If the first victim of war is truth, then the first victim of Covid-19 was a sense of proportion. The pandemic continues to dominate the news every waking hour, as well as continuing to restrict our lives in ways not seen since wartime – in some ways even more severely. Yet how many people even noticed this week when the Centers for Disease Control and Prevention announced that the estimated number of deaths globally from measles climbed to 207,500 in 2019, a 50 per cent increase on 2016? The news was hardly reported. Unless you happened to be visiting the CDCs, or the WHO’s website you were unlikely even to find out.
On sheer death toll alone, Covid-19 has killed more people this year than measles – approximately five times as many. The total Covid victims recorded by WHO so far is 1.29 million. Yet there are two very big differences.
Firstly, while Covid is mainly carrying off the old and already-sick – the average age of a victim in Britain is 82 – the vast majority of last year’s 200,000 measles victims were previously healthy children. Had they not been killed by the disease they would have had a good chance of living into their 80s themselves. If you measure the loss of life in potential life-years lost – which would be a vastly more sensible way of doing it than the metric we are fed with daily in the case of Covid: people who have died within 28 days of testing positive for the SARS-CoV-2 virus – there would be little question as to which is the biggest killer: measles.
The second difference is that we already have a measles vaccine. Children are dying completely unnecessarily for want of a vaccine which is easily available and has been for decades. Why? It isn’t that no efforts have been put into extending vaccination around the world. The WHO is to be applauded for the work it did reducing incidence of measles between 2000 and 2016, a period during which the number of deaths fell sharply (an estimated 539,000 died in 2000).
But four years ago, the downwards trend sharply reversed. Why? Because vaccination rates have tailed off. There are two measles vaccinations, MCV1 and a follow-up, MCV2. To achieve herd immunity, take-up in a population must reach around 95 per cent. Yet global take-up of MCV1, according to the WHO, has stalled at 84-85 per cent and take-up of MCV2, while still rising, is only 72 per cent. Those, however, are the global figures. Outbreaks of measles have occurred in a number of countries, such as Madagascar, Democratic Republic of the Congo, Venezuela and Ukraine due to falling take-up.
But there is something far worse coming. According to WHO, 26 countries have paused their measles vaccination programmes because of Covid-19, with the result that 94 million children who would otherwise have been given the vaccine this year are in danger of missing out on it. We are facing a resurgence of measles which threatens to put that last four years of rising deaths in the shade.
Of course, Covid-19 is a serious disease, but in tackling a disease which kills mostly the elderly and already-ill, globally we are in danger of losing control of a disease which will kill large numbers of otherwise healthy children. If only a tiny amount of the attention which is being paid to Covid-19 could instead be put into restoring and increasing measles vaccination programmes the world could prevent a vast amount of misery.