New COVID Variants Have Changed the Game, and Vaccines Will Not Be Enough. We Need Global ‘Maximum Suppression

By Susan Michie, Professor of Health Psychology and Director of the UCL Centre for Behaviour Change, UCL, Chris Bullen, Professor of Public Health, University of Auckland, Jeffrey V, Lazarus, Associate Research Professor, Barcelona Institute for Global Health (ISGlobal), John N. Lavis, Professor and Canada Research Chair in Evidence-Informed Health Systems, McMaster University, John Thwaites, Chair, Monash Sustainable Development Institute & ClimateWorks Australia, Monash University, Liam Smith, Director, BehaviourWorks, Monash Sustainable Development Institute, Monash University, Salim Abdool Karim, Director, Centre for the AIDS Program of Research in South Africa (CAPRISA), and Yanis Ben Amor, Assistant Professor of Global Health and Microbiological Sciences, Executive Director – Center for Sustainable Development (Earth Institute), Columbia University. Originally published at The Conversation.

At the end of 2020, there was a strong hope that high levels of vaccination would see humanity finally gain the upper hand over SARS-CoV-2, the virus that causes COVID-19. In an ideal scenario, the virus would then be contained at very low levels without further societal disruption or significant numbers of deaths.

But since then, new “variants of concern” have emerged and spread worldwide, putting current pandemic control efforts, including vaccination, at risk of being derailed.

Put simply, the game has changed, and a successful global rollout of current vaccines by itself is no longer a guarantee of victory.

No one is truly safe from COVID-19 until everyone is safe. We are in a race against time to get global transmission rates low enough to prevent the emergence and spread of new variants. The danger is that variants will arise that can overcome the immunity conferred by vaccinations or prior infection.

What’s more, many countries lack the capacity to track emerging variants via genomic surveillance. This means the situation may be even more serious than it appears.

As members of the Lancet COVID-19 Commission Taskforce on Public Health, we call for urgent action in response to the new variants. These new variants mean we cannot rely on the vaccines alone to provide protection but must maintain strong public health measures to reduce the risk from these variants. At the same time, we need to accelerate the vaccine program in all countries in an equitable way.

Together, these strategies will deliver “maximum suppression” of the virus.

What are ‘Variants of Concern’?

Genetic mutations of viruses like SARS-CoV-2 emerge frequently, but some variants are labelled “variants of concern”, because they can reinfect people who have had a previous infection or vaccination, or are more transmissible or can lead to more severe disease.

There are currently at least three documented SARS-CoV-2 variants of concern:

  • B.1.351, first reported in South Africa in December 2020
  • B.1.1.7, first reported in the United Kingdom in December 2020
  • P.1, first identified in Japan among travellers from Brazil in January 2021.

Similar mutations are arising in different countries simultaneously, meaning not even border controls and high vaccination rates can necessarily protect countries from home-grown variants, including variants of concern, where there is substantial community transmission.

If there are high transmission levels, and hence extensive replication of SARS-CoV-2, anywhere in the world, more variants of concern will inevitably arise and the more infectious variants will dominate. With international mobility, these variants will spread.

South Africa’s experience suggests that past infection with SARS-CoV-2 offers only partial protection against the B.1.351 variant, and it is about 50% more transmissible than pre-existing variants. The B.1.351 variant has already been detected in at least 48 countries as of March 2021.

The impact of the new variants on the effectiveness of vaccines is still not clear. Recent real-world evidence from the UK suggests both the Pfizer and AstraZeneca vaccines provide significant protection against severe disease and hospitalisationsfrom 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 illness. We do not yet have clear evidence on whether it also reduces effectiveness against severe disease.

For these reasons, reducing community transmission is vital. No single action is sufficient to prevent the virus’s spread; we must maintain strong public health measures in tandem with vaccination programs in every country.

Why We Need Maximum Suppression

Each time the virus replicates, there is an opportunity for a mutation to occur. And as we are already seeing around the world, some of the resulting variants risk eroding the effectiveness of vaccines.

That’s why we have called for a global strategy of “maximum suppression”.

Public health leaders should focus on efforts that maximally suppress viral infection rates, thus helping to prevent the emergence of mutations that can become new variants of concern.

Prompt vaccine rollouts alone will not be enough to achieve this; continued public health measures, such as face masks and physical distancing, will be vital too. Ventilation of indoor spaces is important, some of which is under people’s control, some of which will require adjustments to buildings.

