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How will pandemic end? Omicron clouds forecasts for endgame – Toronto Star

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Pandemics do eventually end, even if omicron is complicating the question of when this one will. But it won’t be like flipping a light switch: The world will have to learn to coexist with a virus that’s not going away.

The ultra-contagious omicron mutant is pushing cases to all-time highs and causing chaos as an exhausted world struggles, again, to stem the spread. But this time, we’re not starting from scratch.

Vaccines offer strong protection from serious illness, even if they don’t always prevent a mild infection. Omicron doesn’t appear to be as deadly as some earlier variants. And those who survive it will have some refreshed protection against other forms of the virus that still are circulating — and maybe the next mutant to emerge, too.

The newest variant is a warning about what will continue to happen “unless we really get serious about the endgame,” said Dr. Albert Ko, an infectious disease specialist at the Yale School of Public Health.

“Certainly COVID will be with us forever,” Ko added. “We’re never going to be able to eradicate or eliminate COVID, so we have to identify our goals.”

At some point, the World Health Organization will determine when enough countries have tamped down their COVID-19 cases sufficiently — or at least, hospitalizations and deaths — to declare the pandemic officially over. Exactly what that threshold will be isn’t clear.

Even when that happens, some parts of the world still will struggle — especially low-income countries that lack enough vaccines or treatments — while others more easily transition to what scientists call an “endemic” state.

They’re fuzzy distinctions, said infectious disease expert Stephen Kissler of the Harvard T.H. Chan School of Public Health. He defines the endemic period as reaching “some sort of acceptable steady state” to deal with COVID-19.

The omicron crisis shows we’re not there yet but “I do think we will reach a point where SARS-CoV-2 is endemic much like flu is endemic,” he said.

For comparison, COVID-19 has killed more than 800,000 Americans in two years while flu typically kills between 12,000 and 52,000 a year.

Exactly how much continuing COVID-19 illness and death the world will put up with is largely a social question, not a scientific one.

“We’re not going to get to a point where it’s 2019 again,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “We’ve got to get people to think about risk tolerance.”

Dr. Anthony Fauci, the top U.S. infectious disease expert, is looking ahead to controlling the virus in a way “that does not disrupt society, that does not disrupt the economy.”

Already the U.S. is sending signals that it’s on the road to whatever will become the new normal. The Biden administration says there are enough tools — vaccine boosters, new treatments and masking — to handle even the omicron threat without the shutdowns of the pandemic’s earlier days. And the Centers for Disease Control and Prevention just reduced to five days the time that people with COVID-19 must stay in isolation so they don’t sicken others, saying it’s become clear they’re most contagious early on.

India offers a glimpse of what it’s like to get to a stable level of COVID-19. Until recently, daily reported cases had remained below 10,000 for six months but only after a cost in lives “too traumatic to calculate” caused by the earlier delta variant, said Dr. T. Jacob John, former chief of virology at Christian Medical College in southern India.

Omicron now is fueling a rise in cases again, and the country in January will roll out vaccine boosters for frontline workers. But John said other endemic diseases, such as flu and measles, periodically cause outbreaks and the coronavirus will continue to flare up every so often even after omicron passes through.

Omicron is so hugely mutated that it is slipping past some of the protection of vaccinations or prior infection. But Dr. William Moss of Johns Hopkins Bloomberg School of Public Health expects “this virus will kind of max out” in its ability to make such big evolutionary jumps. “I don’t see this as kind of an endless cycle of new variants.”

One possible future many experts see: In the post-pandemic period, the virus causes colds for some and more serious illness for others, depending on their overall health, vaccine status and prior infections. Mutations will continue and might eventually require boosters every so often that are updated to better match new variants.

But human immune systems will continue to get better at recognizing and fighting back. Immunologist Ali Ellebedy at Washington University at St. Louis finds hope in the body’s amazing ability to remember germs it’s seen before and create multi-layer defenses.

Memory B cells are one of those layers, cells that live for years in the bone marrow, ready to swing into action and produce more antibodies when needed. But first those memory cells get trained in immune system boot camps called germinal centers, learning to do more than just make copies of their original antibodies.

In a new study, Ellebedy’s team found Pfizer vaccinations rev up “T helper cells” that act as the drill sergeant in those training camps, driving production of more diverse and stronger antibodies that may work even if the virus changes again.

