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From Pandemic To Endemic---SARS
CoV-2 Now Likely To Be Ever Present
New Strategies
Called For To “Live With The Virus”
Several realities
about SARS CoV-2 virus have become apparent during the summer of 2021
making the herd immunity goal appear impossible. One British
epidemiologist, head of the Oxford Vaccine Group has gone so far as to
describe the goal as now “mythical”.
Sir Andrew Pollard
told Open Access Government that because vaccinated persons can become
infected, then “…that means that anyone who is still unvaccinated, at
some point, will meet the virus. That might not be this month or next
month, it might be next year, but at some point they will meet the
virus and we don’t have anything that will stop that transmission.”
Change Is Coming
Other countries such as China, Australia,
and Singapore which have had a goal of achieving and maintaining
“zero cases” requiring lockdowns and strict border control measures
are also reconsidering their strategy. China has been battling an
outbreak in 17 provinces. All of these countries are facing a need to
reopen to the world for economic or other reasons and that seems
impossible with a zero tolerance approach to new cases of a highly
transmissible virus. Zeng Guang, chief epidemiologist at the
Chinese Center for Disease Control and Prevention, told the South
China Morning Post “the vast majority are mild cases which should not
have caused so much panic and pressure…Staying at zero cases is
absolutely impossible from the perspective of the whole world…and
other countries will not wait for zero cases before they open their
borders.” Beijing is slated to host the Winter
Olympics in 2022 and is looking to adapt its strategy to be workable
in that challenging situation.
Other Factors
The change in thinking
is being prompted not only by the Delta variant of SARS CoV-2, but
the difficulty of achieving high vaccination levels in countries with
access to vaccines, the lack of vaccines for the majority of the
world’s population, the politicization of masking as a control
measure, and the reinfection of vaccinated persons who can transmit
the virus.
Here To Stay
As a result, we must
acknowledge that the virus is here to stay and learn to live with it,
according to former CDC Director Tom Frieden. His conclusion is
the topic of an essay in the Wall Street Journal Entitled “The Delta
Variant and Beyond: Learning To Live With Covid”. Frieden points out
that the virus can still infect persons with previous Covid
infections because the immunity from infection is less robust than
that following vaccination. The level of herd immunity that would be
needed to achieve full control is too high (estimated to be 85%) than
what is achievable in many countries and around the globe anytime
soon. Estimates are that the majority of Global South countries are
less than 10% vaccinated and the majority of vaccines are going to
high income countries. Vaccine immunity itself may wane and produce
breakthrough infections.
A New Strategy
A new strategy is
needed according to Frieden that would utilize different degrees of
control measures depending on the amount of spread taking place in a
particular population. In areas of low spread, something closer to
normal life before Covid might be possible. In areas with high spread,
effective control measures such as vaccination, greater ventilation,
distancing, and masking are likely to have to be implemented. Also,
Frieden notes that how we travel and congregate will not return to
pre-pandemic ways of doing things. Mandates are likely to become
widely accepted as will vaccine verification documents.
Optional Threats
In seeking to
encapsulate what we are learning and have learned from the Covid-19
pandemic, Frieden says “we may recognize that we, as individuals, are
not the sole masters of our destinies and that what we can do safely
depends on what we do effectively as a society…In the long run, Covid
may help us to recognize that many deadly and expensive health threats
are optional. We can choose to adopt programs and policies that can
relegate to history many of the infections and conditions that today
drive up health care costs and drive down productivity and life
expectancy. What we must now change is the cycle of panic and neglect
of public health in response to health threats. Doing the same thing
over and over but expecting different results may or may not be a good
definition of insanity, but it’s certainly a formula for failing to
end the Covid crisis and leaving the world vulnerable to the
next—potentially even more devastating pandemic.” ■
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