Vaccine is not Tokyo Olympics organizers' lone hope of a safe Games in 2021
The fate of the Summer Olympics, if held as scheduled during the coronavirus pandemic, could hinge on llamas?
“Yep, that’s a possibility,’’ said Dr. Barry Bloom, former dean of the Harvard T.H. Chan School of Public Health.
“It turns out camelids, alpacas and llamas are the only species known that ... make not only complete antibodies, they make these nanobodies,’’ he added. “So the genetic engineering that was done was to start from antibodies from llamas made against COVID, and then cloning them into yeast and bacteria, so you don’t need llamas anymore.
“How much crazier can you get?”
On Monday, Pfizer announced that its COVID-19 vaccine is more than 90% effective, fueling hopes that it and other vaccines could be ready early next year, and before the start of the Summer Olympics in July. But while that news drew focus from scientists around the world, there also was talk of llamas, alternate COVID-19 treatments, ethics and hurdles unrelated to track and field.
Pfizer’s vaccine, for example, must undergo further analysis before qualifying for approval from the U.S. Food & Drug Administration (FDA). Only then can distribution begin.
FANS IN TOKYO? IOC is increasingly confident there will be fans at 2021
Q&A WITH PFIZER EXEC:On COVID-19 vaccine timetable and distribution
“It’s not out of the question that an exception could be made for the Olympics,’’ Bloom said. “But (the vaccine) would have to be available before then, before the summer, to almost everybody of the high-risk, essential-worker category, and those are limited numbers."
Pfizer, the U.S. pharmaceutical corporation, has projected it could produce up to 1.3 billion doses in 2021. Vaccination for each person would require two shots, given three weeks apart.
Regardless of the vaccine, the International Olympic Committee (IOC) has made it clear that it plans to hold the Games, which are scheduled to start July 23 in Tokyo. It’s simply a matter of what steps the IOC will take to mitigate the COVID-19 risks
Originally scheduled to be held this past summer, the Tokyo Games were postponed for a year because of the coronavirus pandemic. Japan is spending more than $25 billion on the Olympics, according to a government audit.
“We obviously very much look forward to the development of a COVID-19 vaccine, as it will help the world to recover,’’ the IOC said in a statement provided to USA TODAY Sports Tuesday. “It will also help facilitating the organization of the Olympic Games Tokyo 2020 and will be one of the tools in our toolbox of counter measures for Tokyo 2020.”
On Wednesday, IOC President Thomas Bach said the Olympics organization has looked into the availability of vaccines.
"We are in fact in contact there with the World Health Organization already,’’ he said. “We are in contact with a number of the manufacturers to be informed of what is happening in this respect. And there are different options under consideration there (with) how vaccines can be made available.’’
Bach also expressed optimism that there will be spectators at the Olympics, and on Thursday Tokyo Olympics organizing committee CEO Toshiro Muto took things a step further. Muto confirmed for the first time that a limited number of fans from outside of Japan may be allowed to attend.
'Most devastating super-spreader' event?
The IOC has yet to disclose how it might scale back the event, which is set to include 33 sports, in an effort to minimize COVID-19 risks.
The 2016 Games in Rio de Janeiro included 11,238 athletes from 207 countries, an estimated 85,000 security personnel, tens of thousands of volunteers and 500,000 foreign travelers.
“I think this could easily be one of the most devastating super-spreader events of the century,’’ said Judith Wasserheit, chair of the Department of Global at the University of Washington, imagining boisterous crowds. “If I were a virus, I’d very pleased.’’
Bach said different events in Japan, including baseball games and a gymnastics meet last weekend, have increased his confidence that a “reasonable number’’ of spectators will be in the Olympic venues. Potential countermeasures against COVID-19 could include everything from travel restrictions and quarantine protocols to rapid testing and vaccines, according to Bach.
Jonathan Finnoff, chief medical officer of the U.S. Olympic & Paralympic Committee, said he would be “incredibly surprised if the Games were not held, just based on the success of professional sports around the world right now.''
“If there’s an effective vaccine that’s available and widely distributed around the world, then it’s going to make the Games safer,’’ Finnoff added. “But I would anticipate that that’s probably not going to be the exact case.
“I would anticipate that even if one or more vaccines are found to be effective and safe and given approval, it’s going to take a while to ramp up manufacturing and distribution. The world’s a big place, and it’s likely not going to have permeated throughout the entire world community that’s going to be at the Olympic and Paralympic Games.
“But if you have a vaccine that’s worked and you have a percentage of your population that has been vaccinated, that automatically makes it a safer event.’’
Discussion of whether Olympic athletes will get preferential is inevitable, said Arthur Caplan, founding head of the Division of Medical Ethics at NYU School of Medicine.
