Vaccines & Space Voyages: 2021 In Science

The most crucial science coming in 2021 has got to be an end to the pandemic. Right now, in January, coronavirus rates are at an all time high here in the UK, with test results suggesting over sixty thousand new infections every day - seemingly the highest rate in the world, with the USA close behind. Some are saying the UK numbers reflect a new variant of the coronavirus known as B117 that appears to be more transmissible, and has come to dominate in tested samples. As a result prime minister Boris Johnson has announced another lockdown, saying that it's specifically to contain this new variant. Public health expert Nisreen Alwan joined Phil Sansom, as well as special guests Giles Yeo and Barbara Sahakian to unpack the prime minister's reasoning...

Nisreen - The whole world is watching a disaster unfold, unfortunately, in the UK with this new variant. The answer to the question really is it's very difficult to say if it's entirely responsible for the rise. I think there is enough evidence - maybe not very strong evidence, but multiple sources of evidence pointing to one direction - that this new variant B117 is more transmissible, maybe 50 to 70% more transmissible. But the control measures weren't really working very well even before this variant was announced. These include isolation; so we were hearing reports a lot of people who needed to isolate weren’t isolating for all sorts of reasons; and also the contact tracing wasn't working very well. And also we had different measures, we had what we call the tiers, different restriction measures in different places in the UK, different behaviors also leading up to Christmas. It's very hard to disentangle and say with certainty it was entirely due to this new variant.

Phil - What about schools? Because Prime Minister Johnson also said the following:

Boris Johnson - Primary schools, secondary schools, and colleges across England must move to remote provision from tomorrow.

Phil - How much spread is there in schools? Because this has been a really fraught topic.

Nisreen - Transmission in schools is not really considered controversial anymore. COVID transmission happens in schools, and I don't think as well that this is new with just the new variants. So for example, the latest statistics we had from the Office of National Statistics point that one in thirty-three secondary school age pupils had COVID, and one in fifty of those 2-10. The other bit of evidence which is really interesting is from SAGE, which is the scientist committee advising the government. And they produce evidence looking at how much children transmit, and they found actually that children were more likely to be the index cases, and that means they're more likely to bring the infection into the home. Obviously this is evidence also based on modelling, so there are always margins of uncertainty around it, but I don't think it's controversial anymore that transmission happens. And therefore, when schools do go back at full class sizes, we need to have really good measures to control infection.

Phil - Giles, could I ask you as a geneticist, have you looked at this new variant? Do you know anything about what makes it so special? Because the coronavirus mutates all the time.

Giles - Yeah, exactly. So like all viruses - cold viruses, the HIV virus - viruses, because of their rate of replication, actually mutate all the time. I just want to point out I'm not a virologist and I'm definitely not an expert on this, but I can think of a few things through my reading, through just listening to people, that concern the scientists about why this could be real. First, this B117 variant is not a single variant; it's actually a series of different changes within the genome, the RNA genome of the virus. A couple of them - and this is the concerning thing - actually happened within the spike protein itself. Now the spike protein - this is what gives the coronavirus its crown shape - is what actually binds to the cell surface and actually gets into the cell. It's critical for the infectivity of the virus. So there was a biological plausibility for why it could be in more infectious. Secondly, I've seen some preliminary data - it's not been published yet, so we'll have to see what happens - which indicates that it could be more infectious within a petri dish.

Phil - Nisreen, could you bring some of these aspects together for me and help us sort of predict what might happen for the next few months, maybe for the next year?

Nisreen - Well we're all optimistic about having the vaccine. This is the light at the end of this terrible tunnel we are in. If the lockdown is effective enough and it really brings the infection rates down, then it's a bit of déjà vu really for us! Like we said for the first lockdown, we have to come out from it having a really good test, trace, isolate, and support system to really try and contain the infection; and then distancing, wearing the mask, and having fresh air ventilation measures. We need to have these things in place, particularly in school, they need to be prepared from now to have these effective measures; more effective than what was happening, because we can see obviously that what was in schools wasn't effective enough. The other thing about the vaccine: it's really important to understand that vaccinating a minority of the population is unlikely to end the pandemic, because if the virus continues to circulate in the majority of the population, then there's room for it to mutate further, and then potentially have mutations that would affect the effectiveness of the vaccine. Obviously the trial evidence for the vaccine tells us that the vaccine is really effective at preventing severe disease from the COVID infection. The information about whether the vaccine actually prevents transmission is still uncertain, and therefore we need to be cautious around vaccines. They are great - they prevent the vulnerable from getting it - but I think the behavioural changes that we all have to make, and the resources that the governments need to put in to make sure these behavioural changes work, need to continue for a while until most of us are vaccinated, really?

