The virus spread as variants, ‘No one is safe until everyone is safe’

Cape Town, South Africa – As a dangerous version of the first discovered coronovirus in South Africa, thousands of people have been killed and killed across the country, Jan Matasena said in a supermarket in Cape Town to stock the shelves every Day showed, that he too would catch it. .

A neighbor died in December, then a co-worker the same month. Now Mr. Matsena is waiting for a vaccine to return home to his colony and capture his daughter again. But in South Africa, the country has hit hardest yet, vaccination has not started yet.

“The wait for this vaccine is over long ago,” said Mr. Matasena, a father for the first time who is staying away from his family for fear of exposing them. “People are passing, people are losing jobs. This is shock. “

While more than 90 million people worldwide Vaccination has been, according to the World Health Organization, only 25 in all of Sub-Saharan Africa, an area of ​​about 1 billion people, given doses outside of drug tests.

But as new variants discovered in South Africa shift to more countries – including the United States – it is becoming ever more clear that tragedy for poor countries can become a tragedy for every country. The more the virus spreads, and the longer it takes people to vaccinate, the more likely it is to mutate in ways that put the entire world at risk.

Recent studies suggest that at least four vaccines that are effective in preventing infection with the original virus did not perform as well against variants found in South Africa. According to data compiled by researchers, this variant is also more contagious – as is another one, which has been discovered in Britain – and is now estimated to be 90 percent of cases in South Africa. This has changed in dozens of other countries.

Vaccination causes the immune system to make antibodies to the virus, but as the mutation changes its shape, the virus may become more resistant to those antibodies. In the worst case, failing to stop the spread of the virus globally could lead to more mutations that could make existing vaccines less effective, even leaving vulnerable populations vulnerable.

“The idea that no one is safe as long as everyone is safe is not just a saying, it’s actually true,” said Andrea Taylor, assistant director of the Duke Global Health Innovation Center.

Even in the most optimistic scenarios, Ms. Taylor said, at the current pace of production, by 2023 there will not be enough vaccines for actual global coverage. Existing rollout plans across Africa expect only 20 to 35 percent of people to be vaccinated this year if all goes well.

And while some of the wealthier countries have received enough vaccines to cover their population multiple times, South Africa has achieved just 22.5 million doses for its 60 million people, and many countries lag behind.

The head of the World Health Organization, Tedros Edholm Ghebyeyes, said that this disparity could soon become a “catastrophic moral failure”, as rich countries leave poor and middle-income countries rushing to buy vaccine stocks. Search Supply

South Africa’s first million doses made by AstraZeneca are scheduled to arrive there on Monday, and officials say it will take up to two weeks to deliver the shots. AstraZeneca’s vaccine, developed with the University of Oxford, is currently the world’s most affordable option, developing low and middle-income countries as its goal. The company has not released any information about its effectiveness against the variants, but it is expected to happen soon.

A further 9 million doses are released at the behest of Johnson & Johnson, whose shot does not yet have regulatory approval. On Friday, the company announced that A. Efficacy of its vaccine fell Tests conducted in the United States ranged from 72 percent to 57 percent of those conducted in South Africa.

There are some encouraging signs. A growing body of preliminary evidence – sparked mainly by lightning-fast rollout in Israel – suggests that vaccines are reducing new infections, not only in trials, but in the real world.

But it remains to be seen how well they help the variants already in vogue. Scientists hope that vaccines can be modified and booster shots can be developed to deal with new variants, if necessary, but this takes time. And for a world struggling for itself, time is the essence.

Dr. Tulio de Oliveira, A professor and geneticist at the Nelson Mandela School of Medicine in Durban, who helped discover the version originally found in South Africa, said its emergence should serve as a wake-up call.

He said, “One of such things needs to be exposed to the whole world, not only in your country but the whole world needs to control transmission.”

And while nations have rushed to seal their borders, the variant is already spreading to dozens of countries – just as the virus struck national borders in winter last year. For example, Brazil Seems provoked At least two worrying versions, which had already shifted their borders, before many countries began to cut air travel from there.

The burden of supplying vaccines to low and middle-income nations falls heavily on Kovacs, a nonprofit group formed by a coalition of international organizations.

Although more than 190 countries have pledged to receive vaccines through Kovacs, many of them are directly dealing with pharmaceutical companies, or belonging to multinational groups that are doing so. It threatens to raise prices and dose delays via Kovacs.

Kovacs has announced that it has achieved a 2.1 billion dose for 2021, but it is unclear how many of them will actually be delivered in 2021.

The expectation is that rollouts in poor countries may begin in the next month or two months.

