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UK News When will Covid end? Experts predict how likely we are to ‘learn to live’ with coronavirus in 2022

08:41  10 january  2022
08:41  10 january  2022 Source:   inews.co.uk

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While Covid cases remain at their highest level since the start of the pandemic, heaping huge pressure on the NHS, there is some hope on the horizon.

Hospitalisations have roughly doubled over the last week, but the spike in people being admitted and deaths is far less severe than in previous peaks in January last year and April, 2020.

Research has shown that Omicron appears to be causing less serious illness than previous variants.

England’s chief medical officer Professor Sir Chris Whitty told a Downing Street briefing on Tuesday that Omicron wasn’t leading to a surge in deaths, but warned that rates among older people were rising and that they were “much more likely to be hospitalised”.

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Yesterday the UK recorded another 179,756 cases, a drop on the previous 24 hours but the 16th consecutive day where the figure topped 100,000.

NHS staff have warned they face a “month of madness” if cases continue to soar, with eight new Nightingale ‘surge hubs’ set up to deal with any spike in patients.

We asked some experts for their opinion on how the pandemic may progress in the coming months and years.

How will the virus evolve?

Studies have shown that Omicron struggles to bypass t-cell immunity induced by vaccines or prior infection, helping to protect against severe Covid.

There is also evidence to show Omicron is less likely to infect lung tissue and increase the risk of serious disease or death, with some experts believing the effects of the virus will become milder.

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Prof Paul Hunter, a professor in medicine from the University of East Anglia, told i: “Ultimately, it will just be another cause of the common cold. And we will treat it like a normal common cold, but that is not going to happen just yet.

“As the disease becomes endemic and as we are exposed to it repeatedly throughout the rest of our lives it will become less and less severe.

“Not because of anything the virus does, but because of this build up of immunity – t-cell immunity – that protects us more and more against severe disease.

“If we get another new variant along that will probably cause a surge in infections but the likelihood is it will be even less severe in its outcomes than Omicron, which is itself less severe in its outcomes than Delta.”

Dr Julian Tang, honorary associate professor and clinical virologist in respiratory sciences at the University of Leicester also thinks the virus is evolving to become a milder version more like the common-cold coronaviruses.

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He told i: “I think Covid will evolve itself out of the pandemic strain of the virus.

“But the timescale is uncertain. You might see occasional new variants that are more severe than Omicron, but that may not last very long, as we saw with Beta and Gamma.”

Dr Joe Grove, a virologist at the MCR University of Glasgow Centre, said while there are “encouraging signs” that the virus is less clinically severe there are “no guarantees” it will continue getting milder.

He told i: “There is some research that we and other groups across the UK and world have done over the last two or three weeks which demonstrates that the spike protein has changed in a fundamental way.

“It has changed the way it enters the cells in our bodies. That molecular change is probably what is underpinning that change in severity.

“It has likely switched to more of an upper respiratory tract infection than a lower respiratory tract infection. That is likely one of the reasons why it is less severe.

“If you have got a virus that is killing 99 per cent of the people it infects then there is a strong evolutionary pressure for the virus to get milder and not to kill people quite so aggressively because then it stops the virus from spreading.

COVID-19: fewer deaths, but mostly affects the mortality due to COVID-19 has fallen sharply since the first two epidemic waves, thanks to the progress made in the treatment of patients and the vaccination. People over 70 and non-vaccinated remain the fir

 COVID-19: fewer deaths, but mostly affects the mortality due to COVID-19 has fallen sharply since the first two epidemic waves, thanks to the progress made in the treatment of patients and the vaccination. People over 70 and non-vaccinated remain the fir If the media no longer do the daily count of the deaths due to COVID-19 , the disease continues to make victims. However, deaths are numerous than at the beginning of the pandemic. Indeed, during the first wave of COVID-19, France France has identified up to 500 deaths per day of the virus, and 400 during the second wave. During the summer of 2021, the figures of the epidemic fell down to the lowest, with about fifteen COVID dead per day.

“But Covid is still killing a minority of individuals. There isn’t really an evolutionary pressure to get milder so we have just been lucky in that respect.”

Will we still need restrictions?

Boris Johnson has insisted current Plan B restrictions must remain in England to protect the NHS, but that we have to “find a way to live with the virus”.

Scotland, Wales and Northern Ireland have brought in stricter controls on social gatherings, pubs and nightclubs to curb Covid’s spread.

Prof Paul Hunter said it is “difficult to be definitive” this month about when Covid curbs may be halted, but believes they should end soon.

He said: “But once we are over the peak, ultimately, what we will have is a lot of people who will be vaccinated and many of whom will have had Omicron infections as well. That will – for a time, until we get the next variant – suppress transmission quite substantially.