Fair Access to Vaccines

Global equity in vaccine access is vital too. High-income countries should support multilateral mechanisms such as the COVAX facility, donate excess vaccines to low- and middle- income countries, and support increased vaccine production.

However, to prevent the emergence of viral variants of concern, it may be necessary to prioritise countries or regions with the highest disease prevalence and transmission levels, where the risk of such variants emerging is greatest.

Those with control over health-care resources, services and systems should ensure support is available for health professionals to manage increased hospitalisations over shorter periods during surges without reducing care for non-COVID-19 patients.

Health systems must be better prepared against future variants. Suppression efforts should be accompanied by:

  • genomic surveillance programs to identify and quickly characterise emerging variants in as many countries as possible around the world
  • rapid large-scale “second-generation” vaccine programs and increased production capacity that can support equity in vaccine distribution
  • studies of vaccine effectiveness on existing and new variants of concern
  • adapting public health measures (such as double masking) and re-committing to health system arrangements (such as ensuring personal protective equipment for health staff)
  • behavioural, environmental, social and systems interventions, such as enabling ventilation, distancing between people, and an effective find, test, trace, isolate and support system.

COVID-19 variants of concern have changed the game. We need to recognise and act on this if we as a global society are to avoid future waves of infections, yet more lockdowns and restrictions, and avoidable illness and death.

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  1. divadab

    This approach is all-in for vaccines. No mention of treatments, which seems mighty strange for a medical research paper. Strange and worrying.

    Note that all covid-19 vaccines are only approved for emergency use. In the USA, at least, emergency use authorisation requires that no effective treatments exist. Is this why the CDC and NIH are basically mute on covid-19 treatments, if not actively suppressing them?

    Ivermectin. DO your own research.

    1. Telee

      Many states in the US are now opening up as if the vaccine negates the need for social distancing, masks, hand washing etc. Here in PA. following other states, the governor has opened up the restaurants and bars while reducing testing. From yesterdays NC posts I learned that kids, although not necessarily showing symptoms have a high viral load which makes them efficient spreaders of the virus. Also, that the virus is spread as an aerosol. On NPR an epidemiologist was interviewed and said that 1/3 of the people who contacted covid (includes asymptomatic people) have sustained neurological problems as serious as brain strokes, hemorrhage, psychosis, suppression of mental function as well as cardiac, kidney, liver disorders etc. That means that in the US, at least10,000,000 people will have serious neurological problems. On this basis, it certainly seems irresponsible for restrictions to be alleviated at this time. In the US, it is every person for themselves.

      Another note: Brazil seems to be a tragedy with regard to covid and president Bolsonaro’s disregard. However libertarians who I know think Bolsonaro is the best leader in the world!

      1. Divadab

        We shall see which approach works better in the long run. Texas has about 9% of its population tested positive for COVID-19 and a death rate of 160 per 100k; Sweden about 8.7% tested positive and deaths of 130 per 100k; quebec, still in hard lockdown and curfew has 2.8 tested positive but 120 deaths per 100k. Combined with much higher vaccinated per 100k in Texas says maybe they have achieved herd immunity- tho with a 25% higher death rate plus as you mentioned the long haul effects on that portion of the population that had the actual disease, offset by vaccine risks.

        We shall see.

    2. BlakeFelix

      Better treatments are good, but not getting COVID is better. This paper is arguing for what I think is the right call, stamping it out like a fire. Better treatments are great for improving outcomes but lock downs(China style) with no vaccine is sufficient for eliminating viral spread. Vaccines make it much easier as herd immunity can lower Rt enough to get the viral prevalence down to where contact tracing and localized measures can finish it off(I think, theoretically). That’s what this is calling for. Better treatments and general health can probably lower Rt also, but that’s opening a whole can of worms that isn’t necessary for the strategy they are calling for. Maybe they should have included a discussion, but it would either be brief or complicate the point. In practice you are right those things should be considered.

    3. Yves Smith

      You appear to have a reading comprehension problem. Of the bullet points at the end, three were action as opposed to informational and only one of those was for increased vaccine capacity…..which the authorities are calling for already.

      1. divadab

        Thx for the ad hominem. Please note that NONE of the bullet points you reference mention treatments for covid-19, which was my point entirely. This seems to be general in the health policy mainstream, and includes media enforcement against dissident views, with ad hominems such as yours.

        1. Yves Smith

          It is telling that you lecture me while you misuse terminology. Google is your friend.

          You also straw manned the piece by depicting it as recommending only vaccines, when as I stated it did recommend other practices.

