Signs of pandemic’s end: What the numbers show

How will the coronavirus pandemic end? Medical historians point to two scenarios: The medical ending and social ending. A “medical ending” takes place when cases and death rates drop significantly; a “social ending” is when fear over the pandemic wanes.

There are signposts of the pandemic's possible end.

All past plagues ended

The past gives valuable lessons. Plagues had come and gone. But an outbreak like the coronavirus can end in more ways than one, say medical historians. As to when will it end, there’s no guarantee, and no one can nail a specific date. It turns out the end of this collective COVID misery is a moving target. Also, it depends on what people and experts mean by the “end”.

Past plagues — Athens Plague (430 BC), Antonine Plague (165 AD), Cyprian Plague (250 AD), Justinian Plague, 541 (AD), The Great Plague (1665), and ‘Spanish Flu’ Pandemic (1918), the Russian Flu Pandemic (1977) Swine Flu Pandemic (2009), SARs and MERS — all came to an end.

By the same token, it’s not hard to imagine the hoped-for closure of COVID-19 would come.

Flu as a yardstick

Cases and deaths from influenza offer one marker. Annual influenza epidemics result in about 3-5 million cases of severe illness, and between 250,000 to 500,000 deaths globally per year (from 684 to 1,369 deaths daily).

Some experts say when daily COVID cases go down to the flu cases count and COVID deaths don’t go beyond the flu deaths, that could be taken as a theoretical end to the SARS-CoV-2 pandemic. However, a Nature article points out there's no universally-agreed number of cases and deaths that societies will find "acceptable".

How did the Spanish Flu end?

The Spanish Flu (or the 1918-1920 influenza pandemic) was exceptionally deadly, which claimed an estimated 50 million lives. It’s also known as the Great Influenza epidemic caused by the H1N1 influenza A virus. When it broke out, there was very little medical care (except a hospital bed and hot liquid), no drips and no antibiotics. A lot of people who got the flu got a secondary bacterial pneumonia. And that's what killed them, because there was no medication for it then. Most medical literature point to 1920 as the year when the Spanish Flu pandemic came to an end, as people who were infected either died or developed immunity by then.

What are the signs of COVID’s end?

The numbers point to some signs: In the last six months, global vaccine production and administration has accelerated.

How did the pandemic change the world?

The pandemic has unleashed a life-altering tsunami of death. In so doing, it forced everyone to confront a stark reality: a common enemy in a virus that brought untold misery for everyone.

It dwarfed all social divisions known to man — along the lines of class, wealth, colour, creed. The virus made a mockery of all man-made and natural barriers: national borders, oceans, mountains. It just flew across them. For once, everybody felt vulnerable. It became a mind-altering, behaviour-changing phenomenon that spares no one. Most people understood the need for compliance.

For once, it's a sign people can put infighting aside endless grumbling to fight a common enemy. This is not to say people did not engage in infighting, conspiracy theories, blame-game. 

'Two endings': medical and social

The change in attitudes is one thing. There’s a fringe but very vocal — they’re everywhere on social media — groups fuelling up xenophobia and all sorts of conspiracy theories, libertarians (“my body is my own business”) and anti-vax propaganda which has made herd immunity in some countries like the US impossible.

The death of influential of anti-vaxxers from COVID may force a rethink among their followers; many, however, have simply dug in with their absurd allegations.

In general, pandemics have two types of endings: the medical and social. Medical historians explain a medical ending takes place when cases and death rates drop significantly; social ending is fear over the pandemic wanes.

“When people ask, ‘When will this end?,’ they are asking about the social ending,” said Dr. Jeremy Greene, an internist, author of “Prescribing by Numbers: Drugs and the Definition of Disease,” and a medical historian at Johns Hopkins.

Can you give a date for when COVID will end?

Some experts say it will never end; only that its effect on public health will wane over time as most people, or at least the great majority that will survive, develop immunity. An outbreak can end in more ways than one, say medical historians.

As to when the medical ending actually happens, there’s no guarantee, and no one can nail a specific date. The end this collective COVID misery is a moving target. It also depends largely on what people and experts mean by the “end”.

Recovery, high vaccination rates possible

With single-minded devotion, it's possible for countries to overcome a menace as disruptive as COVID. Today, at 92% the UAE has topped the world in vaccinations, according to Our World In Data (of September 25, 2021) — 82% is now fully vaccinated in the UAE. The percentage of optimism in UAE increased to 94% in August 2021. The UAE is one of the first countries to recover from the pandemic. 

