In a previous article, immunologist Dr Patricia dos Santos Paton asked multiple questions to which no-one appears to have answers. She rightly identified that the government has a moral responsibility to protect its citizens from harm, specifically from Covid infection.
Are we prepared? she asked.
The emergence of a new variant named Pirola (classified as BA.2.86) is causing disquiet amongst scientists and clinicians. Monitoring & testing is not currently being done at the levels it was during the pandemic, although emerging variants are being identified.
It will come as no surprise, that levels of testing in the general population is limited due to a number of factors, not least that test kits now have to be purchased, since governments no longer supply these. Single tests costing £1.75 or 5 packs costing £8.75 are not top of shopping lists for families with a low fixed income or those reliant on food banks. It’s a cruel irony that these are the people for whom Covid is likely to pose the biggest threat, since many are employed in lower paid service jobs, with potentially higher levels of exposure to the virus.
What are the governments doing about it?
Aside from a lack of preparedness and neglect of our healthcare services both NHS and public health; e.g. sufficient staffing levels and in house supply of appropriate PPE, a major criticism of the Scottish and Westminster governments in the handling of the Covid pandemic was the lack of a coordinated and measured response to outbreaks in care homes. Half of all Covid fatalities occurred in care homes.
In 2021, the BBC revealed revealed there was no statutory obligation for homes to notify residents, or their families, of a Covid outbreak or deaths from Covid. Whilst some care home companies such as HC-One, did release details, many others, both public and private, did not.
The Care Inspectorate in Scotland, tasked with ensuring that the quality of care on offer in Scotland meets high standards and responsible for ensuring that improvements are made where needed, refused to release a breakdown of Covid figures. They cited the “significant impact” on the commercial prospects of the operators if it did so, in what was already a challenging environment, particularly in the area of staff recruitment. Existing Care home staff, it has to be said, made a valuable and an immeasurable contribution in minimising the impact of Covid on those in their care.
The lack of transparency which resulted in some families not being aware of deaths in the homes where their loved ones were residents, needs to be addressed, however. To be fair, former First Minster Nicola Sturgeon and Health Minister Jeanne Freeman have since both conceded the Scottish government “didn’t respond quickly enough to what was needed in our care homes”.
What’s happening now?
The Scottish Covid-19 Inquiry has been set up to investigate the Covid pandemic in Scotland and will establish the facts, identify the lessons that need to be learned and make recommendations to Scottish Ministers. The inquiries preliminary hearing was on Monday August 28th.
Let’s hope that one of the lessons learnt, is the need to take heed of the advice of experts such as, Professor of Public Health Richard Ennos (Edinburgh University) who submitted a detailed plan to protect care home residents, to the Scottish Government BEFORE lockdown in March 2020, which was not given due consideration. Note, the first case of Covid-19 was confirmed in Scotland on 1 March 2020!
What’s happening to tackle Covid now?
Vaccine programmes are beginning soon with the initial emphasis on the over 65 age group. To date, which vaccine is to be administered hasn’t been announced. We do know however that the vaccines used haven’t been designed to protect against the most recent variants. In this respect, scientists are behind the curve. The speed with which Covid viruses mutate, it is debatable whether scientists will ever get ahead of the curve. The “pandemic is over” culture is not helping in this regard and the focus is presently on the viruses potential to evade our prior immunity.
As mentioned earlier, monitoring is anything but optimal. In the US, which monitors for Covid infection and the emergence of variants, tracking the virus is mainly pursued through wastewater analysis. See graph by JP Weiland below. The wastewater data has been used in this instance to estimate the number of cases. To date this has been accompanied by a >10% rise in Covid hospitalisations, and no rise yet in deaths. It is not ideal to rely on wastewater analysis alone to track the virus but it’s the only monitoring method available at the moment.
There’s insufficient data to conclude that Pirola is more transmissible, may result in increased hospitalisations or cause significant outbreaks of disease. Currently Pirola is known to have mutated 33 times. The ability of these variants to mutate is mind blowing! The nightmare for those deciding on vaccine formulations continues.
On a happier note, scientists in the US are working towards a combined flu and covid vaccine, the formulation of which may in future be determined, in much the same way as the seasonal flu vaccine is now. Advances in delivery of vaccines are also being made, with the development of an intranasal vaccine.
Building future resilience
How can we afford to address the issues when the NHS is significantly underfunded and working conditions, pay and staff shortages in health and care are stressed. Our block grant is impacted by what Westminster does; e.g. As NHS England becomes more privatised, the less government spend there will be on health services. As a result, the block grant for Scotland will be reduced and therefore the funding of our SNHS may have to be reduced or maintained, through lower budgets available for other public services.
