Two Flaws in Western anti-COVID Strategies

As an observer from a developing country, and a former finance minister of Cambodia, I note with surprise two flaws in the strategies being planned or implemented by Western countries to counter the COVID-19 pandemic and its economic repercussions.

The first concerns measures to remedy the paralysis of air transport and the collapse of international tourism. The second relates to the astronomical orders or pre-orders for a hypothetical vaccination made by Western governments in an attempt to quickly inoculate their populations against COVID-19.

I struggle to understand these failings can be squared with rational and good governance.

I- Remedies for the paralysis of air transport and the collapse of international tourism

Faced with the bankruptcies of international air companies and the loss of tens of millions of jobs in tourism, I am surprised to see only bickering and recriminations between governments concerning the opening and closing of borders and the imposition, or otherwise, of quarantine measures for travellers arriving from abroad.

There is, of course, the fear that these travellers may be carrying the coronavirus and so represent a contagion risk. However, consideration of health issues rapidly gives way to polemic and politics when governments differ in their evaluation of the risks of a particular country, or when they demand “reciprocity” in the treatment of travellers coming from or going to partner countries.   

While waiting for an overall solution to be found, the different governments are patching together piecemeal measures in splendid isolation, but without any coherence. This sometimes leads to Kafkaesque situations and does nothing to resolve the shared fundamental problems which they should be tackling.

Given the characteristics of COVID-19, there is a simple and efficient way to avoid the risks of contagion from international travel: the adoption by all countries concerned of a paper or electronic travel document which we can call a COVID-Free Temporary Certificate, or ‘COFTEC’. This would be a provisional certificate of non-contamination by COVID-19 showing that a person is at least temporarily non-contaminated and non-contagious.

This document could be valid for either 15 days on the basis of a virological test showing non-infection by a coronavirus, or for three months if the virological test is followed by a serological test allowing certification of temporary immunity. Validity for either 15 days or three months would be sufficient to allow most routine international travel to take place, while minimising the risk of contagion.

The COFTEC certificate would have to be presented before boarding. This would give the comfort of a guarantee of health security on the flight and avoid possible quarantine procedures in the destination countries.

Once standardised through international coordination, COFTEC certificates would allow airlines to carry tourists in secure conditions for themselves, the other passengers and the destination countries.

This first proposal is detailed in my article “We need standardised Covid-19 certificates to prevent airline bankruptcies and revive international tourism”, in The Brussels Times on July 29:

II- Rationalising orders and distribution of anti-COVID-19 vaccinations

The race for vaccination has led to a form of panic as well as political and/or financial motives displacing purely public health considerations. Several governments, including those of the US and the UK, have signed agreements worth billions of dollars with pharmaceutical companies to ensure access to astronomical quantities of the vaccinations to be able to inoculate their entire populations as quickly as possible.

The US administration has signed a contract worth $1.95 billion with the pharmaceutical company Pfizer to supply at least 100 million doses. Another company, Moderna, which has just received a billion dollars from the American authorities, says that it can supply 500 million doses per year, and potentially up to a billion, from 2021. Still, the company warns that it “can’t supply the whole planet.” These agreements show that the US does indeed plan to vaccinate its entire population.

The UK has reached an agreement with four American and European suppliers for more than 300 million doses. This will be ample to vaccinate the entire population of 66 million, even if some of the pre-selected vaccinations turn out to be failures.

Are such quantities of vaccination really necessary to overcome the pandemic? Do we really have to vaccinate the entire population of every country to eradicate the sickness?

From a political point of view, the best approach for a rich country would be to vaccinate the whole population as fast as possible, regardless of the financial cost. But from a public health perspective, this approach is wasteful and counterproductive.

The masterful intervention by an American doctor and epidemiologist William Foege to combat smallpox in West Africa in the late 1960s proves the futility of a systematic vaccination campaign for whole populations – even if we assume the existence of effective vaccination. Foege’s historic success in eliminating smallpox was achieved by identifying and immediately isolating those who were sick, and the tight surveillance of those at immediate risk of contamination. Those who were obviously vulnerable to infection were the only ones who needed to be vaccinated. The approach required the vaccination of just 7% to 8% of the population of the countries or regions where he worked, far less than the initial target of 80%, which was impossible for practical and financial reasons. 

It’s clear that a mass vaccination campaign targeting a hypothetical “collective immunity” is an illusory prospect and that there is another approach to eliminate COVID-19 which is faster, more logical and less costly. Recall that smallpox killed 2 million people a year before it was globally eradicated in the 1970s.

Foege’s approach remains topical and relevant for the coming vaccination campaigns, all the more so as we now have tracing and tracking technology which is vastly superior to that which existed 50 years ago.

This proposal to reconsider current official approaches is detailed in my article “Learning From Smallpox Eradication in the COVID-19 Era”, in The Geopolitics on July 28.

Read the French version of this article here