Living with Coronavirus. Life in a post pandemic world
The politicians would have us believe that vaccination will see off COVID-19 for good. Scientists are more pragmatic, resigned to the belief vaccines will eventually establish an uncomfortable truce with the virus. The consensus within the scientific community is that the SARS-CoV-2 virus, and cause of COVID-19, is not going away, we will just have to learn to live alongside each other. If this scenario proves correct, as opposed to the politicians’ rhetoric of the war on the virus being won. The world will move to a COVID-19 endemic, rather than the current pandemic footing. The SARS-CoV-2 virus will be added to the list of infectious agents that our world knows and expects as an ever-present adversary (much like the Influenza virus). And life can return to normal, or the new normal, whatever that is?
Have we eradicated viral diseases in the past?
Yes, we have. The shining example of the benefit of vaccination is easily the eradication of smallpox in the 1970s. Indeed, the outbreak of SARS in Asia in 2002-3 was stamped out too. However, that outbreak was characterised by a virus spread only from people showing symptoms, so tracking the disease and quarantining was far easier than during COVID-19. As we now understand people with SARS-CoV-2 can incubate and pass the virus without knowing they are doing so, as their infection may present no symptoms. This single factor alone makes quarantining the infected near impossible or functions such as track and trace very difficult to implement or deliver any meaningful impact.
Why can’t widespread vaccinations programmes reproduce the success of the eradication of smallpox?
The reason why COVID-19 will not follow smallpox, and probably polio, which has also almost been eradicated from the face of the planet by vaccination too, remaining endemic in Pakistan and Afghanistan only, is the way the respective vaccines work. Unlike the smallpox and polio vaccines, the SARS-CoV-2 vaccines will effectively dampen symptoms, but they are not believed to obstruct transmission. There is another key issue that works against eradication of COVID-19 – the political, economical and social will is simply not there. At least not yet. So, the likelihood is that COVID-19 will, in time, settle down as endemic amongst us – that is, a relatively stable baseline level of infection. The transition from epidemic to endemic is considered normal for infectious disease, even without vaccines. The benefit of the SARS-CoV-2 vaccines is they will accelerate the conversion process and therefore save many lives around the world.
What does endemic COVID-19 look like?
It is too early to know exactly what endemic COVID-19 will look like. Will childhood exposure to the virus protect from severe illness late in life? Will SARS-CoV-2 reduce to little more than the common cold? Who knows? History suggests this outcome is possible. There are several currently circulating coronaviruses inducing common colds that are suspected of being far more dangerous when they first appeared amongst the human population. For example, the Russian flu epidemic of 1890 that killed one million people may well have been caused by a coronavirus, termed OC43, which is now endemic. When we are out of the COVID-19 pandemic there is likely to be much more SARS-CoV-2 to encounter for many of us, we just do not yet know how that relationship will manifest.
Has the way we live our lives changed forever?
Like the Black Death in the 14th Century spreading along the trade-routes of Eurasia, Covid-19 emerged in China and quickly travelled along the modern-day Silk Roads: the intercontinental flight paths.
It is yet to be seen if coronavirus hits global health as catastrophically as the bubonic plague did, certainly in terms of mortalities. However, whatever the statistics say, this latest pandemic has certainly changed the world and the way we will live our lives in the future. COVID-19 has quickly revealed the shaky foundations upon which much of what we take for granted is built, from the intricately interwoven nature of globalised supply chains and manufacturing infrastructure; to the just-in-time deliveries to supermarkets; as well as perhaps the more mundane how we live day to day and of course work. Whom amongst us pre COVID-19 would have specifically sought out cleaning products with antiviral performance claims. Does anybody returning to the office really want to ‘hot desk’ anymore?
Previous global medical events had huge ramifications for the world afterwards. The aftermath of this coronavirus pandemic will also see myriad changes, from personal adjustments to global shifts. Which of these changes will have a lasting impact and which might we never see again will only be proven by the passage of time?
Will there be more pandemics in the future?
Yes, there will, whilst we are still working through the current one this is hardly welcome news. There is some more positive news too however: we can help prevent future pandemics. But only if we take radical action. According to a group of international leading scientists protecting the environment and restoring its natural defences should be top of our list of things to do. This may sound like a strange suggestion under the circumstances, protect the environment to help prevent future pandemics. Well, that is until you consider COVID-19 is the sixth global health crisis since the flu pandemic of 1918 and recent reports say, “its emergence has been entirely driven by human activities”. Another report suggests there are some potential 1.7 million “undiscovered” viruses in mammals and birds – up to 827,000 of which could be zoonotic, IE capable of jumping from animals to infect people.
The same human activities that drive climate change and biodiversity loss also drive pandemic risk through their impacts on our environment. Changes in the way we use land, unsustainable trade, production and consumption disrupt nature and increase contact between wildlife, livestock, pathogens and people. This contact allows viruses to cross over between species and spread more rapidly around the world. It is estimated the economic cost of the current pandemic is 100 times the estimated cost of preventing it by protecting nature.
If no action is taken, future pandemics will happen more often, spread faster and kill more people than COVID-19.