It is now probably fair to say that most of the world is moving beyond the emergency phase of the COVID-19 pandemic response.
“The world has never been in a better position to end the pandemic. We are not there yet, but the end is in sight,” said the head of the World Health Organisation.
Tedros Adhanom Ghebreyesus said this could be a turning point but cautioned against easing prevention efforts.
Even with reported deaths dropping to the lowest number since March 2020, nations must maintain their vigilance, like a runner approaching the end of a marathon.
“Now is the worst time to stop running. Now is the time to run harder and make sure we cross the line and reap all the rewards of our hard work. There is still a risk of more variants, deaths, disruption and uncertainty, so let us seize this opportunity,” he said.
Experts predict that a single annual vaccine, as it happens with the flu, should provide a high degree of protection and return humanity closer to “normal” even if it is expected that there will be future waves of infections caused by different subvariants or new variants.
Governments must consider seriously, from now on, the best way to manage COVID as part of their routine healthcare and prevention.
COVID-19 may indeed become a seasonal illness, like flu, with predictable patterns of infection.
Probably the right way to think about COVID at this point is to think of it as endemic.
As the pandemic continues and new waves of infection are anticipated in the cold season, new vaccines were approved and are now in use. These vaccines are adapted to better match the circulating variants of SARS-CoV-2 BA.4 and BA.5 Omicron variants and original SARS-CoV-2, and are expected to provide broader protection against different variants as the virus evolves.
The vaccination campaigns with the new vaccines have already started and are considered an extremely relevant element in the strategy to combat the pandemic during this winter.
Although the use of the newly-adapted COVID-19 vaccines is authorised from 12 years
old and above, who have received at least primary vaccination against COVID-19, these boosters are directed, as a priority, to people who are more at risk of severe disease because of certain risk factors.
Adapted vaccines work in the same way as the original vaccines. They work by preparing the body to defend itself against COVID-19.
Covid as a cause of death
Whether we call it a pandemic or endemic, it is still an important threat to people.
Experts said that, for the foreseeable future, COVID is likely to remain among the 10 leading causes of death, regardless of new vaccines, boosters or treatments that might become available, and they also express concern that people might skip booster vaccination if they think the pandemic is over.
At present, the mortality rate of COVID-19 is thought to be substantially higher, possibly 10 times or more, than that of most strains of the flu.
Estimates suggest that the total number of deaths could be more than twice as reported globally and more than 10 times greater than what has been reported in some countries.
Looking at official statistics alone, COVID-19 was the fourth leading cause of death globally, accounting for one in 20 deaths worldwide since the beginning of 2020, but accounting for unreported deaths, the total toll could move deaths due to COVID into the second leading cause of death, responsible for an estimated 16.99 million deaths, or one out of every 10 deaths.
As individuals and societies, we must all work to prevent COVID-19 from being a leading cause of death.
Countries with older populations have a higher prevalence of chronic health conditions that increase with age, including obesity, high blood pressure, diabetes, chronic kidney disease and respiratory illness, contributing to higher rates of COVID-19 mortality.
The data from INE (Instituto Nacional de Estatística) shows that in Portugal, in 2020, infectious diseases, including identified COVID-19 viruses and suspected COVID-19, were the third cause of death (16.4% of the total). In first place, 24.3% of deaths were due to circulatory system diseases and, in second place, 22.8% were due to tumours.
Europe’s first cause of death
Europe’s first cause of death, cardiovascular disease, is largely preventable. It is time to act and act fast!
Mortality rates are based on the number of deaths registered in a country in a year divided by the population.
The past two years of the COVID-19 pandemic have stretched the health systems, adding challenges to the ones countries were already facing when managing their health priorities, including diagnosis and management of chronic diseases.
The main causes of death in EU countries are circulatory diseases and various types of cancer, followed by respiratory diseases and external causes of death.
These pressures have distracted European Member States from CVD (cardiovascular disease), even though CVD predicts poor outcomes in people infected by COVID and that COVID also has very relevant cardiovascular impact.
Despite the high impact of CVD, efforts to prevent and treat CVD are behind other diseases, and public health information and actions to raise awareness to its risks are lower than for other conditions. As a matter of fact, the general public does not pay much attention to CVD, in contrast with “cancer” which is Europe’s second cause of death.
There is access to a wealth of information on cancer diagnosis, prevention and cure as most countries have cancer initiatives, including screening programmes in breast, cervical and colorectal cancer. Very few have national cardiovascular strategies.
Some factors that prevent non-communicable diseases (NCDs) are relevant to both cancer and CVD, like stopping smoking, reducing sugars and salts and increasing physical activity. But for CVD, these are nothing more than the tip of the iceberg, as CVD is often presented together with other chronic conditions like obesity, diabetes and hypertension.
The risk of these combined conditions leads to greatly increased risk of compromised health or premature death.
The risk of CVD for Europe’s population must be seriously considered and reduced. It is within our reach. The COVID pandemic has raised the urgency to act.
And so, life goes on … with the Covid virus, the flu virus and all the other diseases that we need to do our best to control.
Best healthy wishes,
Dra. Maria Alice Pestana Serrano e Silva
|| [email protected]
Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service. Administration Assessor – Grupo Hospital Particular do Algarve