Could COVID-19 get worse than the flu year after year? – Community News
Covid-19

Could COVID-19 get worse than the flu year after year?

There is a growing consensus among experts that the coronavirus will likely be with us for many years to come and show up in the pockets even when most people around the world have immunity through vaccination or natural infection.

So healers can expect to deal with some degree of ongoing COVID-19 burden once the virus enters what epidemiologists call an endemic condition, one in which a pathogen simmers and smolders, producing new cases year after year, but the heights not achieved when the level of community immunity was low.

How heavy will that burden be?

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In the short term, with global vaccinations still far from universal, most predict another wave to come this winter. However, vaccination is expected to keep things from spiraling out of control as they did in late 2020 and early 2021. A new variant that could oust the Delta variant from its current dominance could change that outlook.

Since this is the first winter without a home order, it’s already clear in weekly reports that San Diego County will have a flu season this year after seeing very little flu activity in late 2020 and early 2021.

To date, 287 confirmed flu cases have been reported since July 1, nearly 16 times the 18 reported last season. And this year’s rate is slightly higher than the previous five-year average, which includes nearly 12,000 cases per season and 123 deaths across the province.

Winter will then be the first year the region and country feel the full force of the flu and coronavirus at the same time, and experts fear it won’t be the last.

Some highly educated guesses are already pointing to the possibility that the coronavirus could eventually cause as many or more cases than the flu.

It’s one of three scenarios a team of UC San Francisco researchers considered in a paper published in July in the journal Nature.

One possibility is that the virus will not come under relative control as global immunity builds, leading to “a future of persistent manifestations of serious diseases combined with high levels of infection.”

Considered “more likely,” a second option is that SARS-CoV-2 will enter an endemic state similar to the flu, which the U.S. Centers for Disease Control and Prevention estimates kills between 12,000 and 52,000 Americans each year.

The virus, researchers noted, could also behave more like other coronaviruses, which typically have a significantly lower impact than flu, in an endemic state.

When they published four months ago, the research team was hesitant to choose a scenario from the three, stating that more information was needed.

But as the cases increased, some began to feel more comfortable taking responsibility.

Much attention has piled up around a series of 17 tweets from Seattle-based computational virologist Trevor Bedford, recently named a MacArthur Fellow for his work modeling the introduction and spread of the novel coronavirus and his advocacy of real-time genetic sequencing as an essential method to help predict how the pathogen is likely to evolve.

Noting that the new coronavirus has shown an unusual ability to mutate, and that there is ample evidence of declining immunity among vaccinated and unvaccinated, Bedford says his best guess is that endemic coronavirus affects “20 percent to 30 percent” of the population. the population infects every year. In comparison, influenza is estimated to infect about 10 percent of the world’s population each year.

Such a high attack rate, Bedford notes, would produce a greater death rate that could range from 40,000 to 100,000 per year in the U.S.

“Most infections would be relatively mild (just like the flu), but there are plenty that add up to even a small fraction of the serious consequences,” Bedford said.

It’s a prediction that’s terrifying public health officials.

Some years, Dr. Seema Shah, medical director of the San Diego County epidemiology division, said the flu could flood emergency departments in the winter on its own. The idea of ​​adding a similar number of coronavirus cases on top of that is particularly daunting.

“There are some predictions that the coronavirus could cause double the number of annual flu deaths,” Shah said. “How do we allow that level of risk for so many Americans to die each year?

“I find that hard to digest.”

San Diego County is home to plenty of viral evolution experts, and while they all say Bedford’s scenario is certainly possible, this virus has proven itself enough as a wildcard that certainty is scarce.

“I wouldn’t be surprised to see SARS-CoV-2 variants continue to emerge,” said Joel Wertheim, an evolutionary biologist at UC San Diego whose work has traced the early appearance of the virus in China. “That said, every variant, every vaccine, every reinfection changes the dynamics.

“The sand will constantly shift, but this virus has no reason to stop trying to develop more efficient ways to infect and re-infect us.”

Kristian Andersen, a microbiologist and immunologist at Scripps Research in La Jolla, whose lab has spearheaded the global effort to map the mutations in the coronavirus as it spreads around the world, agreed that the outcome of the flu is very possible but not certain. The focus, he has said repeatedly in recent months, should be on reducing the total number of new infections. Every time a virus multiplies, there is a chance of a beneficial mutation.

For too long, he said in a recent email, the sign of public health success in the fight against coronavirus has seen the number of people getting sick enough to be hospitalized have fallen. But reducing infections in the meantime will require higher vaccination levels and, in the short term, stricter masking and social distancing practices.

“Unfortunately, there’s no appetite for something that I’m pretty sure (though not sure) will be a decision we’ll regret later,” Andersen said. “If we had taken this virus seriously from day one, as most experts insisted, I don’t think we would be talking about ‘alpha’, ‘mu’, ‘delta’ and the rest.