COVID-19 can no longer be seen as a global emergency, but with a highly contagious New subtypes are emerging Which have the potential to drive the waves of the future at a time when the health care system is already overburdened – when will the pandemic end?
Dr Maria Van Kerkhove, the World Health Organization’s technical lead for COVID-19, said in an interview with CBC News: “A lot of the world, a lot of us just want it to end, but unfortunately it doesn’t. Not there.” ,
“We’re still in the middle of it, in a sense, but we’ve never been close to the end.”
The uncertainty surrounding the end of the pandemic lies with the virus itself, which is currently mutating rapidly with over 300 omicron subvariants. tracked by WHO around the world, Van Kerkhove said.
“The virus is evolving and it is unpredictable,” she said. “We don’t know what the features of the next version will be.”
Showing new Omicron subvariants derived from previous strains such as BA.2, BA.4 and BA.5 high levels of immune evasionThis is unlike anything we’ve seen before in the pandemic, but what this actually means in terms of real world transmission remains to be seen.
“We are in the second act of a three-act drama,” said Michael Osterholm, an epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, in an interview with CBC News.
“How can you declare that the pandemic is over when we don’t know what the next task is?”
Europe has entered a new COVID wavewhereas Ontario, QuebecManitoba, new Brunswick And B.C already seeing an increase in the number of hospitalizations – as additional pressure is being placed on the health care system Recurrence of seasonal illnesses like flu A tough competition is expected.
“We now have the tools to end the COVID emergency in every country,” Van Kerkhove said. “The challenge of ending the pandemic is something different.”
One thing is for sure, COVID is not going anywhere. The virus continues to spread around the world in one form or another and has even taken root in animal reservoirs. white-tailed deer Meaning it is no longer possible to eliminate it completely.
But while the pandemic is not over, the end of the emergency phase is still in sight. WHO launched an ambitious plan earlier this year end the COVID-19 emergency In every country in the world by the end of 2022, using available tools such as vaccinations, antivirals and therapeutics to prevent serious illness and death.
“Clearly now we are in a very different situation,” WHO Director-General Tedros Adhanom Ghebreyesus said during a news conference on Wednesday, ahead of a committee meeting to determine whether COVID is still a disease. Is Public Health Emergency of International Concern (PHEIC),
“But the pandemic is not over and there is still a lot of work to be done.”
Tedros said the ongoing global risk of declaring an end to the COVID emergency is due to large gaps in vaccination, low surveillance, low rates of testing and sequencing, and ongoing “uncertainties” about the impact of the variants. The decision will be heavy.
“We’re trying to tell countries that the only way we can end the emergency is to be prepared, to be agile, to use the tools — medical science, diagnostics, vaccines — appropriately for those Those are the most at risk. Single countries,” Van Kerkhove said.
“Vaccination plays an important role, but if you look at vaccination coverage, we have over 12.7 billion doses of vaccines globally, but still 32 percent of the world’s population hasn’t received a single dose yet, so Still such a huge amount of inequality.”
Experts warn that the pandemic’s ongoing burden on the health care system will be felt in years to come, with long covid affecting a subset of those infected, and cancer screening delay And surgery There are massive backlogs happening as COVID levels are expected to rise again.
Bill Hannage, an epidemiologist at Harvard’s T.H. Chan School of Public Health in Boston, said in an email, “The past few years have left us with a lot of delayed procedures, a lot of chronic conditions that haven’t gone unnoticed. ” CBC News.
“And as a result things go very thin in many places. Put COVID on top of that (not to mention the flu) and we can expect challenges there.”
Quebec’s health minister is urging residents to get their booster shots as COVID-19 cases slowly begin to rise.
Revath Devanandan, a global health epidemiologist and associate professor at the University of Ottawa, said that while COVID is becoming endemic in many parts of the world, reduced immunity, new variants and the release of restrictions may change that.
“Unlike in past waves, where one variant dominated the others, it now seems that different types of soup will haunt us,” he said.
“This will continue for as long as we allow transmission to occur. And it seems that all of our policy choices are indicating that we want to allow transmission to happen freely.”
Devanandan said ending the emergency phase of the pandemic is a “political definition” concerned with the allocation of resources for COVID and the level of death and serious illness society is prepared to tolerate.
“We are currently at around 40 deaths per day (nationally), and models suggest this new wave will not change substantially as it develops,” he said, adding that the COVID-19 pandemic There may be this consistency in the level of related deaths. “Emergency Return.”
“The second consideration, of course, is the hospital staff, who is definitely in an emergency. And I don’t think that’s going to get better any time soon, without some serious and constructive government intervention.
Given that the virus continues to throw evolutionary curveballs at us, new variants are emerging that have the ability to evade immunity and drive transmission globally, exactly what it would take to end the COVID emergency – and the pandemic as a whole. ?
“We need to have a vaccine or infection immunity that will be relatively protective against new forms and the protection will be somewhat durable,” Osterholm said.
“Right now, even if you take a look at what the annual vaccination approach might be, we’re seeing that immunity drops long before that.”
Pfizer said release This week its updated COVID-19 bivalent vaccine recently approved in canadawhich targets the original strain and the dominant BA.4 and BA.5 subvariants showed a “substantial increase” in neutralizing antibody response after 30 days.
“It seems safe to predict that the updated vaccine will outperform another shot of the same old thing,” a new commentary published in the journal Nature points out, however, that the data are still limited.
And New research from Qatar A paper released in the New England Journal of Medicine before peer review found that previous omicron infections provided stronger protection against future re-infections from BA.1 and BA.2 – but BA. 4 and less than BA.5.
Meanwhile, a new study from Quebec on Hybrid Immunity published this week in JAMA suggested that two or three doses of the mRNA COVID-19 vaccine in people with prior infection provided strong protection against Omicron hospitalizations.
Hannez said we can expect to see continued mutation of the virus in the future in favor of selection pressure that is “more easily able to infect people with certain immunity” than vaccination and prior infection.
“What this means is that the virus will stick around, and it will infect a lot of us,” he said.
“We don’t expect the consequences of those infections to be as bad as we’ve seen over the years because of our immunity, but they won’t be insignificant. Older people especially should get boosters.”
Van Kerkhove said one thing that would be of “massive added benefit” would be the development of a nasal vaccine that could better reduce infection and transmission to prevent serious illness and death.
“It will be a game changer, because it will tackle the challenge that we have about this rapid circulation of this virus and the evolution of this virus that continues,” she said, adding that the vaccines we have are still in place for serious disease. work against and death. “But we don’t have it yet.”
A new nasal version of the AstraZeneca-Oxford vaccine encountered big blow Human clinical trials after this week didn’t produce the immune protection researchers had hoped for, and was actually weaker than the shot, but there are others in development,
“We need to educate the public even more about the fact that this virus will be with us, vaccines will be part of our future. They are not the only solution, but vaccines, requiring additional doses, are something that We do. We’re going to tackle that again,” Van Kerkhove said.
“How often does this happen? We don’t know yet.”
She said that eventually the virus will be with us, and not in the same way as the flu gives that it is a completely different virus that keeps evolving to evade immunity, and we still don’t have any “forecasts” with it. Is.
“We have to live with COVID responsibly,” she said. “I really have a distaste for this phrase ‘living with Covid’ because many people have used it as a feeling of giving up – but we don’t need to. We have the tools that exist now. “
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