Thursday, March 18, 2021

Can vaccination prevent new lockdowns in Europe? (EN)

Back in January, in the second part of this post, I anticipated that EU countries were facing an imminent, devastating third wave of the pandemic over the coming months, driven by the more contagious mutations of the virus. I also wrote that the vaccines roll-out, even if proceeding according to plan (which it hasn't, mainly due to AstraZeneca's failure to supply on its contract with the EU), would not be able to help flatten the curve - they were simply too little, too late for this wave.

In the meantime, much of the talk in Europe has been about gradually lifting restrictions introduced at the beginning of winter. 

But one and a half month later, as more and more countries see again their infections and deaths going up again (below figure from ECDC) and their hospitals under strain, the tone is changing and re-confinement is back on the table across Europe.

The lingering question is: would a faster vaccination have helped significantly mitigate this new wave of the pandemic, so as to avoid renewed lockdowns? 

It's a legitimate question, especially as one compares with the UK, which, having achieved a much higher vaccination rate than continental Europe, is seeing its case count fall and is preparing to emerge from lockdown.

And linked to this, what is the level of vaccination where one can hope to see, if not 'herd immunity' (which we know requires around 70% of people to be immune), at least a meaningful impact on the virus propagation, a noticeable 'flattening of the curve' without the need for tough lockdown-type restrictions?

By looking at the available evidence from different countries with different levels of vaccination and at different points in the pandemic wave, the answer to the first question is, sadly, that even a flawless vaccination rollout wouldn't have avoided the need for fresh lockdowns in Europe.

The answer to the second question is more complicated and depends on a number of other factors (e.g. how many people in a given country already have some immunity after having been infected with covid in the earlier waves), but it points to a level of vaccination that EU countries are very unlikely to reach before summer. So if vaccination can help Europe re-open safely and broadly, this might only be the case from next autumn.

I have looked at different countries that have a higher vaccination rate than the EU, comparing their historic data on covid cases (number of new cases confirmed through positive tests - using the 7-day rolling average for the trend) with the evolution of their vaccination rates (as the cumulative number of vaccine doses administered per 100 inhabitants). In particular, I focused on this simple fact: what was the vaccination rate when the number of new cases peaked before starting its descent?

As an example, see below the corresponding charts for Israel. It shows that the number of new cases in the latest wave of the pandemic peaked in Israel around 17 January, and on that date the country had a vaccination rate of 29.62.

Using a similar approach, we will see, for instance, that:
  • The number of new cases peaked in the United Arab Emirates on 30 January, when they had a vaccination rate of 31.49.
  • In the US, new cases peaked on 8 January, when the vaccination rate was only 2.00 (negligible!).
  • In the UK, the vaccination rate at the peak of new cases (9 January) was around 3.9 (again very small).
  • Chile, on the other hand, is as we speak (data from 17 March) still on the upward slope of the 3rd wave of the pandemic, in other words new cases still haven't peaked, although it has a vaccination rate of 40.70!
  • Similarly, Serbia still sees increasing number of cases while it has administered 30.53 vaccine doses per hundred inhabitants.
  • Hungary appears to have peaked just recently (15 March) in terms of new cases, with a vaccination rate of 18.08 - I would however treat the data around 15 March with some caution, since the date coincides with the country's National Day.
While the above examples - and the list could continue... - don't show any consistent pattern and while a number of factors (such as the different types of vaccines used) are not accounted for, one conclusion still emerges quite clearly in my view: that the rate of vaccination is not the determining factor in mitigating the current wave of the pandemic.
Some countries have managed to slow the infection rates with very little vaccines, by applying measures already used before the vaccines were even available, such as lockdowns (clearly the case in the UK). Others haven't been able to flatten the curve even with a sizeable part of their population vaccinated.

There are several implications for the coming period.

First, that whatever we do on vaccines will not bring relief in the short run - at least not in Europe with its current vaccination rates. It will take months for vaccination to reach a level where it can have a meaningful impact on the pandemic. Meanwhile, we are dealing with a surging third wave and it will be unavoidable to see more sickness and death, as well as more lockdowns in the coming period.

Second, that a vaccine-driven re-opening is not for tomorrow. The European Commission's aim to introduce 'Digital Green Certificates' by this summer should not be seen for more than it is: a limited fix to get around the more stringent travel restrictions currently in place (such as mandatory quarantines) and restore a semblance of free movement, the most cherished right by Europeans. Holding that green certificate will not mean total freedom, nor getting 'back to normal', nor forgetting about covid. 

Third, and this is a more optimistic conclusion, that vaccines will still help us. With the warmer weather kicking in and people being able to spend more time outdoors, we are likely to benefit from a relative respite from the virus in the Northern Hemisphere over the summer months, as was also the case last year. But this time we will be able to use this period for reaching, before autumn, vaccination rates that are likely to make a real difference. So there are good chances for this third wave to be the last of this magnitude, of this gravity - the next one should catch many of us vaccinated and should therefore be significantly milder. There is light at the end of the tunnel, it's just that the tunnel is somewhat longer than many were hoping.

Not least, against this background it becomes clear that the vaccine rivalries among Western nations are not about the real problem at hand, but more of a distraction, you may even call it silly politics. Whether and how fast the EU catches up with Britain or  the US on vaccination is largely irrelevant for this virus. All of them (UK, US, EU) will have gone through the third wave of the pandemic with significant human and economic costs that the vaccines couldn't save.
But still, it's far from trivial. As I argued back in January:

The coming wave will be the deadliest so far in Europe, with or without the vaccine.
But this happening against the background of a bungled vaccine roll-out due to supply shortages, while across the Channel the UK is emerging from the third wave and immunizes its citizens at a much faster clip, will be politically explosive. A full vindication of Brexit would be the cherry on the pie. The collapse of the EU itself cannot be ruled out. The joint action on vaccines by the 27 member states, hailed as a big triumph for European solidarity only one month ago, could become its undoing in the coming few weeks.
Hence, for the EU getting its vaccine roll-out back on track as fast as possible is an existential stake.

And this will explain a lot of what you'll be seeing in the news these days.

1 comment:

  1. Hello !

    Highly-informed post, with the factuals working for the sake of the argument.

    1. My short answer to the title question is no.

    2. My long answer is no, again, but with a qualifier.

    1. ‘No’. We'll never know for sure what would have happened if Europe started earlier and accelerated decisively its vaccination process before the present covid-19 wave. Most probably, some EU countries would have fared better than others and they could have compared favorably even to the UK. But overall, below the supposed 70% herd immunity level, the virus finds enough undefended human hosts and its spread as “wave” becomes inevitable.

    2. ‘Qualifier’. However, my take is that the vaccination rate matters a lot : though too small to prevent this third wave, it can nonetheless contribute decisively to ‘flatten the curve’ and especially to shorten the ‘high-altitude’ curve by reducing the number of human hosts. I think that, as a principle, the greater the vaccination rate, the shorter the third wave.

    But, of course, all this is the principle, and then, we have different situations from one country to another, and from one region to another, and every country has its own approach for its own specific situation.

    In the end, I cannot agree more with your measured conclusion and I would sum it up that for the virus, politics don’t count too much, but for politics, the virus counts a lot.