Millions of lives depend on the end of the pandemic
ALL PANDEMIC finish thereafter. The Covid-19 has embarked on this path, but it will not be eradicated. Instead, it will gradually become endemic. In this state, circulating and mutating from year to year, the coronavirus will remain a threat to the elderly and infirm. But once installed, it’s highly unlikely to kill on the monstrous scale of the past 20 months. The Covid will then be a familiar and manageable enemy, like the flu.
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Although the destination is fixed, the route to endemicity is not. The difference between a well-planned trip and a chaotic trip could be measured in millions of lives. The end of the pandemic is therefore a last chance for governments to show that they have learned from the mistakes they made in the beginning.
As the pandemic subsides, weekly recorded cases and deaths have been declining around the world, including America, since the end of August. Britain is a country with high and increasing cases, but it has had a lot of illnesses and has had a successful vaccination campaign. Because 93% of Britons have antibodies, around 250,000 cases per week result in hundreds of deaths instead of thousands. This is the path of endemicity.
No one knows how many people in the world have such protection, but you can risk a very rough estimate. About 3.8 billion people have received at least one dose of the vaccine. The Economist estimates that during the pandemic, excess deaths are between 10 and 19 million, with a central estimate of 16.2 million. Working backwards, using assumptions about the share of fatal infections, this suggests that 1.4 to 3.6 billion people have had the disease, or 6 to 15 times the official number. There is an overlap, as many have been both vaccinated and infected.
The pool of immune people makes covid less dangerous. However, to end the pandemic, the world is likely to face several tests.
One is the wave of winter infections in the northern hemisphere. Covid thrives when people spend their time indoors. If cases start to overwhelm hospitals, governments will need to step in. One line of defense is treatments, including promising new antiviral drugs like molnupiravir, which halve the rates of serious illness if given early, but still await approval. Another is measures such as wearing masks, protecting care homes and closing hot spots, including clubs and bars. The question is whether governments have learned to act quickly, but proportionately.
A second test is the mutation. Genetic sampling of infections serves as an early warning if the Delta variant is moved, but poorer, unvaccinated parts of the world are still not being monitored. A new variant may require an overhaul of the vaccines. It’s a lot easier than starting from scratch, but it would require the production and approval of new jabs and possibly dropping the inventory of old ones. This could trigger a re-reading of the supply struggles that marred the start of 2021.
The biggest test is how to protect the billion or more people without immunity. China’s response is to try to eliminate the virus with severe and costly quarantines and lockdowns. This leaves time for vaccination and drug storage. The Communist Party has used the country’s small number of cases as proof that its system is better than democracy, so abandoning its zero covid strategy is politically embarrassing. However, as places like New Zealand have accepted, the coronavirus is not going to go away. One day China will have to give in.
Ultimately, people will get immunity either through infection or through vaccination. Because vaccination is so much safer, governments need to put as many needles into the guns as possible. According to Airfinity, a data company, 11.3 billion doses should have been produced by the end of the year and 25 billion by June 2022. If so, the global supply will soon no longer be a constraint. – the delay depends on the demand for boosters. Not all vaccines are equally effective, but all are much better than getting infected.
This impending vaccine glut means exporters are already expected to ship doses in bulk. Instead, many are withholding supplies for booster shots and for immunizing children, who very rarely die from covid. Doses are promised for next year, but they are needed now.
The final obstacles to immunization will be reluctance and the capacity of local health care. The World Health Organization has set a target of 40% of each country to bite by the end of the year. A world vaccine summit set a target of 70% by September 2022. But different countries have different vaccine needs depending on their demographics, ability to deliver vaccines, and the threat of covid versus. other diseases like malaria and measles. Global targets risk turning sensible priorities into failures.
It’s a daunting to-do list. Will governments rise to the challenge? This is where the final test resides. As covid fades into the background, rich countries may begin to lose interest in the coronavirus. The disease it causes risks becoming the death of poor countries, like so many others. ■
All of our stories relating to the pandemic can be found on our coronavirus hub. You can also find trackers showing the global vaccine rollout, excess deaths by country, and the spread of the virus across Europe.
This article appeared in the Leaders section of the print edition under the headline “Covid-19’s rocky road”