The rich world’s super-spreader shame

By Ngaire Woods and Anna Petherick

OXFORD — G-20 leaders will meet in Rome at the end of October, in part to discuss how to deal with future pandemics. But the truth is that their countries’ actions have largely fueled the current one.

Many G-20 countries have been COVID-19 super spreaders. Following the coronavirus’s transmission beyond China, which initially sought to quash reporting of the outbreak, the United States and other rich countries chalked up early failures that greatly contributed to the virus’s worldwide spread. Had they acted sooner, they could have at least slowed its transmission to poorer countries. Worse still, their failure to commit to vaccinating the whole world as quickly as possible has created a self-defeating cycle where more transmissible and harmful variants of the virus are likely to be unleashed.

Statistical models show that international air travel was the key factor in the global spread of COVID-19 until early March of last year. This is borne out by the charts below, which detail the spread of the Alpha variant, also known as the UK or Kent variant, and the frequency of air travel to different countries from London airports in October 2020. Prominent in the Alpha variant’s spread were Spain, Italy and Germany.

Data from earlier in the pandemic enable us to see how different viral strains emerged over time. If we put this information alongside data from the Oxford COVID-19 Government Response Tracker (OxCGRT) regarding government policies, we can pin down the details of disease spread. Among G-20 countries, the failures of the US and the United Kingdom stand out.

New York was one of the early super-spreader cities. It recorded its first confirmed COVID-19 case on February 29, 2020, about a month after the US restricted travel from parts of China. But even though COVID-19 was raging in Italy, the US introduced restrictions on people arriving from mainland Europe only on March 13, two days after the World Health Organisation declared a pandemic; and not until March 16 did it extend these to arrivals from the UK and Ireland.

The viral sequence data demonstrate that the virus did not move directly from China to New York. Instead, US hesitancy to clamp down on travel from Europe was largely responsible for multiple introductions of the virus, which seeded the city’s huge death toll.

Moreover, interstate travel within the US largely continued during lockdowns. OxCGRT data show that 17 US states have never stopped it since the pandemic hit. The similar mix of viral lineages from early in the pandemic across the US indicates that reintroductions of the virus were common even in places that had eliminated an original strain. Research combining air-travel data and genomics has concluded that the spread of COVID-19 within the US resulted more from domestic introductions than international air travel.

The UK was another super spreader with an achingly slow pandemic response, given where and when genomics now tells us the virus was circulating. In that regard, the COVID-19 Genomics UK Consortium, the largest of its kind in the world, has sequenced more than 26,000 viral isolates from people who caught COVID-19 in the UK’s first wave, and compared these sequences with those from other countries.

Two main conclusions emerge. First, Europe was the source of initial infections in the UK. Up until late June 2020, 80 per cent of imported viruses arrived in the month-long period from February 27 to March 30, and these were overwhelmingly from Europe. One-third of them came from Spain, 29 per cent from France, and 12 per cent from Italy, and a mere 0.4 per cent from China.

Second, inbound travel fueled the arrival of many new genetic lineages in the UK, with the rate of these appearances among the infected population peaking in late March 2020. When the UK then finally brought in non-pharmaceutical interventions en masse, causing the country’s score on the OxCGRT Stringency Index to rise from 17 out of 100 to almost 80 in just one week, the diversity of viral isolates began to decline. In other words, the NPIs succeeded in extinguishing many of these lineages in the UK.

These failures cast doubt on G-20 countries’ pandemic management more broadly. Had the world’s large, advanced economies stopped new arrivals earlier, especially travellers from Europe, and had they limited internal travel, they would have reduced their own COVID-19 devastation.

Restricting the export of infections would have slowed or perhaps even largely prevented the disease’s spread to poorer countries until vaccines were developed. That, in turn, might have averted costly lockdowns in places that could ill afford them. G-20 governments have focused on preventing the import of the virus, not its export. With hindsight, the virus would have been contained had they required repeat negative tests for anyone getting on a plane or emerging from a quarantine facility.

Having accelerated the spread of COVID-19, richer countries are now prevaricating about getting vaccines to those who need them most. Wealthy countries have stockpiled doses, prioritised vaccinating children who are at relatively very low risk from COVID-19, and are even preparing third “booster shots” for which there is no evidence yet of widespread, near-term need.

Meanwhile, COVID-19 is ravaging developing countries, where frontline health workers are dying because they have no access to vaccines. The pandemic has already killed more people globally in 2021 than it did in 2020. Many experts harbour grave concerns about the further spread of the Delta variant, as well as other variants to come, especially in regions where vaccination is progressing slowly.

G-20 countries must make up for their COVID-19 failure and commit to vaccinating those at most risk across the world. And as super-connected countries, they must also establish new international standards for pathogen surveillance and travel protocols to ensure that they never super-spread again.

Ngaire Woods is dean of the Blavatnik School of Government at the University of Oxford. Anna Petherick is a departmental lecturer in public policy at the Blavatnik School of Government at the University of Oxford. Copyright: Project Syndicate, 2021. www.project-syndicate.org