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Lex Letter from Seoul: China’s vaccines and efficacy rates

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Dear readers,

Who will get immunised first — or at all — is a hot topic of conversation worldwide. Vaccine shortages add to the uncertainty. Covid-19 shot manufacturers such as Pfizer are hitting production limits. But in Asia, Chinese vaccine makers have no problem meeting demand.

State-owned Sinopharm and Sinovac have shipped more than 20m doses to developing countries including Turkey, Brazil, the Philippines and Thailand. The two businesses have signed deals to provide hundreds of millions of further doses. More than 15m shots have been administered in China, according to the National Health Commission.

Conflicting data surround CoronaVac, made by Sinovac. Initial trials reported a general efficacy rate of 78 per cent. Two doses induced the immune response, according to peer-reviewed papers.

Interim results from a smaller, late-stage trial in Turkey — where CoronaVac has been purchased for more than half of its population — found the vaccine to be 91 per cent effective.

But data from a Brazil trial of 12,500 people showed a lower general efficacy rate of about 50 per cent. That falls below the levels of global peers such as BioNTech/Pfizer, Moderna and Oxford/AstraZeneca.

That lower rate — which means the vaccine stops half of those who take the shot from getting sick — reflects the science behind the jab. CoronaVac uses inactivated virus, as conventional influenza vaccines do. Flu jabs have efficacy rates of about 50 per cent. The BioNTech/Pfizer and Moderna vaccines use messenger RNA genetic material to trigger a more reliable immune response.

Health authorities will deploy CoronaVac widely in Indonesia and Turkey in the coming weeks. Those immunisation campaigns should produce plenty of real-world data.

Even without those results, demand for CoronaVac will stay high. For the hardest-hit countries, especially in the developing world, it is the only option. They need speedy access to vaccines to slow the spread of the virus and forestall new strains. Developed nations have largely cornered supplies of mRNA vaccines.

Column chart of Confirmed number of doses purchased by country income level classification (million) showing Poorer countries fall behind in race for vaccines

For hotter countries, such as Thailand and Indonesia, CoronaVac offers distribution advantages over the Moderna and BioNTech/Pfizer shots. The latter needs to be transported at minus 70C in dry ice shipping containers. CoronaVac can be stored between 2C and 8C.

Indonesia is made up of 17,000 islands with residents spread across 6,000 of them. Transport is unreliable. Flights and road journeys are long.

For Sinovac, growing demand and the relatively high price, of $60 for two doses, will boost its top line. The market for cheap influenza vaccines stands at $4bn a year. About 40 per cent of the population take the flu shot in countries such as the US.

It is expected that 70 per cent of a population will have to get a Covid-19 jab to foster herd immunity. Many experts believe the Covid-19 virus is here to stay. Vaccine makers will benefit from a hefty recurring source of revenue.

Shares of Sinopharm have started to reflect those expectations, up about 30 per cent from March lows. Sinovac is valued at more than $3bn — six times its market value last year, after Sino Biopharmaceutical acquired a 15 per cent stake in a subsidiary.

There is room for more gains in the sector as clinical trials wrap up at local rivals such as CanSino Biologics and Shenzhen Kangtai which are close to bringing their own products to market. Investors will benefit from the new market in Covid-19 vaccines long after the pandemic is over.

Enjoy the rest of your week.

June Yoon
Lex writer



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A harrowing brush with Covid as India is ravaged

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As a foreign correspondent, my job is to tell India’s stories, not be part of them. But when I started feeling feverish while writing an article about Covid-19 vaccine policy last month, I had a gut feeling that the Sars-Cov-2 virus had found me.

I hoped it was exhaustion that I’d sleep off but the next day, still feverish, I was urged to take a Covid test. A leading diagnostic lab chain, which earlier had run an efficient home-testing service, had stopped answering its phones and responding to online requests. But a doctor friend persuaded one of the lab’s phlebotomists to collect my sample. Two days later, the results confirmed I was part of the ferocious coronavirus wave battering India and pushing its healthcare system to breaking point.

