Vaccination Uncertainties and COVID-19 Prospects in 2021

Abstract

As we pass the first anniversary of the World Health Organization’s (WHO) declaration of a Public Health Emergency of International Concern (1), we look back at the impact of coronavirus disease 2019 (COVID-19) in 2020 and the prospects for the pandemic in 2021 The almost inverse correlation between pre-COVID-19 assessed preparedness (2) and actual performance (3) one year since the world first learned of the pandemic potential of the COVID-19 virus (4) is a stark reminder of Robert Burns’s “The best laid schemes o’ Mice an’ Men / Gang aft agley ” Going forward, we clearly need to bridge this disconnect and identify reliable indicators of true preparedness that are widely applicable and can stand the test of a real outbreak In the past year we have observed unprecedented public health and social measures (PHSMs) including lockdowns and travel restrictions (5) The health impact could have been much larger without these sustained drastic interventions, but the societal and economic cost has still not yet been fully realized Although affected earliest in the pandemic, the rapid implementation of effective measures in China resulted in domestic elimination of infections by March 2020 (6) with only very occasional case clusters observed thereafter, leading to one of the lowest rates of infection per capita worldwide (7) and without the need for sustained PHSMs since