  2. Norm de plume

    No Ivermectin? No Vitamin D? Surely ‘all options should be on the table’, shouldn’t they, if we are serious about a global strategy of “maximum suppression”?
    Isnt prevention better than cure, especially when its safe and cheap? And even if they dont prevent, where is the harm?
    Or is the question rather ‘where is the profit’?

    1. Dwight

      I’ve seen a claim that prophylactic & early treatment with Ivermectin could lower transmission. Haven’t seen any studies supporting this, and I’m just speculating with no scientific training, but if it lowers viral replication during the early stage of symptoms, seems possible. The vaccines are also said to lower transmission by reducing viral load.

  3. Randall Flagg

    Probably a stupid question, if the ideal is “maximum suppression” to stop the spread of Covid and it’s various mutations, then shouldn’t all international, and even domestic air travel within individual nations be grounded? Rail travel too?
    I ask this recognizing that it will slam the brakes on both national and the worldwide economies.

      1. The Rev Kev

        If Ian Welch keeps this up, he may find himself cancelled by social media – for spreading “false Covid information”

        1. Solideco

          Apologizes. I’m not sure if the quotes (“false Covid information”) are meant to imply sarcasm or not. I think so, but I’m usually awful at reading these sorts of things.

              1. Keith Newman

                @RevKev, 9:46am
                Indeed! People’s senses of humour are very different.
                When I was at university many decades ago I caught a bad cold and jokingly told friends and acquaintances I had contracted pulmonary leprosy. (As far as I knew then no such disease existed altho perhaps a Naked Capitalism doctor commenter will tell me otherwise!).
                Wouldn’t you know, a couple of weeks later, after I had fully recovered, someone I barely knew said he hoped I had recovered from my bout with leprosy! He was not joking.
                Since that experience I have never assumed that others share my quirky sense of humour.

                1. The Rev Kev

                  Aussies have a different sense of humour to Americans but mine got further corrupted by Monty Python as I grew up and in later years by the BOFH.

      2. PlutoniumKun

        Welsh of course is right. Whenever I’ve pointed this out – as I’ve regularly done so in my circle since last summer, I’m met with a chorus of ‘yes but…..’ There is always a ‘but’. None of them actually make sense, in human or economic terms. When dealing with highly infectious diseases, short term hard measures are always better than long term half measures. Humanity has known this for centuries, but we’ve forgotten the lessons.

        What I find most infuriating is that nobody is holding to task those people who argued implicitly for herd immunity for the economic impacts. The countries that have successfully suppressed the virus are now reaping the economic benefits. And yet it was primarily business interests that have been responsible repeatedly for lobbying for relaxing restrictions which have ended up costing everyone more. If we’d shut down the airline industry last year, there is a good chance everything would be semi-normal now.

        1. Thuto

          UWhen public health policy during a pandemic is dictated by business lobbies the outcome is as predictable as finding sand on a beach. Now that the European summer is approaching I’m sure the tourism lobby is gearing up to pressure governments to open up, and lessons from what ensued last year after policymakers were pummeled into submission aren’t likely to be heeded.

          1. PlutoniumKun

            This is what I find perversely amusing. The business lobby have done more damage to their own businesses by lobbying for premature openings than if they kept their mouths shut or (more sensibly) lobbied for the type of intense short lockdown that could potentially allow for a much earlier re-opening.

            Here in Ireland there was very intense lobbying by the hospitality industry for a ‘normal’ Christmas. Everyone, including the pubs and restaurants and airlines, are now paying a heavy price for that.

            1. flora

              I agree with your comment entirely. However, when the West sent its manufacturing capacity to Asian countries or outsourced to other countries in general and primarily retained the mostly local service industries… what’s a govt to do? This is not a ha-ha question. Not at all. Can a service economy the govt now depends on shut down? This is mostly a question, I guess, about the so-called intelligence of neolib economics that have hollowed out once robust broad national economies. Probably a question for another time.

              1. H. Alexander Ivey

                What’s a government to do? Lower the boom of predatory rent seeking! Make the landlords take a cut in their rent, then make the banks take a cut in their mortgage rates and collection.

                Most small to medium-sized businesses can survive and keep the lights on and their staff working if only their rent is significantly reduced! That is how the London in the South China Sea (Singapore) is doing it.

