The coronavirus will threaten humanity for years to come and the answer is not to talk about ending the pandemic but to be ready to extinguish outbreaks wherever they erupt in the world, a leading expert says.
Vaccines alone will not be enough, because the virus will mutate to overpower the protections offered by the current vaccines, becoming an “ever present threat”, according to Dr David Nabarro, the World Health Organisation’s special envoy on Covid-19.
“This isn’t going to be a disease that can be eradicated any time soon. Indeed, it may not be possible to eradicate it at all, because, by constantly mutating, the virus is indicating its game plan for survival,” he told the Evening Standard’s Vaccine for the World.
“Rather than talking about defeating the pandemic, why don’t we talk about being ready for Covid. And being ready for Covid means being able to defend against the virus when it starts to appear in a community with a spike of disease.”
Those defences should be a mix of vaccinations, hygiene practices, mask-wearing, physical distancing and test, trace and isolate programmes.
“These things have to be brought together into a system, but it’s not going to be vaccination alone that’s going to solve the problem. It’s not going to be hygiene alone that’s going to solve the problem, it’s not going to be face masks alone … its actually pulling them all together and be super clever about how you utilise the balance between these various interventions.”
The next frontier of the coronavirus is the developing world where the virus is embedding itself in the poorest communities in clusters that can explode into surges of infections.
“We believe these explosive surges that have occurred for example in India, in Nepal, in Trinidad and Tobago, in Haiti in Paraguay - we think these are the virus mutating, we think these are the result of people moving around, but most importantly we think that these are here to stay,” said Nabarro, co-Director of the Institute of Global Health Innovation (IGHI) at Imperial College London.
After leaders of the G7 major industrial nations pledged one billion Covid vaccine doses for poor countries, Dr Nabarro said they now need to be accountable for the delivery of the jabs, including overseeing the rollout and boosting manufacturing capacity.
“Move from promising that you’re going to do things to organising a programmed response,” Dr Nabarro said. “We actually need the G7 leaders not to position and posture but to take responsibility for the situation and develop and implement and then be accountable for a global response.”
Of the billion doses pledged, at least 870 million will be shared directly by donating surplus vaccines, with the aim of delivering at least half by the end of 2021. Most of the vaccines will be delivered through the COVAX scheme led by the WHO.
"Many other countries are now facing a surge in cases – and they are facing it without vaccines. We are in the race of our lives, but it’s not a fair race, and most countries have barely left the starting line," said WHO Director-General Tedros Adhanom Ghebreyesus following the G7 announcement.
Dr Tedros has called for a massive global effort to vaccinate at least 10 per cent of the population of all countries by September, and at least 30 per cent by the end of the year. To reach these targets, 100 million doses are needed in June and July and 250 million by the end of September.
“The right thing to happen is that the world helps African nations do everything they possibly can to get ready for new surges... That means dense testing and really rigorous isolation of those with the disease and localised ring vaccination where you vaccinate around a spike to stop cases from coming out. The drag is, there’s no vaccine,” Dr Nabarro warned.
The haphazard delivery of vaccines to Africa has helped to stoke scepticism around the jabs, he said.
“For poor people, people on the margins, people on daily wages, there is a real suspicion of what elites are offering,” said Dr Nabarro.
“This idea that we can give away a little bit of vaccine here and there and they ought to be pleased and grateful, all you do with that is create suspicion and anger and frustration.”