Extermination, elimination or coexistence with Covid-19?

A study published Friday concluded that the world will not be able to restore its pre-pandemic state. However, if vaccinations and boosters continue, the virus can be eradicated in some areas. (icon image)

Keystone

Will Covid-19 be eradicated, or at least eliminated? Does the world have to learn to live with it as it does with the flu, or does the disease continue to flare? According to one study, eradication is probably not realistic, but local eradication is very likely.

“Elimination could represent a more realistic short-term goal for SARS-CoV-2,” says a study published Friday in the Journal of the American Medical Association JAMA.

In Israel, for example, the judiciary is within reach. New Zealand, Vietnam, and Brunei may also be on the brink of it. On the other hand, the United Kingdom, the United States and China are currently more coexisting, which means that they are trying to deal with the virus. However, in India, other parts of Southeast Asia and much of South America, the virus is currently still raging like a wildfire.

For scientists working with Aaron Kaufman of Emory University in Atlanta, the optimal scenario, global annihilation, is “a very ambitious goal even as a thought experiment.” It’s a reminder that smallpox has been eradicated, even though it was once thought inconceivable. Compared to smallpox, there is an increased risk with Covid-19: transmission of zoonoses by bats, farmed mink or as yet undetected reservoir animals. There was no such reservoir for smallpox.

Keep vaccinating

In order to prevent transmission of zoonoses, vaccination against SARS-CoV-2 and its variants must continue. In order to achieve global eradication – i.e. permanently reducing the spread of SARS-CoV-2 to zero – “adequate herd immunity must be achieved through vaccination and prior infection. This immunity must be “highly effective and long-lasting, preventing secondary transmission and re-infection and protecting against all types of current and future viral variants.” These are very strict requirements.

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According to the study authors, a viable alternative to extermination and eradication would be civilized symbiosis with SARS-CoV-2. In this scenario, vaccine-mediated protection would go so far as to prevent the most severe manifestations of COVID-19, break the chain of virus transmission, and fight the majority of emerging virus variants.

The global community decides

Prerequisites will be universal availability of vaccines, reduced reluctance to vaccinate and fewer variants. “In the long term, when global immunity becomes common due to exposure or vaccination, symptoms of illness can resemble those of the common cold caused by seasonal coronaviruses.”

The worst end-game scenario, wildfires, could occur where there are gaps in the provision of vaccines against some variants and/or when there is significant reluctance to vaccinate. An infection that is not controlled by people who are not immunized will allow the virus to evolve continuously, making it more difficult to contain.

Ultimately, it will “depend on both collective decisions and the reality of the global community, as well as on the often ambiguous dynamics of SARS-CoV-2, as individual countries end up on the end-game spectrum.”

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