Three years ago, on March 11, 2020, the Director-General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, announced that the coronavirus that causes COVID was spreading around the world and that the outbreak was officially a pandemic. Announced. At the time, there were over 118,000 confirmed COVID cases and an official death toll of 4,291.
“We expect the number of cases, deaths and countries affected to rise further in the coming days and weeks,” Ghebreyesus said at a press conference at the time.
Three years later, the WHO documented more than 6.8 million deaths from COVID, but studies of global excess mortality, or the number of deaths exceeding expectations in a given time period, have shown the actual number to be twice that number. suggests that it is more than According to the US Centers for Disease Control and Prevention, there are an estimated 1.1 million deaths from COVID in the US. Doctors are increasingly focusing on possible causes and treatments, but the long COVID, which occurs when people linger or experience new symptoms even after recovering from the initial infection, still emerges as a mysterious threat. I’m here.
According to Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in Boston, the population most at risk today have pre-existing chronic conditions with fragile health and regular hospitalizations. COVID is another factor that is driving these individuals to death. As a result, the pandemic is still causing excessive mortality in the United States. Mortality fluctuates from month to month, but in November 2022 it was about 10 percent higher than before the pandemic, Faust says.
If March 2020 was like a flood, today the world is no longer submerged. But the new normal is only a little worse than before, he says.
Amesh Adalja, a senior fellow at the Center for Health Security at Johns Hopkins University and an infectious disease internist, said there is now a growing awareness that the pandemic virus can rock society. But that awareness is not always translated into action. “Policy makers have not set their priorities high yet, and there are very big questions about how the United States will be able to respond to future pandemics,” he said. From 2022 to 2023, he said, public health mistakes in the monkeypox outbreak reflected early failures of the COVID pandemic, from poor access to testing to clumsy vaccine distribution. says.
“Until then [infectious disease] It’s just as prioritized as national security, so I don’t think we’re going to have full resilience,” Adalja said. “What is needed is a proactive and sustained approach that goes beyond just the election cycle.”
Despite the challenges of building preparedness, we have learned some hard-earned lessons about SARS-CoV-2, the coronavirus that causes COVID. This could help future pandemics, and our approach to public health in general.
mRNA vaccines are safe, potent and effective
One of the clear successes of the response to the COVID pandemic has been the rapid development of an effective vaccine.
Pandemic is the first large-scale test of mRNA vaccine technology, which has proven to be safe and effective against severe illness and death, even as the virus evolves and forms new subspecies. rice field. A recent analysis by the Commonwealth Foundation, an independent research group focused on health care issues, found an estimated 18 million hospitalizations and 3 million deaths due to vaccination in the two years since the vaccine was introduced in the United States. were found to have been prevented from dying.
mask work
Masks and mask mandates became a political flashpoint during the pandemic, but evidence shows they slow the spread of COVID and other respiratory diseases. For example, according to the CDC, as of late 2021, at least 10 studies found infection rates declined after local governments implemented universal mask mandates.
The best protection comes from quality N95 and KN95 masks. CDC’s February 2022 Influential Publications Weekly reports of morbidity and mortality They compared mask-wearing habits between those who tested positive for COVID and those who did not. Among the 534 participants who reported mask type, consistent cloth mask use reduced the chance of testing positive by 56%, wearing a surgical mask reduced the chance of testing positive by 66%, and N95 or KN95 83% lower chance. Masks are most effective when well-sealed, worn correctly, and when other precautions are taken.
indoor air quality problems
In early 2020, no one knew how the virus spread. The CDC and other health organizations around the world were sending mixed messages. Hand sanitizer has become a national obsession. People swept out groceries or left them in garages overnight.
However, research quickly confirms that the virus spreads primarily through the air rather than surfaces. This realization has led to interest in improving indoor air quality through both ventilation (bringing in outside air) and filtration (removing particles and pathogens from the air). Studies have shown that continuous high-efficiency particulate air (HEPA) filtration removes the majority of airborne COVID virus particles, dramatically reducing exposure. Also, the effect he is not limited to COVID. Filtration also removes other virus particles, such as influenza, from the air.
Wastewater tracking helps with COVID and other diseases
The idea of tracking the spread of the virus through wastewater was first born in early 2020 and is now a national program. Wastewater begins shedding SARS-CoV-2 before people feel symptoms or seek medical care, thus providing up to weeks of warning of a virus surge. Integrated with monitoring. Scientists have used sewage to track surges in viruses such as RSV and influenza.
Genome surveillance is key to tracking viral evolution
SARS-CoV-2 will not remain static. Over the past three years, variants such as Delta, which caused a surge and severity of the disease in 2021, and the highly contagious Omicron, which spread rapidly in late 2021 and remain the dominant variant worldwide, have increased. It has changed the course of the pandemic. Omicron’s subvariant currently accounts for his 99.9% of all cases, but its dominance increases or decreases as variants outcompete each other and spread throughout the population.
Countries and health organizations around the world are now establishing genomic surveillance to track novelties for variants. Strong surveillance is key to meeting the twists and turns of the new pandemic, said Gervus Barbosa, director of the Pan American Health Organization, which coordinates regional genomic surveillance networks in the Americas. The challenge is to maintain interest in these efforts even as the acute phase of the pandemic recedes.
At a press conference on March 9, Barbosa said, “As we learn to live with this virus, countries must maintain and continue to step up surveillance. The risk of new variants is real. It’s something,” he said.
