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“I see these continuing surges happening around the world,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota at Minneapolis, and adviser to US President Joe Biden. “Then it will drop, potentially a little bit precipitously,” he said. “And then I think we could very easily see another surge in the fall and winter” of this year, he added.
With billions of people around the world yet to be vaccinated and unlikely to eliminate the virus, we can expect more epidemics in classrooms, on public transport and at workplaces. work over the next few months as economies continue to reopen. Even if vaccination rates increase, there will always be people vulnerable to the virus: newborns, people who cannot or do not want to be vaccinated, and those who get vaccinated but suffer from chronic infections as their level of protection decreases.
The next few months will be difficult. One of the main dangers is the development of a variant resistant to the vaccine, although this is not the only risk to come. Over the next few months, Bloomberg will explore the long-term impact of the pandemic on economies and markets, the pharmaceutical industry, travel, and more.
“We’re going to see hills and valleys, at least for the next few years, as we release more vaccines. This will help. But the challenge will be: how big will the hills and valleys be, in terms of distance? Osterholm said. ” We do not know. But I can just tell you that this is a coronavirus wildfire that won’t stop until it finds all the human wood it can burn. “
According to Lone Simonsen, epidemiologist and professor of population health sciences at Roskilde University in Denmark, the five well-documented influenza pandemics of the past 130 years offer a glimpse into how COVID could play out. She is an expert in the ebb and flow of such events.
While the world’s longest influenza epidemic lasted five years, it consisted mainly of two to four waves of infection over an average of two or three years, she said. COVID is already shaping up to be one of the most serious pandemics, as its second year ends with the world in the midst of a third wave – and no end in sight.
The virus known as SARS-CoV-2 may not follow the path of past pandemics. After all, it is a different, new and potentially more transmissible pathogen. And with a death toll of over 4.6 million people to date, it’s already more than twice as deadly as any epidemic since the Spanish Flu of 1918.
Despite brutal initial waves and relatively high vaccination rates, countries like the US, UK, Russia and Israel are flirting with record numbers of cases. Vaccination helps moderate the incidence of severe cases and deaths, but the upsurge in infections means the virus is reaching young people and other unvaccinated people, leading to increased rates of serious illness in these groups.
Countries where vaccination has been rare – including Malaysia, Mexico, Iran and Australia – are in the midst of their largest outbreaks to date, fueled by the contagious delta strain. With the virus still spreading uncontrollably across vast swathes of the planet, another new variant could very well emerge.
History shows that the widespread belief that viruses automatically subside over time – to avoid completely wiping out their host population – is wrong, according to Simonsen. Although the new mutations are not always more severe than their predecessors, “pandemics can actually become more deadly during the pandemic period as the virus adapts to its new host,” she said.
At the start of the COVID epidemic, there was good reason to hope that vaccines would provide long-term protection, much like childhood vaccines that stop diseases such as polio.
Coronaviruses have a “replay” mechanism that corrects innate errors caused when the virus replicates, reducing the likelihood of variants appearing when the virus is passed from person to person.
The number of cases around the world has been so vast, however, that mutations are occurring anyway.
“With the pandemic, we have this tremendous force of infection,” said Kanta Subbarao, director of the WHO Collaborating Center for Influenza Reference and Research at the Peter Doherty Institute for Infection and Immunity in Melbourne. “It counterbalanced the virus’s ability to proofread. “
As a result, COVID could be like the flu, requiring regular vaccine supplements to remain effective as the virus progresses.
Some researchers claim that SARS-CoV-2 is on the verge of becoming completely resistant to the first generation of vaccines. A Japanese study, which has not yet been published or peer reviewed, suggests that potentially dangerous mutations in the delta variant are already detected in a global database used to track such developments. Reports of current strains that have managed to get past vaccinations or trigger higher death rates have so far not stood up to rigorous scrutiny.
“It’s a scenario that we hope doesn’t happen,” Simonsen said. “My God, we would have to redo everything. “
Other even darker possibilities for the coming months include the emergence of a new influenza virus or other coronavirus making the leap from animals to humans.
“As long as there are animal reservoirs of coronavirus, there is always a possibility that another zoonotic coronavirus will emerge in the future,” Subbarao said. “There’s that in the background, the risk of still dealing with this one when another emerges. “
What seems clear is that the pandemic will not be over in six months. Experts generally agree that the current epidemic will be brought under control once most people – perhaps 90 to 95 percent of the world’s population – have some degree of immunity from vaccination or previous infection.
The key element should be vaccination, they say.
“Without vaccination you are like a sitting duck because the virus will spread widely and find almost everyone this fall and winter,” Simonsen said.
More than 5.66 billion doses of vaccines have been administered worldwide, according to Bloomberg’s vaccine tracker. But the success of deployments in some regions, such as the European Union, North America and China, masks failure in others. Most countries in Africa have administered only enough vaccine to cover less than 5% of their population with a two-dose injection. India administered enough to cover only about 26%.
The pandemic will end at different times in different places just like previous outbreaks, said Erica Charters, associate professor of medical history at the University of Oxford and coordinator of an Ending Outbreaks project. Governments will have to decide what proportion of the disease they are comfortable living with, she said.
The approaches vary. While some countries are still targeting zero cases of COVID, the world is unlikely to eradicate the virus completely.
Countries like Denmark and Singapore, which have managed to contain the cases relatively, are already heading for a post-pandemic future with fewer safety restrictions. Others, like the United States and the United Kingdom, are opening even as the number of infections is near record highs. Meanwhile, China, Hong Kong and New Zealand have pledged to continue working vigilantly to eliminate the virus locally. As a result, they will likely be among the last places to leave behind the disruption caused by the containment of the pandemic.
“The final process will not be uniform,” Charters said. The pandemic “is a biological phenomenon, but it is also a political and social phenomenon”.
“Even now we have different approaches to this. “
It’s likely to be messy, leaving a lasting legacy for years to come. Until then, most of us will have to prepare for many more months in the grip of the pandemic.
“We have to approach it with our eyes wide open and with a lot of humility,” Osterholm said. “Anyone who thinks we’re going to be done with this in the next few days or months is sorely mistaken. “
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