On 16 March, 53 days after COVID-19 landed in Europe, two European countries, the UK and the Netherlands, announced their policy to deal with Covid 19: Herd immunization is their mantra, writes Dr. Ying Zhang, professor of Entrepreneurship and Innovation, Erasmus University, Rotterdam, [email protected]
According to the definition of clinical infectious diseases, herd immunity is a form of indirect protection from such disease that occurs when a large percentage of a population has become immune to an infection, whether through infection or vaccination, thereby eventually providing a measure of protection for individuals who are not immune.
To the majority of the scientific world, this strategy on how to deal with Covid 19 came as a big surprise. With a basic reproduction number of COVID-19 of 3 (meaning that one infected person on average can infect another three persons), and a generation interval of 4 days (meaning the interval between the onset of person A to the onset of his/her infected person B is four days, evaluated with the assumption of an average of eight days of incubation period of COVID-19), this coronavirus has been genetically qualified as an epidemic from day one of its appearance.
To figure out how this virus can affect the whole population of Europe, let’s do some simple math:
The whole population of Europe is 741 million. With COVID-19’s basic reproduction number of 3 and generation interval of 4 days, we can generate the below formula
N is the generation of the virus has spread.
Therefore, n = 19.2. This means Covid 19 will take 19.2 generations to infect all Europeans. In terms of days, it is 19.2 * 4 = 76.8 days, equals to 77 days.
This means that if no measures are taken to intervene against the spread of the virus, such as wearing masks, isolating infected people, reducing/eliminating social interaction, etc., the whole European population will get the infection by April 10th, 2020 (counted from the day of the first case of Covid 19 in Europe on January 24th, 2020)
Now the UK and NL announced to "immunize their herd". Will this be effective?
Theoretically and practically, it cannot be effective.
Let’s assume what British and Dutch authority proposed is correct, namely that herd immunity could curb this coronavirus and people who are not immune could therefore be protected, with the basic reproduction number of 3. We can propose the formula below
Where R_0 is the basic reproduction number, P is the proportion of the population that is immune from Covid 19, so 1-P means the portion of the people that will infected by Covid 19.
This formula means that with R_0 =3 to infect the non-immune population, the result must be smaller than 1, so that the virus can be overcome in the end. So, guess what the result is? P = 66.7 %, which means 66.7 percent of the population will necessarily need to be infected to achieve herd immunity from Covid 19.
In the case of the UK, with a total population of 67.5 million people, this means 45 million British people will be infected. If the death rate is an optimistic number of 1 percent (which seems impossible according to the European data coming out of Italy), the UK will at least have 45,000 people die. This is the same death toll that Britain had to endure in World War II.
In the case of the Netherlands, with a total population of 17.18 million people, p=66.7% means 11.4 millions of Dutch people who will need to be infected in order to achieve herd immunity. If the death rate is the same optimistic number of 1 percent (which seems impossible according to the European data coming out of Italy), the Netherlands will have at least 11,400 people die, somewhat less than the number of the military casualties of the Netherlands in World War II (17,000).
On top, the surviving infected herd will end up suffering from the consequences of pulmonary fibrosis. Their damaged and scarred lung tissue will make it difficult for them to breath for the rest of their lives.
In comparison, the battle to achieve herd immunity as a measure against Covid 19, is worse than the nightmare of Word War II. And on top, it might allow Covid20 to be generated along the way if we do not deal with it properly.
How to deal with it? What measures should be applied, at long last, now in Europe?
Let’s see the experience of humans in the past dealing with measles.
Measles has a basic reproduction number of 12 to 18, which is much higher than the reproduction number of 3 applicable to Covid 19 .. On the other hand, measles has a much lower death rate of only 0.3 percent, compared to the optimistic assumption of 1.0 applied to Covid 19.
By 1980 when the first vaccination of Measles came into the market, humanity, for nine centuries, with more than 90 percent of the population infected and immune (meeting the criteria of Herd immunity), never succeeded to achieve full herd immunity protecting those who were not immunized from getting infected. So, in practice , herd immunity was not achieved which will likely be the case for the herds in the UK and the Netherlands mass exposed to Covid 19.
