end of the year was happy or had only had one. and then one young adults would like to actually around the world including using them. if they refer the outbreaks of the virus to government says it will move quickly with an aggressive lockdown. they won't be 0 cases, but when there is one in the community we crushes. but while it's coded free, and as many people as possible vaccinated than usual and international isolation will come to a partial end next year. wayne, hey, al jazeera towed on a new zealand. ah, it says geneva, let's get a reminder of our top stories to tata bon claims. it's captured, afghanistan's 3rd largest city, iraq officials haven't confirmed the claims. the witnesses say the taliban is in

the heart of the city for say there's been heavy fighting and have outs. outskirts, charlotte bellis is in cobble with more that they do manage to hold her off. like they say they have. it would be incredibly significant because this is the 3rd biggest city, the largest, and wish to that's going to stop. there has been fighting happening there for about a month, but special forces and also a local leader. he's a former governor, his name is mel hon. he rallied an uprising in her office. he armed them, the government supported him and he was, he was really seen as a figurehead of keeping the telephone out of herat and we've been hearing just in the last hour that he has actually flayed harass or the government a big loss if they have lost her off this evening and fighting is intensifying for afghan ashton's 2nd largest city kandahar. the government says efforts to push the group back are ongoing us officials for the capital cobble could for in just 90

days. the latest round of talks on afghanistan have wrapped up here in the country, capital doha international invoice, met with delegations from the government and tyler bond. but no breakthrough appears to have been made from 3 days of discussions. algeria is observing 3 days of morning after the number of people killed and wildfires there rose to at least 69000 people have been injured and hundreds of families are homeless. the great prime minister says the recent wildfires are his country's biggest ecological catastrophe and decades. the government is place billions of dollars in aid for people hit by the 5. at least 9 people have died in floods in turkey's northern black sea provinces. the air has been hit hard by heavy rain this week, demolishing homes and bridges and sweeping cars away. those are the headlines inside stories. next. me

is called the 19 heard immunity becoming a miss. you buyers variance and the unequal distribution of vaccine to making it more difficult to achieve that goal. so will government need new strategies to control the pandemic? this is inside story. ah hello, welcome to the program. i'm kim vanelle, falling to so long said so called heard immunity is needed to slow down the spread of coven. 19. that's when 70 percent or more of the population is protected from

the virus, either by becoming infected or by being vaccinated. but some experts now doubt it can be achieved the head of the you case oxford vaccine group says that's because of the contagious delta variant. new infections and deaths rising steadily in person despite 3 quarters of people being fully vaccinated. andrew, paula had this warning to em peeve. we know very clearly with the current of ours that, that this tar parent will still, in fact people have been vaccinated. and that doesn't mean that anyone who still i'm vaccinated at some point will make the virus. i think we are in a situation here with this current parent where community is not a possibility because it's the effects individuals and i suspect that next is a, is a parent which is perhaps even better at transmitting in vaccinated populations.

and so that's an even more of a reason not to be making a vaccine program around her community. other countries with high vaccination rates are also struggling to contain the delta variant. israel, where 60 percent of adults are fully immune eyes to is reimpose and limits on gatherings and restricting and or venues to those who have been vaccinations in the us. 70 percent of adults have received at least one job. but the pace, the vaccination has slowed down. the military, some hospitals and businesses, and now making jobs mandatory and heard immunity is far from big achievable in the developing world. the university of oxford, our world and data says only 1.2 percent of people in low income countries have received at least one dose of the vaccine. ah, ok, let's bring in august from new york. we have was a father, professor of epidemiology and medicine and columbia university in hong kong. we

have john nichols clinical professor and pathology at the university of hong kong. and from johanna spoke helen rees, member of south africa ministerial advisory committee for cove at 19 and cove. vaccines. very welcome to all. thank you for joining us. i'd like to begin with, you was also at the start of the pandemic. we were all saying heard immunity. it was the buzzword. that's what we need. heard. immunity is that done and dusted now . as the cat out of the bag, i think we need at this point to, to really change the discourse and maybe change the narrative around what our goals are. and i think rather than using that term in unity and knowing that these vaccines we have, which are really super vaccines do not absolutely protect against every single infection, but protect against a severe in this hospitalizations. and maybe we should move to using more of a terminology for protection, rather than heard in unity as much more of a she's

