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COVID-19: In the Transition from Pandemic to Endemic. Op-Ed from Ala Tocarciuc


https://www.ipn.md/index.php/en/covid-19-in-the-transition-from-pandemic-to-endemic-op-7978_1090968.html

«Surely in the coming months we will all meet with the Omicron strain and its 30 variations. Some have already done so. It's important for us to take care of ourselves and our community, to respect the work and effort we've all put in since the pandemic began. We have learned to live in a pandemic and are ready to live in endemic. It's going to be all right! »
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From the first months of the current pandemic, epidemiologists assumed that there would be more pandemic waves. The assumptions were substantiated by historical information and epidemiological studies accumulated in previous pandemics.

The COVID-19 pandemic has been a classic pandemic, with several waves up to this point.

This year's political and economic events have replaced the pandemic theme in the headlines. But that doesn't mean the pandemic is over.

In recent weeks, there has been a growing number of new COVID-19 cases, and why this is happening and how we can protect ourselves are the topics I'll cover in this editorial.

What are the reasons for the rise in new COVID-19 cases?

 

  1. New strains and variants of the virus

 

As we have mentioned many times, viruses are constantly mutating, and it was expected that even with COVID-19 there would be more new variants and strains. Currently, there are several main variants of concern, which are called alpha, beta, gamma, delta variants, the latter being a variant of omicron. It is known from the public at this time that the Omicron strain already has more than 30 variations, all of which are highly contagious. Among the current dominant strains are B1.4 and B1.5.

Vaccines developed in 2020 and introduced mainly in 2021–2022 were well effective against initial strains and variations. But in the current pandemic, the effectiveness of vaccines is declining for almost every subsequent option. For current variations of the Omicron strain, the effectiveness of primary vaccines has decreased to 20%.

The official information has always been that vaccination is the best choice to protect us from serious illness and death, but that doesn't mean that the vaccine makes us 100% immune to COVID-19 in all its variations. Even if we're vaccinated, we can still get the virus and spread it.

In the fall, new models of vaccines developed based on the primary strain of Omicron are expected and which are supposed to be more effective with the current variations of the virus.
 

  1. Human behaviour

 

This is the main factor influencing the evolution of infection among humans. Even with the advent of new options, if people continued to follow public health measures as they should have, the number of cases would not be as high.

Since March this year, authorities in many countries have halted  COVID-19-related public health restrictions and allowed mass gatherings, which ultimately contributed to an increase in the number of active cases.

Where are we now and what can we expect?

We are in the transition from pandemic to endemic. We are approaching the beginning of the autumn-winter season, during which COVID-19 will "march around the world by changing clothes", if I may use a metaphor here.

Those who have made the vaccine, including the booster, have immune defences against previous strains, but have a very low level of protection against the Omicron strain and its 30 variations. Thus, they are in a group with a high risk of infection.

Those who have gone through the disease while being infected with previous strains are immune to these strains, but less to the Omicron strain and its 30 variations. And these people are also in the high-risk group.

Those who previously made vaccines and went through the disease with previous strains now have no protection against the Omicron strain and its 30 variations. They also represent a group with a high risk of infection.

Those who have gone through the disease within the last 6 months and have been infected with one of the variations of Omicron – these people have a higher degree of protection against this strain. This group of people is currently at negligible risk of contracting the Omicron strain and its 30 variations.

Right now, we can't say that people in these groups will have protection against a possible new variant or a new strain of the COVID-19 virus.

If you look at the official statistics of diseases and vaccinations over the past 6 months, in light of the above, it may seem that now over 80% of the population is in the group with a high risk of infection.

I think the reality is a little different and I rely on the knowledge gained about this virus. The current reality is determined by the high infectiousness of this strain of Omicron and the two causes of the spread of infection mentioned above.

It is estimated that the official number of people infected with the Omicron strain is almost 10 times lower than the number having gone through the disease with this strain. Some sources give a 1:15 ratio of reported cases compared to real cases, which is a figure of more than 50 % of herd immunity acquired because of passing through the disease.

At the beginning of this year, I already wrote that this variant of the Omicron virus is difficult to control with non-specific measures. In addition, the forms of the disease were somewhat milder, did not always require hospitalization, medical systems coped with the number of patients. The lifting of restrictions in many countries was determined by these aspects.

All this applies to the Omicron strain and its 30 variations both to date and to the subsequent period. If a new variant or strain of virus emerges, we will have new data, and then we will be able to make new decisions. Now, no one can predict what the new strain will be. It is only assumed that it will be very contagious but will not cause serious forms of the disease.

We have clear evidence from real life that the pandemic is slowly becoming endemic.

 

For a better understanding of this process, I will give definitions here.

 

A pandemic is an epidemic that spreads over a very large area.

 

Endemic is the presence of an infectious disease in a community for a long time.

 

COVID-19 is now in the process of transitioning from an epidemic that has spread around the world to an infectious disease that will be present in the community for a long time.

 

As for vaccination: we are waiting for new doses of the booster adapted to Omicron, and we will be vaccinated. Vaccination is mandatory for those who are in groups with high health risk.

In terms of human behaviour, it's important that we continue to comply with public health measures. Continue to wash our hands, maintain social distance, avoid crowded places, and wear a mask if possible. But I think from now on everything will be voluntary.

When it comes to new strains: we're watching developments around the world. In this context, we have the tools at our disposal. We're trying to stay vigilant!

Surely in the coming months we will all meet with the Omicron strain and its 30 variations. Some have already done so. It's important for us to take care of ourselves and our community – to respect the work and effort we've all done since the pandemic began. We have learned to live in a pandemic and are ready to live in endemic. It's going to be all right!