This isn’t the last strain we’ll see. And after almost two years of pandemic hardships, does two weeks at home still seem such a big imposition?

(Originally published Aug. 31 in “What in the World“) The good news is that the latest global surge in Covid appears to have peaked.

And so, by about mid-October, we’re likely to start hearing more about the need to reopen and do what many countries are already saying they plan to do—to “live with the virus.” The problem is that we’re likely to have only chased the virus into hiding somewhere in the world where it can regroup and then come back to re-infect us again. Already, a new and radically mutated strain has been identified in South Africa. No word yet on whether it’s more infectious or deadly, but it’s a reminder that every time the virus is allowed to infect an individual and replicate, it gets the opportunity to mutate into something that is.

This latest surge almost just as severe as the previous ones, despite all the progress we’ve supposedly made with vaccines. That’s because delta is so much more infectious than its predecessors and, eight months after they became available in some countries, only about a quarter of the planet is fully inoculated. Even in those few countries where vaccination rates are very high, moreover, vaccines are proving disappointing at preventing infection by delta and, because they lower the severity of infection, are likely boosting transmission and, therefore, pushing herd immunity against the delta strain out of reach.

The upshot is that the virus is simply evolving faster than we can inoculate ourselves against it. That means that even if we manage to vaccinate one group of people in one country, unless we manage to block transmission of the virus on a global scale, we will keep giving it the opportunity to mutate into something vaccines won’t stop.

Born in the East, perfected in the West

Consider this: the global pattern charted above hasn’t taken place uniformly around the world. It has reverberated back and forth from country to country, continent to continent as people travel. The first outbreak was, of course, in China, which peaked in February of 2020. China managed to quell transmission of the virus so effectively that that surge is hardly perceptible in a graph of global cases now. The pandemic then leaped to Europe, which led global tranmissions until late-March. That’s when the United States joined in, with the April 2020 peak finally plateauing as sporadic efforts at wearing masks, social distancing and lockdowns finally had an impact.

The pandemic’s epicenter moved in May, therefore, to South America, which kept its transmission rates flowing until June, 2020. It was then, as summer dawned, when Americans grew weary of lockdowns and social distancing and, by the end of the month, had resumed their leadership of the pandemic. That and surging cases across Indiacreated the second plateau in the chart above, in August 2020.

North and South America whittled away at transmissions until late September, when the virus regained the upper hand and managed to launch a new offensive in Europe, which by October had resumed its position as the front lines of the pandemic. That lead last only until early November, when the pandemic shifted again to the U.S.

Vaccine, Schmaxine

The start of the U.S. vaccine program in December, 2020, coincided with a sharp, but very brief, downturn in infections by last Christmas, with the pandemic back in rapid expansion across the U.S. by the start of 2021.

Mid-January ushered in a long decline in American infections and Covid looked to be truly on the run throughout February…

But in March, the virus managed to stage a two-pronged counteroffensive in Europe and South America.

Delta Dawn

Europe managed to turn the virus back by the end of March, but by then Covid had managed to stage a coup on the other side of the world in India, unleashing a new and much more infectious weapon—the delta variant—in one of the world’s most populous countries. While vaccines developed for older strains appear to be effective in reducing the severity of infections and thus hospitalizations, they don’t seem to be preventing delta infections as definitively. There’s also some evidence that their effectiveness is fading over time, though how quickly isn’t yet clear.

Despite the massive coverage of India’s plight and the international effort to aid it, India only led the global pandemic for about a week in early May. But between and a resurgent outbreak in South America, it was enough to create the worst peak in the chart. Here’s a look at that month’s figures in nominal terms….

Asia’s Long, Hot Summer

While the U.S. has led the delta surge in terms of severity, the Delta surge has largely been an Asia-led pandemic. Here’s a chart of the outbreak by incidence, which shows the U.S. still clearly doing the worst job of quelling infections….

But in terms of absolute volumes of victims for the virus, Covid is getting most of its fuel for mutation now in Asia…

This has prompted some to conclude that there’s no beating the virus, that we need to learn to “live” with it. And that’s definitely true once it mutates into a strain that is less virulent, i.e. that doesn’t require vaccination to avoid devastating illness. But Asia’s failure to stem delta isn’t due only to delta’s greater infectiousness. It’s due in part to the fact that most Asian nations failed to capitalize on the time they bought with quarantines and strict social distancing to fully vaccinate their populations. And they continued to let some people in, with varying and often inconsistent standards of quarantine.

Only a few Asian nations, most of them very small like Singapore, have managed to vaccinate more than half their populations. That means less than 30% of the world’s most populous continent is protected from severe infection…

But the other reason Asia’s lockdowns haven’t helped is because the rest of the world didn’t follow suit, and instead allowed the pandemic to rage and new variants to emerge. So arguably all these vaccinations in Asia would have been little help against delta anyway, since it seems able to infect vaccinated individuals only slightly less easily than unvaccinated ones. That’s why barring unvaccinated travelers now but allowing vaccinated ones, as the EU is recommending its members do to U.S. visitors, isn’t very sensible. All travelers should be quarantined; and travel from countries with high rates of infection should be barred.

The drop in the rate of severe infections has given popularity to another fallacy: that we shouldn’t focus on infections and instead should worry about hospitalizations and deaths. This would be true if a) we were unconcerned about deaths among the 75% of the world still unvaccinated and b) the virus wasn’t so likely to mutate in infected individuals. As discussed in an earlier column, vaccinated people with Covid rasie the ratio of asymptomatic Covid carriers who spread the virus unknowingly. You may recall that it’s because so many people with Covid have no obvious symptoms, especially in the earliest stages of infection, that they can spread it so rapidly. Thus opening your borders and “living with the virus” is fine if your population is largely vaccinated and stands a lower risk of dying, but means you’re fine exporting deadly carriers to your less-vaccinated neighbors.

We could instead commit to getting the rest of the world vaccinated, but it’s obvious that we won’t be able to do that before the virus mutates again and people in those countries that already have high vaccination rates need booster shots. And the outcry over rich nations depriving poorer nations of doses to provide their own citizens with booster shots has already been muffled by the chorus of calls for booster shots.

The right course is the least comfortable option of all: We need to go back to the original response that epidemiologists recommended—a 2-week lockdown. Anyone who is infected would by the end of that be largely clear of infection. But it can’t be like it was in the early days of the pandemic, when some countries enforced a lockdown and others didn’t.

One could argue that Asia wouldn’t be coping with the delta surge at all had the West followed its lead with social distancing and quarantines in early 2020. Until we stop the transmission of Covid everywhere, it will retain the ability to infect, mutate and re-emerge anywhere.