The most effective ways to protect the uninfected, unimmune population before the emergence of a Covid 19 vaccination , are actually the basic ones:
In terms of community, putting strict measure on reducing and/or eliminating social interaction and applying aggressive testing and case tracking as much as possible and as early as possible . Examples of China, HK, Taiwan, Korea, and Singapore taking the most strict measures in the past two months should be seriously studied. It is very disappointing to see how Europe moved too late and too slow, even with the lessons which have been clear to see in China and Italy. Optimistically, if Europe can apply the most effective and strict measures, the infection rate might flatten out in Europe in two months. To do so, locking down and converting as many activities as possible online are essential.
In terms of medical treatment of Covid 19, it would seem essential to go into a fully transparent medical experience exchange with other countries, particularly China, Taiwan, HK, Korea, and Singapore. They seem to have found a success formula that they could share. Inspiring our medical institutions in Europe with practical lessons from those countries and regions will help Europe to reduce the death toll that unnecessary experiments will cause. Also, learn to use alternative treatment methods such as Chinese medicine to help infected people to recover quickly with fewer side effects and prevent unimmune people from getting infected. Meanwhile, the investment and effort to explore new vaccination with other countries have to be continued and accelerated.
The current crisis laid bare considerable flaws of the "modern societies" of the West. Democracies seem ill equipped to deal with a crisis that needs quick and determined action. To opt for herd immunity as a measure to tackle Covid 19 could be translated into: "we do not know what to do, so doing nothing looks like the best option". The influence of the industrial/business complex in such crisis will also need to be discussed and reflected carefully. In essence this crisis could be seen as an opportunity to upgrade the current model of business and its view of a globalized order, so that business and industries may continue to be globally connected but have more roots that keep them locally sustained.
Coronavirus: Health Security Committee updates the common list of COVID-19 rapid antigen tests
The Health Security Committee (HSC) has agreed to update the common list of COVID-19 rapid antigen tests (RATs), including those whose results are mutually recognised by EU member states for public health measures. Following the update, 83 RATs are now included in the common list, of which the results of 35 tests are being mutually recognised. Commissioner for Health and Food Safety, Stella Kyriakides, said: “Rapid antigen tests play a crucial role to slow down the spread of COVID-19. Diagnostics are a central element for member states in their overall response to the pandemic. Having a wider list of recognised rapid antigen tests will also make it easier for citizens to benefit from Digital Green Certificates and to facilitate safe free movement inside the EU in the coming months.”
In addition, the Commission and the Joint Research Centre have agreed on a new procedure for updating the list of common and mutually recognised RATs in the future. From today onwards, RATs manufacturers will be able to submit data and information for certain tests that meet the criteria agreed by the Council on 21 January 2021. This includes only those rapid tests that are being carried out by a trained health professional or other trained operator and excludes rapid antigen self-tests. Moreover, as part of the new procedure, the HSC is setting up a technical working group of national experts to review the data submitted by countries and manufacturers and to propose updates to the HSC.
They will also work with the JRC and the ECDC on a common procedure for carrying out independent validation studies to assess the clinical performance of RATs. The updated common list of COVID-19 RATs is available here. Manufacturers can submit data on rapid antigen tests available on the market here. The Council Recommendation on a common framework for the use and validation of RATs and the mutual recognition of COVID-19 test results in the EU can be found here.
Europe dares to reopen as 200 millionth vaccine dose delivered
As its vaccination drive reaches a third of adults and COVID-19 infections ease, Europe is starting to reopen cities and beaches, raising hopes that this summer’s holiday season can be saved before it is too late, write Michael Gore and Estelle Shirbon.
Exhilarated Spaniards chanting “freedom” danced in the streets as a COVID-19 curfew ended in most of the country at the weekend, while Greece reopened public beaches - with deckchairs safely spaced.
With 200 million vaccine doses delivered, the European Union is on track to achieve its goal of inoculating 70% of its adult population by summer, Commission President Ursula von der Leyen tweeted on Sunday.
