and the president of the european commission have spoken in gloomy terms about the likelihood of a post—brexit trade deal. the trump administration has increased pressure on the us food and drug administration regulators to approve the pfizer biontech vaccine. final clearance is expected this weekend which means the first americans could get their innoculations early next week. there have been nearly 2,000 deaths counted on friday already. british scientists say they have identified what could make some patients more likely to develop severe covid—19 symptoms. in one of the biggest studies of its kind, researchers analysed mutations in the dna of more than 2,000 critically ill patients.

that is it from me. james will be here at the top of the other. but now, with the promise of a covid—19 vaccine, global questions examines if it could really be a silver bullet to and the pandemic. hello, and welcome to the royal couege hello, and welcome to the royal college of physicians in london. we have come here for this edition of global questions to talk about covid—19 and vaccines. well, the united kingdom is the first western country to roll out a mass nationwide vaccination programme, and we are all hoping this will mark the end of the coronavirus nightmare. but questions linger about the durability of the vaccines, and with millions refusing to take the jab, how safe all the rest of us be? that's global questions, the covid jab: is it really the silver bullet?

well, here in the royal college of physicians, we have an audience drawn from not —— from london's multinational community, and they will be putting their questions to our two panellists. so let me tell you who is in the hot seat this week giving the answers. professor david salisbury is an eminent doctor who has served as the uk's director of immunisation, responsible for the national programme that led to the introduction of many new vaccines. he works extensively for the world health organization on for the world health 0rganization on vaccines. and seery moonjoins us 0rganization on vaccines. and seery moon joins us from geneva, where she is the co—director of the global health centre for the graduate institute. her particular areas of expertise are in health governance issues, infectious diseases and a focus on ensuring that all countries get fair access to global vaccine

supplies. welcome to you both and also to our audience. remember, you too canjoin and also to our audience. remember, you too can join the conversation. give yourselves and our two panellists a big round of applause. it is so nice to have an enthusiastic audience with me here. 0k, let's get right down to our first question, and it is from azad ayube. your question, please? what was the hurry, and was there a race between countries? right. professor david salisbury? why the hurry? was there a hurry? yes, that absolutely was a hurry. the hurry was because people were dying in countries all over the world and we had to get a vaccine as quickly as possible. siri? indeed, it was a race against the virus, but i think we also have to recognise that countries were raising to scientific prestige. they were

racing to be economically more competitive with each other and they were racing to strengthen edgier political relationships with each other, because of course a vaccine with each other, because of course a vaccine in this pandemic isa course a vaccine in this pandemic is a strategic habit. was it healthy or unhealthy competition? some healthy, but i think we could have used a lot more collaboration, actually, among scientists and companies. that would allow us to move much faster towards the finish line than what we have. was there a race between the nations as different countries? david, you answer that. was there a race between nations? was their competition nationally between nations?” think the race was between science groups to get ahead as quick as they can, i think the race was a good race, because everybody was going to benefit from it, and i think that we have seen signs doing its absolute best with great collaboration around the world among science groups, among companies, i think we should really applaud what has

happened to get us to where we are now. all right, terrific. you are carrying the audience with you there. very good. excellent. let's go to a second question. yvonne minnelli from italy. your question? thank you. my question is, if a vaccine is safe and it works, why do we need multiple vaccines from different companies? it is reckoned by next year that there will be something like 20 vaccines available, johnson & johnson working on one, and all sorts of people. why so many?” working on one, and all sorts of people. why so many? i think it is actually a great thing that we have so many vaccines in development, and often times the first generation of product is not as good as the ones that wallow. we a re is not as good as the ones that wallow. we are also already seen wallow. we are also already seen just with the three frontrunners but there is a big difference in safety and efficacy, well, at least on efficacy. and we see a huge difference in price, for example, one vaccine, the astrazeneca vaccine, is about 10% of the price of the madonna vaccine. it will also be a lot

easier to deliver in countries that do not have as many resources as, for example, europe and north america. u nfortu nately, europe and north america. unfortunately, the efficacy data is not as good, but what we hope is that with more and more vaccines coming out of the pipeline in the next year, we will have vaccines that are affordable, available, that are safe and affect, and that can also, you know, that are also shown to prevent transmission. there is still a long way to 90, there is still a long way to go, the race is not over yet. david, the more vaccines there are, the lower the price. is that be thinking? not necessarily. i think the answer to the question is, actually, i'io to the question is, actually, no single company or even two companies or three companies could provide the needs for the world. we are going to have to have as many companies as can produce safe, effective and affordable vaccines, and that is our best chance. does not a nswer is our best chance. does not answer your question, some three next? it does to a certain extent. 0n three next? it does to a certain extent. on my way here, the taxi driver told me, who

