There is unlikely to be enough immunity from Covid-19 in populations to stop the virus spreading, the Irish doctor leading the World Health Organisation’s response has said.
Dr Mike Ryan, director of the WHO's health emergencies programme, said Europe was again experiencing "the roller coaster of Covid" with cases rising in Ireland and other countries.
He warned cases would continue to increase as temperatures dropped and people moved inside with social restrictions easing, nightlife opening up and more people mixing.
“We are just not reaching a point where we have enough immunity in the population that can stop virus transmission and we are very, very unlikely to reach that given the current way the virus is transmitted,” Dr Ryan said in a panel discussion at the online MacGill Summer School.
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Speakers during the discussion on the Covid-19 pandemic painted a pessimistic picture about the winter ahead. Dr Ryan said vigilance would be needed over the winter.
Infectious diseases consultant Dr Mary Horgan, president of the Royal College of Physicians, said the public needed to "knuckle down" and "use all the tools we have".
She said people who get fully vaccinated “get a bit of a false sense of security”, thinking that they will be “absolutely fine”, but during this “time of uncertainty” people needed to adhere to the public health measures to prevent transmission.
“It is using every single tool we have smartly to try to get us through this winter,” she said.
Vaccine limitations
Immunologist Dr Kingston Mills, a professor at Trinity College Dublin, said the Covid-19 vaccines were "very good" at preventing severe disease but cases of "vaccine breakthroughs", where vaccinated people get infected, showed the vaccines were not inducing "sterilising immunity".
He said he did not understand the reluctance in Ireland to accept there was waning immunity from vaccines and that there was a need “to boost our own population” with third doses.
Eventually a vaccine designed specifically to take care of variants would be needed because the vaccines were not working as well against the more transmissible Delta variant, he said.
In the meantime, booster doses, particularly for healthcare workers, would “get us out of this hole that we are in right now of ever-increasing cases”, he said. “I think we are in for a fairly rough winter,” he added.
Dr Ryan agreed with giving “third primary doses” to vulnerable people but opposed boosting entire populations with third doses when there were so many unvaccinated people in the world.
He compared vaccines and boosters to life jackets where people in richer countries in the northern hemisphere have two life jackets while people in the poorer south have none.
“There are millions and millions of people around the world, particularly in low-income countries, with no life jackets, and we are handing out more in the north,” he said.
Sluggish donations
Many developed countries have two or three times the number of vaccine doses they need, even after accounting for booster doses for their populations, and yet only 15 per cent of vaccine donations pledged to lower-income countries have been delivered, he said.
“Big pharma is prioritising the contracts of developed countries because they know that’s good for business in the long term. They are putting profit before people,” he said.
Both Dr Ryan and Prof Mills agreed that booster doses for vulnerable people in vaccinated populations and immunising unvaccinated countries could be done in tandem.
Repeating Dr Ryan’s analogy, Prof Mills said people in their 80s “don’t have a lifebelt that would keep them afloat right now”.
Dr Ryan praised Ireland’s efforts to reduce the spread of Covid-19 and the Irish people for having “really stuck it out”.
“It was needed because the health service could have really collapsed without that effort from Irish people, without the effort from the health workforce,” he said.
