As the Covid pandemic enters its third year, which is its most infectiously supercharged ever, many find themselves asking despairingly – or even – is it ever going to end.
The rise of the Omicron version has been rapid and staggering, pushing cases in Ireland to an all-time high of more than 20,000 a day, potentially thousands more undetected, as testing systems buckle under pressure.
However, a series of new studies have confirmed Omicron’s silver lining: Even as the number of cases has risen, the number of severe cases and hospitalizations has not.
Laboratory tests show that the mutation in Omicron makes it much more contagious than previous variants in the nasal and upper respiratory tract – favoring rapid transmission – but also less likely to penetrate deep into the lungs where Covid does the most damage. The data, some scientists say, indicate a new, less worrying chapter in the pandemic.
“Vaccines are doing a really good job of protecting against serious disease and I think it will continue to be that way,” said Paul Moynagh, a professor of immunology at Maynooth University.
“A lot of people have been infected with Omicron in the past few weeks. Due to which their immunity becomes stronger. Inevitably, over time, we are all going to be exposed to the virus, especially the rate at which it is transmitted.
“What will determine your level of protection for the person at the time they are exposed to the virus.”
Because of the higher number of mutations in the omicron than other covid variants, it can sometimes overtake antibodies created by vaccination or infection.
However, if the virus still enters the body, white blood cells, called T-cells, will attack. As the pandemic enters the next phase, Prof Moynagh expects subsequent editions to be mild again.
“They become a milkmaid,” he said. “Part of the reason is that even with these variants, which have mutated a little, we have essentially seen the first virus with some changes.
“That prior immunity, that wall of immunity that we are building all the time through prior infections and vaccinations, is what is keeping us from getting very sick.
“Although the virus can overcome our antibodies and infect us and give us a sniffle and a cold of the head for a few days, we will clear it.”
How SARS-CoV-2 develops over the coming months and years will determine what the end of this global crisis looks like – whether the virus turns into another common cold or something more dangerous.
A global vaccination that delivers nearly eight billion doses is changing the evolutionary landscape, and it is not yet clear how the virus will meet this challenge.
The Omicron crisis shows that we are not there yet, but as Prof Moynagh says: “I think we will reach a point where SARS-CoV-2 is endemic, just like flu is endemic.”
He predicts that like the flu and other endemic diseases like measles, COVID-19 will cause periodic outbreaks and that the coronavirus will continue to flare up every now and then, even after Omicron passes away.
“I think the effect will lighten over time; this year it will get lighter as well,” said Prof Moynagh.
“We can see peaks and waves in the winter months. At some stage we have to distance ourselves from this testing and reporting of cases, especially with Omicron, where most cases are very, very mild.
“At some stage we have to move to other metrics as indicators to inform what our policies should be in terms of impact on the health system. I can imagine that surely we will all be exposed to this virus for the rest of our lives.
“How we respond and the outcome for you will depend on the level of your immunity. Thankfully, because most of us have been vaccinated, boosters, prior infections, this leaves us where we may not be seeing it the first time.
“We are not back in March of 2020, we are not back in December 2020 with the delta version, because that phase was pre-vaccine. We now have a population that is reasonably safe.”
Other experts predict that as mutations continue to persist, we will need boosters every now and then that are updated to better match the new variants.
“The biggest concern is that the omicron will turn again, have the same level of transmission, but will be even more capable of developing immunity with vaccines,” said Kingston Mills, professor of experimental immunology at Trinity College Dublin.
“Pharmaceutical companies are making Omicron-specific vaccines, so it is likely that people will get a boost, not from the current vaccine, but from it.
“If Omicron were to change a bit from what it is now, it could make it more difficult to protect against existing vaccines.
“These omicron-specific vaccines will be better able to deal with this, because it will be closer to the changes that have been made. So you have the seasonal flu vaccine, because the virus has changed over the past year.
“A vaccine based on Omicron would be better able to deal with a version that came from Omicron, than a vaccine based on the original strain, because it is going back and forth from sequence in the circulating virus.”
As the omicron wave reaches its peak, scientists are looking for clues to other pathogens, searching for ways to predict the virus’s next move.
They are tracking the effects of mutations in variants generated so far, while tracking new ones.
When the endemic state will change, and what a COVID-19 infection might look like at that time, is not yet clear.
“Getting to the spatial level is entirely dependent on the emergence of new forms and we have no way of knowing that,” Prof Mills said.
“The goal to tackle this should continue to be the same way we deal with any endemic infection like influenza.
“We have other infections, such as whooping cough, that come up and re-emerge.
“The vaccine we have against it doesn’t prevent infection, it prevents disease. We control that infection appropriately.
“There are so many examples of infections that we live and control with vaccines and hopefully we go through with Covid-19.
“We’ll have this problem every winter — a seasonal virus that we vaccinate.”