In the midst of the pandemic UAE has also achieved a number of milestones in medical science — starting with hosting a Phase 3 trial for the inactivated vaccine Sinopharm, bold decision to localise vaccine production (Hayat vax) and ramping up global vaccine delivers through its logistic facilities (International Humanitarian City) and airlines.

Sign of the times: Ramped up vaccine production

A look at industry-wide expansion of production capacities shows a spike in vaccine production. This would eventually ensure global supplies, though the level is not there yet.

Vaccine production rate in the last 6 months shows enough doses should be available by the middle of 2022 for every person on this planet to be vaccinated. Boosters should also be possible to the extent required, Moderna Inc CEO Stephane Bancel told the Swiss newspaper Neue Zuercher Zeitung in Zurich.

Spike in vaccine donations

After initial hiccups faced by vaccine makers due to raw material shortage early this year, there’s now huge ramp in vaccine production. Donations are up, too, worldwide.

China

China alone, has promised to deliver 2 billion doses to the rest of the world by year-end. It has already donated 304.9 million shots to Asia-Pacific countries and 180.9 million doses to Latin America.

India

India, for its part, is ramping up production and vaccinations. By October, India’s health minister said the subcontinent will have enough capacity to produce 300 million shots per month. They will also resume donations after halting them in April due to production glitches and spike in cases in. India has donated 60+ million vaccines to neighbours.

US, UK , Canada

The US, for its part, has administered 389 million vaccines so far. The White House also vowed this month to donate 1 billion doses to the less-developed. Some 93.4 million doses had been administered in in the UK and 55.7 million in Canada.  The UK has already donated approximately 5 million vaccine doses to COVAX. It is also donating another 9 million AstraZeneca shots to less developed countries. Canada has promised to donate 40 million vaccine doses to developing-world countries through the COVAX program.

European Union

The EU, meanwhile, has promised to bump up donations to the poor countries to 450 million by mid-2022).

France

On Saturday, September 25, French President Emmanuel Macron pledged to double COVID vaccine doses for poorer countries. "France pledges to double the number of doses it is giving. We will pass from 60 million to 120 million doses offered."

UAE

The UAE, which makes the Hayat-Vax COVID-19 vaccine, has donated several million doses to other countries: 1 million to Malaysia, 500,000 to Indonesia, 500,000 to Tunisia, 100,000 to the Philippines, 40,000 to Palestine, 50,000 to Seychelles, among others. Hayat is the first indigenous COVID-19 vaccine in the region to be manufactured by a joint venture between Abu Dhabi's G42 and Sinopharm.

Good Samaritan spirit

It's clear the "Good Samaritan" spirit is still alive in the world. It’s a basic human instinct. In the face of an external threat, people come to each other’s aid. In many ways, we see this among nations — not just among family and friends, but also among strangers. And it’s heartwarming.

it shows people know how to pull together, fighting the virus as one. Given the external threat, this disease called COVID, people have started redefining who they are, too. As every individual is unsafe from or affected by this virus, the “self” is no longer the individual. People have rediscovered a collective “self”, looking at everyone is “in the same boat”. Psychologists call this “collective resilience”.

Realistic end-point: From pandemic to endemic

In the transition towards normalcy, rapid vaccine rollout plays a role and will continue to do so. In a research paper, the think-tank McKinsey has warned, however, that vaccine hesitancy makes it “all the more difficult to reach the population-wide vaccination level rates that confer herd immunity”.

“Endemic COVID-19 may be a more realistic endpoint than herd immunity… it is most likely as of now that countries will reach an alternative epidemiological endpoint, where COVID-19 becomes endemic and societies decide — much as they have with respect to influenza and other diseases — that the ongoing burden of disease is low enough that COVID-19 can be managed as a constant threat rather than an exceptional one requiring society-defining interventions,” the paper added.

McKinsey stated: "The biggest overall risk would likely then be the emergence of a significant new variant.”

Whether it’s done through intramuscular or nasal route, a higher level of vaccination rates will be essential to achieving a transition toward normalcy. Full approval by the US FDA of Pfizer’s COVID-19 vaccine, and others expected to soon follow, could help increase vaccination rates.

In the coming months, vaccines are also likely to be made available to children in most countries. This will help protect the youngsters especially in countries where they form for a big part of the population.