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.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
