The fourth wave

One year on from the declaration of a global pandemic by COVID-19, figures are frightening: more than 125 million people infected and 3 million dead. The effects of the "third wave" have been devastating, undoubtedly the deadliest of all so far. Coupled with the health crisis, the effects of the economic crisis threaten to return us to a situation similar to that of the beginning of this century.

All data provided by the World Health Organisation indicate a good direction in disease control and a key decline in the third wave. But the WHO is right to set the alarm bells ringing at the highest level: If we neglect basic control, prevention and care measures now, we could be plunged into a "Fourth Wave", which will be even more lethal than the current one. There are several reasons for this: Firstly, the global vaccination rate is too slow, currently not even reaching 1% of the population, so inoculations will have to be accelerated to put a real brake on the spread. Secondly, because the emergence of more than ten new strains, notably the South African, Brazilian and British strains, are quantitatively demonstrating a greater number of infections, i.e. the viruses have a greater capacity for transmission. Finally, as was the case at the end of the second wave, if we relax previous measures and do not accelerate vaccination, the de-escalation and reopening of social encounters could provoke a new uncontrolled outbreak that would show that we have learned nothing.

While it is true that preferential vaccination of the elderly has succeeded in decreasing virus lethality, it is no less true that cases of infection continue to overwhelm health systems. After a year of health crisis, our staff is exhausted and long stays in intensive care jeopardise the normal functioning of hospitals for the care of other diseases that also cause death.

Expert advice is that we should maintain all restrictions in this third wave, until we reach a cumulative rate of less than 20 cases per 100,000 population, and then we can apply follow-up screening and specialised preventive care. But we fear that the rush to promote openness will lead to a fourth escalation. 

And this reality basically refers to the West. But when we look at impoverished countries, we find that the number of vaccines is much lower, that they are not reaching the poorest classes, and that the numbers of infections and deaths continue to rise. We have five years left in the long fight against the virus, but it is obvious that new coronaviruses will emerge and threaten to make the need for vaccination and prevention chronic. Everything we do now to shorten the time will be to our benefit in the future. It is up to us to demonstrate commitment to others and to demand a "Global Plan" that will ensure global success.

Francisco Pineda Zamorano, Expert in International Relations and Cooperation.