The U.S. President has opened a two-front war on the coronavirus: vaccines for the 5.4 billion people who still need them, and booster shots for Americans
(Originally published Sept. 23 in “What in the World“) U.S. President Joe Biden on Wednesday seized the initiative in the fight against the coronavirus, using the occasion of the U.N. General Assembly to convene a virtual “Covid-19 Summit” where he challenged world leaders to adopt his new target of vaccinating 70% of the world’s population against the virus by next year—and backing it up with the purchase of 500 million additional doses of Covid-19 vaccine (with a estimated pricetag of $3.5 billion) that will be donated to needy countries.
Perhaps more importantly, the Biden Administration pledged an additional $750 million to fund vaccine distribution, including $380 million for the Global Vaccine Alliance (GAVI) and another $370 million for “those administering the shots.”
Deglobalized by a Global Pandemic
The new initiative is aimed at finally putting a stop to the ripple effects of a pandemic that since erupting from China 21 months ago has killed at least 4.7 million people and continues to disrupt lives and the global economy. Lack of global coordination, inconsistent restrictions to prevent transmission and a sluggish vaccine rollout have allowed the virus to hopscotch from country to country, mutating as it voyages from England to Colombia to South Africa into new strains that then reverberated into populations thought to have recovered from initial outbreaks. Indeed, in his announcement, Biden repeated what has become a mantra that “to beat the pandemic here, we need to beat it everywhere.”
The result is that the world has been subjected to three distinct waves of infection, the latest by the Delta strain of the virus first discovered in India, each as pervasive as the previous. And humanity has been divided into three groups: those in rich countries incapable or unwilling to enforce the kind of restrictions to mobility needed to limit the spread of the virus, but with plenty of vaccines; those in countries where restrictions have succeeded in stanching the spread of the virus but failed to secure or deliver enough vaccines to lift restrictions without suffering a surge in infections by the more infectious Delta variant; and those poorer countries with neither adequate restrictions nor access to vaccines, where the virus has run rampant.
Unable to limit transmission despite widespread restrictions on personal movement and international travel, the greatest progress against the pandemic has been the success vaccines have shown against severe infections leading to hospitalization or death.
But vaccines cannot completely prevent infection or illness, especially as the virus mutates. Thus the death toll from the coronavirus remain high as the Delta strain sweeps through unvaccinated populations, carried unwittingly in many cases by vaccinated individuals with mild infections. Despite early efforts to coordinate delivery of vaccines through COVAX, rich nations have prioritized domestic purchases and delivery of vaccines to their own citizens, and dragged their feet on delivering the doses they promised to COVAX. Poorer nations all over the world thus continue to decry hoarding of vaccines by richer nations, giving rise to accusations of “vaccine apartheid.”
The global vaccination push is being given urgency by the increasing realization that, the longer the virus circulates, the more likely it is to mutate into a new strain against which current vaccines don’t work. And there’s little question where most of the additional shots will be headed—Africa.
Biden said the latest U.S. purchase would push the number of doses it is donating to 1.1 billion, the equivalent of three shots for every shot administered to its own citizens. But that may not be enough to mollify critics who accuse the U.S. of dragging its feet on global efforts, especially since only 300 million of those 1.1 billion doses are likely to be shipped out within 2021. Indeed, some critics are already saying the sums Biden has committed aren’t enough to achieve the Adminstration’s targets.
It’s also unlikely to defuse the debate over the ethics of administering booster shots in populations that already have high vaccination rates while the rest of the world waits. The U.S. Food and Drug Administration, which has expressed skepticism with calls for boosters to the wider population to offset ebbing vaccing effectiveness, nevertheless on Wednesday approved boosters of the Pfizer/BioNTech vaccine to the elderly and other vulnerable segments of the population.
The False Choice
Criticism of boosters centers on the assumption that booster shots will come at the expense of supplies for countries still struggling to acquire their first doses. But this appears not to be the case, or as Jen Psaki, the White House press secretary, put it Wednesday, “We can do both, and it’s a false choice.”
Biden’s real dilemma is that, despite accusations that the U.S. has hoarded vaccines and has enought to innoculate every citizen three times over, roughly 46% of his constituents—approximately 151 million individuals—remain unvaccinated. Americans are still dying at the rate of 2,000 a day even as infections decline nationwide, and the public remains sufficiently fearful of the virus that a wave of resignations and early retirements has left schools with a shortage of teachers. He can’t afford to declare victory against Covid at home and pursue war against it abroad.
And studies continue to prove what we’ve already deduced: that successive variants are becoming much more infectious, in part by becoming more airborne. Yet the world continues to make the mistake of assuming that vaccines offer an alternative—even rescue from—more aggravating mitigation measures such as travel restrictions and quarantines, social distancing and self-isolation, and wearing of surgical masks. Yet masks are believed to cut in half the amount of viral particles spread by exhaling, sneezing or coughting.
Until we manage to vaccinate people everywhere, we’re going to have to continue wearing masks and social distancing here—wherever here is.