3. We worried a lot about surface transmission
In the early days of the pandemic, it was thought contaminated surfaces were a major means of COVID transmission.
People wore gloves when going to the supermarket (some still do), and washed food packages once they got home. However, we now know the virus is spread primarily through aerosol and droplet transmission. When a person coughs or sneezes, droplets containing mucous, saliva, water and virus particles can land on other people or drop onto surfaces. Larger droplets tend not to travel very far and fall quickly. Smaller droplets called aerosols, can stay airborne for an extended period of time before settling. Scientists now believe transmission through touching contaminated surfaces is quite rare.
3 things to watch out for
There are three key issues we need to be aware of as COVID slowly becomes endemic.
1. Waning immunity
Many older and vulnerable people had their third dose in November or December last year, with their immunity now waning fast. We need to provide a fourth vaccine dose as soon as possible to the elderly and vulnerable.
2. New variants
There’s still the potential for new and more severe variants to hit us. One of the main reasons for this is the low rates of vaccination in many developing countries. The more the virus replicates in unvaccinated populations, the greater the chance of mutations and variants.
Vaccine manufacturers Pfizer and Moderna either manufacture the vaccine in their own facilities, or license the right to produce the vaccine in other countries. This puts it out of reach financially for most developing countries, who then have to rely on the COVAX initiative for supplies. COVAX is a worldwide facility funded by developed countries and donor organizations to purchase vaccines to be distributed to developing countries. Researchers at the Texas Children’s Hospital’s Center for Vaccine Development have unveiled a protein-based vaccine called Corbevax. It uses established and easy-to-manufacture technology, and is being provided patent-free to developing countries. It has now received emergency use authorization in India. It has over 80% efficacy against symptomatic disease, though this is against the no-longer dominant Delta variant. Trials are currently under way to determine its efficacy against Omicron. If approved, this should greatly help lift vaccination rates in many developing countries.
3. Long COVID
Politicians are ignoring long COVID. With thousands of cases a day, over the next year we will be getting a tsunami of people suffering from long-term health problems. So, we simply cannot ignore high case numbers and would be wise to retain at least some public health measures (for example, face mask mandates) in order to bring case numbers down.
The beginning of the end,
Governments are now dismantling public health measures such as the use of QR codes, social distancing measures and face mask mandates. Their thinking is that although case numbers are still quite high, hospitalizations are going down – and of course, elections are in sight. Chief public health officers, who used to give daily briefings, are now rarely seen. “Give us our freedom back” is now a commonly heard cry, even if the inevitable consequence means this is at the expense of elderly and vulnerable people.
In a nutshell, many believe we have moved already from epidemic to endemic status. As much as we all wish for this to be over and life to get back to normal, we aren’t quite there yet. But I think with better vaccines and improved treatments on the way, it’s at least the beginning of the end.