Javier Ibarrondo et al., Rapid decay of anti-SARS-CoV-2 antibodies in persons with mild COVID-19, New England Journal of Medicine, September 10, 2020, nejm.org; Helen Ward et al., Declining prevalence of antibody positivity to SARS-CoV-2: A community study of 365,000 adults, MedRxiv, October 27, 2020, medrxiv.org. Moderna also announced that its vaccine is more shelf-stable than expected and would need only refrigeration to keep it stable for 30 daysanother piece of good news. As of mid-July 2022, mainland China is the only large country pursuing a zero-COVID-19 strategy.3Rhiannon Williams, China is sticking to its zero-covid plan, and how Ukraine is rebuilding its destroyed cities, MIT Technology Review, May 9, 2022. Public-health authorities around the world are considering short- and medium-term strategies for the timing and rollout of booster shots. Even later herd immunity remains possible if other challenges arise, especially vaccine safety concerns or ambivalence to vaccination following a transition toward normalcy. Sarah Feldman and Catherine Morris, Omicron worries America, but not enough to precipitate change, Ipsos, December 14, 2021, ipsos.com. Beyond the cancelled plans and missed Christmases, we don't really have a way to judge the real damage done by the poor testing situation. We believe that herd immunity in the United States is still most likely in third or fourth quarter 2021, but that the chance of delay until first quarter 2022 or beyond has increased (Exhibit 2). Treasury's net migration forecast likely overestimated Among high-income countries, cases caused by the Delta variant reversed the transition toward normalcy first in the United Kingdom, where a summertime surge of cases led authorities to delay lifting public-health restrictions, and more recently in the United States and elsewhere. But he pointed to a number of potential factors. Lockdowns aren't yet a distant memory:Australians are still used to shutting down when cases go up. It nevertheless helps illustrate the relative threat posed by the two diseases. Margaret Keenan, a British nonagenarian, made history on December 8 by becoming the first person to receive the Pfizer-BioNTech vaccine for SARS-CoV-2 outside a clinical trial.133Covid-19 vaccine: First person receives Pfizer jab in UK, BBC, December 8, 2020, bbc.com/news. Anthony Ives and Claudio Bozzuto, State-by-state estimates of R0 at the start of COVID-19 outbreaks in the USA, MedRxiv, May 27, 2020, medrxiv.org. The end of Europes pandemic may come somewhat later, and other countries outlooks will depend on several variables. Other research suggests that even with waning levels of COVID-19 antibodies, the immune system may still be able to mount a response through other specific B-cell and T-cell immune pathways, where emerging evidence shows much greater durability after six months.164Rebecca Cox and Karl Brokstad, Not just antibodies: B cells and T cells mediate immunity to COVID-19, Nature Reviews Immunology, August 24, 2020, nature.com; Jennifer Dan et al., Immunological memory to SARS-CoV-2 assessed for greater than six months after infection, BioRxiv, November 16, 2020, biorxiv.org. Further, manufacturing small molecules rapidly is faster than the process for monoclonal antibodies. Airline passenger volumes in the United States are much closer to prepandemic levels than they were a year ago48TSA checkpoint travel numbers (current year versus prior year(s)/same weekday), Transportation Security Administration, tsa.gov. But Australians have had the need to get tested drilled into them from the start of the pandemic. Both Dr Lydeamore and Dr Griffin said the introduction of bivalent vaccines, which can target two strains of the virus, was a helpful addition heading into 2023. Yesterday, a single test cost $25. Nature, June 17, 2022. There are chances that we witness a re-emergence of previous problems and even an uprise of new ones like fungus. "The ones we've used so far have been tremendous in reducing high-risk people progressing to severe disease," Dr Griffin said. The figures come as the Victorian premier, Daniel Andrews, suggested the peak of the states latest Omicron wave had passed. University of South Australia professor of biostatistics Adrian Esterman told The New Daily on Monday that COVID-19 deaths were slowly rising as governments wound back public health measures, and would likely average 50 a day by the end of July. A number of questions and caveats remain. Soon migrants will be returning to the market. While many people are acquiring natural immunity through infection, variants with enhanced transmissibility, if they predominate among all strains, could increase the proportion of people who need to be simultaneously immune to achieve herd immunity by ten to 20 percentage points, and increase vaccine coverage levels needed to 65 to 80 percent of the population (or 78 to 95 percent of those over 12 