World Health Organization scientists are saying that the latest coronavirus is likely to become endemic, or to be circulating permanently in the population, and that a more deadly pandemic lurks on the horizon.
Although public health experts have previously spoken about the prospect that the new coronavirus or SARS-CoV-2 would not go away, but would remain a recurring although reduced health threat, the year-end comments on Monday by WHO officials they added up to what a scientist called a “wake-up call” for governments around the world.
“It appears that the fate of SARS-CoV-2 is to become endemic, as are four other human coronaviruses,” said Dr. David Heymann, chairman of WHO’s strategic and technical advisory group on infectious risks.
The four other human coronaviruses that have become endemic are responsible for about a quarter of all colds. The most recent endemic coronaviruses, HKU1 and NL63, were discovered at the beginning of the 2003-2004 SARS outbreak.
Heymann said the virus will continue to mutate as it reproduces in human cells, “especially in [geographical] areas of more intense transmission. “
The agency’s bleak projection comes when several countries have already started mass vaccinations, but as the disease continues to cause an alarming number in hospitalizations and deaths – and as new concerns about the virus emerge. The UK is currently struggling with a new variant of the coronavirus that, according to some experts, is proving to be significantly more transmissible. Meanwhile, doctors around the world are finding that a small number of people infected with COVID-19 appear to develop debilitating and potentially dangerous psychotic reactions.
During the press conference, Dr. Mark Ryan, head of WHO’s emergency program, echoed his colleague’s prediction.
“The likely scenario is that the virus will become another endemic virus that will remain somewhat of a threat, but a very low-level threat in the context of an effective global vaccination program,” he said.
So far, only one human infectious disease, smallpox, has been declared eradicated by WHO.
Perhaps in the most dire warning, Ryan said the current pandemic “was not necessarily the big one”. He said that despite killing about 1.8 million people worldwide, the death rate for COVID-19 is “reasonably low” compared to other emerging diseases.
While measuring how deadly a disease in the middle of a pandemic is a difficult estimate, WHO recently put the COVID-19 infection mortality rate at 0.6%, or less than 1%. In comparison, the SARS death rate was almost 10%. For Ebola, the number is between 25% to 90%.
“This is an alert,” said Ryan.
Dr. Amesh Adalja, a specialist in infectious diseases and pandemic preparedness at the Johns Hopkins Center for Health Safety, said the WHO statements were not particularly surprising. He predicted early on that the virus was becoming endemic.
“It wasn’t even a question for me,” he said.
Adalja now projects that SARS-CoV-2 will become more of a virus that people face year after year. While this may sound alarming, he said he believed the presence of an effective vaccine would relegate the disease from a public health emergency to another respiratory illness like the flu.
Meanwhile, Dr. Jeffrey Shaman, a professor of environmental health sciences at Columbia University who recently wrote an article on scenarios in which the virus becomes endemic, said he remains ambivalent about the outcome.
He said that although it has been evaluated by studies showing that people exhibit a strong and durable immune response to COVID-19, which suggests that the virus may fade and disappear, he is also concerned about increasing evidence of repeated infections.
A study in Mexico, the largest so far on reinfections, found that at least 285 people contracted the disease twice. But it is not yet clear how widespread the phenomenon is.
Similar to another Adalja, Shaman said that if the coronavirus becomes endemic, repeated infections can be less severe or even benign with the help of vaccines.
“It may not necessarily be something that overwhelms society,” he said.
One of the main lessons of the pandemic was the importance of investing in public health infrastructure. Mayor Bill de Blasio recently announced plans to build a $ 20 million pandemic response institute in New York City to prepare for future outbreaks. The seed was planted more than 10 years ago, when, under Mayor Michael Bloomberg, city officials envisioned a thriving biotechnology sector in Manhattan that could draw on the expertise of the city’s top research facilities. The development that resulted on the East Side is now home to the city’s Pandemic Response Laboratory, which processes coronavirus tests for 20,000 people a day.
But Shaman warned that complacency is always a risk, especially if several years pass without another major health emergency and while government officials are dealing with budget crises and competing priorities, such as the climate crisis.
“Unfortunately, the reality, especially for places with limited revenue streams, is that if this is in the rearview mirror and we are 5, 10 years beyond that, there will be different conversations about how you prioritize resources,” said Shaman.