2023 could be the year the world finally discovers how to live with COVID. Well, more of the world. Ironically, we’ll have the Omicron variant of the SARS-CoV-2 virus to thank for that.
Successive waves of infections of Omicron and its sub-variants, beginning in late 2021, have produced so much natural immunity in the human population that most countries are now in a good position to face new sub-variants. -variants. “I see the United States and most of the world gradually emerging from the acute phase of the pandemic,” Lawrence Gostin, a global health expert at Georgetown University, told The Daily Beast.
Yes, people will get sick when a new form of virus becomes dominant. But due to their natural immunity, they probably won’t get very sick. And new infections will produce new antibodies that will then extend the population’s natural immunity through the next wave of cases.
“The waves will, however, become shallower and more distant like ripples in a pond,” University of Southern California epidemiologist Jeffrey Klausner told The Daily Beast.
The exception to this hard-earned natural protection is, of course, China. The only major country that has imposed strict lockdowns for much of the last year and therefore lacks widespread natural immunity. China could spend 2023 catching up with the rest of the world, when it comes to COVID antibodies.
The problem, for 1.4 billion Chinese, is that catching up means many people are infected with COVID without the strong protection that natural immunity offers. If 2023 is the first year in four years that most of the world can breathe easily despite SARS-CoV-2 being everywhere all the time, it could Also to be the year China got really sick for the first time.
The world minus China has earned its natural immunity the hard way – by catching COVID. Vaccines dulled the pain, sure, but vaccine-induced antibodies don’t last forever. By the end of 2021, billions of jabs were fading and boosters had just become available to most people. At the same time, many countries were lifting the last major restrictions on businesses, schools and travel. That’s when Omicron appeared.
More transmissible than older variants but less severe, Omicron caused peak cases in late 2021 and early 2022 – and spawned subvariants such as BA.2, BA.5 and BQ.1 which have led to their own smaller increases in cases throughout the year.
But the general trend in 2022 was towards fewer and fewer hospitalizations and deaths. In countries where people were reverting to a normal version and the virus was circulating, everyone who accumulated natural antibodies was doing their thing.
It’s a virtuous circle that feeds itself. “Natural immunity will be continually replenished as the virus circulates widely, which will mean a population that over time will have considerable levels of immunity,” Gostin explained.
“We have long been in the Omicron or sub-Omicron phase of variants. This should continue.”
This protection gives us a glimmer of hope for 2023 and beyond. “Eventually, cycles of repeated waves will gradually decrease to an endemic state of low and stable transmission,” said Edwin Michael, an epidemiologist at the Center for Global Health Infectious Disease Research at the University of South Florida, at the Daily Beast. “New variants will cause flare-ups, but I expect that, given the robustness of natural immunity, such spikes in cases will be small compared to Omicron, for example, and so easily manageable.”
But not in China, which until a few weeks ago still applied strict lockdowns. Widespread public protests, extremely rare in the authoritarian state, put intense pressure on the ruling Chinese Communist Party from late November. On December 7, the party rolled back many of the restrictions.
Epidemiologists have warned that a sudden lifting of lockdowns in a country that hasn’t developed much natural immunity – and where vaccination rates are low for the most vulnerable part of the population, the elderly – could lead to a disaster as serious infections overwhelm hospitals.
A few weeks later, they were already right. A major outbreak in Beijing forced local authorities to reinstate some of the restrictions they had just lifted. But a return to unpopular lockdowns only delays the inevitable.
The Chinese want to return to their own normalcy. They will need natural antibodies to do this. But natural antibodies only come from infections. And those infections — potentially tens of millions of them — could define China’s year 2023.
The rest of the world, however, could be having its most normal year since 2020. Its reward for suffering through Omicron and its offspring. If there’s a possible spoiler, it’s that SARS-CoV-2 can be unpredictable.
As long as the virus circulates, it mutates. For more than a year, mutations have produced Omicron subvariants that diminish the effectiveness of vaccines and, in the case of the latest BQ subvariants, render monoclonal antibody therapies completely ineffective. But they did not escape our natural antibodies.
Klausner, for his part, doesn’t expect that to change. “There can be many different kinds of sub-variants and no drastic changes. We’ve been in the Omicron or sub-Omicron phase of the variants for a long time. That should continue.
If not, and a new variant or sub-variant emerges that dodges our natural antibodies, the whole world – not just China – will have to endure waves of infections. without the protection of natural immunity. This is how the dream of a normal 2023 could turn into a nightmare.
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