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Cuba’s Covid vaccine could be made eligible for tourists

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A man stands near a Cuban National flag at the Melia Varadero International Hotel in Matanzas Province, on October 23, 2020. Varadero, Cuba’s most important beach resort, is reopening to international tourism, amid the coronavirus pandemic.

YAMIL LAGE | AFP | Getty Images

Cuba’s most advanced Covid-19 vaccine candidate is scheduled to enter late-stage clinical trials next week, nudging the tiny island nation ever closer to an extraordinary medical achievement that analysts believe will have far reaching consequences throughout the global south.

Cuba’s most promising vaccine candidate, of the four it has in development, is called Soberana 02. The name of the vaccine translates from Spanish as “Sovereign,” an ostensible nod to Cuba’s sense of national pride in its world-renowned health system.

Soberana 02 is due to enter Phase 3 trials from March 1, and officials say tests will include as many as 150,000 volunteers within weeks. Phase 3 trials represent the final stage before a vaccine is generally approved by national regulators.

It comes at a time when many people in Cuba are forced to wait in line for hours to buy basic goods and as authorities continue to navigate a decades-old U.S. trade embargo — with sanctions tightened even further in recent years by former President Donald Trump.

“It is just this incredible dichotomy,” Helen Yaffe, a Cuba expert and lecturer in economic and social history at the University of Glasgow, Scotland, told CNBC via telephone.

“On the one hand you have this high-tech biotech sector which is bringing a lot of hope to the global south because it is the possibility of an affordable vaccine — (and) vaccinating the global south will be the priority,” Yaffe said.

“And at the same time the Cubans are getting up at four or five in the morning to get into queues because there is real scarcity of really basic foodstuffs and even medicines.”

What do we know about Soberana 02?

Cuba’s Finlay Institute, the country’s leading biopharma institution, is overseeing the development of Soberana 02. Dr. Vicente Verez, director of the institute, has hinted the vaccine could be made available as an option to tourists later this year.

If Soberana 02 is found to be safe and effective, the development of a domestically produced vaccine would likely be hailed as an astonishing scientific breakthrough and a significant political triumph. It would also see Cuba become the first Latin American country to immunize its population with a domestically produced vaccine.

Technician Mayelin Mejias works at the Vaccine Aseptic and Packaging Processing Plant at the Finlay Vaccine Institute in Havana, on January 20, 2021.

YAMIL LAGE | AFP | Getty Images

The government has not yet outlined specific plans for inoculating tourists, but analysts say it is possible foreigners traveling to Cuba could receive their first vaccine dose on the island before receiving subsequent doses to take home with them.

While public data is limited, it is thought up to three doses of the vaccine could be administered at two-week intervals.

People are already talking about sun, sea, sand and Soberana 02. So, I wouldn’t be surprised if people end up going to Cuba seeking the vaccine and I’m sure the Cubans will offer it.

Helen Yaffe

Lecturer in economic and social history at the University of Glasgow

Yaffe, who is also the author of “We Are Cuba!: How a Revolutionary People Have Survived in a Post-Soviet World,” said Cuba’s sophisticated health care system would help the country roll out the vaccine “extremely” quickly.

“I can guarantee that. And if they have got a vaccine which is every two weeks then within a month of starting people could be vaccinated,” Yaffe said.

“By summer, people are going to be pretty desperate to go on holiday and I think Cuba that nominates itself as an ideal destination. People are already talking about sun, sea, sand and Soberana 02. So, I wouldn’t be surprised if people end up going to Cuba seeking the vaccine and I’m sure the Cubans will offer it.”

How does it work?

People queue to buy food in Havana, on February 2, 2021, as Covid-19 cases surge in the island nation.

YAMIL LAGE | AFP | Getty Images

At a virtual session led by the Pan American Health Organization on Feb. 5, Dr. Verez said Soberana 02 had returned “encouraging results” during the early stages of testing. He added the vaccination had not yet generated any significant adverse reactions.

The Cuban government has said it will produce 100 million doses of Soberana 02 this year to meet the demands of its own citizens as well as those in other countries. It aims to be one of the first countries in the world to vaccinate its entire population in 2021, despite the fact that many advanced nations started administering jabs almost two months ago.

Several countries have expressed an interest in acquiring the vaccine, such as Vietnam, Iran, Venezuela and the African Union — which represents all 55 countries in Africa.

Cuba, which has recorded relatively few Covid cases when compared to other countries in the region, has seen a sharp uptick in infections and fatalities in recent weeks. To date, Cuba has recorded 45,361 cases of the coronavirus and 300 deaths, according to data compiled by Johns Hopkins University.

