Friday, October 28, 2022

Universal coronavirus vaccines

 Japan has launched a five-year, $2 billion initiative to develop the capacity to be able to create a vaccine within 100 days from the start of a future pandemic.

That is, when a possible plague is detected and its genome is sequenced, Japan will be able to produce vaccines three months later.

.https://www.nature.com/articles/d41586-022-03000-3

Japan’s $2-billion initiative to prep pandemic vaccines in 100 days

A new centre will invest in shots for a range of infectious diseases so the country is ready for future outbreaks.

After recognizing that Japan was slow to develop vaccines for COVID-19, the government has pledged to invest US$2 billion in a vaccine-research initiative to ensure that the country is ready to respond promptly to future epidemics.

The Strategic Center of Biomedical Advanced Vaccine Research and Development for Preparedness and Response (SCARDA) will initially invest in vaccine research for eight pathogens, including coronaviruses, monkeypox, dengue virus and Zika virus, using a range of technologies for vaccine delivery, such as mRNA technology, viral vectors and recombinant proteins.

In recognition of this delay, the Japanese government established SCARDA in March; the centre will launch formally in November, says Ishii. The government has realized that developing vaccines is complicated and takes resources, and has given the field a boost, says Toshihiro Horii, a vaccinologist at Osaka University. “That is a tremendously huge amount of money,” he says.

Japan’s initiative is modeled after Western programs.

Hundred-day goal

SCARDA’s aim will be to produce diagnostic tests, treatments and vaccines ready for large-scale production within the first 100 days of a pathogen with pandemic potential being identified. This 100-day mission was first proposed by the United Kingdom in 2021, and backed by the other countries in the G7 group of wealthy nations. Similar initiatives include the US Biomedical Advanced Research and Development Agency (BARDA); this coordinates the development of vaccines, drugs and diagnostics in response to public-health emergencies, including pandemics, and invested in several COVID-19 vaccines.

“Since SCARDA is a new organization, it has much to learn from BARDA,” and other initiatives funding vaccines such as the Coalition for Epidemic Preparedness Innovations, says Michinari Hamaguchi, director general of SCARDA.

Two particular programs within this initiative are notable:

  • The development of universal coronavirus vaccine that people would take once a year for protection against any and all coronaviruses.
  • The development of vaccines for more specific coronaviruses related to SARS diseases.

Two of SCARDA’s first approved projects aim to develop universal coronavirus vaccines and vaccines against a group of coronaviruses related to severe acute respiratory syndrome (SARS), such as SARS-CoV-2. Another project will create a fast-track system for evaluating vaccine candidates.

Japan’s centre will operate with around 30 members of staff and funding to last 5 years. Of the allotted $2 billion, $1.2 billion will go to vaccine research and development projects, and $400 million will be used to support start-ups in drug development. Another $400 million will be spent on setting up a virtual network of centres of excellence for basic research in vaccine science, and testing vaccine candidates in early-stage trials. The goal is “to find seeds for future vaccines”, says Kawaoka.

In addition to the central research centre based in Tokyo, there will be four core institutes — Osaka University, Nagasaki University, Hokkaido University and Chiba University. Another five institutions will provide support services such as animal models.

The Japanese initiative is modeled after the Western initiatives, but the article does not mention to what degree there is cooperation or redundancy between them.

One of the motives of the initiative might be the technological spin offs that might result from any scientific breakthrough.

For example, the mRNA vaccines are applicable to the treatment of cancer.

An analogy might be the New Zealand government’s subsidies to its film industry, which also benefits New Zealand’s software industry and its tourism industry.

A more focused effort is to develop a “universal” vaccine that would apply to any and all possible mutations of the Covid-19 virus (SARS-CoV-2).

Such a vaccine might be available in 2024.

As narrow as this ambition might seem because it focuses only on the Covid virus, historically, it would be an unprecedented achievement.

.https://www.bbc.com/future/article/20220815-the-hunt-for-a-universal-covid-19-jab

[A] challenge that has long proved insurmountable for scientists [is] to develop vaccines that can not only protect against a single coronavirus, but multiple strains, varieties, and perhaps even entire families of them. A comparable feat has never been managed in the history of virology, after more than two decades of chasing the same goal in influenza yielded little of note. Some have even compared the task’s ambition, scope and difficulty to the infamous Manhattan Project of the 1940s, which pushed the boundaries of physics at the time, and yielded the world’s first atomic bomb.

