The initial shock of Omicron is over, and it appears that the covid-19 cases are declining globally. Moreover, vaccine availability and its acceptability are improving. It almost looks as if the covid-19 epidemic will end in many places. But it is too early to make any conclusions. Emerging data suggest that covid-19 still poses a significant risk, and it will continue to be one of the leading causes of morbidity and mortality in 2022. Not only that, it may make a sudden and unpredictable comeback in many places.
Cases of covid-19 might be declining, but the chances of rebound are high
Cases of covid-19 are indeed declining sharply and globally. However, it is still causing a significant number of infections. The number of infections is almost close to what it used to be about a year back, in mid-2021.
Although the number of people affected by covid-19 in spring and early summer of 2022 remains moderately high, the number of covid-19 related deaths is relatively low. There are many reasons for low covid-19 associated mortality from vaccination, and improved treatment, to low mortality associated with prevalent variants like Omicron.
However, one should be careful in interpreting all the data. For example, the WHO covid-19 dashboard shows that about 6 million plus people died by May 2022 due to covid-19 since the pandemic's beginning. However, at the same time, WHO suggests that actual deaths are perhaps twice more and are close to 15 million. Such a significant difference is due to the fact that many infections and deaths go unreported in developing economies.
Considering that covid-19 is highly mutative, it is quite likely that new variants may keep emerging. Thus, the probability is high that the infection may rebound in autumn 2022.
We might see localized eruptions of infection in the near future
There are already early signs of it that instead of a sudden upsurge in the cases worldwide, we are more likely to witness epidemics in one or another region. There are many reasons for that, such as the use of medications, different levels for vaccination, varied approach to a booster dose, genetic differences between the people, and more.
It is pretty clear that despite the declining number of covid-19 cases, it will not disappear completely. The recent upsurge of the infection in Shanghai indicates what lies ahead. We are more likely to witness localized and significant upsurges of the infection.
However, due to a better understanding of the infection, there are also greater chances that most countries would be able to control the spread of infection. Thus, in early May, covid still continues to be a significant health threat in South Korea, Italy, Germany, France, North America, and some other nations. However, by autumn picture may be pretty different.
Evolving approach to preventing and managing covid-19
When it comes to preventing and managing covid-19 infections, apart from vaccines, perhaps the pharma industry will start playing a more significant role.
Unlike 2021, there are now few pharmacological options that can help prevent covid-19 spread. Additionally, covid-19 treatment is now supported by greater evidence, and thus medical experts know what works and what does not.
Covid-19 causes biphasic illness. The first phase, which may last as long as a couple of weeks, is about increasing the viral load. It causes symptoms reminding viral respiratory tract infections. During this early phase, a person can readily infect others. However, there are low chances of hospitalization or fatal outcomes during this phase. During this first phase, antiviral drugs are pretty good at preventing the progress of the disease.
Early initiation of antiviral drugs during this phase may help reduce infection severity and prevent the spread of infection. However, antivirals help if started quite early, within 2-5 days of the beginning of symptoms. The drugs that may help during this phase are nirmatrelvir and ritonavir combo, Molnupiravir, Sotrovimab, and Remdesivir.
It is evident that life-threatening illness occurs in the second phase. In this phase that starts after 10 to 14 days, viral load is relatively low due to the initiation of the immune response. However, severe illness ensues mainly due to a cytokine storm or hyperinflammatory response. Thus, there is little benefit from antiviral drugs during this phase, and greater focus...
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