 Hello and welcome to NewsClick. Today we have our discussion on COVID-19 and we are going to now not do it weekly as we did but once in a while we will take a review of what the current scenario is. We have Professor Satyajit Rath to discuss what appear to be some uptick of the COVID-19 cases both in Western Europe as well as Southeast and East Asia as well as the numbers don't seem to be falling as fast as we might have expected for instance in the United States. Satyajit the picture is definitely better than what it was during the Omicron wave in India and the Delta wave earlier but it is not as rosy and as if we are going to an end game when we see now numbers in South Korea seem to be quite high. We have numbers also in certain other East European East Asian countries that seem to be quite high. Hong Kong has a major outbreak right now. China of course is going for a zero COVID policy so 1400 numbers which be considered very low any other part of the world considering there are 1.5 billion people is still considered high in China but if we look at it even in the West European countries where the vaccination rates have been higher a lot of work being done over there to prepare for repeated waves. We see again an uptick taking place there. So what does it say about this? Is it because we have lowered our guard? Is it because there is a new slightly newer Omicron variant which seems to be spreading faster than the older Omicron variant? Is that the reason? So what is the reason for this new outbreaks and the new uptick we are seeing of the cases? So it's an interesting question and it underlines what has come up repeatedly over the past couple of years in terms of what is the future going to look like and the future is not going to look like suddenly one day definitively the pandemic is over, COVID-19 is over, we can go back to life before the pandemic. This is not going to happen and many people we included have been saying that in a variety of ways and this if you like is one of those scenarios that support that caution. So in the first place what seems to be happening is that the newer lineages, the newer strains of the virus, the Omicron cluster of strains is clearly quite capable of infecting vaccinated people. That means that we are not stopping transmission. The last three, four months have now given us adequate evidence for this, we're not stopping transmission which means that the spread of the virus in communities is not coming down in the same kind of fashion as it did during the days of the Delta lineages last year which were coupled to vaccination and wherever vaccination was fairly robust and widespread, mostly in the global north given vaccine inequities, Delta transmissions did come under control. Transmission is not coming under control with the Omicron lineages in vaccinated communities. So what seems to be the situation is that it's only when the bulk of the community is infected with Omicron lineages that an Omicron specific transmission blocking immune situation will emerge and will begin to reduce Omicron transmission. Again, we don't as yet have absolutely hard evidence for this but the initial indications are supported with this. Secondly, because the vaccines even though they don't block transmission do reduce rates of hospitalization and death which is manifest in the current situations where even though infection case numbers are high, are rising, hospitalization deaths, the overwhelming of hospital critical care facilities that we've seen in the previous two years is not really being seen anywhere very much. Hong Kong may perhaps be an exception for very local reasons but is not being seen as widespread a fashion. What that has led to is two things. Number one, the people who were vaccine hesitant have simply settled into vaccine hesitancy rather than going forward in getting vaccinated because it's over and we have on the other hand the so-called community pathways of distancing and the non-pharmaceutical interventions that we've been using. We are beginning to give it up. We are opening up marketplaces, we are opening up schools, colleges, entertainment, everything and as a result we have this convergence of situations where a rapidly transmissible strain that cannot be stopped from transmitting by vaccination even though serious disease can be stopped is being invited by the communities to spread more and more. So it's not particularly surprising that we are seeing an optic. Let me add a note about the quality of some of this evidence. We've said this repeatedly that the number of cases, test positivity rates, all of these remain a little difficult to compare between different times and different places and that's because it's not clear who's being tested, what the criterion for testing is and if the criterion shifts or is different between countries then comparing test positivity rates, comparing numbers all becomes something of a guessing game. The one place where I'm aware a steady consistent effort at statistically designed robust sampling of testing in the community was going on has been in Britain and it is therefore interesting and instructive that it's the British numbers that have begun to show this rise that is reflected by a fall off of vaccination so that communities that have not, sub communities that have not gotten vaccinated are getting more exposed, a slightly more transmissible Omicron lineages apparently spreading and most of all especially in Britain where the disconnect between the high quality science and the poor quality policy is quite striking, the community has opened up to transmission. One thing that I would like to add Satyajit over here is that also a lot of home kits are now available which don't enter therefore the governmental or the public health system in terms of reporting about positive cases though some of them do ask you to report back and so on but a lot of them actually don't so that is also the reason again it's not an apple to apple comparison when you compare the number of people infected being reported today and as you have discussed earlier in with us that in fact this is beginning to become a more less important criteria except to see a broad trend than a real scientific evidence so to say which it was earlier when it was much more difficult to access the tests and therefore the tests were actually led to good reporting as well. Now coming to the other issue that we are talking