Covid pandemic: WHO declares end of emergency – 05/05/2023 – Health

“Mysterious respiratory disease kills two in China and raises alert in the US”, read the title of the report on the website of the Sheet. The text, dated January 17, 2020, spoke of “a new type of coronavirus” in the Chinese city of Wuhan. “Local health authorities have tried to reassure public opinion: according to them, the risk of human-to-human transmission, if not excluded, is considered low.”

At least at the beginning, this was not an unreasonable bet. Other newly discovered coronaviruses, including one that had emerged in China itself — the one that caused the atypical pneumonia Sars, detected in 2002 — had caused very limited damage to the human population before being contained for good.

This was not the case with the virus that would receive the official designation of Sars-CoV-2. The cause of Covid-19 “learned” to infect human cells with relative efficiency and found billions of potential victims before him, with no natural defenses against him.

This Friday (5), after more than three years and almost 7 million deaths, the WHO (World Health Organization) declared that Covid-19 is no longer a Public Health Emergency of International Concern (PII).

The indication that a disease represents a global health emergency is given by a committee formed in the face of a possible threat. Members of that council meet and advise WHO Director-General Tedros Adhanom whether or not the situation represents a global emergency.

In the case of Covid, this occurred on January 30, 2020. Since then, committee members have maintained the position that the infection continues to pose a worldwide risk. This only changed with the last meeting, held this Thursday (4), in which the group observed that the disease no longer represents a concern for public health worldwide.

The result of contact with Covid-19 was the most devastating pandemic of this century so far, responsible for triggering a kind of epidemiological time travel —towards the past.

For the first time since the beginning of the 20th century, one of the leading causes of death in rich countries has again become an infectious disease. The same happened in countries like Brazil, where, despite social inequality, most communicable diseases had also been overcome or contained.

In a large part of the world, life expectancy has even decreased: just over two years less for male Americans, according to a study published in February 2022. The most conservative data, with tests that directly detected the action of the virus, indicate that 6.5 million people died of Covid-19 by October 2022. Of these, almost 700,000 were Brazilian.

The real number, however, could be much higher. When the so-called excess deaths are computed — that is, those that exceed what would be expected according to normal mortality trends, without the pandemic — the victims of the disease could reach 15 million.

According to the hypothesis accepted by the vast majority of the scientific community, Sars-CoV-2 gained access to this global multitude of new hosts following a well-known script. All the main clues point to a genesis of the pandemic in one of Wuhan’s “wet markets” — a place where live wild mammals and their meat came into contact with domestic animals and people.

Almost every major disease pandemic in history seems to have started this way: as pathogens (disease-causing) whose natural reservoir was a species of mammal or bird. Wild animals harbor an immense diversity of unknown viruses, and constant contact with them in environments like the Wuhan market multiplies the chances that one of these viruses will make the leap between species.

Concentrations of cases were noticed in the Chinese city from November 2019, and some doctors in the region soon warned health authorities about the risks of that scenario. Some of them, however, were even punished for alarmism, and more serious control measures took a while to be implemented. Wuhan is a metropolis of 11 million people and a bustling hub for high-speed rail and air travel. In December and the first half of January 2020, the absence of severe barriers to movement allowed the disease to spread across China and had already begun to reach other countries, although the first Brazilian case was only confirmed at the end of February of that year. From then on, the pandemic became very difficult to contain.

Similar situations in the past almost always involved large doses of rumors, beliefs and xenophobia, in the search for magical solutions to the progression of deaths and for scapegoats for the situation. In the case of Covid-19, these predictable reactions were boosted by the black hole of social media and extreme right-wing movements, with emphasis on Trumpism in the US and Bolsonarism in Brazil. The ideological attachment to “individual freedoms” at all costs and the eagerness to keep the economy running made these movements sabotage the main prevention measures.

The only reason the disaster wasn’t greater was because of the unprecedented mobilization of the world’s scientific community against Covid-19, boosted by public investments in the order of tens of billions of dollars. In just a few months, researchers unveiled details of the transmission and replication (roughly speaking, “reproduction”) cycle of a previously unknown virus.

Tests of existing drugs and the development of new drugs took place in record time, an effort that culminated in the approval of the first vaccines against the disease in early December 2020, a year after the first cases in Wuhan. Immunizations have proven safe and effective in protecting the population against hospitalizations and deaths, although they have so far not been able to stop the transmission of the virus.

With relatively fast and inexpensive sequencing (“reading”) methods of genetic material at hand, it was possible to monitor the evolution of a pandemic virus in real time for the first time in history.

A succession of Greek letters began to populate the news, documenting the transformation of the original strain of Sars-CoV-2 from Wuhan. They were variants such as gamma (responsible for the tragic scenes of patients without oxygen in Manaus in early 2021), delta (which led to a strong recrudescence of the disease in Europe and North America in the middle of the same year) and omicron .

For now, it seems that it makes sense to put a period after the designation of this last variant. While forms of Sars-CoV-2 such as gamma and delta emerged from mutually independent lineages, with each of them “discovering” its own path as an increasingly efficient parasite of human cells, the arrival of omicron, at least for the time being, this dynamic has ended. New variants, with greater transmission efficiency and more agility in dribbling that apply to the body’s defense system, continue to emerge, but all derive from the omicron “1.0”.

The end of the global emergency brought about by Covid-19 is far from meaning that new pandemic threats will be slow to appear. The rise of so-called monkeypox (which, it should be remembered, has nothing to do with primates, despite its name) has made that clear, even with its more modest impact.

Despite skepticism about the origin of Sars-CoV-2, and even if a link between the genesis of the virus and laboratory research is someday demonstrated, the reservoirs of disease in nature remain much larger than any laboratory source.

This means that new pandemics will continue to appear wherever intense contact between humans and/or their domestic animals, on the one hand, and wildlife, on the other, is encouraged by economic factors.

The destruction of habitats through deforestation, the trafficking and consumption of wild animals or products derived from them, the indiscriminate advance of agriculture and the climate crisis correspond to a global machine for generating pandemics. Constant monitoring of potentially dangerous pathogens and investment in vaccines and innovative drugs can even prevent a lot of damage. But, without an attempt to slow down the machine, other measures will only serve to dry ice.