Gulf Times

10 Wednesday, September 2, 2020

COMMENT
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Abdullah bin Khalifa al-Attiyah
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Faisal Abdulhameed al-Mudahka
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K T Chacko

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GULF TIMES
Shortcoming in
Russian, Chinese
Covid-19 vaccines
High-profile Covid-19 vaccines developed in Russia and China
share a potential shortcoming: They are based on a common cold virus
that many people have been exposed to, potentially limiting their
effectiveness, some experts say.
CanSino Biologics’ vaccine, approved for military use in China, is a
modified form of adenovirus type 5, or Ad5.
The company is in talks to get emergency approval in several countries
before completing large-scale trials, the Wall Street Journal reported last
week.
A vaccine developed by Moscow’s Gamaleya Institute, approved in
Russia earlier this month despite limited testing, is based on Ad5 and a
second less common adenovirus.
“The Ad5 concerns me just because a lot of people have immunity,”
said Anna Durbin, a vaccine researcher at Johns Hopkins University. “I’m
The importance of digital health
not sure what their strategy is maybe it won’t have 70% efficacy.
It might have 40% efficacy, and that’s better than nothing, until
something else comes along.”
Vaccines are seen as essential to ending the pandemic that has claimed
over 845,000 lives worldwide.
technologies in a pandemic
Gamaleya has said its two-virus approach will address Ad5 immunity two-tiered model has emerged over heart rate with a smart watch, how that these tools are deployable and
issues. the years in which you might see can such data be comprehensively capable of providing accurate patient
Both developers have years of experience and approved Ebola vaccines government or government-affiliated weaved into a patient care plan? record assessments in real-time. An
based on Ad5. hospitals adopting much more Information overload aside, the unassimilated or fragmented patient
Neither CanSino nor advanced digital health technologies, medical record systems we adopt record system serves little purpose
“I think they Gamaleya responded to requests
for comment.
compared to private hospitals. Those today do not allow user-generated
data to be amalgamated into an
even if incorporating the most
advanced of all technologies. We must
hospitals, including Sidra Medicine
will get good Researchers have and Hamad Medical Corporation’s electronic format.
With the increase of technologies
always remember that technology
exists to serve human needs, but
experimented with Ad5-based Primary Health Care Centres, are
immunity in vaccines against a variety of forging the way. The Covid-19 crisis
– along with relevant precautionary
and over-reliance on AI, patient
safety, fair and accessible care become
without applicability, technology will
not be long-lived.
infections for decades, but none
people that don’t are widely used. measures – will see a surge in digital
health technologies being used by the
very important issues that continue
to evolve. Furthermore, there is a z Dr Mowafa Househ is an Associate
They employ harmless viruses
have antibodies as “vectors” to ferry genes from
By Dr Mowafa Househ
Doha private sector to generate income,
only if and when insurance companies
disparity between the adoption of
healthcare technology in developed
Professor at the College of Science
and Engineering, part of Hamad
the target virus — in this case the
to the vaccine, novel coronavirus — into human are also able to compensate private and developing countries, widening Bin Khalifa University. The college