gets which vaccine? how do we decide if i get a vaccine from company a or company be? all right, so, are we going to be spoiled for choice, david? will they be a lot of working out which vaccine is best for who and which country? i think there are going to be difficult decisions that have to be made, but they will be made, you know, really in line with the amount of vaccine that we can have in each country, the quality of the vaccine that we can get, the contracts that are in place, either done by our countries on behalf of our countries, i don't think we can pick and mix year. i think it is going to be a matter of getting what we can get, adapting it to the best circumstances so adapting it to the best circumstances so that we have got the best vaccine in use for high—risk people, we may not need, necessarily, the same vaccine for lower people at lower risk, and we got to adapt to the circumstances. if you a country that is cold, that is quite different, it is different with your in a country that is hot. so we will wait and see and hopefully the

best choices will be made on our behalf. all right, let's go to our next question. this is from ang lee from wuhan, china, well because covid—i9 was first detected. your question, please, ang lee? my question is the following. will people find that their immunity to the coronavirus diminishes eventually? thank you. professor, this is a question troubling and awful lot of people, what is called the durability of the vaccine. so you may get your vaccination but then we don't really know how long you are going to be protected for, do we, really? no, it is a great question. we simply don't know how long these vaccines are going to last, and we don't know whether the lesson we learn from one vaccine will necessarily be the same lesson that we learn from a different vaccine. because there are quite different sorts of vaccines and development. they range all the way across the board, from these rna vaccines that are totally new,

too long techniques, we just don't know. we have to follow really carefully the people who have in these trials to see if they stay protected or if they can catch coronavirus later. remember, for the ordinary coronavirus is, the ones that cause the common cold, we don't get very good immunity to them. so let's watch, we must study, we must learn, then we will know what to do next. siri moon? i fully agree with what david was saying. i think on top of that, this is one of the reasons why we need that next generation of vaccines to continue to be developed. so in addition to continuing the trials of the vaccines that are already being deployed, we do need to bring newer and better vaccines, and one of the characteristics that is very important is, how many doses do you need. because you can imagine, if people need to get immunised every year, it is going to make a big difference whether we canjust

going to make a big difference whether we can just give going to make a big difference whether we canjust give one dose or whether somebody has to go back twice, example. at what we see what a vaccination campaigns is that if you need to give somebody two or even three doses, the numbers of people who really show up to do that, they really drop each time. thank you very much indeed. all right, we're gonna have to questions, one after the other, because they are kind of elated. so, gloria, what do you want to us? during the pandemic it has been widely recognised that people from a bame background are more vulnerable to dying from covid—i9. however, they have not been considered in a higher category to get the vaccination. why has the focus being on age and is not on the vulnerability of individuals? thank you very much indeed. you refer there to the bame community, which is what in the united kingdom we call the black and minority ethnic groups, bame for short. black and minority ethnic groups, bameforshort. 0k, thank you. dominic camps, you have also got a kind of related question to that? i do, thank you. we have seen the first

vaccinations this week in uk hospitals of those over 80 and healthcare professionals. but wouldn't it be advisable to also prioritise young people 18-24 also prioritise young people 18—24 who are the primary spreaders of the virus at this time, even if they might be less susceptible to complications from the virus? professor salisbury, i will start with you. they are both kind of uk —related questions. broadly, they are both asking, how do you choose which categories you started vaccinating first? these are two great questions, they really are great questions. and in terms of the identification of priority groups, it really is an issue that some people in some communities are at more risk than others of both dying or getting very serious illness. however, ithink or getting very serious illness. however, i think what we have to do is come up with a hierarchy we can implement. we know that age is a risk. we know that age is a risk. we know that age is a risk. we know that having other illnesses is a risk. and

clearly there are some communities that are at higher risk. but when it comes to implementing the vaccine, we need to be able to identify the people who are in those risk groups, and for us in the uk, that means identifying them through their primary care provider. to come to the second question, that is again a really good question, why don't we vaccinate young people to stop them transmitting? i think the answer is that we know who is more likely to die and if we can protect them first, then we can protect them first, then we can come onto interrupting transmission. i think there are two strategies that we need to implement. the first is protecting the vulnerable. the second is to stop transmission between people. that means vaccinating the healthy younger people, and i'm just not sure that we are going to get as high uptake amongst those groups of people that we will

