End in sight for COVID-19 pandemic

COVID-19 could be declared over as a public health emergency in 2023, but health systems must be strengthened to brace for future disease outbreaks, say global health leaders.

“The COVID-19 pandemic has declined significantly this year … Since the peak at the end of January, the number of weekly reported COVID-19 deaths has dropped almost 90 per cent,” WHO director-general Tedros Adhanom Ghebreyesus told journalists at an end of year media briefing on Wednesday (21 December).

COVID-19 was declared a Public Health Emergency of International Concern by the WHO in January 2020.

“The virus that causes COVID-19 is not going to go away. But we are going to move it to an endemic phase where people will still get infected but very few of them will get hospitalized,”

Githinji Gitahi, group chief executive officer, Amref Health Africa

Tedros said he was hopeful that the three current health emergencies—COVID-19, Mpox, and Ebola in Uganda—would be over “at different points next year”.

“However, there are still too many uncertainties and gaps for us to say the pandemic is over,” he added. “Gaps in surveillance, testing and sequencing mean we do not understand well enough how the virus is changing.

“Gaps in vaccination mean that millions of people—especially health workers and older people—remain at high-risk of severe disease and death.”

‘Endemic phase’

Githinji Gitahi, chief executive officer for Amref Health Africa, an NGO, is confident that the end of the pandemic is in sight.

“The virus that causes COVID-19 is not going to go away. But we are going to move it to an endemic phase where people will still get infected, but very few of them will get hospitalised,” he told SciDev.Net in the Rwandan capital Kigali, on the sidelines of the 2nd International Conference on Public Health in Africa, last week (13 December).

“That now marks the end of the pandemic.”

Success against the pandemic will be down to the evolution of the SARS-CoV-2 virus, as well as the global vaccination drive, says Gitahi.

“The host—which is us individuals—is changing,” he explains. “But the virus is also mutating. And the rule is that the viruses which survive are the viruses that reduce the death of the host but increase survival.”

For Gitahi, the pandemic has made it very clear: “The future health systems for Africa must be preventative”. He said investment was needed in early-warning systems, disease prevention, and primary healthcare, as well as community education.

Latin American cases up

However, Roberto Chuit, executive director of the Institute of Epidemiological Research of the National Academy of Medicine, in Buenos Aires, Argentina, tells SciDev.Net that COVID-19 cases have been rising in Latin American countries in recent months, with “significant increases” in intensive care units.

“The SARS-CoV-2 virus—although it has stabilised—continues to vary and it probably will present new conditions in the transmission and infection processes,” he says.

“Although we are far from reaching the levels of 2020 or 2021, it forces us to consider that the situation is not over and by 2023 we need to reinforce these processes of care and vaccination prevention.”

According to the Pan American Health Organization, countries in the Americas may still face localised COVID-19 outbreaks in 2023, mostly in institutions such as nursing homes and prisons.

Chuit hopes that new vaccine developments could ease pressure on health systems in the year ahead.

“By 2023, we expect to have a bivalent vaccine, which includes a component of the original virus and a component of the … Omicron variant,” he says.

“This will produce a better quality of antibody in the population, and should also confer better protection.”

China

An improving trend in Asia is now also threatened by the rise in COVID-19 infections in China, since the country eased back on its zero-COVID policy earlier this month (December).

The COVID-19 wave in China is expected to peak in early March, with cases reaching 4.2 million per day, according to estimates from a UK-based health data firm Airfinity.

It has raised concerns across the region. In India—for example—authorities are now monitoring the situation carefully.

“Considering the situation in China and other countries that are showing the surge of COVID-19 cases … we should stay cautious and take up appropriate measures,” says Diptendra Sarkar, a COVID-19 strategist, public health analyst and professor of surgery at the Institute of Post Graduate Medical Education and Research, Kolkata, India.

“It’s only time that will say whether COVID-19 waves will stop occurring in 2023, but, we need to be alert and take steps whenever necessary.”

This piece was produced by SciDev.Net’s Global desk.