Expert Comment: Covid-19 measures might be removed but what is the long-term plan?

Boris Johnson announced that all formal Covid-19 measures, including the obligation to self-isolate when positive, may be removed this month (February 2022). Independently of the question whether this is the right time to do this, Professor Martin Michaelis and Professor Mark Wass from the University’s School of Biosciences, comment on whether and how we will prepare to avoid the re-introduction of restrictions when/if we are hit by additional Covid-19 waves. They said:

‘Admittedly, we do not know for sure whether another Covid-19 wave will strike. There is always a possibility that this wave has been the last one, and that Covid-19 will now transform into a mild illness that does not require special attention anymore. Based on what we know, however, this appears to be very unlikely.

‘The Omicron variant causes severe disease in a smaller proportion of infected individuals than previous variants, but this is not what makes it so successful. The Omicron variant is so successful, because it is highly contagious and because it is a very effective immune escape variant, i.e. it is very good at infecting people who have been vaccinated and/or have had Covid-19 in the past. Hence, the Omicron variant can be considered as a proof-of-concept showing that new variants are evolving that will be able to spread among people who are protected from previous variants.

‘Since viruses like SARS-CoV-2 that are transmitted before infected individuals fall seriously ill do not have a significant advantage from causing milder disease, there is no evolutionary pressure that would favour the formation of milder variants. Hence, we are simply lucky that Omicron is not as deadly as Delta. However, the next variant could be an immune escape variant that spreads as easily as Omicron and that is as or even more deadly than Delta – not least as Delta and Omicron could recombine.

‘Moreover, immune protection provided by vaccinations and previous infections wanes over time. This means that we will gradually become more vulnerable to further Covid-19 waves, and this not only to new variants but even also to previous variants.

Since it is prudent to prepare for the worst (even though we hope for the best), we should put measures in place that avoid sweeping measures when Covid-19 strikes again. However, there does not seem to be any long-term plan to avoid future restrictions. So far, we have not found a way to control Covid-19 spread without drastic measures, and as long as we do not have a proper plan this means that the current cycles of introducing and easing restrictions is bound to continue. We will not get our freedoms back until we have learnt to manage Covid-19 spread without giving them up.

‘To be prepared, we will need to know which variants spread and where. This means that detailed Covid-19 surveillance needs to continue. Moreover, people will need the opportunity to test themselves to find out whether they may be unknowingly spreading Covid-19 and to discriminate Covid-19 from other respiratory illnesses. Finally, basic hygiene rules, proper ventilation, and face coverings in crowded spaces (all these measures can be voluntary and based on guidance) slow down Covid-19 spread and will help us to tackle future COVID-19 waves early with measured responses.’

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