Is anyone still in any doubt that the Covid-19 vaccinations are a sprint? Any lingering suggestions that they might not be dissolve on contact with the latest developments. In Israel, where our New Statesman vaccine tracker puts the latest number of doses at 110 per 100 people, the Health Minister Yuli Edelstein recently announced that over half of adults have received both shots and that infection numbers had decreased despite the reopening of society. Britain (46 doses per 100 people) is gradually moving out of lockdown and is now far enough along with its vaccine programme to be debating the logistics of hospitality reopening. To the winners, the spoils.
Continental Europe, by contrast, feels months behind as countries tighten lockdown rules in the face of a rising third wave. Yesterday, the French government (13 doses per 100 people) limited outside gatherings to six people and expanded mobility restrictions to additional regions. Here in Germany (14 doses per 100 people) the government on Wednesday reversed a botched compromise between Angela Merkel’s chancellery (broadly for tougher restrictions) and state heads (many of whom want loosening) over a short tightening of rules over Easter. Italy (14 doses per 100 people) has been in a new lockdown for almost two weeks now.
The sense of a competitive sprint has been accentuated in Europe in particular by the tensions between the UK and the EU over rival claims to supplies of the AstraZeneca vaccine produced within the EU. At a virtual EU summit last night, leaders of the 27 member states pulled back from the brink of blocking exports to the UK, but gave their support in principle of imposing new controls. In Asia too, the tension between free trade ideals and domestic pressures was on display this week: India (3.9 doses per 100 people) on Thursday reported its biggest rise in new Covid-19 infections this year and is moving to reduce its vaccine exports.
As the finishing line looms into sight for some countries and others only stumble forward, many poorer countries have barely made it off the starting blocks. The first vaccines procured under COVAX, an international multilateral initiative to deliver doses to countries with less market power, have started to arrive. Yesterday for example, the first 132,000 doses of the AstraZeneca vaccine were unloaded at Juba airport in South Sudan. At the current rate, however, much of the global south will have to wait far into the decade to receive enough vaccine to cover their needs. Under COVAX for example, South Sudan (a country of 11m) will receive 732,000 doses by the end of June; it expects to have vaccinated only 40 per cent of its population by the end of 2022.
Yet while the metaphor of a sprint captures some aspects of current global vaccine efforts, it also has its limitations. A sprint only has to be run once, after which athletes return to their resting state. For those in the right condition, it can be run extremely fast. It is consistent: one smooth, straight, predictable stretch of track. And it is increasingly evident, and has become more so this past week, that the comparison fails on these points.
Consider these recent developments. A new double variant has been discovered in India, so-called as it combines two mutations in one virus that according to the country’s health ministry “confer immune escape and increased infectivity”. The health system in much of Brazil is on the verge of collapse as the country battles the more infectious P1 variant that first emerged in Manaus. A new study from Israel’s Ben Gurion University suggests that the Pfizer vaccine is less effective (though not ineffective) against the South African variant. The pattern seems to be clear: the more the virus rages through as-yet-unvaccinated populations, the more it will reappear in new variants against which existing vaccines are potentially less effective.
I cite these examples not as a counsel of despair but to demonstrate that Covid-19 vaccinations are a sprint and a marathon. The faster populations are jabbed now, the less chance the virus has of mutating, so speed is absolutely of the essence. But it will mutate and new variants will emerge, and these may well require revised vaccines and possibly top-up doses for those already vaccinated. Only once the world’s capacity for closing down the emergence of new variants outstrips the virus’s capacity to mutate and perpetuate itself can the race be deemed over. That could take many years. Perhaps we should not rule out the possibility that we will still be battling Covid-19 when the next global pandemic emerges; that the 2020s will be a poly-pandemic decade. As the Bloomberg columnist Andreas Kluth put it this week, “we’re in for seemingly endless cycles of outbreaks and remissions, social restrictions and relaxations, lockdowns and reopenings”.
The mentality has to be: mobilise all available resources to vaccinate as fast as possible now, but also plan for the long-haul of keeping up with and eventually outpacing the virus globally. Vaccine development, production and roll-out capacity must be vastly increased; supply chains made more robust; genomic sequencing infrastructure build; the battle for hearts and minds joined to defeat vaccine hesitancy and disinformation; cooperation between researchers and pharmaceutical firms put on a more long-term, institutional footing. COVAX must be hugely expanded and given permanent financial foundations. Lessons must be learned from debacles such as the EU-UK AstraZeneca spat. Even in countries closing in on herd immunity and reopening, governments must continue to invest in and develop test-and-trace networks. A permanent global compact is needed for mutual recognition and verification of individuals’ vaccine status to reopen travel.
A sprint is good. The faster that countries complete what will probably turn out to be the first round of vaccinations, the better. But it should also be seen as only the first stage in a much, much longer marathon in which humanity is competing, as one, against no other rival but the virus itself.
[See also: How EU naivety led to its vaccine debacle]