Covid-19: The end game

Continuing COVID cases, stagnating vaccination rates, PCR testing, masks, and SafeKeys. When will this all end?

Most of the world’s experts agree that COVID-19 is here to stay for the foreseeable future, but what does that mean for Bermuda?

Premier David Burt says, “The old way of life pre-COVID isn’t coming back soon,” and has often referred to not eliminating this infectious disease but to “moving beyond the pandemic.”

Some are suggesting that COVID-19 will have to be accepted and dealt with as an occurs every year on the Island. Cheryl Peek-Ball says that, historically, the here, and that similarly Bermuda could see deaths during what could be described as “COVID season” without any additional restrictions such as lockdowns. Ayoola Oyinloye, told Bermuda Health & Beauty magazine “We are living with the worst pandemic in 100 years, and at this time, we cannot predict when it will end. We do know that it will end, but when the exact circumstances needed for this to happen will occur, sadly, is unknown. Many experts feel that this will eventually become endemic and will be similar to seasonal geography, is predictable, and can often be managed. For example, malaria is endemic in parts of sub-Sahara Africa. The vaccine is spread of the coronavirus and living with this pandemic.”

Kim Wilson, minister for health has stated that, unfortunately, it looks like COVID-19 will be a permanent problem for the Island. “The science and the evidence suggests that, perhaps, in three years time the pandemic will shift to an epidemic mode, and it may become a seasonal issue, like regrettably, by all accounts, we are going to have to live with.”

Bermuda Health & Beauty magazine also sought the views of experts overseas. Dr. University of Manitoba in the Department of Internal Medicine and Immunology and the Canadian Institutes Health Research Sex and Gender Science Chair in Respiratory Health. She also says that it is unlikely that COVID will be eradicated soon, and that in places with high vaccination rates, like Canada and Bermuda, the disease could move to an endemic phase, while a high disease burden will remain elsewhere in the world.

“In countries like Canada, where there are relatively high vaccination rates, and people are – for the most part – following public health protocols and restrictions, I can see it becoming endemic sometime in 2022. That would also hold true for Bermuda.” endemic and pandemic can be tricky. The other caveat she gives with COVID becoming endemic is “as long as we suddenly don’t see a highly virulent form of the virus. With some of the variants, like the Delta, it seems like the vaccines are working well.”

The immunologist says that, going forward, people who have had COVID but not had the vaccine need to be wary. “Without the vaccine, the natural immunity people get from COVID comes down pretty fast. The long-term memory is much less in individuals who have had an infection. The vaccines are designed as such that the body develops memory. The ability is much more enhanced than someone who has not had the vaccine but has had COVID. They will have some immunity, but studies have shown that natural immunity decreases rapidly after infection. It is not the same at all as getting vaccinated.”

Dr. Mookherjee adds that it might become a normal way of life with people getting booster shots every year or two, to be working very well. The vaccines against severe disease, hospitalisation, and death.” She adds that scientists are constantly tweaking the vaccine, as possible against whatever variant might be dominant.

The immunologist says it is likely that people will still have to wear their masks, keep social distancing, and other health protocols for the foreseeable future. “We will still have to do simple things like wearing a mask while travelling, wearing a mask indoors – these types of public health measures will continue for a while.” She explains that part of the problem is the low vaccination rate in many countries, and “pathogens don’t respect borders. Unless there is a certain equity in vaccination globally, these kind of public health measures along with vaccination are the best way to control infection rate.”

Dr. Aaron White is the Jarislowsky chair in biotechnology at the Vaccine and

Infectious Disease Organization (VIDO) at the University of Saskatchewan. He says it’s possible that one day the COVID vaccine booster may be combined with Bermuda Health & Beauty, “It seems like it is headed that way because the virus is staying one step ahead of the vaccine. The vaccines were good against normal COVID, but the virus keeps escaping immunity. It is mutating enough that, even if a person gets vaccinated, the virus is still able to colonise in them – severe disease is reduced – but colonisation is not 100% prevented. It’s kind think will be most prevalent. “But if another aren’t fully protected. That’s kind of what we are getting to with COVID.”

Bermuda saw this situation develop with the Delta variant of COVID. Before September 18, 2020, the Island only had four deaths and 14 hospitalisations of fully vaccinated people. But, from September 19 to October 23, there were nine additional deaths and 19 more hospitalisations from those who had two doses of the vaccine. Even with those higher numbers, vaccinated people were far less likely to end up dead or in the hospital. During these two months, the death rate for unvaccinated people was one in 361 compared with one in 4,910 for those who were vaxed. For hospitalisation, one in every 199 unvaccinated ended up at King Edward compared with one in every 2,326 vaccinated.

Dr. White adds, “As long as there are people who are unvaccinated, and the virus is able to colonise in people who are vaccinated, we will have low levels of this virus circulating in this population. This will make it endemic. There will always be small pockets of people who aren’t vaccinated that will keep the virus alive and moving from person to person.”

He says that, until there is a vaccine booster covering all the current variants, it will continue to spread and won’t be eradicated. Dr. White adds that COVID’s early as a cold, so people don’t take sharper precautions as they should. “There is this big pocket of people who don’t get severely sick but spread it.”

So how long will people have to wear masks and take other precautions from COVID? Dr. White says, “Until we see vaccination rates at 90%. The best thing is to get vaccinated.”

Dr. Elaine Murray, an epidemiologist, science communicator, and assistant professor at the Boston University School of Public Health, described moving from the pandemic to endemic phase of what life will be like with COVID this way. “We don’t have the political or social will to eliminate or eradicate COVID. But that means we have to continue to control COVID. That’s the only other option. That is what endemic means. So, yes, our only viable choice left is COVID becoming endemic. It didn’t have to be this way, but our leaders made a choice. Now they need to make another choice: They need to choose an ‘acceptable’ level of COVID death and disease. Because pandemics don’t end by a disease just fading away, and pandemics don’t end with everyone able to completely forget about the disease. Pandemics end when we decide how much death and disease we’re