The omicron wave is reaching its peak in Europe, and while it begins its downward curve it will continue to infect and, according to authorities, more than half of the population will have COVID. But this, they assure, can play in favor of public health: a collective immunity capable of returning to the endemic coronavirus could be generated. The same would happen in the United States and other parts of the world.
What will it be like this year? When will the pandemic end? Will the world be ready for the next health crisis? Answers of science, and enigmas that persist, analyzed in this story.
The 000 of January 2022, Marco Cavaleri, director of the area of Biological Threats to Health and Vaccine Strategy of the European Medicines Agency (EMA), said during a virtual conference of the press, something that, if it occurs, would shed light on what follows in this pandemic.
Cavaleri said that the natural immunity conferred by the highly infectious omicron strain may be accelerating the progress of the pandemic towards endemic status.
Difference between epidemic, pandemic and endemic
Endemic refers to the constant presence and/or usual prevalence of a disease or infectious agent in a population within a particular geographic area . Endemic diseases are, for example, Chagas in certain regions of South America, or malaria and River Blindness in certain areas of Africa.
One epidemic is an unexpected increase in the number of cases of a specific disease, known or new, in a particular area. Nowadays, an infectious disease is not only considered an epidemic. For example, obesity, which is not communicable, is defined as a modern epidemic.
The World Health Organization (WHO) declares a pandemic when a disease grows at exponential levels, encompassing new areas every day. In fact, the main difference between an epidemic and a pandemic is not the severity of the disease but the rate of spread. The 1918 flu was a pandemic, as obviously is COVID-19.
The route of COVID-19
Scientists have long wondered if the coronavirus that causes COVID-19 would follow a route similar to influenza, which after the 1918 pandemic became a seasonal virus, present in the daily life of humanity, with spikes and mutations every winter season.
“With the increase in immunity in the population, and with omicron, there will be a lot of natural immunity in addition to vaccination, and we will move quickly towards a scenario that will be closer to the endemic situation”, said Cavaleri.
If this scenario becomes a reality, a fourth booster of the vaccine might not be needed against COVID, but rather a vaccine against the coronavirus that causes it, perhaps once a year.
However, if this journey happens, it will not mean that the virus is no longer dangerous: in fact, this pandemic has already claimed almost 6 million victims worldwide. And the flu causes between 300,000 and 500,000 deaths a year globally.
The other four coronaviruses that cause the common cold are also seasonal, although more harmless.
But there is no virus 100% “innocent”, where the disease develops, from asymptomatic to severe, will depend on many factors: the person’s general health, the quality of their immune system, age, pre-existing conditions and, critically, whether or not they have been vaccinated.
Epidemiologists say that at this point in the spread and mutation of the coronavirus, thinking about eradicating it is an impossible task.
However, the behavior of omicron, the highly contagious variant of the coronavirus, may be indicating that the peak of contagion is beginning to decline, which does not mean that it will disappear.
Therefore, this good news does not mean that you should wear a mask or practice physical distancing forever. This will depend on the level of immunity and vaccination.
With the other coronaviruses that have been circulating among humans for centuries, seasonal vaccines and herd immunity allow life to continue without isolation. Of course, as with other infectious diseases, there is a social and individual responsibility to keep these viruses away from the word pandemic.
It is unlikely, at least in the United States, that if the vaccine against COVID-19 becomes seasonal, becomes part of the school immunization calendar. But it may be possible in other countries where the word of public health is followed to the letter.
What happens with immunity
Immunity is the ability of the body to protect against disease when exposed to germs such as viruses, parasites or bacteria.
It is a complex process that involves proteins known as antibodies.
An antibody is a protein component of the immune system that circulates in the blood, recognizes foreign substances such as bacteria and viruses and neutralizes them. After exposure to a foreign substance, called an antigen, antibodies continue to circulate in the blood, providing protection against future exposures to that same antigen.
Apparently, immunity against the coronavirus that causes COVID-19 remains robust for about 6 to 8 months, whether it is natural immunity (when the person was infected) or by vaccination. Still, there are cells, called memory B cells, that are reminiscent of the virus and can mount some immune response if it tries to infect again.
If the coronavirus becomes endemic, outbreaks are likely (more cases of a disease than normally expected) in less vaccinated areas of the world, as is the case today with measles. Or the product of unvaccinated travelers who “carry” the contagious virus in their suitcases, as in the case of the measles outbreak at Disneyland in 2015.
Contact with animals and coronavirus
The coronavirus that causes COVID-19 is a zoonotic infectious disease, meaning that the virus passed from an animal species to a human being.
Researchers discovered that bats carried this virus, as well as other coronaviruses. However, the bat-human chain is not the only route of infection. Millions of mink died from COVID on farms, and also transmitted the virus to humans
It is also believed that the pangolin carries the virus and can pass it to humans, although with this animal science is divided.
In both cases, minks and pangolins, the animals act as intermediaries, passing the virus from the animal that carries it, in this case bats, to humans in different ways of manipulation.
The next pandemic: lessons…learned?
In his book Epidemics and Society: From the Black Death to the Present, Yale University professor Frank Snowden assures that one of the worst infectious diseases of Humanity is “lack of memory”. Mistakes are repeated for not analyzing those committed in past pandemics, and preventing them.
The expert indicates that, in order to be ready for the next pandemic, it is necessary to analyze and learn from the lessons of the COVID- 19 and the previous ones.
As analyzed by Yonatan Grad, professor of Immunology and Infectious diseases, of the Harvard University, in an interview published on the website of the university’s School of Public Health:
“Past pandemics have caused massive changes in the way we live that we have come to accept as normal. Screens on our doors and windows helped keep out the mosquitoes that carry yellow fever and malaria. Sewage systems and access to clean water helped eliminate typhoid and cholera epidemics. Perhaps the lessons learned from COVID-19 in terms of disease prevention can yield similar long-term improvements in individual and global health.” .