COVID-19: When will this pandemic end — and how?

Masks Mexico mural
The efficacy of vaccines offers hope for herd immunity as the way out of the pandemic. It’s unlikely to come in a flash or a Superman-flipping-a-light-switch moment. There’s a lot of hard work and tough decisions to be made by leaders and ordinary mortals alike, going forward. Photo shows a mural promotes mask use while honouring health workers in Mexico City. Image Credit: AFP

Highlights

  • Irrespective of variants, a growing body of scientific knowledge shows vaccines work both in terms of reducing severity and hospitalisations.
  • That’s a big change from the time when there were no proven therapies, thousands died, the way forward was frightening and unknown.
  • Experts say the evidence is “getting better and better” that this pandemic could end — a major turnaround from a not-too-distant past when the world was gripped with fear, anxiety and despair.
  • How soon that will happen depends on some key factors, and on all of us. 

When do we get rid of COVID-19? Or are we going to have to deal with it forever?

When can we fly to India, Pakistan, the Philippines — anywhere — on a holiday? These are questions many people ask. And while some have already proclaimed “the beginning of the end” of the pandemic, others have declared a “permawar”. The reality is somewhere in between.

Within this continuum can we glean an immediate challenge. Despite the ramped up vaccinations, the toughest hurdles right now are three-fold — vaccine production and distribution at the global level, and adherence to protocols at the individual level. Let’s break it down:

Q: How will the pandemic end?

The most logical, and least painful, route is via herd immunity — through rapid, massive global vaccinations.

Q: If vaccines work, does that mean “herd immunity” will work?

Yes, and vice-versa. The answer to the above question is now clear. Vaccine efficacy is not due to sheer coincidence. Earlier this month, one study conducted in Qatar (where B.1.1.7 and B.1.351 are the predominant strains) found the Pfizer-BioNTech vaccine was up to 97.4% effective at preventing severe disease, according to results published in the New England Journal of Medicine on May 5, 2021.

The B.1.1.7 variant, which is more contagious than the original virus and caused a devastating surge in the UK, now accounts for 75% of new US cases, too. Yet, due to mass vaccinations, data show that daily infections in the US dropped close to 90% since the January 2021 peak. It is now lower than at any point in the past eight months. Vaccines (mRNA shots) and Johnson & Johnson appear to be highly effective against the mutations.

GOOD NEWS, BAD NEWS

• There’s good news and bad news.

• First, the good news: there’s evidence that COVID shots aren’t just helping those who are vaccinated; the vaccines also give “cross-protection” even to the unvaccinated, according to a new research.

• This offers hope for the herd immunity as humanity’s way out of the coronavirus pandemic.

• Now the bad news: the so-called “vaccination apartheid”. Production and logistical challenges, the pandemic’s end is unlikely to come as a big bang or an official decree.

Q: What about the efficacy of vaccines against variants of concern?

Studies show more contagious variants exist. Experts continue to improve their understanding of how similarities and differences between variants could impact potential COVID-19 vaccines.

On June 3, 2021, The Lancet published a study which shows neutralising antibody (nAbs) in response to B.1.617.2 (Delta) after mRNA vaccination in 250 people (median age 42, healthy) demonstrated immune-evasiveness is similar to B.1.351 (high), based on 2 doses of vaccine.

In short: It’s a confirmation of previous studies, i.e. that existing Pfizer’s two dose BNT162b2 vaccines have lesser efficacy, measured in terms of neutralising antibody (NAbTs), the term used is “significantly lower” against B.1.617.2 and B.1.351 variants — relative to B.1.1.7. 

The study has implications for dosing and spacing of existing vaccines,. Still, it shows even a single vaccine still affords considerably more protection than no vaccination. The researchers pointed out that single-dose recipients are likely to be less protected against these SARS-CoV-2 variants.

However, lesser efficacy is not an excuse to doubt the vaccines. Rather, it makes the task of vaccinating people as quickly as possible even more urgent, even as experts and health authorities find ways to deal more vigorously with new variants (through boosters or vaccine tweaks).

Vaccine
But lesser efficacy is not an excuse to doubt the vaccines. Rather, it makes the task of vaccinating people as quickly as possible even more urgent, even as experts find ways to deal more vigorously with new variants.

Q: What’s “vaccine apartheid”? How will affect the world?

It’s the reality that some countries are getting vaccinated — but the rest of the world are not. Currently, most COVID vaccines are going to what are called high- and middle-income countries.

