LOIS KING
Despite the doom and gloom of the pandemic, light remains at the end of the tunnel. But what can we realistically hope for in 2022?
Lois is a researcher at the Global Health Unit on Respiratory Health in Asia at the University of Edinburgh. She looks at how we could beat COVID in 2022.
The year 2020 is likely to live in our memories as the year COVID-19 brought the world to a standstill. Many are hesitant to hope for a more normal 2021, choosing to tentatively take life one day at a time as our future remains uncertain. But how does the world appear if we cast our eyes forward to 2022?
Although the world has experienced pandemics in the past, the closest example we have to a blueprint would be the severe acute respiratory syndrome (SARS) epidemic. This was a coronavirus that cost over 770 lives, largely in eastern Asia, during the early 2000s. But after complications cropped up in animal trials for a SARS vaccine and the virus died out in humans, research funding dried up. Little progress was made into coronavirus vaccine research.
Now, with multiple COVID-19 vaccines available and more on the horizon, life post-vaccine is imminent for those in countries that can afford it. But the dangers of vaccine nationalism may mean that poorer countries will go unvaccinated until 2022, 2023 or beyond, by which time the threat of new variants – given the opportunity to spread and potentially be resistant to current vaccines – is likely to grow.
Although Moderna has confirmed its vaccine is still effective against the new variants that have emerged so far, this news will make little immediate difference to the Global South, as all Moderna’s vaccines for 2021 have been bought by richer countries. Despite the vaccines preventing severe disease, it’s still left to be seen if they reduce transmission and how long immunity will last; some experts believe annual vaccinations may be necessary. So for those who can’t be vaccinated and who exhibit different responses to illness, ongoing research into multiple therapeutics, such as antivirals and antibodies, could be life-saving.
LONG ROAD
While our bodies are capable of some immune response to the virus, assuming that we’ll eventually ‘get used’ to COVID-19 is a deadly gamble – not dissimilar to
the ‘herd immunity without vaccination’ suggestions that prevailed early in the pandemic and proved to be harmful. Likewise, while there are other human coronaviruses that cause colds, a comparison with COVID-19 seems unhelpful as research has shown COVID19 infects both the upper and lower respiratory tract. Also, whereas life often returns to normal after recovering from a cold or the flu, the ‘long-COVID’ phenomenon has seen many continue to suffer with multiple organ damage, fatigue, muscle aches and difficulty breathing, for months after the initial infection. Even 15 years after the SARS outbreak, a follow-up study found that many are still experiencing reduced lungdiffusion capacity.
To reduce the number of strains emerging, a zeroCOVID strategy is the best course of action: by limiting community transmission. Even if a more harmful strain were to evolve, it would eventually die out as SARS did. This can be achieved through a cocktail of interventions, like maintaining hand hygiene, wearing masks, a functioning test-trace-isolate system, government support (such as financial remittance during quarantine) and restrictive measures that hinder social gatherings. While each intervention doesn’t provide complete protection, the more interventions there are, the better the protection is.
It may be that as the situation becomes more controlled, there will slowly be a re-introduction into shared indoor spaces, such as offices. How much we limit community spread is what will determine if COVID-19 continues to circulate, like colds and tummy bugs – only more dangerous. Our next challenge becomes one of logistics, careful planning, and whether equitable access for countries unable to afford the vaccine for their most vulnerable will be championed. But the progress we’ve made in one year since the World Health Organization’s declaration of COVID-19 as a Public Health Emergency of International Concern has been remarkable. Rapid genome sequencing, scientific investigation and multiple vaccine candidates mean elimination is possible. So what state will the world be in a year from now? That’s up to us: as individuals, as government leaders and as a global society.
“The danger of vaccine nationalism may mean that poorer countries will go unvaccinated until 2022, 2023 or beyond”