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Vaccine wars: Nations race to win friends and influence through vaccine distribution

It all seems so long ago now, but as 2019 drew to a close there was a lot of talk about a new “space race.”

In November 2019, a Japanese spacecraft headed back to Earth after a successful landing on a moving asteroid. The following month, President Donald Trump created the new U.S. Space Force with a $ 20 billion (Cdn) budget. Two weeks after that, on January 4, 2020, China made history by landing an unmanned spacecraft on the dark side of the moon. 

But news on that same day about a “mysterious and growing cluster of unexplained pneumonia cases in the Chinese city of Wuhan” would soon consign the space race to second billing.

Sputnik flies again

Perhaps the Russians were thinking of the space race analogy when they decided to name their COVID vaccine Sputnik V, in honour of the launch of the first artificial satellite in 1957. Russia approached the vaccine race much as the former Soviet Union approached the space race — by forging ahead, cutting corners on safety and gambling on the outcome.

Although Sputnik V was deployed without going through full human trials, it has since turned out to be a triumph of Russian science. This week, The Lancet published the results of a full placebo-controlled study with more than 20,000 participants and found “a consistent strong protective effect across all participant age groups.”

Better yet, the Lancet reported “the lessening of disease severity after one dose is particularly encouraging for current dose-sparing strategies.”

Vindication in Argentina

That means two other countries that also gambled on Sputnik — Argentina and Iran — have something to celebrate after a brutal year. Argentina’s vice-president Cristina Kirchner, whose personal relationship with Vladimir Putin was instrumental in obtaining the vaccine, celebrated the result with a one-word tweet:

Sputnik’s adherents in Argentina may feel vindicated after weathering considerable resistance from the medical community and ridicule on social media, where satirical memes warned of Sputnik side effects such as involuntary Cossack dancing.

Doubts, then relief

Victor Ingrassia is a scientific journalist in Buenos Aires who has covered the country’s pandemic and clinical trials extensively.

“It generated a lot of doubts and uncertainty,” Ingrassia told CBC News. “Sputnik’s approval here in Argentina coincided with the approval of Pfizer and AstraZeneca by the U.S. Food and Drug Administration and the European Medicines Agency, the two biggest regulators in the world.

“But those vaccines had presented clinical data, while in Argentina we had a Russian vaccine that hadn’t presented any data in a peer-reviewed international journal. Argentina’s drug regulator ANEMAT had never before approved a drug that hadn’t already passed muster with either the FDA or the EMA. So there was a lot of concern in the Argentine medical establishment.

“Then, overnight, we learned that the Ministry of Health had approved the drug without waiting even for approval from ANEMAT.”

Doses of the Sputnik V vaccine are prepared for loading into a truck at Ezeiza International Airport in Buenos Aires, Argentina, January 16, 2021. (Agustin Marcarian/Reuters)

Ingrassia said public consternation only increased when neighbouring Chile began to receive the Pfizer vaccine, even though more than 4,000 Argentines had taken part in Pfizer’s Stage 3 clinical trials during summer 2020. Many Argentines felt that the government’s choice of Sputnik had more to do with the political ties between their government and the Kremlin than with science.

But since The Lancet gave Sputnik a solid thumbs-up, he said, Argentine doctors’ reticence about the vaccine has mostly evaporated and the government is now planning to re-open schools on February 17, with teachers vaccinated.

Score a win for Russia.

Bad bet in Brazil

Authorities next door in Brazil, meanwhile, have fewer reasons to be thrilled with their bet on CoronaVac, made by China’s Sinovac.

The vaccine, which was promoted by its maker as having 78 per cent efficacy, was found to have only 50.38 per cent efficacy in clinical trials in Brazil, barely meeting the minimum 50 per cent WHO threshold for use. Given that efficacy tends to drop when vaccines are confronted with some of the new COVID variants, CoronaVac may fall under the efficacy threshold in the future.

That’s a headache for Joao Doria, the governor who ordered mandatory vaccination of all 46 million residents of Sao Paulo state with CoronaVac — against the advice of the World Health Organization, which says vaccination should be voluntary.

Politically, it’s good news for his main rival and the man he hopes to replace — President Jair Bolsonaro, who has long questioned the Chinese vaccine and has said mandatory vaccination “should only be for dogs.”

While Bolsonaro and Doria jockey for position ahead of next year’s elections, the geopolitical loser in Brazil’s vaccine infighting is China.

Health workers check the documents of seniors getting vaccinated with China’s CoronaVac during a priority COVID-19 vaccination drive for the elderly in Rio de Janeiro, Brazil, Friday, Feb. 5, 2021. (Silvia Izquierdo/The Associated Press)

The trust deficit

China claims 79 per cent efficacy for the vaccine it’s using domestically, made by state-owned Sinopharm. But Sinovac’s performance in the Brazilian clinical trials now calls any Chinese efficacy claims into question, said China-watcher Lynette Ong of Toronto’s Munk School of Global Affairs.