get among the higher risk people who know they are at risk. suerie moon, how do you a nswer risk. suerie moon, how do you answer those two questions? you do you protect first, among the vulnerable, or should you target the super spreaders first, the people? it is a great question. i think one thing we have to understand is of course, what are the characteristics of the vaccines? the ones that are currently at the front of the pack what we know from the way that those trials were designed is that we actually understand very, very little we have very little evidence, if any, as to whether they block transmission. so until we do have that data, i think it doesn't make sense, indeed, to vaccinate those who are most socially active. such as younger people. but if i may, i would like to come back to that earlier question, we know that in the us, for example, we have similar trends, in the us, for example, we have similartrends, and in the us, for example, we have similar trends, and had disproportionately bearing the burden of this pandemic, the

government has actually said we should take into account not race but many of the things correlated with race, occupation, income, living conditions. there are other ways to try to identify those who are indeed at greatest risk of getting severely ill, and that we should in fact try to immunise them first. 0ne that we should in fact try to immunise them first. one very la st immunise them first. one very last thing i would like to add is that i think this is an extremely important thing for people to track and monitor. we have to be able to look back and say, well be successful as and say, well be successful as a society in actually immunising those who truly were at greatest risk, including minority communities? what undocumented immigrants, for example ? undocumented immigrants, for example? 0r, undocumented immigrants, for example? or, at the end of the day, did these vaccines first go to the elites? and this is going to be a key question for all of us to hold our own governments accountable. well, two very thorough answers there. lori and dominic, wanted to stand up, what did you think of what our two panellists ed? gloria, satisfied? yes.

especially liked suerie's response, especially about the fa ct response, especially about the fact that america seems to be looking at the different categories regarding race about occupation, job, and how that all counts towards vulnerability and, yeah, they appreciate the fact of both responses. all right, thank you. dominic. i think it responses. all right, thank you. dominic. ithink it goes responses. all right, thank you. dominic. i think it goes a long way to satisfy mine. i think as we are now at the point of having vaccines and we're talking about delivery, it's question of ethics in terms of, and maybe is a different group of people we need to engage and the decision around who gets vaccinated, but also responsibilities in the population, that we don't become apatheticjust population, that we don't become apathetic just because population, that we don't become apatheticjust because a vaccine is here. all right. let's go to my next question, which is from georgia chisnall. georgia. thank you. a lot of people are very unlikely or uncertain about getting the vaccine. in the uk, for example, it's about one third. why do you think, despite having months during exceeding

development, that public concern remains widely unaddressed and what you think should be done now to reassure the public that the vaccine is, indeed, safe? in short, they go wrong and what can they do to fix it? let's go to you, suerie, the anti—vaxxers who no matter what you say just suerie, the anti—vaxxers who no matter what you sayjust don't wa nt to ta ke matter what you sayjust don't want to take it, but then there are those who are a little worried and concerned and want to be reassured about the safety of how do you tackle that? i think it is totally understandable that people would be concerned because, of course, these vaccines have been developed in record time, which is something that we should, indeed, justifiably be proud of in terms of the scientific and health community. but i think it is reasonable that this raise questions. there is a huge variation among countries in harmony people are hesitant. we have, i think, harmony people are hesitant. we have, ithink, up harmony people are hesitant. we have, i think, up to 50%just the border in france. and, according to different polls, it really varies a lot by country. i think one thing we

know from the research is that it does help and it does matter what are the traits of the specific vaccine? what do we know about the safety and efficacy and what we know from the leading candidates is that this looks pretty good. sol think that will help convince more people to come forward. but what we also understand about vaccine hesitancy is it's notjust a question about vaccine hesitancy is it's not just a question of information. it's notjust a question of providing the public with data. you have to be able to communicate and have sophisticated communication strategies so that people hear the message from those that they trust. and for everybody that might not be the government, it might not even bea government, it might not even be a medical doctor. it might be a medical doctor. it might be their teacher, religious leader, a community leader. i think was really important is that we have trusted authorities communicating the message to persuade people to come forward and get vaccinated. thank you. david? it was a good question. however, i don't quite agree that it's been got wrong. i