years old).141Based on a reproduction number (R0) of 2.4 for the original strain and assuming that the herd immunity threshold can be approximated using the formula 1- (1/R0). What happens next? We spend less money on traveling overseas, save money by avoiding the daily commute, get away with owning fewer formal items of clothing, and have more money available to throw around. Unless these countries choose to maintain their border restrictions (such as hotel-based quarantine) indefinitely, they might accept the risk of endemic COVID-19 after governments determine that a sufficient portion of the population is vaccinated.102 Salma Khalik, Moving from Covid-19 pandemic to endemic: Singapores strategy and how it can unfold, Straits Times, July 3, 2021, straitstimes.com; Peter Collignon, Australia must eventually face reality: Live with Covid or become a hermit nation, Guardian, June 15, 2021, theguardian.com. This means downsizing is pushed backwards too. A new Covid-19 subvariant is emerging in Australia, with experts warning it might be one of the most transmissible strains so far. We recognize that calculating herd immunity thresholds is complex. Follow our Australia news live blog for the latest updates. Endemicity remains the endpoint. A media law expertexplains, Hopes high that Australian drug may stop brain cell death after traumatic births, Autopsies begin on more than 100 bodies of Kenyan cult members, Fifth man charged over Sydney gangland shooting of Mahmoud Ahmad, Fijis former attorney-general Aiyaz Sayed-Khaiyum taken into custody over alleged abuse of office, Support overwhelms referee as alleged attacker jailed, NRL concedes knock-on error on crucial golden point call for Raiders. On October 21, 2021, PfizerBioNTech announced results from a randomized controlled trial of third doses of its COVID-19 vaccine; protection was restored to the levels seen in earlier trials after the second dose.73Pfizer and BioNTech announce Phase 3 trial data showing high efficacy of a booster dose of their COVID-19 vaccine, Pfizer, October 21, 2021. Estimates of increased vaccine coverage needed are based on R0 = 3.36-4.32, which is 4080% greater than R0 of 2.4. Oral therapeutics that significantly reduce the chance of progression to severe disease after symptom onset may enable a higher fraction of cases to be managed as outpatients. Most countries have deferred the hope of achieving herd immunity until the arrival of a vaccine. Globally, of the approximately 30 million people known to have COVID-19, more than 900,000 have died.1Coronavirus Resource Center, Johns Hopkins University & Medicine, September 18, 2020, coronavirus.jhu.edu. As immunity wanes, however, the next stage remains highly uncertain. then higher vaccine coverage ratesapproximately 60 to 85 percentcould be required to achieve herd immunity. Farah Master and Clare Jim, Hong Kong considers mass testing as COVID fight intensifies, Reuters, February 17, 2022, reuters.com. Nevertheless, recent results from MerckRidgeback Biotherapeutics and Pfizer on their oral drugs molnupiravir and PAXLOVID, respectively (two antivirals, with different mechanisms of action65Merck and Ridgeback Biotherapeutics provide update on results from MOVe-OUT study of molnupiravir, an investigational oral antiviral medicine, in at risk adults with mild-to-moderate COVID-19, Merck, November 26, 2021; Pfizers novel COVID-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of Phase 2/3 EPIC-HR study, Pfizer, November 5, 2021.) For example, a July 2021 study of the PfizerBioNTech vaccine in Israel showed that in every age group studied, those who had been vaccinated by January 2021 were more likely to experience breakthrough infection than those who completed their initial course of vaccination two months later were.70Yair Goldberg et al., Waning immunity after the BNT162b2 vaccine in Israel, New England Journal of Medicine, December 9, 2021, Volume 385. The speed of COVID-19 vaccine development has been an unqualified success. But for now, fewer of us need to get testedand, according to Morrison, that's cause to relax. Exhibit 4 provides a global view of seven factors that are likely to drive herd-immunity timelines for the rest of the world. Nick Paul Taylor, Novavax COVID-19 vaccine 90% efficacious in phase 3, but protection plummets against one variant, Fierce Biotech, January 29, 2021, fiercebiotech.com. However, if the impact of these variants is significant, we could see timelines significantly prolonging into late 2021 or beyond. We also introduce the McKinsey COVID-19 Immunity Indexa tool for understanding a communitys current level of risk from the disease. Coronavirus Australia One consequence is that the vaccines contribution to population-wide herd immunity will depend on adults, at least until vaccines are approved for use in younger populations. The Milder-cron scenario would continue the trend toward less severe