"Vaccine will come, but not without huge challenges" – leading world epidemiologist

Professor Peter Piot was not surprised by the outbreak of a global pandemic earlier this year. “We always assumed there would be a big one”, he explained  in a webinar hosted by Cazenove Capital on 18 June. He was in conversation with Cazenove Capital's Kate Leppard and Mark Ainsworth, Head of Data Insights and Analytics at Schroders.

"Covid-19 is not simply going to disappear," he says – but he is optimistic about the scope to contain future outbreaks.

Peter contracted the virus earlier this year himself and required hospitalisation and oxygen treatment. “It took around three months” to recover, he says of the experience.

"Second wave will happen, whatever we do”

Prof Piot, Director of the London School of Hygiene and Tropical Medicine and an adviser to the European Commission, suggests a second wave will be characterized by “local outbreaks.”

"If we are well prepared, we can limit the damage.” Our response to future outbreaks should be more targeted than the “bulldozer approach” to lockdowns some countries have had to implement so far.  

Successful containment will require us to continue to adopt “basic precautionary measures after the end of lockdown.” Health authorities will also need access to real-time data on where infections are occurring.

"Ultimately, these are political decisions…"

Having worked as both a policymaker and technician for the UNAIDS programme, Prof Piot has long been aware of the potential for conflict between scientific and political opinion. “Ministers shouldn’t use science to avoid making decisions… and scientists should not think they are in charge of government.”

However, it is apparent that governments around the world have had mixed success in dealing with Covid-19. “When dealing with an infectious disease, acting early is extremely important. And some countries were later than others. The UK was later than Germany, that’s very clear.”

Ministers shouldn’t use science to avoid making decisions…and scientists shouldn't think they are in charge of government

Success in what he sees as a long struggle depends not just on policy measures but also on cultural and behavioural change. Looking at countries that have managed this – such as Japan – gives Peter optimism that we will be able to return to a “relatively normal” way of life. 

"Face masks should be compulsory"

Hong Kong is “one of the most densely populated places on earth”, yet very few people died from Covid-19 and they never had to go through a complete lockdown, he says.

It is a  “mystery” why more widespread use of masks hasn’t been made compulsory elsewhere. “When I see people taking the bus without a mask, I  don’t get it. That’s how the virus will spread.”

We already have enough “circumstantial evidence” to know that face masks slow the spread of the virus. We don’t need to wait for absolute scientific proof.

Greater use of masks should also allow the UK Government to reduce its social distancing requirement to one metre.

“Personally, I’d rather be one metre from someone with Covid-19 if both of us are wearing masks, than two metres from someone who may or may not have it if neither of us is wearing a mask.”

Cautious optimism on therapies…

The use of oxygen should be “a priority” as it can save many more lives. Many low income countries are now struggling with access to oxygen.

There has been good news on treatments and Prof Piot is “fairly optimistic that we will find a number of effective therapies, especially if given early on in the course of the disease.”

This could open the door to more widespread use of Post-Exposure Prophylaxis. This would involve treating people who have come into contact with Covid-19 to “prevent the development of disease.” This will probably be "available before a vaccine".   

 … and vaccines

Prof Piot is hopeful about the prospects for vaccines, though cautions they are more likely to  be ready in 2021 rather than this year. One reason for optimism is the fact that the body can rid itself of Covid-19, which is not the case with all viruses such as HIV.

The process of vaccine development will be accelerated, but success is still some way off. “There’s no way around clinical trials. We have to test the vaccine in populations where there is active infection and that is going to take time.”

We also should not underestimate the logistical challenge of making and distributing billions of doses.

Finally, there’s the difficult question of who gets any vaccine first. We will need international agreements to avoid “vaccine nationalism,” he warns.

Unpacking the data - and what it means for investors

Schroders' Mark Ainsworth realised early on that estimates of the number of Covid-19 cases were problematic as they depended “on the ability to identify somebody as a case” – not easy to do before widespread testing. 

Mark and his team instead used mortality statistics, combined with early research into mortality rates, as a better gauge of infection rates. This allowed them to quickly realize that the virus was more widespread than appreciated by policymakers and markets.  

The Japanese government has tried to raise awareness of Covid-19 transmission risks through a campaign focused on “Three Cs” – closed spaces, crowds and close conversations. "We think the messaging provides a useful way of thinking about business prospects in the post-Covid era," Mark Ainsworth says. "Simply put, business models which depend on these characteristics are likely to be higher risk for some time."