Saturday, February 27, 2021

The Lancet: "immune evasion, a virological game changer"

"Populations have so far been relatively complacent, but their doubts and distrust are visible in protest movements in several countries. The impact of general confinement on entire economies has been devastating, with worse still to come in levels of unemployment and national debt. Social and health (including mental health) consequences are also colossal, in particular for the younger generations, despite them being at low risk in terms of morbidity and mortality from SARS-CoV-2 infection.

To best ensure the success of mass vaccination—whatever its hoped-for impact on transmission—and to slow the emergence of new variants, while avoiding general confinement, governments need to integrate and apply available measures in a way that is much more targeted to different generational groups. Different age groups are not affected similarly by the virus; from March to June, 2020, 96% of additional deaths related to COVID-19 in Europe occurred in patients aged older than 70 years.

Crucially, the new approach should be based on a social contract that is clear and transparent, rooted in available data, and applied with precision to its range of generational targets. Under this social contract, younger generations could accept the constraint of prevention measures (e.g., masks, physical distancing) on the condition that the older and more vulnerable groups adopt not only these measures, but also more specific steps (eg, voluntary self-isolation according to vulnerability criteria) to reduce their risk of infection. Measures to encourage adherence of vulnerable groups to specific measures must be promoted consistently and enforced fairly. Implementation of such an approach must be done sensitively and in conjunction with the deployment of vaccination across the various population targets, including all generations of society."

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