The Seychelles Is The Most Vaccinated Country In The World, But...

On a per capita basis, a new Seychelles outbreak is worse than India’s raging surge!

The country is made up of 155 small islands-- although just 3 are inhabited-- and has a population of almost 99,000-- a bit fewer than the number of tourists it was hosting annually before the pandemic closed everything down. One of the attractions of the Seychelles, a tiny Indian Ocean archipelago off the coast of Somalia and north of Madagascar, is how remote it is. But until 1971, when a real airport was built, it was too remote for any conventional tourism, which is now the biggest sector of the country's economy. Most of the tourists are Europeans-- especially French, Brits, Germans and Italians-- although before the pandemic-- there was significant tourism from the Gulf states, China, Russia and India. Not many Americans.

When people think about how the pandemic hit Africa, they think of the 1.6 million cases in South Africa, or countries like Ethiopia, Egypt, Morocco, Tunisia and Morocco that have reported hundreds of thousands of cases. But the sparsely populated Seychelles has only reported 6,373 cases. The problem is that's really a lot when you look at it in terms of cases per million residents-- 64,465, worse than anyplace in Africa other than another island state you may not have ever heard of, Mayotte, still a French colony (72,340 cases per million).

This afternoon, the Washington Post reported that with a 60% vaccinated population, safeguards started coming down and tourists started arriving again, including unvaccinated tourists. That worked out badly and restrictions are being applied again.

With the country’s main treatment center for covid-19 patients nearing capacity and doctors and nurses among the sick, the Seychelles announced the return of coronavirus restrictions, school closures and limited opening hours for shops and restaurants.

“These are an upward trend,” said Public Health Commissioner Jude Gedeon at a media briefing Tuesday. “We do not know how long it will last, but this will depend on what measures are taken and how the new measures are respected.”

The Seychelles situation is being watched all over the world for what it says about the effectiveness of vaccines.

“It is providing a critical case to consider the effectiveness of some vaccines and what range we have to reach to meet herd immunity,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations.

Huang noted that other nations that had vaccinated large proportions of their populations, including Israel and Britain, had seen significant drops in new daily cases.

Sherin Francis, chief executive of the Seychelles tourism board, said that while much of the population was vaccinated, there were pockets that were not.

Government data released this week found that of 1,068 active cases, around 65 percent involved residents who were either completely unvaccinated or had received only one dose.

Francis emphasized that even people who have been vaccinated can get infected. “Vaccines are very effective at preventing serious illness and death; they are less good at preventing infection,” Francis said.

So far, the number of deaths in the Seychelles attributed to the virus is relatively low-- 28 out of more than 6,000 cases. But the surge in new cases may also confirm that the vaccines being used in the country have comparatively low effectiveness.

Roughly 60 percent of the doses administered in Seychelles are vaccines made by the Chinese company Sinopharm that were donated to the Seychelles by the United Arab Emirates. The remaining doses are of the vaccine developed by AstraZeneca and produced by the Serum Institute of India.

In many ways, Seychelles government negotiations for vaccine supplies were savvy and speedy. But the country has ended up using two vaccines that appear to be less effective against symptomatic covid-19.

The World Health Organization had recently estimated the efficiency of the Sinopharm vaccine at just over 78 percent for adults under 60, with little data on its success with older patients.

The UAE has asked some who received the Sinopharm vaccine to return for third doses, citing low immune responses, though officials said only a “very small number” need to do so.

Meanwhile, U.S. trials of AstraZeneca have found that the vaccine is 79 percent effective overall. Both vaccines are considerably lower in effectiveness than the vaccines developed by Pfizer and Moderna, which use mRNA technology and have reported effectiveness rates of around 95 percent.

Jennifer Huang Bouey, an epidemiologist who works with the Rand Corp., estimated that given what was known about the Seychelles’ vaccine rollout and the vaccines used, less than 49 percent of the population could be assumed to have immunity conferred by vaccines.

“Less than half of the population is protected by the vaccine,” Huang Bouey said. “It is still far below the community-level protection requirement.”

“It’s not surprising that they are not seeing a significant decline in cases,” CFR’s Huang said. “But what is surprising to me is that they’ve seen a significant increase in cases since late April.”

