Zhang Wenhong: The Roadmap to Defeat the Covid-19 Pandemic
The source of the new Covid-19 cases in Lu’an, East China’s Anhui province, is slowly coming to light. Drawing on detailed data, professor Wu Zunyou of the Chinese Center for Disease Control and Prevention (China CDC) has come to the conclusion that the center of the outbreak lies in the Bayuquan district of Yingkou, Northeast China’s Liaoning province. By screening close contacts of index cases in relevant cities (Beijing, Shenyang, Dalian and Hefei), the potential timing and location of the case’s origin is narrowing down.
Whether the source is human or material, similar incidents could happen in the future. In fact, as China’s prevention policy gradually relaxes to allow for more international exchanges, the risk of imported cases will hardly decline. The recent outbreak in Taiwan suggests a similar phenomenon. Once imported, cases will spread widely and rapidly.
According to our experience over the past year, so long as Yingkou, Lu’an and Taiwan maintain strict social distancing rules, strengthen testing and track the movement of personnel, it is only a matter of time until their outbreaks are all under control. This is indisputable. Everyone can just sit back and await the good news.
But whether it’s Bayuquan or Taipei, we’ve seen similar incidents replay one after another. It makes one wonder, what is our future going to look like? What does our roadmap for defeating the Covid-19 pandemic look like now? Recent outbreaks have prompted the following revelations:
1. The Covid-19 pandemic is far from defeated, continuing to spread widely around the world. Even a slight relaxation of our containment measures will set the stage for a comeback, which will be no slower than that of last year.
2. The continued globality of the issue means that we can state it definitively — the novel coronavirus has become a resident virus. We must make long-term preparations to fight it.
3. Vaccination efforts around the world are unbalanced, progressing but slowly. Neither Bayuquan nor Taipei have vaccinated enough citizens to create effective “vaccine barriers.” The confirmed cases in Yingkou and Lu’an hadn’t received vaccinations. But being unvaccinated is still the global norm. Even in countries with an ample vaccine supply, rates of vaccination are far from what’s needed to acquire herd immunity and thus block the virus’s continued transmission.
4. The virus does not evolve not as fast as the influenza virus. It cannot fully escape the protective effects of vaccination. Still, a slower pace of vaccination only increases the probability that someday a mutant will emerge that can evade it.
There is, however, some good news. At the World Health Organization (WHO) Emergency Use Listing (EUL) approval meeting for China’s inactivated vaccine held last week in Shanghai, I ran into Nawal Al Kaabi, UAE principal investigator for phase III Covid-19 vaccine trials. Al Kaabi presented China’s inactivated vaccine data to the WHO, which indicates a 93% decline in the Covid-19 hospitalization rate and zero deaths among the vaccinated group. Such data are important, more meaningful than the protection rate itself. If universal vaccination can significantly mitigate the disease’s severity and fatality rate, then Covid-19 can effectively be downgraded to something akin to the influenza virus. By that time, the Covid-19 pandemic will occur every winter, but countries around the world will be able to open their borders again.
The hope is to realize widespread vaccination as soon as possible, before the virus’s mutant variants get the opportunity to escape vaccine coverage. This is our window of opportunity for global normalization.
Now that the WHO has listed China’s vaccine for emergency use, I believe that, along with the implementation of developed countries’ vaccination goals, universal vaccination will gradually become a reality.
After the first-world controlled smallpox through universal vaccination, it took third-world countries 10 years (1967–1977) to complete their vaccination. In the end, the joint efforts of humanity effectively brought the virus under control, eradicating it completely.
I believe the world will also, in the end, walk away from the Covid-19 pandemic. But we haven’t prepared well for this final battle against the virus, even though it is much less harmful than smallpox was. Moving ahead, we need to pool global wisdom, leave our mistakes behind and use global universal vaccination to ultimately gain control over the virus, albeit somewhat differently than we did smallpox. However, as vaccination bellwether countries and regions will be rid of Covid-19 sooner, the world will gradually begin to open.
Zhang Wenhong is director of the infectious diseases department at Huashan Hospital in Shanghai.
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