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Arthur T Knackerbracket [soylentnews.org] writes:

Five years ago, on March 11, 2020, the World Health Organization declared COVID-19 a pandemic. Whether it still is depends on who you ask. There are no clear criteria to mark the end of a pandemic, and the virus that causes the disease — SARS-CoV-2 — continues evolving and infecting people worldwide.

“Whether the pandemic ended or not is an intellectual debate,” says clinical epidemiologist and long COVID researcher Ziyad Al-Aly of Washington University in St. Louis. “For the family that lost a loved one a week ago in the ICU, that threat is real. That pain is real. That loss is real.”

According to recent WHO data, 521 people in the United States died of COVID-19 in the last week of 2024. That’s drastically lower than at the height of the pandemic in 2020. Nearly 17,000 people died of COVID-19 the last week of that year.

Dropping death and hospitalization rates, largely due to vaccinations and high levels of immunity, led to WHO [sciencenews.org] and the United States [sciencenews.org] ending their COVID-19 public health emergencies in 2023. The U.S. government has since reduced reporting of infections and access to free vaccines, tests and treatments. In the last two years, health professionals, scientists and policymakers have shifted to managing COVID-19 as an endemic disease, one that’s always present and may surge at certain times of the year [sciencenews.org].

Over the last five years, researchers have learned heaps about the virus and how to thwart it. But the pandemic also provided insights into health inequities [sciencenews.org], flaws in health care systems and the power of collaboration. But it’s hard to predict [sciencenews.org] how the United States and other countries will manage COVID-19 going forward [sciencenews.org], let alone future pandemics.

To get a sense of scientists’ current understanding of COVID-19 and what’s at stake, Science News spoke with Al-Aly, infectious disease physician Peter Chin-Hong of the University of California, San Francisco Health, and epidemiologist Bill Hanage of the Harvard T.H. Chan School of Public Health in Boston. The conversations have been edited for length and clarity.

We suspected quite early on that, given many people could be shedding virus without very severe symptoms, this was likely to be [something that spreads] like wildfire before anybody knew they were sick. The things that are most societally damaging are … the ones that people don’t notice until tens of thousands are infected.

Deaths and hospitalizations are still being monitored, although hospitals aren’t obligated to report data centrally anymore.

Long COVID can affect nearly every organ system. People think about it [as causing] brain frog and fatigue. Those can be symptoms of long COVID, but it’s much more than that. We have people with heart problems, kidney problems and metabolic problems. In some individuals, long COVID can be mild and not disabling. But in others, it can be severely disabling, to the point of people being in bed and losing their jobs.

Unfortunately, we haven’t really cracked the code for treating long COVID. There are still no established treatments approved by the FDA.

There is some danger in forgetting about COVID, specifically. It’s still causing a significant number of deaths, although much lower than early in the pandemic.

Researchers are looking at longer-term questions. We still have quite a lot to learn about the ways in which SARS-CoV-2 interacts with the immune system, different cells and so on. They matter for devising things like potential treatments for long COVID or antivirals.

Some of the biggest threats are people being fatigued with COVID [news] and the amount of misinformation and disinformation.

If a pandemic breaks out in March 2025, I predict that vaccine uptake would be way less than it was for COVID-19, and there would be less enthusiasm for masking and a lot of the public health measures that protected millions of people in the U.S.

Scientists across the globe dropped everything they were doing and said, “Okay, we’re going to focus on long COVID.” There’s no other condition that, within the span of five years, we have this many academic publications — about 40,000 and counting.

Then, really the patient community that led the way [sciencenews.org]. Patients with long COVID helped us understand that long COVID is happening, alerted the medical community and guided us in every step of the way in understanding long COVID.

Z. Al-Aly et al. Long COVID science, research and policy [nature.com]. Nature Medicine. Vol. 30, August 2024, p. 2148. doi: 10.1038/s41591-024-03173-6.

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