“Our world may decide that it can devote some small supply of vaccines (for Olympic athletes),’’ said Caplan, who has written about sports and ethics. “The time to start debating it and kicking it around is now.’’
Avoiding preferential treatment
Amir Attaran, a professor of law and medicine at the University of Ottawa, recalled a story involving the Calgary Flames of the National Hockey League.
In 2009, during the N1H1 pandemic, the Flames secretly got swine flu shots while thousands of people, including children and pregnant women, waited in line for the vaccine.
“The (expletive) hit the fan over that when the news got out,’’ said Attaran, who then considered the circumstances around the COVID-19 vaccine. “This is the most closely watched vaccine in our lifetime and if it were inappropriately diverted from those who most need it, the health care workers, the seniors, the elderly, to a bunch of 20-year-old athletes in the prime of health, the scandal would be enormous. It would be a scandal from which the IOC would never morally recover."
The NBA came under scrutiny at the outset of the pandemic when players appeared to get access to COVID-19 tests during a severe national shortage. Other professional leagues and college football conferences also faced questions about the prospect of preferential treatment as their sports began competition.
After the NBA resumed play in July, and implemented daily COVID-19 testing, the league launched a community testing program that it said would provide thousands of COVID-19 PCR tests for free both in Orlando and in the league’s 29 other team markets through August.
But Attaran expressed concerns about the allocation of a vaccine.
“Look, every government is going to make that decision,’’ he said. “There is some international guidance from the World Health Organization, which the vast number of countries will disregard. So while it’s noble of them to have created that guidance, it also carries extremely little weight with most.
“It’s entirely clear that there will be misallocation, including for sports in some cases.’’
But Bach, the IOC’s president, on Wednesday suggested that athletes must wait their turn.
“There are different options under consideration there (with) how vaccines can be made available,’’ he said. “But first of all, the first wave of vaccination – and this is what we are supporting very much – must be for the people in need, for the high-risk groups, for the nurses, for the medical doctors and for everybody who is keeping our societies alive."
Preferential treatment for athletes could prove difficult in the United States, where the Centers of Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) are working on a four-phase plan for vaccine allocation.
Athletes are set to be in phase four and among the last group of people to receive the vaccine, said Ana Diez Roux, a member of the National Academies’ Committee on Equitable Allocation of Vaccine for the Novel Coronavirus
And the possibility that athletes will skip to the front of the line?
“Well, it’s not what the framework recommends, that athletes jump to the front of the line,’’ said Diez Roux, dean of the School of Dornsife School of Public Health at Drexel University. “because there are other groups, based on these principles that we developed in terms of maximizing the benefit (of the vaccine). The overall goal with the allocation framework is really to reduce disease and death, obviously first priority, and also to reduce the societal impact of the pandemic, which means allowing people to go back to work, children to go back to school, et cetera.”
Caplan of NYU is among those who speculate the first three phases of allocation might be complete in the spring, leaving Olympic athletes enough time to get vaccinated before the Games— if they’re at the front of the line in phase four.
“I’d like to see public debate,’’ he said of whether Olympic athletes should get some preferential treatment. “Let the Japanese government sponsor some seminars, webinars. Let’s get after it, IOC."
Other COVID-19 treatments
Bloom, the Joan L. and Julius H. Jacobson Research Professor of Public Health at Harvard, expressed skepticism about whether the vaccine will be available in time for the Olympics. But he pointed to other options.
The FDA on Monday announced it has issued an Emergency Use Authorization (EUA) for an antibody against COVID-19 made by Eli Lilly. Bloom also said the FDA is close to awarding an EUA for the experimental antibody cocktail made by Regeneron that President Donald Trump took when he hospitalized in October with COVID-19.
This treatment could be valuable at the Olympics, Bloom said, because it’s fast acting and could provide a month or two of protection against COVID-19 “if they tailor them right.’’
But each treatment would cost about $4,000, according to Bloom, while vaccines are expected to be significantly less expensive.
Another treatment Bloom said could be ready by the Olympics are genetically engineered antibodies called nanobodies that can be made in yeast.
“Which means they can be made by any beer company in mass scale, for peanuts,’’ he said, estimating the cost would be $5 per treatment. “This is cutting edge stuff. We don't know how long it would last. It would certainly last long enough to probably get you through a summer.’’
Granted, the nanobodies have not yet been tested in people. “But it is an exciting, cheap, large-scale promise of science,’’ said Bloom, who noted that these are the same nanobodies from llamas, camels and alpaca.
Thus, the notion that llamas could provide an essential layer of safety on which the fate of the Games hinge.
“You know, science, all of this is bloody astounding,’’ Bloom said. “Even to a guy who spent his whole life doing science.’’
Contributing: Tom Schad, The Associated Press