When will the world turn the “Corona” page?

On his daily commute from his home in the suburb of Helwan in southern Cairo to his workplace in the center of the Egyptian capital, using the subway, the 56-year-old engineer, Khaled El-Desouki, is keen that the muzzle does not leave his face on the round trips, despite the rest of the passengers getting rid of this precautionary measure. Against the virus, which is entering its fourth year.

Al-Dasouki, who works as a civil engineer and has been delaying the moment of moving from domestic work imposed by the epidemic to going to the workplace, told Asharq Al-Awsat: “It is no longer possible to continue working remotely, after the company’s management issued a decision to return to the conditions before the start of the pandemic. The epidemic, but as much as possible I try to adhere to the precautionary measures, even if I feel that I have become a stranger in a society whose members feared months ago, someone sneezing next to them, for fear of infection.

And the majority of the peoples of the world have become behaving like the companions of al-Dasouki in the metro car, which raises a logical question: “Has the world turned the page on (Corona)?”

On his daily commute from his home in the suburb of Helwan in southern Cairo to his workplace in the center of the Egyptian capital, using the subway, the 56-year-old engineer, Khaled El-Desouki, is keen that the muzzle does not leave his face on the round trips, despite the rest of the passengers getting rid of this precautionary measure. Against the virus, which is entering its fourth year.

Al-Dasouki, who works as a civil engineer and has been delaying the moment of moving from domestic work imposed by the epidemic to going to the workplace, told Asharq Al-Awsat: “It is no longer possible to continue working remotely, after the company’s management issued a decision to return to the conditions before the start of the pandemic. The epidemic, but as much as possible I try to adhere to the precautionary measures, even if I feel that I have become a stranger in a society whose members feared months ago, someone sneezing next to them, for fear of infection.

Abandoning Corona precautions gives a deceptive impression of the end of the epidemic (Harvard University)

And the majority of the peoples of the world have become behaving like the companions of al-Dasouki in the metro car, which raises a logical question: “Has the world turned the page on (Corona)?”

Looking at the number of injuries and deaths, which does not stop adding every day, it does not seem that the world has turned that page. Epidemic panic” to “coexisting with the virus,” as the numbers reveal.

The fear of the virus and the closures that countries implemented at the beginning of the epidemic, which was declared by the World Health Organization a health “emergency” on January 31, 2020, helped reduce the number of infections at first, and then soon the countries gradually abandoned these closures. With progress achieved in vaccination campaigns, which led to the infection of a large number of the unvaccinated population, these infections worked, along with the immunity formed by some vaccines, to form community immunity, which reduced infections again.

A paradox revealed by numbers

Despite the feeling of the engineer Al-Desouki – who is not necessarily based on statistics – about the decline in injuries and deaths in his family and professional environment; He is still cautious about wearing a mask for fear of the repercussions of infection with the virus, which has always occupied the world and terrified people.

However, there is scientific evidence that differs to some extent with Al-Dasouki’s extreme fears, as statistics show that the death index was high at the beginning of the epidemic, then it soon decreased by a large percentage, despite the continued increase in the number of infected people.

The “Zero Covid” policy prevented the Chinese from forming community immunity (Getty Images)

However, the death rate rose again, due to “Chinese policies, which suddenly abandoned the (zero Covid) policy that deprived the Chinese community of forming community immunity, and this led to an increase in the number of deaths, especially among the elderly,” according to expert estimates. .

Globally, the statistics of the American “Johns Hopkins” University reveal this paradox. On January 21, 2022, which witnessed the highest number of infections since the beginning of the epidemic and recorded (about 3 million and 851 thousand and 174 injuries), the number of deaths was (9 thousand and 494 deaths), At a rate of less than half a percent (0.246 percent), and compared to January 21 in the previous year (2021), the number of injuries was (651 thousand and 526 injuries), of whom (16 thousand and 878 people) died, at a rate of (2.59 percent), but On January 21, 2023, the rate of injuries and deaths rose again at a small rate, due to the epidemiological situation in China, where the number of injuries was (153 thousand and 257 injuries), of whom (2 thousand and 552 people) died, at a rate of (1.665%).