And, in Germany, a first weekend of summer sun lifted spirits after Health Minister Jens Spahn declared the third wave of the pandemic finally broken.
Yet, Spahn warned: "The mood is better than the reality."
The national seven-day incidence of COVID-19 cases remains high at 119 per 100,000 people, he said. "That makes it all the more important to keep up the speed of the vaccination campaign."
Across the EU, the seven-day incidence of COVID-19 is 185, according to Our World in Data. That is far higher than in countries such as Israel with 6, Britain (31), or the United States (123), all of which made quicker early progress in their vaccination drives.
In Britain, early orders and approval of vaccines and a decision to give first doses to as many people as possible have driven down infections and fatalities far more quickly.
Prime Minister Boris Johnson was expected to set out the next phase of lockdown easing in England, giving the green light to “cautious hugging” and allowing pubs to serve customers pints inside after months of strict measures.
"The data reflects what we already knew - we are not going to let this virus beat us," Johnson said ahead of an official announcement later on Monday.
Vaccine deliveries were slower initially in the EU under its centralised procurement strategy.
Now, with shots from BioNTech/Pfizer and Moderna relatively plentiful, vaccinations as a share of the population in Europe are growing while countries that made early advances see slowdowns as they encounter hesitancy among the unvaccinated.
Some 31.6% of adults in 30 European countries have received a first dose and 12% a full two-shot regime, the European Centre for Disease Prevention and Control's COVID-19 Vaccine Tracker showed.
France expects to give 20 million first injections by mid-May, and hit 30 million by mid-June.
With infection rates falling and occupancy in hospital intensive care units declining, France plans to start relaxing its curfew and allow cafes, bars and restaurants to offer outdoor service from 19 May.
Improving supply has given countries greater freedom to adapt their strategies following reports of very rare, but sometimes fatal, blood clotting in people who received shots from AstraZeneca (AZN.L) and Johnson & Johnson (JNJ.N).
Germany has decided to make the two vaccines available to anyone who wants them, as long as they have been advised by a doctor - an offer aimed at younger adults who would have to wait their turn otherwise.
Norway’s vaccine commission made a similar call on Monday (10 May), saying the AstraZeneca and J&J shots should be made available to volunteers. Some Italian regions are also offering both shots to people under 60.
With some governments shortening the gaps between doses, and plans for an EU digital “green pass” scheme in June for travellers to provide proof of vaccination or immunity, people cooped up for months are finally daring to make holiday plans.
"We're pinning our hopes on tourism," said Nikos Venieris, who manages a beach in Alimos, an Athens suburb.
Tourism accounts for about a fifth of Greece’s economy and jobs, and the country can ill afford another lost summer. Greece is lifting restrictions on vaccinated foreigners from 15 May.
EU says willing to give AstraZeneca more time for vaccine deliveries
2 minute read
The European Union is willing to see its COVID-19 vaccine contract with AstraZeneca fulfilled three months later than agreed, providing the company delivers 120 million doses by the end of June, a lawyer representing the bloc said on Tuesday (11 May), writes Francesco Guarascio.
The lawyer was speaking in a Belgian court as proceedings in a second legal case brought by the European Commission against AstraZeneca over its delayed delivery of vaccines got underway.
Officials familiar with the case said the lawsuit is mostly procedural - pertaining to the merits of the issue - after a first case was launched in April, and would allow the European Union to seek possible financial penalties.
However, the EU asked in court on Tuesday for a symbolic compensation of 1 euro for what it deems a breach of contract by AstraZeneca.
A lawyer for AstraZeneca complained in court that the EU's executive had launched a second case given that one had already been opened.
AstraZeneca had originally agreed with the EU to deliver 300 million doses of its COVID-19 vaccine by the end of June, but has so far delivered only 50 million.
The EU's lawyer told the court that the bloc could accept the full contract of 300 million to be delivered only by the end of September, but the company should deliver 120 million doses by the end of June.
AstraZeneca's lawyer told the judge that it "hopes" to deliver 100 million by the end of June.
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