Money is being thrown at the target in unprecedented sums. CEPI have allocated an initial budget of around $200m (£169m/€193m), with the NIH adding an additional $36m (£30m/€35m) to the pot. Buoyed by their success in developing one of the first Covid-19 vaccines, Moderna has recently entered the fray, announcing their intention to produce a vaccine which could protect against all four coronaviruses that cause the common cold.

Heeney knows the road ahead better than anyone, having also spent the last few years attempting to develop a single vaccine that can protect against different viral haemorrhagic fevers – Ebola, Marburg virus and Lassa fever.

The ultimate goal is to develop a universal vaccine that would protect against all forms of coronaviruses.

However, this will not be achieved until further off in the future.

Developing vaccines that would protect against variants of Covid is therefore a steppingstone to the greater goal of creating a vaccine that would apply to all coronaviruses.

All scientists agree that a truly universal vaccine, which could protect against every single coronavirus that might emerge in future, would be a genuinely game-changing moment for human health, especially in the wake of the devastation caused by the Sars, Mers and Sars-CoV-2 (the virus that causes Covid-19) outbreaks of the last 20 years.

But while this would be the pinnacle of pan-coronavirus vaccine research, it remains to be seen whether it can actually be achieved. Instead some feel that various intermediate targets are more realistic, before scientists consider expanding the remit of these jabs.

As a result, the first step towards a possible universal coronavirus vaccine is likely to be a so-called “variant-proof” vaccine, which aims to protect against all current and future strains of Sars-CoV-2 and help end the worst impacts of the pandemic. With the continuing emergence of problematic variants causing repeated surges in case numbers and hospitalisations, beginning with Alpha in September 2020, to Delta, Omicron, and now BA.4 and BA.5, the need for such a vaccine remains high.All sorts of vaccine technologies are being explored.

In order to do this, scientists are trialling a kaleidoscope of vaccine technologies. They range from modified, harmless viruses known as adenoviruses to ferritin nanoparticles and self-amplifying RNA, which works in a similar fashion to messenger RNA (mRNA) except it can copy itself once inside the body’s cells, meaning much smaller doses are needed.

In each case, the general idea is more or less the same. Whether carried by a nanoparticle or an adenovirus, each vaccine contains a variety of different fragments of the Sars-CoV-2 virus’ spike proteins (which the virus uses to bind to human cells to gain access), and nucleocapsid proteins (which store its genetic material). Some vaccine-makers are looking to incorporate as many fragments as possible to increase the chances of having a broader immune response, while others are focusing on specific parts of the virus that seem to be conserved across each of the strains that have emerged so far. At Duke University, virologists are targeting a particular part of the spike protein known as the receptor binding domain (RBD), as this region appears to have relatively little variation between different forms of the same coronavirus.

Because of the increased complexity of the challenge, progress will be slower compared to the first wave of Covid-19 vaccines. None of the variant-proof vaccines in development have progressed beyond phase I clinical trials (the first test in humans), but the initial data appears to be promising.

Some scientists, however, are looking to develop universal vaccines that take aim at less notorious viruses.

For example, sometimes when we catch a cold, we say that we have a case of the “flu”.

However, many of those cases of the “flu” are not actually caused by influenza viruses.

In fact, some of those inconvenient colds that knock us out for a couple of days are caused by obscure coronaviruses.

Tackling the common cold

Rather than entering the competitive landscape of Covid-19 vaccines, other researchers have decided to look at different forms of pan-coronavirus vaccines.

These are OC43, HKU1, 229E, and NL63, not household names, but the majority of us will have unknowingly encountered them at some point in our lives. They are responsible for around 30% of common colds in adults, and while these viruses have nowhere near the fatality rate of Sars-CoV-2, they can still lead to lower respiratory tract infections and pneumonia in the vulnerable.
There is also an effort to develop a vaccine that would protect against SARS-related coronaviruses.

This in itself is already an ambitious goal, attempting to vaccinate against a group of different coronaviruses, but other scientists are setting the bar even higher. Rather than designing vaccines against existing viruses, they want to initiate humanity’s preparations for the next pandemic.

