Vaccines spark hope, and Cold Reality Dawns: Covid-19 is likely to stay

“As we go through the five stages of grief, we have to get to the acceptance stage that our lives won’t 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 that these are long-term changes.”

Endemic Covid-19 doesn’t necessarily mean ongoing restrictions on the coronavirus, infectious disease experts said, in large part because vaccines are so effective at preventing serious illness and reducing hospitalizations and deaths. Hospital admissions have already fallen by 30% in Israel after it vaccinated a third of the population. The deaths there are expected to plummet in the coming weeks.

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

The number of gene-detecting PCR tests produced worldwide is expected to increase this year, with manufacturers such as Quest Diagnostics in New Jersey predicting that millions of people will need a Pap test before attending concerts, basketball games or family parties.

“We believe it will take years or be forever, like the flu,” said Jiwon Lim, spokesman for South Korea’s SD Biosensor, Inc., a test maker ramping up the production of diagnostic kits for home use. Leading drug manufacturers – Swiss Novartis International AG and Eli Lilly & Co. – have invested in potential Covid-19 therapies. More than 300 such products are currently under development.

Airlines like Lufthansa are restructuring to focus on short-haul flights within Europe, and away from Pacific countries that have said they will keep the borders closed at least this year. Some airports are planning new vaccine passport systems to allow inoculated passengers to travel. Restaurants are investing in more takeout and delivery offers. Meatpacking factories from Canada to Europe are purchasing robotic arms to mitigate the risk of outbreaks by reducing the number of workers on the assembly line.

Diseases are considered endemic if they are persistent but manageable, such as influenza. The degree of spread varies by disease and location, epidemiologists say. Rabies, malaria, HIV, and Zika are all endemic infectious diseases, but their prevalence and human toll vary worldwide.

Very early on, after countries failed to control the coronavirus and transmission raged worldwide, “it was clear to most virologists that the virus was going to be endemic,” said John Mascola, director of the National Institutes of Health’s Vaccine Research Center. “When a virus is so easily transmitted between people and the population [lacks immunity], it spreads wherever it can spread. It’s like a leak in a dam. “

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

Still, there are huge swaths of the human population that will remain out of reach of a vaccine for the foreseeable future, giving the virus plenty of room to keep circulating.

There is currently no vaccine for young children, and supply problems will leave most of the developing countries without a shot until the end of next year at the earliest. Meanwhile, Europe has seen high rates of vaccine refusal: less than half of the French were willing to get an injection when asked in a recent YouGov poll.

As scientists develop new treatments, Covid-19 will further become “an infection we can live with,” said Rachel Bender Ignacio, infectious disease expert at 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 for months after falling ill, such as memory fog, loss of smell, and digestive and heart problems.

Some countries, such as Australia and New Zealand, have put their mean daily numbers of cases in the low single digits, but neither has ever experienced the massive outbreaks America and Europe still see, and both island states have passed the virus beyond their strict see travel restrictions slip. .

“I don’t believe we should start eliminating or eradicating 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 have the virus under control, the virus has no control over us.”

Only one human virus has been completely eradicated in modern history: smallpox. While that disease only infected humans, the new coronavirus can spread among small mammals such as minks, and then, while less effectively, turn back into humans, turning the world’s fur farms into potential reservoirs for the virus.

In addition, tens of millions of cases of Covid-19 have given the virus ample opportunity to improve its ability to infect other mammals, said Sean Whelan, a virologist at Washington University 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 who don’t show symptoms – often the case with the coronavirus – are particularly difficult to eradicate. Decades of multimillion-dollar global efforts have not eradicated another such disease, polio, which, although eliminated from the US in the 1970s, was not expelled from Europe until 2002 and is still prevalent in Afghanistan and Pakistan.

Respiratory viruses such as the novel coronavirus tend to become endemic because they can be transmitted through generally benign actions, such as breathing and talking, and can be particularly good at infecting cells. They include OC43, a coronavirus that researchers now believe caused the Russian flu of the 1890s, a pandemic that killed a million. That virus – still present in the population – is responsible for many colds, although it has become less virulent as humans have developed immunity.

Mutations in the new coronavirus variants seem to have made it better at infecting human cells or evading certain antibodies, raising concerns that existing vaccines may become less effective. Scientists say monitoring for new variants will be critical to long-term vaccination programs. Understanding their characteristics will help you determine whether or not the recordings need to be periodically updated, such as with the flu.

Vaccinations will be just as important as the pandemic wears off and Covid-19 becomes endemic.

“People seem to think that when a virus becomes endemic, it becomes attenuated and not that serious,” said Angela Rasmussen, a virologist at the Center for Global Health Science and Security at Georgetown University. The misconception stems from the fact that viruses usually evolve to maximize the number of people they infect before they kill.

But most people survive Covid-19, so “there is not much pressure on this virus to become more attenuated, as it is already spreading and finding new hosts and new opportunities to multiply before the hosts get sick,” she said . “I’m fine.”

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