Wednesday, February 10, 2021

AstraZeneca vaccine: why Australia is forging ahead as South Africa tackles Covid variant

Medical experts say the jab is effective against severe infection, as researchers work to adapt vaccines against variants and experiment with mixing inoculations

Australian health authorities have moved to calm concerns about
the effectiveness of the AstraZeneca vaccine, after a small-scale study suggested its efficacy against mild to moderate infections from the the South African variant of the virus could be as low as 10%.

AstraZeneca is going through the Therapeutic Goods Administration approval process now and is slated to be rolled out from April. This is what experts are saying.

You should still get the AstraZeneca vaccine

That’s the advice of Australia’s chief medical officer, Prof Paul Kelly. He has urged people not to put too much stock in the results of the South African study, which he stressed was both limited in scope and had not yet been peer-reviewed.

Kelly told reporters on Tuesday that people should be wary of “taking small amounts of information quickly, without looking at it carefully, and making conclusions”.

“At the moment, I can absolutely say – and this may change in future, and we will be nimble in the way we look at that information and putting that into our planning – but at the moment, there’s no evidence anywhere in the world that AstraZeneca effectiveness against severe infection is affected by any of these variants of concern. And that is the fact.”

His comments were echoed by Prof Mary-Louise McLaws, an Australian epidemiologist and advisor to the World Health Organisation on Covid-19.

“I commend your readers to get any vaccine that is offered to them, because it will reduce severity,” McLaws told Guardian Australia. “Any vaccine is better than no vaccine. If you do get the virus it will improve your outcomes, your response, and you may not get severe Covid.”

There is also evidence from another unpublished study in Israel on the Pfizer vaccine, which suggested that people who are not protected by the vaccine nevertheless had a reduced viral load. So even if a vaccine had a reduced efficacy, there is evidence to suggest it will reduce the extent to which a person spreads the disease, McLaws said.

AstraZeneca, unsurprisingly, also played down the study on the South African variant, saying it was a small phase one or two trial, which showed limited efficacy against mild disease from the variant.

“While we have not been able to properly ascertain its effect against severe disease and hospitalisation given that subjects were predominantly young, healthy adults, we do believe our vaccine will still protect against severe disease for the B1351 variant, particularly when the dosing interval is optimised to 8-12 weeks,” AstraZeneca said.

What the South African study actually showed

The study was a small-scale trial of 2,000 people aged 31 which showed the AstraZeneca vaccine had as little as 10% efficacy in preventing mild to moderate infection against the South African variant of Covid-19, B1351. However the researchers expressed hope the vaccine would still offer significant protection against more serious infection, which is the goal of the global vaccine program.

The study is yet to be peer-reviewed or published. The South African government has paused its planned rollout of the AstraZeneca vaccine in response.

It is not the only vaccine to show reduced efficacy against the South African variant. Trials of the Novavax vaccine also showed 60% efficacy against the South African variant, compared with an 89% efficacy overall – 95.6% against the original coronavirus and 85.6% against the UK variant.

Kelly said Australian authorities will be looking very closely at all information which comes out about the efficacy of the AstraZeneca vaccine, but said there was to date no information to suggest it did not protect against severe infections from the South African variant.

He said Australian authorities will be talking closely with the UK, where AstraZeneca has already been widely distributed.

“This is a very good vaccine, very safe, and once it goes through those processes, of safety, quality and efficacy, we will be able to look to roll out that vaccine as well – as always, subject to the TGA advice,” he said.

Yes, but it will take time. AstraZeneca said it has already started adapting its vaccine against the South African variant, “and will advance rapidly through clinical development so that it is ready should it be needed”.

Novavax responded to the lower results in South Africa by saying it would immediately start developing a new vaccine aimed specifically at the South African variant.

AstraZeneca is a viral vector vaccine, which relies on the use of an RNA molecule – the same part of the virus as used in the mRNA Pfizer and Moderna vaccines. Novavax is a more traditional protein-based vaccine, and they take longer to modify.

Kelly said mRNA and viral vector vaccines can be adapted more quickly than protein vaccines, but even if they are able to be adapted,” it is another issue to make nine billion of them”.

