DER SPIEGEL: Ms. Sridhar, coronavirus case numbers are rising again in many countries, despite high vaccination rates. Nevertheless, many countries are continuing to reopen things. Last Monday was "Freedom Day” in the United Kingdom, meaning all restrictions aimed at containing the coronavirus were lifted. Is this really a good idea?
Sridhar: We are entering uncharted territory. The United Kingdom and Israel, especially, are now guinea pigs. Everyone is looking at us to find out: What happens if you let the number of cases rise more or less uncontrollably when the elderly and the risk groups are vaccinated? How many severe courses of disease, hospitalizations and deaths will there be then? How many cases of long COVID will occur, and what will the openings mean for the unvaccinated children and young people? It's a bit like jumping off a cliff. Unlike a year ago, we now have wings – these are the vaccines. But are the wings also strong enough to carry us and keep us from falling?
DER SPIEGEL: Throughout the pandemic, you were one of the most vehement advocates of the "No-COVID” strategy, the aim of which was to push the number of cases down as low as possible, as in New Zealand and Australia. Don't these openings now contradict everything you fought for?
Sridhar: The situation has changed significantly in the meantime. A year ago, it was mainly about buying time for a vaccine or treatment. No COVID was certainly the best strategy for saving lives, the economy and civil liberties and to bridge the time until a vaccine was available, as New Zealand and Australia, but also many Asian countries, have shown. But now we have a vaccine, several even, and now the question is how best to use them to get out of the pandemic. So, I have evolved my position based on safe and highly effective vaccines. I think we humans are, after all, social beings. For some, life becomes meaningful because they go to church. For others, it's the bingo hall, visiting relatives or even the crowded bar. This is what makes people happy and gives them meaning. The only sustainable way to stop this pandemic is therefore vaccination.
DER SPIEGEL: Not just in Britain, but also in the Netherlands, Spain and Israel, the number of cases rose steeply after the openings began, in some cases almost vertically, even though more than 40 percent of the populations in these countries have already been fully vaccinated.
Sridhar: You are absolutely right: In the meantime, the Delta variant of Sars-CoV-2, which comes from India, dominates in many countries, and thus we are in a new phase of the pandemic. Unfortunately, a 60 percent vaccination rate is not enough for the Delta variant, that is clear now. The bar has clearly shifted upwards. For a reasonably normal life, we need a lot more vaccinated people, probably closer to 80 to 90 percent of the population. Delta is changing the rules of the virus game – all over the world. Look at Africa, look at India, look at all the countries that thought the worst was behind them before Delta came. And we don't know what else is coming around the corner, what other new variants will emerge.
DER SPIEGEL: More than 1,200 scientists have protested against Freedom Day because they think the opening is premature and dangerous. Why wasn’t it possible to stay patient for just a little longer?
Sridhar: I don't want to defend the openings. But it is true that in the UK, and I think also in Germany, countries that did not follow the zero-covid strategy in 2020 and ended up in recurrent lockdowns, there is now a huge pressure to finally get the economy going again. The corona exceptionalism felt endless. And it has caused great damage, without question. There have been many encroachments on civil liberties. While I urge caution, I certainly sympathize with people who are now simply fed up with corona.
DER SPIEGEL: If vaccination is our only exit strategy, why are so many people hesitant about getting vaccinated?
Sridhar: I think in the case of Germany, it is also because Sars-CoV-2 doesn't seem very threatening to many people at the moment because of the low incidence. People think: My life is fine now, why do I need a vaccination? When the number of cases increases again, I am sure that will change. In the UK, we are already seeing a huge willingness to vaccinate among young people. They realize that their only choice is between vaccination and infection. The way I see it, we are all on the sinking Titanic in the Delta Ocean. Either you get into the lifeboat – that's vaccination. Or you sink. That's the stark reality, unfortunately. At the point when people realize that vaccination is the only way out, they will get vaccinated. Meanwhile, millions of people around the world have been vaccinated, so we know that the corona vaccines approved here are very safe.
DER SPIEGEL: What about children and adolescents? For 12- to 16-year-olds, vaccination has not yet been recommended by the Standing Committee on Vaccination (STIKO) in Germany, and for those under 12 there is no approved vaccine at all. Will schools have to be closed again as infection rates rise?
Sridhar: Children and adolescents, that is the most difficult issue at the moment. Of course, one could say: Well, actually, a few children die of flu or other respiratory infections, and we don't close schools because of these diseases. On the other hand, Sars-CoV-2 is a new virus, and we know that a few hundred children have died from it in the U.S. Plus, there are issues of long COVID. But the damage caused by preventing children from playing together and going to school is massive. And unlike economic damage, you can't throw money at a child to repair the damage. A child who has missed two years of education may never make up for it. And so, for me, it is an unbearable situation. The hope was always that children and young people would be protected if only enough adults were vaccinated. That's how it looked in Israel at first. But this hope seems to have been dashed.
DER SPIEGEL: So, you think we should now vaccinate all 12- to 16-year-olds, for whom a vaccine has been approved – despite the lack of a recommendation by the Permanent Committee on Vaccination?
My personal opinion is "yes.” I think the uncontrolled infection of children is very risky. The virus not only affects the lungs, but also the heart, the kidneys, the blood vessels and the brain. But there should be no compulsory vaccination. Parents should have the choice, even if it may not be an easy decision for them.
DER SPIEGEL: In the meantime, it seems that countries like South Korea, New Zealand and Australia, which did very well with their no- or low-COVID strategies for a long time, are now having greater problems getting out of the pandemic than we are. The vaccination rates are very low, the number of cases is rising. Is that how you see it?
Sridhar: I maintain that these countries will be a model for us in the next pandemic on how to buy time. They have far fewer deaths and significantly less economic damage. Nevertheless, you are right: The zero-COVID strategy that was so successful there in 2020 will no longer work in 2021. The more contagious Delta variant can no longer be controlled as easily – that's why lockdowns are already becoming more frequent in Australia, and the numbers are rising steeply in South Korea. Moreover, in countries where COVID has hardly played a role, convincing the public to vaccinate is a challenge. But there is no other way out of the pandemic.
DER SPIEGEL: The lion's share of the vaccines produced so far have been bought up by rich industrial nations. For Africa, for example, only a little was left over. Will that change?
Sridhar: For me, one of the big lessons of this pandemic is that Africa cannot rely on the charity of the industrialized nations, nor can the other developing countries. They have to take care of themselves. They will have to set up their own vaccine factories, otherwise they will never have enough vaccine. They need regional hubs for production, they need to build up skilled human capacity and tech transfer, and emergency intellectual property waivers will be needed for situations like this.
DER SPIEGEL: The big concern of many scientists is that virus variants may develop against which the vaccines no longer work well. So, will the pandemic never end?
Sridhar: People hate to hear about variants because they feel it's a never-ending story. They just get tired of this topic.
DER SPIEGEL: The virus doesn’t care.
Sridhar: Of course not. There will always be new variants. We will have to learn the Greek alphabet by heart. But I am an optimist by nature. Vaccines can be adapted. And you can also do a lot with border controls to delay spread, for example by requiring proof of double vaccination and a negative PCR test when entering the country. That gives a layer of protection. I think it's important to think positively and constructively. And, hopefully, in a few years, we will look back on this time and wonder in disbelief how we ever got through it.