The only way is to secure Independence and the establishment of our own Central Bank and currency. Our priorities are different. We were constrained by the four nation approach policies which were dictated to us by the Tories during the Covid pandemic. It was only when the Scottish government diverged from the Westminster ‘diktats’ that they were unleashed to go their own way, establish the way forward in tackling the pandemic whilst being sensitive to our national conditions.
‘Ah but !…we were reliant on the UK for vaccines and keeping our economy afloat’, the majority might say.
Truth is, Scotlands economy is not reliant on U.K. economy. Scotland’s economy is currently captive because we are tethered to the U.K. government’s economic policies and have become prisoners of their ideology…an ideology the Scottish Government has stated it wants to replace with the development a wellbeing economy.
With our own Central Bank and currency, we could have furlough to support our economy and funding for vaccines in the same way as Bank of England used the mechanism of quantitative easing (QE) and would be in a position to tackle health & social crises such as the cost of living, climate change and any future health crisis such as Covid.
Valneva – A cautionary tale
Mistakes have been made. A recent example of poor financial decision-making was investing in a foreign owned vaccine manufacturing facility in Livingston. Valneva vaccine is manufactured in Scotland (many articles state the U.K.). The Scottish government invested £20mn in Valneva, a French company.
In my opinion, this was unwarranted. I simply could not believe that giving £20mn to Valneva was going to have any material financial impact on a company with a net worth of over $1.6 bn.
Also, as a microbiologist, what I have to say about this, may prove controversial. The methodology used to manufacture the Valneva vaccine is traditional involving a fixed batch process. For this reason, reproducibility and variability need strict quality control. Batches can fail and this can prove expensive and cause delivery delays.
Manufacture of mRNA vaccines on the other hand can be done in regional manufacturing hubs such as in mobile units, particularly suited to servicing rural & remote areas, as I’ve stated in a previous Bylines Scotland article. mRNA vaccines can be modified quickly as variants of Covid appear, but also have been developed to treat other diseases such as kidney cancer. Reproducibility and consistency of the mRNA vaccines with continuous batch production is a superior manufacturing platform than traditional processes.
We could have had 20 mobile manufacturing units (although we would need far fewer than that to cover the various regions in Scotland) for the £20mn invested in Valneva, and these could be Scottish owned. I calculated that around half of that 10 would be needed. The reason I know what it would have cost to introduce mobile manufacturing units. I knew the specifications needed and had it costed.
Paul Hunter, Professor of Medicine, at University of East Anglia stated.
“With two highly effective mRNA vaccines, Pfizer and Moderna, in use, I doubt that the Valneva vaccine will play much of a role in the UK’s ongoing Covid vaccination campaign.”
Whilst I do agree that investment in foreign companies is a necessity at times, economically and from the point of view of delivering product in a pandemic, funding should, in my opinion, have been provided to build assets that belong to Scotland. After all, the establishment of regional vaccine manufacturing hubs is now SNP party policy. A resolution on this was passed at the SNP Conference. We just need government policy to reflect that and take it forward.
The £20mn awarded to Valneva did not achieve the security of jobs for bio scientists in the numbers forecast or a single source of reasonably priced vaccine for a future pandemic manufactured in Scotland.
Less than a year after the award of the Scottish Enterprise grants, production was halted at the Valneva manufacturing facility in Livingstone in August 2021, with the Emeritus Professor Sir Hugh Pennington stating “it was a waste of public money “.
The funding was granted in several tranches through the Scottish Government development agency Scottish Enterprise in February 2021 and is now being used in the research & development of vaccines to enhance the company’s portfolio.
Scottish government wasn’t the only loser. Valneva, also received £385mn from the U.K. Government because of a cancelled contract. Valneva boasted total revenues of £295mn in 2021 compared to £93mn in 2020 – an increase of 216% during the pandemic. Meantime, the manufacturing site lies empty and around 50 jobs were lost, the 200 jobs initially promised never having materialised.
Where to now?
The reliance on foreign investment is not the panacea the current Scottish Government make it out to be. Hopefully, in the wake of disaster capitalism, a new dawn of a Scottish nation will be ushered in. A post-Independence government, with its own Central Bank and currency will have the space to determine a very different economic approach to that of the current government. The current Scottish Government has a responsibility to make preparations for the establishment of a Central Bank, the requisite payment systems and a currency. By doing so, they have an opportunity to make amends for past mistakes and increase our resilience to future pandemics.
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