"That’s what viruses do, they evolve, but we can prevent the emergence of variants by preventing transmission. It’s quite simple. More transmission, more variants. Less transmission, less variants."
Dr Tedros (Director General of the WHO)
Dr Tedros: I know that globally there is currently a lot of concern about the Delta variant and WHO is concerned about it too. Delta is the most transmissible of the variants identified so far. It has been identified in at least 85 countries and is spreading rapidly among unvaccinated populations.
As some countries ease public health and social measures, we’re starting to see increases in transmission around the world. More cases means more hospitalisations, further stretching health workers and health systems, which increases the risk of death.
As we have said, new variants are expected and will continue to be reported. That’s what viruses do, they evolve, but we can prevent the emergence of variants by preventing transmission. It’s quite simple. More transmission, more variants. Less transmission, less variants.
That makes it even more urgent that we use all the tools at our disposal to prevent transmission. The tailored and consistent use of public health and social measures in combination with equitable vaccination. This is why WHO has been saying for at least a year that vaccines must be distributed equitably to protect health workers and the most vulnerable.
Full transcript here
Full video here Virtual Press conference - 25 June 2021
This is a graphic I made to show the central idea:
Why the WHO keep saying we need to suppress COVID globally to slow down evolution of variants of concern
Just "back of the envelope" type calculations to show how it works.
Variants of concern by earliest documented sample
(often long before the variant was identified)
Running at about 4 variants of concern every 100 million cases
If 50% of population of EU + US get COVID = 12 new variants
50% of population of Africa = 20 new variants
Same for India or China
CALCULATION IS FOR ILLUSTRATIVE PURPOSES, NOT RESEARCH
The calculation here is just to give a rough idea of how fast new variants emerge depending on cases per day. It's a big generalization from just four variants of concern. Just to give an idea of why Dr Tedros said what he said,
Please don't quote any of this as if this was research or a prediction, thanks!
TIME TO STOP BUILDING NEW 'VARIANT FACTORIES' AND TRY TO CLOSE DOWN THE ONES WE ALREADY HAVE - OUTBREAKS OF INTENSE COMMUNITY TRANSMISSION ARE LIKE VARIANT FACTORIES
I thought this was a good way of putting it. Susan Mitchie (participant in both UK's SAGE and Independent SAGE) put it like this,
And allowing community transmission to surge is like building new ‘variant factories’ at a very fast rate …. https://t.co/w2YM3P5VzK
— Susan Michie (@SusanMichie) July 4, 2021
Professor of Health Psychology & Director of Centre for Behaviour Change, UCL, UK. Participate in SAGE & Independent SAGE.
She was echoing Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center, who told CNN that
"Unvaccinated people are potential variant factories,"
She was talking about the UK situation, but perhaps we can borrow this phrase to use it for the whole world. With all the surging cases around the world we are building new "variant factories".
We can make our job of ending the pandemic far easier if we stop building new variant factories and do our best to close down the ones we have already built.
DELTA CAN BE SUPPRESSED, AND WE HAVE TO HELP OTHER COUNTRIES
This is why we have to help other countries suppress their cases with early vaccines, technology transfer of all technology relevant to suppressing COVID, stopping transmission, and treating it, personal protection equipment and anything else they need. This is not charity.
We can suppress delta, look at what India is doing, with not that much by way of vaccination:
India is suppressing delta - the world can too
In the UK, Bolton suppressed its surge very effectively
Hospital cases in Bolton
Bolton controls delta variant surge with surge PCR tests - very effective if enough people comply with testing and isolation
Vo Euganeo achieved 90% reduced transmission with surge PCR tests in April 2020
Can this success be duplicated in rest of UK?
