What can happen in the fourth year of the pandemic?, by Dr. Elmer Huerta

In general, those predictions came true. But, just as the appearance of the omicron variant in November 2021 it completely changed the course of the pandemic, an event that occurred in December 2022 threatens to completely change the course of the pandemic this year. What can happen in 2023?

The pandemic of the vulnerable and unvaccinated

The appearance of omicron – which some think was a consequence of the evolutionary pressure of the virus caused by the vaccine that saved 20 million lives – meant that during 2022, and fulfilling the WHO prediction, the pandemic would disproportionately affect vulnerable populations, and it is understood as such those over 65 years of age and those affected by chronic diseases (more than 90% of deaths from COVID-19 in the US were in people over 65 years of age).

In addition to age and predisposing diseases, this year revealed that unvaccinated and partially vaccinated people were more likely to be hospitalized and die, compared with vaccinated people. In this regard, data from the US CDC revealed that unvaccinated people died at a rate six times higher than those who received their first two doses of vaccines.

Similarly, people given a booster dose were better protected, and had about eight times less risk of dying than those not vaccinated. Finally, and this is very important to protect vulnerable populations, unvaccinated people older than 50 years had a 12 times higher risk of dying from COVID-19 than adults of the same age with two or more booster doses.

Although it is true that, at least in the United States, the number of deaths was higher in the vaccinated than in the unvaccinated, this was not due -as the figures previously exposed show- to the fact that the vaccines do not protect, but to the arithmetic fact that having many more millions of vaccinated than unvaccinated, it is possible that, proportionally, many more deaths occur in vulnerable vaccinated.

“The fact is that we started 2023 without knowing what could happen with the pandemic. […] It is not ruled out that a variant of SARS-CoV-2 will form.

The pandemic in China

Just as the appearance of omicron in November 2021 derailed preparations to celebrate the holidays with a falling delta variant, and reactivated the pandemic during 2022, the pandemic phenomenon in China threatens to change the course of the pandemic by 2023.

Right now, in a version of the chronicle of a tragedy foretold, the pandemic is out of control in the most populous country in the world, where an estimated 37 million people are infected every day. Due to the absence of official data, the number of deaths is unknown, although reports on social networks show crematoriums working at full capacity and hospitals with patients in the corridors. It is estimated that, until March, more than a million deaths could occur in China.

As mentioned in several previous columns, the Chinese debacle is a consequence of the wrong policy zero COVID-19 stubbornly implemented and maintained by Chinese President Xi Jinping, who unsuccessfully isolated his country while the rest of the world suffered the consequences of the pandemic.

Last December and in an act that many classify as irresponsible, Xi Jinping suddenly went to the other side: he eliminated tests and quarantines, allowed the virus to circulate freely in his country, and completely opened the borders, allowing Chinese citizens –many infected– can travel abroad.

In an effort to slow the spread of new variants, the United States and several European countries have required travelers from China to show a negative COVID-19 test before entering their territories.

The fact is that we entered 2023 without knowing what could happen with the pandemic. The biggest fear of the scientific community is that, when millions of infections occur, it is not ruled out that a variant of SARS-CoV-2 that is so different from omicron, as this was from delta, will form, and make the world go backwards in disease control.

To do?

We think we have to accept that, especially for the most vulnerable in our society, the pandemic is not over yet. In this sense, the first question we must ask ourselves, when guiding our behavior and risk of contagion, is to know if we live with vulnerable people.

Wearing masks when visiting them, doing so in ventilated spaces, and helping them get vaccinated with the booster dose of the bivalent vaccine should be part of our activities in this new year. Bivalent vaccines have shown, in a recent study published on December 30, that, compared to unvaccinated, they are capable of providing 57% protection against the risk of visiting the emergency room and hospitalization due to COVID-19.

In the same way that we did not know what was going to happen in the year that we just ended, we also do not know what will happen in 2023. Control what we can control, in terms of our behavior and protection of the vulnerable, and hope that this is finally the fourth and last year of the great pandemic of 2019 is everyone’s wish.