Ellebedy said baseline population immunity has improved so much that even as breakthrough infections inevitably continue, there will be a drop in severe illnesses, hospitalizations and deaths — regardless of the next variant.

“We are not the same population that we were in December of 2019,” he said. “It’s different ground now.”

Think of a wildfire tearing through a forest after a drought, he said. That was 2020. Now, even with omicron, “it’s not completely dry land,” but wet enough “that made the fire harder to spread.”

He foresees a day when someone gets a coronavirus infection, stays home two to three days “and then you move on. That hopefully will be the endgame.”

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The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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COVID-19: Experts worried about the next Omicron as more get infected – CTV News

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Omicron’s spread has been so extensive that there are few families that haven’t been touched by it at all — and for some families, that means worrying about their children.

In the Toronto area, Sarah Bankuti watched as her newborn baby Aviv spent Saturday in hospital suffering with COVID-19.

“Very scary because my daughter, she’s 10 weeks old,” she told CTV News. “So she had a fever and she, all yesterday, was just non-stop throwing up.”

Although the baby is home now, she’s still quite ill.

The Bankuti family has taken every precaution during the pandemic as their three-year-old daughter Alice has a brain tumour and is undergoing chemotherapy.

Even though the parents are both vaccinated, COVID-19 crept into the family anyways, infecting everyone in the process.

“That’s why COVID is so scary,” Bankuti said. “You don’t know how it’s going to affect people at all, but especially for our children, we just don’t know. For the past 48 hours, we’ve been so worried.”

She added that they family hasn’t been able to sleep while worrying about their children.

“We don’t know what the full side effects are of this,” she said. “It’s new still.”

Doctors do know just how transmissible Omicron is, with its whirlwind advance around the globe and scientists worry Omicron won’t be the last version of the virus.

“More and more people are getting infected,” Leonardo Martinez, an assistant professor at Boston University School of Public Health, told CTV News. “The more people that get infected, the more chances there are for new mutations to occur, and that’s how new variants come.”

The World Health Organization reported a record 15 million new COVID-19 cases for the week of Jan. 3-9, a 55-per-cent increase from the previous week.

“Those mutations, one change, two changes, doesn’t really matter, doesn’t take hold, sometimes it does, and that’s where we go from a variant of interest to a variant of concern,” said Cynthia Carr, founder and epidemiologist with EPI research incorporated in Winnipeg.

Small changes may bring the pandemic to an endemic phase, according to Dr. Gerald Evans, an infectious disease physician with the Kingston Health Sciences Centre.

“The thing that we’re afraid of is the big changes that would produce a new variant with a new Greek letter,” he said.

A new variant may evade immunity better than Omicron, however, and scientists stress the importance of vaccines to reduce hospitalization, death and emerging new variants.

“Mutations are more common in severe and long-lasting COVID infections,” Martinez said. “Therefore, because vaccines prevent severe infections they can also prevent proliferation of new variants.”

All while hopefully creating a circle of protection around those too young to be vaccinated.

“Those would actually protect the people who were unvaccinated because the virus can’t get at them because they’re surrounded by a whole group of people, in which, infection, and or transmission after being infected is remarkably reduced by the vaccine,” Evans said.

Vaccination rates are fairly high in Canada, but the World Health Organization continues to stress the importance of global vaccine coverage.

Although wealthy countries have been able to acquire an abundance of vaccines, it’s a different story for many other regions. Ninety countries did not reach the target of vaccinating 40 per cent of their populations by the end of last year, and 36 of those countries have not yet vaccinated 10 per cent of their populations. 

With files from CTVNews.ca’s Alexandra Mae Jones

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COVID-19 vaccine targeting multiple variants needed: expert – CTV News

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OTTAWA —
Health Canada’s chief medical adviser says variant-specific vaccines can be approved faster than the general ones first issued to combat COVID-19, but one targeting the Omicron strain still likely won’t be ready in time to help with the latest wave.

Dr. Supriya Sharma said what is really needed are vaccines that can possibly stop more than one variant at a time, including those yet to come.

Omicron became the dominant variant in Canada in just over two weeks, and the Public Health Agency of Canada said Friday it’s now believed to be responsible for more than 90 per cent of all COVID-19 cases.

