Covid, Information, Decision-making, in Europe and the US

Speakers:

• Paolo Vineis, Chair of Environmental Epidemiology at Imperial College, London
• David W. Ellwood, Senior Adjunct Professor of European and Eurasian Studies, SAIS Europe

The discussion began with Vineis addressing the necessity for preparedness in the fight against epidemics, as well as predictive models for decisions. As we are aware that new diseases emerge all over the world with increasing frequency, policy-makers should prepare for new pandemics before their appearance. However, the variety in different variables, such as infection or lethality rates, complicates such preparations. For this reason, different predictive models can be used. Vineis mentioned three different models, SIR, agent-based and phenomenological models. Each model is partially built on assumptions, such as incubation time, infectiousness and its variability among infected individuals, and the percentage of infected individuals who require hospitalisation or critical care. With regards to preparation through models for decision-making, Professor Vineis stressed that errors are possible and recommends we mind the assumptions, the framing, the consequences, and the unknown facts when using models.
 
Secondly, Vineis discussed what we can learn from previous epidemics. In New Orleans in the 19th century during a yellow fever outbreak, it was observed that epidemics bring about sociological, political, and ethical problems. Pandemics’ disproportionate impact on ethnic minorities, too, has been historically established. Finally, the type of political system is important: in 1892 Hamburg, a city ruled by merchants who opposed quarantine for trade reasons and had no confidence in central powers, an epidemic outbreak worsened until the German Emperor stepped in sending Robert Koch.
 
Thirdly, Vineis discussed the concept of herd immunity, highlighting several uncertainties in this strategy. It is unknown whether herd immunity can be achieved through vaccination as new variants may emerge all over the world. The so-called Great Barrington Declaration called for the return to normal life for individuals at lower risk of severe COVID-19, as to allow SARS-CoV-2 to spread to a sufficient level to achieve herd immunity even without vaccination. In the Lancet, a response called this approach a dangerous fallacy unsupported by scientific evidence.
 
Finally, the role of vaccines in geopolitics was discussed by highlighting the differences between China and the United States. China was initially leading the global race in vaccine development. Domestically, this was celebrated as “an embodiment of our country’s Science & Technology progress, an embodiment of China’s great-power image and responsibility, and, even more, a contribution to humankind.” In the United States during the Trump administration there was no attempt at seeking the soft power of vaccine aid, opting instead for a nationalist approach. Later, when President Biden took to office, a domestic programme was introduced that will likely lead to mass immunization before China. The USA has since also joined the COVID-19 Vaccines Global Access, increasing the US’ international focus.