The world’s COVID-19 outlook is either very gloomy or quite sunny, according to divergent yet not-incompatible viewpoints expressed in recent days. First came Mark Dybul, the CEO of Enochian BioSciences and a professor at Georgetown University Medical Center’s Department of Medicine, who confidently predicted Tuesday at Fortune‘s CEO Initiative conference that “by March, April, May, we will have a fully vaccine-resistant variant” of the coronavirus. Two days later, Bill Gates said infections and deaths would dip below those from seasonal flu by mid-2022…as long as no dangerous new variants pop up.

So there you have it: it’s all down to the variants. Which is why Europe’s eyes are trained on the U.K. today. According to the latest results from the Real-time Assessment of Community Transmission (REACT) program, the “Delta Plus” subvariant known as AY.4.2 accounts for at least 11.8% of cases in the U.K.; it’s gaining ground each day and the studied cases are now at least a couple weeks old, so let’s call it an eighth.

The scientists in the study say AY.4.2 infections seem to be less likely to trigger symptoms, which could back up suspicions that the subvariant is more transmissible than the original Delta. Others urge caution, pointing out that the data doesn’t provide a profile of those who caught the subvariant, so other factors such as age could be in play. Either way, experts aren’t overly concerned about AY.4.2 right now, as there’s no evidence of it being vaccine-resistant or causing more severe disease.

Even with that in mind, though, the march of AY.4.2 serves as a reminder of how quickly situations can change. It’s been (in the warped continuum of this pandemic) an eon since Delta completely took over and, while nobody is exactly comfortable with its presence, it does at least carry a certain predictability. Things are hard enough without fast-moving new variants being thrown into the mix again.

Infection rates are soaring in Europe, particularly in under-vaccinated countries like Slovenia (55%) and Austria (64%). Here in Germany, the seven-day incidence rate is currently at 337 infections per 100,000 people, which is by far a record for this country. A new law is expected to take effect within days, and it is likely to impose restrictions specifically on the unvaccinated, as has already been done in neighboring Austria. Germany’s vaccination rate is, at a shade above two thirds, pitiful for a country with its resources. Perhaps a bit more pressure on the unvaccinated will help—at the least, a lack of blanket restrictions would be a boon to businesses such as restaurants, for which last winter was particularly brutal.

A year ago, the German government was hinting at what then seemed unthinkable: that the restrictions put in place in November 2020 might last all the way through to March 2021. As it turned out, that prediction was too conservative, by two months. Despite having vaccines now, a quarter of 18-59-year-olds still remain unvaccinated, reflecting widespread opposition to the idea. This time round, they’re the ones facing months of restrictions.

Low vaccination rates remain the reason why experts such as Dybul are making dour predictions about the future efficacy of vaccines. As he explained: “There’s simply no way you can have such low rates of vaccination around the world with the virus ping-ponging between vaccinated and unvaccinated people.” If his prediction is accurate and this phenomenon does produce a vaccine-resistant variant in the coming months, it’s all of us who’ll be heading back into lockdown.

Read on for more news.

David Meyer
@superglaze
david.meyer@fortune.com

DIGITAL HEALTH

Sanofi invests in oncology A.I. The French pharma firm Sanofi has made a $180 million equity investment in Owkin, a New York and Paris-based startup that focuses on artificial intelligence in medical research. Sanofi and Owkin's new "strategic collaboration" will focus on four kinds of cancer, with the aim of optimizing clinical trial design and detecting predictive biomarkers. (Fierce Biotech)

INDICATIONS

Bad signs for Aduhelm in the EU. Biogen's hugely controversial Alzheimer's drug Aduhelm/aducanumab (doctors and insurers in the U.S. have shied away from it despite FDA approval) is likely to be rejected by the European Medicines Agency. The EMA's Committee for Medicinal Products for Human Use gave it a thumbs-down, and Biogen is disappointed but still insists the drug "has the potential to make a positive and meaningful difference for people and families affected by Alzheimer's disease." (BioPharma Dive)

"Huge step forward" in HIV treatments. British health officials have given the green light to a new kind of treatment by injection every couple months, as opposed to having to take daily tablets. The antivirals cabotegravir and rilpivirine reduce HIV carriers' viral load to the point where particles can no longer be detected nor transmitted. (Guardian)

THE BIG PICTURE

Wearing masks is important! A new peer-reviewed global study, by researchers in Australia, Scotland and China, concluded that mask-wearing cuts COVID-19 incidence by 53% and social-distancing cuts it by a quarter. You may think it doesn't need pointing out that masks are necessary by this point, but it's only in the last week that Canadian health officials have started giving aerosol transmission the spotlight it deserves. (Scotsman)

REQUIRED READING

U.S. to fund an additional billion COVID-19 shots a year to distribute globally by Zeke Miller and the Associated Press.

Antiviral COVID pills don’t eliminate the need to get vaccinated, doctors say by Felicia Hou.

How Pfizer’s CEO ruthlessly cut bureaucracy to deliver a COVID vaccine in record time by Alyssa Newcomb.