Pamela Bjorkman, a professor of biology and biological engineering at the California Institute of Technology, is leading a project to develop a jab which can immunise against any sarbecoronavirus – severe acute respiratory syndrome–related coronavirus – a collective which includes Sars, Mers, Sars-CoV-2 as well as other as-yet-unknown threats harboured within animals. Heeney’s team is targeting an even larger viral cluster – the entire group of betacoronaviruses, one of four groups of coronaviruses which includes the sarbecoronavirus sub-group.

While a pan-betacoronavirus jab would still not come close to being a universal coronavirus vaccine – it would still leave the other three groups of coronaviruses, alpha, delta and gamma, untargeted – it is still an incredibly challenging goal. To illustrate the sheer scale of the task, there are thought to be thousands of as-yet undiscovered betacoronaviruses residing within more than 400 different bat species.

Universal vaccines for coronaviruses might be more feasible than universal vaccines for influenza viruses because coronaviruses mutate at a slower rate.

The big question for all pan-coronavirus vaccine developers is whether they can succeed where pan-influenza vaccines have failed. The NIH’s National Institute of Allergy and Infectious Diseases unit has an annual budget of approximately $220m (£180m/€212m) for universal flu vaccine research but progress has been minimal despite decades of striving. However, there is hope that the challenge may be slightly less complex in coronaviruses because in general, they are not so prone to mutating.

Scientists are hopeful that the first variant-proof Covid-19 vaccines will be available by 2024, potentially ushering in a wave of coronavirus jabs offering increasingly broad protection. For many, this would be up there with some of the most important breakthroughs in modern healthcare.

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The bigger question is how many people will get vaccinated if universal vaccines are developed?

For example, as of late 2022 with regard to the Covid vaccines:

  • 20% of Americans have not been vaccinated even once, 
  • one-third of Americans have not gotten a second dose of vaccine, and
  • two-thirds of Americans have not gotten their third dose.

Hundreds of Americans are dying each day from Covid, and it is primarily because they have not been adequately vaccinated.

Dr. Anthony Fauci noted that with the availability of safe and effective vaccines, there is no reason why ANYONE should be dying of Covid.

Who should get the new boosters, and when?

.https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html

CDC recommends that people ages 12 years and older receive one updated (bivalent) booster if it has been at least 2 months since their last COVID-19 vaccine dose, whether that was:

  • Their final primary series dose, or
  • An original (monovalent) booster

People who have had more than one original (monovalent) booster are also recommended to get an updated (bivalent) booster.

The new boosters are called “bivalent” because they prepare the body to fight for both the original strain of Covid as well as the new variants.

This offers protection from many variants, because when the immune system faces different versions of the same virus it generates broader protections overall.

A booster with the new vaccines decrease the likelihood of infection and severe illness and help reduce transmission of the virus.

It could also decrease the likelihood of developing long Covid.

Also, despite common claims to the contrary, vaccines still help dampen spread, and boosters can further reduce transmission of the disease.

This includes reducing infections in the first place, and thus help protect especially the more vulnerable.

Even when variants cause breakthroughs, vaccines still prevent serious illness and death, and even more so with boosters.

However, for various reasons, Americans are not getting the new boosters.

.https://www.nytimes.com/2022/09/15/opinion/covid-booster-shot.html

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How often will people be reinfected with Covid?

There were almost no reinfections during the first year of Covid in 2020.

However, since the arrival of variants, everybody is experiencing reinfection.

.https://www.newyorker.com/science/annals-of-medicine/how-many-times-will-you-get-covid

During the first year of the pandemic, when reports of coronavirus reinfections started to trickle in, the phenomenon was considered exceedingly rare—“a microliter-sized drop in the bucket,” as one virologist put it. As of October, 2020, the world had recorded thirty-eight million coronavirus cases and fewer than five confirmed reinfections. Two years later, the bucket is overflowing. It’s now clear that not only will just about everyone contract the coronavirus, but we’re all likely to be infected multiple times. The virus evolves too efficiently, our immunity wanes too quickly, and, although covid vaccines have proved remarkably durable against serious illness, they haven’t managed to break the chain of transmission.

Rational people now fear Covid not for the death that it might have caused prior to the vaccines but because reinfection may cause them long-term harm.

