Sunday, January 02, 2022

When will the COVID-19 pandemic end? Past diseases, and how they played out, offer some clues

JANUARY 2, 2022

Everyone is hoping we finally reach one destination in the new year: the end of the pandemic.

But with two-year lockdown cycles, exponential case counts, a testing crunch, and an omicron curveball just a few to come by, it can sometimes seem like that point keeps rolling back and forth on the horizon.
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Experts agree that the coming year is difficult to predict, but they can take some of their hopes and fears and lessons from past pandemics.

It is unlikely, they say, that the virus will disappear. But the sharp increase in new cases could mean that they drop quickly before expected to settle into some kind of low-grade, continuous, less heavy presence.

Cases doubled every few days at the end of 2021, with Omicron quickly overtaking Delta to become the dominant version in Canada.

“But sometimes when that happens we also see a really rapid decline,” said Winnipeg-based epidemiologist Cynthia Carr, adding that whether that happens will define the first few months of 2022.

“It burns through a large section of the population.”

An infectious disease epidemiologist at Harvard’s Belfer Center for Science and International Affairs, Dr. Sira Help said, there are still too many unknowns.

The data is “coming out fast and furiously from all different angles, from different countries, I think there’s good and bad,” she said, speaking by phone from New York City, the epicenter of Omicron. one of. Madad is also senior director of the System-Wide Special Pathogens Program at NYC Health & Hospitals.

“The good news we’re seeing right now is that the Omicron version seems to be milder than other types of anxiety in terms of causing serious illness,” she said.

“But because it’s so highly transmissible, you’ll see a lot of people get infected with this virus.”

There have already been some concerning reports of hospitalizations in the US, mostly involving children who have not been vaccinated.

In Ontario, where there are so many new cases that lab polymerase chain reaction (PCR) tests are now limited to people at high risk, Hospitalizations are also increasing,

a recent report Public Health Ontario found that the risk of hospitalization and death from Omicron was approximately 54 percent lower than from Delta, adjusting for vaccination status and region. However, the number of hospitalizations and the impact on the health care system are still “likely to be significant” because it is so contagious.

the variant appears reached its peak in South Africa, where it was first detected, said Madd, who was featured in Netflix’s early 2020 documentary series, “Pandemic.”

“The best way to put it is crash and burn,” she said. But there are “various factors” to consider; South Africa for example “could reach a threshold in terms of testing capacity,” and still “asymptomatic cases are not being taken up.”

Carr suspects that COVID will go away, like Severe Acute Respiratory Syndrome (SARS), which killed nearly 800 people in about 30 countries, including Canada, in the mid-2000s.

Instead, Carr said that COVID can be seasonal, like a flu, “which can still have a very severe impact on some people, vulnerable people in the population,” or called endemic (a stable , but not a heavy presence in some areas).

“If we continue to see again that people are not getting shortness of breath or very medically severe cases, it could be good news that we are turning to an endemic situation where perhaps this strain is no longer there. Moving towards having more strains of coronavirus,” said Carr.

He said these strains cause “one in four” common colds. Although it’s too early to say with certainty, “It’s my hope, that it might actually steer us in this direction, given how quickly it’s moving.”

No one could have predicted Omicron’s “efficacy and just the rate of transmission,” said Tim Sly, a professor emeritus in the School of Occupational and Public Health at the university, formerly known as Ryerson.

“Never underestimate Mother Nature, she has all kinds of tricks up her sleeve.”

Sly agrees that COVID probably won’t “disappear” as SARS did, as eventually “everybody is going to be exposed”. Instead he thinks it will be “in line with the model we’ve seen with influenza viruses for years.”

The flu of 1918–19, which spread around the world after World War I, eventually ended with infected people dying or gaining some immunity. But new strains of that virus have emerged over time, including the swine flu pandemic in 2009, Sly said.

“So these things enter the population and if they stay there, they pop up a few years later as part of the normal seasonal influenza virus,” he said.

“We’ll probably be seeing an annual flu shot that also includes a coronavirus antigen, just to keep us on top every year.”

Where she sits, New York City’s help hears “much fear, a lot of anxiety,” and “flashbacks to March 2020.” But, she said, it’s important to remember that we now have a lot of tools to fight the virus, including vaccines, masks and even new promising treatments.

A few days before Christmas, US Food and Drug Administration (FDA), Pfizer approved a new antiviral pill, called Paxlovid, for emergency use. It is not yet authorized in Canada.

“It’s the kind of sunshine we all needed in the midst of a viral blizzard,” Madd said, and “will definitely be a game changer.” Before people can receive treatment, he said, they need to be diagnosed.

Unfortunately, “the boom and demand for testing is quite astronomical,” in both the US and Canada, and many people may not have access to testing.

Help hopes the virus will transition “in a more seasonal pattern,” with fewer deaths and dire consequences. But that’s “really it’s just a hope and a wish. I’m not going to say it’s going to happen in 2022 just now.”

And what about the likely future, even worse, variants? Eric Arts, a professor in the Department of Microbiology and Immunology at Western University, said that “most of the time” when a virus mutates, it does so to find a way to transmit more easily between people than it seems. That’s what Omicron has done.

Going forward, “we hope that’s what’s going to happen, but again we don’t know. You can get a mutation that helps transmission and that can have really serious consequences in disease, but it There’s a mutation that comes with the ride.”

The best way to prevent this scenario, he said, is to ensure that everyone has access to vaccines.

“We have focused a lot on our situation in Canada and the US, country by country, let us get our vaccines, let us protect ourselves. This world is too small for him,” he said.

“If we really want a good 2022, and we want to see the end of it, we need to do more to vaccinate the world. It’s that simple.

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