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Analysis

The only real herd immunity is global: Why India’s COVID crisis threatens us all

While vaccine-makers are confident their shots block the current Indian variant, it’s transforming the country into a potential breeding ground for new, more resistant mutations

Nathan Jeffay

Nathan Jeffay is The Times of Israel's health and science correspondent

Naga Sadhu, naked Hindu holy men, wait for the start of a procession towards the river Ganges for Shahi Snan (Royal Bath) during Kumbh Mela, in Haridwar in the Indian state of Uttarakhand, Monday, April 12, 2021. As states across India are declaring some version of a lockdown to battle rising COVID-19 cases in a nationwide second-wave, thousands of pilgrims are gathering on the banks of the river Ganges for the Hindu festival. The faithful believe that a dip in the waters of the Ganges will absolve them of their sins and deliver them from the cycle of birth and death. (AP Photo/Karma Sonam)
Naga Sadhu, naked Hindu holy men, wait for the start of a procession towards the river Ganges for Shahi Snan (Royal Bath) during Kumbh Mela, in Haridwar in the Indian state of Uttarakhand, Monday, April 12, 2021. As states across India are declaring some version of a lockdown to battle rising COVID-19 cases in a nationwide second-wave, thousands of pilgrims are gathering on the banks of the river Ganges for the Hindu festival. The faithful believe that a dip in the waters of the Ganges will absolve them of their sins and deliver them from the cycle of birth and death. (AP Photo/Karma Sonam)

Israelis shouldn’t be unduly alarmed by the new Indian coronavirus variant. But they do need to worry about India, and so do people in all countries aiming at herd immunity.

A senior official in the Health Ministry said on Wednesday that “we don’t know enough” about the Indian variant and that she hasn’t seen research on how well the Pfizer-BioNTech vaccine — administered widely in Israel — copes with it.

This is true, but Dr. Sharon Alroy-Preis’s comments were more an exercise in challenging complacency — which she warns exists in other government departments — than a suggestion that the Indian variant dodges the vaccine.

There’s lots we don’t know about the Indian variant. Is it more contagious than the British variant that is currently dominant in Israel? Probably not. Does it make people sicker? There is no evidence to suggest this.

And is it blocked by vaccines? Alroy-Preis, head of public health services at the Health Ministry, is correct that we don’t yet have a definitive answer to that. The data isn’t ready, though it is being worked on. But the fact that BioNTech co-founder Ugur Sahin is “confident” bodes well. He said the same changes that the virus has undergone in India were checked in earlier tests.

A health worker takes a mouth swab sample of a boy to test for COVID-19 in Hyderabad, India, Thursday, April 29, 2021. (AP Photo/Mahesh Kumar A.)

The current Indian variant, found in 41 reported Israeli cases, isn’t the worry. But the next one is, and the one after that, and so on.

In the last week, India has been reporting some 350,000 new daily cases, more than any other country at any point during the pandemic. It takes just one patient to mutate a new variant.

The longer the disease is circulating, and the more people have it, the higher the chance of new variants emerging — and the higher the probability that one of them will break through vaccines

The whole world’s COVID future rests in the hands of simple probability. The longer the disease is circulating, and the more people have it, the higher the chance of new variants emerging — and the higher the probability that one of them will break through vaccines.

Ronen Ben-Ami, head of the Infectious Diseases Unit at Tel Aviv Sourasky Medical Center. (courtesy of Tel Aviv Sourasky Medical Center)

“Think of it like a roulette wheel,” said Ronen Ben-Ami, director of infectious diseases at Tel Aviv Sourasky Medical Center. “The more slots in the wheel, the more chance of winning. Likewise, the more people who have coronavirus, the higher the chance of ‘variants of concern.’”

So, while indications so far are that the Indian variant won’t break through the vaccine, and therefore won’t harm Israel’s relatively COVID-proof status, its rampage in India could turn into very bad news for Israel — and the whole world: India is becoming a mass potential breeding ground for new variants that may be more worrying.

This could be because they cause more harm to infected people, in which case they’d mostly harm unvaccinated countries, or that they break through the vaccine, causing a crisis in places like Israel.

Israel is celebrating nearing herd immunity or even achieving it in some form, but the scenes in India are pushing doctors to suggest that, in a sense, the only reliable herd immunity is global. This observation is relevant to all countries that are busy vaccinating, including the UK and the US, as well as Israel.

“We talk a lot about herd immunity and the idea that if a percentage of a population is vaccinated it becomes protected,” said Ben-Ami. “But given that all countries reside in the world, and the world isn’t immunized, herd immunity may only last so long. The lesson of 2020, learned well in Israel, is that the world is connected, and in a sense the herd isn’t one country, the herd is the world.”

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