Analysis of Down to Earth Magazine: "Covid-19: A Prolonged Pandemic"

Table of Contents

Context

The pandemic’s third year has started with the entry of a new COVID-19 variant and the world needs to prepare for a long period of uncertainty.
While the world hoped for respite, sars-cov-2—the virus that causes covid-19—was changing.The indications of this change were first reported by South Africa and explain the current rise in covid-19 numbers.

The changing pattern of pandemic

There was a lull in covid-19 cases across the world as the pandemic neared the completion of two years. Some had even started harbouring hopes that covid was perhaps nearing its end.
A century ago, the Spanish flu pandemic (1918-20) had shown a similar trend, when it declined towards the end of its second year.
But it did not end and continued for another year. Almost on cue, as covid-19 enters its third year in November 2021, there is a consistent rise in new cases and deaths across the world.
Pandemics, however, do not always follow patterns. Their trajectory depends on the mutations of the pathogen.

What is dangerous about Omnicorn?

The world took half a month to upgrade Omicron to a variant of concern, which is considerably faster than the usual 8-10 months.
This new variant of sars-cov-2 was reported in South Africa and named Omicron, is by far the most heavily mutated form of the virus.
Of its 50 mutations, 32 are on the spike protein alone. More mutations mean greater transmissibility and a higher probability of evading the immunity shield.
On November 26, who named Omicron a “variant of concern” (voc), a label given to variants that are more contagious, deadlier and more resistant to vaccines and treatments than previous strains.
Another grave concern that arises with this variant is of re-infection; who cited preliminary evidence on November 26 that Omicron increases the risk of such an occurrence.

OMICRON V DELTA

The arrival of Omicron also marks a year since the emergence of the now omni present Delta variant that caused deadly waves across the world, including in South Africa and India.
who has recognised five vocs and two “variants of interest” (vois) in two years since the covid-19 hit; Delta was first detected in India in December 2020.
who’s epidemiological update on covid-19 from November 23 maintains that Delta continues to dominate globally “with the prevalence of other variants continuing to decline”.
The original strain that began this pandemic is nowhere to be seen. Data indicates that Delta is 40-60 per cent more transmissible than the Alpha variant and almost twice as transmissible as the original strain of sars-cov-2 found in Wuhan, China. Patients infected with Delta have a significantly higher viral load, which increases transmissibility.
Looking at the initial trends, Omicron seems to be spreading faster than Delta; but the world is also responding to it more quickly. Delta was termed a voi on April 4, 2021 and re-categorised as a voc on May 11, 2021. Omicron, on the other hand, went from being a “variant under monitoring” to voc in just two days.
The potential impact of Omicron can be gauged through the R0 value, or the average number of new cases spread by each infection. It is used to measure how fast a variant could spread. The current R0 value of the new variant is 2, as per a December 2 article in the journal Nature. The value was 1 in September when Delta was spreading, albeit not significantly.

Pre-emptive measure by World Health Assembly

World Health Assembly moves to fortify global pandemic response, preparedness in the face of the current global health emergency and to ramp up joint international efforts against future such crises, the World Health Assembly (WHA) declared a global treaty to “strengthen pandemic prevention, preparedness and response” in its session held between November 29 and December 1, 2021.
An intergovernmental negotiating body will negotiate and draft the treaty under Article 19 of the World Health Organization’s (WHO) Constitution.
The body will hold its first meeting on March 1, 2022, to decide on timelines and work procedures. It will hold its second meeting on the status of the working draft on August 1, 2022.
The body will also be required to hold public hearings and “deliver a progress report to the 76th World Health Assembly in 2023, and submit its outcome for consideration by the 77th World Health Assembly in 2024.”
Article 19 of WHO’s constitution allows for the adoption of conventions or agreements by the WHA “on any matter within WHO’s competence.”
This is the second such initiative taken under the Article since WHO’s inception in 1948.
The first was the WHO Framework Convention on Tobacco Control that came into effect in 2005.
WHO Director-General Tedros Adhanom Ghebreyesus called the treaty a “once-in-a-generation opportunity” to better prepare the global health system against future shocks.

Why did World Health Organization (WHO) warn of reinfection due to Omicron?

What WHO is saying must be put in the right context. Omicron has been declared a variant of concern as it has a number of mutations associated with different characteristics such as immune escape, high transmissibility or a reduced response to treatments.
By November 30, it became the most dominant of all variants—accounting for 90 per cent of cases—according to data available from South Africa’s Gauteng province. This rise is much faster than other variants.
It is too early to say there is a higher risk of reinfection or immune escape. However, this is a good opportunity to review the situation and ramp up the pandemic response in all settings.

Waning immunity and need of booster dose

Immunity is currently measured through an antibody test. Several studies on the efficacy of covid-19 vaccinations, yet to be peer-reviewed, have shown a decline in antibodies after about five months of the second dose. This allows the spread of breakthrough infections.
However, immunologists have cautioned against an overreaction to the waning immunity concept. They have noted that based on previous vocs, hospitalisation and severe disease even in the case of re-infection may be unlikely since that effect depends on the memory T cells of the adaptive immune system and not the antibodies present.
Memory B and memory T cells are the human body’s key reserves to avoid severe disease or death. Their lifespan changes based on the virus.
For instance, a vaccine for measles gives lifelong protection, while the influenza virus calls for regular immunisation. The rate at which the memory cells fade after covid-19 vaccination remains unclear.

Way Forward

The challenges the world faced this year were quite similar to the ones seen the year before—COVID-19, climate change and the impacts of these two existential threats.
Just when 2021 was nearing its end and the world was cautiously hopeful about the pandemic being on the wane, a new variant descended.
Around the same time, peninsular India witnessed heavy rainfall and floods, indicating the modes and extremes with which climate change is unfolding, adding to the mayhem.
So, the govt should proactively start expediting the process to roll out Covid vaccination for those under 18 years.
The numbers may be small yet, but the rising caseload of the Omicron variant of Covid-19 across States hints at community transmission, making it imperative for the Government to expedite vaccine coverage for the unvaccinated.
The government should also boost health infrastructure in all possible ways to fight with this prolonged pandemic and also for preparing for such future pandemics.
How we respond to these challenges will be the defining feature of our times. Let’s bid farewell to 2021 with the resolve to be prepared better for the crises.