 Today, Peter will be talking about COVID-19 vaccinations. The title of his presentation is Will Vaccination and the Pandemic. And as you know, the ECB produces quarterly forecasts of the economy. The evolution of the pandemic has, of course, become a key ingredient of our forecast since its outbreak. The key input indeed is to arrive at the growth path of the economy by looking at the speed of vaccinations and its impact on the pandemic. So we very much look forward to learning today from Peter whether vaccinations will indeed end the pandemic. The format of Peter's talk is as follows. Peter will give a short presentation of about 30 minutes and the remaining time will be interview-based. You can direct your questions to Peter through the host of the meeting via the chat function, which is the fifth button at the bottom of your screen. I will then collect your questions and post them to Peter. I should say that I apologize in advance if I cannot get to your question because of time constraints. Peter, on behalf of the ECB and its executive board, some of which are on the call already, it's a great pleasure to have you with us today. The floor is yours. Thank you very much, Luken. Good morning. I welcome everybody from London, where I'm working remotely from home, and I'm always impressed by central banks because of the very serious research you're doing and one of the things that you may not expect from us, but London School, we probably employ the largest group of health economists or economists of health in any academic institution in the world, but also we have about 100 mathematical models, and I'm sure you must also have plenty of them. Most of them have a mathematics or physics background, but quite a few also economics, and so we've been working with some national banks and trying to, well, to go beyond the crystal ball forecasting with this epidemic, which is not so easy. The question here, of course, that all occupies us, when will this crisis end? The first question is, of course, to define what do we mean by end. That's not a philosophical question, but as I will go into this, for vaccines, the primary impact will be a decrease in mortality, hospitalization, severe disease, but not necessarily that the virus will stop circulating. I'll come back to that, but also you could argue in some countries in Southeast Asia and in East Asia and in like in New Zealand, at the moment life is fairly normal. For example, in Singapore, as of Monday, people will go back to their offices, and my eldest son lives in Laos, they had less than 10 deaths, and life is completely normal, except you can't get in or out of the country. And the same is true in New Zealand, so and the question is, how long is that sustainable? But what I'll do is to give very briefly overview, what are the vaccines in somewhere are we without going into too many technical details? And then what will it take to indeed bring this epidemic under control? Ending it, just like to remind everybody, there is only one human virus, virus that infects humans that has been eliminated, eradicated, and that's smallpox. Now, about 30 plus years ago, and that's it. And so we should be be under no illusion what what we can achieve, certainly in them in the short term. Now, I think it's fair to say that in most of continental Europe, we're entering, I would say a third wave, you can see here on the left side, the reporters daily cases of COVID in the first peak is, you know, is clearly an underestimate because there was the testing capacity was very low. And that was in the spring. And now we got into another peak between October and December, with, if you can see here on every day, about 300,000 people in Europe were infected. This is Europe beyond also the EU. So that includes UK and some of the so-called neighborhood, as I'm learning, EU speak now. And then we were on the really going, it was going quite well, thanks to the lockdowns and all the measures, social distancing and masks and so on. But now there is a rebound. That we know, and we're in some countries, an increase of 30 to 50% in one week of the number of cases. And that's not due this time to increase testing, but there's a genuine increase. It is driven mostly by so-called variant and a virus strain that is more infectious. I'll come back to that also, and that originated in Kent and in England, and which was brought under control in England, thanks to pretty draconian lockdown. So that's the good news is it's possible to do that. But it's this variant plus premature relaxation of the measures that means that we are going into this new wave and while vaccination has not been rolled out sufficiently. You look here at the deaths, you know, COVID-19 is the second cause of death in Europe. It was the first cause of death by the end of the year, of last year. So it's not a marginal phenomenon because to those deaths you should add deaths from other diseases but in people who could not access health care because hospitals are overwhelmed are restricted in terms of what they can do. And so there is quite some good evidence that there is an increase in deaths also from stroke, heart attacks and even cancer. So it is quite, you know, when we think of the impact, as you know, very well as economists, this we should look beyond the, you know, the immediate direct cost and direct deaths. Next slide, please. So the European Centre for Disease Control, which is an entity of the European Union based in Stockholm and has just recently developed and made available a, you know, what they call a COVID-19 forecast hub where various modelling exercises for various groups are being put in, you know, in a database and by country with forecasts. And of course, as you can see here, as you all know, the uncertainty range of the forecast, of course, increases