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Covid-19: what is needed to end the pandemic?


One of the main tools to end the covid-19 pandemic is the vaccine, but inequality in its access has been demonstrated.

Omicron quadruples covid-19 cases in South Africa 1:26

(CNN) -

The covid-19 pandemic will not last forever.

It is likely to continue to wane and fade as it approaches its third year, resurfacing with new variants and then dwindling in the face of vaccines, mitigation measures, and human behavior.

But even if the virus is not eradicated, immunity will improve and the world will be able to live with COVID-19.

On this, the experts generally agree.

"The vast majority of infectious disease specialists think, and have for many months, that SARS-CoV-2 is here to stay," said Paul Hunter, professor of medicine at the University of East Anglia in the UK. .

"Our grandchildren's grandchildren will continue to contract (the virus)," he said.

But "the covid, the disease, will become part of our history as the infection becomes one more cause of the common cold."

However, there is a much more pertinent question, the answer to which is frustratingly elusive: how long will it take to get to that point?


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And that answer does not depend on luck: it is, at least to a large extent, in our hands.

Pandemics fade away thanks to human efforts such as vaccine development, contact tracing, genomic analysis, containment measures, and international cooperation.

In short, the world has a set of tools to end the pandemic as soon as possible.

The problem?

Even after 20 months, those tools are not being used to the full.

"This is the main drawback: There was never a plan, (and) there is still no global plan," said Andrea Taylor, deputy director of programs at the Duke Institute for Global Health.

"We are not good at dealing with global crises as a world: we don't really have the infrastructure, or the leadership, or the responsibility," he added.

Several European countries suffer new waves of infections, and new fears loom over the omicron variant.

(Photo: Francesca Volpi / Bloomberg)

Some countries have fared better than others in the face of covid-19.

But to hasten the end of the problem, numerous experts - including Taylor - are calling for a new global approach, especially when it comes to vaccines, treatments and information sharing.

According to them, this effort is the best way to end the pandemic quickly, and if not done, people in all corners of the world could continue to live under a COVID cloud until 2022 and beyond.

"We knew ahead of time what would happen if we took this nationalist approach, but we did it anyway," Taylor said.

"And now we are living the consequences of it."

The world's key tool: the vaccine

If the world has an arsenal to end the pandemic, the most important weapon it has is a no-brainer.

"The first tool we have is the vaccine," says Roberto Burioni, professor of microbiology and virology at San Raffaele University in Milan, a high-level commentator on the response to the pandemic in Italy.

The development of several vaccines, all of them highly effective in stopping severe disease and also useful in slowing transmission, was a world first.

The previous record for putting a vaccine on the market was four years, but the Covid-19 pandemic shattered all expectations and restored the benchmark in this field.

It's easy to see how crucial vaccines are to the goal of ending COVID-19.

"As more people become infected, vaccinated and re-infected, the severity of the disease will gradually decrease due to the build-up of immunity, that's the theory," Hunter said.

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But having the vaccine doesn't fix the problem

However, having a vaccine is not enough, it should be given to as many people as possible, as many times as necessary.

Even in developed countries, where vaccine availability is not a problem, the gradual decline in immunity, the transmissibility of new variants, and pockets of skepticism about vaccines have shown that extremely high coverage rates are needed. to avoid waves of infections.

"What we should get is widespread immunization," Burioni said.

"One possible scenario is that if we are able to vaccinate a huge majority of people, this virus will circulate but it will not do much damage."

In addition to their continued efforts to encourage unvaccinated people to receive a first dose, richer countries now have two main axes in their inoculation strategies: ensuring the vaccination of school-age children and administering booster vaccines, as many as necessary to maintain protection.

"Vaccinating children could have a huge impact in the future," Burioni said.

Vaccination of school-age children is on the rise in much of the world, and in the US the Food and Drug Administration (FDA) recently approved Pfizer's vaccine for children ages 5 to 11.

Spain has achieved a high vaccination rate against covid-19.

And the UK announced on Thursday a deal to buy an additional 114 million doses of Pfizer's vaccine for its 67 million citizens by 2022 and 2023. It's a move many developed nations are expected to take as they prepare for a future in that vaccines are administered semi-regularly.

"We do not know how many reinforcements we will need, but it is a logistical and economic problem," added Burioni.

This is the case, at least, in the developed regions of the world.

But the world has had plenty of evidence that COVID-19 will remain a threat anywhere until it is under control everywhere, and experts warn that drastic measures are needed to achieve that goal.

Vaccines: unequal access

The emergence of the omicron variant in sub-Saharan Africa, where vaccination rates are low, has once again underlined the importance of a strategy to vaccinate the poorest nations.

The problem?

There is no strategy, some experts warn.

"There never was a plan, and still isn't, globally," Taylor said.

"It's not just about groups - huge swaths of the world have unacceptably low vaccine coverage."

According to the World Health Organization (WHO), less than 8% of people in low-income countries have received at least one dose of the coronavirus vaccine.

Meanwhile, 63.9% of people in high-income countries have received at least one dose, according to the WHO.

In both the European Union and the United States, about 70% of people have received at least one dose, according to the European Center for Disease Prevention and Control and the Centers for Disease Control and Prevention (CDC) from USA

The possible consequences of this disparity are obvious.

All of the globally problematic new variants of the virus have been detected for the first time in places that experienced large uncontrolled outbreaks where vaccine coverage was low: alpha in the UK last December, delta in India in February and omicron in sub-Saharan Africa.

