Health
Vaccine fairness is important to end the COVID-19 pandemic — but that’s not enough
Susan Michie, Chris Valen, Jeffrey V. Lazaro, John N. Lavis, John Thwaites, Liam Smith, Salim Abdul Karim, Janice Ben Amor
By the end of 2020, it was strongly expected that high levels of vaccination would ultimately give humanity an advantage over SARS-CoV-2, the virus that causes COVID-19. In an ideal scenario, the virus would be contained at a very low level without further social disruption or mass mortality.
But since then, the new “Variant of concernHas emerged and spread around the world, putting current pandemic efforts, including vaccination, at risk of derailment.
Simply put, the game has changed and the success of the current global deployment of vaccines no longer guarantees victory.
No one is really safe from COVID-19 until everyone is safe. We are in the fight against time to slow down global transmission rates enough to prevent the emergence and spread of new variants. The danger is that mutations will occur that can overcome the immunity given by vaccination or previous infections.
In addition, many countries lack the ability to track new mutations through genomic surveillance. This means that the situation can be even more serious than it looks.
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As a member of Lancet COVID-19 Public Health Commission Task Force, we call For urgent action in response to new variants. These new variants cannot rely solely on vaccines to provide prevention, but they do mean that strong public health measures need to be maintained to reduce the risk of these variants. At the same time, vaccine programs need to be accelerated in a fair manner in all countries.
Together, these strategies provide “maximum suppression” of the virus.
What are the variants of concern?
Genetic mutations in viruses such as SARS-CoV-2 frequently appear, but some mutants have “”Variant of concernPeople who have been infected or vaccinated before, or More contagious Or may lead to More serious illness..
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Currently, at least three variants of SARS-CoV-2 of concern are documented.
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B.1.351, first reported in South Africa in December 2020
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B.1.1.7, first reported in the UK in December 2020
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P.1, first identified in Japan among travelers from Brazil in January 2021.
Similar mutations occur simultaneously in different countries. This means that even border control and high vaccination rates do not always protect a country from mutations in its own country, including mutations that may have substantial community infections.
How dangerous is the new COVID-19 variant?
If the level of infection is high and therefore SARS-CoV-2 is extensively replicated anywhere in the world, the subspecies of concern will inevitably occur and the highly infectious subspecies will prevail. International mobility expands these variations.
South Africa’s experience is that past infections with SARS-CoV-2 Partial protection only For the B.1.351 variant, it’s about Increased infectivity by 50% Than existing variants. B.1.351 variant has already been detected at least 48 countries As of March 2021.
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The effect of the new mutant on vaccine efficacy is not yet clear.Recently Real world evidence The UK suggests that both Pfizer and AstraZeneca vaccines Severe illness And Hospitalization From the B.1.1.7 variant.
On the other hand, the B.1.351 variant Reduce efficacy Effect of AstraZeneca vaccine on mild to moderate illness. There is still no clear evidence as to whether it also reduces efficacy for serious illnesses.
For these reasons, it is important to reduce community infections. There is not enough single action to prevent the spread of the virus. We need to maintain strong public health measures in parallel with vaccination programs in all countries.
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Why you need maximum suppression
Every time the virus replicates, there is an opportunity for mutations to occur. And, as we have already seen around the world, some of the resulting mutants are at risk of compromising the effectiveness of the vaccine.
That’s why we have Called For a “maximum restraint” global strategy.
Public health leaders need to focus on efforts that help maximize viral infection rates and prevent the emergence of mutations that may be a variant of new concern.
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Rapid vaccine deployment alone is not enough to achieve this. Continuous public health measures such as face masks and physical distance are also essential. Ventilation of the indoor space is important, some of which is under the control of the people and some of which requires the adjustment of the building.
Fair access to vaccines
Global equity in vaccine access Is also important. High-income countries need to support multilateral mechanisms such as COVAX facilities, donate excess vaccines to low- and middle-income countries, and support increased vaccine production.
However, if it is necessary to prioritize the countries or regions with the highest prevalence and infection levels of the disease, which are at greatest risk of developing such mutants, in order to prevent the emergence of viral variants of concern. there is.
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Healthcare professionals help those who manage healthcare resources, services, and systems manage short-term hospitalization increases during surges without reducing care for patients other than COVID-19. Must be available.
The medical system needs to be better prepared for future variants. Control efforts should involve the following:
- Genome monitoring program to identify and rapidly characterize newly emerging mutants in as many countries as possible around the world
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Rapid and large-scale “second generation” vaccine programs and increased production capacity to support the fairness of vaccine distribution
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Study of vaccine efficacy against existing and novel mutants of concern
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Adaptation of public health measures (such as double masking) and recommissioning to healthcare system arrangements (such as securing personal protective equipment for medical staff)
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Behavioral, environmental, social, and System intervention, Ventilation enablement, person-to-person distance adjustment, effective search, testing, tracking, quarantine, support system, etc.
A variant of COVID-19 of concern has changed the game. We, the global community, need to be aware of this and act in order to avoid future waves of infection, more blockades and restrictions, and avoidable illnesses and deaths.
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This article was originally published conversation..Read the original article Here..
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