At the onset of the corona virus infection, it was believed that this outbreak would only last a few months. Later this assumption turned out to be completely wrong and for almost a year and a half the whole world is faced with this epidemic. When scientists learned that the corona virus could spread across the air on a large scale, there were concerns that this epidemic could happen again and again. This is what happened during the 1918 influenza pandemic.
I did not even know the strain and variant of the virus
Other than that, very few scientists had predicted that we would see so many types of viruses mutate in such a short time. This made the virus more transmissible and more able to evade an immune response. The virus has evolved so rapidly that the delta variant, which is currently wreaking havoc around the world, is at least twice as contagious as the ancestral virus.
Is the discussion on collective immunity unnecessary?
This means that mass immunity or collective immunity is no longer a world worth discussing. We must refrain from using the term in reference to SARS-CoV-2 (Covid virus), as it will not materialize – or likely will not happen – in our lifetime. When leaders and others talk about herd immunity, unfortunately, they misunderstand that the current tools at our disposal are sufficient to eliminate the virus. This is not what we have now.
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Now we should talk about living with the virus
Instead, we should be talking about how to live with the virus. The huge success we’ve had with COVID-19 vaccines allows us to do so without actually entering the collective immunity threshold. Debunking the concept of herd immunity creates a false belief that we are in fact going to reach a stage where this virus is about to end. This is unlikely to happen. It will remain so. There are many dangers in continuing to pretend that this is possible.
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First, it can undermine confidence in vaccines. Even if South Africa meets its goal of vaccinating 67% of the population – as set by the Department of Health – there will still be an outbreak of COVID-19. The result would be that people would start to doubt the benefits of vaccination. Additionally, for the now dominant delta variant, immunity to infection (not just COVID-19 disease) would need to be close to 84% to reach the herd immunity threshold.
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Second, failing to face the reality that collective immunity cannot be achieved would mean countries like South Africa continue to believe that ongoing sanctions will get them there. It will jeopardize people’s lives on many fronts, including education and livelihoods.
What is collective immunity?
Collective immunity occurs when an average person infected with the virus does not infect another person on average. So we come to a situation where the immunity of the population against infection by the virus is such that there are very few people in the environment who transmit the infection to others.
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Indeed, they have developed an immunity against the infection, or at least an immunity insofar as they will be able to inactivate the virus very quickly even if they are infected and will be able to transmit it to other people. So herd immunity basically means that you have created a complete blockage in the chain of transmission of the virus in the population. However, some changes have forced us to change the way we think about collective immunity. Today, it is seen more as an aspiration than a real goal.
What changed ?
First, the evolution of the virus and the mutation that has occurred. A set of mutations has made the virus more transmissible or contagious. The Delta version is an example. We initially thought the SARS-CoV-2 infection rate was between 2.5 and 4. In other words, each infected person in a fully vulnerable population will infect an average of two and a half to four others. . But the delta version is at least twice as permeable. This means that the delta version’s transition rate is probably closer to six instead of three.
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The second change is that the virus has shown the ability to mutate which makes it resistant to antibody neutralizing activity induced by previous infection with the parent virus, as well as antibody responses induced by current COVID-19 vaccines.
The third big problem focuses on the timing of security. Our responses from memory last for at least six to nine months of this time. But that doesn’t mean they’ll protect us from infection caused by the progressive variant, even though such memory responses help shorten the clinical duration of infection, leading to less severe COVID-19.
The fourth problem preventing the achievement of the collective immunity threshold is the uneven distribution of vaccines, slow and slow vaccination across the world. Unfortunately, this provides a favorable environment for the continued growth of the virus.
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The vaccine is necessary for everyone
No country will close its borders forever. This means that the entire world population must reach the same stage at around the same time, which is not currently the case: only 1% of the population in low-income countries has been vaccinated. And the figure for the world population is 27%. To overcome the delta version, we will need to develop protection against infection for around 84% of the world’s population as quickly as possible.
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The only permanent solution is to learn to live with the virus. This will require ensuring that most individuals, especially adults, and especially those at high risk of developing severe COVID-19 and at high risk of dying, get vaccinated as soon as possible. I think this can be achieved by vaccinating 20 million people in South Africa – against the 40 million target set by the government. But those two million people will have to cover 90% of people over 60 and 90% of people over 35 who also suffer from other diseases.
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If South Africa gets to this point, it could return to a relatively normal way of life, even as the virus continues to spread and cause occasional outbreaks. It will also guarantee a limit ensuring that its healthcare system will not be overburdened and large numbers of people will not die.
need to be comfortable with corona
We just need to be comfortable with the idea that SARS-CoV-2 will also be one of the many other viruses that cause respiratory illness every day. Usually a mild infection, and sometimes severe illness. So unfortunately people will continue to die from COVID-19, but certainly not to the extent that has been seen in the past 18 months. Not being more serious than what is seen in each influenza season (10,000 to 11,000 deaths) in South Africa would be a major breakthrough for COVID-19.
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All countries should learn from Britain
The British experience is where we should be going. It returns to a relatively normal lifestyle, provided you have a sufficient number of people vaccinated, especially those who are at high risk of developing severe COVID-19. There are currently around 85% of adults in the UK who have already received at least one dose of the vaccine. As a result, they are able to remove almost any restriction. There is an increase in the number of cases of delta infection. But when it comes to hospitalizations and deaths, there has been very little change. Most of the people (97%) who are still hospitalized and die from COVID-19 are those who have decided not to get the vaccine.
Chabbar A. by Madhi, University of the Witwatersrand Johannesburg