Are We Facing A COVID-19 New Reality?

In a recent article in The New England Journal of Medicine, (NEJM) a perspective piece describes what has happened since COVID-19 first appeared in the late fall of 2019 and then swept across the world.

The impact of the virus has gone well beyond the realm of health. It has challenged societal norms, the way we work, and our trust in government.

It has disrupted globalization, the economic force driving the planet for more than four decades.

It has made it more difficult to focus on the other existential crisis of the age, climate change.

It has moved the Doomsday Clock, The Bulletin of the Atomic Scientists’ measure, closer to midnight. It hasn’t done this on its own but has been ably assisted by Russia’s invasion of Ukraine, and the global threat to food security exacerbated by conflict and climate.

At the same time, COVID-19 has accelerated technological innovation in biomedicine and produced new drugs, vaccines, and treatments at an unprecedented rate. The accelerant for biopharma was vast amounts of money coming from governments desperately trying to stem the infection and death rates from COVID-19.

The speed may have fuelled social anxiety as expressed in widespread disinformation becoming a thing.  Anti-vaxxers who had protested measles, mumps, and rubella vaccines for children having latched on to erroneous studies linking the treatment to autism, now focused on new COVID-19 serums. Their vaccine hesitancy message has been widely disseminated using the global voice of the Internet and social media.

The NEJM article describes the current moment as “a pivotal one.” Why? Because the continuing level of threat from COVID-19 is perceived to have waned. “Objectively we are in a better place with regard to the virus than we’ve ever been” states the article.

It was just last summer when America’s President, Joe Biden, casually remarked that COVID-19 was now behind us. It was “over.” That was before this fall’s emergence of the latest Omicron variant sweeping across the world.

The NEJM article argues that we still need feasible solutions, policies and programs to address what it calls “a new, nonemergency phase of the pandemic.” This means public health and trusted community leaders need to do the job of communicating and disseminating what is known and what is recommended for the general public.

It means continuous engagement, not detachment. It calls for consistency to manage the virus from the current pandemic phase to one that is very much like annual seasonal influenza programs for vaccination and treatment.

The politicization of COVID-19 has to end. Governments owe citizens access to credible information resources, not messaging to serve political gain. Political expedience should play no role in disseminating incontrovertible science.

The NEJM article calls for a “move away from universal recommendations, or population-wide prevention policy, toward a more differentiated or tailored approach — one that takes into account the characteristics of various communities and the pathogen.” In other words, NEJM is talking about tailored guidance that reflects local risks and addresses disparities in treatment resulting from socioeconomics, ethnicity, and a lack of health resources and insurance.

The Problems That Remain Unaddressed by the NEJM Article

Because a substantial number of people on the planet have insufficient antibodies to combat COVID-19 as variants emerge, and because levels of vaccination in the global population have yet to achieve herd immunity conditions, the virus will continue to spin off into new forms.

If we are lucky, new variants will be better adapted to coexist in our bodies. At best when infected we will get mild symptoms that last a few days and will develop natural antibodies to give us immunity. But a variant could emerge that causes spikes in death rates, particularly among vulnerable populations including the unvaccinated and those who are immunocompromised.

If we move away from a pandemic to endemic conditions where COVID-19 can be treated in the same manner as influenza, with annual new vaccines made available to all, we will have turned the corner on this virus and have learned enough to prepare ourselves for the next new virus that jumps from animal populations into humans. And although I know that some conspiracy theorists believe the virus escaped from a Chinese laboratory where bioweapons are studied, biopharma and governments will have learned an invaluable lesson about the need for speed in addressing the disruptive changes that seem to be a characteristic of this 21st century.