      3. Patrick

        I read Ian Welsh’s article and while I agree with his overall point of view there are parts of it that are unclear to me. I question why he is grouping Taiwan, New Zealand and Sweden together as succesful examples of pandemic response, unless the inclusion of Sweden is actually meant to provide negative contrast. I hope he’s not implying that Sweden is a positive example of how lockdowns aren’t necessary. Maybe I misunderstood. He correctly cites Taiwan as an example of how effective measures, especially tracking, tracing, screening of airline passengers and quarantining can eliminate the need for harsh lockdowns. No mention though of the difference in the timeline of when the first covid 19 cases were reported. Taiwan’s was in the 3rd week of January whereas New Zealand’s was almost 5 weeks later. Taiwan had an existing pandemic infrastructure in place that allowed them to respond proactively and avoid the lockdowns. New Zealand’s was not quite as robust, having been partially dismantled over the course of the years. Because of that and the different timelines New Zealand’s response was to lock down very hard, very fast, which was effective and gave them the time and opportunity to effectively scale up testing and contact tracing.

        1. PlutoniumKun

          His layout isn’t clear, but he was giving Sweden as a counter example.

          His point I think isn’t on tactics, but on strategy. In other words, what matters is not what measures they took, but what the target was. Those countries which have tried containment/herd immunity/wait for the vaccine are suffering (the arguable exception being Japan). Those which took aggressive means to eliminate the virus are the success stories.

          1. Cuibono

            By aggressive means it essentially boils down to strict border control IMO.
            No nation doing well did NOT do that. No other measure is seen in all successful nations.

    1. John Bohn

      Not a stupid question! The article makes good points but does not discuss that tradeoffs must be chosen between reducing every risk of mortality, and the social cost of health measures like “face masks and physical distancing.” Personally, I would choose to accept a flu-like level of mortality in exchange for going back to a more-or-less pre-COVID way of life. Others may have different views, but since very few people did use face masks and physical distancing to avoid flu (in the United States at least), that’s a choice most already made.

      1. blep

        Australia, Vietnam, and China have none of those trade-offs because they effectively eliminated the virus in their countries, which is what this is implying, correctly, is the best strategy.

      2. DJG, Reality Czar

        John Bohn: As the article makes clear, the U.S. “let’s live with a disease we can’t be bothered to control” approach isn’t going to work out. The usual U.S. genial incompetence is up against a virus that doesn’t care at all about people’s opinions and selected biblical verses.

        Elimination is the only option in dealing with the virus, as Vietnam, Taiwan, and New Zealand have shown.

        1. Dirk77

          Which goes back to Randall’s point that if you aren’t willing to close borders or at least control them to effectively close them, then you aren’t serious about containment. Which leads to a John Bohn’s comment about being willing to accept it’s endemic. It’s either or. Since I live in the neoliberal failed state of the USA, it’s the latter and that’s it.

      3. JTMcPhee

        This does not seem to be a disease one can bargain with, or about. All well and good for you to “choose to accept a flu-like even of mortality,” except you and others who have “chosen” to eschew public health best practices should not get to make that choice for all the rest of us. And this disease does not seem to be “flu-like” in its manifestations.

        It seems to me that willful, ignorant, and selfish people, and maybe people of bad will given human nature, are keeping the virus active, spreading and mutating into many variants, some of which already are proving to be more transmissible and virulent. It’s so amazing to me that Vietnam, with its approximately 4,000 mile border and ties to global commerce, has largely controlled this disease, where California with a similar border has been a poster child for what happens when commerce is “chosen” over public health.

        1. flora

          Since the seasonal flu seems to have disappeared this past flu season, and masking was de rigueur this past flu season (understandable as a public health measure), I think I’ll continue masking from Nov to Feb for a while no matter the public pronouncements, as well as taking other health measures that look good to me. Careful handwashing for example. My 2 cents.

      4. Darius

        I don’t care if I have to wear a mask in public for the rest of my life. I’m really mystified by the resistance to this in the west, especially the US. What difference does it make? I wear glasses too. They’re not an affront to my liberty. Self-styled “Real Americans” are such drama queens.

        Masks, ventilation, and occupancy limits are going to have to be the norm for the foreseeable future. We basically are at square one in terms of ventilation. I have no trouble going to stores, but I will not sit down in a restaurant or go to a church service or a meeting unless it’s outdoors and people are moderately spaced. It’s time for people to develop COVID judgment. The CDC should help in this, not hinder.

        1. Carla

          Darius, I agree with you in almost every respect (the sole exception being that I do not look forward to wearing a mask in public for the rest of my life, but if it’s necessary to protect others and myself, so be it). I am just appalled at the performance of the CDC. It leads me to believe that as an agency, it is not simply captured, but actively corrupt. That’s a very sad realization for this American.

          Now we know exactly where for-profit health “care” leads.

