Living with non-pandemic COVID forever

By Noralyn O. Dudt

SMALLPOX was on its way of being eradicated in 1979, and in the following year, the World Health Organization declared it official.  Its eradication was  not only due to  the aggressive vaccination programs that were launched,  but also due to the unique characteristics of the virus.

These unique characteristics were:  the virus needed animal hosts to keep it alive;  the virus had clear features that made the disease easy to recognize in people who suffered from it;  the virus was  infectious for only a short period of time, and getting infected conferred immunity for life.

Measles, on the other hand,  is an example of a disease that couldn't be eradicated. This highly transmissible respiratory virus only came under control after a vaccine was developed in 1963, and in highly vaccinated regions such as the United States, it has technically been eliminated, although occasional outbreaks still occur.

The endgame for the coronavirus will not look like the smallpox nor the  measles. The “Corona” has features that make it unlikely to be eradicated,  including its high transmissibility, symptoms that are easily mistaken for those of other common respiratory infections, and its ability to be transmitted when infected people are asymptomatic or pre-symptomatic. Additionally,  there are many of those who remain skeptical about the safety and efficacy of the vaccines and refuse to be vaccinated. To vaccinate or not may be a personal choice, but it's a choice that affect others. The concept of individual freedom has never included a right to harm others. The unvaccinated and unmasked spread the coronavirus and when they get sick, they  fill hospital beds, crowding out people with other illnesses.  People have died as a result.

The discipline of infectious diseases has strict definitions for the level of containment of a communicable disease. "Control" means that a disease has been brought down to low levels of circulation with the help of public health interventions such as vaccines. "Elimination" means the incidence of disease has been reduced to zero in a certain geographical region. "Eradication" means the incidence of the disease worldwide has been reduced to zero.  And "extinction" means even remaining stocks of the pathogen kept in secure laboratories have been destroyed. 

Unfortunately, we are still in the "control" phase. Because many people are still leery about getting vaccinated,  it will be sometime before we get to the "elimination" stage. Until we attain herd immunity globally, variants will continue to pop up here and there. Until viral circulations are tamped down globally and until the virus is stripped of its ability to cause severe diseases through vaccination, the world will  not resume a version of normalcy we so desperately crave.

As we see with measles, outbreaks of severe disease will occur among populations unwilling to be vaccinated. Mandates can help increase vaccination uptake and this can be attained by educating the public—to allay their fears with regard to the vaccines, and to allay their distrust of some public officials who are bent to manipulate situations to their personal and political gain.

Antibodies generated by the vaccines naturally wane, but the vaccines also generate “memory B cells”, which produce high levels of neutralizing antibodies if they recognize the virus or its variants again. Memory B cells are long-lasting. A 2008 Nature study found that survivors of the 1918 influenza pandemic were able to produce antibodies from memory B cells when their blood samples were exposed to the same flu strain decades later. “T cells” generated by the vaccines also protect against severe disease and are unfazed by the variants. As the virus continue to circulate, those who are older and immunocompromised will need a booster shot. Since the coronavirus vaccines are remarkably effective in preventing severe COVID-19, they are  our primary conduit to reaching the point of control.

History tells us that pandemics do end, and some do. But others become  endemic, meaning they morph into something that is no longer an emergency. And as we examine COVID-19's features, it will not be eradicated, but will morph into an endemic. A corona virus endemic will be more manageable. We will have the freedom take off our masks. We will again have the liberty to travel to the next town or the next province  without bureaucratic paperwork. We will no longer need to quarantine after traveling. Children will be able to resume their activities in school. Hospitals will have more beds available for those with non-Corona illnesses… and so on.

To those who are holding out, I say, think again. Unless you have a change of mind, we will all  be stuck  in this pandemic mode for a very long time. To those  who got the first dose of the Pfizer and Moderna vaccines, make sure you get the second dose.  To those of you who are politicians, please act like the statesmen you should be, and getting  those vaccines into people's arms should be your priority. To those of you who do nothing but try to profit economically and politically from this catastrophe,  please think again—we are all in this together and we can all "win" together. If we "lose" you will lose too.  If restaurants can't open, there will be less revenue for the city "coffers."  If hotels are only for quarantining, there will be fewer tourists (obviously!), and again resulting in  less taxes.

Getting to the endemic stage will be a win-win for us all.  We are all participants, and participants need to participate in this massive collaboration.  It's a win-win!

 

Noralyn Onto Dudt lives in a place where about 70% ( not counting children under 12) have been vaccinated. Overjoyed in the experience of  meeting friends in restaurants and cafes in this locality again, it's her prayer that more vaccines will be made available worldwide. She's confident that the 2 doses of the  Pfizer vaccines have protected her in the last 9 months and looks forward to getting the third booster shot soon.