What scientists recommend in the face of new Covid variants

This article presents the recommendations of many scientists on the actions to be implemented at the start of 2021 following the emergence of a new variant of the coronavirus.

In Europe, the number of COVID-19 cases is relatively high. Current measures are not sufficiently reducing the spread of the virus, and new variants of CoV-2 linked to SARS are emerging. Two variants, first identified in the UK and South Africa, respectively, have spread to many European countries. Although the biological properties of these variants remain to be characterized, epidemiological data suggest that they have a higher transmissibility than the original variant. These viral properties could increase the effective number of R reproductions in the population. If this holds true, many countries that have successfully reduced R to 1 or less will face yet another wave of viral spread despite current measures. Once a more contagious variant becomes established, it will be increasingly difficult to stabilize the number of new infections.

Vaccine: a long wait before reaching collective immunity

Despite the availability of effective vaccines, production to meet demand and deployment of immunization programs will take months. Countries will have to deal with a high number of cases and their adverse consequences for several months. With the slow increase in the immunity of the population and the pressure of evolutionary selection of the virus, the emergence of new variants of SARS CoV-2 will continue, which could lead to more contagious variants, and possibly be even to variants for which existing vaccines are less effective. These variants could quickly exacerbate the crisis, long before enough people are vaccinated.

For the past year, healthcare professionals and other front-line workers have already been working in extreme conditions, which has had serious consequences for their physical and mental health. If variations lead to a further increase in the number of cases, it could overwhelm health professionals and bring health systems to breaking point. It is essential to ensure that the burden on health professionals is alleviated while maintaining the sustainability of the system. Adequate support for these crucial forces may require additional funding.

A key indicator: the effective reproduction rate of the coronavirus

Containment and mitigation become more difficult with the appearance of a more infectious variant. Assuming the variant actually increases R from 1 to 1.4, letting it spread without changing the behavior of the population means the number of cases will double every week. Significant efforts will be needed to bring R down to 1 or less and to regain control. Acting before the variant spreads widely means that these same major efforts could greatly reduce the number of new cases and slow the establishment of the variant.

Practical recommendation in the face of new covid variants

The joint action of all European countries will make each national and local effort more effective and impactful and will safeguard public health across Europe:

• Define clear objectives and rekindle motivation: clearly define the objectives to be achieved for the measures to be lifted and explain the reasons behind them; communicate convincingly that the fight against the pandemic requires a collective effort in the interest of every citizen; and ensuring adequate social and economic support for those in need.
• Reduce the number of physical contacts: meet as few different people as possible; establish and improve home and online schooling; small, stable social bubbles and stable groups at home and at work should be preferred to alternate contacts.
• Prevent contagion through individual measures such as physical distancing, hygiene, protective masks, ventilation and the use of filters, avoiding confined and crowded spaces and staying at home when you feel symptoms ; providing FFP2 masks to those who need them and to all those who cannot work from home.
• Test, trace, isolate, support: enforce mandatory isolation of people with confirmed infection and encourage preventive quarantine of suspected cases; support affected individuals and families.
• Preventively detect and test: offer free tests in schools and workplaces to quickly detect outbreaks and protect people; increase screening capacity to meet demand; use wastewater monitoring to detect local outbreaks.
• To increase genetic sequencing and PCR detection of variant B.1.1.7, as well as other variants of SARS-CoV-2.
• Improve protection and support for older people and vulnerable groups
• Accelerate immunization: improve the procurement, delivery and allocation of vaccines through mutual learning and international cooperation; coordinate efforts to increase vaccine production.
• Monitor vaccines for infections in order to detect as soon as possible possible reinfection with new variants or poor management of the vaccination.

Act early and effectively to avoid long restrictions

When restrictions last longer and are less effective, the psychological, social and economic resources of those affected are depleted. When new variants require even stricter and longer measures than existing ones, it is of the utmost importance to ensure that people with particularly heavy burdens receive financial and social support, that social charges are distributed equitably and that mental health services meet the growing demand to deal with grief, isolation, loss of income, fear, alcohol and drug abuse, insomnia and anxiety resulting from the pandemic and containment strategies.

The fundamental principle of these measures is to avoid the importation of new variants, to prevent their spread and to improve the monitoring of variations in the coronavirus. The earlier and more effectively countries act, the faster restrictions can be relaxed. All types of measures need to be coordinated and synchronized across Europe. Each additional reduction in contagion (i.e. R) counts, as it more than proportionately reduces the length of time strict measures take.

Reference:

Priesemann, V., Balling, R., Brinkmann, M. M., Ciesek, S., Czypionka, T., Eckerle, I., ... & Szczurek, E. (2021). An action plan for pan-European defense against new SARS-CoV-2 variants. The Lancet.

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