‘One of the world’s best-kept secrets’

Cuba has long been renowned for its medical diplomacy, with thousands of specialist staff sent abroad to help countries tackle short-term crises, natural disasters and medical emergencies.

Human rights groups have expressed concern that the Cuban government imposes repressive rules on doctors working abroad, citing the right to privacy, liberty and freedom of expression and association.

At the start of the Covid-19 outbreak, Cuba was estimated to have had 24,500 medical personnel working in 58 countries. A further 4,000 members of Cuba’s Henry Reeve Brigade, a group of highly respected health professionals, have gone to work in countries from Kuwait to Mexico, Italy to South Africa.

Cuban doctors during a welcome ceremony for Cuban health workers who were deployed to the Western Cape to support efforts in the fight against COVID-19 on May 24, 2020 in Cape Town, South Africa.

Misha Jordaan | Gallo Images via Getty Images

It is a deeply rooted tradition that means the country of just over 11 million is thought to have more medical personnel working abroad than all the G-7 countries put together.

“This is an extraordinary record, mainly unknown by mainstream media — one of the world’s best-kept secrets,” John Kirk, a professor at the Latin America program of Dalhousie University in Nova Scotia, Canada, told CNBC via email.

“Medical internationalism is in the Cuban DNA, and in fact the preamble to the Cuban constitution mentions the commitment that Cuba has to share its medical talent with developing countries,” he added.

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Here’s everything you need to know

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This transmission electron microscope image shows SARS-CoV-2—also known as 2019-nCoV, the virus that causes COVID-19. isolated from a patient in the U.S., emerging from the surface of cells cultured in the lab.

Source: NIAID-RML

Even as the number of global Covid-19 infections drops across the world, leading U.S. health officials are warning of a coming wave of infections as new, more contagious — and possibly more deadly — variants of the virus take hold in the U.S.

Scientists aren’t surprised by the emergence of the new variants and have reiterated that the currently available vaccines should still work against them — albeit, a bit less effective than as against the original, “wild” strain. However, top U.S. health officials and infectious disease experts worry that these highly contagious variants, particularly the B.1.1.7 strain that emerged in the U.K., could reverse the current downward trajectory in infections in the U.S. and delay the country’s recovery from the pandemic.

“I think we should be assuming that the next wave of case growth, to the extent that we have it, is going to be with B.1.1.7, and that’s something that I think everybody has to be even more cautious about,” Andy Slavitt, White House Covid-19 senior advisor, told MSNBC last week. “It’s nice to see the numbers of cases drop, but it could be misleading.” 

Why viruses mutate

As the coronavirus spreads, it makes huge numbers of copies of itself, and each version is a little different from the one before it, experts say. SARS-CoV-2, the virus that causes Covid-19, has had plenty of opportunities to spread and replicate. As more people become infected, the more likely it is that problematic mutations will arise.

The three main “variants of concern” that have U.S. officials on edge were first identified in the United Kingdom, South Africa and Brazil. The B.1.1.7 variant, first found in the U.K., is rapidly multiplying in the United States and is likely to become the nation’s dominant strain by March, according to a January study by the U.S. Centers for Disease Control and Prevention.

Through mutating, the virus is simply trying to “get to the next host and make more of itself,” Dr. Adam Lauring, an infectious diseases expert at the University of Michigan in Ann Arbor, told the JAMA network in a Feb. 4 interview. Like other coronaviruses, SARS-CoV-2 tends to mutate more slowly than other viruses such as the flu because it has a “proofreading” enzyme that fixes some of the changes when it replicates.

In other cases, “escape mutations” allow the virus to adapt to “selective pressure,” which is when the virus encounters a population that already has some degree of immunity against it — whether through prior infection, vaccination or antibody treatments — that limits its ability to spread but doesn’t stop it.

“You can think of it as trying out new solutions,” Lauring said. “Either that mutation is going to make you a better virus or a worse virus, and then what you have is selection. Survival of the fittest, for the lack of a better term.”

Research shows that more worrisome virus mutations could be coming from people who are immunocompromised, since it takes their bodies longer to respond and clear the virus, giving it more time to figure us out and mutate, said Dr. Dennis Burton, the Scripps Research Institute chair of immunology and microbiology.

“If somebody has the virus, and they clear it in a couple of days, you’ve not got much chance to mutate,” Burton told CNBC in a phone interview. “But if somebody has the virus, like an immunocompromised person, and they harbor the virus for weeks, then it’s going to have a lot more chance to mutate.”

