meIt’s hard to predict arrival times on any long road trip, especially when you’re not sure of the destination or conditions along the way ahead. In the case of a pandemic, we know that flight is shaped by a dynamic interaction between the virus, the human host, and the environment, and this generates unpredictability.
Not good news because the coronavirus has already subjected us to two years of uncertainty, but we are making progress towards getting out of the official pandemic period.
A pandemic is declared when a new human pathogen appears, or with an unexpected rise in the prevalence or severity of an existing disease that crosses international borders. We can no longer say that waves of SARS-CoV-2 infection are unexpected after two years of global transmission and four major waves, but the other important aspect of calling a pandemic is that it points to the need for global cooperation and resource mobilization.
This is what keeps us in a pandemic situation where some countries are still struggling to access vaccines, control waves, manage the burden on health systems or the effects of strict control measures.
Eradication of a new human pathogen is the holy grail, but this has always been a very long shot for coronavirus – we knew we would be lucky to create a vaccine that could mitigate the impact of the virus. The virus has now also moved into animal reservoirs, removing extermination from the table.
As the virus evolves, so do we. Vaccine-induced immunity and infection, combined with environmental and behavioral changes, have reduced the likelihood of contracting the coronavirus, and high infection rates no longer risk overwhelming our health systems in most parts of the world. Our progress on this path has only been possible thanks to vaccines, with high uptake in Australia.
This, combined with new monoclonal antibodies and antiviral treatments, helps keep most infections out of the hospital and allows us to provide optimal care for those who end up there.
The risk that you will end up in the intensive care unit if you have an infection is now much lower than it was at any other time in the pandemic, but of course more people have an infection now that there is community transmission across Australia. We have less than half as many people with Covid infection in the ICU now (133) as we did in October last year (300), even though we have on average more than 40,000 new cases reported each day, compared to 2,750 new cases per day. in 2021. This equates to a 33-fold decrease in the rate of intensive care among reported injuries in just six months.
High rates of vaccination during this period is the most effective preventative measure. There is another shift in the dominant variants, with Omicron often described as ‘milder’.
However, Omicron is as harmful as the early variants, with a low rate of hospitalization between infections down to immunity and treatments that prevent the escalation of the disease, and a study in the United States released last week found that Omicron is as harmful as all previous variants when patient characteristics and vaccination status were taken into account. . Thus, Omicron being “light” may have less to do with the virus and more about our success in managing this virus.
With the arrival of Omicron and the relaxation of restrictions, Australia has among the highest rates of “reported infection” for every capital city in the world, just behind New Zealand. However, if you look at hospitalization rates or the death rate per capita, we’re at the bottom of the list.
Take the United Kingdom, for example. They are further afield by their BA2 wave, reporting a case rate of 10% of our rate, yet twice the rate of hospitalization. This tells us that it is not possible to directly compare infection rates as some are ending their testing programmes. In fact, we probably have half the infection rate in the UK today.
But Australia’s infection rates are still 15 times higher than Delta’s, and even with a smaller proportion of infections ending up in hospital than infection, the sheer number of cases still translates into a higher death toll than we’ve seen previously.
There is an urgent need to understand more about who has become severely ill, and whether this can be avoided. The booster doses were necessary to rebuild protection against critical disease with Omicron, and Israeli data show that this protection lasts for more than six months.
GPs can now prescribe antiviral drugs, making them readily available to those at risk of developing serious illness early in the infection. But there may be factors contributing to poor health outcomes that we can address, including delays in diagnosis and missing the critical period of time that antivirals can be effective.
Infection rates remain high, with succession of Omicron variants now increasing the risk of reinfection. Not surprisingly, the sub-variables emerged after massive BA.1 and BA.2 waves hit the northern and southern hemispheres simultaneously – each injury increases the chance of seeing a new variant and new infections peaked at more than 3.8 million per day globally in January 21 this year the previous waves did not reach a million.
We are not out of the woods yet as it may take a few weeks for a new variant to spread enough to be discovered. On the plus side, for the new variants to be successful, they must be more transmissible than Omicron, and this lowers the percentage that will pose a threat.
I think we won’t know we’ve left the pandemic period until after the event, when we’ve entered a period of greater control of the virus and consistency in variables and our public health responses, however, with certainty.
We’re on the way, but in Australia we need to make sure that preventable deaths are addressed before we make predictions for this disease to move on from the pandemic period.
We must also remember that everything we do to avoid contracting the virus, or transmitting it, helps us make that transmission sooner.