In the UK's case it's Johnson's fault for allowing large case numbers of Delta which are his direct responsibility as he elected not to stop flights from India at the same time as he did from Pakistan and Bangladesh, even though India had a higher rate of infections at the time. The lure of a trade deal with Modi being his prime objective. With high case numbers and high vaccination rates here, it puts pressure on the virus to change so that it can get round the vaccine, but it's the high number of cases that allows the virus to have the "space" to mutate in.
If we'd had high vaccination rates but low case rates this issue would not have been such a worry. We were heading in that direction until Delta.
Hi Trent,
OK, so the Flemish vet Vanden Bossche thinks that severe lockdown and vaccines that are 'leaky' select for the more infectious variants once the latter are present in the population. His main argument is that if you look at how vaccination is usually done, it's carried out at a time when the patient is not exposed, or is at very low risk of exposure, to the pathogen and can build up immunity without being infected. With this pandemic, we are vaccinating at the same time as infection is occurring. Because of this continued infection, the virus has as you say more chance of mutating, and when a mutant that can evade the vaccine appears it escapes into the population and becomes dominant. It's not a simple case of get the jab, wait a few months for full immunity then its safe to risk infection. The risk is already high.
In the UK's case, the evolutionary pattern seems to be: prolonged severe infection prevention measures put pressure on wild type, leading to the more infectious alpha mutation escaping infection prevention measures. This leads to a second wave of infection. Then vaccination starts, puts increasing immune pressure on Alpha, so infection with Alpha declines and second wave ends. Then Delta arrives (I didn't vote for Boris, you'll be pleased to know), is even more infectious and severe, so it infects the young and can evade vaccines, leading to a third wave. However, vaccination and younger hosts mean morbidity and mortality are lower (so far).
My thought is that if we could somehow have prevented the more infectious variants occurring we could have achieved herd immunity against the wild type. Vanden Bossche thinks that the immunity acquired through natural infection is 'richer' than that acquired through the current vaccines, and prevents re-infection not just by the wild-type but by more infectious variants, as it also involves natural antibodies that have a broad specificity.
But when the variants cause high levels of infection, this innate immunity cannot cope with the high viral load in the population. So having lengthy lockdown and vaccine-induced resistance that select for more infectious variants, ultimately leads to higher infection which in turn reduces our innate antibodies' ability to deal with the virus and achieve herd immunity.
So in hindsight, we have to go back to the initial infection prevention measures to work out how best to protect the vulnerable, prevent variants becoming dominant and allow enough healthy people to be infected and develop herd immunity.
The key is to lock down while working out how to treat the disease, then as soon as this is achieved allow young people to maintain their naturally high levels of innate immunity, letting them go back to school and young people to university/work.
Also when a person develops symptoms they should isolate, but not when asymptomatically infected, as the latter shed less virus than the former.
