Covid-19 Vaccine Success Will Not Eliminate Virus Risk, UK Concludes


LONDON – In the middle of this year, a Covid-19 vaccine will be offered to all adults in Britain in what is on track to be the fastest inoculation launch in a major Western country. But disease modelers advising the UK government recently made a sobering projection: 56,000 more deaths from Covid-19 by the summer of next year, even if the country tiptoes out of lockdown and vaccines work.

The study points to the uncomfortable prospect that even with an effective vaccine, the virus will continue to affect society and that some restrictions may need to be periodically reintroduced to control the spread of the coronavirus.

The bottom line: companies and governments around the world must prepare to live with Covid-19, accepting that the virus will not go away, but equally that the lockdowns cannot continue forever once hospitalizations are reduced to manageable levels.

“We cannot escape the fact that lifting the lockdown will result in more cases, more hospitalizations and sadly more deaths,” British Prime Minister Boris Johnson told Parliament on Monday as he charted a slow and conditional route out of the lockdown. “Therefore, there is no credible route to a Covid-free Britain or indeed a Covid-free world.”

Future loading

Disease modeling by scientists advising the UK government suggests that Covid-19 will likely continue to cause illness and death even after widespread vaccination once public health measures are relaxed.

Accumulated deaths (February 12, 2021 – June 30, 2022)

Accumulated hospital admissions (February 12, 2021 – June 30, 2022)

* All adults age 50 and older, healthcare workers, and other priority groups receive at least one dose of vaccine by April 21.

† All clinically vulnerable over 70s receive two doses by May 21.

Accumulated deaths (February 12, 2021 – June 30, 2022)

Accumulated hospital admissions (February 12, 2021 – June 30, 2022)

* All adults age 50 and older, healthcare workers, and other priority groups receive at least one dose of vaccine by April 21.

† All clinically vulnerable over 70s receive two doses by May 21.

Accumulated deaths (February 12, 2021 – June 30, 2022)

Accumulated hospital admissions (February 12, 2021 – June 30, 2022)

* All adults over 50, healthcare workers, and other priority groups receive at least one dose of vaccine by April 21.

† All clinically vulnerable over 70s receive two doses by May 21.

Accumulated deaths

(February 12, 2021 – June 30, 2022)

Accumulated hospital admissions

(February 12, 2021 – June 30, 2022)

* All adults over 50, healthcare workers, and other priority groups receive at least one dose of vaccine by April 21.

† All clinically vulnerable over 70s receive two doses by May 21.

Caution does not undermine the value of a successful vaccine implementation. New data released Monday showed that Britain’s vaccination program, which has given at least one injection to more than a third of the country’s 53 million adults, has significantly reduced infections and further reduced serious illnesses.

But while the program is paving the way for a gradual unblocking of the country over the next four months, the government is not treating it as a silver bullet. “Vaccination will lower rates, but it will not eliminate this,” Chris Whitty, England’s chief medical officer, said Monday. He added that Covid-19 “is likely to be a problem during the upcoming winters.”

Epidemiologists have long warned that Covid-19 will likely circulate for years, or even decades, leaving society to grapple with other endemic diseases like influenza, measles, and HIV.

No vaccine is 100% effective and no population will be fully inoculated. So a big question mark in a vaccinated society is what levels of infection governments will be willing to live with before introducing restrictions, said David Salisbury, who previously chaired the World Health Organization’s Strategic Advisory Group of Experts on Immunization.

A Covid-19 patient receiving care at London’s King’s College Hospital last month.


Photo:

Kirsty Wigglesworth / Agence France-Presse / Getty Images

“It is a political and social question about what is acceptable,” he said.

The British government expects Covid-19 in the long term to be treated like the flu. In the last five years, between 4,000 and 22,000 people died each year from influenza in England. Last year, Covid-19 killed 130,000 people in the UK.

In the US, Covid-19 has claimed more than 500,000 lives. Influenza is estimated to have killed between 22,000 and 61,000 people in the US over the past five seasons, depending on the severity of the outbreak.

The entire adult population of England is expected to be offered a Covid-19 injection by the end of July. England’s government is currently planning to ease almost all restrictions by June 21 in four gradual stages. But even with good vaccine acceptance, the virus will still be around. Children will not be immunized, which will allow the virus to circulate freely among one fifth of the population. Not everyone will accept the vaccine.

To make matters worse, infection rates start from a very high base in the UK.

As highly communicable Covid-19 variants spread across the world, scientists are racing to understand why these new versions of the virus are spreading faster and what this could mean for vaccine efforts. New research says the key may be spike protein, which gives the coronavirus its unmistakable shape. Illustration: Nick Collingwood / WSJ

Modelers warn that it could translate into a jump in cases where restrictions are eased. With a vaccine that is 85% effective and three-quarters of British adults inoculated, about half the population would be vulnerable to the virus, suggests the Imperial College London model, because children will not have been vaccinated.

A relaxation of restrictions during the summer would lead to an increase in infections in the fall. Even if the restrictions are not fully eased until August, Imperial College estimates that they could result in 56,000 deaths by June of next year. The University of Warwick model that also informed UK government policy reached similar conclusions.

Marc Baguelin, an epidemiologist at Imperial College, says the model is a base case and could underestimate both the absorption of the vaccine and its effectiveness in slowing the transmission of the disease. Other reasons for optimism include improving treatments for those hospitalized with severe Covid-19, which are reducing the risk of death especially for younger patients.

On the other hand, the virus could mutate to make vaccines much less effective. Some vaccines have already shown reduced efficacy against variants identified in South Africa and Brazil, for example. “That makes the prospect of a third wave much bigger,” said Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.

The long-term effects of Covid-19 infection in younger people are still known. If they are harmful, governments can be more cautious about allowing younger people to resume life without vaccinations or social distancing.

Part of the problem is reflected in simple math. If 90% of the population takes a vaccine that is 90% effective, that leaves 19% unprotected, said David Sarphie, CEO of Bio Nano Consulting, which worked with Imperial College to develop Covid-19 modeling tools for governments and Business. “Nineteen per cent of the UK population is 12.9 million,” he said.

A Covid-19 vaccination center in London this month.


Photo:

Andy Rain / Shutterstock

Successive waves of hospitalization and death in Western countries last year show that the disease can cause significant illness even when a relatively small number of people are exposed, said Martin Hibberd, professor of emerging infectious diseases at the School of Hygiene and Medicine. Tropical London.

“Even with vaccines, there are still a significant number of people who will remain vulnerable,” he said.

Disease experts say the prospect of substantial levels of severe illness and death, even in a population with extensive vaccine coverage, highlights the need for effective systems to detect the virus and isolate those infected and their contacts. Governments must work hard to improve vaccine coverage and overcome misinformation and doubts, they say.

In the UK, UK government advisers say it may be necessary to reintroduce the wearing of masks or working from home in winter to curb outbreaks. The government is reviewing whether the British will have to prove they are vaccinated or virus-free to resume activities such as going to the pub or the office.

Underscoring the potentially bumpy path to normalcy, the UK Treasury is likely to extend emergency financial support for the economy when the government budget is presented next week.

Overall, the coronavirus “will be something we will live with,” said Roy Anderson, an epidemiologist and professor at Imperial College.

Write to Max Colchester at [email protected] and Jason Douglas at [email protected]

Corrections and amplifications
With a vaccine that is 85% effective and three-quarters of British adults inoculated, about half of the UK population would be left vulnerable to the virus, the model suggests. An earlier version of this article incorrectly stated that half of the adult population would be left vulnerable. (Corrected on February 23)

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