Those of you who have been reading this blog faithfully and those who know me personally understand that I’m not someone who makes predictions lightly. In part it is because I have an aversion to being incorrect! Despite this, I am predicting that 2022 is the year that the COVID-19 pandemic burns out.
That doesn’t mean there won’t be SARS-CoV-2 infections in the coming year, or that news outlets won’t breathlessly announce every new variant. It means that by some time in 2022, for practical day-to-day living activities, COVID-19 will not define our actions.
Why am I so comfortable in saying this?
Recently on Flashpoint on WDIV, Devin Scillian asked me when we would “turn the corner” on the pandemic. My response was that it would be more like a downward slope in infection waves rather than an abrupt turn. The following graphs illustrate what I was suggesting.
We have been focused on number of infections with COVID-19 because of the very sensitive and accurate diagnostic tests (PCR) we have developed. In contrast, as we look at the end of the pandemic, we now need to focus less on infections and more on deaths. That is truly the important marker of a pandemic’s impact and the only comparable measure to the 1918 flu epidemic where there were no diagnostic tests.
In the 1917 flu pandemic, after the initial burst of infections and deaths, two waves of deaths followed, each one less impactful. This is how pandemics end; two “echo” waves each being less and less significant. It is because in each wave the most susceptible individuals have been killed off as the rest of the population develops immunity. A similar pattern was seen in the 2011 Influenza A pandemic and it has now emerged with COVID-19 (figure below). This pattern shows the COVID-19 pandemic is burning out.
While the pandemic has had horrific costs, we have accomplished much with advanced care, vaccines and therapeutics. All immunity is the same whether from vaccine or virus. The concept of “natural” immunity being better is just not valid. Worldwide, the 5.5M excess deaths from COVID-19 are about 10% of the 50M deaths from flu in 1918-1919. That pandemic was “managed” with “natural” immunity. Thus, the improved outcome is in no small part due to vaccines.
These medical advances, however, are only partly why deaths are falling from their peak at the beginning of 2021 despite the current, huge increases in infections. The succeeding waves of death, while overall smaller, are still present and occurred with significant portions of the population (U.S. and world) being unvaccinated. Each wave of infection provided more exposure to the COVID-19 virus, leading to immunity that has helped protect the entire population.
At the same time the virus has been hysterically mutating to try to facilitate its survival. It has sacrificed pathogenicity (killing) for transmissibility to improve its chance of infecting people. Omicron is the latest and best example of this. As is always the case, however, the immune system eventually wins out. That is how the human race has survived.
Therefore, make a toast today to the coming end of the pandemic and honor those we have lost. And remember to be grateful for the remarkable capability of our immune system. It has provided us with the ability to survive the worst that nature can throw at us.