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COVID-19 | Will 2022 be the year of the end of the pandemic?

It was presented as an unknown pneumonia, which affected a small group in Wuhan, China, at the end of 2019. But, as days went by, more and more people arrived with respiratory problems at hospitals in that city. It was about COVID-19, the disease caused by the SARS-CoV-2 coronavirus.

Over the weeks it went from being an epidemic that affected China to becoming the largest pandemic in a century.

Two years have passed, and still. However, in this time we have managed to get to know the virus much better, the disease it produces, and we have the main tool to deal with it: vaccines.

On March 11, 2020, the World Health Organization (WHO), the global authority on health, declared a COVID-19 pandemic, almost 10 years after the previous health crisis of similar proportions ended: influenza A (H1N1).

The entity took into account two main criteria for this: (there are six regions in total) and that the cases that occurred in the countries were not imported, that is, that there is a communicative transmission of the coronavirus. Thus, entire countries went into lockdown and ‘normality’ changed.

According to the experts consulted by this Journal, at this time both conditions have not yet changed, but the progress of vaccination in the countries that have advanced the most in their immunization campaigns shows that

For example, the Emergency Committee of the International Health Regulations of the WHO recommended in August 2010 to declare the end of the pandemic because the outbreaks of the AH1N1 flu worldwide returned to the levels of seasonal flu, the virus stopped being the dominant one but continued to circulate and against the virus, due to a natural infection or by vaccination.

Last week, WHO Director Tedros Adhanom said that. “Next year, the WHO is committed to doing everything possible to end the pandemic”He indicated, reiterating that vaccination is the main weapon we have to achieve this.

Although the United Nations agency assumed that the goal of ending 2021 with at least 40% of the population of each country immunized against COVID-19 has not been achieved, it set a new goal: 70% of the global population should be vaccinated by the beginning of July next year, for which Adhanom urged “That governments, industry and civil society work with us in a campaign” to achieve this.

Image shows Moderna, Pfizer / BioNTech, and AstraZeneca vaccine vials.  (Photo: THOMAS KIENZLE / AFP)

Trade spoke with Peruvian doctor Ángela Úyen, health policy advisor at Doctors without Borders, based in Brussels, about

“2022 is a year that finds us much better prepared”says the expert in infectious disease control.

– What challenges will we face regarding vaccination in the country and the world?

The challenge remains to reach those who have decided not to be vaccinated and we should have much greater emphasis on vaccinating those who have not received a single dose with first doses, because they are those who are even at greater risk. That is the challenge: convince people who do not trust vaccines and reach them with adequate communication.

– How can this communication strategy be improved?

In many cases this communication will require social science work, it is essential to improve the relationship we have with community leaders, including church leaders, opinion leaders, politicians, and, of course, the greatest difficulty is one that is underlying to the whole crisis: l, the Ministry of Health, etcetera. Regaining that trust is something very difficult, but it is a challenge that must be faced little by little, because it greatly limits the credibility that people have regarding all control measures. [establecidas por las autoridades], including vaccines.

“Our community leaders, religious leaders and political leaders have to be allies in vaccination”

The work of the itinerary brigades is one of the actions that the Minsa will reinforce to close vaccination gaps against the coronavirus.  (Photo: @Minsa_Peru)

– What things still need to be done?

First of all, we must understand what is happening, know where these reluctant populations are [a la vacunación] and understand what the problem is. And I think you have to appeal a little to interdisciplinary, multidisciplinary and interdisciplinary teams. We have to work more to understand the population, with the social sciences as an input, which allows us -through studies- to better understand the reasons and concerns of the people. We need, in the same way, to arrive through the channels [de comunicación] In this sense, our community leaders, religious leaders and political leaders have to be allies in vaccination.

– Regarding the arrival of vaccines to places of difficult access, what is the challenge?

It is good not to neglect the ability to implement vaccination in many places that have not been able to receive vaccines, for example, messenger RNA vaccines due to not having an adequate cold chain, and even many of the other vaccines that exist in the world. The market, not just messenger RNA, cannot be constantly available in certain places due to the lack of trained personnel or a cold chain. These are, and this definitely has to be a long-term job; primary care has to be precisely the bastion of our health system.

“At some point a large part of the world’s population, or all of them, will be exposed to an infection [por covid]”

A COVID-19 patient is transferred from Iquitos to the Rebagliati Hospital ICU in September 2020. (Photo: ERNESTO BENAVIDES / AFP)

– With the current decisions and panorama of the health crisis, will 2022 be the end of the pandemic?

The end of the pandemic is actually a political term, because who decides what the end is? There is no epidemiological definition today to say when the end of the pandemic is, probably what will happen at this point and seeing the behavior of variants such as Ómicron, which are highly transmissible, is that -probably- we have to think in which at some point a large part of the world’s population, or all, will be exposed to an infection [por covid], and I think that the beginning and precisely what we wanted to avoid from the beginning was to slow down these infections. [como el SARS-CoV-2]Today we already have more than 100 and there are four coronaviruses. Ideally, we would have avoided it, but apparently it has already gotten out of hand and this cannot be avoided, at some point [el virus] it’s going to be endemic [habitual en una región como el dengue].

I just think it is important to remember that endemicity is not an end, that is, it is not that the objective should be for the virus to become endemic, but rather that it is a circumstance, and probably next year we will see vaccines that have an efficacy against all variants and we can – somehow – face it, focusing on protecting the most vulnerable. But we still have enormous challenges in terms of how to attend to the populations that are going to be affected by the virus, not only in terms of its severity and mortality, but also in terms of long-term covid. 2022 is a year that finds us much better prepared, already with vaccines, with more knowledge, with a variant that seems to be less aggressive, less lethal, and we hope that new variants will not be generated because we know that while the virus circulates more than one person , this is more likely to occur. Vaccines are our best allies.

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