The numbers look good, but stay alert

Predicting the course of the COVID-19 pandemic is like predicting the stock market. We are now entering our fourth trough after a strong push. Similar to previous lulls in infections, many predict the achievement of herd immunity and the dissipation of the pandemic. Obtaining collective immunity was also scheduled for spring 2021 after the wave of winter holidays. This prediction was reinforced by a CDC study that found SARS-CoV-2 antibodies in 83% of blood donation specimens. Of course, Delta shattered those hopes and caused a devastating fourth wave in August and September of this year. Although there is no guarantee, I hope that after this fourth wave, the defenders of collective immunity are right.

There are several reasons to be optimistic. First, cases are in free fall in the United States. Even more people have been exposed to the virus and vaccinated, which should further strengthen our herd immunity. Second, according to epidemic.info there does not appear to be a dominant strain developing. Even the dreaded Delta Plus strain (AY.4.2) doesn’t seem to be gaining a foothold.

This was not the case in June 2021, when cases of the Alpha variant were in freefall. We sounded the alarm, because a new variant, the Delta variant, although still having a small number of cases, was increasing rapidly in domination and numbers. At the end of June 2021, the total number of SARS-CoV-2 cases was still very low, but the Delta variant was increasing exponentially, accounting for around 30% of all sequenced cases.

Many are currently worried about the Delta plus variant (AY.4.2) which is said to be 10-15% more infectious and may also have immune escape properties. But this variant has been detected in the United States since mid-July and has not yet seen significant growth against the dominant variant Delta.

However, the analysis of the evolution of this disease in other countries is worrying. It must be said that the poorest countries do not have the testing capacity or the infrastructure to do precise reports. Underreporting is all too common. In Russia, the official death toll is approaching 250,000 but according to the Moscow weather, the number of excess deaths at the end of July was 600,000. The same number of underreporting has been reported in India, where the actual death toll in July is estimated to be between 1.5 and 5 million people. That being said, data from the UK and Israel are believed to be accurate and reflect the severity of the pandemic.

In the UK, cases of the Delta variant spiked at the start of July 17, 2021, and then quickly halved. Then, cases increased with the Delta plus variant on October 28, 2021, reaching another peak almost as high as that of July. This raised concerns that under certain conditions the Delta plus variant could successfully compete with the Delta variant and cause a further increase in the United States.

Immunization rates are another area of ​​concern. The United States has 58% of its population fully vaccinated, like the United Kingdom the vaccination rate is 68%. Overall, the complete vaccination rate for the US population is 52 worldwide and lags behind most European countries. Portugal has 86% of its population fully vaccinated and the United Arab Emirates has 88% of its population vaccinated.

In addition, the United States still does not follow the right public health advice. In many areas, masks are not widely used indoors and the anti-vaccination movement continues to spread misinformation and discourage vaccinations. Last weekend there was a big anti-vaxxer convention at the Gaylord Opryland Resort & Convention Center in Tennessee where none of the attendees reportedly wore a mask, despite signs throughout the hotel indicating unvaccinated people . should wear them.

Infection Control Today® has reported in the past that SARS-CoV-2 is becoming endemic and find host animals which gives the virus many possibilities to mutate and escape vaccines. Laboratory tests that predict the effectiveness of the vaccine and the immune system often do not take into account the increased viral load of a patient when infected with these more infectious variants. Thus, laboratory tests may not be truly predictive of resistance to future variants.

So, to date, the outlook is very good and the pandemic is on a path of exhaustion, but there are valid concerns that compel us to continue our vigilance and public health strategies to limit the speed of the virus.