“Not Going to Have a Vaccine Before Summer of 2021”: 5 Key Takeaways From Columbia University’s Coronavirus Briefing

By Kam Kompani,

March 27, 2020



Columbia University’s Earth Institute yesterday (26 March) hosted a virtual briefing on the evolving COVID-19 pandemic.

The briefing featured three leading Columbia University experts:

– Irwin Redlener, MD, Director, The National Center for Disaster Preparedness at Columbia’s Earth Institute; Professor, Health Policy and Management, Columbia University Mailman School of Public Health;

– Jeffrey Shaman, PhD, Professor, Environmental Health Sciences, Columbia Mailman School of Public Health, and Director, Climate and Health Program, Columbia University;

– Jeff Schlegelmilch, MPH, MBA, Deputy Director, The National Center for Disaster Preparedness at Columbia’s Earth Institute.

Here are five key takeaways from the briefing:

1 — Worst-case scenario: “70% of the population within a year or two could be infected”

“I am not trying to fear monger but I think it is very important that we look at this clear-eyed to see what the worst-case scenario potential of the virus is so we can walk back from that and implement measures to control it and don’t reach those numbers,” Dr. Shaman stated.

Adding that: “But the worst case scenario is something on a scale that we haven’t seen since 1918, with billions of people on the planet infected, up to 70% of the population within a year or two could be infected if we don’t control this effectively; and a substantial number of people being hospitalised and millions of people even dying, maybe even tens of millions.”

2 — “The reality is we don’t know how respiratory viruses are transmitted”

Dr. Shaman then went on to discuss how the virus can spread:

“The virus you may hear is transmitted by droplets and people may be telling you that you should be wearing masks or washing your hands.

“The reality is, for respiratory viruses in general, we actually don’t know how they are transmitted. We know how they can be transmitted but we don’t know how they are.”

There are three dominant routes through which COVID-19 can be transmitted: it can be through droplets (one person to another when in close contact), indirect through objects and surfaces (such as doorknobs), or airborne.

“The reality is that we don’t know which way is dominant in terms of the transmission of this novel virus. We know that in theory all three of these are possible,” Dr. Shaman said.

Dr. Shaman urged people to take steps to protect themselves from all three possible transmission routes.

3 — “Literally out of the question”

Dr. Redlener addressed recent comments by President Trump claiming that restrictions in the U.S. might be lifted by Easter: “I just want to say on behalf of everyone I know in the business, that is literally out of the question.

“That can’t happen, that should not happen, we actually should be increasing the restrictions for some period of time.”

4 — “The crowd size people should be aiming for right now is two”

Dr. Redlener stated that comparing COVID-19 to the SARS epidemic or swine flu is not useful:

“We are really talking about the benchmark of the Spanish Flu of 1918.

“The problem is that we are going to have 150 to 215 million Americans who contract the virus. And because the numbers are going to be large, even though the actual fatality rate might be low, it still could amount to at least half a million deaths in the United States, maybe as many as 2 to 2.5 million deaths in the United States.

“What’s going to drive the outcome here [in the U.S.] and make it better or worse is going to be the only thing we have, which is severe restrictions of movement and congregation. The crowd size people should be aiming for right now is two. Unless there are [more] people who live in your household.”

5 — “We are probably not going to have a vaccine before summer of 2021”

Regarding the development of a vaccine, Dr. Shaman explained that “a vaccine development for something like a flu is something that we have a template for. In 2009, it was just five months between the identification of the virus and the delivery and distribution of an effective vaccine that had been clinically tested and FDA-approved in the United States.

“It is going to take longer, unfortunately, for this novel coronavirus because we don’t have the same kind of experience developing vaccines for coronaviruses in general. Consequently, the estimates are that we are probably not going to have a vaccine before summer of 2021.

“What that leaves us with in the absence of these pharmaceutical interventions are the non-pharmaceutical interventions [such as social distancing and ventilation of indoor spaces].”

6 (Bonus) — Dr. Shaman Explains Why It Takes a Few Weeks to See the Consequences of a New Control Measure

“When a person is infected with this virus, they first undergo what is called a ‘latent period’ where they are not even infectious, they are not aware that they have the infection agent in them — and it lasts for a few days.

“After that they may have what is called pre-symptomatic shedding, where they are contagious at this point but are not showing symptoms. Only after that do some of them, those who develop more severe symptoms, go down the path of having worsening symptoms and eventually seeking clinical care. That usually takes a week, maybe 10 days.

“The testing and the identification can take up to an additional three days. As a consequence, we are looking at a 10- to 14-day delay between infection and identification for a given individual.

“Consequently, any control measure that may be enacted today are not going to affect the people who are already infected. They are going to follow that progression. So we are not going to see changes, or flattening of the curve, until another week and a half or two after a particular control measure is applied.

“I should also add, there are even longer delays when you are looking at what the demands are going to be on hospital beds and ICU beds, which are things you are going to be hearing about a lot and are very critical. Because there is an even longer delay after somebody is confirmed before they progress necessarily to needing a hospital bed or needing an ICU bed.

“Just to give you one quick example. In China, they began implementing control measures in Wuhan, which was the epicentre of this outbreak, on January 23rd. It was not until four weeks later that peak ICU bed demand occurred.

“So there are considerable lags here and it is really important that people comply with the social distancing practices that have been applied and be patient to see that the effects of them are actually realized.”