That rise in cases arrived after something else: the return of tourists to the Seychelles. But so far, the evidence linking the two is unclear.

After almost a year of strict border controls, the Seychelles announced early this year that it was opening back up to tourists beginning March 25. The government said there would be no quarantine requirements and that visitors would not need to be vaccinated, though they would need to show negative PCR tests taken less than 72 hours before travel.

It was an important move for the Seychelles, which relies on tourism for about a quarter of its economy. Economic growth declined by 13.5 percent in 2020, largely because of steep drops in tourism revenue, according to the World Bank.

While the number of new daily coronavirus cases has more than doubled since tourism restrictions were removed, only 10 percent of positive cases are among visitors to the island, according to Sherin.

Even so, the rise in new cases threatens to upend the country’s reopening to tourism. In one recent dispute, vaccinated Israeli travelers publicly complained of “false positive” coronavirus tests that disrupted their stay.

“While applying restrictions, care has been taken to ensure that the visitor experience is not affected and that our visitors are still able to enjoy an uninterrupted holiday in Seychelles,” said Francis, adding that the country was able to guarantee PCR tests with results within 24 hours.

Huang Bouey said that while vaccines can help prevent deaths, there was increasing agreement among medical professionals that they alone could not stop new cases or outbreaks.

“Quarantine, mask-wearing and crowd-avoiding should be part of the public health strategy,” she said.

Senaratne said it was possible that the Seychelles’ ongoing outbreak could drive away tourists and that the government was undertaking a “delicate balancing act between health and wealth management.”

“Covid-19 has starkly outlined the vulnerabilities of an island nation that remains highly dependent on tourism,” she said, adding that the country would need to diversify its economy. “While we hope the spread of the virus will be curbed in the short term, we cannot help but look uneasily towards the future.”

But if you're thinking, "too bad about the Seychelles but I'm never going there," you're missing the point. This pandemic is not even close to over. It's shifted-- for now and with an imbecile like Trump out of power-- away from the U.S. but... the death totals worldwide are going to be worse this year than last year. Today, the Wall Street Journal reported that "more than 1.4 million Covid-19 deaths have been reported globally as the virus has torn through Latin America and swaths of Asia... [and] with global recorded deaths rising by about 13,000 daily, the virus’s toll looks set within weeks to surpass the 1.8 million deaths recorded for the whole of 2020. Patchy recording of cases and deaths means all those figures are almost certainly underestimates."

The shift may not be permanent: The virus has ebbed and flowed unpredictably since it emerged. Variants of the virus able to escape vaccines—incubated as the pandemic rages elsewhere—could spread into the West. Vaccine rollouts in poor countries could accelerate, possibly helped by vaccine donations from richer countries and a world-wide increase in vaccine production.

Epidemiologists and public-health experts say the West must move quicker to help the developing world bring the pandemic under control with cash, expertise, medicines and, above all, vaccines. Not just to save lives, they say, but to reduce the risk that the virus ricochets back.

...The World Health Organization says there have been 5.6 million new cases of Covid-19 reported world-wide and more than 91,000 deaths over the past seven days.

...Thailand recorded more than five times as many Covid-19 cases in April as it did through all of 2020. Infections in the Philippines reached new highs last month and remain well above last year’s peak. Cambodia, which avoided large outbreaks in the pandemic’s first year, has reported hundreds of infections a day in recent weeks, prompting strict restrictions that are hitting communities hard.

...“The disease is out of control in many parts of the world, and is potentially going out of control in other parts that have been relatively spared,” said Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine.

Behind the surging pandemic are multiple variants of the virus that spread more readily than older versions, and may be causing more severe disease. Religious festivals and other mass gatherings in India and elsewhere have seeded the virus and its evolutionary progeny far and wide.

Rickety health systems mean not everyone can get the help they need. Social distancing isn’t straightforward when families live cheek by jowl and government support for workers to isolate is scant, if it exists at all. Keeping economies in the deep freeze for long stretches to suppress transmission is easier for rich countries than poor ones.

Vaccines are in short supply in low- and middle-income countries, partly because rich nations have bought up many more doses than they need and production hasn’t kept pace with demand, squeezing the number of shots available for Covax, an initiative to vaccinate poor countries.