The Overseas Situation Report Friday 18 February 2022
by Mike Evans
“Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less.”
Marie Curie
In the week when we saw the number of cases worldwide drop by over 20% compared to last week and the reported number of deaths due to covid 19 dropping by 7% the question many people are asking is – Are we seeing the end of Covid 19?
In this report we are looking at what the current thinking is regarding the end game of the pandemic.
In the midst of a vast wave of milder infections, countries around the world are dialling back restrictions and softening their messaging. Many people are starting to assume they’ve had their run-in with Covid-19 and that the pandemic is tailing off. As a virus-weary world limps through the third year of the outbreak, experts are sending out a warning signal: Don’t expect omicron to be the last variant we have to contend with – and don’t let your guard down yet.
However, that may not be the case. The crisis isn’t over until it’s over everywhere. The effects will continue to reverberate through wealthier nations – disrupting supply chains, travel plans and health care – as the coronavirus largely dogs under-vaccinated developing countries over the coming months.
Before any of that, the world has to get past the current wave. Omicron may appear to cause less severe disease than previous strains, but it is wildly infectious, pushing new case counts to once unimaginable records. Meanwhile, evidence is emerging that the variant may not be as innocuous as early data suggest.
There’s also no guarantee that the next mutation – and there will be more – won’t be an offshoot of a more dangerous variant such as Delta. And your risk of catching Covid more than once is real. “The virus keeps raising that bar for us every few months,” said Akiko Iwasaki, a professor of epidemiology at Yale School of Medicine. “When we were celebrating the amazing effectiveness of booster shots against the delta variant, the bar was already being raised by Omicron. “It seems like we are constantly trying to catch up with the virus,” she said.
“There is a lot of happy talk that goes along the lines that Omicron is a mild virus and it’s effectively functioning as an attenuated live vaccine that’s going to create massive herd immunity across the globe. “That’s flawed for a number of reasons.” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. “With Omicron, because it has more of an upper respiratory component, it’s even less likely to result in durable immunity than previous variants,” Hotez said. “On that basis, it’s incorrect to believe that this is somehow going to be the end of the pandemic.”
Experts now believe that the virus will never go away entirely, and instead will continue to evolve to create new waves of infection. Mutations are possible every time the pathogen replicates, so surging caseloads put everyone in danger. The sheer size of the current outbreak means more hospitalizations, deaths and virus mutations are all but inevitable. Many people who are infected aren’t making it into the official statistics, either because a home test result isn’t formally recorded or because the infected person never gets tested at all.
In the USA it is estimated that only about 20 to 25% of all cases are reported according to Trevor Bedford, an epidemiologist at Fred Hutchinson Cancer Research Centre in Seattle. With daily cases peaking at an average of more than 800,000 in mid-January, the number of underlying infections may have exceeded 3 million a day – or nearly 1% of the U.S. population, Bedford estimates. Since it takes five to 10 days to recover, as much as 10% of people in the country may have been infected at any one time.
He’s not alone in projecting astronomical numbers. At the current infection rate, computer modelling indicates more than half of Europe will have contracted omicron by mid-March, according to Hans Kluge, a regional director for the World Health Organisation.
Meanwhile, a sub-variant known as BA.2 is spreading rapidly in South Africa. It appears to be even more transmissible than the original strain and may cause a second surge in the current wave, one of the country’s top scientists said.
And just because you’ve already had the virus doesn’t mean you won’t get re-infected, as Covid doesn’t confer lasting immunity.
New evidence suggests that Delta infections didn’t help avert omicron, even in vaccinated people. That would explain why places like the U.K. and South Africa experienced such significant outbreaks even after being decimated by Delta. Reinfection is also substantially more common with Omicron than previous variants.
It’s sobering for a world that’s been trying to move on from the virus with a new intensity in recent months. But the outlook isn’t all gloom. Antiviral medicines are hitting the market, vaccines are more readily available and tests that can be self-administered in minutes are now easy and cheap to obtain in many places.
In six months’ time, many richer countries will have made the transition from pandemic to endemic. But that doesn’t mean masks will be a thing of the past. We’ll need to grapple with our approach to booster shots, as well as the pandemic’s economic and political scars. There’s also the shadow of long Covid.
“As long as there are areas of the world where the virus could be evolving, and new mutants arriving, we all will be susceptible to these new variants,” said Glenda Gray, chief executive officer of the South African Medical Research Council.
Lockdowns and travel curbs aren’t going away, even if they are becoming less restrictive on the whole.
“The things that will matter there are whether we are able to respond when there is a local surge,” said Mark McClellan, former director of the U.S. Food and Drug Administration and director of the Duke-Margolis Centre for Health Policy. “Maybe going back to putting on more masks or being a little bit more cautious about distancing.”
Inoculation is still the world’s primary line of defence against Covid. More than 62% of people around the globe have gotten at least one dose, with overall rates in wealthy countries vastly higher than in developing ones. At the current pace, it will take another five months until 75% of the world’s population has received their first shot.
But studies show one or two injections don’t ward off the pathogen. The best bet at this point is a booster shot, which triggers the production of neutralising antibodies and a deeper immune response.
People inoculated with more traditional inactivated vaccines, such as the widely used shots from China’s Sinovac Biotech Ltd., will need at least two boosters – preferably with different vaccines – to control the virus, Yale’s Iwasaki said.
In the next six months, more countries will contend with whether to roll out a fourth shot. Israel has started and the U.S. backs them for vulnerable people, but India is pushing back and refusing to “blindly follow” other countries.
While the virus won’t be overwhelming hospitals and triggering restrictions forever, it’s still unclear when – or how – it will become safe to leave on the back burner. Experts agree that in developed countries including the U.S. and much of Europe, the virus could be well in hand by mid-2022. There will be better access to pills such as Pfizer Inc.’s Paxlovid, rapid antigen tests will be more readily available, and people will have become accustomed to the idea that Covid is here to stay. Vaccinations and new treatments, widespread testing, and immunity as a result of previous infections are helping. Countries like Denmark are getting rid of all pandemic restrictions despite ongoing outbreaks.
Elsewhere in the world, the pandemic will be far from over.
The threat of new variants is highest in less wealthy countries, particularly those where immune conditions are more common. The delta mutation was first identified in India while omicron emerged in southern Africa, apparently during a chronic Covid infection in an immunocompromised HIV patient.
“As long as we refuse to vaccinate the world, we will continue to see new waves,” Hotez said. “We are going to continue to have pretty dangerous variants coming out of low- and middle-income countries. That’s where the battleground is.”
Let’s all hope that the vaccine programme around the world can help to stop the pandemic as soon as possible. Until the next time Stay Safe.
Total Cases Worldwide – 418,657,700
Total Deaths Worldwide – 5,871,228
Total Recovered Worldwide – 342,122,557
Total Active Cases Worldwide – 70,663,915 (16.9% of the total cases)
Total Closed Cases Worldwide – 347,993,785
Information and Resources:
https://www.worldometer.info/coronavirus/
https://www.worldometers.info/coronavirus/weekly-trends/#countries