“Kovacs is necessary but not sufficient,” Ms. Taylor said. “This is the only mechanism we have for global equity. We need it and we need it to be successful. But even though they are successful, it does not bring countries closer to herd immunity. “

“By the end of this year, 75 percent of the population will be vaccinated in high-income countries,” said Orin Levine, director of global delivery programs at the Bill and Melinda Gates Foundation, compared to 25 percent in low-income countries.

Kovid 19 Vaccines>

Answers to your vaccine questions

Currently more than 150 million people – about half the population – are eligible for vaccination. but Each state makes the final decision about who goes first. The country’s 21 million health care workers and three million residents of long-term care facilities were previously eligible. In mid-January, federal officials urged all states To open eligibility All adults 65 and older with medical conditions at high risk of becoming seriously ill or dying of Kovid-19. Adults in the general population are behind the line. If federal and state health officials can overcome bottlenecks in vaccine delivery, all 16 and older will become eligible by this spring or early summer. The vaccine has not been approved in children, although studies are ongoing. It may be months before the vaccine becomes available to anyone under 16 months of age. Go to your state health website For up-to-date information about vaccination policies in your area

You should not give anything out of pocket to get vaccinated, Although you will be asked for insurance information. Even if you do not have insurance, you should be given the vaccine at no charge. Congress passed legislation this spring to prohibit insurers from sharing any costs, such as co-pays or deductibles. It provides additional protection from billing patients to pharmacies, doctors and hospitals, including those. Still, health experts worry that patients may be weak Leave the bills surprising them. This can happen to people who are charged with a doctor visit with a vaccine, or Americans who have certain types of health coverage that are not covered under the new regulations. If you receive your vaccine from a doctor’s office or urgent care clinic, talk to them about a possible hidden fee. To make sure you don’t get a surprise bill, the best bet is to get your vaccine delivered to the health department’s vaccination site or local pharmacy after shots become more widely available.

It is to be determined. It is possible that the Kovid-19 vaccination will become an annual phenomenon like the flu pill. Or it may be that the benefits of the vaccine stay for more than a year. We will have to wait to see how durable the protection from vaccines is. To determine this, researchers are going to monitor vaccinated people to look for “cases of success” – people who become ill with Kovid-19 despite vaccination. This is a sign of weakening safety and will give researchers clues about how long the vaccine lasts. They will monitor the levels of antibodies and T cells in the blood of vaccinated people to determine if and when a booster shot may be required. It is predictable that people may need boosters every few months, once a year or only a few years. It is just a matter of waiting for the data.

For African countries, the slow pace of rollout feels frighteningly familiar.

When another disease – HIV / AIDS – was killing millions of people every year, most infections and deaths occurred in Africa. Nevertheless, it took at least six years, as the life-giving treatment available in wealthy countries was made available to Africans.

According to an analysis by Africa’s Centers for Disease Control and Prevention, AIDS killed 12 million people in Africa in a decade, even causing a steep decline in mortality in the US. Disputes over international property rights delayed the production of more antiretroviral drugs or cost-effective generics.

Now, India and South Africa have been lobbying the WTO to force pharmaceutical companies to share their intellectual property on the coronovirus vaccine, as they eventually did with HIV / AIDS treatment.

“You have the clear support of every government and every pharmaceutical company that says we are in an epidemic, we are on the path of disaster,” said South African human rights advocate Fatima Hasan. / AIDS drugs and now povid Kovid-19 vaccines. “We’ve got billions to spend sharing technology and saving trillions.”

Solomon Zedu, deputy director for health in Africa at the Gates Foundation, said the maps and charts reflect global vaccination rates – Africa is almost completely absent – sparking public anger and some politicians needing additional vaccine sources in addition to Kovacs Wanted

According to Nisis Nidembi, senior science advisor at the Africa Center for Disease Control and Prevention, the African Union announced this month the purchase of 300 million vaccines to be distributed through the regional body’s African Medical Supplies platform.

In countries such as Mozambique, Zimbabwe, and Zambia, where variants found in South Africa are believed to increase infection, authorities do not have a clear answer about the introduction of vaccines.

South Africa, meanwhile, has been relatively vocal in its epidemic response, which has caused controversy within the country. President Cyril Ramaphosa from 9am to 5pm restricted attendance at curfews, funerals and religious ceremonies, prohibited the sale of alcohol and mandated masks in all public places. Not wearing a mask can result in a fine or six months in jail.

When vaccination is expected to begin about the middle of February, health workers will be first in line, followed by the risk of serious illness being most commonly understood.

For Mr. Matasena, the supermarket employee, who is 31 and healthy, it may be a long wait.

“It would be better if it came first because now people are terrified of this epidemic,” he said. “This is very bad, very bad.”

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