Everyone may realise that illnesses are not fixed things. They change as their pathogens change, the carriers of the disease change and the environments change. This, of course, also came with the coronavirus (Covid-19), so the three are now different from what they were in 2020. Didn’t our immune systems also change to stop spreading of infection? In fact, our lifestyles have changed, as have social norms, medical regulations and public health programmes.
From here and through those changes can I now call Covid-19, Covid-21? Is it not the product of all these changes in the aggregate? It is the disease as it will happen and we interact with it in the coming months and years, with these new mutations of the virus, new public policies and health behaviours, different degrees of immune memory and most importantly, a series of new vaccines!
As we have followed, individuals must take the coronavirus vaccination to ensure their safety and the safety of their families and society, yet it is also certain that the vaccination efforts will change the nature of corona in unexpected ways! In a way, the main question is how long will this protection last, especially against a rapidly mutating virus? The truth of some clinical trials has shown that vaccines are good and even brilliant in preventing dangerous diseases so far, but they have not yet been able to definitively reveal how protection may dissipate over long periods.
However, not everyone may even realise that antibodies are not the only complete story of immunity. There is more than one suggestion that we will be well protected by other immune mechanisms, even after low levels of antibodies (which are usually created after vaccination or after infection with the virus). Actually, there are other cells like T cells and B cells; they also store a memory of past infection and are somewhat more important than antibodies to maintaining long-term protection against viruses. However, this memory is not always preventive, like the presence of high levels of neutralising antibodies in your blood, but a number of studies conclude that it is sufficient to prevent severe disease.
Hence, Covid-21 — if it is right for me to express it as a metaphor for Covid-19, after all the changes it has undergone — finally began as a milder and less lethal version of the disease that we saw last year. Certainly everyone is asking and at this stage, whether our immune memory cells may weaken their performance over time if the virus continues to mutate from one mutation to another? And after taking the vaccination, for instance will we need to take the booster vaccination in the future and at regular intervals?!
Interestingly, this leads us to realise that we are now at an inflection point that will change the reality of this disease and fear that the future will be more treacherous as humanity fails to change its standards, so we end up measuring the risk of Covid-21, according to the standards of 2020. What I mean is that countries that have early access to vaccines give up the continuation of global vaccination efforts against the coronavirus with a decrease in their cases or when the disease becomes more moderate for them, then the disease will be spreading elsewhere in the world and such suffering will continue indefinitely!
There is no doubt that the feeling of fear and terror that society experienced last year is behind us, despite the persistence of unknowns about how long exactly immunity will last and how many cases we will continue to see. Now we have the necessary knowledge and resources, which the government has used to overcome and contain the pandemic despite the accompanying economic and social difficulties, to become more efficient and fast in the distribution of the vaccine and try to reduce cases across the Sultanate, especially because if we overcome Covid-21, the number of cases may end there.
Dr Yousuf Ali al Mulla, MD, Ministry of Health, is a medical innovator and educator. For any queries regarding the content of the column he can be contacted at: dryusufalmulla@gmail.com
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