-term study (especially on Malaysian demographics), potential long-term effects, immunity retainment and potential impact of virus mutations cannot be determined with better certainty;
5. Authorities must ensure it is ready to track, monitor, gather and analyse 'big data'. This must not be overlooked or underestimated. Given the overwhelmed healthcare infrastructure and highly occupied medical professionals and health workers, authorities must plan and execute accordingly. If not, it would be a waste of valuable and potentially life-saving data, and
6. Monitoring viral genome sequence to detect mutations and correlate medical data from the first batch of vaccine roll-out.
Therefore, instead of petty and selfish power squabbles, politicians should focus on the above. The rakyat and the economy depend on it. Furthermore, the above recommendations may allow Malaysian authorities better visibility to pursue data-driven decision-making on the next best course of action.
AMEEN KAMAL
Head of Science & Technology
EMIR Research
Kuala Lumpur