Coronavirus mutants, socioeconomic disparities pose endemic threat: experts

By Thanh Danh   May 13, 2021 | 09:00 pm GMT+7
Experts warn that new novel coronavirus variants pose an ‘endemic threat’ to low- and middle-income countries, where access to vaccines is limited.

While most countries were at the same starting line as the first waves of novel coronavirus infections devastated the world in 2020, the situation has changed since.

The unavailability of vaccines at the time had forced governments of both high and low income countries to consider similar non-pharmaceutical interventions such as lockdown and social distancing.

Now that wealthy nations and those with ample vaccine supplies like China are pushing through with strong vaccination campaigns, "the next period of the pandemic will play out differently in countries with vaccine access and those without such access," David Fidler, Senior Fellow for Global Health & Cybersecurity with the U.S. think tank Council on Foreign Relations, told VnExpress.

The global pandemic now paints a stark difference between countries with robust vaccination campaigns and those with lower or no vaccine coverage due to inadequate resources and vaccine supply. In Britain and the United States, where people were vaccinated at a high rate, infections are subsiding and life is likely returning to a non-pandemic normal. The Food and Drug Administration has recently authorized the use of the Pfizer-BioNTech shot for 12- to 15-year-olds, increasing vaccine access to even more Americans.

India is in a completely different situation. The second wave of Covid-19 brought about by the new B.1.617 variant has paralyzed India’s healthcare system several months after its lockdown was eased. The South Asian country has recorded more than 23 million cases and 250,000 deaths since the beginning for its second wave, officially, and many experts contend the actual figures are much higher.

Tedros Adhanom Ghebreyesus, director general of the World Health Organization, noted Monday that Southeast Asian countries have recorded a surge in both cases and deaths, specifically in Cambodia and Thailand. The same day, Malaysia also imposed a nationwide lockdown, two days after recording the highest daily case total since January.

What these countries share in common is limited access to vaccines, combined with the fact that they have all seen partial pandemic success thanks to stringent lockdown policies, experts say, warning that dangerous variants will continue to emerge if the spread of the virus cannot be halted in under-vaccinated parts of the world.

Vietnam, where only 1 percent of the population has been vaccinated, is experiencing its fourth wave with nearly 700 cases recorded since late April.

"Many countries face a terrible dilemma: Variants arise when countries cannot contain and end the chain of pathogenic transmission. However, without vaccines, the economic and social damage that comes with non-pharmaceutical interventions cannot be sustained long enough to break the chain of virus transmission, which means countries relax non-pharmaceutical measures before the virus is effectively contained," Fidler said.

"Thus, the original virus and variants thereof remain in the population and continue to spread, forcing governments to consider re-imposing non-pharmaceutical interventions," he said, noting that this is particularly likely to happen when such countries have inadequate or no access to vaccines.

Epidemiologist Eric Feigl-Ding, currently a Senior Fellow at the Federation of American Scientists and formerly a faculty member and researcher at the Harvard Medical School, noted that new coronavirus strains will affect countries’ epidemic control efforts in different ways, depending on what the mutations entail. Certain variants may be more contagious, spread faster, and risk a higher rate of re-infection. Available vaccines are likely to be less effective against them, and they might be harder to detect even via PCR tests.

"We don't know enough about the Indian variant or its sublineages. It could be slipping through border quarantines if it remains contagious for longer periods or has longer initial incubation time," Feigl-Ding said.

Health workers carry wood to prepare a funeral pyre for a Covid-19 victim during a mass cremation in New Delhi, India, on April 26. Reuters.

Health workers carry wood to prepare a funeral pyre for a Covid-19 victim during a mass cremation in New Delhi, India, on April 26, 2021. Photo by Reuters.

The WHO has classified B.1.617 from India as a "variant of concern." Earlier, B.1.1.7, a variant first identified in Britain, and P.1 from Brazil, had also been designated as variants of concern. However, there is no evidence yet that these variants may render existing vaccines ineffective, experts say.

Tedros also expressed concern that 47 percent of the population living in low-income countries have received only 17 percent of the world's vaccines. "The shocking global disparity in access to vaccines remains one of the biggest risks to ending the pandemic," he said.

Fidler predicted that new coronavirus variants will remain an endemic threat around the world, "especially for countries that have insufficient access to vaccines." For countries that have vaccines, variants could be a "game changer" if they reduce the effectiveness of existing vaccines. Thus, it is in the self-interest of countries with vaccines to vaccinate their populations as widely and rapidly as possible to produce as much vaccine effectiveness as possible.

This, however, reduces the likelihood that high-income countries with vaccine supplies will release large quantities of their stock to help countries currently face the threat of variants.

"Pandemics will happen, and, when they do, countries must be better prepared to use every instrument of national power to respond because countries cannot rely on 'global solidarity' to protect themselves and recover from the damage that pandemics can inflict," said Fidler.

"We will see variant strains, such as the one circulating in India, causing serious problems for other countries that do not have access to vaccines effective against such strains. The high transmissibility of such strains means they are likely to spread beyond countries currently experiencing them. The spread of such strains will, as seen in India, severely test the public health and healthcare systems of countries already battered by Covid-19," he warned.

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