The pattern of the apparent decrease in the number of deaths, despite the increase in the number of infections, was the reason for “the world’s transition, after three years, from the panic phase of the epidemic to coexistence with it,” as Matthew Woodruff, a teacher of human immunology at Emory University in America, explains in exclusive statements to “. The Middle East”. “Vaccination campaigns have been very successful in preventing countless deaths around the world, which has helped end the virus panic,” says Woodruff. He added, “I think that the majority of the population does not see themselves at great risk, but this does not mean turning the page on the epidemic, because it is unlikely that the virus will stop its course without a new innovation.”

– Mutant “Kraken”

The latest innovation of the virus was the “XBB.1.5” mutator, which became known informally as the “mutant Kraken”, and it appeared in America in October of last year, then moved to at least 38 countries, described by Maria Van Kerkhove, The technical chief of “Covid-19” at the World Health Organization, in press statements, said that it is “the most transmissible so far, with mutations occurring in the viral spike protein (Spike) that allow the virus to bind better to its receptors in human cells (ACE-2) and facilitate evasion.” immune system.

Despite these specifications, Woodruff does not see that this mutant could cause the gains achieved during the years of the epidemic to be lost, and he said: “Despite what is said about the mutant and its capabilities, death rates did not rise the way they were early in the pandemic.”

Woodruff attributes his optimism to the fact that “the population has developed at least a baseline of general immunity, and this does not necessarily mean that people are protected from active infection, but this means that their immune system has a small amount of immunological memory when confronting a new variable.” And he believes that “it is unlikely that we will slip back into the early days of the epidemic, without a large unexpected mutation of the virus, beyond the mere development of a new strain.”

The issue of the occurrence of this large boom, which brings back the epidemiological panic, seems unlikely, according to Ahmed Salman, a teacher of immunology and vaccine development at the Edward Janes Institute at the British University of Oxford, who said in exclusive statements to Asharq Al-Awsat: “If This happened, we will be in front of a new virus for which we are looking for another name, but since (Omicron) was discovered in November (November) 2021, we have been circulating within the framework of new mutants from the same (Omicron) family.

And Salman explains: “In order for the virus to infect the human cell, the physical form of the (spike) protein must be compatible with its receptor in the human cell (ACE-2), so despite the occurrence of mutations in this protein, it remains preserved in the form that enables it to be infected.” Binding to its receptors, and if it loses this ability, and searches for receptors other than (ACE-2), we will be facing a new and different virus, and this is unlikely.

He explains that “the new characteristics that the virus acquires with new mutants such as the (XBB.1.5) mutant, such as the high rate of reproduction and the speed of spread, are due to mutations in other proteins, so it was wise to build vaccines on the (spike protein) formula, because it is the most stable, and this This explains the great effectiveness of vaccines in preventing death, although they do not necessarily provide protection against infection with the virus.

And he adds: “There is no doubt that vaccines, even the old ones, which were produced based on the first version of the virus that was first discovered in December 2019 in Wuhan, China, are still effective in preventing severe illness and death, and this has a major role.” In the transition of the world from the stage of emergency and panic, to coexistence with the virus.

Transition to the stage of settlement

Salman does not expect an end to this virus, but “there may be an end to the epidemiological situation, and the transition to the endemic stage.” In this case, Salman says, “the emerging (Corona) virus will be dealt with like the influenza virus, as there will be annual doses of it allocated on a regular basis.” It is great for vulnerable groups of the elderly and weak immunity.

And while the United States is currently studying changing the composition of the vaccine on an annual basis, as happens with influenza, so that it is compatible with the prevailing variable, Salman does not believe that there is a need for an annual change of the composition because “there is a big difference between the influenza virus and the emerging (corona), although the two viruses are their material.” Genetic type (RNA). He explains that “the genetic material in influenza consists of several small strips (from 8 to 11 pieces), depending on the type of virus, and this makes its mutations many, so there is no alternative to changing the composition of the vaccine annually, but the new (corona) consists of one piece, so Its influential mutations are few, and the evidence for this is that we are still spinning in a variable orbit (Omicron), since it was discovered in November 2021.

