Vaccines Alone Will Not Stop New Lockdowns: Changing Strategy for Fighting Delta Variant and Beyond
World Health Network and Covid Action Group Press Release
Most countries are taking woefully insufficient measures to win the fight against the coronavirus spread. Contrary to many official statements, vaccines alone will not allow us to defeat the pandemic unless they are a part of a conscious virus elimination strategy. The Covid Action Group (CAG) scientists have been predicting since last year that the public health policies of most governments were based on unfounded optimism. At that time, governments believed that lockdowns during periodic peak virus outbreaks (i.e. suppression) and speedy vaccination rollout were the best way to reduce the harm posed by COVID-19 to the health of the citizens and the way of life of our societies. The Covid Action Group believes that vaccines are an essential but insufficient tool. Considering the available comparative data from different regions and countries, we note that the “zero-COVID” (i.e. elimination) approach is achieving better results than the more widely adopted suppression policies – not only in public health but also in terms of economic and civil liberty outcomes.
The need for an elimination strategy is even more acute with the worrying incidence of mutations. The CAG has forewarned that the efficacy of the vaccination effort could be undermined as mutations in the virus create steadily more dangerous variants. Control of a deadly infectious disease requires a response that combines a series of effective individual measures into a greater control program than the sum of its parts. The ever-present danger of a variant emerging that allows, to a substantial degree, the virus to evade the immunity from the existing vaccines makes control measures in all countries a matter requiring urgent attention.
There is a pressing need for both public information and governmental and social action to reflect our improving knowledge on transmission of the SARS-CoV-2 virus. Unfortunately, erroneous information that emphasises droplet spread as the primary means of transmission is still prevalent. In contrast, little attention has been paid to the importance of airborne spread and the necessity of improving ventilation. Of vital importance is the availability of fresh and clean air in enclosed spaces where social interactions occur (e.g. schools, universities, healthcare, retail facilities, food processing, public transport etc.).
Our improved understanding of the airborne transmission of the virus also reinforces the importance of wearing face masks, particularly in indoors and public settings. The shift in our understanding of how the virus is spread also indicates that we need to use appropriately manufactured facemasks that meet international standards rather than simple cloth face coverings. There are additional costs attached to producing and supplying proper face masks. It is essential that governments worldwide ensure that they are available to everybody who needs them, irrespective of their financial resources.
Substantial, persistent health problems are developing in people in the aftermath of the early acute symptoms. The pandemic commenced with an emphasis on acute respiratory illness and mortality. The death toll of more than four million people worldwide is a historic tragedy caused by a preventable disease. Efforts have been focused correctly on controlling the virus to drive down case numbers, hospital admissions and deaths. Compounding that tragedy is the growing number of people experiencing persistent symptoms of illness when the acute phase of COVID-19 has passed. The virus has such a powerful effect on many systems or parts of the body, and the range of symptoms present after the acute phase is extensive. This condition is known as ‘Long COVID’ and is developing in people worldwide. It can occur in people no matter how fit and well they were before contracting COVID-19 and can also occur in people who were asymptomatic or who only had mild symptoms in the earlier stages of the illness. The data suggest that Long COVID symptoms occur in about 10 to 35% of adults who develop COVID-19, and the incidence in children may well lie at the lower end of the same range. Many studies indicate that organ damage to the brain, heart and lung occurs in an even higher percentage of individuals.
The development of vaccines, and our improving knowledge of effective preventive measures such as distancing, ventilation, filtration and face masks, has changed the situation in many countries. But few countries have been added to the list of those that have successfully eliminated the virus and have continued to prevent community transmission if new cases appear. There is a need for a new strategic approach in countries where the virus is prevalent. It needs to combine the tremendous benefits of vaccines, when available, with a dynamic range of public health measures that aim to prevent transmission and suppress any outbreaks or flare-ups that occur.