John Jacobs, 04.01.2021
Non-sterilising mucosal immunity
In East Asia and Australia, the COVID epidemic has been history for six months, similar to the tuberculosis epidemic in Europe for decades. Vaccination did not exert this, we overcame by test, trace and isolate (TTI). Infection prevention is at the heart of this successful policy. Germany and other European countries also aim to pursuit Zero-Covid akin to Zero-Tuberculosis. Unlike the Dutch government, the German government is lead by a scientist who understands exponential functions. Anyone familiar with international politics foresees that the Netherlands will be nominated for a non-green zone in Europe. It does not require a study in Economics to estimate the economic and liberty costs for being labelled unsafe in a trading nation like the Netherlands
From zero-tuberculosis to zero-Covid
The Dutch Minister of Health, Welfare and Sport considers Zero-Covid to be impossible, but - as Merkel explained - fighting an epidemic is increasingly difficult when there are more cases. Every virologist and field epidemiologist will confirm the need to limit epidemics as early as possible, like a fire. The Netherlands opts for the opposite strategy and wants to have as many diseased people as possible, unless it would overflow our healthcare system. We should not be surprised that this strategy sometimes fails, or that many people become ill and die or get Long-Covid. The diseases caused by SARS-2 are too serious not to limit, and no one is safe. The epidemic is hitting death rates in Africa, Europe and both Americas where the virus is controlled.
Viruses that circulate will mutate
Currently, vaccination protects against the contemporary variant, i.e. wildtype virus, but it will not stop the epidemic, as people still will be infected. Protection against infection is only demonstrated in studies with sloppy methodology. The potential mechanism is absent in 22% of the population and it would last an average of three months. About 5% of the population are not even protected against reinfection. It is unclear whether an infection or vaccine will still protect against disease in 1 or 2 years. This rate may be lower when infected by newly arisen mutants. Protection last 6 months for other coronaviruses, but we don’t have this ‘long’-term historical records for SARS-2 vaccination. Variants will evolve as long as viral circulation remains high, similar to the emergence of antibiotic resistant bacteria in individuals who fail to complete the penicillin course.
Science is transparent
Science should be transparent - redefining scientific definitions violates the heart of science. It is naïve to think that a respiratory virus could be controlled without eradicating it. It is hard to capture the mini droplets in the air that will move too fast to catch. An average sneeze of 9 would be helpful for spreading the disease. Keeping 1.5 meter distance will reduce the risk, but not eliminate it, just like the other measures. A serious concerted action could help to stop the epidemic in Europe. Even if Europe partially fails to succeed, the Zero-Covid approach would reduce death rates, social and economic damage. Virologists and field epidemiologists have known this for a long time.
Desperate diseases require desperate remedies.
Vaccination will not yield herd immunity, nor protect the world from SARS-2. The Dutch Covid policy is at best questionable, on track to have 0,9% of the population killed if everyone becomes infected only once. However, people are likely to become infected more often, by either escape mutants that progress to new virus serotypes that escape immunity, or due to waning immunity as is known from other coronaviruses.
Ethics of no protection
Regulating virus transmission to the maximum of ICU capacity implies, in spite of the time management, a maximum number of cases and fatalities. The ethics of the Dutch policy raises some questions and underlying values and norms should be reconsidered. The criticasters of the Dutch Red Team said they did not want to participate in public discussion anymore. The short-term vision of election rhetoric predominates and feeds the voters with relaxation of measures. Democracy seems to make fighting the epidemic of a lower priority than the result on the election date March 17th. A gloomy marking of in red stain.