Almost 22 months since COVID-19 was classified as a global pandemic — spreading to more than 100 countries — the virus continues to be a constant around the world.

While we know more about the SARS-CoV-2 virus that causes COVID-19 now than we did at the start, there is still a big question mark over an end date and the future of the pandemic.

“We are still very much in the middle of the pandemic,” according to the World Health Organization (WHO).

To get a better picture of what lies ahead, the WHO is studying the current level of COVID-19 antibodies, as well as protection in communities around the world.

The WHO is considering a number of scenarios: if vaccination initiatives remain at the same level; if production changes; and, if countries can actually get access to vaccines and roll out the vaccination programmes.

“We’re looking at the time between now and end of 2022, which is the time we estimate for the global rollout of vaccines — and vaccinating those most at risk and vulnerable — that will change the dynamic of the patterns of transmission that we’re seeing now,” the UN health agency told Global News.

A number of effective COVID-19 vaccines at our disposal have altered the course of the pandemic, reducing severe outcomes of the disease.

However, more than half of the world’s population is still not fully vaccinated, according to Oxford University’s Our World in Data.

Inequities in vaccine distribution is a major concern, as only five per cent of people in low-income countries have received at least one COVID-19 vaccine dose.

“We shouldn’t start talking about a COVID endgame until we’ve gotten the vaccine to everyone who’s willing to get one,” said David Dowdy, an infectious disease epidemiologist at the Johns Hopkins Bloomberg School of Public Health, during a media briefing on Nov. 17.

“Vaccines are far and away our best tool and will remain that way,” he added.

Barriers related to access amid a limited global vaccine supply are holding many countries back, experts say. Despite donation pledges from high-income countries to COVAX, a WHO-led vaccine sharing facility, doses have been slow to arrive for developing nations.

“We need to think about ways in which we can find innovative approaches to incentivize vaccination, whether that be through food incentives or financial incentives,” said Rupali J. Limaye, a social and behavioral scientist at Johns Hopkins Bloomberg School of Public Health.

A widespread vaccination drive is needed to curb the global spread of COVID-19, according to Horacio Bach, an infectious diseases expert at the University of British Columbia. Long-term immunity and new variants pose challenges to vaccination efforts, he said.

Going forward, affordable treatments and innovations like inhaling neutralizing antibodies — which is being tested in animal trials — could be a game-changer, Bach added.

Without a cure, the disease can’t be completely wiped off the map.

“Zero COVID is never going to happen,” said Dowdy.

“This is a disease that’s going to be with us for the foreseeable future. It’s going to come and go.”

The good news, though, is as immunity goes up — with greater vaccine uptake and infections — cases of COVID-19 will likely get milder over time, he added.

Pandemic vs endemic

In March 2020, the WHO characterized COVID-19 as a pandemic, as it had spread to 114 countries.

However, since the term is not recognized under international law, there is no general, formal mechanism for declaring the beginning or end of a pandemic, the WHO told Global News.

“When the worldwide spread of a disease is brought under control to a localized area, it is no longer a pandemic but an epidemic,” it said.

“Further, if a disease is globally present but at expected or normal levels, it is not considered a pandemic, but instead, endemic.”

There is growing consensus COVID-19 will likely transition to becoming an endemic disease, like chicken pox or malaria. That means it will be restricted to a specific region or certain countries.

“We have largely lost the possibility to eradicate or eliminate it early on because we did not attack it, at a global level, as strongly as we could”, the WHO said.

The agency says even if the virus becomes endemic, it does not mean it stops “being dangerous or disruptive”.

“In the long run, we hope to bring this virus under our control. With widespread vaccination, and wide availability and strategic use of the tools we have, we can do this.”

In the immediate future, a winter surge is looming.

Europe, the global epicentre of the pandemic, is seeing another resurgence with infections spiking again, despite nearly two years of restrictions.

In the United States, cases have climbed steadily over the last three weeks, especially in states where colder weather already has driven people indoors.

While an end to the pandemic is not a certainty, Dowdy said there is reason to be optimistic as vaccines have proven to prevent severe illness, hospitalizations and deaths.

“The world may never look like it did before the pandemic, and we may still be in for a winter surge in cases this year, but from a COVID-19 perspective, there are many reasons to believe that things will be much better in 2022 than they have been for us these past two years.”

Last Updated on November 22, 2021 by shalw

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