Perhaps it’s inevitable that, two years into the pandemic, the emergence of a new variant that appears milder than any before it, has prompted some to predict the end of the pandemic. At first glance, this scenario fits neatly with how previous pandemics have ended, with the pathogen gradually evolving to become less dangerous.

Predicting how a virus might evolve is tricky, but even if Omicron turns out to be a less severe variant, there’s no reason a much more severe one won’t emerge shortly.

But this theory doesn’t quite hold up to scrutiny. For one thing, even though Omicron may seem anecdotally milder than Delta or other variants of concern, it is still not clear whether it does indeed cause less severe disease or if it’s because so many people have some pre-existing immunity from being vaccinated or previously infected with the virus.

As the World Health Organization’s (WHO) head Dr Tedros points out, Omicron is still a lethal virus, hospitalising or killing millions of people, so this is not the time to drop our guard.

Pandemic fatigue

Despite such warnings, a more relaxed approach is exactly what people in many countries seem to be taking. The concern is that if people assume the pandemic is beginning to fizzle out, this could drive complacency. Indeed, countries such as South Africa have seen a slump in vaccine uptake in recent months.

Several countries appear to be operating under the assumption that we now have to “live with the virus” and are thus also relaxing restrictions that would reduce the spread of infection. That has contributed to health systems again becoming overwhelmed, even in wealthy countries. 

Not yet endemic

Believing that the virus is here to stay assumes it has become endemic – meaning a disease is constantly present, but that case numbers are stable and relatively predictable. Although many are using this term in relation to COVID-19, the disease has not reached endemicity yet.

Although the precise shift from pandemic to endemic can be tricky to pin down, there are various characteristics of an endemic disease that COVID-19 does not yet meet. Viruses that cause the common cold or flu are endemic because most people have been infected at least once – yet globally, there are plenty of people who do not yet have immunity to COVID-19, either because they have not yet been vaccinated, or they have never been infected with the virus that causes it. For as long as there are huge surges in cases and deaths, COVID-19 is not close to being an endemic disease.

The virus is still evolving

Billions of people in low- and middle-income countries are still waiting to have their first dose of COVID-19 vaccine. Because of this, the virus continues to widely circulate in both vaccinated and unvaccinated populations, putting evolutionary pressure on it to mutate in ways that might help it evade vaccine-induced immunity.

Predicting how a virus might evolve is tricky, but even if Omicron turns out to be a less severe variant, there’s no reason a much more severe one won’t emerge shortly.

WHO’s COVID-19 technical lead Dr Maria Van Kerkhove has said it was “very unlikely” that Omicron would be the last variant of concern before the pandemic is over.

TOPICS: COVID-19

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