A return to normality? Not for everyone

A vaccinated Aotearoa of late 2021 may look a bit like pre-pandemic NZ. But it could be a microbially more dangerous place for some, writes Nicholas Agar 

There is a race on to find a vaccine for Covid-19. The fact some of the tested possibilities do prompt immune responses suggests we can be optimistic one or more of these competing efforts will, sooner or later, yield a safe-enough vaccine.

As we peer though the gloom of Covid-19 to the exciting return to normalcy promised by such a vaccine, it’s worth noting that return to normalcy for most may mean something different for some. I’m a type-1 diabetic and it is likely to mean something different for me.

Dr Anthony Fauci, prominent member of the White House Coronavirus Task Force, expressed doubt about a vaccine that offers perfect protection against the coronavirus, saying, “I would settle for [a] 70, 75 percent effective vaccine.” The good news for many is we don’t need a perfect vaccine, something that provides 100 percent protection, for almost all of us to return to life as it was in late 2019.

No vaccine offers perfect protection. According to the Immunisation Advisory Centre based at the University of Auckland, the influenza vaccine protects “four–six in 10 healthy adults”. This is clearly not perfect, but it does offer sufficient protection for us to get on with our lives.

I get my annual flu shotI’m covered both as a diabetic and an employee of Te Herenga Waka—Victoria University of Wellington – briefly speculate about what it might be like to get B/Phuket/3073/2013-like virus (one of the strains covered by New Zealanders’ 2020 jab), and promptly banish flu from my thoughts.

It’s possible a coronavirus vaccine will offer this degree of protection. Perhaps it won’t. But if it helps at all, there will be a powerful collective desire to fully restart our economy, welcome rich tourists back to Aotearoa, and speedily put the pandemic far behind us.

The ‘team of five million’ rhetoric sustained us through almost two months of lockdown. But the team games that gave us this metaphor are of finite duration – rugby players know when their games will end.

Fauci would settle for a 70 percent effective vaccine. I suspect there will be immense pressure for us as a nation to accept much less. There’s simply a limit to how much longer we can go on like this.

The ‘team of five million’ rhetoric sustained us through almost two months of lockdown. But the team games that gave us this metaphor are of finite duration – rugby players know when their games will end.

The many acts of rebellion at the return of strict measures in parts of Europe going through their second wave of the pandemic suggest many people are about done with all this social isolation and mask-wearing. The process of repeatedly going in and out of lockdown is emotionally wearing.

If we do settle for less, we mustn’t forget about people with compromised immune systems. So far in countries like New Zealand that have responded well to Covid-19, the immunocompromised have been unexpected beneficiaries of the pandemic. Research on influenza trends in South Korea attributes a significant decrease in flu diagnoses to the social distancing and handwashing prompted by the coronavirus. Influenza can be especially bad for diabetics.

The degree of protection offered by whichever vaccine we end up going for may offer sufficient protection for a full economic restart. But it may leave immunocompromised people significantly exposed. A vaccinated Aotearoa of late 2021 may look a bit like the pre-pandemic Aotearoa of late 2019. But it could be a microbially more dangerous place. It may turn immunocompromised people from lockdown winners into losers in an age in which we’re just having to get used to a world where the latest strains of the coronavirus will be added to B/Phuket/3073/2013-like virus on the list of things that could be especially bad for us.

It would be absurd to insist immunocompromised people have the power to veto the return to normalcy potentially offered by a Covid-19 vaccine. We’re all hoping for a future in which a sneeze could again be just a sneeze, and not a potential extinction event. We could collectively unclench our shoulders, go back to occasionally bringing our snotty noses into work – “it’s just a cold” – and basically letting all our microbes hang out.

But building back better will demand additional resources not only for businesses and universities, but for immunocompromised people, who will be grateful for any extra help in a microbially more dangerous Aotearoa.

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