The so-called “endemic stage” that was promised turns out to be rougher and somewhat more dangerous than what we had anticipated.

On the whole, however, things are continuing to improve on the Covid front with each new round of vaccinations — and reinfections — as humans slowly build their immunity to Covid.

In the U.S., covid is still on pace to kill more than a hundred thousand people per year; many of us share the reasonable worry that some future reinfection will be the one that causes longer-term harm to our health and quality of life. Has our battle with covid-19 come to such a standstill that a slow burn of disruption, debility, and death will continue for years to come?

The specialists I consulted for this story shared a conviction that, despite the relentlessness of reinfections, our covid woes are slowly starting to recede. They said that, although coronavirus infections will always carry risks, and we may still suffer periodic surges and new variants, infections should get less serious and less frequent as our immunity grows. Vaccines and therapeutics will also continue to improve, helping to lessen the worst effects of reinfection. But the duration and severity of this transitional period matters, too. How many times will we have to sit through quarantines and ride out symptoms, worrying how bad this one might be? How many more surprises could the coronavirus have in store?

The rate of reinfection has increased with each new variant.

The reinfection era began in earnest last winter, when the Omicron variant first spread around the globe. A recent study conducted in Serbia found that for people who were infected in the first twenty months of the pandemic, the risk of reinfection rose steadily but slowly: at six months, around one in a hundred had been reinfected; at twelve months, one in twenty; and at eighteen months, one in five. But Omicron sent reinfections skyrocketing. Nearly ninety per cent of all reinfections occurred in the study’s final month, January, 2022. (The researchers found that one in a hundred reinfections led to hospitalization, and one in a thousand resulted in death.) By some estimates, the initial Omicron outbreak caused ten times as many reinfections as the earlier Delta variant. And Omicron now circulates in the form of even more contagious subvariants, such as BA.4 and BA.5.

However, reinfection is inconsequential as long as our immunity to Covid has not faded, if our system still recognizes a mutated virus, and if exposure is only to small amounts of virus.

Fundamentally, our risk of reinfections depends on three main factors: 

  • how much our immunity has waned, 
  • how much the virus has changed, and 
  • how much of it we encounter. 

Our collective immunity increases with infections, reinfections, and vaccines. Booster shots are meant to slow the drawdowns in our immunity, and the recently approved bivalent vaccines, which target the Omicron subvariants BA.4 and BA.5, may be particularly helpful. But the immune system must be judicious: it encounters countless threats and can’t maintain enormous standing armies for each one. Over time, our bodies pare back their defenses, and whether we’re reinfected depends partly on how quickly and intensely they remobilize during the next encounter.

Our immune protections also exert pressure on the virus to evolve around them. Viruses can change so much that the body has trouble recognizing and subduing them. The original Omicron variant had at least thirty-two mutations on its spike protein—twice as many as Delta—and, in recent months, its subvariants have accumulated many more. sars-CoV-2 is mutating faster than any of its cousin coronaviruses—faster, even, than the world’s dominant flu strain.

Finally, the chance you’re reinfected is a function of “viral dose.” It’s more than just a numbers game: our immune cells have to be stationed in the right places. “It’s like real estate in Manhattan,” Florian Krammer, a virologist at Mount Sinai’s Medical School, told me. “Location really matters.” covid vaccines injected into muscle produce relatively high levels of antibodies in the blood and lungs, but not in the nose, mouth, and upper airways, where the coronavirus usually enters. (Natural infection seems to produce a longer-lasting immune response in the nasal cavity.) That’s why scientists are so interested in mucosal vaccines, which are administered in the nose or mouth. India and China recently authorized such vaccines, but it’s still not clear how effective they’ll be.

There are four other types of coronaviruses other than the Covid virus that afflict humans

However, they cause only cold symptoms because the human immune system knows how to deal with them. 

This familiarity also reduces the frequency of infection because the immune system has learned how to block the virus from reproducing even a little in the body.

Thus, these viruses tend to reinfect humans only every three years, either with or without symptoms. 

Humans are now gradually developing an immunity to Covid.

Within five years or sooner, humanity might reach a point where we will only be reinfected with Covid once every five years. 

But that would still mean that many of us could get Covid ten times or more in our lifetimes.

Importantly, reinfection might still be a big problem — for some people.

