Restrictive measures due to the coronavirus pandemic in Russia may be lifted by the end of the summer, President Vladimir Putin said in late March. According to him, this will happen after 70% of adult Russians are vaccinated, which will create collective immunity. Putin is confident that this indicator can be achieved by the end of the summer, given the current vaccination rate. Experts doubt the feasibility of these plans.
This is not the first time that Russian officials have publicly attempted to estimate the timing of herd immunity and, based on that, made optimistic predictions. Moscow Mayor Sergei Sobyanin, for example, said last July that there would be no second wave in Moscow and that Muscovites had “essentially developed a collective immunity that allows us to confidently continue easing restrictions.” The mayor claimed that about 60% of the capital’s population was immune to the coronavirus. At the end of the summer, Sobyanin declared that the city would completely defeat the coronavirus within six months. In November, the city authorities tightened restrictions again, and the second wave hit Moscow and the regions, many of which were unprepared. In February, the number of cases began to fall, and this trend is continuing, but it is still too early to talk about victory over the disease. The third wave of the coronavirus, which has partially started in Europe, has not yet reached Russia.
Deputy Prime Minister Tatyana Golikova explained the absence of such a wave in Russia, including due to the lockdowns in which residents of many European countries are staying. “One of the reasons for such a development is that they were permanently closed. People stayed at home, they didn’t go out, they were virus-free. They go out – and they catch it,” she said. Russia appears to have adopted a somewhat hybrid approach, with flexible restrictions on who can come into contact with the virus and mass vaccination. Judging from various statements, the authorities hope that this approach will lead to the development of herd immunity, which will help combat the pandemic.
Collective immunity is indirect protection against infectious diseases that occurs as a result of vaccination or previous infection, according to the WHO website. The organization emphasizes that herd immunity to Covid-19 should be achieved by protecting people through vaccination, not by exposing them to the coronavirus. Attempts to achieve herd immunity by exposing people to the virus are considered unethical by the World Health Organization (WHO). Scientists have doubts about its effectiveness from a scientific point of view.
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Another controversial issue is the proportion of the population that needs to have individual immunity to achieve herd immunity. WHO notes that this proportion varies depending on a variety of indicators – the specific disease, the vaccine used, the priority groups for vaccination, the social structure, and other factors. Last August, a study published in the journal Science claimed that the threshold for herd immunity against Covid-19 is only about 40%. The authors argued this based on the heterogeneity of the population – the infection is primarily transmitted among the more active and younger population, whose immunity tends to be stronger than that of the elderly and infants. In March of last year, researchers at Johns Hopkins University concluded that more than 70 percent of people need to have recovered from the new coronavirus in order to develop herd immunity.
The percentage of immune individuals required for herd immunity has changed slightly in statements by Russian officials. In early March of this year, for example, Deputy Prime Minister Tatyana Golikova hoped to reach 60% of immune people by August – although she did not specify whether this included only those who had been vaccinated or those who had also recovered from the virus. “We expect that if vaccination continues at the current pace and the number of vaccination sites remains the same, we as a country will achieve herd immunity in August 2021,” Golikova said. She stressed that this date could be brought forward depending on the vaccination rate.
About 500 studies have been conducted worldwide, concluding that less than 10% of the world’s population has antibodies to the coronavirus, Sumia Swaminathan, WHO’s chief scientist, said in a tweet earlier this March. “Of course, in some places, especially in densely populated urban areas, there are areas where 50-60% of the residents have been infected with the virus and have antibodies. But that does not mean that the entire city, province or country has achieved herd immunity,” Swaminathan said. “If people without antibodies go to places where the level of herd immunity is lower than in their city, they can get infected, the expert explained.
In a Lancet commentary published in February this year, scientists suggest that the increase in the number of cases in Manaus may be linked not only to changes in the virus itself, but also to errors in measuring the number of immune individuals, as well as a decrease in the level of protection in those who have already had the disease. According to scientists, the virus could first spread actively among one group of people, and in a second wave, it could reach another group that had not previously been exposed to the virus, and that group could be even larger. “In order to understand that everyone has already had the virus, it is necessary to take tests from everyone, which has not been done. Here, the basis of the research itself has been misinterpreted by the scientists,” says doctor Timur Pesterev, explaining the situation in Manaus.
The complexity of calculating herd immunity for a population is also related to the fact that immunity acquired through disease and immunity acquired after vaccination are different, their duration of protection varies from person to person, and it is still unclear what exactly it depends on. “Now we see that immunity after an illness generally lasts about nine months (according to some studies – about six – BBC), and then the level of protective antibodies begins to decline significantly,” says infectious disease physician Nikolay Lunchevkin. Epidemiologists are only now beginning to understand how long immunity can be maintained in the population, he adds.
