No, absolutely not.
Whilst this model may conceivably apply in the future, in my view this ignores some key issues.
1. This is a novel virus and we don't understand it yet.
2. Long COVID is HUGE
BBC News - Is catching Covid now better than more vaccine?
bbc.co.uk/news/health-58…
Whilst this model may conceivably apply in the future, in my view this ignores some key issues.
1. This is a novel virus and we don't understand it yet.
2. Long COVID is HUGE
BBC News - Is catching Covid now better than more vaccine?
bbc.co.uk/news/health-58…
3. We know infection, even in vaccinees can leave tissues damaged. We don't understand this yet either.
4. We aren't used to dealing with virus pandemics, where the sheer scale of infection can mean things are different to the endemic viruses we are used to.
5. This is hugely
4. We aren't used to dealing with virus pandemics, where the sheer scale of infection can mean things are different to the endemic viruses we are used to.
5. This is hugely
important because we appear to still be at the start of several possible trajectories for SARS2 evolution. This is explained brilliantly here by folks far better qualified than I...
sciencemag.org/news/2021/08/n…
sciencemag.org/news/2021/08/n…
6. In essence, it's a common mistake to assume viruses become less virulent over time. However, we know this doesn't happen unless the damage to host populations limits viral transmission.
7. There may be trade offs between increasing transmissibility and immune escape, there
7. There may be trade offs between increasing transmissibility and immune escape, there
may not. Until we understand this better we won't know what SARS2 will look like as time passes.
8. This may mean that we need variant vaccines, possibly including additional targets, and/or delivered via different routes...hopefully mucosal immunity can be achieved.
9. However
8. This may mean that we need variant vaccines, possibly including additional targets, and/or delivered via different routes...hopefully mucosal immunity can be achieved.
9. However
we need the safest possible start point that also limits the ability of the virus to evolve. In my view, this requires mass vax coverage supported by sensible restrictions to limit prevalence. Note, this is aiming to AVOID long and harsh lockdowns.
10. We can do this with our
10. We can do this with our
current vaccines, which are fantastic! They're not perfect, but they'll certainly perform better if we achieve high (90%+) coverage. This IS doable, it requires political will.
11. Until we have built the vaccine wall, assuming that natural infection is a reliable or safe way to
11. Until we have built the vaccine wall, assuming that natural infection is a reliable or safe way to
approach protective levels of population immunity is, in my view, a huge risk, both in terms of safety and efficacy. Long COVID should be enough of a concern to make this a massive problem, especially with current infection rates ahead of schools returning.
12. So, what would I
12. So, what would I
do? Obviously vaccinating everyone is the ideal, these vaccines are safe. This should not preclude supporting covax, @GYamey explains this far better than I can, he helped establish it after all...💪
13. We need to slow or stop Delta. Our vaccines may help this, but they should
13. We need to slow or stop Delta. Our vaccines may help this, but they should
not do it alone. Sensible precautions like masks and ventilation are a no-brainer imo...please no tokenistic crap about masks being population control, honestly...🤦♂️
14. The future vax game really depends on us winning the race, or at least keeping up with the virus as it changes
14. The future vax game really depends on us winning the race, or at least keeping up with the virus as it changes
, the main battleground will be countries with high prevalence and part-vaxed populations...ahem. I truly hope that we might avoid getting into a flu-like scenario with annual boosters that aren't used widely enough to prevent all severe disease. Current policy seems to be on
this track...please refer to points above.
15. The key is keeping Rt below 1, which can be achieved by a Swiss cheese approach, vax being several slices. BUT, this will also require effective contact tracing...this, combined with border control should limit outbreaks.
16. Our
15. The key is keeping Rt below 1, which can be achieved by a Swiss cheese approach, vax being several slices. BUT, this will also require effective contact tracing...this, combined with border control should limit outbreaks.
16. Our
testing capacity remains high, and our genetic surveillance is world class, no worries there, but we need to deploy LFDs appropriately as red, not green light tests.
17. To increase our immune repertoire beyond spike is one argument for the BBC article, and this is absolutely
17. To increase our immune repertoire beyond spike is one argument for the BBC article, and this is absolutely
essential for longer term plans, plus mucosal immunity might help towards a sterilising response. Thankfully there are projects developing other routes and targets in the pipeline. However, there are also whole virus killed vaccines available now, time to try this as a booster?
18. Finally, I don't mean to berate the BBC article, it is right to discuss this sort of thing and one day I hope we do reach a point where natural exposure is similar to seasonal CoVs. However, we're not there yet, and vaccines are by far the safest route to get there imo.
As an addendum, I tried to keep this simple, plus I always tweet about this, BUT, natural infection endangers CEV people tremendously, as does high prevalence, plus long COVID is growing at scary rates.
Our current course is wrong. We need high vax coverage ASAP.
Our current course is wrong. We need high vax coverage ASAP.
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