a will go for all of us to try to achieve, to ultimately try and scale up vaccination around the world. so we can protect as many people around the world as possible from the most severe effects of this fibers missed calls, is that your take as well that heard immunity is not an achievable goal? yes, i agree with what's been said before and also to pick up what you also previously said. is that the, the 2 ways of cheating, the hood immunity with the true natural infection or through the vaccination? i think the experience from northern europe last year has shown that basically doing it through the natural infection is not the way it guy leaves phenomena, taxable mortality. so yeah, so vaccination is the way it goes. but the problem is, is that because we're dealing with now on a virus noted dna boss, it's always going to be news facing. and so i don't think we're going to be able to

get this level of in the population of immunity that we would like to with other g . and i back seems mr. call. what does that mean for the future though? i mean, well, the virus then be here with us to stay in one form or another for the foreseeable future. i think we look at the other on a bosses which ran well lines. i think influenza is a good model to use because these are the vaccine video. bosses are always mutating and he don't get with vaccination, a lifelong image, unity or protection. so i think we're going to be seeing like we've seen of the past year. we've got to be seeing variance of the vos evolving, and then we're going to be seeing that the fact that the vaccines, which we have will not be able to give that complete protection. so i think if you look at the extra to the went we've not been able to. she mean you see on that. so we're going to be looking at either annual vaccinations and the recognition that we

were going to have to. so adapt and, and live with boss in the community. on that point, helen res. i'd like to bring you in as well as being a member of south africa's ministerial advisory committee. for coven, you are also a member of the w t. o strategic advisory group of experts on the coven, 19 vaccine. so you're very well placed onto this question. is the world of global ball and bodies? governments? are they pivoting in the way they should be to this new understanding this new acceptance that heard immunity is not a goal that we should be looking for? i think the answer is yes. i also think that there's a technical definition of heard immunity and i don't think that's what people are actually asking for. i think what the community is saying and countries are saying is we want to get back to some sort of normality. we want to protect health, we want to get so they can all make situations stabilize the income and again,

but we also want to impact on transmission. and those things are not necessarily the same as achieving heard of unity. so i agree with my colleagues, what we need to do is probably change what we're aiming for. i think we are adding a thought to normality. and in order to achieve that, we certainly need to get a vaccine coverage well, lives up much, much higher. and you mentioned the counsel station in the d. g of the work council station. and that's a goal for them to put that vaccination coverage by the middle of 2022. so that's the kind of thing that we, we probably need to be discussing at the moment. and what would that mean in terms of getting countries and communities back to us before we move on, i mean that goal for the continent of africa, where i believe just 1.5 percent of the 1000000000 people on the continent has actually been vaccinated is that even a realistic goal?

well, the one good thing is, so a lot of the countries in our region are the key towards the kodak facility, which is going to be providing the facts. and also the african union. and the vaccines are now starting to become available. so we're very much hoping that in the next 3 months that we're going to see a much larger flow back into the country. the, the, the big question for many countries however, is that we're trying to introduce the brand new back with a new target, not sure, which is what we normally do into very weak health services. so the question is, will we be able to absorb it and distribute them and get them to the, the population for most at risk and then out to the board of population going to be a very big challenge. and the 3rd thing is that we have to sustain your 70 percent from under 2 percent, which is where we off is that huge. and that will require

a commitment not only from back the manufacturer to all the time limited income countries, including all region, but also to support the purchasing of these backs, invent support services so that we can roll them. otherwise, we're not going to manage that. and if we don't manage them, we won't be able to, we have a whole continent where we're not able to get back to mission coverage up really significantly. we are not going to be able to break the back of them. ok, not fall for the other to come back to you. how is it that we've gotten to this point now where we're looking to head protection rather than heard immunity? is it a matter of the vaccination rollout? just being too slow? the delta vary and coming in, what are, what are the fact that you see that have gotten us to this point? there are several factors, and some of them were touched on by my colleagues on this, on this program is i think it's, it's the nature of the infection itself. because what is the nature of the vaccines?

we have our hands and i think we, what we know is that the vaccines don't provide food in unity, meaning protect people, the recipient of the vaccine from giving infected. we know that vaccines are really good at preventing illness and preventing optimizations and best 19. so because of the fact that they don't provide full in unity, meaning protection against infection, it makes it very hard to, to aim for. achieving heard in unity. so i think it is, it's an appreciation and much more realistic, realistic appreciation of the nature of the virus itself. and it's transmission. it's high time sensibilities very contagious. as well as the challenge with the evolution of new and i want and the nature of the vaccines we have all of these aren't together. give us pause in terms of aiming for heard in unity. i think what we need to focus on is, as, as helen mentioned,

and as well is we need to think about how can we use the vaccines we have at hand to be able to protect as many of our population of the global population as, as possible from the severe consequences that can happen from over 90. and that means we have to scale up vast vaccine availability and distribution and deployment to places around the world where this hasn't happened thus far. there's now huge disparity that's become very evident where with richer countries, wealthier countries having access to back scenes. while other countries around the world are still at the one or 2 percent coverage with the scenes or just. and this is just a tenable situation and it is so i always tell you if there's covert anywhere this covered everywhere. so we have to think and moving forward. how do we protect the global community from the dire consequences of covered 90 to the use of our vaccine?

