For most of 2020, the center of focus for the Covid 19 pandemic was on Europe, the UK, the USA, and Brazil. Daily record-breaking new infections, hospitalization, and deaths in these countries dominated global headlines. Lockdowns, restrictions, face masks, testing, track and trace, and social distancing were the standard response in the absence of effective treatments and vaccines.
As 2020 ended, vaccines for "emergency use" were approved. The hope was in 2021; mass vaccination would be the beginning of the end of this pandemic.
New variants
However, in the first half of 2021, significant new waves of outbreaks shifted to the Indian sub-continent, South America, Southeast Asian countries, the African continent, and some Pacific Islands nations.
Staggering record-breaking daily numbers of new cases, hospitalization, and deaths dominate headlines as lockdown and restrictions return.
More transmissible variants (Kappa and Delta) emerged and are now the dominant strain in many countries. These new strains were also responsible for fresh new infections in countries (Singapore, South Korea, and Australia) previously praised for their pandemic responses. While their new case numbers are comparatively small, the response by governments have been swift in bringing back lockdowns and restrictions.
The broader negative social impact of lockdowns this time round seems to be more pronounced as community resilience starts to run on empty. A case in point is what's happening in Malaysia, where the desperate plea of a growing number of ordinary people in need sparked a grassroots-led "white-flag" (benderaputih) movement.
Vaccinating the population & efficacy against new variants
On a brighter note, some developed countries (for example, parts of the USA, the UK, Israel, Singapore) have vaccinated most of their eligible population. However, with the arrival of new, more transmissible variants, all eyes are watching the efficacy contest between current vaccines and these new variants such as Delta closely.
In the UK, as is in Israel, as restriction eases, the number of new cases is starting to rise, especially amongst the unvaccinated younger population. Experts are also watching the data on breakthrough infections; fully vaccinated people are still getting infected. Although none of the approved vaccines had 100% efficacy against infections, the concern here is an unacceptable reduction in efficacy to prevent infections. Early reports indicate a slightly reduce efficacy against being infected.
Both the UK and Israel governments admit that new cases may arise in the coming weeks and months, their focus is on hospitalization and deaths.
Thus far both these metrics have remained relatively low despite the increase in new cases. However, the UK’s chief medical officer warns that the links between infections and hospitalisations has only been weakened, not severed.
Living with the virus
With most of their eligible population vaccinated, countries like Israel, the USA, the UK, and Singapore are taking the lead to switch from a suppression strategy to a "living with the virus" strategy. There are differences in the pace and details of how these countries intend to reopen their borders and ease restrictions. While some are taking a much more cautious approach, others like the UK are already taking big steps in this new direction.
All eyes will be on what happens two weeks after the 11 th July Euro Cup final at Wembley Stadium. The estimated crowd of 60,000 has the potential to be a super spreader event, especially for those attending that have not been vaccinated. New cases are likely to rise, but the UK government is hoping that hospitalization and deaths will not rise proportionately. Understandably, the suppression or elimination strategy architects have strong reservations for this alternative strategy, and some have gone so far as to call it a “reckless” move. If hospitalization and deaths rise to the dark days of 2020, it will be reckless for the UK to proceed with the planned "freedom-day" on 19 th July.
Vaccine Booster shots
If new variants infect more vaccinated people in the coming weeks and months, the call for booster shots will get louder. Already Pfizer last week announced that they are "developing a Covid-19 booster shot intended to target the Delta variant as concerns rise about the highly transmissible strain that is already the dominant form of the disease in the United States." Authorities say that at this time, there is not enough data to support this claim. If and when data is available to support a booster shot to combat rising infections amongst previously vaccinated people, this will add further complications even for countries ahead of the vaccination game.
FINAL WORD
The second half of 2021 will be different from the first half. The race between vaccines and the virus will be more complex. For countries ahead in the vaccination game and embarking on the "living with the virus"strategy, there is little doubt there will be new waves of infections as they open up. On the other hand, countries playing catch-up in the vaccination game will hope that their countermeasures are good enough to hold back these new variants in the meantime.
Proponents of living with the virus are banking on rising infections not crippling their health systems, resulting in unacceptable deaths and suffering. In the short term, society might accept this trade-off after nearly two years of lockdowns and restrictions. Ultimately, steps have to be taken to minimize any significant outbreaks, if only to deny the SARS CoV2 virus fertile grounds for mutations and the uncertainty of long Covid even for those who may have recovered from mild infections.
Chai 。仁材 Chuah 蔡
Wellington, New Zealand
12 th July 2021