By the end of 2020, people strongly hope that high-level vaccination will enable humans to finally beat the SARS-CoV-2 (SARS-CoV-2) virus, which is the virus that causes COVID-19. Ideally, the virus will be contained at a very low level without causing further social damage or mass deaths.
But since then, new “variables of concern” have emerged and spread all over the world, putting current pandemic control efforts (including vaccination) at risk of derailment.
In short, the game has changed, and the successful promotion of vaccines on a global scale is no longer a guarantee of victory.
Unless everyone is safe, no one will truly be safe from COVID-1
Moreover, many countries/regions lack the ability to track emerging mutations through genome monitoring. This means that the situation may be more serious than it seems.
As a member of the Public Health Working Group of the Lancet COVID-19 Committee, we call for urgent action to respond to new changes. These new variants mean that we cannot rely solely on vaccines to provide protection, but must maintain strong public health measures to reduce the risks posed by these variants. At the same time, we need to equitably accelerate vaccine programs in all countries.
Together, these strategies will provide “maximum suppression” of the virus.
What are “variables of interest”?
Gene mutations in viruses like SARS-CoV-2 often occur, but some variants are marked as “variants of concern” because they can reinfect people who have previously been infected or vaccinated, or are more likely to spread, or Can cause more serious diseases.
Read more: UK, South Africa, Brazil: A virologist explains each COVID variant and what it means for the pandemic
There are currently at least three interesting variants of SARS-CoV-2 that have been recorded:
B.1.351, first reported in South Africa in December 2020
B.1.1.7, first reported in the UK in December 2020
P.1, first discovered among Brazilian travelers in Japan in January 2021.
Similar mutations can occur in different countries at the same time, which means that even border controls and high vaccination rates cannot protect the country from indigenous variants, including variants of concern, because of the large amount of community transmission in these places.
If there is a high level of transmission anywhere in the world, and therefore large numbers of SARS-CoV-2 are replicated, variants that will inevitably attract more attention, and more infectious variants will dominate. With the development of international mobility, these variants will spread.
The experience of South Africa shows that the SARS-CoV-2 infection in the past can only partially resist the B.1.351 variant, and the possibility of transmission is about 50% higher than that of the previous variant. As of March 2021, B.1.351 variants have been detected in at least 48 countries/regions.
The impact of the new variants on vaccine efficacy is unclear. The latest practical evidence from the United Kingdom shows that both Pfizer and AstraZeneca vaccines provide effective protection against serious diseases and hospitalizations of the B.1.1.7 variant.
On the other hand, the B.1.351 variant seems to reduce the efficacy of the AstraZeneca vaccine against mild to moderate diseases. We have no clear evidence to show whether it will also reduce the effectiveness of fighting serious diseases.
For these reasons, reducing community transmission is crucial. No single measure is sufficient to stop the spread of the virus. We must work with each country’s vaccination plan to maintain strong public health measures.
Why do we need the greatest suppression
Every time a virus replicates, there is a chance for mutations. As we have seen all over the world, some of the resulting variants have the potential to erode the effectiveness of vaccines.
Therefore, we call for the adoption of a “maximum suppression” global strategy.
Public health leaders should focus their efforts on minimizing the rate of viral infections, thereby helping to prevent mutations that may become new mutations of concern.
The timely introduction of vaccines is not enough to achieve this goal. Continued public health measures, such as masks and physical distancing, will also be crucial. Ventilation of indoor spaces is very important, some of which are under people’s control, some of which will require adjustments to the building.
Fair access to vaccines
Global equity in access to vaccines is also crucial. High-income countries should support multilateral mechanisms such as COVAX facilities, donate surplus vaccines to low- and middle-income countries, and support increased vaccine production.
However, in order to prevent the emergence of the virus variants of interest, it may be necessary to prioritize the countries or regions with the highest levels of disease prevalence and transmission, where such variants are most at risk.
Read more: 3 ways to vaccinate the world and ensure that everyone benefits, rich or poor
Those who have control over healthcare resources, services, and systems should ensure that support is provided to medical professionals to manage the increased hospitalization in a shorter period of time during the emergency, without reducing the need for non-COVID-19 patients Care.
The health system must be better prepared for future variants. Inhibition should be accompanied by:
Genome monitoring program to identify and quickly characterize emerging variants in as many countries as possible in the world
Rapid large-scale “second-generation” vaccine plans and increased production capacity can support the fairness of vaccine distribution
Existing and new vaccine efficacy studies focusing on variants
Adjust public health measures (e.g. double cover) and recommit to health system arrangements (e.g. ensure that health workers are provided with personal protective equipment)
Behavioral, environmental, social, and system interventions, such as achieving ventilation, distance between people, and effective finding, testing, tracking, isolation, and support systems.
Read more: The World Health Organization says the number of COVID cases that occur every week around the world is declining-but “if we stop fighting it in any way, it will roar again”
The interesting variant of COVID-19 has changed the rules of the game. If we, as a global society, want to avoid future waves of infections, more blockades and restrictions, and avoidable diseases and deaths, we must recognize and take action.