Good news from Australia they are well on their way to control delta with short lockdowns and their other measures, likely to be able to ease their lockdowns soon. Australian state reports drop in new COVID-19 cases; lockdowns ease in some areas
VACCINES STILL STRONGLY PROTECTIVE AGAINST HOSPITALIZATION FOR DELTA - BUT NEW VARIANTS OF CONCERN WILL INCREASE RISK
The vaccines are still strongly protective against hospitalization for delta, and reduce hospitalization risk 10 or 20 fold but each new variant of concern increases the risks of higher percentages of breakthrough infections and deaths of vaccinated people.
. Vaccines strongly protective against hospitalization for delta variant ~20-fold reduction for Pfizer, and ~10-fold reduction for AstraZeneca after 2 doses also significant protection after 1 dose - wide error margins
VACCINES CONTINUE TO IMPROVE FAST
Long term science is delivering. Vaccine capacity increasing hugely. By 2022, enough to make a new dose for everyone globally every 2 months COVID-19 Vaccine Market Dashboard
Hexapro tweak will make vaccines stable at higher temperatures and should make them more effective. Licensed for free to weaker economies & new vaccines grow in hens eggs.
. The 2P tweak - Why Pfizer and Moderna are so effective as vaccines - this tweak could be used by other vaccines like Astra Zeneca - and 2nd generation vaccines may use the even more effective Hexapro tweak published July 2020
Existing vaccines are being tweaked to the variants. By fall 2021 we'll have vaccines able to protect against multiple variants at once. Also 2nd gen. vaccines present fragments common to all variants for antibodies to attack.
32 vaccines in large scale phase 3 trials.
The pace of vaccine research is astonishing. Some say we have had 10 years progress of vaccine technology in 1 year.
LIGHT AT THE END OF THE TUNNEL
Dr Maria van Kerkhove, technical lead for COVID for the WHO, says she does see an end in sight, light at the end of the tunnel. The vaccines are incredibly powerful additional tools.
She says we need to drive transmission down. It's a case of "Vaccines and", not "vaccines only".
She says that we will get out of this pandemic. How quickly we get there is up to us.
Full interview here
SCIENCE IS MOVING WITH EXTRAORDINARY SPEED
The science is moving with extraordinary speed. But we can help by keeping cases down to stop transmission and evolution of variants. If you want to help, be a COVID superhero and #DOITALL. Wear masks, physical distancing, ventilation, whatever you can.
STACK THE DECK IN OUR FAVOUR AND AGAINST THE VIRUS
Let’s stack the deck in favour of us and against the virus!
Let’s stack the deck in our favour
Slow down transmission to slow down evolution of variants of concern
background image from here
SOURCES FOR MAIN GRAPHIC
I used the chart from Worldometer because it shows more dates along the x axis. COVID Live Update:
The dates of first samples are from the WHO table for the new naming system.
The delta variant B 1.617.2 goes back to October 2020. The earliest entry in the GISAID database is in December but the inferred date of origin is 27th September to 30th October with a best guess of 15th October 2020.
SEE ALSO - OTHER BLOG POSTS BASED ON RECENT WHO PRESS BRIEFINGS AND SOCIAL MEDIA Q/As
. WHO: not the time to let up - keep up with physical distancing, masks and other individual protection measures, keep up with societal test, trace, isolate, deliver vaccines for the whole world - this is how to end restrictions and lockdowns quickly
This is why it is so important for wealthy countries to help weaker economies with fast transfer of knowledge and technology to make vaccines and prioritize early doses globally.
~4 variants of concern in first 100 million cases
Assuming one variant of concern every 30 million cases (for illustrative purposes)
- 1 variant per year (early 2020), 3 - 4 per year (late 2020) peaks at 8 - 9 per year, second peak in spring 2021 peaks at 18 variants a year, now back to 4 per year.
Why the WHO keep saying we need to suppress COVID globally to slow down evolution of variants of concern.
“That’s what viruses do, they evolve”
50% of population of EU + US with COVID = 12 new variants
50% of population of Africa = 20 new variants
Same for India or China
variants of concern by date of 1st sample (often from before variant is identified)
Show graphic in separate tab here