Sixth COVID-19 Wave: the Same Storm, Different Boats

Over the last few days, all our attention has been focused on what the new variant can -or cannot- do, as if we had forgotten that we are already in the midst of a sixth wave that has little to do with omicron. The constant rise in case incidence over the last weeks in Spain and the rest of Europe should remind us that we are still knee-deep in a pandemic and facing the first winter with the highly transmissible delta variant. We are certainly at a better place than last winter, when the first vaccines were being administered and the alpha variant was charging in. Today we have several highly effective vaccines against severe disease and death (even if protection against infections has declined) and, in some countries like Spain, a high percentage of the population is fully vaccinated, which has allowed to considerably weaken the link between cases and hospitalisations or deaths (the impact of vaccination on long-Covid is still not clear).

Over the last few days, all our attention has been focused on what the new variant can -or cannot- do, as if we had forgotten that we are already in the midst of a sixth wave that has little to do with omicron.

However, it is not a time for complacency or for throwing confetti (or facemasks) into the air. We are at a moment where the population aged over 60 needs a booster dose to recover high protection against disease. We are at a moment where the healthcare workers, particularly those in primary healthcare centers, are exhausted after almost two years of crisis, and are struggling with several respiratory viruses at the same time. And we are at a moment where the population is tired of following safety measures and is eager to meet with friends and family this holiday season. Being vaccinated decreases the individual risk perception (we are indeed protected from severe disease but we can still get infected and infect others). All these factors combined, together with the possible arrival of omicron, set the stage for another big wave.

What omicron is capable of doing and whether it can displace delta remains to be seen. But as the proverb says: one should hope for the best and prepare for the worst. The good news is that we know what measures work: facemasks and ventilation. We also have a good fraction of the population with enough immunity (due to infection, vaccination or both) to protect against severe disease (to date, no variant has managed to evade vaccine immunity). And we have the option of updating vaccines relatively fast, if needed.

To avoid the worst, we need to do our bit as individuals, and much more as countries, to accelerate our way out of this tempest

To avoid the worst, we need to do our bit as individuals, and much more as countries, to accelerate our way out of this tempest. At the individual level, we have to maintain the minimum protective measures during this winter, despite the fatigue we are all feeling: facemasks in closed public spaces, limit social mixing as much as possible, ventilate adequately the spaces where we meet. In addition, each country must reinforce its epidemiological and viral genome surveillance, and communicate data in a fast and transparent manner (as South Africa did). At the international level, rich countries must stop acting based on their political interests and start taking actions based on scientific evidence, starting by reinforcing controls among travellers instead of closing borders, or stop hoarding vaccines for third and fourth doses and do whatever is necessary so that these vaccines reach low and middle-income countries right now and in sufficient quantities to at least vaccinate healthcare workers and the most vulnerable populations. Otherwise, we will run out of letters of the Greek alphabet with all the variants that will keep on emerging and spreading in places with low vaccine coverage.

Not only we are in better boats, but our selfish actions create even more waves for the fragile boats

As the British poet Damian Barr said, “we are all in the same storm, but not in the same boat”. Nothing could be truer for this pandemic. Not only we are in better boats, but our selfish actions create even more waves for the fragile boats. This winter is the time to show more solidarity – with the people around us, the healthcare workers, the vulnerable populations, the countries that cannot access vaccines and treatments.

It has been said time and again: in this crisis, we row together or we sink together. Let us row together to steer through this sixth wave. With a bit of luck, it will be among the last.