WHO Director-General Tedros Adhanom Ghebreyesus said that “2022 must be the end of the COVID-19 pandemic,” and we’re 100% hoping that he’s right.
He believed the pandemic will end this year because, two years into the outbreak, “we know the virus very well and we have all the tools [to fight it].”
The Economist, in a recent article, wrote: “COVID is not done yet. But by 2023, it will no longer be a life-threatening disease… It will still pose a deadly danger to billions in the poor world… COVID will be well on the way to becoming just another disease.”
The Latch has looked into what history’s previous pandemics can teach us about how they normally end and we know that it normally takes humanity about two-three years to get on top of it. That’s without all the medical intervention, scientific knowledge, and, of course, vaccinations that we now have in the present.
So, is 2022 the year that the pandemic finally ends? Here’s what Molecular Virologist and Leader of Infection and Immunity Research Strength, at the Jeffrey Cheah School of Medicine at Monash University Malaysia, Dr. Vinod Balasubramaniam had to say.
COVID-19 in 2022
With more than 281 million infections and 5.41 million deaths recorded worldwide, COVID-19 pandemic has emerged as one of the most devastating human pandemics in recent times. “When will this end?” has been an important question lingering in many of us for the past 2 years.
The key point, which is the most important determining factor, is whether COVID-19 is here to stay or whether we can eradicate this virus.
Mutations are an essential evolutionary process particularly pertinent in the ever-changing nature of RNA viruses in adapting to their host. In other words, the virus’s genetic diversity increases over time. Viruses mutate because they’re constantly making copies of themselves in enormous numbers and each time it is transmitted from one person to another, the chances of making errors (mutations) are high.
Think of it this way. If you were writing a draft of something millions of times on a computer, extremely quickly, you’d probably make some typos. This has happened millions and billions of times across the globe. The longer the pandemic rages on, the more chances the virus has to evolve, especially in unvaccinated individuals. Vaccines provide a barrier to the virus freely replicating and getting transmitted and lowers the chances of the virus mutating.
When Will This Cycle End?
The virus will not be eradicated. Only one disease, smallpox, has ever been eliminated. Instead, global immunity will increase as more people are vaccinated or contract COVID-19.
Some 3.8 billion have had at least one jab and 2.8 billion are fully vaccinated. Together with those who have caught the disease, around half the world’s population has some level of immunity. Eventually, COVID-19 will become endemic: transmission will remain at a steady rate, following seasonal patterns, with fewer spikes in infection.
The harm caused may end up somewhere between that of influenza, which kills an estimated 300,000 to 650,000 people annually, and other coronaviruses, such as the common cold.
This is of course the ideal situation, but endemicity is still a long way off for most countries. The virus will continue to affect our lives and livelihoods unless the global community collectively addresses inequitable access to vaccines, therapeutic agents and diagnostics, as well as the fact that we are giving the SARS-CoV-2 virus the room it needs to thrive through uneven and inconsistent national policies to reduce transmission, some of which are undermined by division and politicisation.
Of the more than 7 billion doses administered so far, less than 3% have been in countries on the African continent. The World Health Organization (WHO) has recommended that those at higher risk of severe disease and health workers be prioritised for COVID-19 vaccination in all countries. The number of doses administered by the end of September 2021 was enough to have covered 40% of the population in all countries. The failure to provide access of sufficient doses of vaccines to low- and middle-income countries is not only unethical, but it is epidemiologically and economically unwise, and is prolonging the pandemic.
Unfortunately, vaccines alone will not end this pandemic, in part because of more transmissible new variants and also because vaccines are primarily designed to protect against severe disease and death. The more the virus is allowed to circulate, the more opportunity the virus has to evolve.
Throughout the course of the pandemic, SARS-CoV-2 has shown its ability to become better adapted to the human host, with variants Alpha and Delta demonstrating enhanced transmissibility. One of the biggest unknowns in 2022 will be how this evolution continues. Delta continues to evolve, and the Omicron variant has shown that the virus will continue to adapt, and such variants may be more transmissible, cause more or less severe disease, and/or develop properties of immune escape.
