Covid-19: new global risk map should have Brazil in ‘red zone’, say scientists

RIO DE JANEIRO, BRAZIL – Virologist Julian Tang, from the University of Leicester, UK, says that European nations, Oceania, Israel, and parts of Asia, such as Singapore and South Korea, are expected to resume trade, tourism, and travel between these territories by mid-year, thereby enabling their economies to rebound.

Countries that fail to complete vaccination of their population and control the emergence of variants may eventually be isolated from the rest of the world, being officially or informally classified as “yellow” or “red” risk zones.

“We could see a breakdown by risk zones. For example, Southeast Asia and Europe will be green. Orange is India and part of Africa. And red might be South Africa, Brazil and the United States, where there are high rates of transmission and insufficient vaccination,” Tang exemplifies.

“That may officially exist, on travel websites, or even in people’s heads.”

The nations that tend to become more isolated are countries that have neither systematically implemented covid-19 control measures nor negotiated vaccines in advance, such as Brazil, which on Wednesday, March 10th, totaled a record 2,286 deaths in 24 hours and is viewed by researchers as a potential breeding ground for variants.

So far, about 9 million people have been administered at least one vaccine dose in the country. The number may seem high, but it represents only 4.26% of the Brazilian population.

Brazil currently only has Oxford-AstraZeneca vaccine doses, purchased by Fiocruz, and the Butantan Institute’s Coronavac, which would not be enough to immunize the whole population aged 18 and older still in 2020. On Monday, March 15th, Health Minister Eduardo Pazuello pledged to buy more than 100 million doses of Pfizer and Janssen’s vaccines.

Poor countries, which lack the resources to buy immunizers, will also suffer from isolation, which will deepen the social inequality between the northern and southern hemispheres, assesses Professor Peter Baker, deputy director of the department of Global Health and Development at Imperial College London, in the UK.

“We will end the year with a zonal division system, with parts of the world vaccinated whereas others will not,” he said.

“And if we decide to introduce policies based on immunity acquired by countries through vaccination, we will see curtailment of rights, travel, and the economy of poor countries which are currently struggling to access vaccines.”

Resumption of tourism in green zones

Currently, the countries where alarming coronavirus variants have emerged – Brazil, South Africa, and the United Kingdom – are faced with the most restrictions on entry into other nations, according to a survey conducted by the Folha de S.Paulo newspaper.

But the UK may come out of this “red zone”, as since the lockdown in force since early January the infection rate has dropped by two-thirds. The entire population over the age of 18 is expected to be administered at least one vaccine dose by July 31st.

By then, other European and Asian nations should also have vaccinated between 60% and 70% of their populations, the percentage required for the circulation of the virus to decelerate even in the absence of containment measures.

For Professor Julian Tang, it is likely that these nations in the “green zone” will maintain flight restrictions to world regions that have not been able to vaccinate their populations, throughout the year and part of 2022.

But he says that even if this is not the case, the demand for travel to red zone countries should naturally reduce in light of the risks involved. That is, non-vaccinated countries with still high infection rates may ultimately be isolated from the rest of the world, primarily in order to contain the risk that new coronavirus variants will leave these territories and spread in large numbers.

“What I think will happen is that people will feel comfortable traveling between countries that have vaccinated their populations, like between the UK and Europe, or the UK and South Asia, Australia, New Zealand,” the University of Leicester professor assesses.

“But it’s possible that these people may not be willing to travel to regions like Brazil, for example, because the virus is not under control through vaccination and, as a result, a vaccine-resistant variant may emerge.”

‘Green passport’

The reality of Israel, the country with the best vaccination rate to date, provides clues as to how the global divide is likely to play out. According to data from Oxford University’s Our World in Data platform, the country currently boasts the highest vaccination rate in the world, with 98.85 doses administered per 100 inhabitants.

For comparison, the Brazilian rate stands at 4.58 doses administered per 100 inhabitants.

In Israel, vaccination is not mandatory, but in practice, people who do not get vaccinated will end up isolated from the rest of the population, with no access to most public areas. The reason is that vaccinated people in Israel are issued a so-called “green passport” – an electronic document that allows access to restaurants, gyms, theaters, cinemas, and other establishments.

The country has begun to gradually open up its economy after three lockdowns with harsh confinement measures. In a way, this division between vaccinated and non-vaccinated people, with the latter group being isolated, is likely to be replicated on a global scale.

“We can expect most wealthy countries to vaccinate their populations this year. But most of the world is expected to be unable to do so. And these two factors are sadly interlinked,” says Professor Peter Baker of Imperial College London.

“Wealthy countries are buying vaccine doses beyond what their populations need, and this is limiting other countries’ access. And in nations like Tanzania and Brazil, the political message is affecting the demand for vaccines, which is a problem,” adds the British professor.

According to researchers, the main problem in having parts of the world with no mass immunization against covid-19 is the emergence of variants that are resistant to the effect of vaccines.

Uncontrolled virus in a country is a global threat

Researcher Charlie Whittaker of Imperial College London cautions that even if travel restrictions between countries are imposed, the world will only be fully protected from covid-19 if all nations immunize their populations.

He led a study on the Manaus strain that found it to be between 1.4 and 2.2 times more transmissible than the original virus. The study also showed that this strain, named P.1, is able to evade the immune system from previous infections in between 25% and 61% of cases. This means that it can easily reinfect people who have already had covid-19.

Although many countries have banned flights from Brazil and imposed quarantines and covid-19 testing on passengers flying from the country, the P.1 variant has already been detected in 25 countries. Meanwhile, the UK variant has spread to the US and the South African variant has reached Europe.

“No one is safe until we are all safe. And ensuring we are safe means limiting the chance of variants emerging. Control measures are useful to achieve this, but perhaps even more important is to ensure an equitable global vaccination strategy. This means that no country should be left behind,” Whittaker said.

And so that the southern hemisphere is not left behind, the World Health Organization (WHO) has been advocating that wealthy countries donate their vaccine surpluses to poor countries and contribute financially to the purchase of immunizers for regions most affected by covid-19.

WHO Director-General Tedros Adhanom Ghebreyesus has even declared that the “world is on the brink of a catastrophic moral failure,” as he criticized the fact that young people are now being immunized against covid-19 in wealthy countries, while the elderly in poor countries are likely to be denied access to the first dose in 2021 and even 2022.

Leaving countries behind will be costly for everyone

Global Health Professor Peter Baker of Imperial College London warns that leaving the virus uncontrolled in emerging and poor countries could lead to human and financial costs for all nations, as new, fully vaccine-resistant variants could emerge.

If this occurs, third and fourth doses of today’s existing vaccines will have to be developed and administered to all populations.

“In places of uncontrolled infection and low vaccination rates, a strongly vaccine-resistant variant will most likely emerge. Then we will have to readjust our vaccines, redo research, and redraft regulatory processes,” he says.

“It is worrying to see that several countries in the global south have been left behind because developed countries have bought the vast majority of vaccines and access is challenging. Experiences in Brazil, the UK and South Africa with variants show that the virus does not respect international barriers. To solve this problem, we need a global initiative,” adds researcher Charlie Whittaker.

Source: BBC Brasil