„All this knowledge allows us to make some plans for 2021 at least. We can also have a short- and mid-term perspective and planning, i.e., up to 2023-2024. Having certainty is a good thing! ...”
We've reached the last week of the first pandemic year of this century. A lot of people inspired by the first, approved and administered to humans, vaccines, believe that the pandemic is coming to an end and memories of COVID-19 will remain in the history of 2020.
How does a pandemic end?
The pandemic will end when at least 60-70% of the population will have herd immunity to COVID-19.
This immunity can be achieved on several scenarios.
The first scenario is a natural immunization, i.e., through the contact with the virus, with immunity formed after the disease.
Some people will have the contact with the virus only once and will have antibodies after the first contact. These antibodies will provide protection for an estimative period of 2-4 months, then their number will slightly decrease, and people will become susceptible to the virus again.
Some people won't have antibodies after the first contact. They will potentially contact within the virus for a second time, after which they will have antibodies and will be protected for an estimative period of 2-4 months.
This process of community illness transmission will be lasting over time for at least two to three years, as we have nearly three million people in the country, some of whom will go through the disease twice or even more times.
The second scenario to achieve herd immunity is vaccination against COVID-19. In the case, when the vaccine will be widely available, immunization against COVID-19 can be carried out within two months in such a country as Moldova. Here comes the problem of vaccinating children, because the available vaccines are exclusively approved for adults now. Children cannot be vaccinated with these vaccines. Children will go through contact with the virus and will continue to have the natural immunity which, as it is known, is not long lasting.
The third scenario of achieving herd immunity is the mixed one. According to this scenario, some of the people at the first stage will go through the disease, and some of them will be vaccinated, and in the total amount we will reach those 60-70% of the population carrying antibodies to COVID-19. In this scenario, children also remain a vulnerable group because they cannot be vaccinated.
Which scenario is now in Moldova?
In Moldova we now go to the first scenario and get natural immunity against the virus. We're going to go on this scenario until we get the vaccine. There are several predictions about vaccine availability.
Economist's intelligence unit assessed the possible widespread availability of the vaccine globally. According to the estimates of these experts, the vaccine will be widely available in Moldova in 2022-2023.
WHO predicts a gradual availability of the vaccine for various countries and vulnerable groups. According to WHO provisions, the first doses of the vaccine would be to reach Moldova in the second quarter of 2021.
Within the available vaccine we're going to go to scenario three, the mixed one, where we're going to continue to have sick people from the community transmission and we're also going to start having people immunized with the vaccine, gradually, step by step, depending on the vaccine stocks available.
This period will extend to the widely available vaccine and massive immunization of the population, i.e. until approximately 2023.
It would also be fair to take into account the existence of followers of anti-vaccination movements and the high probability for these people to reject the vaccine and go through contact with the virus several times, which can prolong the pandemic in our country inclusively for 2024.
When will the pandemic end in Moldova?
We can certainly say that the pandemic in Moldova will not end in 2020.
We now have a decrease in the number of tests and a decrease in the number of tested positive patients, and it creates an illusion, that we have all already gone through the disease and the pandemic ends. It's not really like that. The virus didn't go anywhere. Virus is here, among us, being actively transmitted from man to man. More recently, this virus also has various mutations, some of them being very contagious, especially for children and young people. We are obliged to prepare for these new challenges and the many other surprises, unknown yet.
Is everything so pessimistic about this pandemic? My answer is – NO!
We now have far more certainty than we did in early 2020. We already know a lot about the virus. We know how to treat, how to protect ourselves, how to avoid contamination. It is known that reinfection and passage through the disease is possible several times. We already know that immunity after the disease will be active for 2-4 months, and the vaccine will be needed annually, in two doses within 21 days interval.
We have two vaccines, several drugs with small molecules and monoclonal antibodies, which are already approved in several countries, which gives us high hopes. There are currently over 990 anti-COVID-19 products in the investigation phase at various stages. Many of them will end up being officially approved for human use.
All this knowledge allows us to make some plans for 2021 at least. We can also have a short- and mid-term perspective and planning, i.e., up to 2023-2024. Having certainty is a good thing!