As vaccines spark hope, cold reality looms: Covid-19 likely to stay

“Going through the five phases of grief, we need to come to the phase of accepting that our lives will not be the same,” said Thomas Frieden, former director of the US Centers for Disease Control and Prevention. “I don’t think the world has really absorbed the fact that these are long term changes.”

Endemic Covid-19 does not necessarily mean continued restrictions on coronaviruses, infectious disease experts have said, largely because vaccines are so effective at preventing serious illness and reducing hospitalizations and deaths. Hospitalizations have already fallen by 30% in Israel after vaccinating a third of its population. Deaths are expected to drop in the coming weeks.

But some organizations envision a long-term future in which prevention methods such as masking, proper ventilation, and testing continue in one form or another. Meanwhile, a potentially lucrative new Covid-19 industry is rapidly emerging, with companies investing in goods and services such as air quality monitoring, filters, diagnostic kits and new treatments.

The number of PCR tests for genes produced around the world is expected to increase this year, with manufacturers like Quest Diagnostics of New Jersey predicting that millions of people will need a swab before attending concerts, sports games. basketball or family reunions.

“We assume it would last for years, or be forever, like the flu,” said Jiwon Lim, spokesperson for SD Biosensor, Inc. of South Korea, a test maker that is ramping up production of diagnostic kits to home. Major drugmakers – Novartis International AG and Eli Lilly & Co. in Switzerland – have invested in potential Covid-19 therapies. Over 300 such products are currently in development.

Airlines like Lufthansa are restructuring to focus on short-haul flights within Europe and away from Pacific countries which have said they will keep borders closed for at least this year. Some airports are planning new vaccination passport systems to allow vaccinated passengers to travel. Restaurants are investing in more take-out and delivery offers. Meat packing plants from Canada to Europe are purchasing robotic arms to reduce the risk of an outbreak by reducing the number of workers on assembly lines.

Diseases are considered endemic when they remain persistent but manageable, such as influenza. The extent of the spread varies depending on the disease and location, epidemiologists say. Rabies, malaria, HIV, and Zika virus are all endemic infectious diseases, but their prevalence and human toll vary globally.

Very early on, after countries failed to contain the coronavirus and transmission raged around the world, “it was obvious to most virologists that the virus would become endemic,” said John Mascola, director of the National Institutes of Health Vaccine Research Center. “When a virus is so easily transmitted between humans and the population [lacks immunity], it will spread wherever it has the opportunity to spread. It’s like a leak in a dam.

Immunologists now hope the vaccines will prevent transmission, a finding that would dramatically reduce the spread of the virus. A study from the University of Oxford published last week found that people receiving the AstraZeneca vaccine may be less likely to transmit the disease.

Yet there are large pockets of the human population that will remain beyond the reach of a vaccine for the foreseeable future, giving the virus plenty of room to continue to circulate.

There is currently no licensed vaccine for young children and supply issues will leave most developing countries without injections until the end of next year at the earliest. Meanwhile, Europe has seen high rates of refusal to be vaccinated: less than half of French people were ready to be vaccinated when asked in a recent YouGov poll.

As scientists develop new treatments, Covid-19 “will become an infection we can live with,” said Rachel Bender Ignacio, an infectious disease specialist at the Fred Hutchinson Cancer Research Center in Seattle. As such, she said, it will be important to develop therapies for the persistent debilitating symptoms that many patients struggle with months after falling ill, such as memory fog, loss of smell and pain. digestive and heart problems.

Some countries like Australia and New Zealand have cut their average daily number of cases to a lower figure, but none have ever seen the huge outbreaks that the Americas and Europe continue to see, and both island nations have seen the virus pass beyond their strict travel restrictions. .

“I don’t think we should start placing the elimination or eradication of this virus as the bar for success,” said Mike Ryan, executive director of the World Health Organization’s emergency program. “We have to get to a point where we control the virus, the virus does not control us.”

Only one human virus has been completely eradicated in modern history: smallpox. Although this disease has only infected people, the new coronavirus can spread among small mammals like mink and then, though less effectively, revert back to humans, transforming the world’s fur farms. into potential reservoirs of the virus.

In addition, tens of millions of cases of Covid-19 have given the virus numerous opportunities to improve its ability to infect other mammals, said Sean Whelan, a virologist at the University of Washington in St. Louis. A mutation present in the South African and UK variants gave the pathogen the ability to infect mice, he said.

Diseases that spread from people without symptoms – often the case of the coronavirus – are particularly difficult to eradicate. Decades of multi-billion dollar global efforts have failed to eradicate another such disease, polio, which, though wiped out from the United States in the 1970s, was only eliminated from Europe. ‘in 2002 and still exists in Afghanistan and Pakistan.

Respiratory viruses like the novel coronavirus are likely to become endemic because they can be transmitted through generally mild acts, such as breathing and speaking, and can be particularly effective at infecting cells. They include OC43, a coronavirus that researchers say caused the Russian flu of the 1890s, a pandemic that killed a million people. This virus, which is still present in the population, is responsible for many colds, although it has become less virulent probably because people have developed immunity.

Mutations in the new coronavirus variants appear to have enabled it to infect human cells better or elude certain antibodies, raising fears that existing vaccines may become less effective. Scientists say monitoring for new variants will be essential for long-term vaccination programs. Understanding their characteristics will help determine whether vaccines need to be updated periodically, as is the case with influenza.

Vaccinations will be just as important when the pandemic subsides and Covid-19 becomes endemic.

“People seem to think that when a virus becomes endemic, it subsides and doesn’t get as severe,” said Angela Rasmussen, a virologist at the Center for Global Health Science and Security at Georgetown University. The misconception is that viruses usually evolve to maximize the number of people they infect before they kill.

But most people survive Covid-19, so “there isn’t a lot of pressure for this virus to subside further as it is already spreading and finding new hosts and new opportunities to replicate before her guests don’t get sick, ”she said. “I’m very good.”

Write to Daniela Hernandez at [email protected] and Drew Hinshaw at [email protected]