“I think the biggest issue is the trust deficit,” she said. “When Pfizer or AstraZeneca put out a number, we have no a priori reason to question that number. But when Chinese authorities or Chinese companies give you a number, you need justification to trust that number, because of what happened in the last 12 months.

“I think that is what I see as the major implication of the pandemic — that they have to take the extra step to convince people that they could be trusted.”

Sinovac’s vaccine has been sent to many more countries than has Sputnik. World leaders have received the Sinovac shot, among them Turkey’s Recep Tayyip Erdoğan and Indonesia’s Joko Widodo. China has set aside $ 2 billion to fund vaccinations in Africa and has made available another $ 1 billion for Latin American governments to buy its vaccines on credit.

But since the Brazilian study poured cold water on China’s vaccine claims, Malaysia and Singapore have put their plans to use CoronaVac on hold while they wait for more testing results.

Media outlets in the Philippines have been suggesting that President Rodrigo Duterte doesn’t want to take the CoronaVac shot himself — and also doesn’t want to admit that he’s saddled his country with 25 million mediocre doses. Duterte has announced that he’s chosen to get his shot in the buttocks, rather than the arm.

“Let’s respect that,” Francisco Duque, the country’s health minister, told reporters recently — adding that Duterte’s choice means he’ll be getting his shot in private.

India the vaccine superpower

“What we see is that the countries that prefer Chinese vaccines are the ones that have supported the Belt-and-Road Initiative, meaning that as a whole, they’re favourable to growing Chinese influence,” said Ong, referring to Beijing’s ambitious global trade infrastructure strategy.

“Quite a number of countries in the regions are quite receptive to Chinese vaccines, as they are to Chinese investment.”

But some Asian countries have preferred to deal with a different giant: India.

India can’t compete with China militarily or economically — but India produces more than half of the world’s vaccine output.

Not only is India producing vast quantities of AstraZeneca’s vaccine under license, it also has its own Covaxin — which, like Sputnik V, was rushed to market under a somewhat dubious process but still seems to work.

And India is giving its vaccine away to neighbouring countries free of charge. It gifted millions of doses in January to Bangladesh, Nepal, Myanmar, Mauritius and the Seychelles, among others — a gesture of generosity so far unique in the world.

India began this giveaway within days of starting to vaccinate its own people. India “shared even before meeting [its] own needs,” said Bhutan’s PM Lotay Tshering. 

In this Jan. 29, 2021, file photo, Sri Lankan nursing staff administer COVID-19 vaccines to front line health workers in Colombo, Sri Lanka. India has gifted its neighbours with more than 5 million doses. (Eranga Jayawardena/The Associated Press)

Indian officials have made no secret of the fact that they hope to burnish their nation’s image at China’s expense. Relations between the two countries are at a low point following deadly clashes on the Himalayan border last June.

That might explain why, as January ended, India also sent two million doses to Brazil and plans on shipping more. It’s a gesture calculated to highlight the contrast with CoronaVac — which is not only of doubtful efficacy but is also surprisingly expensive.

Split image

But despite its failures in vaccine diplomacy, China’s Communist Party can console itself with its performance at home. 

“In spite of the early hiccups, Chinese authorities have handled the pandemic way better, domestically, than the Indian authorities,” said Ong. “Domestically, they have been able to manipulate the narrative and turn the image around.

“It’s like there was a war with suffering at the beginning, but then the government has fought very hard and won the war. So I think competence has boosted confidence in the government domestically.”

Outside of China, she said, “it’s been the opposite, especially in countries with a free press that don’t rely very heavily on Chinese aid.” 

Ong said that while China was the only country with a surplus of personal protective equipment (PPE) at the beginning of the pandemic, it’s now in competition with other vaccine-producers that have produced better vaccines.

Not over yet

While China flounders and Russia and India gain ground, the West seems curiously absent from the field of vaccine diplomacy.

That’s partly because western vaccines are produced by private corporations, rather than state-affiliated organizations like the Serum Institute of India or Russia’s Gamaleya Research Institute.

But countries such as Canada have ordered a vast number of doses — many more than they need for their own citizens. And that suggests that they will soon find themselves in a position to play the bountiful ally with developing countries that are likely to still have billions of unvaccinated citizens when 2022 rolls around.

The great game of pandemic diplomacy is far from over.

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CBC | Health News

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How to talk to family and friends who ignore social distancing appeals

You’ve likely seen footage of young people partying it up on beaches last week or families gathering en masse in public parks last weekend. Perhaps you’ve argued with seniors in your life about needing to curtail their social lives for the time being.

“We’ve all seen the pictures online of people who seem to think they’re invincible,” Prime Minister Justin Trudeau noted on Monday during his daily briefing.

“Well, you’re not,” he said, directly addressing Canadians who are flouting public health appeals for social and physical distancing amid the coronavirus pandemic.

What’s behind this behaviour, and how can you persuade those around you to reconsider?

Outside of COVID-19 hotspots like China or Italy (or in their immediate neighbours), changes in public behaviour have initially been “slow to materialize, with many continuing to engage in previous social behaviours,” according to Darrell Bricker, global chief executive of public opinion research firm Ipsos.

