US public health expert Dr Eric Topol weighs in on New Zealand versus Delta, saying we have the unique opportunity to learn from the mistakes of others
Dr Eric Topol wishes he was in New Zealand.
As founder and director of the Scripps Research Translational Institute and editor-in-chief of Medscape, Topol has had his finger on the pulse of the Delta variant as it has ravaged the United States.
Speaking from La Jolla, California, where the death toll from the Delta variant of Covid-19 continues to climb, New Zealand’s burgeoning cluster must almost seem paltry in comparison.
But Topol warns that Kiwis shouldn’t be complacent.
“Most people, in most countries, have underestimated how difficult Delta is,” Topol said. “I can't convey enough how challenging it is and you don't want it there in New Zealand.”
He said while much lower vaccination rates could have contained earlier forms of the virus, now close to 100 percent coverage of the population would be necessary.
“Delta’s changed the whole calculation and I don’t think people have gotten that yet,” he told the National Institute for Health Innovation at the University of Auckland in a webinar as a virtually visiting professor last week. “A place like New Zealand, which is naive to Delta and basically to the coronavirus - if it does get going there, it will go really fast, and lead to a vicious spread.”
But speaking two days after the news of New Zealand’s community transmission of Delta, he said the country has a unique opportunity to learn from the mistakes of others.
“The beauty of it is that you can learn from everything that’s happened,” he said. “Including the mistakes of others.”
He gave the example of the recent discovery of a better response from certain vaccines when given in a specific order.
“If you give the AstraZeneca or the Johnson & Johnson first, and then for the second dose you give an mRNA, it’s better than either vaccine by itself,” he said. “So mixing and matching these vaccines - in that order - could be another way to get a really strong immune response.”
He said cutting edge developments like this may give New Zealand a better chance of getting through this outbreak with minimal harm done. “We didn’t know about that until recent weeks,” he said. “But that’s the kind of thing we are learning all the time.”
Another lesson New Zealand can learn is extending the time between doses, he said.
“The countries that adopted the longer spacing helped to get a stronger and more durable immune response,” he said. “That’s why I recommended New Zealand consider using the delayed second dose.”
He also recommends getting as close as possible to a fully-vaccinated population.
“If you get to 90 percent quickly, that would be a great thing to help,” he said. “We need a country in the world that stands up to Delta.”
However, he also emphasised that the vaccine is just one tool out of many that will be needed to combat this "ferocious" strain of the virus.
“Just the vaccine is not enough,” he said. “It may have been for earlier versions of the virus, but it isn’t for this one - it’s just so formidable. That’s why we’ve got to pull out all the tools in the kit.”
He cautions the vaccinated not to develop a sense of false security. “Even after getting vaccinated, you have to keep your mask and guard up,” he said. “Ideally, you should act as if you aren’t vaccinated, with a good quality mask, distancing, ventilation and avoiding crowds - it all works together.”
However, despite the threat of Delta, Topol seems optimistic about the world’s ability to adapt and find a way to conquer coronavirus.
“What we should be doing right now is developing a vaccine that will squash this virus once and for all,” he said. “We don’t know how it's going to further evolve. A vaccine that was so potent it didn’t just cover the many different mutations and variations of the genome sequence of the virus - that’s what we should be targeting right now.”
Topol said work on a vaccine that covers the whole coronavirus family is underway, but he’d like to see governments and health agencies around the world pull together to expedite it.
“We’ll get there. There’s too many great leads we have. We’re inching closer and closer to it,” he said. “But we haven’t put our pedal on the gas in terms of going after it, accelerating whatever it takes - that should be our number one priority in vaccination.”
A broader vaccine would allow the health response to get ahead of the virus, he said.
“We've been trailing the virus all along - we have to get ahead. By the time you’re done testing on a specifically-targeted vaccine, another Greek letter comes along.”
Topol is confident that a vaccine like this could be ready in the first half of next year, if states and pharmaceutical companies play ball with one another.
“I want it to be US national priority,” he said. “But we'd love to see it be not just one country but something we all work on together.”
But despite his hopes for a broader vaccine, Topol closed out his webinar last week with the University of Auckland by saying it will be some years before we see the back of coronavirus.
“As optimistic as I am, we have to acknowledge the issue that it’s not going to go away,” he said. “We will be living with this coronavirus story for years to come.”
