Coronavirus: the new wave has started?

As daily reported cases of Covid-19 are falling across the globe, most countries are ending pandemic restrictions. Gone are the mask mandates and some countries have even forgo vaccine mandates. Travel restrictions have been eased, and many airlines have started dropping even testing mandates. Public, politicians and media are so tired of these restrictions that everyone wants to go back to pre-pandemic days. The ‘normal days’ as we fondly remember were the days when we were free to travel and do business without even thinking of a respiratory disease which could kill us in millions? Covid-19 death numbers have passed the grim mark of six million, but by all estimates actual deaths are at least three times higher than reported numbers if not more. Only few public health officials were warning about dangers of premature declaration of victory, even facing personal hostility, abuse and ridicule both from public and government officials. Epidemiologists, infectious disease and public health experts who are watching this pandemic very closely have not seen a sign in the virus which shows that its weakening, is less mutating or moving towards herd immunity.

Europe has started seeing an uptick of cases from the last week of February, but more alarming is that an increase is being observed in daily reported deaths too. Media is reporting this as a major news headline, adding that ‘experts’ have no clue why this is happening. Governments, public and media are wondering because all thought that once we have a population with high vaccination levels, herd immunity will kick in and Covid-19 could be like any other disease. So now ‘everyone’ is baffled why this is happening even when the population has around 80% vaccination coverage. Where I could ignore the premature conclusion and hopes of victory by the general public, I am disappointed to see the so-called ‘government experts’ who did not show the reality to the decision-makers. All the evidence until this moment is that SARS-COV-2 (the virus which causes Covid-19) is acting like a seasonal virus with periodic waves. A decline of cases on the tail of one wave does not mean that we are out of this pandemic. Increase of cases in highly vaccinated populations also tell us that virus infection or vaccination does not produce long-term immunity.

After antibiotics, it was thought that infectious diseases would be a thing of the past. When I started studying epidemiology at the University of Washington in the 90s, most students were doing research in non-communicable diseases. Except HIV/AIDS pretty much no other infectious disease was generating funding for new students. But coming from a clinical practice in Pakistan I was aware of a practical problem of seeing too many typhoid patients, especially kids. So, it was natural for me to do research in this area but even job opportunities were fewer in infectious diseases then. But even then, antibiotic resistance was a known problem and issue of the re-emerging and emerging infectious disease was becoming bigger. The infectious diseases, which we thought were under control, started to become a problem again. Before the pandemic, the world realised that if antibiotic resistance stays on the same path we will quickly run out of treatments of many diseases and reverse to the pre-antibiotic era.

That is exactly what is happening in Covid-19 pandemic. After vaccines we foolishly thought that this one intervention would solve the problem in seven billion people immediately. But we forget that relying on one measure alone only gives viruses a chance to evolve into immunity evading variants. Only a comprehensive public health approach would have put the brakes on the transmission and a possibility of winning this war. More than a year ago when vaccines were coming onto the horizon, and everyone was excited I wrote on these same pages: “Vaccines are part of our arsenal but never think you can ride out this pandemic just on them. Think public health to safeguard our survival in the long run.”

Published in The Express Tribune, March 16^th, 2022.

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