mr. nicole's, if we're not looking to word heard immunity, we're not looking toward elimination either. are we going to start to see people who are vaccinated getting sicker? with the same virus or with new mutant new mutations of this virus. i think the extension of time is that the answer is no. right now is that those have investigated is that they can get actually very mild infection. and i think it's not just us infection, but the ability trashy transmit because these people may be also a since matawan, very mild symptoms, which is going to mean that that chain of transmission is not going to be broken. but as the 2 previous speakers have already mentioned, a main function of vaccination is actually decrease the mortality and the mobility . and i think all the days which has come in been come across from all costs. well, that the ice use and the incentive in the hospital is that the thing is the

unvaccinated for developing the re a disease. we're getting every now and then you know, some of the very small number of cases of moderate disease and the facts. nice. but the main thing on the vaccination is to decrease mortality and the more business he asks you to reduce the stress on the health care. i guess i just want to try that because my question, i mean this, i will always be very clear getting vaccinated. you're much the font key to get very on. well, you're, you're in, you're less likely to pass the virus on even. but my question is, if the virus is still going around in the community, even with the vaccinated people, are we going to see new mutations? the, the offer is fortunately, yes, because the, with these on a vax, these are the bosses, the more you get a boss replicating, the greater the chance of mutations can be occurring. it's just by the sheer numbers. so if you can actually get those numbers down,

all the number of people being infected or the number of severe cases which are producing more than you can be reducing that chance, but he's extra mutation to be coming in. so that's why we've been saying where there's been high rates of it in infection, that's what the mutations have been arising. so, and that's sort of the, the negative feedback is that what you don't want to have is that if you can keep those mutations kind. and then that means that you don't need to come up every year with that with a new vaccine. so people break down that cycle of more vos being produced, and that's where it's going to be occurring in the reasons whether it's low faxing coverage in, in africa and also in, in parts of asia. so i think the main emphasis on this is what i feel quite strongly about it is, is instead of that boosted those would be to actually have the vaccines where there is a more chance of people getting the primary disease. and so you can actually decrease

that, that potential for more mutations come about. we'll get to booster shots at the moment, but 1st i want to come back to you, helen reads, should we be investing more in therapies for people who are sick? you know, we have time, a flu, if you've got the flu. what about people who get covert but who are vaccinated and might just get it in a mild way i get somewhat on well, is there enough invest in? is there enough investment in your opinion in that side? no, i don't think there is. and i think that's an excellent point. i mean, one of the reasons that people are individually, very frightened to this far offended community, had to go into locked downs repeatedly because we don't have good treatment. we don't have good treatment yet. we have some treatments, but then limited for people who are there and, and we don't have good treatment that don't people who got moderate disease or disease progressing to that serious and part. and when we got good vaccines,

but we, we could also do some other interventions in addition to the mosse of the social distance thing of the ventilation that we are recommending to assist in, in preventing infection. we haven't invested, i believe nearly enough in the, in those other therapies. the other problem is that some of the things that have looked very promising and indeed some of the things that are being evaluated, mouthful and treatment of hospitalized patients are extremely expensive. and so once again, i guessing a secondary effect of access to therapy for rich countries, which simply would not be feasible to be either manufactured or introduced into resource limited setting. so in addition to investing much more in therapy, we also need to say to, to think about what are going to be appropriate therapy to the minister and to afford in their thoughts limited mis was coming back to booster shots. israel

is, is offering booster shots, the u. k. is planning to for the vulnerable to roll it out alongside the flu, to add without talking about vaccine equality globally, which is a whole other issue in which we've, we've dedicated a few programs to. but from, from a science point of view, what difference will boosters make to transmission to we? do we have any data? i think we have some data that do support that for specific population, specific groups of individual it booster. those may be maybe a value. we don't have data that support the booster for the general population. so for example, there are some data that show that for some immunocompromised individual individuals, these people will do weekends, immune system. for example, people who receive organ transplants or people with guy allison. so there are some

data that tell us that in those individuals can be some gains in terms of a boost of their antibodies. protective antibodies after receiving a 3rd don't actually shooting another, those off the same vaccine that before. so that's, this is a subset of the population, and i think that may be the focus moving forward when you're discussing booster dosing is to really try to think about where we have that data and where the focus should be. rather than thinking broadly of a need for boost of this for the general population overall. and this is big and then not just be some issues of equity and access globally. but as you said, also based on the find, find difficulty or that we haven't had mr. nicole's. 8 if we're not talking, if we, if we're giving up the idea of her immunity and instead looking towards her protection, what does this mean for countries like new zealand that have basically attained elimination?