Phil - And we're going to be talking to a virological immunologist later in the program more about the vaccine. Could I ask you Nisreen, if you were optimistic versus pessimistic, what sort of timescale would you give us for the pandemic?

Nisreen - Phil, this is a very difficult question! I don't know. Hopefully if the vaccine really happens quickly and most of us get vaccinated, then maybe by the summer we'll be in a much better place, but until then we really... a lot can happen, as we've seen, in a few months, and let's hope the direction is more positive in the next few months.

Phil - You've also been looking at people who are left with Long COVID symptoms for many months after they get their infection. Since we last reported on that back in the middle of 2020, what new has emerged, and are people getting better from this long term condition?

Nisreen——这就是问题所在,菲尔,我们也't know how many are getting better because we're not measuring Long COVID in any kind of sensible way. We don't have stats on recovery. We do have some worrying statistics recently that also came from the ONS, the Office of National Statistics, that 1 in 10 people still have symptoms 12 weeks after the onset of infection. And we still don't know the long term effects, the extent of any organ damage. So Long COVID is a big problem and it needs much more attention, and actually at times of crisis like what we're going through now, it's very important to highlight it to people and say, "if you're a younger age and you're healthy, there is a chance that you may not be able to function for several weeks or months, and then also we don't know the long term health effects of it." So that needs to be communicated over and over.

Phil - Just quickly, Barbara, some of these long term health effects do include neurological symptoms, don't they?

Barbara - Absolutely. So there's neurological and psychiatric symptoms, and we don't really know how they're going to pan out in the long term; whether for some people, fortunately they'll get better as time goes on, but for other people it may require treatments to actually get them better. And we'll have a lot of other problems with people who haven't even got the COVID, because there's been so much anxiety and depression amongst people who have just been locked down, because we know that loneliness and isolation is not good for you. It's not good for the brain, it's not good for your wellbeing. And we also know that adolescence at school is a time when you are relying on your peers and interacting with your peers and you're becoming an adult and to miss out on a lot of that behaviour, it's very difficult and could change the way that you start to interact when you come back. And I'm particularly worried also about the very young children, because that is one where they're learning their social cognitive skills and they're learning how to interact and they are developing the theory of mind is social cognition and all these things. But if you're kind of isolated and maybe you're only with your parents and maybe your parents are having to work at home or go out to work, it's very difficult for these children to actually get socialised because there are usually mother and baby groups, so you can be in primary school or whatever, but now that school has been so disrupted. I do worry about how they're going to have this natural development.

尽管冠状病毒仍然是每个人的表面上ry concern, 2020 saw some of the most extreme weather events ever recorded, as well as being virtually tied for hottest year on record. And the fact that we hear this almost every year nowadays gives you some idea of the accelerating state of the catastrophe. So what’s going to happen this year? Jenny Turton is an atmospheric scientist from the Institute for geography at Friedrich-Alexander University in Germany, and she discussed the subject with Phil Sansom and special guests Barbara Sahakian and Giles Yeo...

Jenny - Well, it does seem like year on year in the Arctic we're having record breaking circumstances: record sea ice levels, fastest melt, something like this. So it wouldn't surprise me if 2021 followed in the same vein. Just over September last year we had the second lowest sea ice record, so perhaps we could see another record low sea ice year. It also froze up quite slowly this year - normally it starts to freeze in about September, this year it was mid-October - so potentially it's not as thick or as solid as it normally is, and so maybe we'll have quite a lot of melting in the sea ice this year.

Phil - What about other types of extreme weather across the world? Because in 2020 we had wildfires in Brazil, and western North America, and Australia; might it be the same sort of story?