‘It’s over there’

“Coronavirus is being seen to be more of an economic threat than a health crisis, which explains partially why people aren’t as absolutely engaged in the social distancing behaviours that we’re being asked to engaged in,” Bricker noted Friday during an online Q&A.  

For many in North America, the reaction continues to be: “It’s over there. It’s not over here,” he said.

“There is strong public consensus for closing borders and self-quarantining,” but rather than taking the advice themselves, many believe these measures are meant to stop other people “from doing things they shouldn’t be doing.”

Many people, he said, think: “I’m not the source of the problem. Those other people are the source of the problem.”

And contrary to stories and videos being shared, the data doesn’t indicate that just one generation group — gen Z or boomers or millennials — is engaging in riskier behaviour than the others. 

People walk and cycle Sunday on the seawall in Vancouver, between English Bay and Sunset Beach. Officials have asked people to maintain a distance of two metres between one another. (Darryl Dyck/Canadian Press)

While there’s no doubt that “within the boomers, there are some populations that are fairly risky,” it’s not something common to the entire demographic, said Doug Norris, senior vice president and chief demographer of data, analytics and marketing services firm Environics Analytics. 

By the same token, younger people might tend to be more risky, but we can’t paint all of gen Z nor millennials with the same brush, Norris said from Ottawa.

“There is a lot of diversity within [each generational demographic].”

Strategies for discussion

There could be many reasons why friends and family members are ignoring directives against gathering and socializing in groups, whether it’s believing the rules don’t apply to them or feeling invulnerable to the notion “nobody is gonna tell me what to do,” said Mary Pipher, clinical psychologist and author of Reviving Ophelia and Women Rowing North.

Accordingly, there are a variety of approaches you can try to persuade them otherwise, she said.

  • One starting point is to get into the person’s headspace with questions like “how do you see your situation?” and “how do you see it as different from other people?” 

  • Another strategy the Nebraska-based Pipher favours is appealing to a sense of heroism and community. “It’s a chance to be a hero. It’s a call to sacrifice, and it’s an opportunity to grow into even more profound people,” she said. “This is a chance when every person in the world can do their part by following the rules.”

  • When talking to older rebels taking an “I do what I want” attitude, a shift in perspective could help. You might suggest that they risk “putting a family that cares for them in deep mourning” if they fell ill or died from coronavirus. “Think about who would miss you,” Pipher explained. “You owe it to those people to stay alive.”

  • For younger folks feeling invulnerable, try discussing the fact that they could spread the virus to a friend who may not have divulged an underlying condition that puts them at higher risk, she said. “You never know, even if you’re out with a peer, what else that peer might be dealing with.”

  • A good tactic is to share your own experiences, feelings and worries. “Use yourself as someone who is struggling with the same issues. The other person can choose to listen and accept your story — or not.”

Pipher stressed the importance of acknowledging that, for some, social distancing and staying at home can be a true struggle. For example:

  • Extroverts.
  • Those living on their own.
  • People residing in tiny spaces.
  • Those grappling with having lost (or being in danger of losing) their livelihood amid the pandemic. 

Finally, she advises: “If you start an argument with somebody, you’ve already lost. The whole trick with persuasion is defusing resistance before you’re in an argument.”

If the person is looking irritated and your voices are being raised, “you might as well not go any further, because anything further is only going to make the person more resistant.” 

Pipher sees this unprecedented moment in history as an extraordinary teachable moment about our role in the wider world. “We’re all interconnected, and if we don’t take care of each other, we won’t be OK. Each of our fates is tied to the fate of the whole.”

‘We are social animals’

Framing your discussion around communal versus individual goals is also the approach advocated by Igor Grossmann, associate professor of psychology at the University of Waterloo and director of the school’s Wisdom and Culture lab. 

“It’s not about what benefits you. It’s what benefits your parents, your friends, your partner,” he said.

Grossmann suggests calling on people to be reasonable — “to consider the context, to consider the norms of caring for others” — instead of urging them to be rational, since that person might be an individualist who considers it rational to buck convention or “to maximize their fun” by going outside.

Spring break revellers party together in Pompano Beach, Fla., last week. Florida officials ordered all bars shut for 30 days and many state beaches are turning away crowds due to refusal to engage in social distancing. (Julio Cortez/Associated Press)

“We are social animals. It’s really hard for us to be bound to our little apartments,” he said.

And what if the person you’re dealing with simply isn’t moved by a consideration of others?

Grossmann proposes appealing to his or her immediate personal benefit. “If you don’t maintain social distancing and partial physical distancing now, the country will impose a total lockdown and you will not be able to go out at all.

“It will really suck for you … and you will have no freedom whatsoever.”

The notion of more strictly enforced movement-restriction measures also seemed to be what Trudeau was getting at during his briefing Monday.

“Go home. And stay home,” Trudeau said. 

“This is what we all need to be doing, and we’re going to make sure this happens, whether by educating people more on the risks, or by enforcing the rules, if that’s needed.”

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CBC | Health News

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