Studies suggest two doses of the existing mRNA vaccines from Pfizer-BioNTech and Moderna are not good at preventing infection from Omicron.

Multiple studies, however, suggest the vaccines are excellent at keeping symptoms mild, preventing hospitalizations, and shortening the stay and lowering the level of care for those who do get admitted to hospital. Fewer vaccinated Omicron patients, for example, need mechanical ventilation.

Both Pfizer and Moderna are working on new versions of their vaccines that specifically target the Omicron variant.

Moderna is hoping to get its product into trials early this year. Pfizer said it could have 100 million doses of theirs ready as early as March, and Canada has contracts for boosters from both companies that would include vaccines for variants too.

But Sharma said even with the expedited review process for vaccine variants, that’s “probably not” fast enough.

“By that time, based on what we’ve known about the Omicron wave, it might well and truly be through,” she said. “And then the question is always, ‘is there another variant that’s coming up?”‘

The solution, she said, likely lies with vaccines that can target more than one variant at a time.

The COVID-19 vaccine technical committee of the World Health Organization said the same thing on Jan. 11, noting Omicron is the fifth variant of concern in two years and “is unlikely to be the last.”

Booster shots that heighten antibody development became the immediate response to Omicron for many governments, including Canada.

Dr. Srinivas Murthy, a British Columbia pediatrician and co-chair of the WHO’s clinical research committee on COVID-19, told The Canadian Press that boosters aren’t a long-term viable option.

“Boosting your way out of a pandemic is going to inevitably shoot you in the foot in the sense that you’re going to have a future variant that’s going to emerge that’s going to cause problems,” he said. “It’s going to evade your vaccines, and then you’re going to have to scramble.”

Omicron doesn’t evade the existing vaccines entirely but a future variant could, he said. The issue largely stems from the fact that the original vaccines train the body’s immune system to recognize what is called the spike protein found on the surface of a virus, and that spike protein is mutating significantly.

Think of the mutated spike protein as a bit of a disguise that makes it harder for the immune system to recognize the virus and mount a defence to kill it off.

Omicron has more than 50 mutations, and at least 36 are on the spike protein.

Multivalent vaccines that use the spike protein from more than one variant, or that target the genetic components of a virus rather than the spike protein, are possibly the ones that could offer protection for both this pandemic and the next novel coronavirus that emerges.

“It’s pan-coronavirus, where it’s looking at big broad neutralizing responses and you don’t have to update it every season and so on,” said Murthy. “That’s been the Holy Grail of flu vaccinology for the past number of decades. We haven’t achieved that yet, because flu is a bit tricky, but we think that it’s achievable for coronavirus, specifically.”

The United States Army has a version heading into Phase 2 trials that can attach multiple spike proteins. A vaccine with the specific spike proteins from all five COVID-19 variants of concern would likely be more successful, even against future variants, because they all share some of the same mutations and what one might miss another may catch.

Moderna is working on trials for multivalent vaccines using combinations of the spike proteins from the original virus and one of the variants, or two of the variants together. It’s not clear when they would be ready for use.

Sharma said even if the vaccines aren’t working as well against variants as they were against the original virus, to her “they’re still miraculous.”

“To have a vaccine that was developed that quickly, that still has, through multiple variants ΓǪ with boosters, up to 70, 80 per cent effectiveness against serious disease, ailments, hospitalization and death,” she said. “That is miraculous for a new vaccine for a new virus.”

This report by The Canadian Press was first published Jan. 16, 2022.

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Another COVID outbreak at BGH – Brantford Expositor

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The Brant Community Healthcare system declared a COVID-19 outbreak Friday on Brantford General Hospital’s B5 surgical floor.

In a news release, BCHS, which operates BGH and the Willett urgent-care centre in Paris, said two people have tested positive for the disease. They did not indicate if those infections were in staff members or patients.

Visitors will not be permitted in the unit, though exceptions may be made for compassionate reasons.

BCHS said safety precautions remain in place, including enhancing cleaning and disinfection efforts, screening, mandatory masks, and contact tracing.

Outbreaks were declared Jan. 7 at three units at BGH – B6, B7 and B7- and on Jan. 5 at the Willett transitional unit.

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