T
cells, prompting an immune he convergence of digital
but a lot of response to fight the actual virus. health technologies can
But many people already have have great benefits and
people do” antibodies against Ad5, which a positive impact on
could cause the immune system healthcare delivery, now more than
to attack the vector instead of responding to the coronavirus, making ever. As early as 1879, telephone
these vaccines less effective. calls were identified as one method
Several researchers have chosen alternative adenoviruses or delivery of facilitating patient consultations.
mechanisms. In 1925, the Science and Invention
Oxford University and AstraZeneca based their Covid-19 vaccine on a magazine touted a then unlikely use
chimpanzee adenovirus, avoiding the Ad5 issue. for radios – to educate the wider
Johnson & Johnson’s candidate uses Ad26, a comparatively rare strain. population about health aspects.
Dr Zhou Xing, from Canada’s McMaster University, worked with Today, with the advent of personal
CanSino on its first Ad5-based vaccine, for tuberculosis, in 2011. computers, Internet connections,
His team is developing an inhaled Ad5 Covid-19 vaccine, theorising it mobile devices, social media, artificial
could circumvent pre-existing immunity issues. intelligence (AI), holograms, wearable
“The Oxford vaccine candidate has quite an advantage” over the devices, and telesurgery, digital health
injected CanSino vaccine, he said. technologies have evolved into an
Xing also worries that high doses of the Ad5 vector in the CanSino integrated ecosystem, and become
vaccine could induce fever, fuelling vaccine scepticism. even necessary for our everyday
“I think they will get good immunity in people that don’t have survival.
antibodies to the vaccine, but a lot of people do,” said Dr Hildegund Ertl,
director of the Wistar Institute Vaccine Center in Philadelphia. zDigital Health in a Health
In China and the United States, about 40% of people have high levels Crisis
of antibodies from prior Ad5 exposure. Unsurprisingly, the Covid-19
In Africa, it could be has high as 80%, experts said. crisis has helped shed more light
Some scientists also worry an Ad5-based vaccine could increase on the importance of digital health,
chances of contracting HIV. especially when it comes to education,
In a 2004 trial of a Merck & Co Ad5-based HIV vaccine, people with diagnosis and treatment of patients
pre-existing immunity became more, not less, susceptible to the virus or health consumers. Contact-tracing
that causes Aids. applications, for example, have
Researchers, including top US infectious diseases expert Dr Anthony become a widely accepted method for
curbing the spread of the Covid-19
Fauci, in a 2015 paper, said the side effect was likely unique to HIV vaccines.
virus. Teleconsultations – already on
But they cautioned that HIV incidence should be monitored during
the rise pre-Covid – are now a new
and after trials of all Ad5-based vaccines in at-risk populations.
normal.
“I would be worried about the use of those vaccines in any country
In the digital health implementation
or any population that was at risk of HIV, and I put our country as one
arena, Qatar is spearheading efforts
of them,” said Dr Larry Corey, co-leader of the US Coronavirus Vaccine
within the region. The country’s
Prevention Network, who was a lead researcher on the Merck trial.
biggest success over the years has
Gamaleya’s vaccine will be administered in two doses: The first based
been the implementation of the
on Ad26, similar to J&J’s candidate, and the second on Ad5.
Electronic Health Record system,
Alexander Gintsburg, Gamaleya’s director, has said the two-vector
which connects primary, secondary,
approach addresses the immunity issue.
and tertiary hospitals. Such flux of
Ertl said it might work well enough in individuals who have been
information within healthcare sectors
exposed to one of the two adenoviruses. improves clinical decision-making,
Many experts expressed scepticism about the Russian vaccine after patient flow, hospital management,
the government declared its intention to give it to high-risk groups in and policy planning.
October without data from large pivotal trials. But when it comes to these
technologies, we will find that not all
implementation is equal. In Qatar, a
medical clinics for such services. the adoption and equitability gaps. offers two advanced degrees in health
zSomething for the sceptics
On the other hand, if AI algorithms
are becoming widely available and
informatics, including the Master
of Information Systems in Health
Qatar’s adoption of its Ehteraz
application poses a unique model
accessible: what is to stop a general
practitioner from running a patient
Management and the Master of Data
Analytics in Health Management.
for the world. Once a sceptic myself, record assessment akin to that of a
I soon came to realise its ability to specialised doctor? (This article is submitted on
safeguard public health. Ehteraz behalf of the author by the HBKU
is chiefly successful because the z Way forward Communications Directorate. The
associated government policies also What is even more important views expressed are the author’s own
circumscribe an ill individual’s entry than adopting digital tools that and do not necessarily reflect the
into public spaces. Without adequate fit our personal needs is ensuring University’s official stance.)
enforcement, the Ehteraz application
would have been unsuccessful.
But as is the case with any
technology, infringement is possible,
and loopholes will continue to exist.
In its current form, the Ehteraz
application facilitates QR code scans,
leaving less doubt as to whether
quarantined users are presenting a
‘green’ yet static screenshot. China,
once identified as the origin of
Covid-19, has managed to eradicate
all traces of the virus with strict
adherence to contact tracing.
As Western countries come
with their own disparities, the full
enactment of such technologies can be
harder to achieve, where the general
public perception generally perceives
them to be a violation of personal
freedoms. China’s application for
instance has been under scrutiny
because of its tendency to collect
private and personal user information.
In much of the Western world,
adoption of such technologies is left
solely to the discretion of the user.
zUse and misuse
The biggest challenge we now
face is bridging the gap between
patient and clinical adoption of
new technologies. The wider the
spectrum of tools available to us,
the more difficult it is to integrate,
interpret, and consolidate data. If a
patient was to track his or her sugar
levels with a glucose monitor patch,
sleeping patterns with a Fitbit, and

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Qatar’s adoption of its Ehteraz application poses a unique model for the world.