"Vaccine inequality ... will prolong the pandemic," said Michael Head, senior global health researcher at the University of Southampton.

"The best way to be selfish" is not to be, Burioni insisted.

"You have to provide vaccines to everyone."

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Is there a solution for this inequality?

The possible consequences of this disparity are obvious.

All of the globally problematic new variants of the virus have been detected for the first time in places that experienced large uncontrolled outbreaks where vaccine coverage was low: alpha in the UK last December, delta in India in February and omicron in sub-Saharan Africa.

"Vaccine inequality ... will prolong the pandemic," said Michael Head, senior global health researcher at the University of Southampton.

"The best way to be selfish" is not to be, Burioni insisted.

"You have to provide vaccines to everyone."

The solutions are less clear, but they are not out of reach.

First, the vaccine supply needs to be increased and stabilized.

WHO's vaccine delivery program COVAX predicted in September that 25% fewer doses would be delivered to developing countries than had been anticipated.

"Right now, it's either a feast or a famine situation: (countries) get nothing for three months and all of a sudden they get millions of doses," Taylor said.

"The supply has to arrive predictably and reliably."

Head, who has published research on the supply of vaccines in Ghana in the last year, added that, when vaccines arrive through COVAX, they have often been close to their expiration date, and were not accompanied by freezers or the equipment necessary to transport them through the destination countries.

He called for the creation of new vaccine production centers in Africa to establish a more stable flow of vaccines.

The WHO blamed shortages at a Johnson & Johnson plant for failing to meet the COVAX target in September, and delays at an Indian plant developing AstraZeneca vaccines led to supply problems in the UK and the EU in the early days. months of 2020, demonstrating the dramatic effect a single installation can have on global distribution.

"The supply has to be accompanied by financial support to ensure that those doses can reach the arms," ​​added Taylor.

Richer countries should also fund research and field aid to nations where vaccines are not distributed quickly, Head and Taylor agreed.

"There is a real lack of clear data on what is happening at the country level in sub-Saharan Africa. We need more clarity on this in order to understand the scope of the problem," Taylor said.

Staff receive the covid-19 vaccine at a hospital in South Sudan.

(Photo: Andreea Campeanu / Getty Images)

"We do not have a global responsibility"

This is the question that Duke's COVID Global Accountability Platform tries to address, which Taylor helps steer.

The initiative offers an analysis of trends and obstacles in the poorest countries, where vaccine deployment has faltered.

And developed nations should also lead by example.

Head said that participants in his Ghanaian study "were seeing how the western world had handled the AstraZeneca vaccine," which is the injection that COVAX relies most on, but that it suffered several false starts during its deployment in Europe.

In March, several countries suspended the deployment of AstraZeneca vaccines due to blood clot problems.

The medicines regulatory body in Europe later declared that their use was safe, but confidence was undermined.

Doubts about the vaccine among its participants increased after those setbacks and pauses in the European rollout, Head said.

"What we see and do in the global north with respect to vaccines is seen and heard in other parts of the world."

But above all, the experts demand leadership.

"It's really similar to what happens to us with climate change: we have leaders who are leaders of nations, we don't really have global leaders. We don't have a global responsibility," Taylor said.

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An international look is needed

According to experts, national measures remain vital as the pandemic approaches its final phase.

The waves will continue to affect different nations at different times, and "countries will have to work within their own experiences and capabilities," Head said.

That could mean that a selection of measures to keep the covid at bay is here to stay.

"As individuals, we must continue to protect ourselves and the people around us through masks, social distance and vaccination," said Ana García, professor of Preventive Medicine and Public Health at the University of Valencia (Spain), a country that has achieved a high vaccination rate but still maintaining mask standards.

But it must be accompanied by an international outlook to accelerate the end of the pandemic.

"We have been talking about globalization (in) commerce, finance, tourism for a long time," Garcia said.

"This pandemic - as (with) climate change - seems like a test. It seriously requires us to act as in a global world."

World leaders have replicated this sentiment, but experts say no action has been taken.

Recently, travel bans imposed on South Africa and other nearby nations after authorities successfully detected the emergence of the omicron variant have divided scientists.

The president of South Africa, Cyril Ramaphosa, denounced that the bans are "unjustified", and were condemned by the UN and the WHO.

"I am deeply concerned that those countries are now being penalized by others for doing the right thing," WHO Director-General Tedros Adhanom Ghebreyesus added on Wednesday.

"There is a very real risk that what we are doing now will deter them from facing the next (pandemic)," Taylor said.

"Because there will be a next one."

Global treaty to avoid the same mistakes in the next pandemic

Experts are calling for countries to unite around COVID-19, not separate, and that call was picked up by the WHO this week when it called for a global treaty to avoid the same mistakes when the next pandemic hits.

"Ómicron demonstrates why the world needs a new pandemic deal - our current system discourages countries from alerting others to threats that will inevitably hit their shores," Tedros said.

"At heart, the pandemic is a crisis of solidarity and sharing," he added.

It can be hard to come by.

Several scientists drew parallels with the fight against climate change, an effort that, even at this critical moment, is being held back by competing national interests.

But it is a proposal that many are desperate to see realized.

"Some kind of binding legal agreement that countries sign could give us something of a coordinated global plan, which is what we are missing right now," Taylor said.

"We are never going to be successful with altruism," he acknowledges.

But with a new outbreak in any part of the world that threatens all countries, "the need to do things in a coordinated and global way can be argued nationalistically."

"It would make a difference," Taylor said.

"If we could make it happen."


Source: cnnespanol

All news articles on 2021-12-05

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