Re: Covid-19: Prepare for a third wave, warns England’s chief medical officer
Dear Editor,
We read this news story with great interest and we would like to emphasize the need of preparedness in all countries regardless of the current epidemic trend. This includes Jordan.
One message was clear during the 74th session of the World Health Assembly, which witnessed the greatest ever attention to Emergency Preparedness and Response by Member States: the COVID-19 pandemic is not over. “Much of the world remains susceptible to infection, variants continue to emerge and impact, implementation of Public Health and Social Measures remains inconsistent, vaccination is uneven and inequitable” is the message conveyed by the Executive Director of the WHO Health Emergencies Programme.
This message is well received in Jordan, where the situation remains unstable: as of 18 June 2021, Jordan has reported 743,366 cumulative cases and 9,635 cumulative COVID-19 deaths. Jordan has witnessed two major COVID-19 “waves”, with almost 37,000 reported cases between 9-16 November 2020 and 58,000 between 8-15 March 2021.[1]
Some crucial elements should be taken into consideration when preparing for a possible recrudescence of COVID-19 infections:
- The nationwide seroprevalence survey conducted at the end of December 2020 indicated that 34.2% of the Jordanian population had been exposed to the virus since the onset of the outbreak (unpublished); this is in line with the finding of Sughayer et al., which found a seroprevalence close to 30.0% in early February among blood donors.[2] Considering the increased COVID-19 mortality (2.5 times) in 2021 when compared to 2020, and the predictions of the WHO modelling (unpublished), we estimate that the current seroprevalence might have reached 60.0%;
- The Jordanian Government started the COVID-19 vaccination campaign on 13 January 2021 (all individuals in the Jordanian territory are eligible, including refugees and migrants irrespective of legal status) and so far, slightly less than 2.0 million doses have been administered (less than 8.0% of the Jordan’s 10 million people have been fully vaccinated) [3];
- All the COVID-19 Variants of Concern (VoC) are currently circulating in Jordan [4];
- Enforcement of restrictions has been relaxed from April with removal of Friday lockdowns and extension of curfew hours, likely leading to relaxations of public health and social measures (PHSM) and gatherings [5];
- Other aspects comprise the presence of fragile populations like refugees and migrants, and the need of reopening borders to stimulate tourism-related financial outputs.
We welcome the stepwise approach taken by the Government of Jordan to ensure a reasonable balance between PHSM on one hand and social and economic activities on the other. At the same time, it is crucial for Jordan to continue enhancing preparedness and response in view of a potential “third wave”. Experience from UK, where a current upsurge of cases is unfolding due to the Delta VoC, and from Seychelles, where an important recrudescence has being recently witnessed despite a very good vaccination coverage (>60.0%), should be taken as a clear warning.
References
1. World Health Organization, Regional Office for the Eastern Mediterranean. COVID-19 Situation in the Region. Available from: http://www.emro.who.int/health-topics/corona-virus/index.html (last accessed on 18 June 2021).
2. Sughayer MA, Mansour A, Al Nuirat A, Souan L, Ghanem M, Siag M. Dramatic rise in seroprevalence rates of SARS-CoV-2 antibodies among healthy blood donors: The evolution of a pandemic. Int J Infect Dis. 2021 Apr 20;107:116-120. doi: 10.1016/j.ijid.2021.04.059. Epub ahead of print. PMID: 33892190; PMCID: PMC8057684.
3. Our World in Data. Coronavirus (COVID-19) Vaccinations. Available from: https://ourworldindata.org/covid-vaccinations (last accessed on 18 June 2021).
4. GISAID. Tracking of variants. Available from: https://www.gisaid.org/hcov19-variants/ (last accessed on 18 June 2021).
5. COVID-19 Community Mobility Reports. Available from: COVID-19 Community Mobility Reports https://www.google.com/covid19/mobility/ (last accessed on 18 June 2021).