over time and the various models don't always agree. However, in general, I would say that the current third wave was fairly accurately predicted by most mathematical models. Because of the, as soon as this variant came up from England, because that variant is 70 percent, up to 70 percent more transmissible. So you have in a sense a bit of an epidemic in the epidemic and the virus that is taking over, which complicates life tremendously, and there are other variants in other parts of the world. Again, I come back to it. It's also increasing mortality. This is all work by the London School of Hygiene Tropical Medicine. And so I'm not suggesting that, for example, I just took Germany, since you're based in Germany, that we will go that path. As you know, there is the worst case scenario is not always or usually not what we see here. Plus, it assumes that the, you know, that the measures will be relaxed. However, it should give us some pause to reflect that we're certainly not out of the woods. And also when you take a bit of a longer term modeling until the end of the year, most models predict in the autumn, winter, another increase, but much less because of vaccination, fewer deaths. And that is to do with seasonality. Because we all have experienced in our life during when it's getting colder, we get a cold as it's called. And, you know, because we spend more time in closed, you know, rooms and, you know, we interact much closer to country to people. And also the viruses are response, our immunity, the fence against viruses is less effective. So that's a bit for the time being, but it's a really good resource there. And you can play with it and extend it to the time and so on. Next slide, please. Now, going to the, so the situation is serious again. We all had hoped that by the spring, we would could be able to relax and without this variant that would have been the case. But the viruses are one purpose in life. When you think of it, there is no death of a virus is survival is eternal life and is finding a host and that means a living cell, be it a plant, a animal or a human being because viruses cannot survive and multiply without living cells. They actually parasitize. They use our machinery to multiply and to then find another host. So this is what the race between the virus trying to multiply and escape the, you know, the evolutionary pressure that we're putting on there and then our control measures. In Europe, there are four vaccines that have been approved by the European medicines agency. As you know, is the first one was the BioNTech Pfizer vaccine, this is the Moderna vaccine from an American startup. We have the Oxford and AstraZeneca vaccine and the Janssen and Johnson and Johnson vaccine. These are all approved and they're roughly equally effective when it comes to preventing death and, you know, and severe disease. The interestingly here is that two of these vaccines, the BioNTech developed and the Moderna developed vaccines are completely new, never before have they been made available because they use directly a technology called messenger RNA. So you inject in a sense the genetic code of the spike protein, which then the body fools the body and the body thinks it's a natural infection and creates this immunity. And I think this will be the start of a whole new generation of vaccines. As we all know, this has been, these vaccines have been made in record time in less than a year. Normally it takes just to mind you about 10 years at least to develop a vaccine and sometimes no much longer. For example, HIV, which is actually killing still close to, you know, a million people a year and was discovered in 1983. We still don't have a vaccine because there the virus is so smart and changes so much that it's difficult. So we've been lucky that vaccine was possible biologically against the coronavirus. And these vaccines are not only have been shown to be effective in clinical trials but also the real world effectiveness is also high because that's not always the case. Often the real world effectiveness is lower than when you do a need study and you know when you eliminate all the things that you don't like and that you want to have a proof of concept. Now here and the first data came from Israel, the country that has had the fastest deployment with over 60% of people in Israel in fact vaccinated now. And that in no time and all with the same vaccine, the biotech Pfizer vaccine. And I won't go into the details here but the effectiveness even after one dose was already 70% and that's confirmed by data from Scotland, from England and from smaller groups in the US and soon we'll see more and more of that. So basically you can hardly say it's just eliminates nearly 100% deaths, hospitalization and severe disease, which means that the burden of disease is going to be much much less. However, the vaccination coverage as you know very well and become one of the big political and geopolitical issues of our time, including last, yesterday on the European Council, there's very uneven deployment and supply of vaccines. On the left upper side you see and this is another source of information is the vaccine center of the London School of Aging Tropical Medicine has a daily update of a vaccine tracker and so you can see here the percentage of population that is being covered. Over 60% now in Israel, the UK is at about 45% now. United Arab Emirates using Chinese vaccines is also very good, well placed and the US is moving very rapidly as you may have heard yesterday, President Biden announced that 200 million vaccinations will be given in the first 100 days. He said vaccinations that means that not everybody will be fully covered, but this is a major effort. Also interestingly that Chile is doing very well in this nearly all European countries are lagging