CoronaVirus Pandemic – XVII
GETTING Closer to the End Game?
As we get closer to two years since the arrival of Covid-19 in American soil, all of us have only one question in mind: Is this pandemic going to end sometime and if so, when? Sadly, none of us know the answer. With free availability of vaccines, well-established vaccination programs and continued observation of safety protocols, we thought the pandemic would be declining by this time. But with persistent vaccine hesitancy among the public and arrival of new virus variants along with a section of rebellious population not observing mitigation measures, the possibility of herd immunity appears to be elusive and COVID continues to rage in all states. CDC estimates that the current situation is likely to continue and may slowly abate perhaps towards the end of 2022. Hopefully, by that time majority of the country will be vaccinated.
Now let us look at the potential Covid-19 endgame scenarios. According to one great physician/scientist Dr. Eli Adashi, professor of Medical Sciences at Brown University, this would include four possibilities: “Eradication, Elimination, Cohabitation, or Conflagration.” Eradication of the virus from the face of earth, the best option, is almost impossible although we have eliminated small pox and polio before. Elimination from specific regions is a good possibility, but for this to occur there has to be a global strategy with all nations working together. And we need to embrace the spectrum of prevention, prompt detection, quarantine and treatment protocols.
The first step is to get everybody vaccinated. My wife and I got the booster dose recently and so did many I know, especially the ones with weak immune system or chronic diseases. Hopefully, the booster controversy will subside soon. And with the mitigation measures continued for some more time, this would lead to containment of the infection. As we go back from mitigation to containment, everyone is anxious to get back to business as usual. But I'm not sure we'll ever get back to business as before in the near future. The whole concept of promoting good health practices will have to continue even after the pandemic has started declining significantly. And many feel that our prevention activities have not been as robust as the recommended models suggested that would lead to a decrease in the rate of infections and deaths. This is why the disease still continues to rage in many states and death rate hasn’t fallen significantly.
We also need a smart quarantine system so we can isolate the asymptomatic carriers or “superspreaders” and make at least some sections of the society Covid-19 free. For this, we need high precision, easily available testing methods and sincere cooperation of the public. “At present, less than 10 percent of the needed 20 million tests a day in the United States are being done. And the testing that’s being done today provides only a simple yes-or-no answers and has variable quality,” as per one source.
The next scenario is living with the virus or Cohabitation. This means the virus will become endemic just like the seasonal flu and we must figure out a way to keep the disease at bay by taking suitable precautions – annual Covid-19 vaccine shots like the flu shots, treat those who become infected quickly and efficiently and minimize death even in severe cases. Some of the current antiviral treatments like remdesvir and monoclonal antibodies are reasonably effective. Countries like Israel and New Zealand have done well in controlling the pandemic and Japan has adapted to the virus reasonably fine by strictly adhering to all precautions. So, cohabitation is the most likely realistic scenario in the near future. The last prospect is Conflagration, a fancy term, that means outright fighting – effectively, a war between us, the humans and a merciless assassin, the virus. This cannot go on for long since the virus is evolving and mutating constantly and one day a so-called ‘doomsday variant’ could appear; a terrifying possibility. Thus, we have no choice other than finding a proper cure or at least a viable solution.
So, what’s the final answer? Get as many people vaccinated; it doesn’t have to be 100 percent. With herd immunity established, the infection can’t jump from person to person and eventually the virus will subside or lay dormant and we can go on with our normal activities while continuing to observe all precautions.
To be continued …
M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. For further reading, “Second Chance - A Sister’s Act of Love” by Dr. Nathan from Outskirts Press, can be found at www.amazon.com