[ukmicky (OP)]

So our attempts at making a vaccine whilst valiant hasnt helped as much a we have hoped as they can’t stop you getting infected .So the way I see it there are only two possible futures for the world and COVID as the world won’t keep locking down forever as such an action is not economically viable into the long term

1.  It evolves hopefully into a more infectious but less deadly variant that takes over from delta and omicron and becomes something no worse than the flu.
 or
2. we just learn to live with it and accept it’s going to cause many fatalities and hope some new drug will come along which will effectively treat its symptoms.

I beginning to think 2 is probably the way most countries will deal with it in the future.

Any thoughts

[alancalverd]

1 is a good longterm option for the virus as dead or seriously incapacitated people are less effective spreaders.

2 is not a good option. We have eliminated smallpox and polio by different and evolving mixes of social behavior and vaccination, and I see no reason for not eliminating COVID by a similar means. The problem of idiocy can be addressed refusing free healthcare to anyone who has refused a vaccination, and declaring the USA an inherently unsafe area..

[ukmicky (OP)]

1.  is a good longterm option for the virus as dead or seriously incapacitated people are less effective spreaders and experts say it’s not good for a virus to become more deadly as it will wipe out  it’s hosts and it’s ability to spread but a virus  doesn’t think before it evolves and  could  theoretically suddenly evolve into a new deadly but super infectious variant that does wipe out most of its hosts eventually but  thats maybe a subject for a new thread.


2. It’s not that simple and you can’t simply compare one type of virus to the next .

COVID 19 will be with us in one form or another for a long time into the future as the current crop of vaccines don’t prevent you catching or spreading it . They only reduce the symptoms and someones ability to spread  the virus , they don’t stop transmission. Which is why Vaccinating the world with the current vaccines won’t wipe it out or prevent it evolving into new variants. 


Maybe in the future they will come up with a better vaccine but currently as none of the vaccines prevent you from catching or transmitting it COVID 19 is here to stay and the only questions is therefore is do we continue as we are or do something different.

The world can’t continue with the current strategy , of  boosters every few months ,lockdowns  and border closures even if we would like to think we can or all the economies around the world  will collapse within a few years which will then cause even more fatalities as other important causes gain reduced funding.

Is it time for  the world to come together and work out a new strategy . After 2 years I think it is.

[evan_au]

Lockdowns are likely to return if hospitals look like they will become overloaded. But if there is a 4 week delay between infection and hospitalization (which we saw with Delta), politicians will realize too late that hospitals are in trouble, and will act too slowly.

Indications out of South Africa suggest that with the Omicron outbreak in December 2021:
- new infections during the outbreak peaked rapidly (very infectious)
- but the duration of the peak was fairly short (many people were infected rapidly, so fewer susceptible people to infect)
- If there is a 5-week gap between infection and ICU/death (like Delta), we don't know when deaths will peak, and whether it will be at a lower rate than Delta. But early indications suggest that Omicron is less deadly than Delta.

Omicron seems likely to displace Delta, so overall that seems like a good thing.

Possible future variants are less predictable.

lockdowns  and border closures

In Australia, all the politicians agreed that borders would be open for Christmas.
- Public Health officers warned that plans made for Delta did not apply to Omicron, but the border openings proceeded anyway
- Now, the airlines are having trouble finding aircrew to fly the planes (staff who haven't been exposed to COVID), and half the flights are cancelled
- States still expect to see a PCR test taken within 72 hours of arrival - but the time to return PCR test results has ballooned out past 72 hours, so fewer people are allowed onto a plane.
- And some states have closed borders again.

The language of science: As additional evidence becomes available, reassess your advice; if you aren't sure, state that clearly.
The language of politics: Make confident statements, even with no evidence. Repeat your confident statements even if contrary evidence appears, or you will appear weak and indecisive.

It appears that some governments eventually listened to the science on Omicron, while some are still staying with their Delta-inspired policy.

[Bored chemist]

declaring the USA an inherently unsafe area..

It already was.
But the issue sin't so much the USA where they are too dim to vaccinate.
The problem is those parts of the world where they are too poor. (It's no coincidence that polio remained longest in poor countries).

The sensible rich nations need to pay for the vaccines in the developing world, otherwise the virus will circulate and mutate there rendering any elimination  protocol impossible.

[ukmicky (OP)]

declaring the USA an inherently unsafe area..

It already was.
But the issue sin't so much the USA where they are too dim to vaccinate.
The problem is those parts of the world where they are too poor. (It's no coincidence that polio remained longest in poor countries). countries).

The sensible rich nations need to pay for the vaccines in the developing world, otherwise the virus will circulate and mutate there rendering any elimination  protocol impossible.

.  Paying for vaccines in the developing world, may reduce it circulating but won’t stop it circulating and mutating as the vaccines don’t prevent someone catching or transmitting the virus ,they only reduce the likelihood.

In a study by nature magazine 90 % of immunologists, virologists etc believe it will never be eradicated and will become endemic.

[CliffordK]

With nearly 8 Billion possible human hosts, a virus won't care how lethal it is.

Smallpox didn't care how lethal it was.  Nor has AIDS/HIV. 

The biggest factor will be human behavior based on perceived risk.

I fully expect this to settle down somewhat like the flu, with most of the global population either having been vaccinated and boosted, and boosted again, or having gotten the disease, perhaps multiple times.  Either way there will be a certain amount of immunity built up which will reduce the severity of the disease. 

I do think we are beginning to see some society immunity effects that are protecting from Omicron. 