“Ultimately, we will start to see the pressure on hospitals waning and I think once we are out of this peak we should get on with our lives normally.

“Once we get over the peak and it starts getting back to normal and the levels when we started opening up again, I think that’s probably the point when we will say we won’t actually need to go back to these sorts of restrictions anymore.”

He said that we are likely to be living with Covid “forever”, with problems likely next winter, but hopefully less pressure on the health service than at the current time.

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Dr Tang said: “Living with the virus – people were doing that. Between July’s freedom day and the emergence of Omicron last month people were quite happy living with 50-60,000 cases a day and about 1-200 deaths per day.

“People were already living with it. We have been there before. It is nothing new.”

But Professor Martin Mckee of European public health at the London School of Hygiene and Tropical Medicine said the phrase “living with the virus” would leave people “with profound uncertainty”.

Speaking to the Mirror last month, Prof Mckee said: “Who can plan to go to the West End theatre, if they don’t know whether there’s going to be a cast on stage, that’s living with the virus”.

And Dr Grove said: “In the UK it would appear we have a higher threshold for strain on the NHS than some nations. Some other nations across Asia and Europe have been more aggressive than this and squashed the infections to the point where they haven’t burdened or shouldered much from the pandemic.

“In the UK we seem to be taking a more relaxed approach. But that is a politician’s decision, it’s up to people to make their own opinions about that.

“A year ago with the UK variant, Alpha, I found myself working in the lab over Christmas and the New Year. I didn’t expect to be doing it again this year and yet I was. I am not a betting person but I wouldn’t bet against myself having to do the same next year.”

Will we still need vaccinations?

Only vulnerable people may need to be vaccinated if Covid evolves to become milder, some experts believe.

The cost and labour of administering current vaccines to new variants “is not going to be worth the effort”, according to Dr Tang.

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He said: “I don’t think we are going to need vaccinations forever. Once the virus becomes mild enough like the common cold we don’t need to have vaccines anymore, except perhaps for someone who is more vulnerable as we do for flu every year.

“We can’t keep vaccinating everybody every six months. It’s impossible to maintain that, especially when the virus is changing all the time and the vaccines we are using are still the same vaccines building up to the Wuhan virus almost two years ago.

“If you use a vaccine that is two years old for a fourth-generation variant – Alpha, Delta, Omicron and the next variant – it’s going to be even less effective.”

Prof Paul Hunter said we may need to give further boosters and vaccines to more vulnerable people for a few years yet.

“I can’t for the life of me see us doing these huge population level boosting like we are doing at the moment,” he said.

“It is plausible we might have another round, but in five years time I can’t see us doing it.”

Dr Grove believes we will need to carry on vaccinating “for a while” adding that Covid had “just made a really dramatic change in the way it is infecting cells and there is no reason to think it’s not going to tweak its strategy further.”

He said: “Omicron has taught us that virus can exhibit a lot of immune evasion and escape immunity from vaccination and infection.

“Ultimately we might be on a journey towards Covid becoming seasonal like the common cold or flu. But there is still a lot of balancing going on.”

How will the pandemic end?

In November, sources told i the Government didn’t expect the pandemic to be declared over for at least another year, with the transition depending upon the effectiveness of vaccines, new anti-viral treatments and new variants.

Prof Hunter believes the pandemic will have “very different endings in very different places” with some countries currently better placed than others.

He said: “South Africa, which still has a relatively low vaccination level, but has had four big waves of infection will have pretty reasonable t-cell immunity against severe disease.

“They will probably see another surge at some point which will be associated with even fewer hospitalisations than we have had in this wave.

“At the other extreme we have got New Zealand who have done pretty well on the vaccine front, but not had much infection and I suspect they will not get to normal living until they have had a nasty outbreak.

“Those of us in Europe where we have done really well at the vaccines and many of our countries have had high levels of infection we will be somewhere in between.”

Covid could evolve us out of the pandemic before vaccinations are delivered to the global population, some believe.

Dr Tang said: “I think overall….at a global level, a longer-term time timeline 12-24 months, I think this virus is going to evolve us out of the pandemic and we may not have to vaccinate people against a milder form of the virus going forward.

“For example, but by the time we have reached, say, Gabon with two doses of the vaccine and the virus then is a variant that is so mild it doesn’t put anyone in hospital and just causes the common cold or runny nose like we see every season then you don’t need to vaccinate them.

“We don’t see the variant going back in time to re-emerge later on. Otherwise we would have seen it by now. Alpha has gone, pretty much. Delta is going very quickly, the Wuhan virus has basically gone.”

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