| Year 2021 swung between hope and despair, and it’s time for a wrap-up and a look ahead.
The emergence of the Delta variant, its rapid spread, and gradual decline in India reinforced the destructive potential of the virus and showed how tough it can be to predict its ways.
If 2020 brought new waves of the outbreak, 2021 was about tsunamis. India went through its worst in April and May, with the virus claiming thousands of lives. However, the caseload started declining around the middle of the year, and by December, the seven-day average was consistently below 10,000 and deaths at roughly 600 a day.
However, in another part of the world, the virus continues its deadly run, having taken a toll of 800,000 lives in the US. What makes the situation worrisome is that this is playing out in a country that has an advanced healthcare infrastructure and 62% of its eligible population has been fully vaccinated.
Nonetheless, there was hope around the globe that the tide might be turning, when a new variant Omicron emerged, throwing the world into yet another phase of risk and uncertainty.
Even as Wall Street analysts were making forecasts about the end of the pandemic based on historical evidence, South Africa’s medical experts detected a rapidly transmissible variant that turned the country’s Gauteng province into a hotspot almost overnight. On November 26, the World Health Organization (WHO)declared Omicron a variant of concern, saying it had the potential to alter the course of the pandemic. It was a call to brace up for a new threat.
But then, crowded airports and marketplaces showed people were desperate to travel and go out. This stirred up debate around the risk of such actions, but one question would always come up: By when will the pandemic end?
It’s been two years and yet nobody can answer that. Here’s why.
As new information comes to light from studies, even experts are forced to change their views. Relying on data from genome sequencing of the virus, WHO faces a predicament of its own. If it flags a variant too early, it gets panned for basing its stance on insufficient data; if it is late with its alert, it draws equal criticism.
The world’s top virologists are baffled. Global epidemiology and genome experts cited preliminary data to interpret that Omicron may be four times more transmissible than Delta in the early stages. But so far, infections have been mild.
On the other hand, more information emerges every day that reins on optimism. A study by the London School of Hygiene & Tropical Medicine has predicted 25,000 to 75,000 deaths in the UK over the next five months. As a result, the UK has enforced restrictions, and more curbs are expected.
Omicron’s ability to evade the immunity provided by vaccines is indeed a matter of worry. Initial studies in real-world settings show that mRNA vaccines were only 30% effective against the variant and those based on the adenovirus platform, such as AstraZeneca’s Vaxzevria and Covishield, offered no protection. However, the variant itself being new, these results may change over time.
Here is a silver lining. Experts say booster shots after the first two doses can improve protection against Omicron.
India has announced precaution doses for frontline workers and those above the age of 60 years with known comorbidities. The vaccine coverage will now include children above the age of 15. These are important pre-emptive steps. Clarity is expected in the coming days on the vaccines to be used for precaution doses.
Heterologous doses — vaccines built on different platforms — have been found to be highly effective against the virus. Pfizer CEO Albert Bourla has even spoken about the need for a fourth booster dose. Indeed, among people with hybrid immunity — those who have had prior infection and have also taken the vaccines — the rate of reinfection has shown a significant drop.
Omicron cases have so far been mild, but how severe they may get is still being examined. Even though the variant has displaced Delta as the dominant variant in South Africa, no death from it has been reported. However, severe cases may increase, because the progress of the infection to the level of ICU admissions or ventilator-dependence comes after a lag.
The most important point to keep in mind is that the data till now is not based on robust clinical-trial settings and may have inherent shortcomings and observational biases. While sharing insights, experts have cautioned that their own interpretations may not hold as new trends emerge.
Omicron could unleash another wave of deaths across the world, but that may be less due to the lethal potential of the virus and more because it may push hospitals into chaos with its ability to infect more people.
By now, the world knows the best way to halt the spread of the virus. Making vaccines available to all nations, particularly to low-income and middle-income ones, is critical. Maintaining robust hospital infrastructure will be important too, as will be taking basic precautions such as mask-wearing and hygiene. In essence, the world will have to take the outbreak seriously and fight it as one unit.
The lesson from 2021: Science is yet to know enough about viruses, and people are only reacting to a transforming virus; they are not ahead of it. Predictions must be seen as a cue for caution than to panic. The pandemic will end only if people stop fooling around with the virus.
Vikas Dandekar,
Editor – pharma and healthcare,
ET Prime |
/ Prime Vantage
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