Sure enough, in his most recent Washington Post column Fareed Zakaria latches onto the point I made yesterday—we can’t end the pandemic here without controlling our borders and isolating the United States from foreign contact or inoculating the entire world:
We can all see the outlines of a post-pandemic world. With vaccinations ramping up in the United States and Britain, and with Israel and the United Arab Emirates racing toward herd immunity, it is easy to imagine that a return to normalcy is on the horizon. The only question seems to be: How long will it take?
But we might be seeing a false dawn. Despite the amazing progress we’ve made with vaccines, the truth is that our current trajectory virtually guarantees that we will never really defeat the coronavirus. It will stay alive and keep mutating and surging across the globe. Years from now, countries could be facing new outbreaks that will force hard choices between new lockdowns or new waves of disease and death.
The basic problem is in how the vaccine is being distributed around the world — not based on where there is the most need, but the most money. The richest countries have paid for hundreds of millions of doses, often far in excess of what they need. Canada, for example, has preordered enough to cover its 38 million residents five times over.
Meanwhile, Nigeria’s 200 million people have not received a single dose of the vaccine.
and, as we are learning, it won’t be enough to inoculate the entire world. We must inoculate again and again and again.
I believe there is a long-term/short-term factor that Mr. Zakaria is ignoring. Frankly, I don’t believe it’s possible to inoculate the entire world multiple times per year every year forever. There will be bottlenecks that we haven’t even imagined yet in doing that. In the short term we can inoculate the population of the U. S. Without controlling travel between the U. S. and other countries in the long term that will prove to be a futile gesture.
I also believe that in the truly long term we will need to live with a heightened level of risk than we thought we did in 2019. Because this is only the first of many pandemics and what is presently being characterized as a “once-in-a-century” event will become an annual one or a multiple times annual one. That is the implication of more people, faster, cheaper travel, and easily traversed borders.
Starting to seem like my son’s trip to South Africa this summer may be in question / understatement. It was rescheduled from last summer.
I’ve paid attention whenever I’ve seen a reference to SA in regards to COVID, and they are few and far between. Occasionally I’ve see attempts to explain why Sub-Saharan Africa has not suffered from the pandemic; I linked to one here in which blood samples from Nigeria were shown to have evidence of immunity derived from previous coronaviruses not present in comparable U.S. blood samples. The whole paper doesn’t have any value without the underlying assumption that Nigeria/ SSA is having a substantially different experience with the pandemic.
Other issues are certainly demographics (age); climate; and I believe Scott Sumner did a long thought piece on why this is a first world pandemic, not a third world, which included the notion that advanced economies are built on large, complex social networks through which viruses spread and are difficult to restrict. Lack of testing makes this complicated, but just looking at Worldometer, Nigeria is 179th for cases per capita, worse than Vietnam, better than Australia.
What would be the basis for giving a Nigerian a vaccine over a Nigerian-American, or a 65-year old descendent of sharecroppers in the Mississippi delta?
Equity!
It is a pickle.
We know the mRNA vaccines storage requirements limits them to developed countries. There are articles online expressing skepticism that the viral vector vaccines (Oxford/AstraZeneca, J&J, Sputnik VI, some of the Chinese vaccines) can be effective in inoculating multiple variants on a yearly basis.
There’s also the fact humanity has never mass vaccinated the entire world against a single disease in a year, never mind doing it multiple times in a year.
Just looking at this country; there are issues. How does the government ensure the vaccine is effective against a mutant strain before it is approved? The standard way would be a phase 2/3 trial; but that requires a huge outbreak to occur to prove it. If the government does not require a trial and just hope for the best like the flu vaccine; the efficiency could be < 60% and an outbreak could occur while everybody has false reassurance from a vaccine.
Let alone vaccinating the entire world multiple times a year forever.
My solution would be to shut down all foreign travel while vaccinating the people of the U. S. Canada will do the same. Then forge an agreement with Mexico to do the same thing and help Mexico vaccinate its people. And so on.
But all of this takes time, personnel, and materiel. Most of all it requires the realization that there is no more urgent matter requiring attention. That’s why I think we’ll all just need to learn to live with a heightened level of risk.
I dont think we will give up travel. We might restrict it some at best. We will just accept more deaths.
Steve
@CuriousOnlooker, I’m not that pessimistic about the mRNA vaccines, the preliminary reporting appears to be that they will work well. Pfizer and Moderna are willing to update the coding for a stronger fit and can do so quickly. I don’t see changes to the “ingredients” that would cause any new health risks, and I think the design adjustments would not be likely to create any observable changes to efficacy rates barring the largest of trials. I assume FDA would approve small updates the way it does influenza vaccine changes. While we need to prepare for the worst, etc., I can’t help but think if we assume the need for mRNA update too readily, we’ll be entering the path of mRNA dependency for the next generation.