May 23, 2022 | Rome, Italy

COVID: It ain’t over

By | 2022-02-19T16:00:40+01:00 February 4th, 2022|"Bedside Manners"|
Among so many differing opinions regarding the virus, Fauci's is the most circumspect.
I

s the pandemic nearly over and is the SARS-CoV-2 virus about to become as common and tame as the common cold?

If you believe medical profiling guru Chris Murray and other experts, the answer is yes. In early December, I, too, might have been nodding my head in agreement. Even in late January, the World Health Organization’s Regional Director for Europe, Hans Kluge, was beating that drum: “Omicron may turn out to be not the variant from hell but the variant from heaven.”  It was plausible, he added, that Europe was “moving towards a kind of pandemic endgame.” But his boss Tedros Adhanom Ghebreyesus backed him up only in par. “Countries can end the acute phase of the pandemic this year,” he explained, but warned that speaking in such terms was risky because “conditions are ideal for more variants to emerge.”

What some at the WHO think but do not say out loud is that the next variant may be even more contagious and vaccine-resistant. Some suggest it will also be significantly more severe.

My December optimism is therefore over. I say this, Omicron is only heavenly if we assume:

  • That nearly everyone will at some point become infected, and
  • That infection isn’t such a bad thing if the illness is mild or the patient is asymptomatic or barely-symptomatic, and finally,
  • Being infected will guarantee permanent immunity against present and future variants.

Heavenly? Not quite.

The antibodies that keep some people largely infection-free have a short shelf life, some say a year tops.

It’s true that an early study of the virus suggested those who were asymptomatic or suffered only mild illness would help induce immunity — but that work was done long before variants altered the landscape by demonstrating the virus’ many faces, some brutal (Delta), others relatively benign (Omicron).

It is now believed the antibodies that keep some people largely infection-free have a short shelf life, some say a year tops, which would leave now hopeful masses anything but shielded from the next incarnation of the virus, whatever its potency.

Much recent optimism was generated by a report that found antibody-producing cells could remain at the ready in bone marrow for as long as eleven months after a mild COVID-19 episode. It was this finding, above all else, that created the “If you’ve had it once, you’re out of the woods” line that sounds great but lives mostly in fantasy-land.

Again, variants didn’t exist when these ideas first began making the rounds. Now, nearly two years after COVID-19 grabbed the headlines, variants are the name of the game, if not the framework that houses most discussion about COVID’s future.

It’s true that most patients with mild infections are largely protected against reinfection for up to six months after becoming infected, but frankly not a very long time. According to the Centers for Disease Control, research conducted in Brazil and the American state of Kentucky suggests that some patients didn’t even make it to the six month mark before contracting the virus again. There are simply no absolutes when it comes to this virus.

Based on this, and on other research, the cheering idea that Omicron’s mildness means the pandemic is over is, to steal a line from a no-nonsense news reporter, “a mass delusion.”

The only Omicron data relevant to reinfection rates and patterns comes from a tiny study that asserted anti-Delta antibodies rose among some of those infected with Omicron —  but only if they’d had Delta first. Sorry, but this is flimsy stuff.

The idea that Omicron’s mildness means the pandemic is over is, to steal a line from a no-nonsense news reporter, “a mass delusion.”

More to the point, there are already real-world hints that Omicron doesn’t even protect against re-infection from Omicron. It certainly doesn’t shield from other existing variants. And here by the way is a word about Delta: Nothing prevents it from making a comeback after the Omicron surge has run its global course. Again, this virus comes with few certainties, making blanket statements about an end in sight or it becoming endemic is both premature and foolish.

Listen please to the words of American COVID veteran Anthony Fauci, who always errs on the side of caution: “It is an open question as to whether or not Omicron is going to be the live virus ‘vaccination’ [as in antibody protection] that everyone is hoping for.”

Recently, six former scientific advisors to President Joe Biden made waves by publishing medical opinion essays in which they rec0mmended ways of creating a “new normal” to reduce the exhausting pressure placed on the American health systems by this crisis. Most of their many recommendations were uncontroversial. Quicker and easier access to masks, easier and better testing, improved processing of swabs, and, of course, universal vaccination. They also reminded the public of the vital need for better ventilation and air filtration in health facilities and all public places.

More complex was the suggestion that the entire medical infrastructure be overhauled as quickly as possible to make public health reporting more centralized, widening the medical data base and making it easier to access.  Better surveillance of vaccine effects was also essential, they added. In all, the list was a tome of its own.

There is of course no lack of opinions about this virus, both by those in the know and by those who really shouldn’t be discussing medicine they know nothing about.

I do know a little about medicine. Trust me when I tell you the “Omicron solution” is no solution at all, just wishful thinking on the part of millions who want all this to just go away. Unfortunately, that’s not the way a virus thinks. Four variants does not mean there won’t be a fifth, or a tenth, or that the thirteenth isn’t positively lethal.

It’s good the WHO is hopeful. Let’s now hope the hopefulness is scientifically justified.

About the Author:

New York native Susan Levenstein, MD, maintained a private practice in Rome for four decades. She maintains a blog and in 2019 published a book of memoirs entitled"Dottoressa".

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