People are treating vaccines as license to travel, helping the virus find new hosts in which to mutate. Sorry, but case numbers still matter.

The Wall Street Journal has published an article that manages to cover most of the points this blog has been ranting about for a while now: vaccines reduce the severity of Covid infections and the risk of death, but every infection is still an opportunity for the virus to mutate. The article then deduces that, if we can all just get vaccinated, Covid will become “like the flu.”

This is an alluring conclusion, but sadly it’s incorrect. Covid won’t become a virus with which we can live normally once we all get vaccinated, at least not yet. There are a couple of reasons why. First, Covid remains much worse than the flu, with a death rate 30 to 40 times higher that of seasonal influenza. We don’t recommend flu vaccines for healthy adults and teenagers because they can easily ward off a flu infection without danger of hospitalization or death. Only the old and infirm need regular flu vaccines. Our ability to survive Covid will thus continue to depend largely on how well vaccines work against new strains and, supposing they do, how recently we’ve been vaccinated. Given that we’ve so far only managed to vaccinate slightly more than 25% of the planet’s population, the odds don’t look good that we’ll be able to do this on a regular basis.

And as the Journal’s article reminds us, every infection, whether it puts the patient in hospital or not, is another chance for Covid to mutate into a strain that evades vaccines. The article makes the helpful assertion that Covid will over time mutate into something that is either less virulent, or less contagious. And the history of viruses would suggest there are good odds of this happening.

But it won’t necessarily happen very soon. As Kai Kupferschmidt wrote in the August Science feature highlighted in this space last month, this virus hasn’t even been seriously challenged yet: “While one might reasonably hope that its next iteration will move towards evading immunity while becoming less deadly, there are reasons to believe that Covid might be able to have its cake and kill us, too: ‘In SARS-CoV-2, most transmission happens early on, when the virus is replicating in the upper airways, whereas serious disease, if it develops, comes later, when the virus infects the lower airways. As a result, a variant that makes the host sicker might spread just as fast as before.’”

So, vaccines do reduce the risk of infection (by about 75%, according to the latest CDC figures) and help us survive the virus, but have proved less effective than hoped at creating herd immunity. For the latest evidence of that, look no further than Singapore, which began triumphantly reopening after achieving what it said was an 80% vaccination rate on Aug. 29, only to suffer an alarming resurgence in infections since.

Luckily, Singapore’s surge in cases is nowhere near as bad as the ones going on in the UK or the U.S., where vaccination rates are much lower than Singapore’s—nor as bad as Singapore’s own surge in the spring of 2020, which was led by rampant outbreaks in overcrowded dormitories for immigrant blue-collar workers. The reason? Despite relaxing some them to some extent and reopening its borders to travelers from countries with very low infection rates (the likely source of the new surge), Singapore continues to enforce social distancing measures and mask wearing. While it remains to be seen, those measures will hopefully keep Singapore’s latest surge from getting as bad as those in the West.

In the West, meanwhile, the wholesale surrender to Covid continues. Leaders are planning to convene in New York for the UN General Assembly, promising a high-level, super-spreader event. And even the snowbirds, a group as risk-averse as they come, are making plans to migrate South to Florida this winter, armed with the confidence that their vaccinations will keep Covid from killing them. The urge to reopen prematurely is also spreading to Asia, where Thailand is hoping to reopen many of its top tourist destinations to visitors next month, even as it struggles to quell its own surge in Delta cases.

The best advice for travelers this fall is to try to avoid catrching and spreading Covid by sticking to destinations that have achieved actual herd immunity: at least 80% vaccination/infection rates, and low reported infection rates (i.e. fewer than 1 in 1,000 residents over a two-week period). Here’s a complete list of those countries. I encourage anyone who’s vaccinated and feeling an uncontrollable itch for international travel to go there, if permitted:

– Chile (closed to all but citizens and residents)

– Qatar (registration required)

– Uruguay (closed to non-resident foreigners)

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