Jenny - I've been reading up on the hurricane prediction for next year, and that doesn't seem to be as extreme. They do predict that it's going to be above average; so average is around 12 storms, maybe six or seven of them are hurricanes, and I think for the next year - or this year - they're predicting around six. So we're having more than normal, I believe, but maybe not as extreme as 2020, where we had over 30 tropical storms.

Phil - And we've also got La Niña, is that correct - this weather phenomenon across the world, and the Pacific especially?

Jenny - Yeah, that's right. It started last year and I think there are thoughts that it will continue onto this year. La Niña is where you get a buildup of cold water along the coast of Chile, and then you get a lot of different weather patterns happening because of that. So typically you get slightly drier in the United States and wetter in Australia, that's kind of a big cause, but you also get... globally during La Niña it's a little bit cooler. So it was quite interesting that 2020 was still one of the hottest years even though we had a La Niña phase.

Phil - Barbara, I'm thinking of the environmentalist Naomi Klein, who talks about all the different ways there are to look away from this catastrophe because it's so painful. What psychologically do you think is behind that?

芭芭拉- - - - - -很明显,有一件事要做的就是直接your attention from something that is giving you a lot of anxiety, so some people will choose to do that. What I'm pleased about is that so many people have chosen to engage with actually trying to do something about this; themselves, and with institutions and things like that. So I think we're in a much better shape. I think it's very difficult for people to deal with uncertainty. Hugo Critchley has done some marvellous experiments showing that, with uncertainty, we get activations in areas of the brain. And we have a difficulty dealing with uncertainty and with... I was listening to the radio just the other day and they were talking about the fires that they'd had in Australia, and every time now it gets hot people begin to wonder, "oh, is it going to start up again?" So the sort of constant stress... it's almost like a chronic stress that people are under worrying about these things, and sometimes if you don't feel you have any resilience or mastery over it, the preference is to avoid dealing with it at all. But fortunately, I think many people have realised it's just time now to engage. We all have to engage. We have to do what we can do as individuals, and then we have to force governments and institutions to also do what they should do.

Phil - Jenny - ring a bell?

珍妮——是的,这听起来确实很对。Sometimes I even find it hard to spending day after day researching these things; sometimes it's nice to distract myself with a YouTube video of a cat or something! But no, it does seem that now is the time when a lot of countries are getting on board with the climate crisis; including China, and hopefully once Joe Biden becomes president, they will rejoin - as well - the climate talks.

Phil - Here he is in fact promising to do exactly that, for the Paris agreement....

Joe Biden - First thing I would do, day one, as president: I'd rejoin the Paris climate accord, which we - Barack and I - put together...

Phil - Jenny, what does that mean? This is obviously the second biggest carbon emitting country in the world.

Jenny - Yeah, so it was quite a shock for a lot of people when Donald Trump decided to pull out, because like you say, they're the second biggest emitter ,and they had joined the Paris agreement under Barack Obama.

Phil - Could you explain exactly what the Paris agreement means?

Jenny - Yeah, the Paris agreement is a legally binding treaty that was signed by 196 countries back in 2015 with the aim of tackling climate change. Every four or five years, the countries that are in the agreement will give an update on what they have done to tackle it, and also put further targets in place to try to reduce their emissions.

Phil - And what kind of targets are we talking about, do you know?

Jenny - Well it varies depending on the country, because obviously some countries will be able to do a lot more - should do a lot more - than others. So the UK for instance: their target is to use electric cars only by 2040; and also pledge to go net zero, which means the amount of CO2 they're outputting, they will intake with something like forests or some offset projects.

Phil - As we're recording this, in fact, we've just found out that Trump has just signed a document allowing looking for oil and gas in protected Northern lands. What's going on in this area of the world, do you know?

Jenny - Well yes, I did see earlier that there was some idea that Trump might be allowing people to mine or to put in some pipelines in the Arctic. I think partially it's a long line of other things that he's already done in the environmental sector; I think there are seven agreements or important treaties that he's pulled out of or dismantled while he's been in power. So I do think that it's kind of a last ditch attempt.

