Coronavirus: here it comes again

Most of the world had said goodbye to the coronavirus pandemic and returned to life as normal. Many countries stopped daily reporting of cases, and some moved toward just focusing on hospitalisation numbers. Mask mandates were lifted or were being ignored in most countries and testing dropped to very low numbers. Vaccine uptake has become very low and there is actual danger of millions of vaccine doses expiring in the next few months in some rich countries while still millions are unvaccinated in poor countries. Government leaders across the board wanted to move beyond pandemic and to start working on other geopolitical issues. Continuous pandemic status in the country was considered bad for approval ratings. However, SARS-COV-2 (the virus which causes Covid-19) does not care about how others are feeling about it and is continuously churning new variants and sub-variants to better fit and be successful. Now Covid-19 cases are creeping up in many countries including the USA, UK, UAE, India and Pakistan.

However, daily reported Covid-19 numbers are not that high (except in UAE) as compared to previous waves. There are multiple reasons for these reduced reported numbers. There is reduced testing by governments and the public is also not going for Covid-19 testing even if they have symptoms. Many symptomatic patients are now opting for rapid tests which are not reported in national numbers. That has given a false sense of normalcy to governments and populations, and they had the illusion of pandemic end. In UAE however there is a requirement of periodic Covid-19 testing before you could enter any public spaces and there, we see more realistic new wave numbers which are comparable to previous waves. There are reports of increase in hospitalisation numbers too, but they always lag for two to three weeks.

Omicron sub variants BA.4 and BA.5 are either offshoots of original Omicron variant or according to some are offshoots of BA.2 variant which was responsible for a spike of cases a few months back. It’s interesting to note that before Omicron all variants (alpha, delta and Omicron) were originated from the original virus. They were not successive generations of the virus. For public understanding, they were all sons of SARS-COV-2 (which started the outbreak in China) and brothers but now in Omicron sub-variants we are seeing one brother’s family more successful. Omicron was the most infectious of all variants and now its sub-variants are responsible for spike of cases. In South Africa where these sub-variants were identified just a few months back did not see an increase in serious disease even with increased case numbers. In Portugal however hospitalisation rates are similar to previous waves probably due to old age of population. Another significant point is that BA.4 and BA.5 could evade both vaccination immunity and natural infection immunity. Recently one of my students, who had initial vaccination and two boosters and a prior Covid-19 infection, became positive again with strong symptoms.

So, what should we do if vaccines are not working either? Vaccines are working and saving lives, but they are never 100% effective. It was the wrong impression given by “pseudo” epidemiologists and “national leaders” for the pandemic control. Public Health uses all the resources it has and minimises the risk for populations. There is never a zero risk, and sustainable interventions are more important for long term protection than the flamboyant but short term actions. We need to improve ventilation of buildings to save our populations not only from Covid-19 but from other respiratory diseases too. Buildings were built well ventilated just a few decades back in most of the developing countries and a century back in developed countries. Desire to live in a comfortable but controlled environment is very recent and could be reversed easily. We need to think long term to ensure that we don’t play with millions of lives every time a new microorganism is ready to start a pandemic. Governments should plan long term and until then please ensure ventilation in public spaces alongside vaccinations and masks. As many as 3,500 Monkeypox cases have been diagnosed in 58 countries now and most of these countries never had monkeypox cases before. According to some reports there is a probability of its spread both by droplet and by air. Open your windows please!

Published in The Express Tribune, June 28^th, 2022.

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