If You Think Covid-19 is Over, Read this

hospitals in Osaka near collapse overburdened by COVID-19 surge

A covid-19 hospital in Osaka

By Umair Haque

We’re now two years into a global covid-19 pandemic. And Europe’s going into lockdown again. Meanwhile in America and Britain, cases have never really fallen — just plateaued at a consistently high level. Is it going to be another brutal, bleak Covid winter?

I have good news, and I have bad news.

See that chart above? It’s the most important bit of research into Covid and vaccines so far, period. Everyone should know it, but few do. Everyone should understand what it means so let me explain it.

This is one of those charts that tells a story — a dramatic and urgent one. A story which lets us peer deep into the future. I’m going to try to tell you that story.

The story begins with a study done in Israel, of more than 16,000 cases, comparing the vaccinated to the unvaccinated. What did the study find? Take a look at the left panel of the chart.

The X-axis is time — days since the second vaccine dose. The Y-axis is, for all intents and purposes efficacy. It’s expressed in “Ct regression coefficients” — that just means how many less Covid genes were expressed, relative to the unvaccinated group. Let’s get technical for a second now — and you can skip this if you want. You can think of the Y-axis as the difference in the mitigating effect of vaccines on viral loads, between the vaccinated and unvaccinated.

Now. To test for Covid using a PCR test, there’s something called a “cycle threshhold” — that simply means that how many times the machine has to try to copy the amount of nucleic acids (RNA/DNA) present to produce a positive result on the test. So if there is a high viral load — meaning lots of COVID nucleic acids present — then the cycle threshold is lower, because it takes less time to replicate the COVID that’s there because there’s simply more of it to start with.

A higher “Ct regression coefficient” simply means the reduction in viral loads between the vaccinated and unvaccinated. You just multiply the Ct coefficient by two to get to an estimate of viral loads, or as the researchers say “a difference of 1 Ct unit is approximately equivalent to a factor of 2 in the number of viral particles per sample”.

Yes, I know — that’s a little complicated, but it’s going to become a lot clearer as we discuss what it all means. I think it’s important for everyone to really understand this research, so, like I said — just think the Y-axis, roughly, as the efficacy of vaccines, and crucially, boosters. I want to tell you this story in depth, because I think everyone should know it in detail.

So what does the chart show us? Well, initially, there’s a huge, dramatic effect of taking a Covid vaccine. The Ct coefficient increases by about 4.5 times — and since, as the researchers say, “a difference of 1 Ct unit is approximately equivalent to a factor of 2 in the number of viral particles per sample”, that means that viral loads in vaccinated people are about ten times less than in the unvaccinated. That’s a wonderful thing to know. Covid vaccines work — amazingly well.

But — you knew this was coming — there’s a catch. In fact not just one, but three.

The next thing the data reveals is a super dramatic decline in vaccine efficacy over the following six months.You can see that the “Ct coefficient” — again, think of this as viral load relative to the unvaccinated control group — begins to drop. Sharply. And by about six months, there’s no statistical difference between viral loads in vaccinated and unvaccinated groups. As the researchers put it, the efficacy of vaccines “gradually diminishes, ultimately vanishing for infections occurring 6 months or longer after vaccination.”

You might have heard that too, but I want you to see for yourself just how sharp the decline in efficacy really is. And maybe it even corresponds to how you feel. Me? Most people I know? We agreed that we felt pretty good after getting our vaccines. But over the next six months, we began to feel…not so great. Day by day. Am I imagining things — or does the chart just confirm how most of us feel, after having had our vaccines?

That brings me to the next part of the story. At six months, patients were given boosters. What did the study find? A dramatic reduction in viral loads, all over again. Ct regression coefficients — the reduction in Covid gene expression relative to the unvaccinated group — rose sharply, if you want to think about it technically. That’s complicated, so if you don’t, then you can simply observe, by thinking about the Y-axis as efficacy that boosters work. Again, that’s a wonderful thing to know.

But this time, there’s a cruel twist to the tale.

How great is the efficacy boost of boosters? The data now begins to show us something a little bit alarming. Boosters didn’t have nearly the same effect that the initial round of vaccine doses did. Look at the first bar — it’s a towering spike, meaning that viral loads were wiped out in the vaccinated. But the booster’s bar? It’s not as high.

