General Society: Society: News: Hankyoreh 21

One year has passed since Corona 19 was known to the world. In Korea, after the first confirmed case in January 2020, a total of 60,000 infected and nearly 1,000 died. Now we are going through a third epidemic, and the 2.5-stage social distancing continues for a month. I hope that all of the people are tired of long-term quarantine, and return to the world before the Corona 19 epidemic. Group immunity is presented as the only means. Infectious diseases such as Corona 19, once outbreaks, spread until a certain percentage of the total population is infected. Corona 19 requires a population immunity level of at least 70%. There are two ways to secure collective immunity. It is a method of obtaining immunity by being infected with a coronavirus or artificially inducing immunity through a vaccine. However, collective immunity through infection has to bear too much damage. Sweden’s recent publicly admitted policy failure is a prime example. In the end, vaccination is the only alternative to end the Corona 19 epidemic and return to the past.

Massive immunity in the US in July

So far, there are a total of three vaccines that have obtained urgent use approval or have released the results of a phase 3 clinical trial tentatively. It is a vaccine made by Pfizer and Modena made of mRNA, and AstraZeneca’s vaccine using a viral carrier. The vaccine of Pfizer and Modena reported 94-95% efficacy, and vaccination is in progress after obtaining emergency approval from the United States. At least millions of people vaccinated both vaccines with no acute life-threatening side effects. Very few allergic reactions have been reported by the substances that make up the vaccine, but it is evaluated as a level that can be resolved if observed and responded after vaccination. AstraZeneca’s vaccine has been delayed due to the problem that the effect of AstraZeneca’s vaccine appears differently depending on the usage, but it is expected that it will show sufficiently excellent effects and safety based on the results of the studies so far. Vaccines that pass the stringent standards of modern biotechnology and medicine are both effective and safe. The Korean government announced a plan to secure a total of 56 million vaccines. These are vaccines for virus carriers such as AstraZeneca (for 10 million people) and Janssen (for 6 million people), and mRNA vaccines such as Pfizer and Modena (for 20 million people). The amount of vaccine introduced is sufficient, enough to inoculate the entire adult population. The results of a Phase 3 study on the effectiveness and safety of these vaccines and millions of cases of vaccination abroad (excluding Janssen) will be published. Concerns about effectiveness and safety are low. The problem is the timing of introduction and completion of each vaccine. According to the government’s announcement, the first AstraZeneca vaccine will be available from February to March 2021. Janssen’s vaccine is expected after the second quarter of 2021, and Pfizer and Modena’s vaccines are expected after the third quarter. In other words, the amount sufficient to form collective immunity can only be secured in the third quarter. Now it’s a fight against time. Scholars in the United States and Europe have predicted when immunity from infected people and vaccination will form collective immunity in each country. The United States is expected to reach the level of collective immunity as early as July 2021. Of course, COVID-19 does not end as soon as collective immunity is formed. But from then on, we will gradually return to the world of the past. Our tedious social distancing and quarantine can also be gradually reduced with the formation of group immunity. The Korean people and quarantine authorities have done their best to prevent the spread of Corona 19. These sacrifices and efforts are to make time until the time of vaccination. The best way to shorten the period of socio-economic losses is to accelerate the formation of collective immunity by early vaccination. Now, compared to the US and European countries, the number of confirmed cases and deaths is small, and there seems to be relatively room. This situation may be the main reason for the controversy over the recent vaccine introduction. However, if the third epidemic continues and then the larger fourth epidemic arrives, then it is difficult to have a margin.

It’s a strategy for’who will be right first’

As important as the timing of vaccination is the priorities and strategies of vaccination. Since vaccines cannot be produced in a short period of time, social consensus is needed on who must get the vaccine first. In countries where vaccination is started first, medical staff, long-term care facility residents, and the elderly over 80 are given priority. This is a reasonable decision. Corona 19 deaths rapidly increase from the age of 60 or older. The protection of medical staff will make the medical system sustainable even in the corona 19 epidemic. You should also consider your vaccination strategy in advance. Vaccination requires a strategic approach based on targets and regions. Since medical personnel work at medical institutions, vaccination is easy, but visitation vaccinations must be prepared for residents of long-term care facilities. In addition, vaccination should be considered in areas where the outbreak is severe, and training for vaccination personnel should be provided according to the storage conditions of the vaccine. Lastly, long-term monitoring is needed as there is public concern over vaccine side effects, and proactive countermeasures against the tertiary epidemic must also be prepared. There are several indicators of the severity of the outbreak, but the most important is the number of confirmed cases per day. Many new confirmed cases lead to an increase in the number of critically ill and fatalities. This is the only factor that puts a burden on quarantine. Even if the tertiary epidemic is fortunately controlled, it is self-evident that a fourth outbreak will occur until sufficient vaccination is given. The real goal of Korea is not to return to the level of confirmed patients before the tertiary outbreak. If the number of new confirmed cases per day is maintained by more than 1,000 as it is now, it will be of great help in the next year by reducing the number of confirmed cases now where some strong measures are applied.

Vaccines can effectively respond to mutations

The recently discovered COVID-19 virus mutation has raised public concern. However, the viral mutation is the expected result. There is no evidence that the currently discovered mutations affect viral lethality and vaccine effectiveness. In the worst case, even if the vaccine’s effectiveness is negated, the vaccines developed now are genetically engineered to effectively respond to mutations. It is necessary to keep an eye on domestic virus mutations and their effects while strengthening the monitoring of foreign inflow cases, but this is not an impossible problem. 2020 will be remembered as the’Corona Year’. This pain also gradually ends. However, a lot of pain is expected to get there. The 4th and 5th trends will be bigger and more difficult than the 3rd one. It is most important to reduce the number of confirmed cases by blocking the radio waves occurring at this moment. The government should also make efforts to accelerate the introduction of vaccines and the formation of population immunity. Ultimately, the overcoming of this crisis lies in the rapid inoculation of a safe and effective vaccine.Jae-Hoon Jung Professor, Department of Preventive Medicine, Gachon University College of Medicine