New findings about COVID

It has been about four years since COVID-19 was first identified, and a great deal of progress has been made both in our understanding of the virus and the ability to control it since then. Our approach to the pandemic has evolved with the development of antiviral tablets, simple at-home diagnostics, and new immunisations suited to current virus strains. However, despite these advances, health experts believe that COVID-19 still poses a threat, and it will continue to remain with us for some time to come.

It needs to be remembered that respiratory viruses are more prevalent during the winter months. Unlike flu which follows a seasonal ebb and flow, COVID-19 defies a fixed schedule. Its waves are observed in winter, spring, summer, and autumn.

According to Andrew Pekosz, a Professor of microbiology at the Johns Hopkins Bloomberg School of Public Health, if the virus moves into a fall and winter pattern, it could provide multiple benefits. If that happens, he says, vaccination efforts would be simplified and public health messaging would be more effective, especially when compared to a virus with a year-round presence and irregular surges. Predictable seasonality could allow hospitals and healthcare providers also to better plan for an expected increase in patient numbers. Doctors and scientists are warning that the situation has now changed drastically, with new omicron descendants such as BA.2.86 and FL.1.5.1. Experts are now projecting an influx of new variants in 2024. Dr. Ziyad Al-Aly has stressed that the virus’s continual evolution also will require people to accept and adapt to this constant transformation.

Experts are now underlining that since the emergence of Omicron in late 2021, the virus has primarily undergone small changes. That has allowed us to adapt through updated vaccines that address its latest variants. However, there’s uncertainty about its future trajectory. Health experts express concern that a divergence in the virus’s evolutionary path may render our current vaccines ineffective. This could, in turn, necessitate the development of new vaccines or lead to current antivirals becoming outdated, thereby prompting the need for novel designs.

Experts are also pointing out that individuals have the ability to prevent the spread of possibly more dangerous virus variants. The greater the spread of a virus within a population, the higher the likelihood of mutations. By protecting ourselves and others against COVID-19, we need to actively contribute to the prevention of new variants from emerging.

It would be useful for us to remember that millions of people have been affected post-COVID-19 recovery by the enduring, sometimes incapacitating symptoms caused by long COVID. While there is still a great deal of uncertainty surrounding long COVID, scientists expect significant results in 2024.

The National Institutes of Health in many countries has launched a series of clinical trials aimed at gaining a deeper understanding of treating, and preventing long COVID. One trial will look into the efficacy of the COVID-19 therapy Paxlovid in treating the symptoms of this mysterious condition. Another trial will look at therapies for brain fog, memory loss, and cognitive problems associated with extended COVID. The outcomes of this extensive study project, which includes multiple investigations, will be released in stages. COVID experts are optimistic about uncovering additional insights into its occurrence and duration in the coming year, as well as its underlying mechanisms.

According to Dr. Rachel Presti, Professor of Medicine and Medical Director of the Infectious Disease Clinical Research Unit at Washington University School of Medicine in St. Louis, we should expect new vaccines to appear as the virus evolves requiring regular upgrades of the COVID-19 vaccine to reflect the most recent viral strains.

In the meantime, it has also surfaced that a potential combined flu-COVID vaccine could be in the world by the end of 2024 as manufacturers are exploring a single-shot solution guarding against both influenza and the coronavirus. The prospect of a combination vaccine has made experts optimistic about delivering a key message to the majority of the population, particularly those at risk of severe forms of COVID or influenza. The aim through this format would be to highlight a simple way for individuals to protect themselves.

In the meantime, it has been underlined by physicians that people in general should resort to mask wearing to fight the new mutated type of corona JN.1 which is slowly spreading in different countries of the world.

Fortunately, till now this mutated type has not yet been identified in Bangladesh. However, the National Technical Advisory Committee on Covid-19 has advised everyone to wear masks as a precaution. A statement signed by the Chairman of the Committee Prof. Mohammad Sahidullah has particularly drawn attention to the fact that masks should be used as a precaution in high-risk places such as hospitals, medical centres and high-risk individuals with weak immune systems. The Committee feels that it will be helpful in preventing other health problems besides Covid-19. Prof Meerjady Sabrina Flora, a member of the Committee has emphasised the unpredictable nature of the virus and drawn attention to the fact that “even though this particular Covid-19 variant hasn’t spread in Bangladesh, we cannot be complacent. Global travel makes it easy for variants to cross borders. If someone entering Bangladesh carries this variant, it can potentially lead to local transmission. We must remain alert to all possibilities.”

It has also been suggested that concerned authorities should take steps to prepare for the screening of passengers coming from abroad. World Health Organisation (WHO) has recommended that high-risk individuals may need to receive a fourth dose of the vaccine. We need to remember that COVID-19 is mainly transmitted when people breathe in air contaminated by particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing. Transmission is more likely the closer people are. However, infection can occur over longer distances, particularly indoors.

The transmission of the virus is carried out through virus-laden fluid particles, or droplets, which are created in the respiratory tract, and they are expelled by the mouth and the nose. There are three types of transmission: “droplet” and “contact”, which are associated with large droplets, and “airborne”, which is associated with small droplets. If the droplets are above a certain critical size, they settle faster than they disappear, and therefore they pollute the surfaces surrounding them. Droplets that are below a certain critical size, evaporate faster than they settle; due to that fact, they form nuclei that remain airborne for a long period of time over extensive distances.

Infection can begin four to five days before the onset of symptoms. Infected people can spread the disease even if they are pre-symptomatic or asymptomatic. Most commonly, the peak viral load in the upper respiratory area samples occurs close to the time of symptom onset and declines after the first week after symptoms begin. Current evidence suggests a duration of viral shedding and the period of infectiousness of up to ten days following symptom onset for people with mild to moderate COVID-19, and up to 20 days for persons with severe COVID-19, including immunocompromised people.

Infectious particles range in size from aerosols that remain suspended in the air for long periods of time to larger drops that remain airborne briefly or fall to the ground. Additionally, COVID-19 research has redefined the traditional understanding of how respiratory viruses are transmitted. The largest droplets of respiratory fluid do not travel far, but can be inhaled or land on mucous membranes on the eyes, nose, or mouth to infect. Aerosols are highest in concentration when people are in close proximity, which leads to easier viral transmission when people are physically close, but spread through air can occur at longer distances, mainly in locations that are poorly ventilated; in those conditions small particles can remain suspended in the air for minutes to hours.

The IEDCR has also been advised to carefully follow the global response and strengthen surveillance. It has been recommended for making necessary preparations for rapid treatment including Covid test and ICU in case of future infection.

Before concluding, I take the opportunity to remind the readers that since the virus’s initial detection in China’s Wuhan on Dec 31, 2019, and the first reported case in Bangladesh on Mar 8, 2020, the country has confirmed over 2 million Covid-19 cases and nearly 30,000 deaths. It also needs to be mentioned that as many as 18 new Covid-19 cases were recorded in the health directorate’s latest daily count on 2.1.24. We need to be careful. 

Muhammad Zamir, a former Ambassador, is an analyst specialised in foreign affairs, right to information and good governance.

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