Over the following days, my physical symptoms remained mild. But it was still harrowing to be sick from a notoriously unpredictable virus knowing that drugs, hospital beds and oxygen were scarce. I suffered constant anxiety knowing I’d struggle to get medical help if I took a turn for the worse.

I quickly discovered that I’d been so focused on avoiding infection that I had no clue what to do once sick. A friend connected me to a Kolkata-based infectious disease specialist, who felt I was at low risk for severe illness. I’d had the first dose of a Covid vaccine 10 days before my fever started. But the doctor urged me to treat the illness aggressively from the start, given the chaos at hospitals.

He prescribed the antiviral drug, favipiravir, now undergoing clinical trials in the UK as a potential Covid-19 therapy but already approved in India for emergency use. Many of his patients had taken it, he said, and none suffered severely, including people in their 90s.

Normally, I’m reluctant to medicate. I knew favipiravir’s effectiveness as a coronavirus treatment wasn’t yet scientifically validated. But with hospitals turning away ailing patients, the logic of taking an experimental drug made sense. The challenge, I discovered, was to get hold of it.

I called five pharmacies, but all had run out of stock. A friend called six more to no avail. I panicked — the doctor wanted me to start the drug fast and Delhi was hours from the start of a weekend curfew. Then a friend, who’d heard I was Covid-19 positive, called.

“I’m looking for this drug,” I told her. “Any idea where I can get it?” She said she’d check. It turned out that people with foresight had prepared small emergency drug stashes. Her friend had such a stash and was willing to share it.

I was elated to get the pills to start treatment that night. But it wasn’t enough for the prescribed course. Days later I spent hours calling pharmacies in an unsuccessful hunt for more, before finally begging an industry friend to help.

My difficulties pale in comparison with the desperation, anger and grief beyond my sickroom. My Twitter feed was filled with pleas for hospital beds, oxygen cylinders, the antiviral remdesivir, plasma or a place in an intensive care unit. Top hospitals begged on Twitter for refills of dwindling oxygen supplies. Friends and many professional contacts were fighting for their lives. Doctor friends were weeping with impotent rage.

There was much grim news of death. A former Indian ambassador died after hours waiting in a hospital parking lot for admission; inpatients whose oxygen ran out; a top politician’s 34-year-old son, young journalists. Crematoriums struggled with an unprecedented flow of bodies.

I decided I had to tune out of the unfolding crisis, to ensure my physical recovery and to protect my mental health. I stopped checking Twitter. Newspapers piled up, unread.

Once I felt better and tuned back, I saw Narendra Modi’s government had cynically expanded eligibility for vaccination to all over the age of 18, despite an acute shortage of jabs.

And with thousands dying daily, often for want of medical help, the health minister was callously citing dubious official data to claim India’s Covid fatality rate was lower than richer countries — hardly consolation to grief-stricken families.

Today, I’ve recovered from my encounter with the virus. It will take far longer to get over the trauma of watching this calamity engulf the place I call home.

amy.kazmin@ft.com



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Indian foreign minister self-isolates after Covid cases detected in G7 delegation

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India’s foreign minister on Wednesday said that he was self-isolating after two members of the country’s delegation to the G7 meetings in London tested positive for coronavirus.

The face-to-face meetings in the UK capital began on Monday and are scheduled to end on Wednesday. Representatives from G7 countries such as Canada, Germany and France are attending alongside Australia and India as the UK seeks to strengthen its ties within the Indo-Pacific region.

Subrahmanyam Jaishankar, India’s external affairs minister, confirmed on Twitter that he was informed on Tuesday evening that he had been exposed to a possible Covid-19 case.

“As a measure of abundant caution and also out of consideration for others, I decided to conduct my engagements in the virtual mode,” he added. It is understood that the rest of the Indian delegation will self- isolate for the remainder of the G7 meetings.

Jaishankar held a socially distanced meeting with UK home secretary Priti Patel on Tuesday, where two agreed on a “migration and mobility deal” which will provide a “bespoke route” for young professionals from India looking to live and work in the UK. He met Antony Blinken, the US secretary of state, earlier this week.

