Omicron, by far the most contagious coronavirus variant to date, is so high tide around the world that it’s easy to feel discouraged about the prospect of pandemic relief – let alone an end – in 2022. But there is good reasons to think that Covid-19’s toll on world health and its wider social and economic impact could decrease this year, if governments and health authorities follow appropriate policies and if this volatile virus develops in the way many scientists believe is most likely.
A debate is growing between those who think that new pathogens like Sars-Cov-2 tend to cause milder diseases over time and those who say that they are just as likely to develop in a more virulent direction. Without taking sides, it is reasonable to conclude that the interaction between virus and the human immune system means that the more people gain some protection against severe Covid-19 symptoms through vaccination or infection, the better the prospects. No conceivable descendant of Sars-Cov-2 can have enough mutations in the right places to fully escape the attention of both antibodies and T cells generated by prior exposure to an earlier variant.
So the top priority is to vaccinate the whole world – as it should have been in the past year. Unfortunately Covid-19 vaccine inequality has never been larger, with only 10 percent of the population in low-income countries experiencing at least one sting, according to the World Health Organization, while rich nations roll out third or even fourth shots. As the WHO says, with global vaccine production close to 1.5 billion doses per month, there will be enough for these stimulus programs to continue, while far more supplies to poorer countries than in 2021 are directed by schemes like Covax.
Although industrialized nations are justified in protecting their populations with adult boosters and campaigns to extend vaccination to children, we can not expect to continue to excite people every four to six months in the face of new variants. We will have to rely on the immunity provided by annual vaccinations – preferably with a new generation of products that are effective against all coronavirus variants – and by repeated exposure to what will sooner or later become an endemic infection.
Governments and regulators should encourage the development of new vaccine technologies to complement the near-duopoly that Moderna and BioNTech / Pfizer enjoy in the developed world with their mRNA products. At the same time, more investment needs to be made antiviral drugs which may play a greater role in suppressing symptoms in those infected.
Another important area that needs to be strengthened is diagnosis and supervision. Requirements here range from ensuring that enough rapid lateral flow tests are available for humans to see if they are infected before meeting others, to building more genomic sequencing capacity worldwide to monitor the emergence of new variants.
What a slim chance we had at the beginning of 2020 to eliminate Covid-19 is long gone. Attempts to control the pandemic have so far been justified in the context of a global health crisis, but it cannot continue indefinitely. The collateral damage – to mental health and well-being, social cohesion and the world economy – would be too great. This year, the world will have to build resilience so that we can live with Sars-Cov-2 and its descendants, in a way that causes less disruption while still protecting those who are most vulnerable.