World Health Organization officials have warned that the world will most likely have to learn to live with Covid-19 as the global pandemic turns into an endemic. Experts working for the public health agency have also expressed concern that while the coronavirus pandemic has been extremely severe, it is ‘not necessarily the big one’ and there may be another one on the horizon.
Despite mass vaccination programs beginning to be rolled out across the world, Professor David Heymann, the chair of the WHO’s strategic and technical advisory group for infectious hazards, believes that the ‘destiny’ of the virus is to become endemic.
An infection is said to be endemic when it is constantly maintained at a baseline level in a population without external inputs, meaning a country will have to constantly cope with a level of its people suffering from the particular infection. They can be controlled by measures such as vaccinations and booster shots and examples of diseases that are endemic in the US include influenza, pneumonia and AIDS/HIV.
“The world has hoped for herd immunity, that somehow transmission would be decreased if enough persons were immune,” Heymann told the WHO’s final media briefing for 2020.
“It appears the destiny of SARS-CoV-2 [Covid-19] is to become endemic, as have four other human coronaviruses, and that it will continue to mutate as it reproduces in human cells, especially in areas of more intense admission.
“Fortunately, we have tools to save lives, and these in combination with good public health will permit us to learn to live with Covid-19.”
Part of the international teams that first investigated the Ebola and Legionnaires Disease outbreaks, Heymann is also an epidemiologist with the London School of Hygiene and Tropical Medicine.
The public health expert believes the concept of herd immunity is misunderstood and that Covid-19 will remain an issue for a long time to come.
The head of the WHO emergencies program, Dr Mark Ryan, said: “The likely scenario is the virus will become another endemic virus that will remain somewhat of a threat, but a very low-level threat in the context of an effective global vaccination program.
“It remains to be seen how well the vaccines are taken up, how close we get to a coverage level that might allow us the opportunity to go for elimination,” he said. “The existence of a vaccine, even at high efficacy, is no guarantee of eliminating or eradicating an infectious disease. That is a very high bar for us to be able to get over.”
That explains the reasons that the first goal of the vaccine was to save lives and protect the vulnerable, Ryan said. “And then we will deal with the moonshot of potentially being able to eliminate or eradicate this virus.”
Ryan also warned that this pandemic is not necessarily the biggest such challenge the world will have to face in the coming years. “This pandemic has been very severe … it has affected every corner of this planet. But this is not necessarily the big one,” he said.
“This is a wake-up call. We are learning, now, how to do things better: science, logistics, training and governance, how to communicate better. But the planet is fragile.
“We live in an increasingly complex global society. These threats will continue. If there is one thing we need to take from this pandemic, with all of the tragedy and loss, is we need to get our act together. We need to honor those we’ve lost by getting better at what we do every day.”
WHO chief scientist Dr Soumya Swaminathan, known for her research on tuberculosis and HIV, was also present at the briefing. She told those present that an extensive and successful vaccination rollout would not mean public health measures such as social distancing would be able to be stopped in future.
Swaminathan said the initial role of the vaccine would be to prevent symptomatic disease, severe disease and deaths, but whether the vaccines would also reduce the number of infections or prevent individuals from passing the virus on remains as yet unclear.
“I don’t believe we have the evidence on any of the vaccines to be confident that it’s going to prevent people from actually getting the infection and therefore being able to pass it on,” Swaminathan said. “So I think we need to assume that people who have been vaccinated also need to take the same precautions.”
WHO director general, Tedros Adhanom Ghebreyesus, told the briefing that the end of year was a good time to reflect on both the toll the pandemic had taken on the world but also the progress that has been made so far. Ghebreyesus also said that he expected the year ahead to see new setbacks and new challenges.
“For example, new variants of Covid-19, and helping people who are tired of the pandemic continue to combat it,” Ghebreyesus said.
“New ground has been broken, not least with the extraordinary cooperation between the private and public sector in this pandemic. And in recent weeks, safe and effective vaccine rollout has started in a number of countries, which is an incredible scientific achievement.
“This is fantastic, but WHO will not rest until those in need everywhere have access to the new vaccines and are protected.