behind. There's a big issue on supply, that's for sure, you know all the troubles with AstraZeneca which is not honoring the contract made with the Commission and only delivering about 20 to 30% at the most and many countries have based their strategy on that vaccine because it's easier to administer and supply chain and the price. But there's also the fact that when you look at it through this, the Buyer's Club to say so of the Commission, 88 million doses have been distributed to member states but only 62 million have been given so there is like 26 million that are hanging there. Some of that you need a reserve to give the second dose, that's good management. But many countries have started far too late with their vaccine plans and deployment and which is amazing even if the Commission had already in July and then in October again issues some recommendations for people get ready. So it is not only supply but it's supply and logistics and the commitment plus there is also some other issues that I'll come back like vaccine confidence. However, the situation is far worse in low and middle income countries, particularly low income countries where only recently have vaccines arrived. Next slide please through a mechanism called COVAX. COVAX is an alliance as part of the anti-COVAX COVID tools accelerated accelerator you see on the left side and on the right side COVAX and which was launched by President von der Leyen in on the 4th of May and now is managed by the Coalition for Epidemic Preparedness Innovation which was launched after the Ebola outbreaks in West Africa which killed about 11,000 people but was limited to three countries but paralyzed these three countries for over a year and Liberia, Sierra Leone and Guinea and the mining sector was very heavily affected there and so that is CEPI it's called is there to develop vaccines where there was market failure against Ebola but came in very rapidly. I'm a board member and already during the World Economic Forum in Davos now two years no last year we issued the first contracts and that was around the 20th of January so before that we were certain that this would become such a bad issue. Then is also Gavi the Vaccine Alliance and the World Health Organization so their goal is to provide vaccines to fund vaccines for particularly low income countries and the money is starting to come it's not enough but they've started to deploy vaccines there the problem is supply and one of the big issues now are exports of bands in India but also the US with the Defense Act which prohibits the export of any material that can be used for vaccine manufacturing and so even Indian companies depend on that. At the same time the African Union has started to negotiate with companies and so I think that the issue today is not so much money but it's supply and this is not just a let's say a moral issue you know in terms of global equity and the quality but the reality is also that no country is safe unless every country is safe. If we if we vaccine if we're all vaccinated we could become like in New Zealand close all the borders and so in Europe forget it but also what's happening if there are millions of people infected with it virus that will be a breeding ground for you know for variants to for mutations to come up and and I'll move to that now. Next slide please. Yeah being Belgian I like to show the name of it so where are we going and the next slides please. The first question is will vaccination work and I put vaccination rather than vaccines because the vaccination is the act of yeah of of immunizing people and the first question here is will they work against new variants and I'll come back to the next slide but the many unknowns how long will they protect us is it one year two years five years and we have like measles vaccine that's as a child you get it you're protected for the rest of your life for influenza and for the flu every year we need another shot because there is a new variant coming up so that's the first unknown and time will tell are they safe I think the answer is now safely we can say yes because we have now close to well over 100 million people have been vaccinated in the world and there will always be side effects I was actually yesterday I got my second dose of the Pfizer one all I have is a bit of a sore arm but there was this scare of thromboembolic events particularly in women after the AstraZeneca vaccine but the European medicines agency was very firm with no evidence that this was caused by it and in Norway they had some people who died but then it turned out they were very frail very old people in care homes who yeah with the death rate was not higher than you would expect but number four is really as at the moment is a huge bottleneck will there be enough the supply is definitely not there but in all fairness this has never been tried before one to develop a vaccine in 10 months 12 months and then to manufacture billions of it no company has done it and it's interesting to see that with the exception of Pfizer the big vaccine manufacturers just as JSK Sanofi Merck and Merck Sharp and Dome in the US they're not involved at the moment in the initial development of these vaccines they will now start producing and they teamed up like JSK with CureVac and Merck is gonna produce some of the Janssen vaccines and Sanofi I can't remember but also another one so this is supply issue is a huge issue and and as we you know we all know it's a big so you know political issue and India is the largest vaccine manufacturer in the world just that it is for medicines but there they also can't follow at the moment so but I think this is a temporary issue by the end of the year we may have more vaccines than there are arms in the world so we have to so it's really now that's a problem is and there are no easy