We all hoped that if enough people were vaccinated against COVID-19 we would reach herd immunity – the point at which enough of us were immune that outbreaks would no longer be able to circulate. In this scenario, the vaccine would have been the silver bullet. The pandemic would be over and, with luck, we would be rid of the virus altogether. Then along came the Delta variant.
Far more infectious than the original version of the virus, Delta has been a game changer. It is now considered more likely that we will only see the end of this crisis when nearly everybody, through vaccination or by being infected, gains sufficiently strong immunity that COVID-19 loses its deadly sting and moves to being endemic, similar to other coronaviruses that are the cause of some strains of the common cold.
For most countries, including Australia, the challenge is how to get to that point of blanket immunity while minimising hospitalisations and deaths along the way. At the moment, with just over a quarter of eligible Australians fully vaccinated, the only way to contain the number of COVID-19 infections is to continue with strict lockdowns to contain outbreaks. But even at higher vaccination rates, many people, those who remain unvaccinated, will still have no immunity to the virus, and Delta has proven highly effective at spreading in those groups.
Israel is the most obvious case in point. A world leader when it came to rapidly getting the jab to its population – about 78 per cent of those 12 and older are now fully vaccinated – it is finding itself facing a fourth wave of infections with a growing death toll (more than 230 have died so far in August) after it largely abandoned social distancing restrictions. It is now offering booster doses to further protect already vaccinated people, and has reintroduced a range of restrictions.
The lessons for Australia are obvious. And the Doherty Institute modelling that underpins the national strategy for opening up Australia supports this view. Reaching a high rate of vaccination is an absolute necessity, but it is not the cure-all sometimes cited by our political leaders. A double dose of vaccine may protect an individual from ending up on a ventilator in a hospital, but high rates of vaccination alone will not fully protect society. And recent studies show that while vaccines keep people out of hospital, their ability to prevent infection weakens over time.
As a result, the Doherty modelling shows clearly that if there are high rates of infection in the community, even at an 80 per cent vaccination rate, we will still need a mixture of mask wearing and restrictions to keep the infection rate from growing. Which means, while we “learn to live with the virus” a range of levers including vaccinations, boosters, masks and further restrictions will be needed to keep hospitalisation and deaths rates at an acceptable level. Given some people are already well past sick of being locked down, some of those levers are going to be difficult to pull.
Overseas examples are not encouraging. In America, which is considerably better vaccinated than Australia, there have been more than 620,000 deaths in total and nearly 1000 people are dying every day. And yet there is still resistance among many to vaccination or even following simple rules such as wearing a mask.
Sound and sensible political leadership is going to be more important than ever as we navigate the path back to normality. Each of us will also need to recognise that while getting vaccinated is imperative, our success may well depend on us still doing much more.
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