Interview
Is 2022 the endemic year?
- The virus may enter a more manageable endemic phase in 2022, though the transition to this state is viewed as tentative and unlikely to happen this year.
- Omicron is expected to replicate faster in human lung tissue than Delta, leading to higher viral titers, earlier contagion, shorter latency periods, and increased shedding in respiratory droplets and aerosols.
- Due to its ability to infect hosts before Delta, Omicron is predicted to outpace and displace Delta entirely in the population.
- Experts reject the notion that the virus will naturally evolve to be less virulent, citing that evolutionary mechanisms do not guarantee a shift toward mildness.
- Future variants are predicted to emerge based on their ability to evade immunity, potentially resulting in strains that differ significantly from Omicron and arrive between 2022 and 2024.
- Without global vaccine equity or boosters, there is a risk of a new variant with true immune escape that could bypass vaccination coverage and lead to a worse outcome.
- While prior infection, vaccines, and boosters may provide partial protection against new strains, the durability of this protection is uncertain and the virus may not be manageable like a once-per-year flu.
- Multiple outbreaks are possible in the short and long term, with a managed state potentially causing fewer deaths but still straining hospital systems.
- Pfizer's oral antiviral Paxlovid is expected to be effective across all variants by targeting the stable MPRO enzyme, potentially reducing viral load tenfold if administered within the first few doses.
- Paxlovid and annual boosters are viewed as tools to bridge the pandemic toward a more manageable phase, though a pan-coronavirus vaccine and widespread Paxlovid availability are not expected this year.
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