“If we’re going to vaccinate the whole world, it’s going to take time,” he said.

Why don’t we just all take the Pfizer vaccine?

That would be a great option, says McLaws. Except we don’t have enough, and there is significant pressure on the global supply. Australia recently secured an additional 10m doses of the Pfizer vaccine, taking the total contracted amount to 20m doses by the end of the year.

That’s enough to administer the required two doses to 10 million people, or just under 40% of Australia’s population. The first 80,000 doses of the Pfizer are still on track to arrive in Australia by the end of February, Kelly says, and authorities are hoping for weekly deliveries thereafter. People in the highest-risk cohort – frontline medical staff, hotel quarantine workers, aged and disability care home residents and staff – will get that vaccine.

The balance of the population is likely to receive either AstraZeneca, which is manufacturing 50m doses in Melbourne that are expected to be administered from March, pending TGA approval, or the Novavax vaccine, which is several months away.

What are the other options?

Well, we could mix vaccines. That concept is being trialled in the UK – they called for volunteers just last week – and will involve giving 820 unvaccinated people over the age of 50 a first dose of either the AstraZeneca or the Pfizer vaccine. Half the group will have their vaccine switched for the second dose, and the other half will get the same again.

It is an option worth considering, McLaws said. Without it, the risk is that people vaccinated with AstraZeneca – largely the 20- to 39-year-old cohort – may not be fully protected against Covid-19. That’s a problem because that age group, while not at highest risk of serious disease or death, made up half of all people who contracted Covid-19 in Australia last year. They are highly mobile and more likely to be underemployed and working multiple part-time jobs, which increases their risk of exposure.

Even without considering new variants, AstraZeneca has a lower reported efficacy than Pfizer and Novavax, the other options in Australia’s stable. It sought regulatory approval in the UK on the basis that it has about 70% efficacy.

“The risk is that if our 20- to 39-year-olds are vaccinated with AstraZeneca, we have at least a 30% risk of them not eliciting an immune response without the additional problem of a variant,” McLaws said. “This is an opportunity to look at how we protect the unknown 30-odd percent. And that may be to mix up the second dose with something that doesn’t have such low efficacy for the South African strain and the Brazilian strain.”

What does this mean for borders and other restrictions?

To date there have been no reported cases of the South African variant in the Australian community.

But the risk remains. Since Friday there have been 87 samples of B117, the UK variant, detected in hotel quarantine in Australia and 18 of B1351, the South African variant.

But the vaccine results solidify what epidemiologists have warned for some time: that life will not instantly go back to normal once the majority of the population has been vaccinated


Climate risk sees bank divest from Port of Newcastle, the largest thermal coal terminal in the world

The port is the largest thermal coal terminal in the world, last year exporting 160 million tonnes and accounting for 99.2 per cent of its exports by volume.

ANZ was previously a major lender to the port as part of its $950 million debt pile, but in November the port refinanced and ANZ took the opportunity to divest.

It is understood the bank deemed the port too risky an investment which could end up a stranded asset in a world that is quickly shifting away from coal.

Last year the bank also announced an ambitious net-zero emissions action plan which adopted the issue of climate change as a condition of lending.

Analyst from the Institute for Energy Economics and Financial Analysis, Tim Buckley, said ANZ's decision was not surprising and in the best interest of its shareholders. "It will absolutely end up a stranded asset if the world is able to deliver on the Paris Climate agreement, and my conviction that the world will deliver on the Paris agreement has never been stronger," Mr Buckley said.

"The world is moving 100 miles an hour to address this critical global issue of climate risk and ANZ is understandably working with all of its customers to transition."

The United States has committed to rejoining the Paris Agreement to drastically cut carbon emissions, while large coal consumers like Japan and Korea have set net zero emissions targets for 2050, and China 2060.

The National Australia Bank, among several others, have meanwhile stepped in to underwrite the Port of Newcastle as it plans to diversity into non-coal operations in the long term, particularly container cargo.

"We are working with responsible lenders who are interested in helping businesses like Port of Newcastle become more sustainable and diversify," it said in a statement. "This is crucial to a business that supports our local, regional, and national economies."