  4. BillS

    I am not a virologist, but the question that comes to my mind is “The variants may be more transmissible, but are they more dangerous?” Does anybody know which variants are more dangerous and which are less? It seems to me the “one size fits all” model is the wrong approach. Selection pressure will favor the variants that are more successful at reproducing. Reducing the transmission probability (by reducing mobility) in regions where dangerous variants exist makes sense, but would it also make sense to favor the transmission of weaker variants? Limited immunity provided by the weaker variants may give some protection from exposure to the dangerous variants. I would love to hear from experts on the topic!

    1. Skip Intro

      Apparently in the UK variant, transmission and mortality increases were both due to increased viral reproduction rates, meaning a heavier viral load faster, which both increases transmission, and more quickly overwhelms the immune system. That variation seems to be a pure fitness adaptation.

    2. Lee

      Mutations are random but high transmission frequency between hosts reduces a pathogenic mutation’s reliance on the extended survival of an individual host to reproduce itself. A readily available population of hosts allows for a greater probability of the emergence and persistence of more lethal variants. The process of genetic mutation may be a crap shoot, but allowing for rapid transmission of a disease is playing Russian Roulette.

    3. megrim

      I’ve been suspecting for a while that since deaths lag infections by a number of weeks, variants that lead to higher viral loads will have no problems being both more transmissible and deadlier.

    4. Anthony G Stegman

      As has been discussed here(and elsewhere) higher transmission rates will lead to higher death rates. The math is plain and simple.

  5. Mikerw0

    Let’s be honest, we have given up. The collective decision has been made to rationalize the behavior we want to pursue regardless of the consequences. And, as more get vaccinated this will get exacerbated. We are past the point of listening to the scientists, as if we ever really did.

    I cannot count how many friends and family are de facto returning to pre pandemic normal. Spring break family vacations, summer trips, etc. The logic is I can travel safely as I know what to do. This includes international travel. Kids are going back to school, sports, play groups, etc.

    People, or at least those with the right incomes, are easing back into restaurants, offices, etc., all the while tsk, tsk-ing about Spring Break celebrations in Florida.

    So, we will incur a much higher death toll.

      1. Randall Flagg

        I would have to agree with your “Family Blog” comment. The Scott administration has certainly been a bit inconsistent at times, (to be nice) and when comparing Vermont’s protocols on just about anything, to our neighbor to the east, New Hampshire, it’s even more so.

    1. DJG, Reality Czar

      Mikerw0: We never bothered to try. In my work as a writer/editor, I received some text from an author who was explaining “individualism” (U.S. style) to high-school students. He slipped (it appears) and wrote that U.S. individual doesn’t take into account the needs of the community.

      And here we are.

  6. DJG, Reality Czar

    Thanks for this post. It brings up two important course of action being forced on us by necessity: Universal vaccination, including a program to vaccinate in poorer countries, plus elimination of the virus as the only option.

    [And, yes, elimination will be helped by better public health, vitamin D (it appears), zinc (it appears), and better hospital outcomes.]

    In the U.S. of A., where arguing things to death is the dominant ethos, we are going to end up with endemic COVID. But, hey, the U.S. of A. hasn’t done well at controlling HIV, and there are those pesky outbreaks of medieval diseases like cholera, typhus, and plague. It’s the price of freedom!

    As many, many writers have pointed out, the economy won’t recover till the virus is under control (eliminated). Meanwhile, here, “essential workers” are no longer essential, I guess. After the occasional outbreak at the plant, we’ll just get us some new workers as replacements.

    The pandemic has indeed been revealing.

    1. JTMcPhee

      HIV now has effective treatments, though the virus also happily produces variants that have become less- or un-treatable,

      And the world health organizations, NGOs and for-profit corps don’t seem to be putting all that much energy into developing treatments — which as with HIV may not extinguish the virus, just preserve it in the infected population with resurgence dependent on the fortuities of mutation.

      I guess it is a good thing that HIV so far is not transmitted via and airborne route.

      Anyone doubt that CV19 will be followed by other global pandemics? Anyone believe humans in all their diversity will fail to act to preserve life in preference to “staying open?”

      Gaia is not pleased with us…

    2. Cuibono

      elimination is not a possible goal IMO.
      The disease is already in many animal species last i checked and the we have a virus that like many respiratory viruses probably does not generate long last immunity

      1. Samuel Conner

        Elimination may not be an achievable goal, but — per the argument at Ian Welsh’s recent “Zero COVID” ‘blog-post — it is the most effective strategy for managing the pandemic over time. The alternative would appear to be to simply accept shortened life-span and chronic after-effects due to repeated infections in the entire population. I am already seeing hints of this being normalized — a ‘blog-post by a person influential in his social circle who writes of having been repeatedly infected and who suggests that this will happen to his readers, too.