solutions as some people there is the people's vaccine movement is said if we just abolish IP we'll have vaccines everywhere now you should know that there are for to make a vaccine there are about 300 to 400 steps and with all with the patent and but it's mostly technology and it's it's like you have a I love cooking so you can have a cookbook of a three Michelin star chef that doesn't mean you can make the same meal and so safety and quality assurance are really really key so but there are moves for local manufacturing again in Africa for example in Dakar the they're producing already a yellow fever vaccine on the market and that is really a proof that they can do it and that could be the foundation of you know of vaccine manufacturing Brazil has some also and of course in Asia I wouldn't be worried about that and then the last point is will people accept them there is a growing movement of what a neutral term calls vaccine hesitancy or vaccine confidence it's very unequal but in Europe it is very strong in country like France and Poland and Bulgaria even among healthcare workers on doctors and and this could derail completely the impact of vaccination next slide please just a interlude here on the so-called variants what is a variant it's a it's the same virus but it is undergone mutations which every virus does all the time it's like an error in their multiplication so that's a random phenomenon but now and then that error gives them an evolutionary advantage so that they're more transmissible and will take over from their competing viruses now corona virus is not too bad in flu influenza virus they mutate like double the pace and HIV is like when you're infected with living with HIV you can have 100,000 different viruses in your body and so that's why we have problems so do this vaccines work against the variants and we know that for the British variant it's fine to make a long story short no difference with the original you know virus for the South African one which is now invading quite a few countries there the AstraZeneca vaccine showed only 10% efficacy in other words it's not working but the Novavax not yet on the market was a decrease but the Janssen the J&J vaccine was you know was highly effective against severe disease and hospitalization a bit less against mild infection so here we see a difference in among vaccines and that's why in Africa now they're very keen to have Janssen vaccine also because it requires only one injection next slide please now this is a huge challenge and we and what we don't know is will people require just as for influenza a regular booster vaccine a vaccination so against new variants how many variants will there be is there a defined spectrum can we predict that we will be using AI and machine learning to try to to see as you know there's a system there and that's very important for for industry and about all these companies are now working on already on the second generation of vaccines and this is where the Commission has really come up to speed with together with industry but also the EMA and the ECDC and this is called the HERA incubator and here are for health emergency preparedness and response authorities which is a proposal for later because clearly we as EU we were not prepared also as you know health is not a competency a legal competency of the EU and the Commission could have said okay fine it's not a competency but that is of course not an option and it's of course I don't think you should have competency in health care and all that every country so specific it goes back to centuries in Germany to Bismarck you know you don't want to mess with that however with the you know for when it comes to pandemics cross-border issues are so important and also the US for example has an instrument called Baada that has invested about 12 billion billion dollars in the development of vaccines we didn't have that and that put us in a weaker position and so again to make a long story short there is a whole program now and in close contact with industry but also regulatory fair so that we can have fast tracking of these much needed new vaccines next slide so when I'm coming to the more to the end now and the future of the pandemic when you take the long-term view it will vary by country of course and depends on many factors I mean is the societal and public health responses and that's going to be more and more difficult I think there's enormous let's say corona virus fatigue plus the economic impact is enormous vaccine coverage and then the older issues that I mentioned duration of immunity seasonality future mutations of the virus and can have the next slide I think that the these are very simplistic models but based on pretty sophisticated work and so you could have first of all nearly all experts agree that we're not going to get rid of this virus like sister within our the next two years however we will be able to manage it and to live with it and the question is will this be like an annual outbreak like for the flu or every other year or five years so that we should know better I think after the next winter next slide but it won't be that and there's a lot of talk about herd immunity so herd immunity being a the level of immunity in the population that makes that you know that every that the virus doesn't find enough susceptible individuals to you know to infect and then you know that it will you know fade out and that's a combination of vaccine induced immunity and natural immunity but again this is modeling from our school also but from and could just in his group and and the and the it shows that for example in the UK they would need to reach 95% vaccine coverage because the vaccines are not perfect people don't always take them etc so I think that this is going to be extremely difficult to achieve we know that