Why the most vaccinated country in the world suffers an exponential increase in coronavirus cases

WASHINGON.- A few months ago, when the Seychelles islands started offering free coronavirus vaccination, the president of the archipelago, Wavel Ramkalawan, told reporters that in a few weeks his country would obtain collective immunity.

It was an ambitious goal for a small island nation and geographically isolated in the middle of the Indian Ocean, but since its economy depends heavily on tourism, it has received the favors of its regional allies, such as the India and the United Arab Emirates.

At first, the plan seemed to be a success. Seychelles is the most vaccinated country against Covid-19 in the world: more than 60% of its population adhered to the full vaccination schedule, more than other vaccine champion countries, such as Israel and Great Britain, and almost twice as much as in the United States.

But that success was in doubt this week, as Seychelles has the highest number of new infections per capita since the start of the pandemic, and the government has been forced to reimpose numerous restrictions.

Although the number of new cases is relatively low – with an average peak of just over 100 new cases per day – they are a real problem for a country of less than 100,000 inhabitants. If you consider the rate of infections per thousand inhabitants, the epidemic in Seychelles is worse than the tidal wave of cases in India.

In a small country, even a small number of infections can cause the system to collapse. “A boom in cases like this puts a huge strain on a public health system that was already on the cutting edge.”says Malshini Senaratne, director of Eco-Sol, an environmental consultancy firm in Seychelles.

With its main treatment center for Covid-19 patients nearing maximum capacity, and with several doctors and nurses among the sick, Seychelles has announced the return of restrictions, the closure of schools and a limited time slot for opening. shops and restaurants.

“The trend is on the rise”Public Health Commissioner Jude Gedeon said. “We don’t know how long this will last, but it will depend on what action we take and how long we follow them.”

Witness case

The Seychelles case is being closely watched around the world for what it reveals about how vaccines work and how well they work. “The Seychelles case is crucial because it allows us to assess the effectiveness of certain vaccines and the level of vaccination needed to achieve collective immunity”says Yanzhong Huang, global health researcher at the Council on Foreign Relations.

Huang noted that other countries that have vaccinated a large part of their population, such as Israel and Britain, have seen a sharp drop in new cases every day.

Sherin Francis, executive director of the Seychelles Tourism Board, says that while a large part of the population is vaccinated, there are parts of the archipelago where it is not. Of 1,068 active cases, approximately 65% ​​came from residents who had not received the full immunization schedule. François is careful to point out that vaccinated people can be infected. “Vaccines are very effective in preventing worsening disease and death, but they do not prevent a person from being infected,” he says.

So far, the number of deaths attributed to the virus in Seychelles is relatively low: 28 out of a total of more than 6,000 cases. But the increase in infections can also confirm that the vaccines applied in the country have comparatively low effectiveness.

About 60% of the doses administered in the Seychelles are vaccines manufactured by the Chinese company Sinopharm, given in the Seychelles by the United Arab Emirates. The remaining doses come from the vaccine developed by AstraZeneca and produced by the Serum Institute of India.

In more ways than one, the Seychelles government’s vaccine negotiations have been smart and swift, but the country ended up using two vaccines that appear to be less effective against symptomatic Covid.

Recently, the World Health Organization (WHO) estimated the efficacy of the Sinopharm vaccine to be just over 78% for adults under the age of 60, with little data on its success in patients over 60. years. The UAE has asked some of those who have received the Sinopharm vaccine to come forward for a third dose, arguing there were cases of “weak immune response”, while noting that only a “very small number” people needed this reminder. .

Meanwhile, trials of AstraZeneca in the United States revealed an overall effectiveness of 79%. Both vaccines are considerably less effective than vaccines developed by Pfizer and Moderna, which use mRNA technology and report efficacy rates of around 95%.

According to Jennifer Huang Bouey, an epidemiologist working with the Rand Corporation, what we know about the Seychelles campaign allows us to estimate that there is less than 49% of the population vaccinated. “Less than half of the population is protected by the vaccine,” he says. “They are still well below the protection requirements to be considered collective immunity.”

“I’m not surprised that they don’t see a significant decrease in cases,” says Huang of the Council on Foreign Relations. “What surprises me is the significant increase in the cases they have suffered since the end of April.”

Tourists

But the increase in cases in Seychelles did not come alone, but coincided with the return of tourists. Either way, so far there is no hard evidence linking the two situations.

After nearly a year of strict border controls, Seychelles announced earlier this year that it will reopen its doors to tourism from March 25. The government said there would be no quarantine requirements and visitors would not need to be vaccinated, although they would have to submit a negative PCR result taken within 72 hours of travel .

It was an important step for the archipelago, whose economy depends almost 25% on international tourism. In 2020, the islands’ economy fell 13.5%, largely due to falling tourism receipts, according to World Bank data.

The Washington Post

Translation of Jaime Arrambide

The Washington Post