On the 15th February the European Centre for Disease Prevention and Control (ECDC) issued an update on the risk related to the spread of new SARS-CoV-2 variants of concern in the EU/EEA. Here are some key quotes:
“Due to the increased transmissibility, the evidence of increased severity and the potential for the existing licensed COVID-19 vaccines to be partially or significantly less effective against a variant of concern (VOC), combined with the high probability that the proportion of SARS-CoV-2 cases due to B.1.1.7 (and possibly also B.1.351 and P.1) will increase, the risk associated with further spread of the SARS-CoV-2 VOCs in the EU/EEA is currently assessed as high to very high for the overall population and very high for vulnerable individuals.
Modelling analysis shows that unless Non-Pharmaceutical Interventions (NPIs) continue, or are strengthened in terms of compliance during the coming months, a significant increase in COVID-19-related cases and deaths in the EU/EEA should be anticipated.
Although vaccination will mitigate the effect of replacement with more transmissible variants, and seasonality could potentially reduce transmission during the summer months, easing measures prematurely will lead to a rapid increase in incidence rates, detection of severe cases and mortality.”
Whilst there is some evidence that vaccination programmes in Israel, the UK and Ireland are leading to reduced infection, it’s clear from the ECDC report that variants represent a clear and present danger. We know that mutations (and hence variants) occur where there are high numbers of cases and transmission and that levels of both are high in most countries at present. Further modifications to vaccines takes between 6 weeks and 6 months to manufacture, and that excludes production!
My conclusion is that unless we do something different now, we may lose this battle and be battling the pandemic for at least another year! I came across a report in Le Monde on South Korea that has mounted an effective campaign against the virus, without trashing citizens’ rights. The following is loosely based on the original report in French.
South Korea and Covid19:
In one year, the virus has killed only 1,400 people in South Korea, the first country to be affected after China. Researcher Eric Bidet deciphers, in a forum in the “World”, a strategy based on transparency in information and on the strict isolation of patients.
Just one year ago, the city of Daegu (2.5m inhabitants) was severely affected by Covd19. This was the first outbreak of the virus discovered outside China. Schools across the country were closed immediately and did not reopen until September. Daegu’s entire population was confined for a few weeks. One year later, Korea has just over 1,400 deaths for less than 80,000 cases of Covid-19. Yet, except for very temporary and very local measures, Korea has never confined its population or closed its borders or businesses.
How can we explain such success in the face of an epidemic which, almost everywhere else, has resulted in much more restrictive measures and considerable damage and some irremediable? First, South Korea learnt much from the MERS epidemic in 2015 ansd had put strong public health policy and management in place. Second, the relative success reflects a capacity to adapt and quickly take measures widely accepted by the population, including relaxing administrative procedures authorizing the marketing of products or devices for testing people.
Third, there was great concern for transparency of information and decision-making. Fourth there was huge emphasis and discipline placed on the isolation of patients in order to stop the spread of the virus. Having a public agency dedicated to epidemic management with broad powers has been essential.
This approach guaranteed the effectiveness of the dedicated measures, accelerated their implementation and helped generate great confidence among the population. It also helped to strengthen the legitimacy of the government, as demonstrated by the wide success of the ruling party in the parliamentary elections last spring.
Yet, except for very temporary and very local measures, Korea has never confined its population or closed its borders or businesses. We might conclude the Korean strategy offers a remarkable balance between equity and efficiency while preserving the freedoms of the greatest number of citizens.
ECDC 15th February: SARS-CoV-2 increased circulation of variants of concern and vaccine rollout in the EU/EEA, 14th update
Emerging COVID-19 success story: South Korea learned the lessons of MERS
Le Monde on South Korean Experiences (French)