disease. Different combinations of those two factors will drive varying levels of conferred immunity, implying the extent of natural immunity that will be required to reach herd immunity under each scenario. NSW Chief Health Officer Kerry Chant admitted as much in the state's Friday press conference. It appears that the two vaccines mentioned will be indicated first for use in adults.156Development and licensure of vaccines to prevent COVID-19: Guidance for industry, US Food and Drug Administration, June 2020, fda.gov. The threshold to achieve it is governed by a number of factors, including the transmissibility of the disease.138Eames, Fine, and Heymann, Herd immunity: A rough guide, pp. Digital cash, digital ID. 17. Here's how likely you are to get it more than once, Charting the COVID-19 spread: Australia passes 10,000 coronavirus deaths, Sudan humanitarian crisis turning into a 'full-blown catastrophe', UN says, 'Every second is critical': Major upgrade to national emergency messages to receive more than $10m, Flood-prone communities demand better planning to protect life and property, Russian freight train derails after being hit by explosive device, governor says, Major route into the Kokoda track appears to have been blockaded amid tour operator feud, Tony Abbott mounts attack on Voice after spat with parliamentary committee, Baby with bowel obstruction died after hospital's failures, coroner finds, Violence and chaos erupt at the May Day labour union march in Paris. Scientists race to find answers, Nature, February 19, 2021, nature.com. Public-health authorities may therefore need to look at a wider range of indicators to support their planning and disease management efforts. As opposed to the basic reproduction number, which was used at the start of the pandemic, the Reff (effective transmission number) assumes that people have some immunity to the virus either from being vaccinated or having already been infected. There is still much more to learnsample sizes in the new studies were small, antibody titers are an imperfect metric of immune protection, and major manufacturers are yet to release similar information. On the other hand, if vaccines are efficacious but distributed only to adults, who comprise only 76 percent of the US population,157Age and sex composition in the United States: 2019, US Census Bureau, accessed November 15, 2020, census.gov. In the United States, COVID-19 hospitalization and mortality rates in June and July were nearing the ten-year average rates for influenza but have since risen. The pandemic didnt impact all of us in the same way. Our analysis accounts for waning immunity and suggests that even if Omicron were to have no impact, the next six months of Delta-driven disease in the United States could be about as severe as the past six months were. Steps may include a return to fully in-classroom education, fewer restrictions on the operations of bars and restaurants, more gatherings with larger groups of people, the reopening of offices, and fewer prohibitions on interregional or international travel. As Australia battles its latest COVID-19 wave, many will be hoping 2023 is the year the pandemic "ends", the year that weighing-up exposure risks, mask use, skipping social events due to that tickle in the throat, can all be put behind us. Higher scores mean that more people have immunity and that the community has greater protection against symptomatic disease. Dr Griffin said he believed Australia was "heading in the wrong direction" on testing. Seven Northwestern experts give their top predictions for 2022, from supply chain disruptions to the endemic phase of COVID-19 to green energy transitions. Beyond that, a more realistic epidemiological endpoint might arrive not when herd immunity is achieved but when countries are able to control the burden of COVID-19 enough that it can be managed as an endemic disease. Causation hasnt been proven. This comparison should be qualified, insofar as the burden of COVID-19 is dynamic, currently increasing, and uneven geographically. Evidence so far suggests that the Omicron variant, relative to Delta, is likely to be more infectious, show more immune evasion, and be less severe, on average. While countries such as Israel have shown what is possible, the United States has fallen behind its targets.144Coronavirus: Israel leads vaccine race with 12% given jab, BBC, January 3, 2021, bbc.com.145Michelle R. Smith, Governors scramble to speed vaccine effort after slow start, Associated Press, January 6, 2021, apnews.com. This article was edited by Mark Staples, an executive editor in the New York office. In the short term, an accelerated rollout of booster doses of COVID-19 vaccines is likely to be one of the best protections against an Omicron-fueled wave of the disease. We made this point in the last four editions of this article, and unfortunately it remains as true as ever. On the other