Coexistence with an infectious agent is not necessarily painless, as malaria teaches. Too much optimism and always thinking that the pandemic is about to end slows down the essential investments to reach a new normal
According to some scientists, the end of the pandemic would not be far off. The data coming from the United Kingdom are encouraging, infections and hospitalizations are decreasing thanks to the vaccine but also due to the high circulation of the virus. Even in Italy, infections and hospitalizations are growing less explosively than in recent days and this bodes well for the future.
But what happens next? No, the virus will not go away with a snap of your fingers, and now here with the intention of staying. As Dr. Anthony Fauci, medical consultant to US President Biden for Covid we are still in the first phase of the five pandemic phases, with a still very negative impact on the entire globe. Follow aat deceleration, presumably in the summer period as we have already seen twice, and will follow, except for variations, the control phase, the one defined endemic.
Endemicity means that the virus will continue to circulate in parts of the world population for yearsbut its prevalence and impact will drop to relatively manageable levels, so Covid should become more like a flu rather than a world-blocking disease. To classify an infectious disease in the endemic stage the infection rate must more or less stabilize over the years rather than appearing with peaks that are difficult to manage as is happening now with Covid. An endemic disease though the basic reproduction number R0 (r with zero) stable at one explains the epidemiologist from Boston University Eleanor Murray. It means that an infected person infects another person on average, in the absence of containment measures.
evident that we are still far from this moment (let’s be clear, Omicron is not endemic), however many scientists predict that Omicron represents a transition period to endemic because infecting such a large number of people will create an important layer of natural immunity. Also because Omicron ifmbra to be less severe than the Delta variant. Studies tell us that the variant thrives more in the upper airways than in the lungs. As a result, hospital stays are shorter and fewer patients require intensive care and the belief that over time SARS-CoV-2 will become like other cold-causing coronaviruses.
The sense of an imminent end of the pandemic is therefore reinforced by the image of a mild variant (largely as a consequence of vaccinations) combined with the many references to endemicity and learning to live with the virus cited by several politicians in recent days. But Omicron, with its high contagious rate, is still stressing the health systems of the world, still in difficulty, and the new variant seems to have important potential to delay the long-awaited endemicity.
But what does it actually mean to deal with an endemic virus? The term endemic refers to a disease that is constantly present in a certain area, regardless of its severity. The malaria, for example, it is endemic to tropical and subtropical areas and killed more than 600,000 people in 2020. It is true that people live with it, but not painlessly. Endemicity does not imply mild illness and mild illness does not imply endemicity, he explains to the Financial Times
Elizabeth Halloran, director of the Seattle Center for Inference and Dynamics of Infectious Diseases. Endemicity is not just about reducing the reproductive number of the virus to one. This is the bare minimum to obtain the endemic classification – he underlines Angela Rasmussen, a virologist at the University of Saskatchewan in Canada – but there are also other factors that come into play: what is the rate of hospitalizations and deaths? Is the health system overloaded to the point of risking a staff shortage? Are there treatments available to minimize the number of people who will become seriously ill?
There is not much we humans can intentionally do to move towards endemicity. . . much depends on how the virus evolves Halloran adds. Its next step cannot be predicted, aside from the fact that any new variant will have to be more transmissible or more capable of escaping immunity – or both – to get the better of Omicron.
L’incognita greater in this journey towards endemicity is the very real possibility that they arise new variants. There is no law that requires a virus to become milder over timeor. very difficult to predict the evolution of virulence he says Eddie Holmes, evolutionary biologist who helped publish the Sars-CoV-2 genome sequence in January 2020. It could rise, fall, or stay the same. Certainly it is still possible that a more virulent variant will emerge in the future. The virus is circulating a lot all over the world, and I know that it is the high circulation that favors the emergence of new variants. With the real risk of having to start all over again in October, when the cold season will begin.
The idea that SARS-CoV-2 can stay with us forever may certainly sound disturbing. We can never go back to our pre-pandemic life without always having to wear the hateful masks (not so hated by teenagers because they hide pimples), without having to show the green pass wherever you go, without giving up travel, handshakes, travels, rock concerts standing on the parterre?
Perhaps understand (and accept) that the pandemic is a long-term emergency it could help governments (and psychologically citizens) to organize themselves more effectively by introducing new safety measures in daily life, choosing the right investments. Rather than thinking about when the pandemic will end, perhaps we should discuss how to manage to live with Covid, without being surprised at each wave to think: But wasn’t it over?.
Last fall, when the Delta variant seemed under control, just before Omicron’s explosive invasion, Jeremy Farrar, director of the London-based Wellcome Trust global health foundation told the New York Times: We need to start thinking, planning and understanding that we are facing an infection that will never go away. Own optimism could be one of the biggest obstacles to implementing coexistence plans: if every time you think that Covid is going away, you will tend to let your guard down without proceeding with essential investments.
Which?
1 Strengthen your search as much as possible to get to a universal vaccine single-dose that applies to all variants (daring challenge, but work is in progress);
2 Develop a true pandemic plan focusing on territorial medicine and hospital wards ad hoc because after more than two years of pandemic doctors and health workers cannot work continuously, as well as patients with other diseases, primarily oncological and cardiac diseases, cannot be postponed for examinations or interventions every time an emergency phase is entered ;
3 Continue into development of effective antiviral drugs, safe and low cost (to date we have Pfizer and Merck pills);
4 To ensure the vaccine to all countries of the world because this is the only way to really reduce the circulation of the virus;
5 To reduce the risk of contagion (which with large numbers involves restrictions and stress for the health system)engineering can immediately come to the rescue and help create a new normal
, thanks to controlled mechanical ventilation inside buildings, a system similar to the fans that in kitchens suck in fumes and odors: with an air exchange calibrated according to the level of risk, a closed environment can be made, saturated with viruses, as if it were open. Crucially, the variants do not affect how it works.
January 20, 2022 (change January 20, 2022 | 14:26)
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