People who are reinfected by the virus are much more likely to suffer a range of medical problems in subsequent months, including heart attacks, strokes, breathing problems, mental-health problems, and kidney disorders, according to a major new analysis of U.S. veterans.

There are some caveats. The study has not yet been published in a peer-reviewed journal, and many veterans are older men with multiple medical conditions, so they have a higher level of risk than the general population. It’s also possible that people who get reinfected are somehow dissimilar from those who don’t. Al-Aly was careful to note that a second infection isn’t necessarily worse than a first one—rather, that it’s worse than not getting reinfected at all.

The bad news is that getting reinfected with Covid might remain risky.

The “good” news is that people die all the time from viruses, but with Covid vaccines and reinfections the deaths won’t be as overwhelming as they were in 2020.

Recently, I called Florian Krammer, the Mount Sinai virologist, and outlined a pessimistic scenario: a future in which covid reinfections are common, dangerous, and inevitable. “When you say it like that, it sounds very bad,” Krammer admitted. “But I actually don’t see it that way.” There’s nothing special about the coronavirus, he argued. Yes, sars-CoV-2 caused a global pandemic, but he thinks that was primarily because of its novelty. We perceive the virus as unique because we’re so focussed on it—it’s one of the most closely studied pathogens in human history—but it obeys the same general rules as other viruses.

Viruses have always caused a variety of immediate and lasting health problems. It’s just that “most people haven’t been paying attention,” Krammer said. Long before this pandemic, for example, viral infections were linked to diabetes, cancer, heart problems, and autoimmune conditions. Five years ago, in her book on the 1918 influenza pandemic, the journalist Laura Spinney wrote about people who suffered prolonged weakness, fatigue, brain fog, insomnia, and mood changes. 

In parts of Africa, post-viral syndromes were so widespread among farmers that they’re thought to have triggered a famine. Recent research suggests that even non-pandemic influenza may be associated with protracted symptoms: according to researchers at Oxford, nearly a third of people who contract the flu virus today report symptoms that resemble long covid, and could be suffering what might be called “long flu.”

“In the long run, sars-CoV-2 will be just another respiratory virus,” Krammer predicted.

Al-Aly was less sanguine. He sees little reason that covid risks will necessarily drop to the level of influenza, and, in any case, we’re not there yet. “We have to balance the need for normalcy with the need to protect the health of the people,” he said. Still, he agreed with Krammer and the other experts on one thing: the added burden of a third, fourth, or fifth infection will probably be lower than the first or second. Each new infection may come with diminishing marginal pains. “There will come a point where reinfection will not add more risk,” Al-Aly said. “Whether that is the sixth or seventh or nth infection, we don’t know yet.”

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Vaccine hesitancy might be as greater in parts of the developing world than in the USA.

In the developing world, however, vaccine hesitancy might not primarily be based on political polarization or lessened social cohesion and loss of social trust.

In fact, quite the opposite, if the case of New Caledonia is any indication.

The source of vaccine hesitancy in the developing world might be traditions that underpin social cohesion. 

From a March, 2022 New York Times story:

.https://www.nytimes.com/2022/03/12/world/australia/new-caledonia-coronavirus.html

On Pacific Islands Covid Once Spared, an Outbreak Accentuates Inequality

New Caledonia escaped the coronavirus for a year and a half, but a surge in cases has led to a state of emergency, with the disease disproportionately hurting the French territory’s Indigenous people.

Historically, people in New Caledonia have responded to pandemics by sealing their borders for years.

With a locally sourced complete diet and an economy based on subsistence, this is not the kind of challenge it would pose to a globally integrated modern society.

Unfortunately, the habits of the people have not caught up to the reality of living in a modern France administered from Paris.

With the introduction of vaccines, New Caledonia was opened to travel — but the New Caledonians largely failed to get vaccinated.

They were hit hard by the Delta variant.

NOUMÉA, New Caledonia — Festooned with hibiscus flowers and woven palm fronds, scores of guests gathered for a celebration during New Caledonia’s wedding season. The aroma of grilled fish and yams bathed in coconut milk wafted over the revelers on the island of Lifou, population 10,000.

The celebration on the atoll in late August seemed safe. For a year and a half, New Caledonia, a French territory in the South Pacific, had escaped the coronavirus pandemic. Quarantines and border controls kept the virus out, just like they had done during the worst of the influenza pandemic a century earlier.

