Is vaccinating against Covid enough? What we can learn from Chile and Israel

Contrasting lessons from the two countries, both with high rates of inoculation against the virus, show the danger is not past

A trio of countries stand out for the effectiveness of their Covid-19 vaccination programmes: Israel, Chile and the UK. All have managed to inoculate an impressively high percentage of their people but each has fared very differently in controlling the disease.

Israel has done so well it is resuming university lectures, concerts and other mass gatherings and has opened up its restaurants and bars. By contrast, Chile is experiencing soaring levels of Covid cases and faces new lockdown restrictions.

In Britain, deaths and hospital admissions have plummeted but it remains to be seen what will happen when lockdown restrictions are eased in England from Monday. (Scotland, Wales and Northern Ireland each have their own timetables for easing.) Will the UK follow the grim example of Chile or the happier precedent of Israel?

Vaccinations

The nation will soon find out although it should be noted that Israel and Chile are not the only ones that provide helpful illustrations of how the fight against Covid-19 should be shaped in coming months. Australia, New Zealand, France, Germany and many others provide key lessons.

Nevertheless, it is Chile that supplies the sharpest warning for the UK. Its health workers have delivered first jabs to 37% of the population but daily cases are still rising sharply. Several reasons have been put forward for this unexpected jump: the spread of more virulent coronavirus strains from Brazil; increased numbers of Chileans travelling around the country; and reduced adherence to social distancing after the vaccination programme gave people a false sense of security.

The importance of this last point was stressed by Prof Lawrence Young, a virologist at Warwick Medical School. “I think that Chile shows the danger of being too reliant just on vaccines. Vaccines are fantastic but they’re never going to be a solution on their own and what is happening in Chile provides us with a very clear warning.”

People wait to receive their second dose of the Covid-19 vaccine in Santiago, Chile
People queue for the second dose of their Covid vaccine in Santiago. Despite a successful vaccination programme, Chile has seen sharp rise in cases. Photograph: Esteban Félix/AP

Prof Stephen Griffin, of Leeds University School of Medicine, agreed. “You still need to get cases under control while you’re vaccinating. If you don’t, you will still be in trouble.”

Chile therefore reveals the dangers of vaccine hubris. By contrast Israel demonstrates the need for constant planning and preparedness. Since its mighty vaccine rollout began, it has set up a number of initiatives to maintain its progress against Covid. These include a system of green passes that are given to people who have either had both vaccine doses or have recovered from the illness and are therefore deemed unlikely to be infectious. The plan is controversial and many have protested against its imposition.

“However, for universities, it has helped to get students back into lecture theatres where academics can teach students in person,” said Linda Bauld, professor of public health at Edinburgh University. “These are the sorts of measures we need to be discussing now so we can be sure we are opening up safely over summer.”

Two other Israeli measures were also highlighted by Bauld. Antibody tests – which will show if a person has Covid antibodies either from a vaccine or a previous infection – allow international travellers arriving in Israel to avoid quarantine. At the same time, health authorities are also considering giving vaccines to older children once they are approved by regulators. These initiatives show just how far ahead Israel is planning, added Bauld.

Other scientists point to the examples of Australia and New Zealand. The former has had just a handful of cases despite launching its vaccination programme only a few weeks ago – thanks to the rapid closure of its borders last year and its carefully managed hotel quarantine system that has reduced Covid’s spread to minuscule levels. By contrast, Britain’s lamentable test, trace and isolate system remains rickety and unproven – despite the fact it will be crucial to suppressing new outbreaks of Covid-19 once restrictions are lifted. “To put it simply, we have not learned just how important isolating infected people is still going to be,” said Griffin.

Then there is the issue of vaccinating the world – for until this happens, Covid-19 will remain a menace and Britain will continue to be under threat. It therefore has a role to play in providing jabs around the globe.

Israeli musician Ivri Lider performs in front of an audience wearing protective face masks
Israeli musician Ivri Lider performs for an audience wearing face masks and who had shown a ‘green pass’ to enter a stadium in Tel Aviv last month. Photograph: Oded Balilty/AP

Scientists estimate that more than 11bn doses of vaccines will be required to provide double jabs for 70% of the world’s population – a number that would, hopefully, achieve some form of global herd immunity. However, recent figures indicate that the richest nations – who make up a fifth of the world’s population and include the UK – have already bought 6bn doses, while the remaining poorer nations – four-fifths of humanity – have secured only 2.6bn.

In the face of this huge vaccine imbalance, India and South Africa have asked the World Trade Organization to suspend patent rights on various Covid-19 techniques, vaccines and drugs to help them produce their own treatments to cope with the pandemic. The proposal has now been backed by more than 100 nations.

“We cannot repeat the painful lessons from the early years of the Aids response when wealthier countries got back to health while millions of people in developing countries were left behind,” Winnie Byanyima, executive director of Unaids, the United Nations HIV/Aids agency said in the journal Nature recently.

This point was backed last week by Dorothy Guerrero, head of policy at Global Justice Now, an NGO campaigning for equitable vaccine access. She accused rich countries of hoarding vaccines at the expense of low- and middle-income countries. “There is one rapid, sure-fire way to increase global vaccination – waive patents on Covid-19 vaccines and let countries produce their own jabs. Countries like the UK need to step up.”

However, the European Union, the UK and many other western nations, together with major pharmaceutical companies, argue that waiving patent rights would not help. They say making vaccines involves the implementation of a series of careful, quality-controlled steps.

Negotiating the distribution of patent rights for these different processes would take far too long. It would be better to increase vaccine production to its highest level and then distribute jabs.

Scientists, though, are emphatic that the world will not be safe from Covid-19 until global immunisation has taken place. As the slogan states: no one is safe until everyone is safe. Achieving that goal could take years, however.

Contributor

Robin McKie Observer science editor

The GuardianTramp

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