It is likely that variants will emerge that elude all existing vaccines.
The job of a virus, like all living things, is to survive and reproduce. Every time a virus reproduces itself, mutations occur. If the virus encounters an immune response that prevents it, variants that have mutated in a way that allows them to escape that immunity are more likely to survive and spread.
The known variants that have emerged so far have occurred in the absence of significant vaccine coverage – possibly due to immune pressure from relatively high infection rates. So far, the variants appear to be sensitive to available vaccines.
However, the rapid spread of variants, even with relatively high vaccination coverage, is of serious concern. For example, the Delta variant in the UK is now dominant, leading to an increase in the number of new infections and a delay in lifting lockdown measures.
Overcoming the variants requires a full vaccination. With the exception of the Johnson and Johnson vaccine, a jab won’t. While the UK has one of the highest vaccination coverage rates in the world, less than half of the population has been fully vaccinated. The United States is slightly behind.
About 10 percent of the world’s population have been fully immunized. In the poorest countries, less than 1 percent received a first dose. Many of these countries are delaying the second strike to try to provide some protection to as many people as possible.
Partial vaccination, of a person, a country or the world, is a recipe for disaster. The way to stay ahead of the virus is to vaccinate completely to achieve the illusory “herd immunity”. However, experts estimate that the presence of variants could require up to 90% coverage.
Of course, a new vaccine to overcome the variants can be generated in a matter of weeks. But it requires the recall of all stocks, the production and distribution of new vaccines, and many sore arms and other side effects, potentially increasing hesitation – and a lot of time. If we don’t act now, we could be locked into persistent cycles of partial immunization, new escape routes, and new vaccine production and distribution.
The Independent Panel on Pandemic Preparedness and Response (IPPPR) made concrete recommendations on how to avoid the current crisis. First, basic public health measures like social distancing and masks for unvaccinated people must remain in place.
Rich countries have obtained nearly 5 billion doses of vaccine for a population of around 1.16 billion. Even with two doses for each person, that’s a surplus of almost 3 billion doses. Since not all doses have been delivered, the IPPPR has recommended that at least 1 billion doses be delivered to low-income countries by September and at least 2 billion by the first half of 2022 .
President BidenJoe Biden Criminal justice group calls for leniency for house arrest offenders during pandemicThe commitment of 500 million doses is a good start. However, the sluggish performance of the rest of the G7 at their recent meeting is worrying. The G20 is expected to take strong action before meeting in October.
But vaccines are not enough. The yawning gap between full vaccination and herd immunity, combined with current and likely future outbreaks of variant infections – and the possibility of variants that escape vaccine protection – necessitates a wide availability of diagnostics and treatment. easy-to-use effective anti-coronavirus therapies. The recent announcement by the NIH of $ 1.2 billion for innovative approaches is commendable.
In addition, new approaches to prevent all of SARS-CoV-2 with pan-coronavirus vaccines or prophylaxis are needed.
Finally, local manufacturing is needed to increase the supply of vaccines, diagnostics and treatments. The commitment of European countries and the Biden administration to invest in vaccine manufacturing in Africa is a good start, but much more is needed.
Unfortunately, the focus is much more on where the virus started than where it is going. It is ultimately important to know whether the SARS-CoV-2 virus that causes COVID-19 escaped a lab or was an unusual but not unprecedented genetic leap from bats to humans. However, focusing now on the origin could divide the world into American and Chinese camps at a time when we need global unity to end this pandemic and prepare for the next.
We understood. No one wants to think of variants that escape all vaccines just yet. We want some return to our pre-pandemic lives. And it’s easier to look for scapegoats and focus on the past than the future. But if we act now, we can potentially get ahead of the virus before it gets there.
Because the place where COVID-19 is going could be a very scary place.
Mark Dybul and Deus Bazira are co-directors of the Center for Global Health Practice and Impact, Georgetown University Medical Center. Dybul was a member of the Independent Panel on Pandemic Preparedness and Response and led the President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria.