Coronavirus: "SARS-CoV-2 remains unpredictable and life-threatening" says top WHO official

"It is too early to talk about the endemicity of the virus in 2022"

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These days mark an anniversary that we all wish did not exist. This is the European anniversary of the two years of the SARS-CoV-2 pandemic (on January 24, 2020, France became the first European country to confirm cases of COVID-19): two years full of mourning, pain, fear, anxiety, isolation, catalysis of life as we knew it on all levels.

But also two years full of scientific progress and achievements, altruism and self-sacrifice, two years that taught us, in the harshest way, the truth is that pandemics are extremely real dangers that become a tangible reality and require readiness, cooperation and solidarity.

Is this the second pandemic anniversary the last we will be forced to "celebrate"? Is the fast-spreading Omicron variant of SARS-CoV-2 spreading across Europe at tremendous speed the road to the end of the pandemic? And how many more mutant obstacles do we have until the end? These and many other burning pandemic issues were raised by BIMA-Science to one of the "key" people at European level regarding the two-year-old pandemic of SARS-CoV-2, the regional director of Europe of the World Health Organization ( ΠΟΥ), δρα Hans Henry Klugge.

The 54-year-old Belgian doctor and public health specialist said that it is too early to say that the endemicity of the virus will become a reality in 2022, while stressing that in order to reach the point of a more normal coexistence with SARS-CoV-2 we must not case to underestimate its new pandemic face, the Omicron variant, considering it "innocent". He added that with our actions we will play a decisive role in how quickly we will reach the finish line of the pandemic crisis.

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The sweeping Micron

Dr. Kluge spoke of an Omicron wave that is currently sweeping Europe from west to east: "Evidence shows that the Omicron wave has already reached - earlier than expected - its peak in some countries, especially in Western Europe. At the moment the variant is spreading to Eastern Europe, with a very high peak of cases in the Balkans. "Micron is displacing the Delta with unprecedented speed and its wave is coming to add to the already big wave of the Delta, which the countries were trying to manage by the end of 2021". According to the head of the WHO in Europe, the course of Omicron in each country will be… a personal matter. "The peak of Omicron will depend on many parameters, including the measures that will be imposed depending on the transmission in each country and of course the level of vaccination. "The peak will be different in each European country based on the prevailing epidemiological situation."

Despite the differences, will the admittedly "sweeping" Omicron be the one who will lead (some sooner and others later) to the pandemic end, as we hear more and more often? "Although we have come a long way since January 2020 when the first case was confirmed COVID-19 In Europe, it is too early to say that SARS-CoV-2 is endemic - it may become endemic in due course, but to say that this will happen in 2022 is premature. The virus remains unpredictable, highly contagious and life-threatening, and it is not yet time to discuss how to "harmoniously" coexist with it. This will send the wrong message to the population, causing them to relax their defenses at the most inopportune moment. Eventually the entire population in Europe will acquire some form of immunity to the virus either through vaccination or through disease. The choices are the same for everyone: to be vaccinated or to get sick, but knowing that a full vaccination can save him from hospitalization and death. The virus is constantly and rapidly evolving, constantly posing new challenges to us. And we must not forget that if and when it becomes endemic will depend to a large extent on us. "Increasing vaccinations on a fair basis both in Europe and globally will be the key to endemicity."

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A medical specialist tends to a patient suffering from the coronavirus disease (COVID-19) in the intensive care unit (ICU) of the Clinical Emergency Hospital Number 7, in Volgograd, Russia January 26, 2022. REUTERS / Kirill Braga

The data show that the Omicron wave has already reached - earlier than expected - its peak in some countries, especially in Western Europe. At the moment the variation is spreading to Eastern Europe, with a very high peak of cases in the Balkans

Evolving threat

We are really experiencing the rapid and continuous evolution of the virus in our own skin: let us remember when we fought with the previously indisputable "queen" Delta and in how little time the queen was "dethroned" by Omicron both in our country and in others European countries. Of course, we hear more and more often that this dominance of Omicron can be to our advantage since it is a more "innocent" variant of the virus. Is that how things are? we asked Dr. Kluge. "It's dangerous to think that Omicron is causing a mild illness so we would not mind being infected with it. It is a highly contagious variant, which spreads to vaccinated populations as well as to those who have acquired immunity through the disease, and which, due to the huge number of cases it causes, leads to increased hospital admissions, especially among unvaccinated individuals. "It is not at all innocent a variant that is already putting tremendous pressure on health systems and basic services."

And of course one question that concerns us all is "what after Omicron?". Can we expect other, newer variants of SARS-CoV-2, possibly more dangerous? - already while Omicron 1 is hanging over our heads, there is a lot of talk about a second branch of it, Omicron 2 which is spreading mainly in Northern European countries.

