By Salvador Macip. Professor of Molecular Medicine at the University of Leicester.
Until most of the planet is well immunized we will not be able to relax.
This 2023 has started with the feeling of living on groundhog day, again everyone looking to the east in fear. The wave of covid cases that China is suffering is a cause for concern, without a doubt, but also a good opportunity to discard a series of misperceptions and dangerous that have spread lately. The first, and most obvious, is that the pandemic was over. Although we are in a much better moment, it is clear that we still cannot let our guard down. The second is that we should not suffer, because the virus is now more benign. It is not true either: we already see the havoc it can cause in a poorly vaccinated population.
The situation in China is tragic and will result in a considerable number of deaths (at least one million, it has been estimated). It is the result of a miscalculation: thinking that the pandemic would be brief and, therefore, it could be dealt with with the zero covid strategy. This, which was a good idea at the beginning, is unsustainable in the long term, for social and economic reasons, so one had to prepare for the inevitable moment when the restrictions would have to be lifted. In this phase, the key was to vaccinate the entire population as quickly as possible, which Europe did well. China, on the other hand, used less effective vaccines and was not in such a hurry to protect the most vulnerable population. Now they are paying dearly.
How will the situation in China affect us? We must insist that a pandemic is a global problem and, therefore, until most of the planet is well immunized, we will not be able to relax. The virus will always mutate and evolve and, if we give it room to run, as is happening now in China, but also in other places (let’s remember that in Africa the vaccination level is only 26%), the chances of it appearing will increase. more aggressive variants that once again complicate life in the rest of the planet. We saw it with Delta and, later, with Omicron, two versions of SARS-CoV2 that became dominant when we thought the infection was almost under control.
The main concern, then, is that a more contagious variant is imposed in China or that escapes the antibodies we have, and then spreads everywhere. What is needed now is vigilance: sequencing as much as possible to rapidly detect dangerous forms of the virus, if they appear, that would require more radical containment measures. This has not happened so far, but we must be alert, because the possibility exists.
The other problem that we may have is that the Chinese wave arrives here and we see a spike in cases. This could be alarming, because we have an already strained health system: little has been done to strengthen it after the critical phase of the pandemic, and the intense season of flu and other respiratory infections has strained it. If primary care and hospitals are now saturated, which is what is happening in China, the number of victims may rise.
The increase in infections will not be prevented by selective PCR testing of travelers coming from China, as has been proposed. We have seen over the years that it is a useless measure in the face of a virus that spreads so quickly. The covid can enter us from other parts, therefore, surveillance must be transversal. Now the waves are detected mainly due to the presence of the virus in wastewater, but it would not hurt to recover part of the measures (test, isolation of positives…) that we took before, to have more room for manoeuvre.
While the health authorities carry out this surveillance of possible variants and new cases, citizens can also contribute. It is a good time to return to sanity: wear masks where they are mandatory (and anywhere there are crowds), protect the most fragile and, above all, get vaccinated. We know that covid antibodies don’t last forever, so it’s essential that everyone who hasn’t already done so gets their booster dose. It’s the best way to keep serious cases to a minimum. What makes the situation in China impossible to repeat here is precisely the good immune status of our population. It is essential that we do not lose it.
The pandemic will still take time to end. The fact that we have left behind the hardest moments does not mean that we can completely ignore ourselves. But neither should we panic. What is needed is to be alert and know how to react quickly if the situation changes. This, as always, is everyone’s responsibility.