Phil - We've also got a big climate change conference coming up; that was supposed to be 2020, it's now 2021, and this is going to be in Scotland. What is that going to be? Because I think people are tired of hearing commitments and resolutions, and feeling like that's just hot air.

Jenny - Yeah. So it's the COP26, and the COP stands for the Conference Of the Parties, and it's the 26th meeting. But like you say, people seem to speak a lot and not too much happens at these conferences. Almost every year people are not quite happy with the outcomes, that maybe they don't reach enough, or they don't agree enough. The hope is in the Glasgow one this year that the UK and other nations will be able to provide financial aid to developing countries to help them really tackle climate change, which they might not be able to afford and which they probably also didn't contribute largely to. And also we're hoping this time to look at efforts of how to offset CO2, so how to pull out some of the CO2 from the atmosphere that we already have there,

菲尔-我们中那些不听这一个d are leading a country, I think we'll still probably be thinking, "is there anything I can do?" Giles, I believe that one of the best things that a single person can do is change their diet?

Giles - It is! We - particularly here in Western Europe, Australasia, and United States - we eat far too much meat. Look, I am not a diet evangelical or zealot; I eat meat. But I think it's undoubtedly true that we eat way too much meat per capita. And the problems with meat are twofold. First of all, there is deforestation in order to make sure that we can actually keep the various ruminants, and cows, and sheep, and what have you, in grass. And there's also the gases that are released by these animals in and of themselves. So actually, if we as a species are able to drop our meat intake even by 10/20% - I'm not talking about turning everyone vegetarian - the actual impact on carbon emissions would actually be enormous. Enormous.

The first doses of the coronavirus vaccine developed by Oxford University have been administered to patients in the UK, and now over 15 countries worldwide have begun administering various vaccines to their citizens. But there are still open questions about how they work and how quickly they can get distributed. Phil Sansom, alongside special guest Giles Yeo, got the picture from viral immunologist Zania Stamataki...

Zania - Well, aren't we fortunate. We've got over 200 vaccines in development, a handful already approved in different parts of the world. The data from clinical trials are pouring in and guess what? The vaccines work. We now need to get the logistics right, to protect our vulnerable and then the rest of us. And it's important to note of course that while vaccinated, although we are protected, we may still transmit the virus to others.

Phil - This Oxford vaccine - can you remind us, what exactly is it?

Zania - The Oxford vaccine has used a harmless chimpanzee virus to infect our cells and pass on a message, the genetic information, so that we can make coronavirus spike protein ourselves. This stimulates our immune system and we prepare our defenses, which takes a couple of weeks to happen. And after that, our body's ready, and if infected with the coronavirus, our immune system can stop it in its tracks before we get COVID.

Phil - We've got a question for you about it as well, from listener James who asks: "Can you explain the Oxford COVID vaccine approval by MRHA, the UK regulator and what new data is now available since their," and I quote from him, "horrendous first reporting in early December? Seems as though the UK population is being offered a 62% minimally effective solution to me." What is he talking about and what is your opinion?

Zania - Well first of all, we need to separate the vaccine effectiveness from efficacy data. Efficacy is the 62% number that your listener was quoting. And he's talking about the outcomes of clinical trials that are very short and contain a small number of people. Now don't get me wrong, the vaccine has been given to thousands and thousands of people before the clinical trials concluded, but only a small proportion of these people have become infected. So we are getting data back from a small amount of people. Now the Oxford vaccine was given to people in two different doses; some of them showed 62% efficacy in that arm of the trial; others that received a lower dose at the beginning of the trial showed up to 90-odd percent efficacy, which is all very good. But let's remind ourselves that the FDA had said that they will approve any vaccine with efficacy above 50%. And for flu vaccinations, we accept vaccines from 20 to 60% efficacy every year. So the Oxford vaccine we expect to be highly effective, and the effectiveness data is going to change as the vaccine is rolled out and we get data from real life people.

Phil - What would you say to someone who said, “no, I want the Pfizer vaccine, that one's got a higher number. That looks better to me."