Why some are worse than others

Only a small number of variants become a public health concern, infectious diseases experts say. Those variants typically become easier to spread, cause more severe illness in people who are infected, or evade some of the protections from vaccines and antibodies.

CDC Director Dr. Rochelle Walensky told JAMA on Wednesday that the B.1.1.7 variant is thought to be roughly 50% more transmissible and early data indicates it could be up to 50% more virulent, or deadly.

There’s also evidence to suggest that people infected with earlier strains of the virus could be reinfected with the B.1.351 variant, found in South Africa, Walensky wrote in a JAMA viewpoint with White House Chief Medical Advisor Dr. Anthony Fauci and Dr. Henry Walke, the CDC’s Covid incident manager.

SARS-CoV-2 is a coronavirus, which is a large family of viruses named “for the crown-like spikes on their surfaces,” according to the CDC. Researchers monitor those spikes, or the S-protein, for mutations because they can allow the virus to bind to cells easier or increase the amount of virus a person sheds.

The S-protein has what’s called a “receptor binding domain” that acts like “the hand of the spike” that grabs hold of what’s known as an ACE2 receptor on human cells, Dr. Daniel Griffin, chief of infectious diseases for ProHEALTH, told CNBC.

Changes to the S-protein could be a problem because those spikes have been the target of neutralizing antibodies that fight Covid-19 and are created through natural infection or vaccination, Griffin said. They could also impact the performance of monoclonal antibody therapies that prevent people from developing severe illness.

For instance, the B.1.1.7 variant first identified in the U.K. has several different mutations, according to the CDC. One of the key mutations, N501Y, is a change in the spike protein that scientists think helps the virus bind to cells easier.

The same key N501Y mutation has separately developed in the B.1.351 variant, identified in South Africa, and the P.1 variant, found in Brazil. Both strains have also developed another concerning mutation in their spike proteins, known as E484K.

The CDC warns that this mutation, which has now been identified in some B.1.1.7 cases, could be resistant to antibody drug therapies, and early studies show that it may reduce the effectiveness of some vaccines.

“This is the one that actually gets me concerned,” Griffin told CNBC, referring to the E484K mutation.

What this means for vaccines

While the vaccines have still proven to be effective against the variants, there’s concern that the B.1.351 strain could present some challenges.

Large clinical trials from Johnson & Johnson and Novavax reported in late January that their vaccines dipped in effectiveness when tested in South Africa. Novavax said its vaccine was just 49% effective among 44 Covid-19 cases in South Africa, and J&J said its vaccine was 57% effective at preventing symptomatic Covid-19.

The World Health Organization’s immunization director, Kate O’Brien, said on Thursday that these results don’t provide much certainty because the number of cases in the South African trials were low.

“We’re in still these early days of interpreting the evidence and, again, the most important thing is to get more information about what’s actually happening with respect to disease,” O’Brien said at a press briefing. “In general, we see that the vaccines retain efficacy against disease albeit at a lower level in settings without the variants that are highly prevalent.”

Pfizer and Moderna

Clinical trials from PfizerBioNTech and Moderna were performed before the variants emerged, so scientists have been performing laboratory tests to determine how well blood samples from people who were already vaccinated react to lab-constructed virus variants with the key mutations.

Those studies, which look at whether the sera in the blood neutralizes the virus and prevents it from replicating, have shown a reduction in performance when tested against the B.1.351 variant. That “suggest(s) that currently employed vaccines might be less effective at preventing infection due to this variant,” Walensky, Fauci and Walke wrote in their viewpoint.

However, your body’s ability to fight off the virus might depend on more than just neutralizing antibodies, including T cells and B cells, which could help fight the virus but aren’t measured in the early lab assessments, Lauring told JAMA.

The good news is that the Pfizer and Moderna vaccines also showed a high efficacy rate in earlier trials — roughly 95%. So there’s a cushion that would allow for a dip in their performance while they would still be considered effective by doctors, experts say. The shots have also been shown to provide protection against people contracting severe forms of disease that would result in hospitalizations or death.

Both Pfizer and Moderna have already said they’re working on a booster shot for their vaccines that will hold up better against the B.1.351 strain.

Finding the mutations

The B.1.1.7 variant was first identified in the United Kingdom in December, but it’s thought to have emerged at some point in September. Many experts have credited the U.K.’s ability to conduct genomic sequencing on a wide scale for the discovery of the variant.

Genomic sequencing is a laboratory technique that breaks down the virus’s genetic code, allowing researchers to monitor how it changes over time and understand how these changes might affect it, according to the CDC.

