Amidst a welter of national and world crises that coincided and followed the first two years of Covid-19, by September 2022 it appeared to have become the forgotten pandemic – and in many countries, most notably the UK – the highly infectious ‘elephant in the room.’

CBNW Editor Andy Oppenheimer explains why.

In July 2021 the WHO warned of a new wave of Covid-19 spreading through Europe. At that time the Delta variant was uppermost amid the widespread lifting of restrictions, reduction or cessation of mandatory mask-wearing, partial vaccination take-up,and increased indoor social mixing.

Omicron’s offspring
From November 2021 the ongoing spread of SARS-CoV-2 propelled the various progeny of the Omicron variant, notably BA.2 and BA.5. Each successive sub-variant is several times more infectious than its predecessor.

Summer 2022 saw a rising case toll. In the UK in one week in July more than 3 million were infected, with almost 3,000 fatalities in Europe per week. We face the risk of health worker absences, overburdened health systems, struggling businesses and overcrowded transport as we approach another Covid-laden winter.  But Covid-19 is now relegated to the third division of media reporting, unless you follow specific developments.

Life goes on…
Hospitalisations are predicted to increase further in the autumn and winter months as schools re-open, people return from holidays and social mixing moves indoors. But many other crises – some of them unprecedented and equally global in their enormity – dominate the news. And many think it’s all over and talk of ‘post-Covid’; or are inclined towards the ‘we’re all going to get it anyway I’ve had it and it’s like the flu’ brand of fatalism.

Long Covid and after-effects
Even a so-called ‘mild’ dose of this virus can knock patients out for days with high fever, shivers, headache, and shortness of breath in addition to cold symptoms like sore throat, cough and gastrointestinal problems.

But the threat of long Covid and subsequent illnesses persists with each variant. Among a multiplicity of symptoms, so-called ‘brain fog’ has since been proven as brain-related abnormalities in Covid-19. Strokes occurring months after an initial infection is believed to be due to blood clotting caused by the virus.

One study published in The Journal of the American Medical Association in April 2021 found that the risk of stroke was more than twice as high for COVID-19 patients when compared to people of the same age, sex, and ethnicity in the general population: 82.6 cases per 100,000 people compared to 38.2 cases for those with no COVID-19 diagnosis.

Repeated infections with SARS-CoV-2 can also lead to long Covid. In the UK alone this affects an estimated 2 million people – 3% of the population. Much more needs to be done to treat long COVID patients.

The WHO strategy
The WHO calls on countries to be ready to respond to a winter wave of Covid by:

  • Increasing vaccine uptake in the general population
  • Administering second booster doses to immunocompromised people aged 5 and above and their close contacts
  • Offering a second booster to specific at-risk groups, at least 3 months after their last dose
  • Promoting mask-wearing indoors and on public transportation
  • Ventilating crowded and public spaces (such as schools, offices, public transport, restaurants, etc)
  • Applying rigorous therapeutic protocols for those at risk of severe disease.

The WHO also recommends:

  • Strengthening laboratory capacities to ensure reliable rapid diagnostic SARS-CoV-2 detection and tracking of variants (which have declined in several countries)
  • Continued population use of rapid diagnostic testing (also declined as not mandatory)
  • Integrating population-based surveillance systems for influenza, SARS-CoV-2 and other respiratory viruses to monitor the spread and intensity of respiratory viruses
  • Prioritising contact tracing and quarantining based on WHO recommendations for individuals, high-risk settings and situations of concern
  • Promoting informed individual choices around protection measures, including respiratory hygiene, mask-wearing, ventilation, handwashing and vaccination
  • Strengthening infection control practices in all healthcare and care settings, as well as in the community.

Simple prevention
With governments and much of the public in a state of denial about Covid – or preoccupied with other myriad problems – all of the above is a tall order. Increased ventilation, for example, is much more difficult in winter, with huge rises in energy costs adding to the need to close windows. However, wearing an FFP2/N95 facemask and getting booster vaccinations are vital and doable preventive measures against this potentially deadly and highly unpredictable virus.

The health of the population is vital if any economic recovery can take place and the health of individuals and their loved ones and colleagues overrides just about everything else. This is the (oft-abandoned) duty of government but the public – despite all their other problems – must also realise that this is a serious illness and understand how to reduce the risk to themselves and others.

By early October, Covid infection rates had increased in England and Wales, with one in 65 individuals infected in the week ending September 17 – up from one in 70 the week before. In England one in 65 – 857,400 people – had Covid in the week ending 17 September, up from 766,500 (1 in 70) the week before. Therefore, a new wave is already upon us, with flu and other infections added to the autumn-winter mix.

The public enquiry into the Covid Pandemic opened in the UK on 4 October. It expects to hear a cross-section of views among the hundreds of thousands of bereaved people in the UK. Most such enquiries conclude with the aphorism “Lessons will be learned.” But at least reports on these hearings will be a reminder to the public at large of the extent of suffering caused by this pandemic and successive failures to deal with it.

A crowd of subway users in June 2020 follow CDC face mask guidelines at Milpitas station in Milpitas, California. Mask-wearing on public transport in 2022 is now rare.