for reasons it's also 93% but that's for children and we reach that but if you go below below for example people refuse it you get epidemics next slide so coming to the end so there is a quite a movement of zero COVID people say we should you know go we should not accept anything less than zero COVID so in other words zero is means zero is not no COVID and I think that's a real illusion for many reasons that you can see that maybe in the longer term we need to aim for that but we have to see in as a society what is acceptable we accept that every year there are depending on the country thousands of people die from influenza if we set a bar for a COVID to zero that will completely paralyze society but it's it's an appealing fact but once you start thinking it through it's not going to be feasible and we'll go more to a you know and so what we call endemic next slide and so the I think that have to be optimistic also but realistic to answer the question will vaccination end the pandemic I think it will bring it under control definitely and we can go not back to normal but we can go forward to normal it'll be a kind of a new normal and for example I guess that masks and more testing and so will be part of the system digital green certificates also called vaccine passports very controversial but the reality is it's it's already going to be there so again I'm not going to go into all this but I think we we will go the next one to a kind of a normal type of life but with a lot of providers so we'll need to continue a number of social distancing and mask wearing just like in Japan when you have a cold you just you know you wear a mask to protect the community and one of the fascinating things for me is why some Asian countries and Southeast Asian countries have been so successful in bringing this pandemic under control where using exactly the same measures as Western societies where it's just out of control with 126,000 deaths in in the UK for example and some probably we need to look at on the one hand what governments can impose and what's acceptable in one society the other but also if you have a hyper individualistic type of culture with me myself and I that that is really a big friend of the virus I'll so we'll need to continue and the last slide here and and this is a question I often get good do we have to choose between the economy or the or health and the answer is actually you can't save the economy if you don't bring this epidemic under control this is this is already some early research that was published in the Financial Times which by the way is a very good source of information also for us in public health and so we need to bring this epidemic under control otherwise we can forget the you know the economic reliance and so the the the answer to the question is yes but and and and not completely but there's frankly no other way out thank you very much and sorry to speak a bit to them thank you so much Peter so I will kick off with a few questions from the floor and I will also turn it over a bit later on in the interview to our board members and give them an opportunity to ask you questions as well so Peter as I said you're the special advisor to the European Commission on COVID-19 matters we explained to us that the development of vaccines has been extraordinarily impressive but the rollout of vaccines has been slow for a variety of reasons the question is when do you expect that all adults in Europe will be vaccinated yeah that's a key question for for the to go back to the question of the talk and the goal is to have like 70 percent of adults vaccinated by the summer in July August I think that's still feasible but it requires two things enough vaccines but also countries must really accelerate I mean like I got my first vaccine here on a Sunday morning I mean you need to work seven days a week and it has to be like a military type of operation and and with very good communication in some countries you know you have to go first on online and a website and all that and that's fine for many people but the most vulnerable the most the oldest one they may not know how to do that so we need to to make it people-friendly and so it is in our hands and it's in the hands of every government and I don't understand that with this new surge that this isn't a national priority in most countries Peter in the european continent there are many questions about the effectiveness and especially the side effects of the AstraZeneca vaccine you explain the difference between this vaccine and other vaccines are these concerns warranted yeah I think that when I hear people who are skeptical about vaccines you have a hardcore of let's say anti-vaxxers and that's because they want natural immunity and they're against this or think it's a conspiracy of the of big pharma and so on okay that's one group but that's pretty small group then you've got people with legitimate questions you know indeed if it normally takes 10 years to develop a vaccine how do you know that this works and that it's safe particularly if you only spend a year on it so I think that is a very reasonable question and but the answer is any equivocally that it is safe that um yeah as I said we have now about 100 million people the fact that these thromboembolic events were detected I find is a an indication that the monitoring system of monitoring side effects is working it's and but again I understand that you know with the precaution principle which is stronger in some countries than in others in some it's enshrined in the law in others not and I but I think that yeah I'm I would be happy to to take the AstraZeneca vaccine I think it's they've not helped themselves with their own communication I must say but uh no I and the same is true for the other vaccines on the market and by the way the AstraZeneca