Two Years Covid-19: What’s Next?
Two years ago, the World Health Organization declared COVID-19 a pandemic. It was obvious that the new coronavirus represented a historic threat to global public health. The impact of COVID-19 would continue for many years.
The world has responded in a remarkable way to this challenge. As countries fell into lockdown, mask-wearing, self-testing, and other measures became routine, the public began to check daily for infection levels.
Many people hoped for a day when COVID-19 would no longer be a major problem in the worst months of 2020. The UK seems to be in this phase thanks to its high immunity levels from previous infections and vaccinations.
The pandemic saw experts from Imperial College London play a crucial role in our understanding of the virus. They have performed world-leading epidemic modeling and conducted major trials of vaccine technology and treatments.
We talked to our pandemic researchers about the future of COVID in the UK.
Where Are You Now?
It was agreed that strict social restrictions were necessary to avoid a catastrophic peak in hospitalizations due to the pandemic. This changed in 2021 when the Omicron and Delta variants of the virus caused waves of illness that peaked. However, major measures were not taken to stop the spread of the virus. Mass vaccination was able to lower the severity of COVID-19.
All COVID legal restrictions in England and Northern Ireland have been lift. Only a few remaining in Scotland and Wales remain. Recent weeks have seen a significant drop in reported cases in the UK, from 275,000 infections per day at the beginning of January to 35,000 cases by February. However, daily infections have been rising in recent days.
This experience, combined with improved treatment, has led some to speculate that the worst of this pandemic is over. However, the Imperial experts that we spoke with agreed that there could be a new variant that will dramatically change the situation.
Professor Samir Bhatt from Imperial’s COVID-19 Respond Team, part of the School of Public Health explained that the pandemic seemed to be entering a “period of quietness” in high-income countries with high vaccination rates.
He said that the combination of vaccinations, natural immunity and drugs has reduced the rate of infection fatalities in older people to an extremely low level. However, it is still lower than seasonal influenza.
The situation elsewhere in the world could change, however, as countries with low vaccination rates are still likely to experience large epidemics from the virus.
“In the UK I believe we are entering a more stabilizing phase of the epidemic because of very high levels of protection from vaccination and infected,” stated Dr Anne Core from Imperial’s MRC Centre for Global Infectious Disease Analysis. She also worked with the COVID-19 Response Team.
“We are less likely to experience very large waves of hospitalizations or deaths than we have in the past, but variants can alter that.”
What Happens After Omicron
Although Omicron has resulted in less severe cases, scientists worry that there is no way to predict what the next Omicron variant will be.
“We are at a point where we don’t quite understand why certain variants are more severe than others, and we don’t know the entire breadth of this virus,” Professor Wendy Barclay of Imperial University’s Department of Infectious Disease said.
“It is risky to assume that the next Omicron-like variant will come along.”
“There might be a variant that solves Omicron’s problem of transmitting in an immune population in a very different way. It is possible to end up with a very severe variant that breaks down the vaccine and causes severe diseases.
There are still some hopes that the virus can be treated even if it is reintroduce.
Professor Anthony Gordon from Imperial’s Department of Surgery & Cancer is the UK Chief Investigator of the REMAP-CAP platform trial. This platform has been evaluating COVID-19 treatments in hospitals.
He explained that treatments can be divided into anti-inflammatories or antivirals. Professor Gordon explained that there are treatments that address inflammation, which is the body’s reaction to the virus.
“Anti-inflammatories will likely work if you have excess inflammation. It doesn’t matter how it happened.”
There’s No Time To Be Complacent
While we believe there is a better outlook for the UK’s outbreak, many scientists we spoke with were still concerned about complacency regarding case numbers. COVID-19 continues to infect thousands every day, putting thousands in hospitals each week.
An immunological perspective, Professor Danny Altmann from Imperial’s Department of Immunology and Inflammation said that he sees a real danger of the virus erasing the recent gains in healthcare and quality of living.
“The planet missed out on any elimination or eradication of COVID in January 2020 because we did not have the vigilance necessary to stop it spreading across the globe,” Professor Altmann said. Professor Altmann stated that it was too late to do so.
“But I believe there are still options for countries to make other choices. The future of their economies, employment and other aspects will be influenced by how COVID-tolerant they are.
This view was echoed in Professor Peter Openshaw from Imperial’s National Heart & Lung Institute. He warned that COVID is still “unacceptably high”.
“I think that we have become quite accustomed to hearing large numbers, and in a sense, we are thinking, well it could be worse. He said that it could be much better.
While some commentators may argue that COVID is the cause of many COVID-related illnesses, Professor Openshaw insists that this is not the correct way to look at the problem.
He stated, “It is evident to me that with many people who are hospitalized for other reasons but have COVID that COVID is contributing factor to their other condition becoming unstable.”
“For example, people who have diabetes or dementia or chronic bronchitis will be destabilize if they get COVID. So, although hospital admissions may be due to diabetes, their reason for being admitted is COVID.
The Long Covid Issue
Over the past two decades, the focus of health officials and policymakers has been on the immediate effects of the virus on hospitalizations and deaths.
In the initial months of the pandemic, the consensus was that most people who contracted COVID-19 would quickly recover. However, some people would need to be admitted and others would die. The reality was much more complex than that.
An Office for National Statistics survey published January found that about 1.3 million people have long COVID – which is a broad term that refers to symptoms that last more than four weeks following an initial infection. It includes fatigue, loss in smell, and difficulty breathing.
Some people recover fully, but others have symptoms that last for months and no sign of recovery.
Professor Danny Altmann has been a leading researcher in long COVID research and he expressed concern that this serious issue was not being fully understood.
He stated, “The bottom line is we have acquired a large group of very desperately and chronically unwell individuals. We don’t know if that will last for one or two years, five years, five years, or ten years.”
This is an amazing new piece in the NHS healthcare puzzle that you cannot solve by trying harder. It has implications for the number of clinics, nurses, doctors, radiologists, therapists and other healthcare professionals
Professor Altmann expressed concern that long COVID could have a similar impact on the NHS to Chikungunya, South America. This viral disease, which is transmitted by mosquitoes and can cause debilitating joint pain for long periods of time, has had a devastating impact on Brazil’s health system. It has also caused a significant number of people to lose their jobs and put them in constant need of long-term care.
“You cannot build this infrastructure overnight without investing and training. The challenge is immense and could lead to the destruction of our healthcare system. Professor Altmann said, “I can’t emphasize it enough.”