about an end state clearly the middle state if not the end state today is relaxation of controls the non-pharmaceutical interventions because it's also true after two and a half years people are also becoming tired of not having various activities which are considered normal not visiting each other so even though you may be quite willing to accept all these are important at the same time the ability to follow it becomes lax particularly if you are vaccinated and you feel that hospitalization is going to be of much less chance and therefore there is this possibility of then weakening your barrier so to say of this non-pharmaceutical interventions but sorry I've said it the other way around but I think anyway people will understand so in any case so what are we looking at in terms of end state now given the fact that COVID-19 and its different lineages are here to stay of course if a new lineage comes up like Omicron did and proves to be much more dangerous than infection causes all kinds of other problems that all bets are off but looking at it and I know this crystal ball gazing is not what you like to do as a scientist but as a public health guest guest expert no it's not an expert can you tell us what is the guessing game we should play now as a possible outcome in the short run rather than the long run so in the first place we clearly need to go the last mile that phrase is actual mockery of many countries in the global south which have not even started the first mile of the vaccination campaign marathon but we really really really need to have the vaccination campaign reach hard to reach hesitant disconnected underprivileged communities I'm not really just talking about each individual vaccinated I'm talking about the problem that it is whole communities that are not vaccinated and as a result virus circulation in those communities becomes a sort of a simmering coal in in epidemiological terms so that's absolutely essential I also think that while it is perfectly true that draconian extensive and long-lasting law and order style public distancing measures especially on a wide scale have been long overdue for removal I think that there is a difference between restarting economic lives and the simple act of masking and I think that one of our biggest failures in public discourse is that we have not managed to separate these we have not managed to separate the fact that many of these restrictions lead to economic hardship and therefore need to be narrowly focused need to be only when needed need to be coupled with a great deal of support on the one hand and on the other hand good as we've repeatedly said in these discussions in 95 level masking by making reusable masks available from the state along with a public information campaign that makes wearing masks a matter of habit even when we are dealing with the opening of these other controls that in itself would contribute significantly to slowing down the rates of transmission and anybody who has heard that heard us discuss these matters over the past two years will remember our constant harping on rates of transmission and the control on rates of transmission as the critical issue in the pandemic and that I think has been a a a conflation and a failure of all of us and not simply blaming government and public health authorities on this but community is so-called guest birds and all of us so that's something of an issue all of that said I suspect that what we are going to come to is these ups and downs over coming months that will lead to invitations especially from people who stand to make a lot of money on it such as the Pfizer and Moderna chief executive officers for not only third dose vaccines but fourth dose vaccines of the tried and tested proven vaccines but I suspect that in the next few months we're also likely to see Omicron specific versions of vaccines beginning to come up and beginning to be tested at that point how vaccination campaigns are going to integrate these multiple vaccines not simply multiple forms of the 2020 generation vaccines but now the added complication of 2022 vaccines all of that is going to remain to be is going to have to be looked at carefully and it's going to be a challenge for global public health authorities that challenge is going to be complicated immeasurably if we treat the pandemic as over in that way. Two measures points that I will take out of what Satyajit has said one of it is that if we can slow down the rate of transmission through non pharmaceutical measures like masks etc whenever we have such a scenario the advantage we get in public health terms the number of people who overwhelm the hospital the real reason why hospitals collapse and death rates shoot up that can be avoided so therefore speed of transmission is the key to helping your public health systems survive therefore the importance of masking whenever numbers started up tick or even under normal conditions in busy places when you go into any crowds when you go into for instance the aircraft or you go into the metros all of that then become particularly important unfortunately we can't say that about restaurants because eating with masks is still going to be a difficult exercise but leaving that the second part of it which is that we need to look at vaccines again the public health part of it not the profit part of it the public health part of it and the fact that even now 700 million people in Africa do not have vaccines to the extent that even having covered the population with one vaccine or with two doses which is the minimum when you are talking of the third and fourth booster dose in other countries this is something which is completely incompatible with global public health if that's really even in your self-interest this is something that we have to we have to stop because if we don't we're going to see this new variance emerge continuously this is I think something we need to talk about in a larger way and we will have one discussion also purely devoted to vaccine what is the production processes what is the intellectual property issues and maybe we should have a larger discussion not just Satyajit and me discussing this issue but also those who deal with the intellectual property aspect of it and the production aspect of vaccines thank you very much Satyajit for being with us and thanks to all of you do visit our website and do see what we are discussing about COVID-19 and other issues