Analysis: Why is Covid third wave still a risk after vaccination programme?

Scotland’s Covid-19 vaccination programme is moving forward at pace, with almost all over-50s given a first dose, and all adults set to be offered one by the end of July.

So why, amid such good news, are health experts still warning of a third wave of the virus?

Mark Woolhouse, professor of infectious disease epidemiology at Edinburgh University, told a conference held by the Royal College of Physicians of Edinburgh on Wednesday that Covid-19 is “here to stay” and that Scotland should prepare for a third wave in the autumn.

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Scotland should prepare for third wave of Covid in winter, says epidemiologist
Health and social care staff wait in the rest area after receiving their coronavirus vaccines at the NHS Louisa Jordan Hospital in Glasgow.Health and social care staff wait in the rest area after receiving their coronavirus vaccines at the NHS Louisa Jordan Hospital in Glasgow.
Health and social care staff wait in the rest area after receiving their coronavirus vaccines at the NHS Louisa Jordan Hospital in Glasgow.

This is despite the fact that pretty much everyone over 18 is expected to have had two doses of a vaccine by then.

The statement won't be a welcome one for many in Scotland, who have pinned desperate hopes on a permanent return to normal even as soon as Boris Johnson's restriction-easing date of June 21.

But it boils down to the same line of thinking that is already in play – more than 600,000 people in Scotland have now had two doses of a vaccine, but restrictions have not changed for them.

This is mostly around uncertainty about the effect of the vaccines we have. Initially there was no evidence that vaccination cut transmission rates – but we now know it does – but experts still don’t know how long vaccine protection lasts for. Many are hoping for at least a year.

There’s also the fact that no vaccine will offer 100 per cent protection, and across a whole nation, even small percentages of people falling through the cracks can cause problems.

And then there are variants. In January, Prof Devi Sridhar, chair of global public health at Edinburgh University, labelled 2021 as the “year of vaccines and variants”.

She later said watching people allowed to travel to the UK from European countries where the South African variant of Covid-19 was established was like watching “a slow-moving car crash”.

A small study, published in the New England Journal of Medicine, Prof Sridhar suggested the AstraZeneca jag had a much-reduced efficacy against that variant.

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During that conversation with Prof Sridhar in January, to mark one year of planning for Covid-19 in Scotland, I asked her if the pandemic would be behind us by the autumn.

I’ve never seen a public health expert look more horrified.

"I don’t think anyone would say that,” she told me. “This is a chronic problem.”

As Prof Woolhouse highlighted on Wednesday, few health experts now believe that elimination of Covid-19 is a realistic target to aim for.

The unfortunate truth is the vaccination programme, while your best chance of reducing harm, is not a silver bullet to make all our pandemic woes disappear. You should still accept your jag though – both doses, of whichever type is offered to you.

Stephen Reicher, professor of social psychology at St Andrews University, told the same conference at which Prof Woolhouse spoke that setting clear expectations was one of the most important aspects of the vaccination programme.

Health officials have consistently said the vaccine will not herald an immediate end to the pandemic, but it has so far been news that many do not want to hear.

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