It has taken a lot of infections, a lot of jabs and even more patience, but Belgium is approaching the point that the corona virus will remain under control without restrictive measures. Covid-19 will no longer disappear, but the coronavirus will become an acceptable risk for the economy and society, comparable to the annual flu wave.
The British celebrated ‘freedom day’ on July 19, when most of the remaining corona measures were abolished. That seemed a reckless move, because the United Kingdom has been struggling with a spicy flare-up in the number of infections in recent months. Yet Boris Johnson’s government did not roll out the red carpet for the highly contagious delta variant with her gesture. In recent weeks, the number of infections has even fallen sharply, despite the relaxation. The past few days showed another stagnation. The volatility in the curve is a logical consequence of the arm wrestling match between the increasing number of vaccinations and the allowed relaxations.
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The British celebrated ‘freedom day’ on July 19, when most of the remaining corona measures were abolished. That seemed a reckless move, because the United Kingdom has been struggling with a spicy flare-up in the number of infections in recent months. Yet Boris Johnson’s government did not roll out the red carpet for the highly contagious delta variant with her gesture. In recent weeks, the number of infections has even fallen sharply, despite the relaxation. The past few days showed another stagnation. The volatility in the curve is a logical consequence of the arm wrestling match between the increasing number of vaccinations and the allowed relaxations. The British curve remains under control because more than 90 percent of the population is now protected against infection and certainly against hospitalization, either because the British have been vaccinated at least once or because they have built up natural immunity after being infected. Also very important: the link between infection and hospitalization may not be broken, but it is seriously weakened. Vaccines provide about 95 percent protection against a shot. The Low Countries have almost comparable figures. In the Netherlands, no less than 92 percent of all blood donors now have antibodies against the virus, implying that they are at least partially protected. In Belgium there are no recent data yet. At the end of May, antibodies against Covid-19 were found in 60 percent of blood donors. Thanks to the advanced vaccination campaign, it can be assumed that more than 90 percent is now at least partially protected. Due to the particularly high infectivity of the delta variant, these high percentages are insufficient to achieve herd immunity. “It is unfortunate, but even with a vaccination coverage of 100 percent, herd immunity is probably no longer feasible. The chance that we can still eradicate the virus is virtually non-existent. Those who are not vaccinated will in all probability become infected sooner or later.” “, says biology professor Tom Wenseleers (KU Leuven). The delta variant has reversed the logic of herd immunity, US scientist Eric Topol recently tweeted. Instead of the vaccinated majority protecting the unvaccinated minority, this minority now threatens the protection of the group, including as a breeding ground for variants. Because herd immunity is no longer feasible, the coronavirus will remain among us. That sounds worse than it is, because the virus is about to become endemic. This means that the number of infections remains under control, without the need for measures. Thanks to the high degree of protection of the population, that point is not far away. “We can only speak of such an endemic balance when almost everyone has antibodies,” says Tom Wenseleers. “Then the number of hospital admissions will be only a fraction of that during the pandemic. British epidemiologist Meagan Khall calculated on the basis of the number of breakthrough infections in fully vaccinated people that in such a balance we would have about the same number of covid-19 deaths per year as in an average flu season. That risk is gradually becoming acceptable. Hospitals will normally no longer be overwhelmed by an influx of corona patients. Living with the virus is gradually becoming possible, and the end of the pandemic is fortunately in sight.” There is therefore a light at the end of the tunnel, but as long as the endemic balance is not reached, measures remain appropriate, as evidenced by the increasing number of infections and hospital admissions in recent weeks. The models warn of further increases in September if we were to have as many contacts as before the pandemic, which is not the case until further notice. For now, caution is advised. If 10 percent of the population is still susceptible to the virus, a sudden large increase in the number of infections, together with a limited individual chance of admission, could still cause a significant influx into hospitals. Tom Wenseleers: “We saw a too hasty reopening in Florida, for example. There was relaxation too early, while the older population in particular was still too little vaccinated. The result was that the number of hospital admissions was higher than ever before.” Not only in the US does the vaccination rate and therefore the number of infections differ from state to state, there are also major differences between provinces and municipalities in Belgium. This increases the risk of local outbreaks, especially in the autumn. Research by Bart Mesuere shows that the vaccination rate is lower, especially in the poorer neighborhoods and municipalities (see graph). In Brussels, no municipality has more than 60 percent fully vaccinated. Income is not the only explanatory factor. “In the municipalities with an average annual income of 20,000 euros per inhabitant, the vaccination rate varies from 55 to 75 percent. Cultural differences also play a role,” says Bart Mesuere. “The vaccination campaign has not reached part of the population. That can still be rectified with low-threshold campaigns, but there is not much time left,” says Tom Wenseleers. In the slightly longer term, the point at which we reach the endemic equilibrium may shift somewhat. That depends, for example, on how quickly the immunity decreases, how sick people with antibodies still become from an infection, to what extent new variants are still emerging and whether we use booster vaccinations. Better vaccines are also becoming an important weapon in the fight against the virus. Tom Wenseleers: “If the current vaccines had been adapted to the delta variant, herd immunity would have been close to being possible. I hope that modified vaccines can be approved and brought to the market more quickly than is currently the case. There will also be new vaccines .” Getting closer to endemic equilibrium is good news for the economy. Harsh measures, which have a severe impact on economic activity, are a thing of the past. The economic indicators show that the Belgian economy is making strong progress now that most of the measures have been lifted. Business and household confidence remains high. The economy is not quite back to normal yet, but by the end of this year we should be back to pre-pandemic prosperity unless the crisis creeps in through the back door again. The rest of the world is far from envisioning that endemic balance. In the US, a number of southern states in particular are confronted with a heavy wave of infection that also causes overcrowded hospitals. Not surprisingly, it’s the states with the lowest vaccination rates. The American economic recovery continued smoothly until the end of July, as witnessed by the strong creation of new jobs, also in corona-sensitive sectors such as the catering industry. The US has been much more tolerant of hospitalizations and corona deaths since the start of the pandemic. Yet cracks appear in the recovery. American consumer confidence was hit hard. More and more people are limiting their movements again. The delta variant threatens to drag on the back wheel of the American economy. Japan, China and the emerging markets are also far from finished with the delta variant due to their relatively low vaccination coverage. In Japan, a rising curve after the Olympics threatens to overshadow the recovery. In Malaysia, a strong wave of contagion is torpedoing economic indicators. China must firmly nip outbreaks in the bud to prevent worse. There is therefore still a big question mark behind the global recovery. Unfortunately, we do not remain immune to corona problems elsewhere in the world. Ultimately, only a quarter of the world’s population has been vaccinated at least once. If new, even more contagious variants appear elsewhere, we will also have to deal with them a few months later. And if the economy has to slow down elsewhere, that will also weigh on our exports. The end of the acute phase may be in sight, but it will be a pandemic with a very long tail.
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