One of the defining characteristics of the Omicron wave here in Canada may be our sense of unstoppable from the virus.
During the first wave of the pandemic, public health measures often limited the spread of the virus to isolated outbreaks, tragically claiming lives in susceptible places such as long-term care homes. With Beta and Delta-type COVID-19, the spread of the virus in the community was substantially reduced as vaccination increased.
Now, as the curve for COVID-19 transforms into a near vertical line, and several provinces impose strict limits on who can get tested because so many people are exposed, our collective sense of being able to avoid infection is altered. Omicron really seems unstoppable.
It’s the term that came to mind when Karen Lopez learned that dozens of her friends had contracted the virus in three weeks, a number that was many times what she had seen in any of the previous waves.
After nearly two years of carefully avoiding COVID-19, López is not letting go of his caution. But the Toronto woman said she’s thinking differently about what it might mean to get COVID-19 now, especially with indications that the virus is less severe for vaccinated people like her, and a level of spread that seems much more difficult. to avoid forever.
“I guess I’m thinking: I should expect me to get it sometime next year, and that won’t be a terrible thing,” he said. “Maybe I can rethink other risks, like car accidents.”
The appearance of the Omicron variant, with its rampant transmissibility, has made some wonder: Is this a preview of what life will be like, when the pandemic phase of COVID-19 ends and the virus continues to spread, endemic, in society? for the rest of our lives?
Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto, agrees that the public and officials trying to control the pandemic are treating the Omicron wave as more “inevitable” than previous waves, doing less to prevent cases than in previous ones. waves, when restaurants and schools were closed with far fewer cases circulating.
“I really don’t know what’s driving it, but for all intents and purposes, it’s like there’s a decision that says: let it go, let it spread,” he said, referring to the decision to have schools come back on January 1. 5 and to keep restaurants and events open (although with capacity limits).
For Furness, it’s a level of acceptance that comes too early, as children under the age of five cannot yet be vaccinated, and Omicron may still pose a significant risk to vulnerable populations.
COVID-19 is not yet endemic, which is technically defined as a disease that exists consistently in a population over time, usually not exceeding one’s reproductive value, but Omicron’s sense of unstoppable, combined Hoping for its milder properties, it seems to prompt officials and parts of the public to act like it’s something less threatening, like the flu or a bad cold.
“So I’m not sure endemic is the correct word, although in common parlance I think (people who use this term) mean that COVID-19 is there and it will never go away,” he said.
Indeed, at this point in the pandemic, the decision to call it “endemic” rather than “pandemic” can be as much a social and ethical as it is a scientific matter.
It’s worth noting that there is more agreement that COVID-19 will last in the long term (become endemic) than what kind of threat the virus will pose when it does.
In a survey of more than 100 immunologists published last February by Nature, there was almost consensus that COVID-19 would become endemic, and 89 percent said it was “likely” or “very likely” that it would continue to circulate indefinitely in at least some foci of the world’s population.
The reason is that over time, as more and more people are exposed to the virus and more people protect themselves from vaccines, scientists hope that the transmission of the virus will reach some kind of balance. With endemic disease, we would not expect massive waves or crashes, but rather a predictable cycle or constant tick of the disease over time.
That does not mean that endemic COVID-19 is harmless. Other endemic diseases are not.
In the case of the 1918 flu, that balance meant living with a nasty seasonal illness (for which we can get vaccinated annually today). In the case of four human coronaviruses, which are also believed to have caused pandemics in the past, they have become some of the viruses that cause common colds. A less common outcome is near-eradication of a disease, which seems like a distant possibility in the case of COVID-19.
“Right now, you could say that the coronavirus is endemic; it is among us, there is no indication that we can get rid of it locally or worldwide,” Shaman said.
But the virus is still emerging in dramatic waves and putting pressure on the healthcare system, so it cannot be said that it has reached a consistent equilibrium, he said.
Even if we think of influenza, which is endemic by most people’s understanding, that disease kills 500,000 people per year worldwide.
“We have been accepting 25,000 deaths a year from influenza (in the US),” he said. “And maybe we shouldn’t have been.”
Complicating matters is the fact that the COVID-19 we’ve come to know mutates faster than the flu and causes more serious illness. Still, it may be that populations tired of pandemic restrictions and eager to return to normal life and all of their close contacts may be eager to treat COVID-19 as endemic more quickly.
“We are going to normalize and socialize the idea of going back to work, going back to life,” Shaman said. “You could frame that as if the virus was endemic.”
One pending question is whether Omicron could help COVID-19 reach its endemic phase.
The data available so far shows that Omicron infections are less likely to result in hospitalizations compared to Delta infections, although Omicron spreads much more rapidly.
Shaman is skeptical that the pandemic will end after large numbers of people are infected with Omicron.
“The question is, is this Omicron the beginning of a milder, highly transmissible virus that we will be dealing with?”
He said he’s not sure. While he believes the data that Omicron itself appears to be milder than Delta’s, he said there is no guarantee that the virus will continue to evolve into a milder form. Instead, it could evolve to be more virulent and just as transmissible as Omicron.
Such an outcome would keep COVID-19 in a pandemic phase for much longer.
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