think that people have been trying to deal with it, but with at least one if not two hands behind their backs, tied there. and the issue as nobody was going to tell you that these vaccines were safe and nobody was going to tell you that these vaccines were effective until we had the a nswe rs. effective until we had the answers. and those come at the end of the trials. you can't tell while the trials are going on who's had the vaccine and who hasn't stopped so until the trial is finished we can't tell you that the vaccine is both safe and effective. all right, georgia, what are you going to say to david? he doesn't agree with you that public concerns remain widely unaddressed.” will politely disagree, just because on a couple of occasions... so, in terms of having to wait until there is the data there, vaccine a cce pta nce the data there, vaccine acceptance and vaccine hesitancy is more than going at

the end of the thing is safe, it is about ongoing public trust, ongoing public medication, ongoing education about what vaccination actually is and what it means, notjust simply at the end of the line it is safe, because ultimately, while logistics and the biology is important, people don't choose to take the vaccine then it's simply not going to be just a can't work. 0k, it's simply not going to be just a can't work. ok, thanks. 0ur just a can't work. ok, thanks. our next question is from a mexican—american. your question. my question is along a similar thread. question. my question is along a similarthread. related question. my question is along a similar thread. related to efficacy and logistics. the vaccine is to be stored at very old temperatures, what measures are being taken to ensure quality control when mass badges are being supplied from two middle america, for example. professor david salisbury? while a vaccine is ina box salisbury? while a vaccine is in a box we know what is happening to it. we know that it will go into —70 degrees breezes at the point of distribution of the bop ——

freezers. what is really difficult is how you then split the box, which has got 5000 doses in it, into smaller quantities that can go out to communities and i think everybody is seeing that as really difficult. the easier answer is to bring people to where the vaccine is, but that requires them to be mobile and it disadvantages those who do not have transport or who are frail and can't get to where the vaccine is. it's a huge challenge for low income countries. in fact, we have a question that relates to that hannah thomas from singapore. hannah. thank you, zeinab. in terms of first world countries having an egg advantage in securing many having an egg advantage in securing many more having an egg advantage in securing many more doses of the vaccine in comparison to third world countries, how do we ensure that there are no vaccine shortages in such developing countries? suerie, we have heard an alliance of charities coming out saying countries in north america like

canada and in europe are buying up canada and in europe are buying up millions and millions of doses, far more than their populations actually number. and nothing much left for the lower income countries. how do ensure they get fair access? is a big toppie —— topic for you, i know, suerie. indeed. it is not hypothetical. it is a reality that high income countries have secured up to four times over the entire population. meanwhile, we have, in the rest of the world, that is going to have to struggle with a lot of less. i think one thing to point out that perhaps has not been widely appreciated is that you do have lots of what we would call middle income countries who are able to produce vaccines and who have secured access to vaccines on their own, such as brazil or indonesia or mexico, for example, india and china. but we also have many, many countries who are really relying on a global solution,

ona relying on a global solution, on a multilateral solution. and there is one called kovacs that has been developed very quickly. i think the ambitions are quickly. i think the ambitions a re really quickly. i think the ambitions are really important and really admirable. they are trying to reach the most vulnerable 20% of people in every single country in the world and that is how you prevent death, that's how you prevent hospital systems from getting overwhelmed. but, u nfortu nately, overwhelmed. but, unfortunately, right now unless wealthy countries are willing to share some of the vaccines that they have already secured, covax is really going to struggle to meet that objective. david, you have something to add to this, just briefly? i think the countries that have ordered five times the quantity they need on the population bases are not going to draw down all the mean. so, hopefully, they will be able to cut back on the contract that they've made so they don't take vaccine that could so will be used elsewhere. i think the warrior i have about covax is that, wonderful as it is to

help countries protect their most vulnerable in their health services, the quantities are not going to be enough to stop transmission amongst people, because you need more than 20% coverage to do that. and so we've got to find ways of getting more vaccine to places where there are many, many vulnerable people to help them. thank you. hannah? yes. well, kinda politely disagree. because they feel that people from different social economic backgrounds sometimes may have less of an advantage over people that come from high income families. so it doesn't exactly answer the question on what we can do to help the vulnerable and those living in poverty. thank you. all right, let's go to our final question. you are from pakistan, originally. thank you. thank you. my question is how long until we actually start living our normal lives now the

vaccine is out? do we have a timeline? that's what we all wa nt to timeline? that's what we all want to know! professor salisbury, when can we go back to normal? well, my family keep telling me why to make it being so gloomy? however, i think for a while we are going to be in vaccine plus. i think we have got to see the rollout of vaccines before we can make any changes to our lives and i think we will continue having to socially distance, wear masks, work from home where we can, and only when we can see that we are impacting on saving lives, saving our health services, and only when we can really be sure that we are impacting with our vaccine programmes can we carefully, gradually move back. i don't know when it will be, or simply hope it will be soon. yeah, well, soon but you don't know when it will be. all right, let's hope it will be very soon. let's hope it will be very soon. suerie moon, last word on