The Road Towards Endemicity
One of the essential factors governing the future of COVID-19 is our immunity to the illness. Immunity to any pathogen, including SARS-CoV-2, isn’t binary like a light switch, where you either switch on or off. Instead, it’s more like a dimmer switch: The human immune system can confer varying degrees of partial protection from a pathogen, which can stave off severe illness without necessarily preventing infection or transmission.
In general, the partial protection effect is one of the reasons why the four known endemic human coronaviruses — the ones that cause a common cold — have such mild symptoms. Studies have shown that, humans are first exposed to all four of these coronaviruses between the ages of three and five — part of the first wave of infections that young children experience. These initial infections lay the foundation for the body’s future immune response.
As new variants of endemic coronaviruses naturally evolve, the immune system has a head start in fighting them off — not enough to eradicate the virus instantly, but enough to ensure that symptoms don’t progress much beyond the sniffles.
In a way, the virus is also its own enemy because every time it infects us, it tops up our immunity. Past studies make it clear that partial immunity can keep people from getting seriously ill, even as coronaviruses successfully enter their systems. Long-term, the same is likely to be true for the new coronavirus, including the current Omicron strain.
Will There Be More Variants?
Newer variants are inevitable when it involves an RNA virus. The RNA virus (in this case, the SARS-CoV-2) replication machinery is error prone and each time the virus transmits from person to person, given time, the possibility of new variants is high. This is where vaccine equity comes in. Vaccines protects us from severe symptoms and mortality. There are also data showing that vaccines clear the virus much faster from the body compared to unvaccinated individuals, therefore indirectly limiting transmission from one to another.
Why Do We Get Variants?
Every time the virus reproduces inside someone there’s a chance of it mutating and a new variant emerging. This is a numbers game. It’s a random process, a bit like rolling dice. The more you roll, the greater the chance of new variants appearing. It’s basically a ticking timebomb.
The main way to stop variants is equal global vaccination. The emergence of Omicron reminds us of how important that goal remains. We must get vaccines to these people as quickly as possible (especially in countries who are behind in their vaccination rate), both to help the people there who are vulnerable but also to stop new variants from emerging.
Let us not forget that in South Africa, where just over 40% of people are fully vaccinated, the variant has begun to spread rapidly. A number of factors could be contributing to the rising caseload, including the nation’s low vaccination rate. Vaccine equity is a global problem. If we don’t address this quickly enough, our exit from the pandemic will be set back, possibly for months or even years on end.
We Have the Tools to End This
All pandemics end. The COVID-19 pandemic will end, but it is not over yet. Already, we have endured two years of missed opportunities, missed education, missed connections with family and loved ones. Without action, 2022 could be the same. But it doesn’t have to be.
In any scenario for the future of the COVID-19 pandemic, much depends on the ways in which societies respond. Three levers are likely to be especially important, starting with the extent to which countries can effectively scale and make available new oral therapeutics with the potential to reduce the chance of progression to severe disease, and which are unlikely to be blunted by omicron.
Second, evidence is accumulating that booster doses are especially important for protecting against the omicron variant; accelerating their rollout will help protect populations.
Third, given public fatigue and the lessons of the past two years, finding the right combination of public-health measures will be critical. As I said before, 2022 is truly the year we can have the pandemic under control. We cannot let out guard down and remove public health measures and suffer the unwanted consequences earlier.
While vaccines have given us a huge boost the past year in terms of giving protection against disease severity and mortality to the majority of the population, we are still learning more about this new variant and the pandemic is still far from fully over. Despite the risks from Omicron, the overall public health strategy used throughout the pandemic remains effective and is of utmost importance. We should not forget that already we have the ‘weapons’ (e.g., masks, social distancing, etc.) to reduce the risk of becoming infected.