hand, ECDC also notes that it is too early to draw definitive conclusions on disease severity. The threshold for achieving herd immunity for COVID-19 is the percentage of a population that needs to develop immunity to disease to prevent sustained future transmission. A third is demographics: while the younger populations of many lower-income countries have led to lower COVID-19-associated mortality, they also make it harder for adult-only vaccination programs to drive herd immunity. This article was edited by Josh Rosenfield, an executive editor in the New York office. The nation has seen thousands of COVID-19 deaths since then, dwarfing the tolls from 2020 and 2021. But a number of other factors could delay the timelines beyond those described, including unexpected safety issues emerging with early vaccines, significant manufacturing or supply-chain delays, continued slow adoption, further mutation, or a shorter-than-anticipated duration of vaccine-conferred immunity. Workers still need to come to the office occasionally, and settling too far away from the office towers isnt an option for many. The authors wish to thank Giles Colclough, Alina Glukhonemykh, Abhishek Sharma, and Zihao Xu for their contributions to the article. A communitys level of immunity is a precarious balance, constantly shifting as individuals gain and lose immunity. Some are close to eliminating excess mortality. Follow Us. Web2022 Nostradamus seven 2022 predictions: From the death of Kim Jong-un to war in Europe and the collapse of the EU From the death of a dictator to cataclysmic quakes, Nostradamus is believed to have predicted dire events for 2022. Data shows that more and more people have concluded that the health risks of COVID-19 are not significant enough for them to change their behavior, either because of their vaccination status, their youth, or a desire to move on from the pandemic.26Sarah Feldman and Catherine Morris, Omicron worries America, but not enough to precipitate change, Ipsos, December 14, 2021, ipsos.com. and more large employers in the United States implementing vaccine mandates.93 Leslie Josephs and Robert Towey, Covid vaccine mandates sweep across corporate America as delta variant spurs action, CNBC, August 9, 2021, cnbc.com; Alexis Benveniste, From offices to restaurants, companies are requiring proof of vaccination, CNN, August 4, 2021, cnn.com. 7. COVID-19 lockdowns by country Omicron is a game changer, Prime Minister Scott Morrison said on Thursday. The short term will be hard, but we can reasonably hope for an end to the pandemic in 2021. However, even that share has been too small for them to achieve herd immunity, because of the emergence of the more transmissible and more lethal Delta variant80 Sarah Zhang, What if we never reach herd immunity?, Atlantic, February 9, 2021, theatlantic.com. Today, nearly every country finds itself in a similar position. "I think we've had a strategy of extremes," Dr Griffin said. variant continues to spread around the world as coronavirus pandemic enters 2021, Washington Post, Jan 2, 2021, washingtonpost.com.143Carl Zimmer, U.S. The emergence of Omicron led to tighter rules around travel in many countries, with some, such as England, also restricting domestic travel.76Prime Minister confirms move to plan B in England, United Kingdom, December 8, 2021. The prevalence of the more infectious B.1.1.7 variant varies by country; most countries with cases are between the high UK levels and lower US levels. Both Pfizers and Modernas would be two-dose vaccines, necessitating rigorous follow-up for series completion. 15. The R0 value for COVID-19 is under debate, with estimates ranging from two to four. Scientists race to find answers,. Many governments are employing packages of measuresthat aim to minimize the number of COVID-19 cases and excess mortality while maximizing social and economic degrees of freedom. Some are debating a strategy that would combine annual flu and COVID-19 boosters in the autumn.8Official sees strong possibility Covid shots will be given every autumn, Bloomberg, February 22, 2022. Generations mixing together after months of distancing. Seasonality and associated changes in behavior will begin to work again in our favor in the spring, and the combination of early doses of vaccines targeted to those at highest risk (and the benefits of the Pfizer and Moderna vaccines in reducing severe disease), advances in treatment, expanded use of diagnostics, and better implementation of public-health measures should serve to significantly reduce deaths from COVID-19 in the second quarter. We are as excited as others about the stunning developments in vaccines. This distinction will have much to say about whether the United States reaches normalcy in Q2 or Q3 of 2021. "We need to reset how we think about the pandemic, and how we manage ourselves and the things we need to do as governments," he said, announcing new