"As all viruses evolve and mutate, it is highly likely that we will see another new variant of SARS-CoV-2 emerging in some parts of the world and rapidly spreading to other countries," he said. as was the case with Delta and Omicron. Against this background, vaccination remains one of the best ways to prevent serious illness and death, but we need to apply all the other measures that we know are effective against the virus: mask use, proper indoor ventilation, keeping distance and frequent hand washing remain of paramount importance ”.

Regarding the new emerging pandemic "star" Omicron 2, Dr. Kluge noted that "at the moment there is no cause for concern for Omicron's BA.2 industry. "The data so far show that it does not lead to an increase in hospitalizations and deaths." Note that Omicron which is referred to as B.1.1.529 has three main sub-strains: BA.1, BA.2 and BA.3. As of December 23, according to the WHO, more than 99% of the samples in which the virus was genetically sequenced belonged to subtype BA.1. "At the moment, however, there is an increase in BA.2 in Denmark and some other countries, which indicates that BA.2 may displace BA.1."

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Vaccination and drugs

Whatever the new "face" of the virus that will appear, the response to the threat is primarily vaccination, the WHO Europe director has not stopped repeating. "Vaccines have been and are effective. They have already saved almost half a million lives in Europe and continue to be the best strategy for preventing serious illness and death, even against Omicron. In fact, it is equally important for those people who have become ill to be vaccinated as the natural immunity acquired through the disease can not offer prevention of a new infection with Omicron ".

Vaccination yes, but with how many doses in the end for protection - a fourth sting awaits us soon? And how many doses will the children need - will not the basic scheme of the two doses be sufficient in them as well, as happened with the adults? "Based on the available data, the WHO has not yet recommended additional vaccine boosts beyond the third dose given in many countries," said Dr. Kluge. We first need to understand how the protection provided by the two doses decreases over time but also depending on the evolution of the virus.

Our defense against the virus is growing stronger - in addition to the effective vaccines that give us the wall of prevention against serious disease and death, now comes a second line of defense, that of new oral antiviral drugs. "The new treatment protocols will be vital in helping us move from the pandemic to the endemic phase of the virus, significantly reducing mortality from COVID-19 as societies will learn how to coexist with SARS-CoV-2, which at some point will continue to circulate in the community but at low levels. Oral antiviral drugs can really change the "pandemic game" if used in conjunction with vaccination and other preventative measures that we know are effective against the virus. But we must not rely solely on these drugs - they are the last resort to prevent serious illness and death. "Prevention is better than repression, and our goal must always be to avoid becoming infected with the virus from the outset."

We remain vigilant

As a final question, we asked the WHO "head" in Europe the priority for all of us after two (endless) years of pandemic: when could we return to a life of normalcy, a life without masks but with (many) hugs? "We have to be cautious about making predictions. We have not yet come out of the alley, especially when so many people in Europe and other parts of the world remain unvaccinated. However, we must not forget that compared to the corresponding period last year, we now know and we can do much more so that we and those around us are safe ".

Dr. Kluge even drew attention to the countries that are already changing their anti-virus strategy, considering that the COVID-19 will turn into an infection more easily manageable in the near future. "This is a possible scenario that is supported by emerging data, but we are far from meeting the conditions for the endemicity of the virus in Europe - according to which there needs to be a stable transmission to a given population. So what I would emphasize is that surveillance must be maintained after the Omicron wave, that vaccinations continue to be boosted as well as access to antiviral drugs. Vulnerable people should also continue to use a mask and keep their distance. "Readiness and flexibility must continue to be our guide in the face of new possible waves of the pandemic."

In closing, Dr. Klugge wanted to send the following message to all of us: "What I can say with confidence is that this pandemic, like all other pandemics in human history, will one day end. "SARS-CoV-2 will become endemic, but at this time it has not yet arrived." For knowledge and (mainly) compliance by the most competent European lips…

Omicron and the five-day isolation

The Omicron variant has brought to our country - and in other countries - new data regarding the period of self-isolation after a positive diagnosis: people infected with SARS-CoV-2 now remain in isolation for 5 days instead of 10 that was valid until recently. This recommendation, originally made by the US Centers for Disease Control and Prevention (CDC) and adopted by several states, was based on studies showing that the incubation period of Omicron is shorter than previous variants of the virus, with people with the disease being contagious two days before the onset of symptoms and three days after onset. However, there have been reactions from scientists as well as reports of people who even ten days after their diagnosis continue to be positive for the virus. Is the five-day quarantine enough in the end or does it add "oil" to the… fire of the spread of Omicron? we asked Dr. Kluge.

"Countries need to weigh the risks and rewards of reducing quarantine and isolation days. As a scientific body the WHO has not recorded any change in the data - SARS-CoV-2 remains just as contagious as before. However when there is vital pressure on basic services due to absences due COVID-19, the reduction of the self-isolation period could be put on the table, but it is the last measure. The worst thing we can do is send someone healthier to work sooner while they are still contagious. A healthcare provider providing care to vulnerable patients who may not have been vaccinated or are at risk of dying from COVID-19».