In March, Nature reported that middle- and high-income countries had secured more than 6 billion out of 8.6 billion doses. In late March, the Times reported that “86% of shots” that went into arms across the globe were “administered in high- and upper-middle-income countries.” In early May 2021, less than 8% of the world’s population had received one dose.

Today, the world’s poorest countries may not be able to vaccinate their populations until 2023, according to the Open Society Foundation.

This is a yawning gap. It’s now known as “vaccine apartheid” — and it’s a big challenge. The long and short of it is this: when a country reels from viral infection while there’s a known cure elsewhere, it has the potential to scuttle the advances made on the virus in places where vaccine adoption is high — and a common post-pandemic future would look unlikely. 

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A colorized scanning electron micrograph of a dying cell infected with the coronavirus, with virus particles in red. Image Credit: NIAID

A global pandemic requires a global, concerted world effort to end it: None of us wil be safe, until everyone is safe.

Q: Will viral mutations ever end?

Not in the foreseable future. Mutation is simply making copies (of an organism, or virus) during replication. As SARS-CoV-2 infects more people around the globe, it mutates — thus acquiring genetic changes (variants). The term “viral mutation” may sound scary, but a great number of these mutations are minor, and don’t confer them more virulence or potential to cause severe infection. In fact, some mutations could make the virus less infectious. But as long as coronavirus infects people, it will keep mutating.

For example, it’s been declared that the world has essentially eradicated the poliovirus. Yet, polio is not really eradicated in the sense that the virus is still circulating. It’s also proven that it mutation rate is higher than that of viruses like the HIV. Scientists have also found circulating poliovirus strains in unimmunised populations serve as a “reservoir” that can seed new outbreaks. That’s why populations, especiallyt the young, need to be continue to be inoculated against polio.

Q: Do vaccines stop COVID infection altogether?

It’s a fact that COVID vaccines work, reduce disease severity. That means even if we get infected post vaccination, it won’t be as bad (needs hospitalisation). Now, there’s also evidence that vaccination curbs infections or prevents the onset of disease.

One of the clearest indicators of the efficacy of vaccinations is Israel. Real-world data show it has achieved one of the world’s fastest and most effective campaigns mounted against COVID-19. Israel’s rapid progress in immunising adults has been linked to big drops in infection rates — even among unvaccinated people, based on a preliminary data.

For every 20% increase in adult vaccination rates, infections in unvaccinated children is reduced by 50% for unvaccinated children. Again, this finding, though preliminary, shows hopes for herd immunity. Based on the Israeli study, vaccinated people pose little threat to others. More important, vaccinated people also face little peril themselves.

vaccination doses June 5, 2021
Image Credit: Our World in Data

Q: Can vaccinated people spread the virus to others, especially unvaccinated people, as well as children?

Cases of fully-vaccinated individuals contracting coronavirus are rare, though it is possible. So far, however, the evidence is quite encouraging, say researchers.

Because vaccinated people are unlikely to contract the virus, the vast majority won’t be passing it on. And even the small number of vaccinated people who experience “breakthrough infections” (vaccinated people getting infected) have much less of the virus circulating in their bodies, and may be less infectious. Even the CDC still continues to recommend vaccinated people with symptoms get PCR tested for COVID-19.

World in data
Image Credit: Our World in Data

Q: When can the world reopen?

However, reopening in the way we used to be prior to the pandemic won’t be like switching on a light bulb. WHO experts say it’s not going happen to soon, not this 2021, if at all.

Reopening will be more like a cascade. To safely reopen and bring this pandemic to an end, a large portion of the world needs to be inoculated from SARS-CoV-2. History tells us that humanity has often relied on vaccines to curb severity and deaths caused by infectious diseases.

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Passengers wait at check-in desks in the departures hall in Terminal 5 at London Heathrow Airport in London. After a year of false starts, rogue virus strains and vaccine drama, Brits are finally able to travel again, if only to a handful of “green list” destinations that won’t require quarantine on return. Image Credit: Bloomberg

We’ve already seen an unbelievable feat: Within 11 months since the SARS-CoV-2 genetic sequence was published, several teams rose to the challenge and developed vaccines that protect from the virus.

Now comes a fresh challenge: Make these vaccines available to people around the world. The key is to let people in all countries — not just in rich countries — receive the required protection.

At present, less than 8% of the world has been fully vaccinated. In developed countries, it’s already plus/minus 50%. Any solution on a global scale would take time. A more localised/regionalised opening is expected, instead of global. Instead of one giant switch for all, it will be like a chain of candles, illuminating one part of the world at a time.

COVID-19: When can we resume our lives without masks?

