Monday, November 02, 2020

Breakthroughs and the Ticking Clock

 

Israel has developed a new and faster test for Covid-19 using the PCR standard, cutting the time from nasal swab, considered the most accurate test, to results from seven hours to two hours, according to a statement by Israel’s Health Minister Yuli Edelstein.

Israel’s infection rate has dropped from a high of nearly 15% of those tested to just over 3%, Israel has also slid down the list from #24 in worldwide infections to #29. The USA is still number one in the world, followed by India, Brazil, Russia, France, Spain, Argentina, Colombia, United Kingdom, Mexico, that make up the top 10.

Still, Israel is bracing for an upswing in the virus. According to media reports, the Health Ministry has seen a slight rise in infections and suspects this may come from young school children. The Health Ministry is weighing requiring preschool and kindergarten children to wear masks. As of Sunday, Israeli schools, grades 1-4 have reopened, as well as houses of worship, beauty salons, and bed and breakfast getaways. Small stores have still not reopened. One source said that Israel has succeeded in taking down the percentage of infections through a country-wide lockdown. But at the same time the lockdown also paralyzed Israel’s economy.
 

While the infection rate has dropped in the ultra-Orthodox community, there are still red zones. Ultra-Orthodox rabbis have been more willing to warn their followers of the deadly dangers of Covid-19. Still, some ultra-Orthodox still insist on having weddings and not always following the rules. The Arab community has seen a spike in infections resulting in six Arab towns , mostly in Israel’s north, declared red-zones and locked down. Only one Israeli town is still in lockdown, Hazor Hagalil, in Israel’s north. 

The Cornona committee today approved an increase in fines, up to 10,000 shekels from 5,000 shekels for businesses and educational institutions, like those ultra-Orthodox schools, who ignore the regulations, and a fourfold fine for those holding large gatherings, like weddings. The fine is now 20,000 shekels (@$6,000) up from 5,000 shekels (@$1,500).
Israeli media reported today that the first few patients to receive Israel’s experimental Covid-19 vaccine were released from the hospital. “I’m feel great,” said Segev Harel, who was discharged following a 24-hour observation period. He said he hopes Israel “will bring the vaccine to the whole world.”

According to Ynet news Hebrew edition, a number of companies are racing to bring a Covid-19 vaccine to market, Israel’s Institute for Biological Research, funded by Israel’s Ministry of Defense, is one of those in the race. The IIBR is in the process of producing 11 million doses of the vaccine that will be given to the public once the phase three trials are finished. Phase one was done on small animals and rodents, phase to on pigs, who share many human physiological traits, and now phase three, the human trials. Once the first few volunteers are given a clean bill of health 30,000 Israeli volunteers will then be injected with the vaccine, some will receive a placebo.

The IIBR vaccine, VSV-G ,is based on VSV, that causes illness in animals. According to an article in Ynetnews, “To produce the vaccine, scientists modify the VSV-G protein found in the VSV virus, which serves as a viral platform. This protein of the engineered virus is known to be a significant factor in the destructive ability of the virus in the body. Thus, the virus becomes a kind of "skeleton" that can serve as a carrier of other virus particles that will make the body "think" that it is a real virus, produce antibodies against it that will be stored in the body, and attack the real virus in case of infection.”

Other companies in the race to find the vaccine, who are already in phase three trials, rely on different methods. Johnson & Johnson have developed a vaccine using their vast experience in fighting the Ebola plague.  Pfizer, another American pharmaceutical giant, has joined up with the German company BioNTech to produce a virus that attacks the RNA of the virus. This vaccine was given in two doses, and, according to the article,  from the results so far, very high levels of antibodies and T-cells against the corona virus have been found in the vaccinated. In the third phase, which is now coming to an end, 30,000 subjects also participated, and recently they were joined by 12-year-old children who volunteered to receive it.
 

Moderna, another American company, also developed a vaccine based on the RNA that requires two separate injections. Moderna has invested nearly $500 million to develop the vaccine and hired 150 employees to develop it. Moderna has will also finish phase three trials this week and expects FDA approval of the vaccine by February 2021. However, both the Moderna and Pfizer mRNA vaccines require they be stored at -80 C, not so easy in many countries where normal refrigeration is only 4 C.
 

Another leader is AstraZeneca. While initial tests resulted in volunteers suffering side effects, treatment with paracetamol relieved the symptoms that cleared up in a few days. Interim results have shown that a single dose of the vaccine is sufficient to induce an immune response, which is maintained over time in more than 90% of the vaccinated. It has also been shown that giving a vaccine and a booster  improves these results even more, and inspires a more significant and long-lasting response. Millions of doses of the vaccine have already been produced and will soon be distributed, starting with the UK.
 

Russia’s Gamlia’s “Sputnik 5” vaccine has been tested extensively on those at risk, like medical workers, with no side-effects. Russia hopes to vaccinate the entire Russian population by early 2021. Chinese firms like Consivo have been running phase three trials on soldiers who volunteered, as well as on subjects in countries like Saudi Arabia, Pakistan and Russia. Another Chinese company, Sinoparm, have already inoculated over 500,000 residents 18 and over as well as thousands in the UAE.  
 

Israel’s Covid-19 Czar, Ronni Gamzu, has finished his term and has returned to run Tel Aviv’s Ichilov hospital. He was replaced Nov 1 by Nachman Ash, a former chief medical officer of the IDF and head of the medicine division of health fund Maccabi Health Services. According to the Globes website, Ash has been critical of Israel’s slowness in imposing a second lockdown saying ‘lockdown skeptics distort science.’ According to Globes, “The first challenge that Ash will have to meet is to influence Israel's plan for exiting lockdown, a plan that has so far not been fully discussed and approved even though steps have begun to reopen the economy.” Globes also wrote that, “Ash has a wealth of experience in medicine but is not familiar with the innards of the Ministry of Health, the internal politics, and the delicate relationship with the politicians.” That could be a problem for Ash, who reportedly has a “pleasant demeanor.” Pundits point out that in Israel during Covid-19 politics frequently became more important than fighting the virus.
 

Israel observed the 25 anniversary of the assassination of Prime Minister Yitzchak Rabin last week. A reminder of how dangerous a split in the society can become. With the US election only hours away, Israel’s papers have been awash with reports of how many Israelis support President Trump. According to the Jerusalem Post, 65%-20% with 10% undecided, the majority mainly among the orthodox and settler populations. However, the feeling among non-orthodox is similar to that of the American Jewish community, that Biden is the better choice. Should Trump loose the presidency, will he go peacefully, or will the US face a split similar to that Israel faced before Rabin’s assassination?  The outcome is as yet unclear. And the clock is ticking.