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GLASGOW: COVID-19 vaccines are now being rolled out, but in some parts of the world, this good news has been tempered by the emergence of new, potentially more infectious strains of the virus.
Exactly how the pandemic will evolve has become more uncertain.
Certainly the next three months will be challenging, and a virus-free life is probably far away. Some things may not be the same again.
It’s hard to predict exactly how things will play out, but there are a few things we can predict with a relative degree of confidence.
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REMOVING THE PANDEMIC A PRIORITY
Currently, there is only limited information on the new viral strain.
Although it has not yet been confirmed, it appears to be more infectious, but it does not lead to more serious disease nor can it evade immunity derived from the vaccine.
However, the variant suggests that the virus is capable of producing significant mutations, and additional mutations could change the course of the outbreak.
Therefore, the rapid suppression of the pandemic has become an even more urgent task.
Tighter restrictions on behavior are likely to last well into the new year, and we may need more restrictions to control the virus if it is in fact more infectious.
BUT IT WILL TAKE MANY MONTHS TO IMMUNIZE PEOPLE
Producing sufficient doses of vaccine is a big task – production could have a bottleneck. Even assuming we can do everything we need to do, immunizing people will take many months.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, prepares to receive his first dose of the COVID-19 vaccine at the National Institutes of Health, Tuesday, Dec. 22, 2020, in Bethesda, Maryland (Photo: AP / Patrick Semansky)
In the UK, GPs are launching vaccines, and the average English GP cares for almost 9,000 people.
Assuming GPs work eight hours a day, need 10 minutes to vaccinate someone, and each patient needs two injections, it would take them over a year to see all of their patients.
Others of course will help with the implementation, but this shows the size of the task. Delays will be inevitable.
Additionally, the two doses of Pfizer vaccine must be administered 21 days apart, and full immunity must arrive seven days after the second shot.
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Other vaccines, like AstraZeneca’s, require an even longer period between doses. It will take at least a month (if not longer) to see the full effect in each vaccinated person.
In countries that relaxed social distancing rules for Christmas, we may see an increase in cases after Christmas. In this case, vaccines are unlikely to change much at first – the disease will get too much of a boost in early 2021.
This will likely also be the case in the UK thanks to the new strain of the virus, even though the restrictions were not lifted for many. Public awareness about the disease drive is necessary to avoid loss of confidence in vaccination.
HERD IMMUNITY WILL REQUIRE HIGH VACCINATION RATES
After people have received COVID-19 (or received a vaccine), they become immune (at least in the short term). Those infected later have more and more contact with immune rather than susceptible people. Therefore, transmission decreases and eventually the disease stops spreading, which is known as herd immunity.
The level of immunity in the population necessary to stop the spread of the virus is not precisely known. It is believed to be between 60 and 80 percent. We are currently nowhere near that, which means that billions of people around the world will need to be vaccinated to stop the spread of the virus.
People wearing masks to protect against the spread of the coronavirus walk in the domestic terminal of Haneda Airport in Tokyo on Tuesday, Dec. 29, 2020 (Photo: AP / Koji Sasahara)
This also depends on the vaccines that prevent transmission of the virus, which has yet to be proven. If so, we will see a decrease in COVID-19 cases, perhaps as early as spring 2021.
However, blockades and other measures to limit transmission will continue to be needed while vaccination strengthens the immunity of the population, especially wherever the most infectious strain of the virus has taken hold.
On the contrary, if the vaccine only prevents infected people from becoming seriously ill, we will remain dependent on infections to develop herd immunity.
In this scenario, vaccinating the vulnerable would reduce the mortality rate, but serious diseases are likely to persist, affecting the very young.
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CAUTION PER MONTH
Vaccines are not a silver bullet – you will need to maintain a certain level of caution for months.
In areas where the highly infectious strain is rampant, high-level restrictions can last until the vaccine deployment is complete. Any changes will come slowly, mainly in the area of home visits and reopening of hospitals for regular treatment.
Over time, hopefully travel will become easier, although airlines may start requiring vaccination certificates.
Although some countries require yellow fever vaccination to enter, the application for immunity passports for COVID-19 is likely to be controversial.
The use of masks could become a global social habit as it is now in Asia, for example, when someone is not feeling well or is concerned about their health.
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A GLOBAL EFFORT
Can the vaccine lead to virus eradication? We don’t yet know how long vaccine-based immunity lasts, and long-term immunity will be key.
Completely eradicating the virus will be very difficult and will require a global effort.
While we are close to eradicating polio, smallpox is still the only human disease that we have completely eradicated, and this took almost 200 years.
Measles, for example, although nearly eradicated in many countries, continues to make a comeback.
Some vaccines, such as measles, provide almost life-long protection, while others must be repeated, such as tetanus.
If COVID-19 mutates regularly and significantly, and its potential to do so has just been demonstrated, we may need to take new vaccines periodically, as we do for the flu. In the long term, we would also need to vaccinate children to maintain herd immunity.
The social and economic effects of the pandemic will likely be long-lasting as well. Life may never be the way it was before. But it is up to us to make it safer by being better prepared for future pandemics.
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Adam Kleczkowski is professor of mathematics and statistics at the University of Strathclyde. This comment first appeared on The Conversation.
