Up to a few weeks ago, Chile was raking in praise for its vaccination programme. And this praise wasn’t entirely unfounded.
Over a third of the Chilean population has received at least one dose of a Covid-19 vaccine by now, with over a fifth being fully vaccinated.
Few countries can boast of such an impressive performance: among those with over one million people, only Israel and the United Arab Emirates have administered more doses per 100 people.
But despite Chile’s impressive vaccination efforts, it recorded more than 7,000 new cases of Covid-19 on 3 April, an all-time high for the country and one of the highest rates in the world. Just a few days earlier, on 29 March, Chile recorded 316 deaths, the highest number since June last year.
Meanwhile in Israel, the leader when it comes to vaccination rates, Covid-19 cases and deaths have been steadily declining since January, and are at the lowest levels since last summer. Both countries had roughly identical test positivity rates at the beginning of February, though Chile’s share of tests that turn out positive has grown since then.
So why are the paths of the two countries drifting further apart? A simple answer proves surprisingly elusive.
Chile’s vaccine success, argue some experts, might have been its downfall. The early lifting of restrictions by the government may have given Chileans a false sense of confidence that the pandemic is over.
That is a temptingly straightforward narrative, but data from the Oxford Coronavirus Government Response Tracker project shows a different story. The figures, which measure the level of stringency based on school and workplace closures, restrictions on public gatherings, stay-at-home requirements and other metrics, show that Chile has maintained a relatively stable level of restrictions for most of the pandemic.
Israel, on the other hand, has been much more flexible in how it approached restrictions throughout the past year, and has been gradually easing them since the beginning of the year. More flexible rules might have helped Israel avert Chile’s lockdown fatigue and encouraged its citizens to stick to the rules.
There are also differences in the number of people entering a country. This has become particularly relevant in the past few months, when new and more dangerous strains of the virus were discovered around the world.
But here, variations in border controls are the wrong way round. Chile fully closed its borders in March last year, gradually easing restrictions from November. Now, in response to the rising number of new Covid-19 cases, officials have decided to close down again for the month of April. Israel, meanwhile, started easing up travel restrictions last month. Both countries are nowhere near close to their usual levels of incoming tourists. So that doesn’t explain why Chile is faring so badly.
A third factor that could shine some light on why things are evolving differently in the two countries is the type of vaccines they’re using.
Israel’s most commonly used jabs are those made by Pfizer-BioNTech, which show an efficacy of 95 per cent against severe Covid-19.
Chilean authorities, on the other hand, have allowed the Chinese manufacturer Sinovac to hold phase three clinical trials in the country in exchange for early access to its doses.
Chile’s bet has meant the country could start vaccinations well before others in the region. The downside is Sinovac’s significantly poorer efficacy — initially pegged at 78 per cent, and later revised down to 50.4 per cent.
Other factors, such as the demographic differences between the two countries, the presence of new strains of the virus and the difference in timing may have also led to the contrasting outcomes.
It is also important to remember that, while both countries have been lauded for their vaccination performance, Israel is still far ahead of Chile. The Middle Eastern country has fully vaccinated — meaning it has administered both doses — over half of its population (56.5 per cent), compared to just over a fifth of the population jabbed by its South American counterpart (22.2 per cent).
The UK, which also counts itself among the countries with the best vaccination performances in the world, is nevertheless behind at just 8.4 per cent of people fully vaccinated (although many more have received a first dose).
At a press conference on Monday 5 April, chief medical officer Chris Whitty said both Israel’s impressive figures and Chile’s stumbling performance may serve as a lesson for the UK.
“We absolutely need to learn from those countries that are far ahead of us in terms of or alongside us in terms of vaccine roll-out, and those are two of the key ones,” he said.
Whitty confirmed that the expectation is Britain will experience another spike in coronavirus infections as restrictions are eased. Modelling from the Sage team shows that while the new surge, due to peak in July or August, is unlikely to overwhelm the NHS, it could lead to hospitalisations on the same scale as in January.
It is difficult to say whether the UK will manage to follow in Israel’s footsteps. Like Israel, Britain is only easing restrictions after the most vulnerable have received at least one dose of the vaccine. But like Chile’s Sinovac, Britain’s reliance on the Oxford-AstraZeneca may cause herd immunity to develop slower, with the jabs being less effective than the Pfizer vaccine, particularly against new strains. It is also worth noting that the UK’s vaccine roll-out is also slowing down due to supply issues.
Chile has proven that vaccinations alone are not enough for a safe reopening and that the pandemic is not going away anytime soon.
“The information from other countries as well as our own will tell us how much we can gradually lower our guard,” said Whitty.
“This is the reason we want to do things in a steady way, because the assumption that just because you vaccinate lots of people, then the problem goes away, I think Chile is quite a good corrective to that.”
[See also: International coronavirus vaccine tracker: how many people have been vaccinated?]
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