COVID-19 is a life-threatening disease that first was reported in December of 2019. Since then, the infectious disease has plagued the entire world causing the world to go into lockdown. Caused by the SARS-CoV-2 virus, it can either be symptomatic and show signs of acute respiratory distress or be completely asymptomatic. The coronavirus is named SARS-CoV-2 as this viral strain is genetically linked to the strain of coronavirus that caused the SARS (Severe Acute Respiratory Syndrome) outbreak in 2003. Similarly, the disease caused by the infectious strain is called COVID-19 due to the year it was first discovered.
Ever since the first cases were reported in Wuhan, China towards the end of 2019, the strain has traveled the whole world, mutating and becoming more contagious during the process. And while the virus took a world tour, scientists and researchers in the world have studied the strain, and the strain from the previous SARS outbreak to find a way to create a vaccine. Although many of them have been successful, the consequences of the COVID-19 pandemic are far from over. There are currently five vaccines available on the market to help combat the viruses, but are they effective against the new mutated strains of the virus? Or will people need to get vaccinated every time a new strain is discovered and an appropriate vaccine is made?
As time has passed, the COVID-19 pandemic has persisted, all the way to the year 2021, mostly due to the mutation of the viral strain into new ones. This calls for the renaming of the new strains and the disease they cause to correlate with the year they were found in. For example, the Indian strain recently discovered should cause COVID-21 rather than COVID-19, to give a little perspective on the situation that the world is currently in. Moreover, COVID-21 is not just the same disease as COVID-19 but happening in the year 2021, but rather is the result of the effects of the new viral strains, the public health response, and lastly, but most importantly, the new vaccines that may be needed. In a way, the COVID-19 pandemic may be long over. It is maybe COVID-20 and COVID-21 that may be now that haunting us.
One thing that is for sure is that the SARS-CoV-2 pandemic is here to stay, albeit not in the way it first began. More has been understood about the viral pathogen and research is being conducted to find a cure. But just because it is not as bad as before doesn’t mean it is good either. It is better than before, but not good overall. However, most of the public and governments have taken this ‘better than before’ to mean just ‘good enough’ where restrictions have been loosened or completely ignored. This is only worsening the current state and allowing for the mutated strains to spread like wildfire. The ‘good enough’ state may not be as permanent as most people have made it to be. In fact, it may be the reason for worsening the situation.
Vaccines against COVID-19
Currently, there are three authorized vaccines available in the United States; Moderna, Pfizer-BioNtech, and Johnsons&Johnson Janssen. Two more vaccines are currently in Phase 3 of their clinical trials, namely AstraZeneca and NovaVax. Except for the Johnson & Johnson Janssen vaccine, all the vaccines require two shots taken approximately 3 weeks to 4 weeks apart. Most of the vaccines have greater than 90 percent efficiency in protecting against the initial coronavirus strain but not much is known about their efficiency against the novel strains that have emerged recently.
Of course, the vaccination programs worldwide have altered the course of the pandemic and slowed down the progression to an extent. But the question still remains; how long will this immunity last? As the infectious disease has only been around for less than two years, not much can be said about its ability to re-infect even in vaccinated individuals. The long-term effects on the human immune system, mainly on its memory cells, are not known either since not enough time has passed.
Although the development of vaccines has helped slow down and protect the most vulnerable populations against COVID-19, the fight is far from over. The COVID-19 vaccines have been found to increase the antibodies against the coronavirus after both doses have been given. However, the same antibodies also have been found to drastically decrease by the three-month and six-month mark. Moreover, with new emerging strains, the efficiency of vaccines is being questioned. Will people need to get vaccinated every 3 months to six months to be able to protect themselves from COVID-19 or more aptly, COVID-20 or COVID-21? And if yes, how will new vaccines be made against the new strains? Making and testing the currently authorized vaccines took this long, will people have to wait the same amount of time for the new vaccine? The collective answer from the authorities to all of these questions, as of now, just seems to be, ‘We don’t know.
The Future of COVID-19: Life-threatening disease or a mild cold?
When discussing the future of COVID-19 and whether the current vaccines will become obsolete or not, there are two perspectives to keep in mind. And both perspectives are the polar opposites of each other but both are very likely to be the future of this pandemic.
Perspective A: A mere cold
While it is true that the neutralizing antibodies start to drop a while after being vaccinated, there are other aspects of the immune system that still provide the body the immunity it requires against the SARS 2 virus. The T cells and the B cells of the immune system play a much more important role than the antibodies in protecting the body. In a recent study, researchers studied the lymph nodes of vaccinated individuals by taking a small sample and found that there was strong B cell activity in these lymph nodes. This indicates protection against the virus despite low antibodies.
Similarly, a study was performed focusing on the T cell activity in the vaccinated people and this study found that the T cells of these individuals had the same half-life as those affected by Yellow fever. This is important because the vaccines against yellow fever provide lifelong immunity. Another study that focused on the initial SARS outbreak from 2003 found that the T cells of those individuals could still identify the SARS viral protein, almost 17 years later. This all points towards the efficiency of T cells in providing lifelong immunity.
If this perspective was to be believed where the presence of B cells and T cells plays a huge role in providing immunity, then the future of COVID-19, for us, is quite bright. Eventually, after vaccination programs are completed, the disease will become a mere cold that affects individuals but never progresses to the life-threatening condition it once used to.
Perspective B: A life-threatening disease
Although perspective A shows a lot of promise and is quite optimistic, not all researchers agree with it. A former Harvard professor, Haseltine has warned against the first perspective saying that although T-cell theory is accurate, it is not as potent as it is made out to be. The disease, after vaccination, may be milder or not as life-threatening but that may not be the case when the virus mutates. The vaccines may not be effective against the new strains, and the disease caused by the new strains may be even more life-threatening than before.
Another area of concern, according to Haseltine, is the concept of a universal vaccine. Although he hopes for one to be developed, it is important to note that several attempts have been made to develop a universal vaccine against the flu and none of them have been successful. He worries that this may be the case with COVID-19 too. However, there is no scientific evidence to back this specific concern of Haseltine.
Analysis of perspectives A and B
Although perspective B seems quite bleak, there is a solution to the problem. Although Haseltine stresses the fact that the vaccines are only a temporary solution, it is worth noting that boosters can always be given to maintain immunity against the novel SARS-Cov-2 strain and the mutated strains. Moreover, the CEO of the German Biotech CureVac has already made a statement regarding the efficiency of vaccines against the new strains. According to him, they now understand that the virus will keep on mutating and their new goal is to not only combat the problem at hand but also find a solution to the upcoming pandemic.
Pfizer is responsible for creating one of the most effective vaccines on the market right now and now, they are studying the effects of their vaccines on animal models to analyze if the vaccinated people can transmit the infection or get infected again. Moreover, both Pfizer and Moderna have studied ways in which the vaccines can be modified to fight the emerging new strains whether they are named COVID-20 or COVID-21, or by any other name.
One important thing to note here is that despite all of the scientific and medical concerns of COVID-19, it is the public health response of COVID-19 that is the most concerning. Dissolution of restrictions and rules to restart a life because things are good enough may be the reason for the emergence of the new strains and their rapid spread.