In the U.S., there are now 1,661 documented Covid-19 cases with the B.1.1.7 variant, 22 cases with the B.1.351 variant and five cases with the P.1 variant, according to the CDC’s latest data. Officials acknowledge that the U.S. is sequencing a small fraction of cases and the spread of the variants is likely far broader. The federal government, however, has recently tried to ramp up how many samples it sequences each week to detect these variants and other mutations that may be developing domestically.

The CDC has partnered with public health and commercial laboratories to rapidly scale up the nation’s genomic sequencing. Walensky told JAMA on Wednesday that in January, the U.S. was sequencing only 250 samples per week, which has since grown “to the thousands.” She added that “we’re not where we need to be.”

Dr. Ilhem Messaoudi, the director of the University of California at Irvine’s Center for Virus Research, said the process can be time consuming and labor intensive but emerging strains will be missed if laboratories aren’t sequencing a certain percentage of all positive Covid-19 test results to find the new mutations.

“Now we’re trying to catch up,” she said in a phone interview with CNBC. “We’re like, ‘Let’s go back and see if we have this.'”

Masks and social distancing

The rapidly spreading variants renew the importance of suppressing the coronavirus’s spread through public health measures, such as wearing masks, socially distancing and practicing hand hygiene, to prevent further mutations and buy time for countries to deploy life-saving vaccines.

But coronavirus variants aren’t just a problem for the United States. If the virus circulates in other parts of the world that are unvaccinated, it could lead to mutations that may threaten the widely deployed vaccines in other countries, the head of the CDC warned on Wednesday.

Eventually, the whole world will need to build an immunity to the virus or else the variants will continue to be a problem, Burton told CNBC.

“Sooner or later variants will get everywhere if they’ve got a big advantage,” Burton said. “It’s a global problem; it’s not just a problem for any one country.”

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Kia unveils 2022 Carnival as new SUV-inspired minivan with VIP seating

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Kia Motors is replacing its Sedona minivan with a new SUV-inspired model called the Carnival beginning in the second quarter of this year.

The 2022 Carnival “multi-purpose vehicle,” also known as a minivan, features a boxy exterior, large front grille and an overall design that looks more bold and rugged than the outgoing model. It features new front and rear signature lighting as well as Kia’s new logo, which was announced earlier this year.

The vehicle, which was unveiled Tuesday, features a host of new safety features as well as new sliding configurations for the second-row seating and an available “VIP Lounge Seating” with power controls and leg extensions much like a traditional reclining chair.

 “The Kia Carnival is here to disrupt a staid segment and proves once again what is possible when conventions are shattered,” Kia Motors North America CEO Sean Yoon said in a release.

The 2022 Kia Carnival has available heated and ventilated second-row “VIP Lounge Seating” with power controls, wing-out headrests and leg extensions.

Kia

The drastic design change is the latest for the minivan segment as automakers attempt to compete against crossovers and SUVs — segments customers have been flocking to for their space, capability and more rugged persona.

After decades of growth and minivans accounting for about 8% of the U.S. light-duty vehicle market, sales in the mid-1990s to 2000, sales have nose-dived to less than 400,000 units in recent years. Much of the segment’s decline is attributed to the rise of crossovers and SUVs as well as a stigma of the vehicles being uncool and for “soccer moms.”

Sales of the Sedona declined about 70% between 2016 and 2020 to only 13,190 vehicles sold in the U.S.

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Snap tells investors it’s on track for several years of 50% growth

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Evan Spiegel, CEO of SNAP Inc.

Stephen Desaulniers | CNBC

Shares of Snap popped suddenly on Tuesday after it announced that is in position to drive multiple years of revenue growth of more than 50% during the company’s investor day.

Shares moved from around $58.50, which was about 7% below Monday’s close, and closed at $70.45 on Tuesday, up more than 11%.

“Via the work on our self-serve ad platform, we’re in a position to drive multiple years of 50% plus revenue growth,” Peter Sellis, Snap’s senior director of ad products, told investors.

Sellis explained how the company has been building out its Ads Manager self-serve ad tool since its launch in 2017. The company has expanded the tools ability to target users and allow advertisers to place different types of bidding outcomes .

Now, Snap has built out its self-serve advertisement ecosystem that has driven cost per impression for Snap while driving return on investment for advertisers, Sellis said.

“The more advertisers we have, the more diverse the set of ads that we can show,” Sellis said. “That makes these ads more relevant and it makes Snapchatters more likely to engage with them. This in turn drives higher ROI and makes us more efficient with our inventory.”

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