they're going to open up new deal. it is going to open up to vaccinated travelers from low risk countries next year. but based on this assumption that we're only going for heard protection is a global community, a country like that is going to have to accept that the virus is going to come in. and it's going to infect the population. speaking as a new zone vested interest in that, but i think the reality is that what, what works well for one country will not work well for another. and, you know, i think if you look at across waldron for stress, stress seem to be doing very well. and then you just needed that one case to be brought into new south wales. and now you've got a 3000 people. so, so even the feed into us relation is that wake have a low, you know, the well with the cobra last year is that the enthusiasm for vaccination is not as high. so and so the vaccination rate is higher in reason some countries which is

suffered and which had may drive rates. so i think the whole problem is that we found this in many parts of the asia. we did very well, what residency? well, in the 1st part of last year, and so the enthusiasm could take up, the vaccine was not as high as possible. and that's a really big problem, is that we're still getting that stubborn, 2530 percent, no matter what a government can do, the advertising, which is saying, basically we don't want the vaccination. so i think that's going to be the challenge for new zealand. and for those of us, how would you sort of convince that success will population lives? are the ones you just see that one case and that in that 2530 percent. and also the what we'll spend talks about is off the 70 percent. i think we're ignoring the fact that the p dash population, which is the one which, which if you've got countries, we've got 1520 percent of the population,

about the vaccination strategies for them. because right now what we're seeing is that where the vices is spreading, and this is the data coming out from the southern hemisphere is in the pediatric and the young adult population. that's a group which have not been now will be back nice. and then they spreading it to the parents and then to the grand parents and it goes for them. that's what it was was happens in influenza. it's a, it's that pediatric relation which, which i think can be very challenging to get those numbers up to for sufficient protection. i think very round the early point. it's a very different ball game for those countries that don't have that experience of you know, everyone knows somebody who's had cove it or has had close it themselves or seen their local hospital. overwhelmed, very different countries that haven't had that. i don't to come back to you on that front, helen rees. what is the best incentive for people to get vaccination from a public policy point of view? what do we know works to get people out and to get those jobs?

what don't think there's several things. one is that, and i think everyone's familiar with the, the anti backs expression. now that's the minority minority and those people exist full of it and they will exist off because they don't like vaccine. and how many people that are given for that, but the majority of the sort of search that we just mentioned are people who are never or people who don't see themselves at risk. i mean, many young people in the 20s don't necessarily see themselves risk and that's when i get it on the sick and the body. so why is that group those 2 on know many of the reasons nothing like have we develop the vaccine too quickly. and so we have to be able to explain about things like compressing the timeline of back to development and monitoring, to back in safety and, and people who want to see the back row about other people the how does it go for them before they will take it so, so i think the 1st thing we have to do, i'm,

you know, you've got to be here with you, is do a better job from the buyer perspective and the public health perspective waiting those people to cassidy to have the confidence to come forward. the 2nd thing is, you know, sort of the sort of carrots and stick in the beginning to see this country from, for example, if you want to do that, because there's a, if you're not fascinated, you really will need to have a vax. and if you want to go into restaurants, if you want to go into it, so that the source of, it's the most current, i'm sick if you'd like. and i think we got to see more of those kinds of incentives . i put the incentives in the way because if you don't do it, you won't be able to do that now. and the 3rd thing under why discussion is whether for some joke, for example, it needs to be compulsory. the same. and kenya, discussion about topics says,

and we've seen in other countries discussion about health care workers. so if you're in a job in the age old age firm environment, and i do, you have a responsibility and the government have responsibility show that you're backs. and i think countries around the world grappling with exactly that, hey, we're going to leave it there for time. thank you very much to all of our guests. waffa father john nichols and helen rees. i thank you to for want to, you can see the program again any time by visiting our website to elgin or dot com . and to the end of the discussion, go to our facebook page at facebook dot com, forward slash ha inside story. you can also join the conversation on twitter. handle is at a inside story for me can vanelle and the whole team here in bo huh. bye bye. for now. the news

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