Covid-19 is no longer a pandemic? : Kathmandu Post Contributor

KATHMANDU – The Dictionary of Epidemiology defines a pandemic as “an epidemic occurring worldwide or over a large area, crossing international borders and usually affecting a large number of people”.

On March 11, 2020, the World Health Organization (WHO) declared SARS-CoV-2, the causative agent of Covid-19, a pandemic, after it had spread to 114 countries around the world. and that thousands of people lost their lives. By now, however, the Covid-19 restrictions have all but been lifted and related deaths have dropped significantly. Last week on Friday, Nepal recorded no cases of Covid-19. Such events raise the question: are we still living in a pandemic?

Other pandemics

In 1918, the influenza A H1N1 virus, nicknamed the Spanish flu, appeared. It is considered the most serious pandemic in history, with around 50 million deaths worldwide. Of the four waves of the Spanish flu pandemic, the second was the deadliest, killing mostly young adults.

A similar scenario i.e. the second wave or delta wave of Covid-19 turned out to be the deadliest wave in Nepal and it was mainly young adults who died from it. There has been no official announcement or criteria regarding the end of the Spanish flu pandemic. However, it was thought to be over after the virus became less deadly.

In 2009, influenza A H1N1, later referred to as influenza A(H1N1)pdm09 virus, also known as swine flu, reappeared. It has spread to 74 countries with 144 deaths, leading the WHO to declare it a pandemic. After a year, on August 10, 2010, the WHO announced its end, but the virus continued to circulate in the form of seasonal flu. Currently, SARS-CoV-2 is also circulating at a low level, similar to swine flu.

SARS-CoV-2 will likely remain a seasonal infection for months to years to come, although its seasonality is still unclear or to be determined. Preventive measures such as mask-wearing and physical distancing are no longer mandatory in public places, and compliance with hand hygiene has dropped significantly.

Variant XBB

A new virus, XBB, a subline of two descendants of the Omicron variant, which first appeared in Singapore, has spread worldwide. The XBB virus is said to spread rapidly and evade antibodies developed by vaccines and natural infections. Initially, many experts assumed that the rate of infection, hospitalizations and deaths could increase because of it.

However, no significant increase in hospitalizations and deaths was observed. For the first time, on October 23, the government of Nepal officially announced the detection of XBB virus in various places in the country. The Ministry of Health and Population has warned of possible spread of the virus during Dashain, Tihar and Chhath. Interestingly, there were no significant increases in hospitalizations, deaths, or infections as a result of these festivals. Vaccination against Covid-19 or natural diseases is a possible and justifiable explanation.

SARS-CoV-2, which causes Covid-19, continues to evolve. Therefore, new emerging viruses are not unpredictable events. An outbreak can occur if the new virus is introduced due to mutations or hybridization between two or more subvariants. In such a condition, scientists generally warn (had warned after the introduction of the new XBB virus) of a possible new wave of Covid-19.

Nevertheless, the outcome of the infection must be assessed, analyzed and predicted, depending on the before and after the arrival of vaccines, hereafter called the pre- and post-vaccination era.

The hybrid (recombinant) virus XBB (even other new viruses) was unable to create a deadly wave of Covid-19 after it was introduced into communities. Vaccines were not widely available or accessible during the second wave; thus, hundreds of people lost their lives due to serious complications, while the number of people vaccinated increased dramatically during the third wave of Covid-19 (Omicron wave).

As a result, serious complications, hospitalizations and deaths from Covid-19 have decreased significantly compared to the second wave. This clearly shows the differences in the outcome of the severity of Covid-19 between the pre- and post-vaccination eras.