The Federal Minister for Trade Dan Tehan said he was disappointed by ANZ's decision and described the port as a viable and strong business.

"I'm very pleased that it looks like there's going to be alternative finance that will be secured because it's an incredibly important business. It supports 9,000 jobs and plays an important role in our export mix," he said.

"It's incredibly important to understand that our coal is the cleanest coal exported in the world and if we're not exporting our coal other countries will be, and that will add to emissions."

When asked, Mr Tehan did not acknowledge that there was any need for the port to diversify its activities in the long term as demand for coal declines.

The port itself has openly acknowledged the need to diversify, but its push to develop a container terminal for general cargo has so far been hampered by the NSW Government.

When selling Port Botany and Port Kembla, the state implemented laws that would restrict any container traffic through Newcastle for the next 50 years. The Australian Competition and Consumer Commission (ACCC) deemed the move anti-competitive and illegal, and the matter is currently being dealt with in the Federal Court.


MGA Thermal, a start-up born at Newcastle University, hopes to revolutionise the storage of energy and accelerate the shift to renewable power

"This is our lab where our manufacturing currently happens at the University of Newcastle," MGA Thermal's Alex Post tells the ABC as he takes us into a workshop in the engineering faculty.

The young engineer has the dual titles of chief technology officer and chief disruption officer at the company.

He's a protégé of Erich Kisi, a professor of materials science at Newcastle, who pioneered a technology for storing energy as heat in "bricks" made from an alloy of recycled metals.

Alex Post explains a process that's remarkably simple. "We stack the bricks up into large energy storage systems; we heat them with waste heat from industry or with electricity from the grid when we have too much solar, and these bricks store all of that energy as heat.

"Six to eight hours later we can use all that stored heat to drive an industrial process or create steam to run a power plant and put energy back onto the grid." It's modular, scalable and carbon emissions free.

The main applications for the technology will be powering factories and providing storage for solar power plants that use concentrated solar thermal power, but it could also be used to turn the turbines in former coal-fired power stations — without burning coal.

It's the kind of clean technology that groups working on the transition from coal see as the future of this region.

"Our vision is that, by 2030, the Hunter is the electric motor of the Australian economy and possibly the global economy," says Sam Mella, Hunter engagement lead for the think tank Beyond Zero Emissions.

"We have everything we need to electrify industry using renewable energy and create thousands and thousands of jobs."

Another business, Energy Renaissance, is looking at manufacturing large-scale lithium-ion batteries for storing clean energy.

The Hunter Valley has also this week been announced as a centre for the development of hydrogen fuel — a clean energy when generated from renewables — that could become a multi-billion-dollar Australian export to Asia.

Newcastle, the city that was synonymous with BHP's giant steelworks for decades until it shut down in the late 1990s, is now looking at manufacturing steel again — in blast furnaces powered by renewable energy.

The great legacy of the coal industry and the old power stations is a massive network of electricity transmission infrastructure and a vast rail freight network going directly to a deep-water port.

"We'll have massive renewable energy industrial precincts making green steel, green aluminium, carbon-free batteries and we'll be exporting all of this through the port," says Sam Mella.


Cold snap blamed for mass deaths of tree martin birds in WA's South West

What! No global warming?

Conservationists have blamed a summer cold snap for the widespread deaths of a small native bird in Western Australia's South West.

A low pressure system brought unseasonal cold temperatures and heavy rainfall to southern WA for several days from the weekend.

Parks and Wildlife conservation officer Ben Lullfitz said after the cold weather people had found dead tree martin birds from Augusta to Bunbury.

"It's a small bird which looks a bit like a swallow, basically they are insect feeders which don't like cold weather in the summer … which has caused them to get into quite a bit of distress," he said.

Mr Lullfitz said the birds were unable to feed or regulate their body temperature during the cool conditions.

"We don't know how many exactly have died but it's been a widespread event," he said.

"We haven't had any reports of other species not surviving this cold weather but generally [birds] will find a spot to shelter and wait out," Mr Lullfitz said.

He recommended local residents dispose of any dead birds they find. "If animals are still alive and in distress take them to the nearest vet or call the wildlife helpline," he said.




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