Virus should not be underestimated

SARS-CoV-2, the coronavirus that has caused the current COVID-19 the wave has come on and accelerated, the pandemic, has circulated since late wave has begun to withdraw and the number 2019 and was declared a pandemic in early 2020. The two years of this pandemic have been devastating, with more than five million deaths worldwide, more than 850,000 deaths within the United States, and more than 15,000 deaths in Louisiana being attributed to COVID-19. The pandemic has also disrupted schools, church, work, travel and many other things that we were used to doing or have wanted to do. These disruptions from a communicable disease have not been on this wide a scale in nearly a century. In the past, of COVID-19 cases are declining. We are all hoping this will happen in our community in the Ark-La-Tex. It is important to note that we should not underestimate the virus and that it is likely with us for life. That is, it will come and go over the years, with some years being filled with mild and annoying infections and some years filled with more severe outcomes of that returned virus.

Getting back to the “glass halffull” approach that the pandemic is winding down, we see high levels of vaccination around the world, which pandemic viruses were common reminds us that this virus is a global and are now largely forgotten. For threat that any answer must be thought example, smallpox, polio and the 1918 flu all give virologists, infectious disease experts and medical historians the shivers because of the incredible numbers of death and long-term consequences of these viruses over the years.

The questions that we have all been asking are, “What does the end of the pandemic look like and how do we go forward in dealing with the virus? What is a pandemic and what happens when a virus becomes endemic?”

Q: What does the end of the pandemic look like?

A: This answer certainly remains unknown, although it seems like the pandemic is winding down (the “glass half-full” view). The Omicron variant wave has happened quickly, and there have been high levels of spread around the world. Fortunately, as quickly as of in this global nature. We also see natural infections increasing due to the wide rates of infection from Delta and now Omicron; thus, it is likely that everyone will either be vaccinated, infected – or both – soon. This, in turn, will provide most people with some level of protection against circulating variants. It is not ideal to be infected with any of the variants now or in the future as outcomes can be serious for many. Even those with mild outcomes may show evidence of long COVID (there are estimates of up to tens of millions of people with long COVID). Boosters might be needed yearly to maintain high immunity levels and long-term protection from any future variants.

Q: What is a pandemic?

A: When the World Health Organization (WHO) declared that SARS-CoV-2 was a pandemic in 2020, it was about the spread of the virus and not its severity, its virology or the type of virus that it is causing the worldwide issues; it is really based on the rapid and high levels of spread to many countries around the world. A pandemic generally will end more slowly. It could end when the virus is eradicated, or that outbreak stopped, which was observed with SAR-CoV-1 in the 2002-2003 outbreak, for example. On the other hand, the pandemic could end when the virus is declared endemic and found to be everywhere, existing with us for life. This latter idea is currently in favor because of the spread of the virus to essentially all communities around the world.

Q: What does endemic mean?

A: In the simple sense, endemic refers to a virus (or any pathogen) that is always present. In general, this makes rates of infection and spread somewhat predictable. Influenza, or the flu, is a good example of this point. Thus, it is likely that the pandemic will end with a whimper, and we will see this coronavirus and any variants that come up in the future over the rest of our lives. The hope is that it will become like the other mild or benign coronaviruses, be an annoying seasonal cause of cold-like symptoms, and not disrupt our daily lives. As noted above, one should not underestimate the virus, and like the flu, there will probably be mild years, serious years and years where a pandemic is declared. Why is this? Any virus that can mutate (which is all of them), as well as jump species barriers, can change with time to avoid the immune response and/or change how easily it replicates, or where within us it infects (upper respiratory tract vs. lower respiratory tract, for example).

Final Thoughts:

There is much more to discuss this virus and where it might head in the long term. One hopes that the virus will get milder, and as it becomes endemic or stays with us for life as a circulating pathogen, it will not be much more than an annoying pest from year to year. With vaccinations and the new technologies developed to address this pandemic, we now have the tools to deal with the next pandemic outbreak effectively. There will undoubtedly be more, and we must retain this strong surveillance and public health response developed and utilized over the past two years. There have been nearly a dozen significant viral outbreaks worldwide in the last 20 years. Thus, we must remain vigilant and be ready to deal with any future threats robustly and strongly.

The author is a professor and viral immunologist with over 30 years of experience working with the immune system and viral disease. He is currently the executive director of the Center of Excellence in Emerging Viral Threats. He heads the National Institutes of Health Funded Immunology Center of Excellence (Center of Applied Immunology and Pathological Processes) at LSU Health Shreveport.

Andrew D. Yurochko, PhD, professor and Carroll Feist Endowed Chair in Viral Oncology; vice-chairman, Department of Microbiology and Immunology; executive director of the Center of Excellence in Emerging Viral Threats; and director, CoBRE Center of Applied Immunology and Pathological Processes, LSU Health Shreveport.