This is the first in a four-part series looking at facets of the pandemic.
The end of the pandemic may be in sight says World Health Organization director-general Dr Tedros Adhanom Ghebreyesus. Although we’re not out of the woods just yet, weekly global COVID-19 deaths have hit the lowest number since the pandemic began.
There are clear metrics for defining a pandemic — from how widespread to how deadly a disease is — but there’s no clear definition for its end.
In this four-part series, Crikey looks at how the end can be defined, how the impacts of COVID are here to stay, and how normality is not the same for everyone.
What’s the situation now?
The past month has seen a steep decline in COVID cases and deaths across the world. Global weekly cases have dropped to about 3.45 million, down from an all-time high of 24 million. About 6.5 million people have died, but deaths are at an all-time low. In Australia, there’s been a 20% drop in new daily cases in the past week alone.
Vaccines are to thank, with 62% of the world’s population fully vaccinated against the disease. Second-generation vaccines — jabs tailored to protect against the Omicron variant instead of the initial Wuhan strain — are being approved and released across the world.
But that doesn’t mean the virus will soon disappear. Although passengers will no longer have to wear masks on public transport in NSW and South Australia, Prime Minister Anthony Albanese announced last week that pandemic leave disaster payments would be extended for as long as mandatory isolation periods were in place, signalling that the effects of the pandemic are here to stay.
Damage, disease and death over behaviour
Do we define the end of the pandemic by measuring the dangers of a virus or by how the public responds to the threat? Is it about transmissibility or complacency?
Deakin University epidemiology chair Professor Catherine Bennett told Crikey that “pandemic” was a trigger word for countries to work together to coordinate their response to infectious diseases.
COVID-19 would no longer be a pandemic when the international community recognised “we no longer need the capacity to respond to a crisis globally, in the same way”, she said — something that would be retrospective. It was less about the disease and more about our ability to manage it.
As with HIV, Bennett said, COVID-19 is a human pathogen that’s here to stay, with the world moving to co-evolve with the virus instead of being in crisis mode — though still alert for transmission upticks.
For University of Queensland infectious disease physician Dr Paul Griffin, the definition is ambiguous: “A pandemic is defined by when we see more transmission than expected normally in a number of locations. So the end is kind of the opposite of that initial definition.”
But we have no baseline for “normal” levels of transmission for the novel coronavirus, he said, and the virus isn’t going anywhere.
“Even when the pandemic … is [declared] over, it’s not going to mean the virus is gone. It’s going to mean it’s still going to be circulating at lower levels, and we’ll still expect to see waves of transmission increase, hopefully, to lower magnitude and less frequently than we’ve seen recently.”
For University of Sydney infectious diseases paediatrician Professor Robert Booy, the definition is a little clearer. For him, it’s not about case numbers but about impact: “Influenza transmits. The key issues are its case fatality rate, its damage, its disease and its death. These spell out whether the virus is no longer a pandemic of severity, rather than an infection that spreads easily.”
A warning on complacency
Ghebreyesus was careful not to signal the end of the pandemic, saying instead that the world needed to sprint to the finish line by focusing on testing, clinical care, vaccines, infection control, rebuilding trust in public health authorities and addressing misinformation.
Booy was even more cautious: “Anyone who says we’re definitely at the end of the pandemic hasn’t learnt from the past two and a half years where the virus continues to surprise and evolve.”
Viruses continuously mutate and evolve, becoming more transmissible but less deadly. Vaccines combined with natural immunity means we’re currently about 10 times less likely to die from COVID than we were at the start of the pandemic, Booy said, and each iteration has fewer mutations than at the start of the pandemic.
But he warned: “There may still be some tricks up the sleeve of the virus.”
It’s still better to be vaccinated for Covid than expect that once you have had Covid you are safe from other attacks.
I’d rather make sure that I don’t have long Covid.
Doesn’t sound all that good- fuzzy mind, shortness of breath- no not for me.
A fast needle in the arm is for me every time.
Thanks science for keeping me safe.
I think “Long Covid” is of major concern and it’s something we still don’t know a lot about. Cardio Vascular issues were something I read about recently. So minimising the transmission should still be an important initiative IMO.
see theconversation com
search even-mild-covid-raises-the-chance-of-heart-attack …
Couldn’t post the actual link. The nonce bot complaining.
Yes after my 4th jab (yes I’m over 70), I actually got Covid from somewhere it and isolated for a week. A bit of discomfort and since then (a few months) no furhter issues at all. I would never spurn a beneficial vaccine.
Amber how can we in Australia be 10 times less likely to die of COVID than a few years ago ? Deaths in Australia so far this year are over 10.000 compared with 2000 deaths in the first two years. Please explain.
It’s about the virulence of the disease, not how it spread. If we didn’t lock down in 2020 and contain the virus, the numbers would have been far higher than this year’s numbers. The virus is less virulent now, thanks mainly to the use of vaccines.
We reduced movement to reduce transmission early on, so less were catching Covid. She means the chances of dying IF you HAVE Covid, not the general risk.
You know Amber I do not expect your article to attract a great deal of comment. Not because it is unimportant but rather because we have ‘moved on’. Once upon a time I can recall as few as ten deaths daily being the cause of anguish and concern. Now we lose over 350 people weekly and one hardly bats an eye. I presume that each of these have others who will grieve greatly over their loss. But apparently there is little grief from the self-serving.
We have now been conditioned to accept without question by the media, government and business that this is the ‘new’ norm. This is an acceptable trade off for ‘our freedom’ our right to do as we please and to hell with those at greater risk to life and well-being than ourselves and most of all what must be sacrificed at the great ‘altar of the economy’
Strange I thought the economy was there to serve us not the other way around.
