World Health Organization experts have warned that even though the coronavirus pandemic has been very severe, it is “not necessarily the big one”, and that the world will have to learn to live with Covid-19.
The “destiny” of the virus is to become endemic, even as vaccines begin to be rolled out in the US and UK, says Professor David Heymann, the chair of the WHO’s strategic and technical advisory group for infectious hazards.
“The world has hoped for herd immunity, that somehow transmission would be decreased if enough persons were immune,” he told the WHO’s final media briefing for 2020.
But Heymann, who is also an epidemiologist with the London School of Hygiene and Tropical Medicine, said the concept of herd immunity was misunderstood.
“It appears the destiny of SARS-CoV-2 [Covid-19] is to become endemic, as have four other human coronaviruses, and that it will continue to mutate as it reproduces in human cells, especially in areas of more intense admission.
“Fortunately, we have tools to save lives, and these in combination with good public health will permit us to learn to live with Covid-19.”
The head of the WHO emergencies program, Dr Mark Ryan, said: “The likely scenario is 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.
“It remains to be seen how well the vaccines are taken up, how close we get to a coverage level that might allow us the opportunity to go for elimination,” he said. “The existence of a vaccine, even at high efficacy, is no guarantee of eliminating or eradicating an infectious disease. That is a very high bar for us to be able to get over.”
That was why the first goal of the vaccine was to save lives and protect the vulnerable, Ryan said. “And then we will deal with the moonshot of potentially being able to eliminate or eradicate this virus.”
Ryan warned that the next pandemic may be more severe. “This pandemic has been very severe … it has affected every corner of this planet. But this is not necessarily the big one,” he said.
“This is a wake-up call. We are learning, now, how to do things better: science, logistics, training and governance, how to communicate better. But the planet is fragile.
“We live in an increasingly complex global society. These threats will continue. If there is one thing we need to take from this pandemic, with all of the tragedy and loss, is we need to get our act together. We need to honour those we’ve lost by getting better at what we do every day.”
WHO chief scientist Dr Soumya Swaminathan told the briefing that being vaccinated against the virus did not mean public health measures such as social distancing would be able to be stopped in future.
The first role of the vaccine would be to prevent symptomatic disease, severe disease and deaths, she said. But whether the vaccines would also reduce the number of infections or prevent people from passing on the virus remains to be seen.
“I don’t believe we have the evidence on any of the vaccines to be confident that it’s going to prevent people from actually getting the infection and therefore being able to pass it on,” Swaminathan said. “So I think we need to assume that people who have been vaccinated also need to take the same precautions.”
The WHO director general, Tedros Adhanom Ghebreyesus, said the end of the year was a time to reflect on the toll the pandemic had taken, but also the progress made. He said the year ahead would see new setbacks and new challenges.
“For example, new variants of Covid-19, and helping people who are tired of the pandemic continue to combat it,” he said.
“New ground has been broken, not least with the extraordinary cooperation between the private and public sector in this pandemic. And in recent weeks, safe and effective vaccine rollout has started in a number countries, which is an incredible scientific achievement.
“This is fantastic, but WHO will not rest until those in need everywhere have access to the new vaccines and are protected.”