This is a race between nations to see who is the first to emerge from the horrors of the COVID-19 second or third waves.
The advantages of becoming able to break free from lockdown are enormous. Not only to the “captive populations”, but also economically as countries start to get to grips with the enormous damage this pandemic has wreaked on their economies.
Who are the riders and runners in Europe, the Middle East and Africa?
Israel is clearly in the lead. Approximately 30 doses per 100 people of the population have been vaccinated as I write this and this is an extraordinary achievement. Although it is not exactly typical of its peers with a small (9.2 million) population in a small geography, in many respects Israel has become the laboratory for the world. They also enjoy excellent digital infrastructure and have the capacity to mobilise their population quickly. They have already vaccinated more than seven eighths of the over 60s. The effect of this on the number of 60-year-olds and above in intensive care should be discernible over the next few weeks, when according to the Weizmann institute this will translate into a halving of their number in critical care and if we extrapolate further, most COVID-related deaths will have disappeared in Israel by the Easter in early April.
The U.A.E. is in second place with nearly 20 doses being administered per hundred people in the population, again a country enjoying superb digital infrastructure, a high level of digital maturity and literacy, with Bahrain not far off in third place with a figure of just over 8 doses per hundred people in the population, and this figure is likely to be much higher now.
Why is Europe lagging behind?
There are many causes of this, some of which are associated with politics rather than science. The debate is heated around reguation speed – particularly around the European Medicines Agency and the structures inherent within the European Union. There is also an issue with the availability of vaccines, with Europe taking longer to secure orders from the manufacturers than other countries.
Having said that, we are seeing some incredible efforts, particularly in countries like Denmark, Italy, Spain and Ireland. Germany, uncharacteristically, is in the bottom quartile – while Sweden and France still have a considerable way to go.
The UK is the outlier here. There was a concerted effort to secure vaccines from suppliers very early and also approaches to licensing these new vaccines early, which initially drew some criticism. At present the numbers vaccinated are close to 7 per hundred people, and it is likely to increase rapidly as a national attempt is being made to vaccinate all people in the highest risk groups including those citizens over 70 by mid February. Should this supreme effort be successful, the result could be that COVID-19 related deaths would fall by 80% by mid to late March.
What can we learn?
Clearly the countries that had the ability to organise and deploy early are in a potentially favourable position. However this observation is tinged with sadness as what has not happened and what we all wished would, is that countries would act in concert. There are some laudable initiatives like the Global Alliance for Vaccines and Immunisation (GAVI) through the World Health Organisation which translate the global pandemic into a global response. Although the fact that the first to emerge from the darkness of the pandemic into the light could reap economic and political advantage is likely why these initiatives have not been adopted by all countries.
I remain hopeful we will soon defeat this virus. Yes, it will mutate and yes, we will need revaccination perhaps on a yearly basis in the future and COVID-19 will remain a nasty disease which will remain a force to be reckoned with, but not a disease which can close down whole continents and damage whole populations.
Dr Charles Alessi is the chief clinical officer at HIMSS.