I note that there was great outpouring at the death of the Queen. I pose the question ‘Is the death of Queen Elizabeth 11 COVID19’s highest profile victim’?
We already know of ‘long COVID’ even if it is not fully understood.
Recent research is now finding evidence of COVID19 induced deaths as late as 6 -12 months after an initial infection. This finding holds whether the initial infection is mild – as supposedly was the Queen’s or more serious. While the risk of later death is higher for the more serious infection the odds of death are still higher for even mild infections and presumably more so for older persons.
I still have not heard one thing regarding the circumstances of the Queen;s death.
Yet government, business groups and the selfishness of many people who now find the smallest restrictions intolerable continue to push on reducing safeguards to CODID19 infections. So much for any concern for the lives and welfare of others, especially those most vulnerable.
But bad as this is we have heard said many times COVID19 has less impact on our children. Really!!! And how do we know this/ In fact by allowing COVID19 to rip as did the Swedes we may find that it will take many years for the impact’s of COVID to wash through our society.
For all those who find maintaining even the bare essentials of restrictions to reduce the spread of COVID and knowing what we do of its long term impacts then to that extent we as a society are complicit in whatever the consequences may be down the track.
Friedrich Engels, a 19th century philosopher although writing about the evils of unbridled capitalism in industrial England could just as easily be describing our current attitudes to COVID and the other’s well being: ‘…the brutal indifference . .. of each in (their) private interest becomes … repellent and offensive’.
The economy does serve us. If things progressed as they were in 2020 and 2021, the end result would be cities without food or sanitation.
People need to live, and by live, I mean survive. this is why Covid is over, so that we can survive.
This virus is real, but also heavily politicized, it will never end whilst political or financial benefits can be engineered from it.
PS I saw a good name for it online somewhere the other day, “Covid1984”, ala George Orwell.
I’m glad that in the 2nd last paragraph natural immunity was acknowledged as a significant factor in the slowdown of infections and deaths.
Throughout the pandemic, vaccination was very often presented as a panacea, but it wasn’t as effective as it was promised to be.
A recent study out of Qatar showed that natural immunity from a previous Covid infection in unvaccinated individuals offered far more protection against the Omicron VOC (symptomatic) than 2 shots of Pfizer in people who had never contracted covid previously (46% efficacy vs -1.1%)
3 shots without prior infection, and 2 shots with prior infection were slightly more efficacious than prior infection alone, while people who’d had a prior covid infection and 3 shots had the highest rates of protection.
https://www.nejm.org/doi/full/10.1056/NEJMoa2203965?query=featured_home
“Throughout the pandemic, vaccination was very often presented as a panacea, but it wasn’t as effective as it was promised to be.”
I have a very different recollection of this. For the first 12 months, I remember the uncertainty and pessimism about the vaccine – would we even get one given no successful vaccine for a coronavirus, and if so just how effective would it be? I remember talk about 50% efficacy against severe disease being an achievement. What we got turned out to be a lot better than that.
Guess it depends on where one gets their info. I don’t remember anyone even implying the vaccine is a panacea, let alone calling it one. Just that it was a lot better than not getting vaccinated (still true).
Really?
You don’t recall government health officers and state premiers describing vaccines as our “path back to normal”?
You don’t recall govts mandating workers to receive said vaccines? And promising to open up the economy again once 80% of the population was vaccinated? You don’t recall the daily 10am press conferences where vaccinations were frequently talked about and regularly described as “the only way out of this”? You don’t recall that lockdowns would end once vaccination rates were high enough?
While no one uttered those actual words, covid vaccines were frequently implied to be panaceas, particularly by government officials, which is why experts had to come out and remind people that additional measures would be required.
https://www.afr.com/policy/health-and-education/modelling-says-vaccines-alone-won-t-be-panacea-back-to-normal-life-20210705-p586wi
That’s how I saw the situation.
There was pessimism in 2020 about the likelihood of developing a vaccine quickly, but in 2021, no vaccine mania took hold. Every day the media reported how many jabs had been delivered the day before, and the vaccination status of every person in hospital with covid.
The AstraZeneca vaccine was widely reported as having an efficacy of 65%, while the majority of Australian media breathlessly reported that Pfizer and Moderna had efficacy rates over 90%. I don’t recall Crikey, the Guardian, or the ABC ever reporting a 50% efficacy rate.
None of those say, or even imply, it’s a panacea. They imply that it was a necessary step at the time, which it was given what the vaccines did in terms of reducing spread and severe disease. In that, there was always the possibility that a vaccine-resistant strain could take hold (beta was mentioned), and that happened after.
I also think you’re being selective in your memory of 2021, where the scare over the potential danger of Astrazeneca made headline news. At one point, ABC News had two separate headlines on the same day about suspected AZ deaths, which is a horrible shame because uptake slowed right before the delta breakout. Same goes for the government bodies that caved to the pressure of the scare and played it super safe by changing the recommendation of who should get the AZ vaccine.
“particularly by government officials”
I’m curious to meet the person who listens only to government officials and doesn’t put that into context. Political messaging is deliberately crafted to be simple and easy to follow. It should be! Even with the sorry state of journalism today, the media still featured experts who were more than willing to put what was going on into context and explain things. Political messaging is about changing behaviour, experts are for understanding. If you conflate the two, no wonder you think it’s implied that it was a panacea…
Fair enough. Our personal experience shapes how we see things, and we view this differently.
And I’ll concede that AZ got some negative coverage in 2021, though I’m not sure I can agree with your wording that govts “caved to the pressure of the scare”.
There are several govts who this year have made large compensation payments to the families of ppl who died due to side effects from the AZ vaccine.