uses the same or a similar platform as it's called to vaccine delivery as Janssen as the J&J and and there also we have experience already of hundreds of thousands of people so combined um no it's it's fine I mean I think yeah I I wouldn't hesitate to take it I mean that's not a scientific argument but uh if if you would I always think if you make a policy statement and you would not apply it to yourself then then it's not credible. Peter you explained that it will be difficult to reach community against the virus explaining that large parts of the world will have low vaccination rates what about children do you see a prospect that they will be vaccinated? Very good question and ultimately in terms of bringing it really under control we will need to vaccinate children as well because even if children don't get ill they are playing some role in the in transmission it's quite controversial because it has many practical implications for you know keeping the schools open or not and scientists don't fully agree on the immediate risk and we know for example that infection rates in teachers are not higher than in the general population but children get infected yeah but in you could argue let's assume all adults are vaccinated but then the virus will just infect you know happily as many children as possible and that is so the the good news is that the vaccines were tested initially in adults because before you do trials and you test out new medicines and new vaccines in children you want to have you know certainty about the safety particularly of vaccines and in adults and and and that passed the test and now you know I expect that in well a couple of months or so we will know the results but I anticipate that it will work with children children are far more used to vaccinations than we as adults but that's a good question and that means that that's probably only for the end of the year however I would say the goal of vaccination today is in the first place you know eliminate mortality so people don't die anymore people don't get into intensive care units don't be hospitalized and don't have severe disease and then you know and you can really we can have a pretty we can open societies again thank you Peter we understand that a person who has been vaccinated can still fall sick that would be less affected with only light symptoms after taking a vaccine do we already know whether a person who has been vaccinated can still contract the virus and infect others yeah first of all vaccines are not 100 effective I mean even like Pfizer and so on the Moderna it's 95 96 percent so that's why exactly we don't know yet this is new so it's not 100 percent so in rare cases it may happen and up to now indeed people who became then infected they their disease was much milder and that's but it's still early days because there are also people who get reinfected naturally particularly there's now quite a few cases in Brazil because there is a variant that seems to be quite different and most seem to be milder in disease but some not so this is open question but an important question is that when you're vaccinated it's not only vaccination is a very interesting it's both egoistic and altruistic and it's a win-win as we would say you know you become you know you're immune so you're protected but the question is do you also shed less virus are you less likely to transmit so are you not a risk for others and here the data are starting to come in particularly from Israel and the answer is that most most likely and the question is will this reduce transmission by 50 percent or 90 percent we we don't know yet but my guess it's going to be very high also because why do virus the vaccines work they reduce your vaccine your virus load and that's why you get less severe disease and if you have fewer viruses you will exhale fewer viruses and infect fewer people but that's not yet supported by the facts this is just a matter of time thank you some have argued that the virus may be settling into a limited set of mutations or variants and that vaccines will therefore remain effective what is your view on this yeah i hope that that's true but we can't take the risk no that i think from an evolutionary perspective that's probably what will happen but is that how long is going to take and so a big question if i were you know a vaccine company i would want to know are there four or five or ten you know significant variants that could influence the effectiveness of my vaccine or only two so that's yeah but it's it yeah and it's not an all or nothing when i show this the the data on the effectiveness of vaccines it's not when you're exposed to another this new variant that suddenly your vaccine is no longer effective but it could reduce it so yeah it's i wish i had the answers to all these questions because that's what we're working on very but they're very very good questions yeah thank you peter let me ask one more question before turning over to the board members on the call peter we understand that you were exposed yourself yourself to the virus and you just shared with us that you also took the vaccine do you have any advice for the participants by the way we have 140 on the call what to do when you get sick with the virus yeah about a year ago i was in the hospital indeed you know i was one of the first here in the uk to to become infected and even after we had already closed our university and work from home but anyway i got infected i still don't know where and um yeah so and i made a mistake of continuing to work i'm a bit of a workaholic so that's not i would advise when you get sick stop working and take good care of yourself and isolate yourself um but um and and monitor make sure you know you have a good medical council and that you know in case you deteriorate that were to go