Instead, the booster’s bar is only about as high as at 60 days post-vaccine. In technical terms, the initial round of vaccines corresponded to about a tenfold reduction in viral loads. But at sixty days, that had fallen to a fivefold reduction in viral loads. The booster produced that effect — just a fivefold reduction in viral loads.

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That’s pretty good — but it’s not as good. Remember the initial round of vaccines reduced viral rounds by tenfold. But the booster only does so by fivefold. What does that mean, in practical terms? That boosters seem to have about half the efficacy of vaccines.

That finding should be like a bomb going off in your mind. It means that the more boosters you take, the less and less efficacy they’re going to deliver. Until, finally, even boosters show no statistical difference relative to the unvaccinated. Because, of course, we will need new vaccines against a now constantly mutating virus, not just boosters of old vaccines.

Now we can finally begin to understand about what it really means, the story this chart is trying to tell us. It goes like this. You take your vaccine, and yes, you’re protected. Over the next few months, though, the efficacy of that vaccine falls. Why? Because the virus is constantly mutating and changing, subtly, genetically drifting towards a whole new variant. So you get your booster, which is essentially another dose of the vaccine. The booster fights off the virus — but not as well. You don’t have as much protection as you did the first time around.

And over the next six months — every six months — that story’s repeated.
I said this chart would let us peer into the future, and it does. It shows us something very, very troubling. The efficacy of boosters appears to half every six months. Right about now, we’re still in a place where the first round of boosters we’re all taking still have half as much efficacy as the initial round of vaccines — that’s a good place. But the next halving of efficacy brings boosters down to a 2.5X reduction in viral loads compared to the unvaccinated. The next one after that, a 1.25x reduction. The next one after that? Statistically insignificant.

Suddenly, you should feel the sting in the tail of the story. That is a year and a half away. We are just a year and a half away from even vaccine boosters having no effect anymore. Bang.

If that happens it’s game over. Covid rampages through the world, just like it did the first time around, all over again. Alarmed? Worried? Scared? You damned well should be. This is an incredibly serious situation, and hopefully you can see why.

The story that this research tells us is dramatic and terrifying. We are not winning the war against Covid. We are barely holding Covid at bay. We’re like a city besieged by an enemy, which is barely, just barely, holding the gates closed. And it’s not at all clear how long we can keep that fight up.

What does it all really mean?

Well, not so long ago the head of the WHO warned that we’re now in a war against variants and vaccines — a long, hard one — and we’re losing it. Nobody really took him seriously, I think. Not Prime Ministers and Presidents, not the average person who just wanted to go back to the bar or football game, not even, for the most part, healthcare systems. Nobody was listening to the warnings. We didn’t vaccinate the world and stop the virus in its tracks. Joe Biden listened to billionaires like Bill Gates, who told him not to vaccinate poor countries.

The result? We didn’t defeat Covid when we could have, and now we’re all going to pay the price. You can see that story told right there in the chart, because you’re one of the people for whom vaccines and boosters are going to stop working, too. And what then?
So here we are.

This is what it means to be in a war between variants and vaccines — and to be losing it. We now have a year and a half window, essentially, in which we need newer vaccines against a mutating virus. Because the boosters of the old ones are having a dwindling effect every time they’re taken.

If we don’t develop new vaccines for this variant in the year and a half window we have, as the virus slowly mutates, then the virus wins, and all our protections against it simply stop working.

If a new variant emerges between now and then — in the year and a half window we have — then the situation is even more dire. Those losses in efficacy speed up, fast.

The story that this research tells us is dramatic and terrifying. We are not winning the war against Covid. We are barely holding Covid at bay. We’re like a city besieged by an enemy, which is barely, just barely, holding the gates closed. And it’s not at all clear how long we can keep that fight up.

We are running out of ammunition against the deadliest enemy we’ve had in generations. Yes, deadliest. Do you know how many people Covid’s killed in America alone? Three quarters of a million. Worldwide? More than five million. We’re already at numbers approaching, exceeding for many countries, a World War.

We are losing the war against Covid, my friends.

A cynic might even say: that is exactly how power and money, fascism and capitalism, want it. I’m not a cynic, though, so I’ll just observe. We are going to have to fight a lot harder if we want to win this battle.

You might have thought Covid was over. I’m here to tell you that it’s not.
Is it going to be a long, brutal Covid winter? My friend. The question right about now is: when won’t it be?

*Umair Haque is the Director of the London-based Havas Media Lab and heads Bubblegeneration, a strategy lab that helps discover strategic innovation. He wrote this article for Medium.

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