But by mid-September, the Delta variant was racing across New Caledonia, home to about 270,000 people. Of the nearly 13,300 people who tested positive within the span of a few weeks, more than 280 people died, a higher mortality rate than what the United States or France experienced last year.

The Omicron variant has been more merciful than the Delta, but vaccination rates remain relatively low in New Caledonia.

Of all the South Pacific islands recently struggling with outbreaks, New Caledonia was among the most inundated, prompting the government to declare a state of emergency earlier this year. Less than 70 percent of the population has been fully vaccinated, despite plentiful supplies. (Few people here have died from Omicron, compared with Delta, and the surge has eased in recent days.)

Local vaccine resistance might at first seem libertarian — but the mentality is really traditionalistic and communal.

A protest encampment on a coastal road in Nouméa, the capital, is decorated with hand-scrawled signs declaring “non” to vaccine mandates and health passes.

Serious coronavirus infections have disproportionately affected New Caledonians of Pacific Island descent, highlighting social inequalities in a territory that is agonizing over whether to break free of France.

What some observers often do not notice is that indigenous peoples tend to be ultraconservative and their lives are governed by tradition, religion, and ritual.

An independence referendum in December failed in part because many Indigenous Kanaks, who make up about 40 percent of the population, boycotted the vote. They had called for a delay because traditional mourning rituals for those who died of Covid precluded political campaigning. (After so many deaths from Delta, some New Caledonians have been consumed by the Kanak rituals of grief, which unfold over a year.) Paris, unmoved, forged ahead with the referendum.

The habits of American journalists might be to perceive indigenous peoples as victims of “inequality”, but this sort of analysis might be compromised.

In fact, the indigenous people of New Caledonia have some of the best medical facilities in all of France.

New Caledonia’s health system benefits from the largess of the French state, which heavily subsidizes the territory. Critically ill Covid patients are warded in a state-of-the-art intensive care unit at the Médipôle Hospital near Nouméa, far fancier than many facilities in France. When cases spiked last year, about 300 medical professionals converged on New Caledonia, coming from France and its overseas territories.

But the strong social safety net hasn’t bridged the divide between New Caledonia’s population of Indigenous Oceanians and largely white migrants. Eighty percent of doctors at Médipôle are from France, hospital officials said. There are few Kanak doctors in all of New Caledonia, and none at Médipôle.

The real problem in New Caledonia might be too much equality.

As equal citizens of a generous French state, the indigenous peoples have lost control of their borders and their way of life.

High levels of diabetes, hypertension and obesity among people of South Pacific descent have compounded New Caledonia’s Covid crisis, doctors said. The territory may be one of the richest places in the South Pacific because of French subsidies and mineral wealth, but the income gap is wide. Most of New Caledonia’s impoverished people are Melanesian Kanaks and Polynesian immigrants from a pinprick French territory called Wallis and Futuna. European settlers, who make up about one-quarter of the population, tend to occupy the upper wealth rungs.

As Frenchmen, New Caledonians are compelled to accept an unhealthy and alienating existence.

As more Kanaks move from tribal villages to Nouméa, congregating in grim apartment blocks, they leave behind gardens brimming with taro, yam and plentiful vegetables and fruits.

But fresh produce is expensive in the capital, with prices skewed by the high salaries given to employees of the French state. In Nouméa, boulangeries selling croissants made with imported French butter stand next to groceries offering wilted greens at exorbitant prices. The cheapest fare is processed snacks and sugary sodas.

“When I was a child, there were few fat people here,” said Dr. Thierry de Greslan, 52, a neurologist at Médipôle. “But our sedentary lifestyles and bad diet have created a terrible problem, and that has made us very scared of Covid.”

When the French did attempt to be benevolent, it so often made things worse.

A scattering of islands strewn north of New Zealand, New Caledonia has long seen its history shaped by disease. Europeans arrived in the 19th century, bringing with them pathogens and toxic notions of empire. The French colonial administration herded Kanaks onto reservations and stole their land.

Diseases like cholera and smallpox proliferated. A campaign to force Kanaks to whitewash their homes led to high cancer rates from the asbestos in the white clay. Three-quarters of a century after their first contact with Europeans, the Kanak population had declined by about half.