  7. DJG, Reality Czar

    LaStampa has been carrying stories the last several days about a Japanese variant, E484k, that sure looks as though it will be a “variant of concern.” Today’s lede paragraph:

    Infetta di più e sfugge ai vaccini. Sos per la variante giapponese E484k. Rispetto alle mutazioni finora individuate, resiste sia ai vaccini sia gli anticorpi prodotti dal Covid. A lanciare l’allarme sono gli immunologi che l’hanno sequenziata a Tokyo. «Non vanno ripetuti gli errori di un anno fa, bisogna correre immediatamente ai ripari o le terapie intensive andranno in ulteriore sofferenza- spiega alla

    1. Jeff W

      “…E484k, that sure looks as though it will be a ‘variant of concern.’”

      The journalists at La Stampa might be playing a bit fast and loose with the terms.

      Variants in this context refer to different versions of the SARS-CoV-2 virus. E484K is a specific mutation that occurs in several variants, including B.1.351 and P.1 (and in some samples of B.1.1.7), which are “variants of concern.” E484K appears to help the virus avoid certain antibodies.

  8. The Rev Kev

    If anybody is interested, they are going to do a “live-fire’ exercise with Coronavirus and how effective the vaccines are going to be with the new variants soon. In about 15 weeks, they are going to gather thousands of people of all age groups from over 200 countries and bring them together in their own city. They will be all vaccinated of course and they will be testing them, probably on a daily basis if not more often. The interesting thing will be that more than a few of them will be coming from countries where they have not been able to vaccinate their people because all the wealthy countries snapped up all the vaccines for themselves, leaving the rest to pound sand. And of course nobody can say if any new variants will arise in the next 15 weeks. It’ll be great this for researchers.

        1. PlutoniumKun

          There is a really disturbing rise in cases in Tokyo and Osaka (the previous Japanese outbreaks have generally been confined to Tokyo and Hokkaido). I wouldn’t bet my house on the Olympics going ahead.

          1. Basil Pesto

            fwiw in January in a bar I met a purported team doctor involved in the Australian setup (athletics, I think?) and he was extremely sceptical (in fact, outright dismissive) about the Olympics going ahead when I asked him. NB ‘met a doctor in a bar’ is an extremely weak data point.

        2. Keith Newman

          Ahhhh….. Here I am myself not getting someone else’s humour! (see my earlier comment to The Rev Kev)
          I plead guilty with an explanation. I am trying to figure out which vaccine I want and when to take it. It looks like my wife is about to get Pfizer but I prefer to wait for now as our risk level is very low. So I was too eager for an imminent and reliable way to figure it out.

    1. Mantid

      Dear Revisionist Kevlar, love your proposed “exercise”. However, isn’t that about what Pfizer et al are doing right now? Mantid/

  9. Irrational

    Is it even realistic/honest to talk about elimination rather than suppression when it seems to be possible to transmit the virus to and between animals (various new headlines over the last year, apologies for not providing links).
    Won’t there always be a risk of a new virus emerging from there?

  10. dummy

    we dont know nearly enough about this virus, right now europe cases are going parabolic, they are in their third phase, give it some time and you will see the same here, vaccine or not. Looks like this virus likes to thrive in cold weather, expect some reduction in intensity during the summer then off we go by september, its time to build resilience in our communities and economy, this isnt over.
    The mystery is still complete as to how china and vietnam brought this under control.

    1. Cuibono

      the mystery is no mystery at all. Border control and hard measures for brief periods. Solid public health. Same as Austalia, NZ, Taiwan, etc etc

    2. Carla

      “its time to build resilience in our communities and economy”

      @dummy — you’re not an American, are you?

    3. ProudWappie

      Come on, you’re talking cases instead of people dying or in hospitals. Given the large number of tests, mostly on asymptomatic people, you get a significant number of false positives, depending on the test parameters. By keeping up the number of tests, the number of cases seems to be high or increasing, whereas the number of people hospitalized is going down or steady.

      In The Netherlands, the third wave is still missing in action (which is acknowledged by the officials), despite an increase in the number of tests. The number of people dying, compared to the average in other years, seems to have moved into negative territory as well in recent weeks. That’s another counter which is way more objective, and less easily gamed, compared to the number of positive tests.