And Salman concludes from this that “the differences are not great between the different mutants of the emerging (corona), so the acquired immunity, whether from the vaccine or from infection, will provide protection from any upcoming mutant, and this explains the cause of the crisis that China has been experiencing since it decided to abandon the policy.” (Zero – Covid). He says: “China’s implementation of this policy deprived the Chinese of natural exposure to the (Omicron) variable when it appeared, just as their vaccination level was weak, in addition to its low quality compared to other vaccines. Therefore, when they decided to abandon that policy, the sub-mutants of (Omicron) were completely new to the immune system, which caused an increase in the number of deaths among the less immune groups of the elderly and the sick.

The irony is that the state of epidemiological panic, even with the increase in the number of infections, and the high death rate among the elderly and the weak in immunity, does not seem to exist in China. so that they can gain immunity by infection,” a behavior that Tamer Salem, professor of virology at Zewail City, rejects, but attributes it to “the availability of antiviral drugs, which have become an important control tool.” Salem told Asharq Al-Awsat: “This tool was not available at the beginning of the epidemic, but its presence now gave reassurance that greatly reduced the state of fear when contracting the virus.”

The “Paxofield” pill, developed by the American company “Pfizer” for the pharmaceutical industry, has become one of the most prominent control tools, and the Chinese companies “Gunshi Bio” and “Vigonvit Life Science” have developed a drug (VV116), which will appear on the market soon, and its clinical trials showed that Published last December in the New England Journal of Medicine, it is superior to Paxofeld in average recovery time and fewer side effects.

Wait and see

And if the situation seems to be reassuring, as the experts went, then why did the “WHO” announce a few days ago (on January 30) to maintain the “emergency situation”, even though the Director-General of the organization, Tedros Adhanom Ghebreyesus, said on September 17 (September) From last year in a press conference, that “the end of the epidemic is imminent”?

The famous medical journal, The Lancet, had anticipated the meeting that ended to announce the continuation of the “state of emergency” with an article in its editorial on January 14, in which it said that it did not believe that the situation was ready to announce the end of the epidemic, noting that “the epidemiological situation in China, the mutated (XBB.1.5) is spreading rapidly, do not encourage this decision.”

And “the decision to declare the end of the epidemic is taken when there is seasonality in the outbreak, in addition to fewer deaths,” estimates Lone Simonsen, an epidemiologist at Roskilde University in Denmark.

Amjad Al-Khouli, head of the International Health Regulations Follow-up and Evaluation Team at the WHO Regional Office for the Eastern Mediterranean, told Asharq Al-Awsat: “Perhaps we will have to wait and see for the coming winter, then the picture will be clearer, whether or not to make this decision.” However, he believes, at the same time, that “there is no need to care about when the organization will announce the end of the epidemic, because in any case we have reached a stable situation with the entry into the fourth year of the pandemic.”

Al-Khouli says, “We have largely passed the panic stage, given that hundreds of millions of people have already been infected with the virus, and there are vaccines and treatments that can prevent severe disease, and there is a significant decrease in the number of deaths, and this is what is important.”

And, “If the world has passed the stage of panic, then this should not be a justification for recklessness,” asserts Al-Khouli, because the most likely scenario is that “the virus will turn from an epidemic situation into an endemic situation, like influenza.” And he explains: “Just as influenza causes injuries and deaths annually, especially among the elderly and immunocompromised groups, this virus will do the same, and we are supposed to have become more aware during the past years of precautionary measures that help us avoid infection with it and other respiratory viruses.” And he adds: «Among these measures may be an annual dose of the vaccine, which is a proposal that is currently being studied, and wearing a (muzzle) in high-risk places, such as traveling in crowded conditions, crowded indoor places, or on public transportation, should also be part of the procedures. Our health culture, especially in the winter, and finally, the implementation of self-isolation, in the event of respiratory symptoms.