However, I also like the theory that Omicron evolved in one or several HIV/AIDS patients, and evolved to be less lethal (don't kill the already diseased host), while picking up several mutations to become more infectious. 

Also, while there were a lot of Delta infections at the time, a non-Delta variant may have spread easier in the population that already had high levels of Delta infections.

Like the flu, we may end up with several dominant strains in the future.  I still expect this to become seasonal, jumping from the Northern to the Southern hemisphere and back every year.

[chris]

Worth bearing in mind that Alpha (the "Kent" strain) evolved in the UK, and Omicron emerged in southern Africa, which has relatively high vaccine uptake. So it's not a given that you vaccinate the third world and the variant problem goes away. What will solve this, long term, is population immunity accrued by successive encounters with the virus from a young age.

[Petrochemicals]

Worth bearing in mind that Alpha (the "Kent" strain) evolved in the UK, and Omicron emerged in southern Africa, which has relatively high vaccine uptake. So it's not a given that you vaccinate the third world and the variant problem goes away. What will solve this, long term, is population immunity accrued by successive encounters with the virus from a young age.

Fact checked Chris, South Africa has a rate of 26 percent according to Our World Data and 36 according to Wikipedia. That said it should be enough to vaccinate those over 50 who are likely to have long term severe infections.

[evan_au]

An immune-compromised patient (eg transplant patient, poorly-controlled or asymptomatic AIDS) are likely to churn out variants, as their immune system can't gain the upper hand, and the virus can keep changing to stay ahead of the weakened immune system.

[Bored chemist]

Simplistically, this disease only kills the over un-immunised 50s.
In 50 years, there won't be any.

That's because anyone over 50 will have "grown up with" this virus.
Either they will have been jabbed or (in the bits of the world where jabs are rare) they will have been infected, and shaken off the infection.
So, in 50 years this will be a childhood disease and or  "just another cold".

The questions are, what do we do in the mean time and what do we do about variants?

As far as I can see, the best available answer to both of those is to slow the spread by vaccination. That policy also minimises the effects of "Long covid" etc.

[set fair]

Even among virologists, who know know much more than any of us, there are two opinions about what drives the variants;-
1) So many infections, the variants won't stop until we vaccinate the world.
2) Variants are down to people having some immunity to Covid
For what it's worth I'm in camp 2 and see the shorter incubation period as the virus evading immune memory. I expect it to end up as common cold virus, Omicron could be that transition or we might have to wait 20 years. We know very little about what it is about the virus that makes it lethal apart from the fact that 20% of those who died had autoantibodies against interferon. Knowing so little, short term prognostication is guess work. Although we can say that unless we vaccinate every 4 months there will be loads of cases next year.

The immunocompromised individual as the creator of Omicron is plausible, but so is the idea that the virus spilt from us to another species and spilt back as Omicron. Animal reservoirs pretty much guarantee that the virus can't be defeated by herd immunity.

We just have to wait and see if we get an Omicron / Delta chimera or a new variant which could be much more or less lethal. IMHO those doctors who are proclaiming Omicron as the beginning of the end should be struck off.

[sceptic-eng]

If you are correct in guessing that it covid could mutate into something similar to a common cold then we should immediately start to get back to normal.
To stop media hype we should not issue information on test results; in fact we should tell people to self isolate if they have a cold, loose their taste or have a temperature which could be flu.  Only doctors should be allowed to authorize a test.

[Petrochemicals]

IMHO those doctors who are proclaiming Omicron as the beginning of the end should be struck off.

And what medical training forms your medical opinion? The repeated claims of vorologist s has been a mutation into a less lethal more transmissable strain is the norm.  We have also been told that vaccines would give herd immunity, but recently to my knowledge of a group of 3 vaccinated adults and 2 unvaccinated children, only one child had no symptoms and tested negative.

https://www.nhsinform.scot/covid-19-vaccine/the-vaccines/how-the-vaccines-work

[evan_au]

20% of those who died had autoantibodies against interferon

This was  news to me. 
Interferons are one of our first lines of defence against viral infection. COVID-19 has genes which suppress interferons, assisting asymptomatic spread.
If patients have a chronic or genetic interferon deficiency, that would make COVID infection worse.
Here is an article about it in The Lancet.
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(21)00034-5/fulltext

[evan_au]

Only doctors should be allowed to authorize a test.

In Australia, some states require a PCR test before anyone enters their state. And another one a few days after they arrive (and the same on the return journey).
This was clogging up PCR testing in both the originating and destination states.

We had the crazy situation where PCR testing clinics were turning away people who were symptomatic and/or had a positive RAT result so that tourists could go on vacation (with a government-funded PCR test).

It looks like states might halve the number of PCR tests and/or accept somebody’s word that they had correctly self-administered a RAT, and it was negative.

These Christmas/Summer holidays will definitely be an Omicron super-spreader event!

[Bored chemist]

Only doctors should be allowed to authorize a test.

They did.

[Bored chemist]

2) Variants are down to people having some immunity to Covid

Practically everybody has some immunity to it, so that idea makes no sense.
Can you cite a reference so we can see what the virologists actually said?

[Bored chemist]

If you are correct in guessing that it covid could mutate into something similar to a common cold then we should immediately start to get back to normal.

Nonsense, It could mutate into something less harmful- indeed it will do, very frequently. But we will not hear about those variants.
But it can also mutate into something more harmful.
Why do you think that means we should get "back to normal"?

[gerardseal]

I heard a version from the Swiss expert Pitte that in the future COVID-19 can become like a common cold. I hope he's at least a little right