Living with Covid-19


IO – There is a general sense of optimism since the start of aggressive vaccine roll-outs in the United States and other developed countries, offering hope that herd immunity against Covid-19 could be reached in the latter part of this year.

There are plenty of reasons to think otherwise. One reason is logistics. As health experts keep reminding the public, it’s not the vaccines but vaccinations that save lives. Most developed countries have the resources and infrastructure to distribute and administer the vaccines, but that is far from the case in less affluent countries.

Simple math explains the enormity of the task at hand. Reaching herd immunity on a global scale will require a minimum of nine billion doses of vaccines to be made available. And right now, for what is being produced, the overwhelming majority of the doses are being sold to richer countries.

Over time the production of doses becomes less of a constraint, but getting that many vaccines into the hands of health care providers worldwide is no easy undertaking given the fact the doses can’t be distributed in areas with poor cold storage chains. And even where cold storage facilities are available, another challenge presents itself, namely the availability of syringes and needles, something that many countries are currently finding difficult to obtain.

Indonesia is a good example of how difficult it is to quickly inoculate enough people to bring the Covid-19 virus under control. The government estimates it will need to jab roughly 182 million Indonesians, but so far only 2.9 million people have been inoculated. Vaccine availability and distribution will be a major hurdle; due to supply constraints, the target rate of one million vaccinations per day will not be reached until early July, and for eastern parts of the archipelago, especially rural areas, distribution of the vaccines will prove extraordinarily challenging. In the most optimistic of scenarios, it will take almost three years to inoculate the 182 million Indonesians that is needed reach herd immunity.

Another reason not to be overly optimistic is the level of resistance for taking what could prove to be a life-saving jab. In Indonesia, for example, a survey found that only slightly more than one-third of the respondents are willing to be inoculated and 17 percent would refuse it. Similar levels of resistance are being seen worldwide, and it is cause for great concern. Statisticians in the U.K. recently ran a simulation on vaccination rates and found that if just 10 percent of Britons refused to be vaccinated and if social distancing practices were relaxed, then there would be a tremendous spike in infections and deaths.

Such is the sobering reality. Supply constraints, logistical challenges and vaccination resistance add up to a picture that strongly suggests that Covid-19 will remain a major health risk for at least the next few years, especially in the developing world.

Finally there is the issue of Covid-19 variants, such as the ones found in Brazil and South Africa. These variants have disturbingly been found to defeat immunity acquired from previous infections. It is thought such cases will be milder, but nonetheless the variants will find unprotected people and put them in harm’s way. At the same time, pharmaceutical companies will have to tweak their vaccines to protect people from the variants. Variants will more than likely continue to appear, which means the disease will become endemic and there would be a need for getting an annual jab to stay protected.

How the world adjusts to this new reality remains to be seen. Covid-19 could persist much longer than most of us imagined before.