  11. antidlc

    “For these reasons, reducing community transmission is vital.”

    Well, that ain’t happening, sadly.
    Photos of the packed crowds at the Texas Rangers’ opening game look like they were taken in 2019

    I’ve given up.

    Here is a list of things family members and acquaintances have done and said:
    1) Throughout the whole pandemic, some really have not changed their lives — multiple trips to Florida, hopping on airplanes, continuation of sports (ice hockey, no less!), large family gatherings at Thanksgiving and Christmas, going out to a restaurant at Easter.
    2) “I’ve already had covid, so I don’t have to worry.”
    3) Plans for airline trip in May, “I’m vaccinated, I have my N95 mask. At least I won’t die if I catch it.”
    4) “This is all overblown. If COVID was that bad, we’d have all the workers at Walmart, Target, and grocery stores dropping like flies.”

    I’ve given up. I’m tired of banging my head against the wall.

    1. Darius

      I’d be less concerned about a baseball game if only every other seat was occupied. There should be a limited number of tickets to a game. I don’t care about outdoor activities with adequate distancing, masks, and crowd control. Climate-controlled luxury boxes are out. Sorry, rich dudes.

    2. flora

      I note that Texas is below the 35th North latitude, (vit D production in winter months), that Texas has a good voluntary uptake of the vaccines, and that Texas’s numbers overall are falling. Shorter: I’m waiting for data to show that Texas Rangers’ game attendance is either a horrible breach of public health or is an interesting data set to add to public health decision making based on X, Y, Z variables. imo.

    3. BlakeFelix

      Barring a dangerous varient wave(which is very possible IMO) I would think that a vaccinated person flying with an n95 mask on shouldn’t be too high a risk, but other than that, I agree. Sigh…

      1. Yves Smith

        Flying is not that high risk period. Filtration of air on planes is excellent. Studies have determined the main risk is crowding while boarding/deplaning. TSA process might pose a risk too if they don’t make people space out in lines.

        Having said that I still would be nervous about a long-haul flight…

  12. Tom

    How many actual variant cases?
    Yes, there are a handful of cases, often separated by great distance.
    But how many actual variant cases, and how many people are affected?
    I don’t hear of more than just the headlines, lot much information.

    1. Patrick

      The majority of the variant cases in the U.S. are In the state where I live. The Florida Department of Health refused to release the data on variants despite requests from a local newspaper. They withheld the information for 57 days until faced with a lawsuit alleging violation of Florida’s public records laws and the constitution. They disclosed the information one day after the suit was filed, on March 19th. At that time there were 912 variant cases. Yesterday Florida counted 3,191 of the UK (B.I.I.7) variant cases, an increase of 840 from a week ago. In addition there are 64 cases of the Brazilian (P.1) variant and 24 cases of the South African (B.135) strain. The Florida DOH continues to hold back data specifying the counties in which the variants are located, despite repeated requests. Health officials are concerned about what will happen when the crowds of college kids who flocked here en masse for spring break return home from Florida.

      1. Tom

        I’m a data scientist. I was yelling bloody murder a year ago. I could see the data was not available. Apparently they are gonna do what they are gonna do, and there is not much point in the citizens asking good informed questions. Losing my account every time I say something is not worth it. Let them inject everyone on the planet, apparently everyone is wearing a mask and eagerly signing up to be injected.

    2. Mantid

      Dear Tom, there are many variant “cases” as Patrick mentions. A Feb. 2020 doc. from the WHO documents 129 total variant types (including missense, non-coding, synonymous, etc.). As this is a bit old, I’m not positive but I think we’re up into the low thousands of “variants”. Some are nondescript and some substantial such as the South African, UK, etc. Here’s the link:

  13. IM Doc

    One little observation that is tangential but very germane to this article.

    Our health officials and Big Pharma seem hell-bent on vaccinating teens and kids as soon as possible. Despite the fact that kids have just a miniscule chance of getting ill. I believe the numbers from the CDC in the past week revealed a total of less than 150 serious illness or death in kids in America out of 85 million kids.

    It seems completely absurd – and I feel unethical – to be contemplating vaccinating kids in this country before every old or infirm (in other words high risk for death/morbitity – but also high risk for variant production) person in this entire world has been vaccinated.

    I have seen this concern repeatedly stated by epidemiologists in this country accompanied with a face palm – it is just they are not the medical “experts” pumping Pfizer stock on the TV.

    This problem is going to have to be solved by the world – not individual countries. If that advice is not heeded – the consequences may be severe.