Vaccinations, safety protocol will help us live normal lives as coronavirus threat lingers

Shyam A. Krishna, Senior Associate Editor

COVID-19. When will it end? How will it end? These are questions on everyone’s lips. There are no clear answers. Experts think the SARS-CoV-2, the virus that causes COVID-19, will never go away. They say COVID-19 will cease to be a pandemic in a few years. But it will be endemic. Much like flu.

So what happens? Like the influenza virus, the new coronavirus too will be around us. It will continue to mutate, so our researchers will have to keep updating the vaccines. This means we will have to take shots periodically to protect ourselves from newer variants.

India Pakistan Philippines vaccinations
The coronavirus has wreaked mayhem worldwide, killing more than 3.7 million people: many of them our friends and relatives. And the threat is far from over. So we should remain vigilant as we continue to live our lives.

Not a comforting thought, I know. At the moment, it looks like it. I guess we will learn to live with the virus. After all, our lives can’t be held hostage by a microbe, even if it’s a pathogen. Looking back at the last 15 months, we have done well. We have adjusted to a new normal — a life that includes face masks and sanitisers.

But we shouldn’t be lulled in complacence. The coronavirus has wreaked mayhem worldwide, killing more than 3.7 million people: many of them our friends and relatives. And the threat is far from over. So we should remain vigilant as we continue to live our lives.

COVID-19 muddled medical science

This is no ordinary virus. It can kill. But with proper safeguards, we can beat the virus. I have. So did millions of others. But if you have pre-existing health issues, don’t waste time. If you are infected, seek medical help as early as possible.

The mortality rate hasn’t changed much for more than a year. So we don’t have to be scared, but we’ve to be careful since variants have become the new menace.

The mortality rate hasn’t changed much for more than a year. So we don’t have to be scared, but we’ve to be careful since variants have become the new menace.

The coronavirus has totally upended all expectations. I was wrong last year when I wrote the next big news break would trump COVID-19. But at the time, it wasn’t yet a pandemic. Having followed the outbreaks of mad cow disease, bird flu, swine flu, Ebola, Sars, Mers and several other epidemics, which had the potential to become pandemics, I was sure that COVID-19 too would fade away. And I have absolute faith in medical science. It has advanced so much that I was confident that there wouldn’t be a repeat of a Spanish flu-like situation of 1918-20.

Life’s near normal in the UAE

COVID-19 is a reminder of how much we don’t know. Forget the search for lives in other galaxies; we still don’t fully understand the human body. We don’t know all our organs and their full functions. The mesentery, which connects the intestine to the stomach, was classified as the 79th organ in the human body only in 2017. Medical science has come a long way (we got COVID-19 vaccines in less than a year, a record), but it still has a long way to go.

All is not gloom and doom. India may be struggling with the second wave of infections, but we can take heart from the recovery of the United States and Europe. Remember how Italy, Spain, Iran, France and the United Kingdom reeled from the onslaught of the virus.

The new coronavirus has muddled the field for doctors and researchers. Blood clots are an issue, so is the long COVID, where the symptoms persist long after patients recover from infections. The full impact and the ramifications of a COVID-19 infection are yet to be understood. So we’ve to be patient if any of us or our relatives and friends are hospitalised. Even healthy people have to follow the safety protocols; there could be undiagnosed health issues that could endanger their lives.

All is not gloom and doom. India may be struggling with the second wave of infections, but we can take heart from the recovery of the United States and Europe. Remember how Italy, Spain, Iran, France and the United Kingdom reeled from the onslaught of the virus. Look how they overcame the health crisis. No deaths have been reported from Britain, and the US have opened up public places for vaccinated people.

Here in the UAE, our life is close to normal. All credit should go to the government and its timely action. School closures, temporary shuttering of non-emergency businesses, disinfection programme, field hospitals, and medical assistance helped contain the spread of the virus. It helped partially open the economy as early as September with strict guidelines. The people in the country too deserve plaudits for following the safety protocols diligently, which helped keep the infections down.

How vaccinations helped

Free vaccinations have helped inoculate much of the country. Schools and offices have resumed operations. Restaurants, cinemas, parks and other leisure activities are in full swing. Life is close to normal. Our lives are buzzing again.

Masks, let’s keep it. The time to ditch it hasn’t come. The virus is still lurking. So, let’s also maintain social distancing, and wash or sanitise hands frequently. We’ve kept COVID-19 at bay, and resumed our lives. Let’s keep it that way.

Shyam A. Krishna

@ShyamKris_

Shyam A. Krishna is Senior Associate Editor at Gulf News. He writes on health and sport.