“We deeply regret that foreign minister Jaishankar will be unable to attend the meeting today in person,” a senior UK diplomat said. “(He) will now attend virtually, but this is exactly why we have put in place strict Covid protocols and daily testing.”



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Blinken rejects claims of ‘cold war’ between US and China

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America’s top diplomat Antony Blinken has rejected claims the US is entering a cold war with China during a visit to London to discuss with G7 counterparts how best to respond to the challenges posed by Beijing.

In an interview with Financial Times editor Roula Khalaf for The Global Boardroom, Blinken said he resisted “putting labels on most relationships including this one, because it’s complex”.

“This is not about initiating a cold war, this is all about doing our part to make sure that democracy is strong, resilient, and meeting the needs of its people,” he said, referring to Washington’s intention to hold a “democracy summit” later in the year.

Joe Biden, US president, has promised to “win” the 21st century in what he has portrayed as a “battle” between democracies and autocracies and has pointed to Chinese activities that the US says are damaging the international order.

Relations between the US and China deteriorated under the Trump administration and the countries remain at loggerheads over security, human rights, intellectual property, and rules governing trade and commerce.

“We’re not asking countries to choose [between the US and China],” Blinken added in remarks at the FT Live event on Tuesday, which were broadcast after G7 countries opened their meeting with a session on China.

Ahead of the event, a US state department official said the G7 session on Tuesday morning was intended to be a forum to discuss how to work closely with allies and partners to address shared challenges from a position of strength.

Antony Blinken, US secretary of state, far right, is meeting with G7 leaders in London to discuss how best to respond to the challenges posed by Beijing © Stefan Rousseau/Pool/Getty

Blinken said the US recognised that countries have complicated relationships, including with China, and that the US did not believe other countries’ economic relationships with Beijing “need to be cut off or ended”. However, he said the US wanted to foster and protect basic rules governing commerce, the environment, intellectual property and technology.

Biden has surprised many foreign policy experts by taking an approach to China that has more in common than not with the harsh stance taken by former president Donald Trump. One big difference has been a significant effort to work with US allies and partners to create more leverage to deal with Beijing.

His approach has been welcomed by allies in Asia, such as Japan and Australia. But there is concern in the EU about the bloc being caught between the US and China, particularly in Germany.

Angela Merkel, German chancellor, has said the EU and the US do not agree on everything and that it was “absolutely clear” that their interests were “not identical” when it came to China.

The G7 comprises the US, Canada, UK, France, Germany, Italy and Japan, and this year the UK has also invited Australia, India, South Korea, Brunei and South Africa to attend as guests.

Biden recently convened the first leader-level meeting of the Quad — a group that includes the US, Japan, India and Australia — as part of this effort to work with allies to counter Beijing.

Evan Medeiros, professor of Asian studies at Georgetown University, said the Biden team’s engagement with the G7 formed part of its effort to assemble coalitions to tackle the China challenge.

He said the administration was pursuing the right strategy by saying the US did not want a cold war and did not want countries to pick sides, but he added: “The reality is everybody is going to have to make choices when it comes to China.”

But Bonnie Glaser, Asia programme director at the German Marshall Fund of the US, highlighted concerns among some that Washington’s stance was “too aggressive and too confrontational”.

“I definitely have the impression that the Germans and some other Europeans are really quite unhappy about the US approach to China,” she said.

In March, the US, EU, UK and Canada co-ordinated the imposition of sanctions on Chinese officials over the country’s treatment of Uyghur Muslims in the western Xinjiang region, triggering retaliatory sanctions from Beijing.

Biden administration officials including Blinken frame the future of the US relationship with China as “competitive, collaborative and adversarial”, depending on the issue in question.

Washington wants to co-operate with Beijing on foreign policy issues including Iran, North Korea and climate change while also defending US interests in the military, technological and economic spheres and pushing back on human rights abuses in Hong Kong and Xinjiang.

Blinken said that “a democratic recession around the world” had occurred over the past 15 years, but admitted the US had its own challenges “visible for the world to see” when it comes to democracy, in a thinly veiled reference to the disputed presidential election and January 6 Capitol attacks.



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