For most people, a vaccine against the coronavirus can’t come soon enough, as it will be the only tolerable way to achieve herd immunity. So it’s encouraging that more than 100 drug candidates in 12 countries are in development, and eight are already entering clinical trials. To accelerate the process, some people are heroically volunteering to expose themselves to infection. With luck, some of us can get our shots next year.
And yet, there’s still a danger that humanity will fail in its quest to control COVID-19. The culprit wouldn’t necessarily be the medical complexity, fiendish as it is, of engineering a vaccine. It could also be the ensuing politics surrounding inoculation. The fights will be intense, irrational and sometimes nasty.
The first problem is that even after we become confident that a particular vaccine is effective and safe, there won’t be enough for everyone. So we’ll have to decide: Who should get the shots first? Who won’t get any? These questions will come up between countries and within them.
Given the right leadership, the world would overcome these difficulties with dignity and wisdom. Forty years ago, for example, as the world shivered in a Cold War between the U.S. and the Soviet Union, humanity nonetheless managed to unite and eradicate smallpox.
Today, however, the odds for health-care multilateralism are bad. A new Cold War is underway between the U.S. and China. And a “My Country First” nationalism is infecting ever more countries, including several of those working on vaccines.
Rich nations will try to outbid poor ones in securing supplies of the vaccine. And someone like President Donald Trump may not necessarily “share” a scarce vaccine invented and made in America with other countries. German officials were outraged earlier this year after reports — never confirmed — that Trump tried to buy CureVac, a German company working on a vaccine, in order to get exclusive access.
Ethical problems of triage will also haunt domestic politics. Most people will agree that health-care workers on the front lines should get first dibs on jabs. But, after that, nothing is clear. Should pregnant women get priority? What about the elderly? They’re in greatest danger of dying if infected, but they respond much less to vaccination than younger people do. So if herd immunity is the goal, inoculating the old may not make sense.
On it goes, with increasingly charged decisions. What about “essential workers,” and who are they anyway? Migrant workers and prisoners live in cramped conditions. Should they jump the queue? Not least, in this time of Black Lives Matter, there’s the question of whether ethnicity should in some cases confer priority. In the U.S., Black and Latino people are suffering disproportionately from COVID-19. Should they get shots before white Americans?
If these dilemmas are political dynamite, they may end up looking trivial next to what’s sure to be the biggest showdown: the standoff between scientific rationality and conspiracy theories. Early in the pandemic, there were hopes that the balderdash of anti-vaxxers would become untenable and their movement would atrophy. Instead, it’s booming.
Humans have always spun conspiracy theories, especially at times of calamity. The anxiety that comes with loss of control primes people to seek simple explanations with compelling story lines and an obvious culprit. Unsurprisingly, the COVID-19 epidemic has been accompanied all along by an “infodemic.”
For example, a fake-news video called “Plandemic,” claiming that the new coronavirus was hype and that a vaccine would kill millions, was viewed more than 7 million times on YouTube before it was taken down. Demonstrators from Germany to the U.S. have been spreading bizarre fantasies that Bill Gates, one of the world’s great philanthropists, conspired with “Big Pharma” to engineer SARS-CoV-2 so he could establish a global health dictatorship. He’ll police this with microchips implanted under your skin. There’s no end to this bilge available on the internet.
None of this is funny. Conspiracy theories have already led to anti-vaxxers refusing to get shots against measles, thus compromising the already-achieved herd immunity and causing new outbreaks of this deadly disease. The same could happen when a coronavirus vaccine becomes available. The threshold for herd immunity against COVID-19 is estimated at between 55% and 82% of a given population. But only about 50% of Americans say they’d get vaccinated.
So the time for corona statecraft and education is now, before the vaccine arrives. Internationally, countries are likely to be most open to multilateral solutions before it’s clear which nation will first develop a vaccine. Domestically, the debate about who has priority has the best chance of staying scientific before people are clamoring for jabs. Above all, educating people to distinguish facts from fake news is effective only before they become exposed to, and infected by, conspiracy theories. We have to win the struggle against disinformation this year, or lose the fight against COVID-19 in 2021.