Last week, researcher Dr. Christina Pagel tweeted about why the pandemic is not over yet. Pagel contends that the Omicron variant does not actually signal viral endemicity, a phase where transmission should look more stable and predictable.
CHRISTINA PAGEL, MD, c.pagel@ucl.ac.uk, @chrischirp
Pagel is a professor of Operational Research and Director of University College London’s Clinical Operational Research Unit.
Pagel asserts that new variants will emerge and will not necessarily, or even likely, be milder than Omicron. This is because none of the main variants we have seen so far evolved from one another; instead, they have all been part of their own distinct lineages. Omicron’s mildness (much debated in the first place) may have been “pure chance.” Contrary to some publicized assumptions, there is “no steady progression to mildness.” In fact, because most COVID transmission happens “while people have no or few symptoms… there is no particular reason for severity to play a role in evolutionary selection.” Further, because vaccines are less protective against variants that are further from the wild type, vaccines formulated for current strains of the virus are likely to be less effective against new strains.
Pagel says: “Omicron is just the latest variant to sweep the world. Given the near inevitability of a new wave, whether it’s in three months or a year, we need to prepare so that we can reduce its impact. This could involve improving indoor ventilation, having plans to increase testing and contact tracing, introducing mask mandates in a new wave, strengthening health services, improving sick pay and encouraging vaccination.”
These recommendations have been echoed by some U.S.-based doctors, like Stanford infectious disease physician Abraar Karan, who says that the COVID-19 dialogue in the United States is overly focused on the lifting of public health restrictions.
Dr. Karan says the questions he cares about right now are: “What are we doing for preparedness? For health equity? How is indoor air and ventilation going to be improved in schools, businesses, and public places? What’s the timeline? Cost? Who is paying? What’s the accountability mechanism if this doesn’t happen? When will N95 mask supply be increased and to what extent? How will it be distributed? What were previous bottlenecks and how have they been addressed? When will more comfortable options be added? Will poorer communities have more access and supply? What about the terrible comms? What’s the plan for future vaccines? How are we addressing distribution shortcomings? What about ongoing vaccine hesitancy or resistance––what efforts are in place to address this? And what about further closing vaccine inequities globally––what are we doing about this?”