One of the bright spots of New Caledonia’s history was their ability to restrict travel during the 1918 influenza pandemic.

The locals seem to have thought that the same policy of restricted travel would remain in place until Covid largely disappeared from the world.

Thus, so many indigenous New Caledonians did not get themselves vaccinated.

However, French courts determined that with the availability of Covid vaccines, the restrictions on travel were illegal.

But when the influenza pandemic began racing around the world a century ago, New Caledonia was one of the few places on the planet to emerge largely unscathed. A strict quarantine kept the virus out until 1921, by which time its virulence had diminished.

In January 2021, New Caledonia was one of the world’s first places to receive ample coronavirus vaccines. The territory had boosters available before much of France. Yet when Delta hit, less than half of the population had been vaccinated.

“There is a closed island mentality, so people thought they were safe,” said Yannick Slamet, the health minister of New Caledonia. “People forget history quickly.”

But when the influenza pandemic began racing around the world a century ago, New Caledonia was one of the few places on the planet to emerge largely unscathed. A strict quarantine kept the virus out until 1921, by which time its virulence had diminished.

In January 2021, New Caledonia was one of the world’s first places to receive ample coronavirus vaccines. The territory had boosters available before much of France. Yet when Delta hit, less than half of the population had been vaccinated.

“There is a closed island mentality, so people thought they were safe,” said Yannick Slamet, the health minister of New Caledonia. “People forget history quickly.”

Anti-vaccination rallies in New Caledonia are one of the few places where the socially conservative native and the libertarian Frenchman interact and agree.

Anti-vaccination rallies are one of the few events in Nouméa that draw both Kanaks and white New Caledonians in an otherwise often segregated society. At a demonstration late last year in front of the New Caledonian Congress, with its wooden totems standing guard, protesters set up speakers and danced to Bob Marley. They hissed at onlookers wearing masks.

One Kanak protester, a hospital worker, said she drew inspiration from QAnon. She wanted to know how to get in touch with the far-right conspiracy movement. Another, of European descent, said he didn’t want the state dictating his life, even if he supported France continuing its rule over New Caledonia.Last month, tribal leaders in Lifou, one of the first Covid hot spots in New Caledonia, forced the airport to briefly close to protest a rule requiring health passes or testing for travelers. In January, an anti-vaccination and health pass mandate protest in Nouméa attracted 1,000 people. Covid restrictions have since eased.

Again, if the issue of vaccine hesitancy is “inequality” as the New York Times article asserts, it is not the inequality between the French and the indigenous peoples that is causing it.

Vaccine hesitancy in the case of New Caledonia seems to be based on the past reliance on border closures, and a traditionalist mind frame that assumes that this policy still exist.

That seems distinct from the vaccine hesitancy of France’s population.

There is a subset of France’s population that violently opposes any government initiative.

This is the reaction against a highly centralized French state, and the persistence of the spirit of the French Revolution.

There is also the populist phenomenon of vaccine resistance that was explored during the Canadian trucking strike.

Truck driving was pointed out to be a classic isolated existence that has become more isolated because of Covid restrictions and the decline of labor unions.

The argument is that with the decline of civil society, people turn toward conspiracy theories to simulate the feeling of being in an embattled community.

In any case, it might be useful to glance at what territorial status means in the French republic to better understand New Caledonia.

Overseas territories of France like New Caledonia that were once a part of France’s empire have varying statuses. 

https://en.wikipedia.org/wiki/Overseas_France

Overseas France (French: France d’outre-mer)[note 3] consists of 13 French-administered territories outside Europe, mostly the remains of the French colonial empire that chose to remain a part of the French state under various statuses after decolonization. They are part of the European Union. This collective name is used in everyday life in France but is not an administrative designation in its own right. Instead, the five overseas regions have exactly the same administrative status as the metropolitan regions; the five overseas collectivities are semi-autonomous; and New Caledonia is an autonomous territory.

Outside Europe, four broad classes of overseas French territorial administration currently exist: 

  1. overseas departments/regions
  2. overseas collectivities
  3. the sui generis territory of New Caledonia, and 
  4. uninhabited territories. 

From a legal and administrative standpoint, these four classes have varying legal status and levels of autonomy, although all permanently inhabited territories have representation in both France’s National Assembly and Senate, which together make up the French Parliament.