definitions of "close contacts" and loosening the parameters for who needs to get tested. COVID-19 vaccinations in the United States, The Centers for Disease Control and Prevention, February 23, 2022, covid.cdc.gov. Since the Omicron variant of COVID-19 was named by WHO on November 26, 2021, it has moved at lightning speed. Many are worried if not for themselves then for their more vulnerable loved ones. The worlds reaction has been an unpleasant mixture of dread, fatigue, and dj vu. Heres what you need to know, Super discrimination worsens for women as the gender gap widens in key age groups, Fixing shortage of aged-care workers through migration has risks, Rana Plaza tragedy in 2013 a wake-up call for consumers, Australians have been scared off loans and thats exactly what the RBA wants, Why was Bruce Lehrmann given the all-clear to sue? Gaining that confidence will require a continuation of the progress made to reduce mortality and complications, as well as further scientific study regarding long-term health consequences for recovered patients. On the other hand, locations with lower up-to-date vaccine coverage, including parts of the United States, set all-time records for hospitalization and deaths. Peter Marks, Coronavirus (COVID-19) update: FDA recommends inclusion of Omicron BA.4/5 component for COVID-19 vaccine booster doses, US Food and Drug Administration, June 30, 2022. Coronavirus (COVID-19) update: FDA authorizes Moderna and Pfizer-BioNTech COVID-19 vaccines for children down to 6 months of age, US Food and Drug Administration, June 17, 2022. Vaccination data are compiled from the US Centers for Disease Control and Prevention for the United States and Our World In Data for other countries. Lots has been written about this. While we dont yet know the full extent of waning immunity for Omicron, new evidence indicates that those who have received three doses of vaccine may benefit from medium-term protection.32Frauke Muecksch, Zijun Wang, Alice Cho, et al., Increased potency and breadth of SARS-CoV-2 neutralizing antibodies after a third mRNA dose, BioRxiv, February 15, 2022, biorxiv.org. It's unclear at what price these changes come, in terms of increased risk to essential workers and their families. In this extract from Pandemedia, The Australian Financial Reviews Patrick Durkin explains how his coronavirus experience began with a car race. The United States, Canada, and much of the European Union are now in the throes of a Delta-driven wave of cases.95 COVID data tracker weekly review, accessed August 15, 2021; COVID-19 daily epidemiology update, August 18, 2021; SARS-COV-2 Delta variant now dominant in much of the European Region and efforts must be reinforced to prevent transmission, warn WHO/Europe and ECDC, European Centre for Disease Control and Prevention, July 23, 2021, ecdc.europa.eu; Ceylan Yeginsu, The new reality of a European trip: Things are going to change, New York Times, July 30, 2021, nytimes.com. FDA issues Emergency Use Authorization for third COVID-19 vaccine, US Food and Drug Administration (FDA), February 27, 2021, fda.gov. Yair Goldberg et al., Waning immunity after the BNT162b2 vaccine in Israel,. The 'winter shot': Everything you need to know about getting your next COVID-19 booster, If you catch COVID again, will your symptoms be worse? WebThis was followed by two schemes in Australia, which in 2022 were merged to form the Pacific Australia Labour Mobility (palm ) scheme. The PALM scheme has since expanded to include hospitality, age care and tourism jobs. Were still seeing thousands of people being infected; were seeing many, many people ending up in hospital, he said. Dr Abul Rizvi reports. Smriti Mallapaty, Can COVID vaccines stop transmission? Singapores government has announced that it will make this shift, and more countries may follow its lead.96 Niharika Mandhana, From pandemic to endemic, Singapore creates model for living with Covid-19, Wall Street Journal, July 1, 2021, wsj.com. That would mean that between around 90 million and 300 million people around the world have some immunity to SARS-CoV-2. Some have suggested that particular populations, such as those who are immunocompromised due to HIV or other causes, are disproportionately at risk of incubating new variants.41Lawrence Corey, Chris Beyrer, Myron S. Cohen, Nelson L. Michael, Trevor Bedford, and Morgane Rolland, SARS-CoV-2 Variants in Patients with Immunosuppression, The New England Journal of Medicine, August 5, 2021, nejm.org. The experience of these countries, with total excess mortality from the pandemic far lower than it is in other parts of the world and only a limited need for ongoing restrictions, can make a case that their response to the COVID-19 pandemic has been among the most effective in the world.2Estimating excess mortality due to the COVID-19 pandemic: A systematic analysis of COVID-19-related mortality, 202021, Lancet, March 10, 2022.
