How will the Covid-19 pandemic end? This is what the experts think

How will the Covid-19 pandemic end? When there are still millions of people to be vaccinated, several experts have analyzed the various scenarios that will remain once the global pandemic is overcome and in which great care must be taken with the various variables that possibly remain of the SARS-CoV-2 virus How will the Covid-19 pandemic end? This is what the experts think: Will our life be like it was before 2020? This is the question that many people around the world ask themselves and although it seems that “normality” is gradually returning, everything indicates that the Covid-19 pandemic will continue to suffer for a while. have analyzed the future that awaits us, among the hypothetical scenarios is that Sars-Cov-2 becomes an endemic virus, like the common cold viruses, which can cause reinfection and generate enough immunity to protect against serious diseases. On the other hand, there are those who look to the past and how the epidemics of history ended. Generalizations that, in any case, are usually something quite generic, because Sars-Cov-2 is proving to be a virus with evolutionary capabilities that have raised many concerns “It mutates much more than other viruses that we know, such as herpes”, highlighted days ago the virologist Rafael Sanjuán, one of the leading experts in viral evolution in Spain, in an interview with El País.According to Sanjuán, before thousands of variants already in circulation, the conditions are being created for the appearance of the so-called recombination mutants, that is, genetic mixtures of two or more coronaviruses that, when co-infecting the same host, exchange parts of the genome , thus acquiring information that can give the new pathogen one or more particular advantages, for example increasing the infection capacity, offering the possibility of escaping the recognition of antibodies induced by previous infections (or vaccination) and even infecting multiple animal species. In other words, there is no historical precedent for a pandemic due to respiratory viruses as widespread and as severe as that caused by the SARS-Cov-2 coronavirus. “In recent history, it’s all been about the flu, with a timeline of a couple of years,” said Jennie Lavine, a biology researcher at Emory University and first author of a modeling study published in Science predicting how the Covid-19 pandemic could disappear. The endemic virus, according to Lavine and his colleagues, as older adults, more susceptible to hospitalization and death from Covid, gain immunity against Sars-Cov-2, the number of severe forms of Covid-19 will decrease. This “training” of the immune system, through infections and vaccination, will likely turn future Sars-Cov-2 infections into the equivalent of a cold. Over time, as some degree of protection becomes more common in adults, the most commonly infected people will be the youngest children, whose infections, even now, are rarely serious.Therefore, the hypothetical scenario indicates that Sars-Cov-2 will continue to circulate in the population anyway, although in a different way. “It is not a death sentence or a way of saying we will not achieve herd immunity,” Lavine added. It simply means that the virus will become endemic, so the question we ask ourselves is: will the virus be mild and endemic in the future or will it be severe and endemic? I would say that it is very likely that, at some point, the infections will be mild and endemic. ”The utopia of herd immunity The Emory University research team is not alone in supporting the status of the endemic thesis, leaving aside the possibility of controlling the spread of Sars-Cov-2 through herd immunity. Earlier this spring, Jonathan Yewdell, principal investigator in cell biology and viral immunology at the US National Institute of Allergy and Infectious Diseases (NIAID), published an article in the journal PLOS Pathogens arguing that coronaviruses do not activate the type long-term immunological protection that we would need to be able to establish herd immunity. In contrast, the endemic Sars-Cov-2 infection would have a seasonal pattern, spreading mainly in the winter months, when children are in school and when we spend more time in closed and crowded places.Florian Krammer, School vaccinologist of Medicine Icahn of Mount Sinai in New York, said that, at least in principle, some of these flu seasons may be more serious than others, but will not lead to a major pandemic.”If this virus becomes seasonal and there are countries where the vaccination rate is still low, those flu seasons could be a little more intense at first,” Krammer said. “In countries where vaccination rates will be high, influenza seasons will be weaker.” Globally, this transition to an endemic state will occur at different times. “I think we will see a big difference between Western countries with extensive vaccination campaigns and countries that have not received enough vaccines,” Krammer said. “Even countries like Iran, where infection rates have been incredibly high, I think they have such a level of immunity that the pandemic is unlikely to come back in a wave.” The risk of variants However, other experts are more cautious with this hypothesis of Transition. The reasons for the caution derive from what has already happened in Brazil and India, where despite the widespread transmission of the infection at the beginning of the pandemic, there have been subsequent terrible waves of Covid-19 caused by the so-called variants of concern. . “I think we have to take into account how things really were this year, the multiple waves and the fact that there is still no concrete evidence that the pandemic can be extinguished by itself, in any country,” said Marc Lipsitch, epidemiologist of Infectious Diseases at the Harvard TH Chan School of Public Health “And I think a slower natural history is probably a part of this evolution.” Mike Ryan, head of the emergency health program at the World Health Organization, is of the same opinion. “We do not know where we are, because this is the first pandemic of a SARS coronavirus.From my point of view, we may not even be near the end. I also believe that we can, however, achieve a very high level of disease control, so much so that this pandemic will no longer be a health emergency. So, in this sense, I think it will end ”.