After over 18 months of the current pandemic, with social distancing, wearing masks, and closing economies, what we all want to know more than anything else is when it will end and how it will end. While there is nothing certain, we have a lot of evidence on which we can build some realistic expectations, of how the pandemic will progress over the next year or even longer.
This may not be the first time the Covid-19 coronavirus has caused a terrible global pandemic. Thus, we hypothesize that the “Russian flu” that appeared in 1889, and that was not actually a seasonal virus, but was caused by another coronavirus, OC43.
That pandemic caused 4 or 5 shock waves over the next 5 years, after which it seemed to disappear. In England and Wales, most of the excess deaths it caused were limited to the years 1890-1891 alone.
OC43, the probable cause of that pandemic, still circulates today, although it rarely causes severe forms of the disease.
The data so far suggest that SARS-CoV-2, the coronavirus that causes Covid-19 disease, is here to stay, a conclusion reached a few months ago by many scientists studying the virus. Neither vaccines nor natural infection with it will stop the spread of the virus.
And while vaccines reduce its transmission, they will not be able to stop infections to such an extent that they will kill the new coronavirus. Even before the Delta variant arrived, we saw cases of people being vaccinated with both doses that had been affected by the virus, and that it had spread to others.
Because vaccines are somewhat less effective in combating the Delta variant, compared to other forms of the virus, the chance of infection after vaccination is increased. Even the immunity created by the vaccine to not get infected, starts to decline within a few weeks of receiving its second dose.
And because immunity to infection is neither absolute nor permanent, herd immunity is an unattainable target. This means that Covid-19 is likely to become endemic, with daily rates of infections falling depending on the amount of immunity and social interaction throughout the population.
Other human coronaviruses cause recurrent infections on average every 3-6 years. If SARS-CoV-2 ends up behaving the same way, it suggests that in the UK on average 1/6 to 1/3 of people, ie 11-22 million people, can become infected with it each year, or 30,000 to 60,000 per day.
But this is not as scary as it seems. But ongoing research suggests that immune protection against the symptomatic onset of Covid-19 appears to be waning. However, protection against serious forms of disease, created by vaccination or natural infection, is much longer.
It also seems that it does not completely disappear when faced with new variants.
In fact, for other coronaviruses that affect humans, the vast majority of infections are either asymptomatic or at worst a mild cold. All indications are that Covid-19 may end up being the same.
How the current pandemic will end, this will vary from country to country, and will largely depend on the percentage of people immunized, and how many infections there have been since the onset of the pandemic. In Britain and other countries that have a high vaccination rate, but also an equally high number of cases that have passed the disease, most people will have some form of immunity to the virus.
In England, for example, it was estimated earlier this month that over 94 per cent of the adult population had antibodies to Covid-19. In those who have a prior immunity, it has been observed that Covid-19 tends to be less severe.
And as immunity grows in more and more people over time, from natural re-infections or booster vaccine doses, we can expect an increasing percentage of new infections to be symptomatic, or at worst, cause mild illness.
The virus will remain with us, but the disease will become part of our history. But in countries without many patients with the virus, but also without many vaccinated, many people will remain at risk. Even in countries with the highest vaccine coverage worldwide, over 10 percent of people have not yet received a vaccine dose.
Almost everyone who has not been vaccinated is likely to be infected with the virus. When infected, they will be just as vulnerable to serious illness and death (depending on their age and health condition) as at any other time during the pandemic.
And in these countries, the opening will surely lead to an exponential increase in infections due to the large number of people without immunity. And as the amount of virus circulating increases, even in vaccinated people there will be more infected, given the fact that vaccines do not protect 100 percent.
Although Covid-19 tends to be less severe in vaccinated people, some of them still become seriously ill, and these sites can hospitalize a significant number of vaccinated people who will still need hospital care. Also, the removal of restrictions from these countries will have a critical impact.
There are many other people waiting to be vaccinated soon, while the effectiveness of those who have already been vaccinated may have begun to wane. The main lesson from the Russian flu, however, is that Covid-19 will become less important in the coming months, and that most countries have already almost certainly gone through the worst of the pandemic.
But it still remains very important to provide vaccines to populations that are still unvaccinated in the world. It is more than clear that the main impact of vaccination will not be to prevent SARS-CoV-2 infection, but to reduce the severity of the infection the first time people encounter the virus.
In case people have been affected by the coronavirus once or twice and have already developed a natural immunity, vaccines will relatively increase the protection. In order to have the greatest reduction of severe forms of the disease, vaccines should be distributed to as many people as possible./ (By Paul Hunter – “The Conversation” – Bota.al)
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