On the face of it, New Caledonia’s political status as an autonomous territory does not seem immediately comparable to any territory of the USA.

In the USA, there seems to be a continuum of political integration that involves a tradeoff between power and autonomy.

  • The 50 states of the USA enjoy political representation and, with it, power and financial patronage; 
  • territories like Puerto Rico do not pay federal taxes, but have only a non-voting representative in the US House; and
  • territories that become independent nations have the greatest independence but are now on their own.

.

This leads us to a detour into re-imagining territorial status.

The thought-experiment here is to imagine a new kind of territorial entity that would enjoy the best of both worlds.

Such a territory would enjoin autonomy and zero federal taxes, but maintain political power and substantial federal investment.

The goal would be economic development and diversification to offset the tendency for small, geographically isolated places to be economically doomed.

The “problem” is that New Caledonia has something like this mix of autonomy and generosity from the central government — but it largely remains in a state of semi-development.

That seems to be the way people in New Caledonia want it to be so it is not really a problem in their eyes.

That might also be true of American territories.

For example, it’s been said that the typical dream of Puerto Ricans is to live on a small farm next door to their parents’ small farm.

But a small farm in Puerto Rico is really small and pre-industrial, with the chickens and the goats and the gandules bean plants.

Not everybody wants a modern, dynamic economy.

But the larger thought-experiment behind re-imagining territorial status is to figure out a way to make a country like Singapore apply to be an American territory.

For example, the Soviet Union had a federal system that incorporated over a dozen distinct nation-states in a “union of socialist republics”.

 There were ideological and practical considerations behind this arrangement.

https://en.wikipedia.org/wiki/National_delimitation_in_the_Soviet_Union

Rationale

Russia had conquered Central Asia in the 19th century by annexing the formerly independent khanates of Kokand and Khiva and the Emirate of Bukhara. After the Communists took power in 1917 and created the Soviet Union it was decided to divide Central Asia into ethnically based republics in a process known as National Territorial Delimitation (NTD). This was in line with Communist theory that nationalism was a necessary step on the path towards an eventually communist society, and Joseph Stalin’s definition of a nation as being “a historically constituted, stable community of people, formed on the basis of a common language, territory, economic life, and psychological make-up manifested in a common culture”.

NTD is commonly portrayed as being nothing more than a cynical exercise in divide and rule, a deliberately Machiavellian attempt by Stalin to maintain Soviet hegemony over the region by artificially dividing its inhabitants into separate nations and with borders deliberately drawn so as to leave minorities within each state.[13] Though indeed Russia was concerned at the possible threat of pan-Turkic nationalism,[14] as expressed for example with the Basmachi movement of the 1920s, closer analysis informed by the primary sources paints a much more nuanced picture than is commonly presented.

NTD also aimed to create ‘viable’ entities, with economic, geographical, agricultural and infrastructural matters also to be taken into account and frequently trumping those of ethnicity.[21][22] The attempt to balance these contradictory aims within an overall nationalist framework proved exceedingly difficult and often impossible, resulting in the drawing of often tortuously convoluted borders, multiple enclaves and the unavoidable creation of large minorities who ended up living in the ‘wrong’ republic. Additionally the Soviets never intended for these borders to become international frontiers.

There is one more possibility not mentioned above that explains this willingness of Soviet leaders to recognize and respect non-Russian political and ethnic identity (made visible in ostentatiously gifting Russian land to other nationalities within the USSR).

This policy would facilitate the expansion of the USSR by reassuring other nations that they could maintain their cultures and administrative structures as members of the federation.

Drawing inspiration from the USSR, the idea here is that the USA would develop an additional territorial status that would appeal to small, prosperous countries like Singapore.

  • Singaporeans would be able to freely travel to and work in the USA.
  • Singaporeans would pay minimal US federal taxes.
  • Singaporeans would have their own laws and complete political autonomy.
  • Singapore would have voting representatives in the US House.

Singapore would be put under American protection, but otherwise Singapore would remain Singapore.

Moreover, something like this new territorial arrangement would be available to an independent Scotland, Quebec, or Texas.

With Texas as a territory of the USA, there would be no federal taxes in Texas, the USA would handle Texas’s foreign policy, Texas would get representation in the US House — but Texas would otherwise be an independent country.