Rapid Response:
Re: Covid-19: Prepare for a third wave, warns England’s chief medical officer
Dear Editor,
We read this news story with great interest and we would like to emphasize the need of preparedness in all countries regardless of the current epidemic trend. This includes Jordan.
One message was clear during the 74th session of the World Health Assembly, which witnessed the greatest ever attention to Emergency Preparedness and Response by Member States: the COVID-19 pandemic is not over. “Much of the world remains susceptible to infection, variants continue to emerge and impact, implementation of Public Health and Social Measures remains inconsistent, vaccination is uneven and inequitable” is the message conveyed by the Executive Director of the WHO Health Emergencies Programme.
This message is well received in Jordan, where the situation remains unstable: as of 18 June 2021, Jordan has reported 743,366 cumulative cases and 9,635 cumulative COVID-19 deaths. Jordan has witnessed two major COVID-19 “waves”, with almost 37,000 reported cases between 9-16 November 2020 and 58,000 between 8-15 March 2021.[1]
Some crucial elements should be taken into consideration when preparing for a possible recrudescence of COVID-19 infections:
- The nationwide seroprevalence survey conducted at the end of December 2020 indicated that 34.2% of the Jordanian population had been exposed to the virus since the onset of the outbreak (unpublished); this is in line with the finding of Sughayer et al., which found a seroprevalence close to 30.0% in early February among blood donors.[2] Considering the increased COVID-19 mortality (2.5 times) in 2021 when compared to 2020, and the predictions of the WHO modelling (unpublished), we estimate that the current seroprevalence might have reached 60.0%;
- The Jordanian Government started the COVID-19 vaccination campaign on 13 January 2021 (all individuals in the Jordanian territory are eligible, including refugees and migrants irrespective of legal status) and so far, slightly less than 2.0 million doses have been administered (less than 8.0% of the Jordan’s 10 million people have been fully vaccinated) [3];
- All the COVID-19 Variants of Concern (VoC) are currently circulating in Jordan [4];
- Enforcement of restrictions has been relaxed from April with removal of Friday lockdowns and extension of curfew hours, likely leading to relaxations of public health and social measures (PHSM) and gatherings [5];
- Other aspects comprise the presence of fragile populations like refugees and migrants, and the need of reopening borders to stimulate tourism-related financial outputs.
We welcome the stepwise approach taken by the Government of Jordan to ensure a reasonable balance between PHSM on one hand and social and economic activities on the other. At the same time, it is crucial for Jordan to continue enhancing preparedness and response in view of a potential “third wave”. Experience from UK, where a current upsurge of cases is unfolding due to the Delta VoC, and from Seychelles, where an important recrudescence has being recently witnessed despite a very good vaccination coverage (>60.0%), should be taken as a clear warning.
References
1. World Health Organization, Regional Office for the Eastern Mediterranean. COVID-19 Situation in the Region. Available from:
http://www.emro.who.int/health-topics/corona-virus/index.html (last accessed on 18 June 2021).
2. Sughayer MA, Mansour A, Al Nuirat A, Souan L, Ghanem M, Siag M. Dramatic rise in seroprevalence rates of SARS-CoV-2 antibodies among healthy blood donors: The evolution of a pandemic. Int J Infect Dis. 2021 Apr 20;107:116-120. doi: 10.1016/j.ijid.2021.04.059. Epub ahead of print. PMID: 33892190; PMCID: PMC8057684.
3. Our World in Data. Coronavirus (COVID-19) Vaccinations. Available from:
https://ourworldindata.org/covid-vaccinations (last accessed on 18 June 2021).
4. GISAID. Tracking of variants. Available from: https://www.gisaid.org/hcov19-variants/ (last accessed on 18 June 2021).
5. COVID-19 Community Mobility Reports. Available from: COVID-19 Community Mobility Reports https://www.google.com/covid19/mobility/ (last accessed on 18 June 2021).
Competing interests: No competing interests