    Furthermore, as it was nicely pointed out by someone on CNBC this AM – the average blockbuster drug in this decade in this country is a 20 billion dollar generator over 5-10 years. This vaccine has already put SIXTY BILLION or so into Pfizer’s coffers – risk free. They are going to do everything they can to keep that cash coming – whether it improves the health of the world or not. Hell – three boosters a year – why not?

    The corporate money grubbing – what is it going to take to reach its event horizon?

    1. flora

      Oh, indeed. And I thank you again for you calm and sensible and guided by experience comments.

    2. Tom

      So who is supposed to provide balance for the Pharma fan club?

      Ordinary people who try to comment get deplatformed from Facebook and Twitter and generally are ignored and discredited.
      Apparently the plan is to inject everyone of all ages, as soon after birth as possible.
      Regardless of health conditions: everyone get jabbed. Zero thinking or discussion or dialog or dissent allowed.

      1. flora

        Everyone gets jabbed, or, maybe not. I was at a local feed store today and all their doors, including dock doors, were open. Excellent ventilation throughout. They are listening to what makes sense. They are smart and careful. Teh ‘Makes-more-money’ Wall St. crowd doesn’t have a lot of purchase with them, for good reasons. ( Ergo, they’re deploradoes, heh.)

      2. Basil Pesto

        Apparently the plan is to inject everyone of all ages, as soon after birth as possible.
        Regardless of health conditions: everyone get jabbed. Zero thinking or discussion or dialog or dissent allowed.

        Isn’t this… how vaccination has worked for the last several decades (in the so-called developed nations, anyway)? I understand these vaccines are unknown quantities and support further study as discussed by Yves, below, but this is a level of hysteria I would expect from an outright anti-vaxxer. If the vaccine is shown to be safe, why would this be controversial? I understand that’s a significant ‘if’, but my concern now is that a large group of people will simply never accept these vaccines as safe, because big pharma, which is of course ad hominem.

        fwiw one of my earliest memories is going to the local council with Mum for (I think) a booster shot, at about age 3. I think it was for MMR? I dimly remember my little rectangular vaccine booklet with all the stamps in it for all the different vaccines. I had no say in the matter (if I had, I would’ve skipped it!).

    3. polecat

      But we’re supposed to ‘Trust the Perts’ & ‘Trust the Lience’, for Big Pharma and their investors sake??

      Hell No!

      I’ll take my chances with hurd immunity. You’ll can quiver in fear all you want. The result of which seems to be headed towards “Papers Please” and all that entails …

      No thanks.

    4. Yves Smith

      The reason that I am not keen about vaccinating kids is that there’s only been one study done on them, IIRC of 2000 by Pfizer, of 12 to 15 year olds. Not happy with an interested party running that show.

      However, contrary to the blather of Rochelle Walensky, the large scale UK studies show that kids are major Covid vectors even though the disease poses little risk to them. Elementary school children were 2x as likely as adults to bring Covid into a household, and older kids, 7x.

      So if you want to reopen schools and not risk a new wave, your alternatives are:

      1. Outdoor classes

      2. Open windows a ton (note not even possible in a lot of schools)

      3. Upgrade HVAC systems (not cheap and not fast)

      4. Vaccines

      1. fajensen

        Well, “Option 3” is well overdue anyway. In Denmark there are specific exemptions made for the occupational health legislation for schools precisely because:

        1) there is a huge overhang of garbage HVAC systems, that never worked properly,
        2) the responsibilities for fixing it and the bill for it falls onto the government,
        3) it is only children, they can take it, and anyway, they don’t get a vote on it,

        and, most importantly,

        4) To keep the ideological purity reasons of their dead faith, the “leadership” does not (yet) want to deal with COVID-19 in a similar way that the Oil Crisis was dealt with.

        The neoliberal- and npm- infestations in government would really, really loathe if COVID-19 forces them to demonstrate that directed and effective efforts by government actually *can* transform a country and the “way things are done” into a much better state for all, and in only 1-2 decades.

        Except, they have a problem: The current crop of Danish business leaders were mostly created by the Oil Crisis. We all have good memories from those years, with new freedoms, and new opportunities opening up. They *want* government to step up, and “transform”, give the same to their kids, and they will make them do it too “… or The Jobs gets it”, as we say.

        1. Yves Smith

          Look, I agree 100% that the HVAC ought to be upgraded and that should have been a priority. But parents are screaming for schools to reopen. So effectively the pressure to vaccinate kids is coming from them.

  14. nothing but the truth

    never let a crisis go waste has morphed into never let a crisis disappear.

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