Are vaccines the perfect solution?

Primum non nocere (Above all, do no harm) is familiar to every young doctor since Hippocrates. In 2020, as the world seeks to contain SARS-CoV-2, this cornerstone of bioethics is still key, not least to pharma companies racing to find a vaccine. But how much can we rely on vaccines alone?

Hippocrates himself (he’s said to have predicted the arrival of the plague to Athens in 430BC based on weather and wind direction!) might have had a few choice comments on our own pandemic. Developed countries seem to have become complacent. In recent decades, infectious diseases have been consigned to the ‘problems of the developing world’ box, with its poverty and seemingly less than adequate health services.

In her 1994 book Betrayal of Trust Pulitzer Prize-winning medical journalist Laurie Garrett lamented the underfunding of public research and the spurning by American medical students of infectious disease for more ‘cutting edge’ specialisms.

And since the book there have been warnings, as when EVD (Ebola) reached London, Madrid and New York during the West African epidemic, zika swept the world, swine flu caused panic and SARS turned out to be a ‘near miss’.

Nevertheless, companies which dealt with diagnosis or treatments for infectious diseases were completely out of fashion.

And then came COVID-19.

Never has the term “shock and awe” been better demonstrated for a relatively low-mortality virus, at least compared with, say, smallpox or Ebola. Repercussions of COVID-19 may last for years to come.

And now a vaccine is coming!  At last!

International relief was powerfully demonstrated by the response from the stock markets. The FTSE 100 jumped 5 per cent in reaction to Pfizer’s preliminary announcement this month. While the situation is still deteriorating in many countries, optimism is now on the rise.

So, are vaccines the perfect solution?

And how will they affect the diagnostic part of BATM and similar companies? In fact, safe, effective vaccines and diagnostic tools are complementary.

Unlike medicines, vaccines are given to healthy people. Bio safety here is of the utmost concern. No clinical trial can guarantee 100 per cent safety. But risk must be minimal.

Vaccines have two purposes. The first and most important is to prevent the recipient getting sick. The second is to prevent the recipient infecting others.

However, a lot of data collected so far indicates a COVID-19 vaccine might confer only short-term immunity. Some experts also believe COVID-19 could end up replacing flu as the main winter bugbear. If this is so, we will be living in a far more cautious world for some years to come.

To reduce the impact, a range of diagnostics are needed alongside vaccines to enable people to live as normally as possible and lessen harm to e.g. mental health and the economy.

Primum non nocere.

Sticking swabs into everybody’s noses especially children’s looks to us a bad idea. We believe a self-test is required which is easy to buy and use at home, even on kids and infants. Therefore, we have designed and are testing simple saliva and pharyngeal mucus rapid tests.

These are accurate up to 80-85 per cent. To back them up we have designed tests with close on 100 per cent sensitivity and specificity that can be carried out at any POC or lab. Our newest kit (PCR) independently tests four different virus genes including the famous spike protein with which the virus enters cells. We believe these kits are second-to-none in accuracy and capability. Users include combat pilots and other military units where precision is paramount.

The third member of the BATM tests ‘family’ is a very precise antibody test which checks in a drop of blood not only for the presence of antibodies, but how many.

These measurements are important. No point in vaccinating or re-vaccinating somebody who already has enough antibodies and probably therefore a good immune response. No reason this person can’t go to work or on a nice vacation.

With accurate, user-friendly diagnostics tests and ever-improving vaccines, we believe the world could be back to (almost) business-as-usual, we could pursue most leisure activities…. and at the same time prepare for the next pandemic.