COVID-19: the next phase and beyond

After living with COVID-19 for more than 2 years, with more than 6.2 million confirmed deaths (but probably many more, with an estimated 20 million excess deaths) and more than 510 million confirmed cases, the world is finds at a critical point. The omicron wave, with its high transmissibility and a lighter course than previous variants, especially for people who are fully vaccinated and without comorbidities, is declining in many countries. Restrictions are easing and people are slowly returning to pre-pandemic activities such as meetings, office work and cultural events. Mask warrants are being lifted in many countries. Testing and surveillance have diminished and travel is widely restarted. People are understandably exhausted and want to forget about the pandemic. That would be a serious mistake.

First of all, the situation of the pandemic is not the same all over the world. China, for example, continues to use its so-called zero-COVID dynamic strategy of mass testing, quarantine of those who test positive, and blockade of districts or even entire cities (the most recent in Shanghai). The Chinese authorities have applied these measures harshly and ruthlessly, without much regard for human costs. The goal, according to Chinese officials, is to prevent further spread, protect the health care system and prevent deaths. The problem is that older and vulnerable people are often not fully vaccinated and the effectiveness of authorized vaccines is suboptimal. For China, the top priority must be to accelerate an effective vaccination strategy. The current approach is not a long-term solution for the Chinese.

Second, the global vaccination strategy is far from over. Unacceptable inequality in vaccination persists. The WHO goal of complete vaccination of at least 70% of people in all countries by June 2022 is far out of reach. Although 59.7% of people worldwide have received two doses of vaccine, in more than 40 countries less than 20% are completely vaccinated. Even in high-income countries, a significant proportion of the population continues to refuse vaccination. The emergence of a new variant of SARS-CoV-2 is almost inevitable with high continuous transmission rates. Omicron BA.4 and BA.5 subvariants first observed in South Africa are being closely monitored. Surveillance must be maintained everywhere.

Third, vaccine inequality is reflected in slow and delayed access to one of the few effective oral treatments for COVID-19: paxlovid. When taken early, paxlovid reduces the risk of hospitalization and death by 89%. Although high-income countries are asking for millions of doses from the manufacturer, Pfizer, the mechanisms for making paxlovid available in low- and middle-income countries through the group of drug patents are slow. An agreement has been reached with 35 generic manufacturers in 12 countries, but the drug is not expected to be delivered before 2023.

Finally, now is the time to plan, learn from mistakes, and build strong, resilient health care systems, as well as nationally and internationally prepared funding strategies with lasting funding. The capacity of health systems needs to be strengthened, not only to be prepared for future pandemics, but also to deal immediately with delays in the treatment, diagnosis and care of other diseases after the interruption of the last two years. Vaccination campaigns are urgently needed to catch up on diseases such as measles. Preparedness plans, both nationally and internationally, should place great emphasis on early data exchange and transparent monitoring. Health should be the underlying principle, taking into account both human and animal health. At the 75th World Health Assembly (May 22-29, 2022), there is an opportunity to examine progress in the revision of the International Health Regulations and to discuss more about a pandemic treaty: the process of a treated has been too slow. The Intergovernmental Negotiating Body’s progress report is not expected until 2023.

At the national level, countries need independent consultations on their responses to COVID-19. Learning from mistakes is never easy and governments can be reluctant to even accept that they have been made. When the UK High Court ruled last week that it was illegal to discharge hospital patients into residences without COVID-19 evidence, the UK government claimed to have acted with the best evidence available at that time. moment. This is a blatant lie. Evidence of asymptomatic transmission was clearly available in late January 2020.

Now is not the time to move away from COVID-19 or rewrite history. It is time to commit vigorously, redouble our efforts to end the acute phase of the 2022 pandemic for all, and lay a solid and sustainable foundation for a better future with clear responsibilities and honest acceptance of uncomfortable truths.

Linked articles

Leave a Reply