what's interesting with this is that um you don't have to cough or to be short of breath and to be in trouble because the that can come later so in my case my what we call oxygen saturation so the fact that you're you know your blood and your lungs are not functioning and giving off oxygen to your brain and everything which then creates brain fog and all that can happen without being short of breath so i would suggest to buy an oxygen saturation you know this is something you put on your finger very easy to monitor and if that goes below a certain level it's all in there then i would go to the hospital but but also even if you had it because i assumed that some of the people on the audience will have had the infection i mean it's so prevalent that take the vaccine and but probably we only need one injection because the the first injection is like a booster because we already have immunity and we know already that that gives you a fantastic boost of our protection but still i took the both partly also because i want a vaccine certificate and that i can finally travel again thank you for sharing this this personal mouth with us and i'll turn over to our board members Fabio Fabio Panetta do you want to start thank you well first of all i want to thank peter for next and seven very interesting very clear um you explained very very clearly how to prevent covid the efficacy of vaccines and the constraints that we face in mass vaccination but you did not say anything on how to cure covid so my question would be what is the state can you say as something on the state of research on possible medicines to cure covid once you are effective do you expect any effective anti-inflammatory medicine to become available in the near future no fabio this is a very important question because even with vaccines that some people will continue to be sick and we need that particularly those who are more vulnerable and whereas i was let's say pleasantly surprised with how quickly we had vaccines i was this i've been disappointed by progress on treatment i thought the opposite will happen so i was wrong on that one and there are a few things we know that you know if you apply you give very early on in the infection before it typically would be hospitalized then with an uh you want to kill the virus an antiviral um meets like remdesivir for example it's a bit controversial but that works however after that uh it's the virus is going so like in my case i was in dorsal and thanks to oxygen i made it um but then i went home and then my trouble started i had this long covid for six months and and then it's the immune response and so you have to suppress immunity and there there's a very cheap drug dexamethasone which has been shown to work but up to now we still not really uh you know very effective in our treatment although survival is much higher than a year ago and that's more of a experience you know we know how to manage this clinically um and so there's a lot of research going on at the european level there is now a network um or for clinical trials there are two one for treatment and one for um vaccines and the problem was that up to recently everybody was doing their small trial and and the results were inconclusive so we need to join forces there uh on both sides and um and i think time is everything what may work in the beginning may not work at the end and if you start suppressing immunity in the beginning you may actually make things worse so it's it's far more um sophisticated than we originally thought and also for example uh thrombinabolic events where since we know that that's for Anzac Zeneca was in the news is very they're very common in uh you know i had this myself and then you have cardiac involvement so you can prevent that so it's yeah but it's uh something that uh the where i'm most optimistic is that we will have so-called monoclonal antibody therapies that kill the virus just as that these are therapies that are being used also in cancer for the beginning and then immune modulators afterwards and and there i would look at there are a few coming from you know treatments for autoimmune diseases so but it's um yeah we we need a far more systematic approach and that's now what the this clinical trials network is is attacking and i'm glad that that the time should be over that every clinician do their little trial and then and the results are inconclusive that's the problem thanks for that thank you so we also have uh Frank Alderson and Philip Lane on the call Frank or Philip do you want to ask a question thanks a lot uh extremely interesting um my actually i the first i would like to ask um you know this is to to get this under control of course all these scientific things have to be done but we you you made abundantly clear in your slides also that it's a question of of people's trust in the virus and in the whole process now of course we are just central bankers and supervisors but we have a you know we have a strong presence in the in the debate we we publish all the time we we give interviews we are called to the european parliament so from your perspective ideally uh what would we be saying and what would help as much as possible to get some control very fair question not an easy one but i would say that um first of all um let's i think you have a high credibility and so getting the right uh how to say and the fine line is to say there is hope but folks at the moment no time to relax and um and maybe it's i'm just thinking aloud um to uh to think about some key messages around this that's something that we could work on i i did about a year ago with the bank of england when mark carney was still the you know the governor and um and when the unknowns were even bigger but i would say that uh and i give regularly um talks and uh you know and in a dialogue with