There is still no consensus in the scientific community as to whether herd immunity will help in dealing with the coronavirus, given the mutation of the virus and the fact that no one knows how long the protection will last for those who have had the virus and those who have been vaccinated. It cannot be ruled out that vaccination against the coronavirus will be necessary every year, as is the case with influenza.
In October 2020, about two thousand scientists signed the John Snow Memorandum (the website is currently unavailable), calling for the abandonment of the idea of developing herd immunity against the coronavirus. According to the authors of the memorandum, this approach has “no scientific basis,” so its use may be dangerous for the population. In contrast to the Memorandum, there is also the Great Barrington Declaration. It is a document developed and signed on October 4 last year at the libertarian research center AIER (American Institute for Economic Research). Its authors oppose the implementation of lockdowns and propose to live life as before, but at the same time to “better protect those who are at the highest risk” of getting sick and dying.
Over 700,000 “concerned citizens” and over 50,000 people claiming to be medical professionals signed the document. The White House, under the administration of Donald Trump, has endorsed this letter. Later, the American Society of Infectious Diseases, which includes over 12,000 scientists and physicians, called the Barrington plan “inappropriate, irresponsible, and based on a lack of information. “In the history of public health, the concept of herd immunity has never been used as a strategy to respond to a disease outbreak, let alone a pandemic. This is both scientifically and ethically problematic,” said WHO Director-General Tedros Adhanom Ghebreyesus.
In Israel, for example, about 60% of the population has been vaccinated, and the number of cases has dropped by 59% compared with the last peak, while the mortality rate has dropped by 20%. The number of cases in the United Kingdom is also decreasing significantly,” says Lunchevnikov. In other words, we can already see from the example of countries that are actively vaccinating that incidence and mortality rates are significantly decreasing, which means that this method of achieving herd immunity is indeed effective,” the expert explains.
Such a trend is also visible in Moscow, where vaccination is currently being carried out most actively among Russian regions. “Taking into account the statistics in Moscow, where only a thousand people out of a million vaccinated got sick, it can be said that the vaccine provides collective immunity, and those who got sick had a mild form of the disease and there were no fatal cases,” said doctor Timur Pesterev in an interview with the BBC.
There are no official data on vaccination in Russia, but according to unofficial sources, at least 5% of the population has been vaccinated with at least one component of the vaccine. On average, 110-120 thousand people are vaccinated every day. For comparison, the US vaccinates 2.5 to 3 million people per day, and to date, at least 32% of the population has been vaccinated with at least one component. In the UK, more than half a million doses are administered each day, and 57% of the adult population has been vaccinated. According to the calculations of the website Gogov.ru, at the current rate of vaccination in Russia, at least 50% of the population can be vaccinated in over 500 days, which is about one and a half years, assuming that people are willing to be vaccinated.
According to official statistics, 4.5 million people in the country have recovered. If we add this number to those who have been vaccinated with at least one component (and not taking into account that we still do not know exactly how long immunity to the virus lasts), it turns out that currently less than 10% of the population of the country has immunity. It will be difficult to reach the predicted level of vaccination by the end of the summer, as stated by Putin, if only for the reason that it is unlikely that there will be such a number of people willing to be vaccinated, says Pesterev. Another reason, according to the expert, is that there may simply not be enough vaccines. He emphasizes that the reasons are specifically socioeconomic.
Pesterev considers the predictions premature, but notes that Russia must prepare for an increase in cases in the fall, which will definitely happen, but not to such a large extent. According to the expert, the coronavirus will then officially turn into a seasonal infection. “It will be extremely difficult in [Russia] to reach even the current level of vaccination in the UK (around 60%) by the end of the summer,” says infectious disease specialist Nikolai Luchenkov. According to him, the only way to achieve this is to make vaccination compulsory. “If 90% of the population is vaccinated, it will be possible to return to the pre-pandemic situation,” the doctor notes.
Viruses are organized in such a way that the more likely a person is to become infected and transmit the virus, the more likely that virus is to mutate as it finds ways to continue to exist and be transmitted. This means that as the number of immune people slowly increases, there will be more room for the virus to mutate, allowing new strains to emerge against which existing vaccines will be less effective. “If we vaccinate a large number of people, the chances of new strains emerging that help the virus evade the immune response decrease significantly,” Lunchenkov explains. “And if only a small number of people are vaccinated, those chances only increase.”