COVID-19 vaccine trials are well under way, but Bill Gates is not optimistic that phase III of these trials, which measures the efficacy and safety of a vaccine in a wide group of users, will be successful before the end of the year.
Gates spoke about the work toward a COVID-19 vaccine and how the coronavirus pandemic will continue to shape our future in a TED2020 live conversation with Chris Anderson on Monday. When asked about where we are in the quest for a vaccine, Gates mentioned three companies that—if they work—are on track to have vaccines the earliest: Moderna, Johnson & Johnson, and AstraZeneca.
“Those three will be gated by the safety and efficacy trial,” he says. “That is, we’ll be able to manufacture those—although not as much as we want—before the end of the year. Whether the phase III will succeed, and whether it will be complete before the end of the year, I wouldn’t be that optimistic about.”
This echoes what leaders in the health tech industry think, according to a recent 300-person survey. Even though at least 90 vaccine candidates for COVID-19 are in development, seven of which had advanced to phase I trials by April, only 31% of the experts surveyed thought a vaccine would be broadly available by 2021.
Chinese officials did just approve a COVID-19 vaccine for use in its military, but the Chinese government is skipping phase III trials for this vaccine. Studies so far have shown this vaccine is safe and has some efficacy, according to Reuters, but phase III trials are a more robust consideration of a vaccine’s effects.
How helpful a vaccine is to curbing this pandemic still depends, ultimately, on how many people get the vaccine. Gates says that like mask wearing, vaccines have a huge community benefit. Getting a vaccine and wearing a mask are important to protect your community from the novel coronavirus, not only yourself.
In the U.S., mask wearing has become a point of political contention rather than something unilaterally adopted by the public as part of a collective effort to curb the virus’s spread. Some have held onto the fact that the World Health Organization (WHO) initially did not advise people to wear masks. When asked if that was a “terrible mistake” the organization made, Gates replied, “Yes.”
“The fact that the medical mask was a different supply chain than the normal mask, the fact that you could scale up the normal mask so well, the fact that it would stop that presymptomatic and never-symptomatic transmission,” he says. “It’s a mistake, but it’s not a conspiracy. It’s something that we now know more. And even now, our error bars on the benefit of masks are higher than we’d like to admit, but it’s a significant benefit.”
Looking forward to fall, Gates does not expect the COVID-19 pandemic to wane in the U.S., especially without widespread mask wearing, vaccines, or other drugs or innovative tools. While there is good progress on such tools, he says, there’s “nothing that would fundamentally alter the fact that this fall in the United States could be quite bad, and that’s worse than I would have expected a month ago.”
The degree to which shelter-in-place behavior has lapsed, the amount of people not wearing masks, and the presence of COVID-19 in cities it had not been in previously pose a challenge for the upcoming months.
“There’s no case where we get much below the current death rate, which is about 500 deaths a day, but there’s a significant risk we go back up to the even 2,000 a day that we had before because we don’t have the distancing, the behavior change to the degree that we had in April and May,” he says. “We know this virus is somewhat seasonal, so that the force of infection—through temperature, humidity, more time indoors—will be worse as we get into the fall.”