that? i would agree it is difficult to predict. but i think returned to anything coming close to normality will be very different for very countries around the world, going back to hannah's question, if countries are not able to get vaccines to take the hardest edge of this pandemic, that is to protect those at greatest risk of dying, then we are going to see a much, much lower return to normality in most countries in the world and that does have an impact on countries in uk —— like the uk and back in europe. because people want to travel all over the world, because our economies are interdependent, and because of diplomatic relations with other countries. so there is a real moral imperative as well as a strong self—interest argument that we have to find a solution and make vaccines more available to everybody. take you very much indeed. that is all from this edition of global questions. before we go. i want to get a quick indication of what audiences think of this question. do you think now we have the covid—i9 vaccines

being rolled out, this one here in the uk do you think that is it, it is a silver bullet? put your hand up if you think the jab is the silver bullet. 0h your hand up if you think the jab is the silver bullet. oh my goodness, just one solitary person. so who thinks it is not a silver bullet? my. professor davis salisbury, you see your family tell you not to be so gloomy. you clearly have some of yourfamily gloomy. you clearly have some of your family members gloomy. you clearly have some of yourfamily members in gloomy. you clearly have some of your family members in this room here with me, because they are also saying that the jab is not going to be the silver bullet. well, thank you very much indeed to professor davis salisbury and suerie moon, in my audience here at the royal couege my audience here at the royal college of physicians and you wherever you're watching or listening to this programme was not don't forget you can be pa rt not don't forget you can be part of our programmes in the future. admit a question. please e—mail global questions. but for now from me, zaynab badawi, and for the rest of the team, it is goodbye from the royal college of physicians here in london stop until the

next time. seasons greetings, stay safe, and goodbye. hello there. friday was another unsettled day, a day that brought many of us outbreaks of rain. the rain was most persistent in aberdeenshire but, equally, there were a few brighter moments — for example, here in cornwall to allow these rather stunning rainbows to develop. we have at the moment a very slow—moving area of low pressure crossing the country. further patches of rain moving generally slowly eastwards and with the winds very light, again, we're starting to see some dense patches of fog form particularly across eastern england. visibility is already down to 100 metres in places with the foggy weather really from essex northwards into the east midlands, perhaps east anglia, lincolnshire, and yorkshire. that's where the poorest visibility is likely to be. whereas further west, the skies tending to clear. this is where we'll see some of the lowest temperatures early on saturday morning. and saturday itself, it's a day where pressure is going to be rising

across the whole of the uk. what that will do is it will squish this area of low pressure. so, in the next 2a hours, it won't exist at all, it willjust be gone. further west we get this ridge building in and that will have quite a big impact on the weather. it means across these western and southern areas, it's an improving weather picture with sunny spells developing but with that slow—moving area of low pressure close by, it stays pretty cloudy and there probably will still be some patches of rain well on into the afternoon across the north east. so, a mixed bag of weather. for many of us, though, saturday morning will be a rather grey start to the day. extensive cloud, some patches of light rain and drizzle. very slowly pushing eastwards because there's barely any wind to move those features along. but eventually, we'll get some sunshine. sunshine to start the day in northern ireland, that will tend to spread to south—west scotland, western areas of england, wales, the midlands, and much of the south of england as well. so, an improving weather picture for some of you. now, the second half of the weekend is dominated by this next area of low pressure. there are more

isobars on the chart. so, you'll notice the weather certainly turning a lot windier and also a lot wetter as well. yes, outbreaks rain spreading up from the south west, heavy as well, as it dives in across england and wales, pushes northwards across northern ireland into scotland through the afternoon. so, although it will be a dry start across northern and eastern areas, rain will arrive later in the day and it will be blowy as well. gales developing around our southern and western coasts and hills. the winds, though, coming from a south—westerly direction blowing in mild air. so, temperatures up to 13 in the southwest.

welcome to bbc news. i'm james reynolds. our top stories: the us supreme court rejects a legal application seeking to invalidate voting in four key states in yet another blow to donald trump's attempts to overturn the election result. "get it done" — the trump administration puts pressure on regulators to approve a coronavirus vaccine, asking it to do so within hours. hello and welcome to bbc news. the us supreme court has rejected a legal application by the state of texas seeking to invalidate voting results in georgia, michigan, pennsylvania and wisconsin.