Virus not likely to be eradicated, says Hirji
Even a vaccine is unlikely to wipe out COVID-19, but it can be kept in check
Even if an effective vaccine is developed, COVID-19 may well be a permanent fixture of life for decades to come, says Niagara’s top medical official.
In the history of medicine, smallpox is the only disease that has been truly eradicated from the planet. Other dangerous diseases, including the measles and polio, have been greatly reduced through immunization, but never fully wiped out. Despite the best efforts of public health authorities, outbreaks still occur, often driven by enough people refusing to get vaccines to allow the diseases to return.
So when Niagara’s acting medical officer of health, Dr. Mustafa Hirji, considers the future, it is not one where COVID-19 is a relic found only in history books and medical journals.
“Sometimes the language around this frustrates me because it is inaccurate,” Hirji said.
“Eradication means the disease has been wiped out everywhere on Earth. To eliminate it means you have gotten rid of it locally and I think for three weeks, New Zealand absolutely did that. But now they have two new cases, and that is a good reminder to us that COVID-19 isn’t going anywhere.”
New Zealand had recently declared itself COVID-19 free, and lifted all the restrictions the country put in place to fight the spread of the novel coronavirus. But the virus returned in two travel-related cases, Hirji said, demonstrating even when a community is successful in fighting the spread, the virus itself can find its own backdoors.
China is another example, Hirji said, noting the resurgence of cases in Beijing.
“So in China, a country that has had to do the most to really get COVID-19 under control is facing more cases,” he said. The future won’t be one where the virus is extinct, but rather one where it is controlled by a combination of immunization, emerging medical therapies and infection control measures.
Just how much of that control will be done by a vaccine, and how much will depend on public behaviour isn’t clear yet.
Hirji said the best-case scenario is that a COVID-19 vaccine has a degree of effectiveness similar to the MMR vaccine that prevents measles, mumps and rubella. That vaccine, when used widely, provides decades of immunity and can effectively suppress the possibility of an outbreak.
But since there has never been a vaccine for a SARS virus before — the novel coronavirus is genetically related to SARS with an official designation of SARS-COV2 — is not clear how effective a vaccine will be.
Hirji said it is just as likely as not that a COVID-19 will be more like the annual flu vaccine, which requires a new formulation each year as the influenza virus mutates.
And then there is the United States. Even as Canada’s case count continues to fall, the virus continues to rampage across America. For border communities such as Niagara, the proximity of the U.S. presents a continuing risk of virus spread from travellers.
Hirji pointed to a recent editorial written by U.S. Vice-president Mike Pence, who claimed there is no second wave of infections and pointed to a low percentage of new positive tests for COVID-19 as evidence the crisis is over.
Hirji, who called Pence’s claims “an exercise in misinformation,” pointed out the first wave of COVID-19 is not yet over, and the percentage of positive tests in the U.S. — about 10 per cent — is actually very high.
In Ontario and in Canada, three per cent is considered a high, if manageable, threshold. In Niagara, where testing has ramped up, the percentage of positive tests is about one per cent, he said, further evidence of the relatively low level of virus spread locally.