Editorial: Free the vaccine, not the virus

IssueAugust - September 2021
Comment by Milan Rai

England is entering a dangerous period. British prime minister Boris Johnson is knowingly creating the perfect conditions to breed stronger variants of COVID-19 that can overcome the vaccine.

A group of experts warned in a letter to the medical journal, the Lancet on 7 July that the complete lifting of almost all COVID restrictions in England on 19 July was ‘dangerous and premature’.

One of the concerns of the expert group was the long-term health of the millions of children and young people who are not vaccinated who will become infected with COVID-19.

The experts warned that it’s possible that ‘hundreds of thousands’ of people will go on to develop long COVID: ‘This strategy risks creating a generation left with chronic health problems and disability, the personal and economic impacts of which might be felt for decades to come.’

Symptoms of long COVID include insomnia, tiredness, headaches and muscle pain.

Estimates of long COVID rates in children in the UK range from 4.4 percent of schoolchildren who’ve had COVID to 13 percent for 12–16-year-olds.

Another concern expressed in the 7 July experts’ letter to the Lancet was that ‘the government’s strategy provides fertile ground for the emergence of vaccine-resistant variants.’

‘With the way we are opening up, we could see one or two million infections in a highly vaccinated population; that is the perfect environment for generating new variants that might be more resistant to vaccine protection.’ That is the view of Martin Hibberd, professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine, also speaking to the Lancet Respiratory Medicine on 12 July.

The COVID-19 virus (SARS-CoV-2) continues to mutate. It can change into versions l that transmit from person to person faster/more easily l that are more deadly l and/or that can overcome vaccines.

Delta and after

The problem with the Delta variant, now the most common version of SARS-CoV-2 in the world, is that it does the first thing very well. It transmits much faster between people than the last ‘variant of concern’. It doesn’t seem to be more deadly or cause more serious disease, though.

On the third issue, Delta seems to be a bit better at infecting vaccinated people than previous variants. However, it doesn’t seem to cause serious disease or death in vaccinated people. (That still leaves fully vaccinated people with some risk of long COVID if they become infected.)

Going back to Martin Hibberd’s point, when you have a lot of infection in a population with a lot of vaccinated people, this gives the virus a good chance to enter someone whose antibody defences are weaker or weakening.

The four ‘variants of concern’ have developed in places that were very heavily affected by COVID-19: England, South Africa, Brazil and India.

That observation led Tulio de Oliveira, a bioinformatician at the University of KwaZulu-Natal in South Africa, to the theory that having a large pool of people who’ve survived one wave of COVID may create the conditions for the virus to evolve antibody resistance.

This also applies to having a large pool of vaccinated people as well. In both cases, you have a lot of people with antibody defences against COVID-19. By the law of averages, in some people the defences will be weaker than in others.

If someone is exposed to COVID-19 and their antibody response is very weak, their immune system won’t be strong enough to kill off all the SARS-CoV-2 virus in their body. That will leave some ‘stronger’ strains alive: the versions of the virus that are better able to cope with antibodies created either by vaccination or previous infection.

This is one way of breeding antibody-resistant, which is to say vaccine-resistant, versions of COVID.

That’s exactly what England is doing now: increasing the level of infection in a highly-vaccinated population.

Vaccines are important, and we need to vaccinate everyone in the world who is willing to be jabbed, but vaccines by themselves are not enough. As professor de Oliveira told the FT in January: ‘This should be a wake-up call for all of us to control transmission, not just in our own regions but globally.’ (emphasis added)

We need to keep levels of infection as low as we practically can in order to avoid new ‘variants of concern’ developing.

That means vaccinations, yes, but it also means working from home if we can, it means masks, it means ‘social distancing’, it means avoiding crowded indoor or enclosed situations – especially where there’s no good ventilation. The measures that the British government is throwing away.

Topics: Covid-19
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