Zania - We can't really make that decision based on the data that we have because we haven't compared vaccinations side-by-side, and as scientists, that's how we make comparisons: we get the same population, we vaccinate them with the same preparations, and then we expose them to the disease and we get data back. So this has not happened. And what I can say to people that are worrying about which vaccine is going to be more effective is, I would personally accept any vaccine that was given to me that was approved by MHRA - and I'll be grateful for it as well! I think a vaccine that is approved, that works, is tremendous news. We, as a population, are going to respond differently; but if the vaccine works, take it.

Phil - Giles, I'd like to ask you actually about some of the people who don't share this kind of trust, because am I right that it actually overlaps in strange ways with diet?

Giles - It does actually. I interact on social media and otherwise with diet evangelicals, who believe one diet versus the other; so they are crazy low carbers, for example, like extreme low carbers, people who are on carnivore diets and what have you. And I have found - anecdotally I want to point out, I didn't do a study - that the Venn diagram of diet evangelicals and anti-vaxxers, or anti-COVID, or anti-maskers, actually overlap quite a lot. Why might this be the case? I think underlying it is probably: there's a lot of pseudoscience that actually goes into either camps, and also a lot of going on to Instagram influencers, and social media influencers and seeing what people have to say. I think there is also an element of “I want to live natural. I want to live real. I don't want to inject something created in a lab!” Look, this is entirely, obviously nonsense, particularly since they're probably taking paracetamol or ibuprofen for their headache. But I think there's probably a little bit of that as well. And there is also another group of people who have been calling COVID a ‘diet related illness’. Now clearly our metabolic state, living with obesity or type two diabetes, increases the chances of us suffering severely from COVID infection; but COVID infection is an infectious disease, it's not a diet related disease. So it's very interesting just to see this swimming around out in the dark net of social media.

Phil - Zania, there are other concerns arising that I'd like to address with you. People are a little bit worried about the UK delaying the second dose of the Pfizer vaccine to people who've received the first one; the manufacturer said three weeks, the UK is saying could be more like months. What's behind that, and is that scientifically sound?

Zania - Well as scientists that work in the lab, we get very nervous when we deviate from a protocol. And Pfizer has only tested their vaccine with a booster within the three weeks, like you said. The Oxford vaccine was tested with later booster jabs too. Now we know however from experience that vaccination boosters continue to work well after several weeks. In the UK we have an urgent public health need, with one in 50 of us currently infected, and we are losing around 900 people a day to COVID. This decision was made to save more lives. But it is important for us to gather data to inform future vaccination protocols for different patient groups.

Phil - One other thing from listener Richard who asks: "What I'd like to know is, what are the risks of developing a serious disease if you catch COVID on the same day as having the first dose of a vaccine? Is there any reduction in your risk of serious disease?"

Zania - Within the day that you are vaccinated, you have not had enough time to generate protective immune responses. As a rule of thumb, you calculate about a week until your responses start to kick off. And then beyond that up to two weeks, when you're mounting decent memory cells, that will protect you from re-infection. So within the first couple of weeks, I would say, take utmost care. You are not protected yet - and this is in your little pamphlet as well that you receive when you become vaccinated - so it takes a little while for the immune system to develop immunity. And this is the whole idea behind vaccination: by getting our jab, we are giving our immune system a sort of stimulation early on so that when we come into contact with the real thing we'll be good to jump to it.

Phil - Zania, if I can ask you to make some predictions for me, how long do you see this pandemic lasting?

Zania - Well it depends on ourselves, really. It depends on our personal behaviour. You do need the vaccine to generate immunity for a population, so that we can protect each other for a long period of time. But if you keep to the rules, as they have been advised to: mask yourself so that you can protect others from infection if you are asymptomatic; keep your distance, so you don't catch the virus yourself; wash your hands; avoid touching your face, like I do all the time without realising - I've become so used to my sanitiser now because I just can't stop touching my face! If you stick to the rules you can protect yourself. And in fact we know from countries around the world that have been very, very strict at sticking to the rules, that they can control infection. And this way, when you have outbreaks that are small, they can quash them very, very quickly. So it is possible for us to have good news, even in the absence of vaccination; but for us to eradicate the virus as a problem, we do need to vaccinate ourselves.