investment companies and uh banks and all that not the central banks um private equities just and and they all want to know how long is this going to take and and where and some and um but i think that the at the moment uh we need to how to keep hope alive in the population uh and i say yes there is light at the end of the tunnel if we can deploy the vaccine um but uh yeah i think that um yeah i don't know enough about what's alive in your milieu you know what people look at it i guess everybody's fed up with the you know all the constraints and so on and and and hoping that we will have a a a nice summer um but that may or may not be the case i would say at this stage probably the best would be push authorities in every country to to be far better organized for vaccination i mean it's really not acceptable some countries start really seriously vaccinating or organizing themselves after christmas or after new year honestly um and this is um you know it's not that there was no warning uh for me that's hard to understand because it's also from a perspective of every country if you get your population vaccinated it gives you an enormous advantage economically um societal and and everything so this is not just a public health issue as you know you know well thanks for a good question i need to think about it further yeah uh philip maybe i'll just again jumping beyond the pandemic i mean obviously in your career you spend a long time at dinner with aides and with abola so so now you have this pandemic so so what you know from this i mean do you think uh whether you personally or the professional public health specialists uh what a surprise to in terms of uh not so much as you say you were surprised by the vaccine progress but how advanced economies uh have dealt with this uh has been unnet impressive or unnet disappointing or you know the humanities believing that uh the world uh you know has done a reasonable job or or the more focused on the fact it's it's clearly uh being quite limited in terms of global vaccination and then as he's just said that rollouts and communication issues in different countries yeah philip by something i think a lot about and uh one is for the last five six years i had one of my standard speeches to say so was uh are we ready for the next pandemic and uh you know and the answer was no uh but but i made one mistake i thought the next pandemic would be an influenza virus one of those spanish flu type of thing which will happen one day you know that's uh that's not rocket science um it's like the big one in california one day they will have the earthquake will wipe out silicon valley and everything it could be tomorrow it could be in a hundred years so we can expect something influenza so that's but then i think um your question is yeah and then there was a ranking of um advance of economies of countries how well are they prepared and number one was the u.s number two the u.k both have a very bad track record on this how to deal with this epidemic i mean uh with 126 deaths in the u k over half a million in the u.s and so on and didn't do a good job um whereas some countries that were very low ranked like vietnam and uh as it allows in taiwan and and they they've done a really good job and that's why i'm so fascinated i i i go a lot to singapore i mean i have um i'm there at the national university of singapore and work with them and and in japan and they had uh you know the number of deaths is like in some countries less than 10 vietnam is like what a hundred million people something like that um and when they have one case it's panic and they do everything um so we've not we've not done well i think and too slow um and um so for me what the lesson is that uh you always use a crisis to i know there is opportunities in there and you we need to get ready now for the longer term and for the next crisis and that sounds a bit far-fetched but that's what also the with the commission this whole area of being um you know more self-sufficient than before we really enormous weaknesses um what i had not anticipated at all but that's more of your type of area is that i okay the economic fallout yes but not the um the geopolitical type of fallout and uh that we're seeing at the moment that uh i had uh well it was not on my radar screen i mean uh and so um yeah and and it's not a solution that every country would say we're i'm gonna uh develop my own vaccines and so on it's not i mean the global supply chains is are are enormous and for i mean are very complex so that's um but i think now um if we don't know as individual nations as regions um don't get our act together to better prepare it because like in southeast asia east asia and in hong kong and so on they were they had this south's outbreak in 2003 and they put in place um let's say a fire brigade uh you know in case some an outbreak would come up they were well prepared testing and tracing immediately had the laws they had everything and what we've been doing is to set up the fire brigade when the house was on fire that's and but it means that you need to invest and in in the fire brigade and you hope that they will never have to be deployed and that's in politically not so easy to to get so that's what we need to do and and uh at the moment while of course we this should be part of the the recovery plans for for covid otherwise we'll go exactly through the same mess thank you is that okay yeah thank you Peter um so we've come to the end of your talk uh on behalf of the ECB really want to thank you very much for your talk today i think it has become crystal clear that us that there should be more of these conversations between economists and health experts and we should do definitely more of that so thanks everyone also for joining and until the next webinar um wish you all the best Peter