IO – Ever since the pandemic erupted roughly two years ago, the world has experienced a roller coaster of variants surging, then declining, followed by a collective sigh of relief as countries began to relax Covid-19 related policies, only to face the emergence of yet another and even more deadly variant.
Suddenly, as the less lethal Omicron variant continues to subside in Europe and America and is reported to have peaked in Africa, there is a growing consensus that we can live with the virus. Epidemiologists and public health organizations are now painting a rosy scenario of infections from the Omicron variant coming under control by mid-year, and some are optimistic that even if new variants replace Omicron as the dominant strain that these variants would not pose the types of deadly threats as were posed by the Alpha and Delta strains. In other words, there is an emergent consensus that the pandemic just might be coming to an end.
This sounds encouraging, but some important caveats need to be kept in mind.
As noted by the World Health Organization, bringing the pandemic to an end will require a larger percentage–more precisely 70 percent or more in total– of the world population to become fully vaccinated. So far only 54 percent of the world is fully vaccinated, and around 62 percent have received at least one dose of Covid19- vaccine.
Going from 54 to 70 percent does not sound llke much of a challenge, but it is much more difficult than it sounds. Although the majority of people living in developed countries have received at least one dose, only 10 percent have in low-income countries.
Low income countries such as in the African continent face a myraid of challenges in getting more people vaccinated. One problem is a lack of public funds to purchase sufficient vaccines. During the beginning of the pandemic there was a concerted effort by the international community to provide vaccines at a lower cost to these countries through a vaccine facility known as COVAX, but unfortunately, for various reasons, this facility has failed to meet its supply targets.
Supply side issues are not the only problem. Even in cases where vaccines are being made available, developing countries need to grapple with a lack of cold storage facilities and the logistical challenges of delivering and administering the vaccines to rural areas.
In Nigeria, for example, which is Africa›s most populous country with over 206 million people, only 3 percent of the population has been fully vaccinated and only 7 percent has received at least one dose. Africa›s second most populous country, which is Ethiopia with 117 million people, is in a similar dire situation: only 2 percent of Ethiopians have been fully vaccinated and 8 percent have received at least one dose.
Taking these numbers and constraints into account, it becomes obvious that while getting half the world fully vaccinated was achievable, getting an extra 20 percent is not going to be an easy task.
Even if the world were to find the means to get around these challenges and managed to get 70 percent of the planet fully vaccinated, one must still consider that vaccines offer limited immunity. Clinical trials with the Moderna and Pfizer vaccines, for example, have revealed that they offer immunity for a period of six months. This means that in order to effectively suppress infections that annual vaccinations and boosters will be needed.
A second caveat about the prospects for the pandemic coming to an end is purely related to the epidemiological facts about how the virus mutates and new, potentially more dangerous variants spread through populations.
There is a wide spread misconception in some circles that viruses tend to evolve to become more benign. Since the Omicron virus replaced Delta as the dominant strain, there was speculation that because it is less lethal than previous variants then future variants will necessarily become even less deadly.
Hence the talk about how perhaps we are beginning to see the end of the pandemic.
Unfortunately, viruses do not evolve in a predictable manner– evolutionary virologists are telling us that there is no predestined evolutionary path for the pathogen, either for it to become more or less benign. This is evident if we consider how the original Wuhan strain of Covid19- was followed by the more virulent Alpha and Delta strains. It is also useful as a reference to remember the second wave of the 1918 pandemic was much more deadly than the first.
Which leads us to an obvious conclusion. Is the pandemic coming to an end? The science behind viruses is clear: we don›t know, and to make any conclusions or policy decisions on the misconception that future variants will be less deadly would be foolish.
Of course, the situation could ostensibly take a turn for the better. We could wake up one day to hear the World Health Organization has declared Covid19- is no longer a pandemic but endemic.
But what, exactly, is an endemic disease? Technically it means overall infection rates are neither falling nor rising. Yet, as one epidemiological points out, «Yes, common colds are endemic. So are lassa fever, malaria and polio. So was smallpox, until vaccines stamped it out. In other words, a disease can be endemic and both widespread and deadly.”
Given these uncertainties, one thing is for sure: policymakers and politicians alike should not allow the Omicron variant to lull us into a state of complacency. The decreases in Omicron infections could very well prove to be a shortlived reprieve from the pandemic, and responsible leaders should be taking measures to prevent more lethal or more transmissible variants emerging.
For sure, the best way to protect the world against more dangerous variants in the future is vaccine equity. A fact that needs to be kept in mind is that the larger the spread of infections the more opportunity the virus has to replicate and therefore there is a higher risk of more deadly and transmissible variants arising. This happened in India, where the deadly Delta variant first appeared during a massive surge in the country, and again in South Africa where the Omicron variant emerged in the midst of a surge, as well.
As the developed world begins to remove masking mandates, ease entry requirements at their borders and relax social mobility restrictions, it is imperative that everybody stays aligned on how to ensure a safer future, especially when it comes to vaccine equity for low-income countries. Vaccine equity is not just an exercise in helping people living in poor countries–it also helps reduce the threats from Covid19- for people living everywhere.