The pandemic, it turns out, is not a war. It won’t end in either complete victory or in a negotiated treaty. That leaves us with no clear line between pandemic and not-pandemic. 

The consensus among public health experts and epidemiologists is that Covid will, at best, turn into a background danger, something that pops up in localized and seasonal outbreaks that we have to live with and work around. 

But that’s the best outcome, not the guaranteed one. Everything depends on how many people get vaccinated and what variants develop. And because no variant can be contained in one country or region, one country’s problem is every other country’s problem.

According to Alessandro Vespignani, professor of physics, computer science, and health sciences, “Vaccination of the low- and middle-income countries is the most altruistic thought and at the same time, the most selfish. Because we have to protect those populations so that we can protect us.” 

So that’s a definite maybe on the pandemic ending, not a resounding yes. Pack away the trumpets, the confetti, the Mission Accomplished banners. That banner stuff looked a little silly anyway, back when Bush Jr. tried it. And keep your eye on what’s happening in the worst prepared countries, because what happens there will be knocking on your door and mine in no time at all.

 

More on long Covid

First, the disclaimer: There’s no one definition of long Covid, so if this all seems a little murky, that’s because it is. Long Covid’s symptoms range from the annoying to the life-changingly disastrous, and at this point they all get lumped in together. Some of them go away after a while and others get milder. Some do neither–they set up housekeeping. 

If that sounds ominous, allow me to make the picture worse:

Almost a fifth of the people who caught Covid infections but had no symptoms show symptoms “consistent with long Covid” a month after they got infected. In other words, people who had no symptoms may be going on to develop long Covid. 

And 27.5% of non-hospitalized people with symptomatic Covid did the same thing, as did 50% of the people who were hospitalized. 

That comes from an analysis of medical insurance claims by 1.96 million people in the U.S. The weaknesses of the study are that it didn’t have a control group and that it only studied people who had certain kinds of insurance. In the U.S., what kind of insurance you have says a lot about your class, which in turn says a lot about how Covid hits you.

Did I say “class”? Sorry. Everyone in the U.S. is middle class. It’s just that a very few members of the middle class are obscenely rich, some are doing fine, some are just hanging on, and some are long-term broke.

I’ve been away so long. I sometimes forget. 

But back to the study. Its strength is that it’s huge. 

But you can’t look at it and say, “This group of people definitely had long Covid.” On the other hand, with no solid definition of long Covid, it’s hard to look at any group of people and say that. At the very least, it’s enough to make us stop and think about what we’re dealing with in the long term. The pandemic is likely to leave us with a long-term public health problem, something individuals, families, health systems, and governments will all have to deal with.

The report also “drives home the point that long Covid can affect nearly every organ system,” according to Dr. Ziyad Al-Aly, chief of the research and development service at the Veterans Administration St. Louis Health Care System. “Some of these manifestations are chronic conditions that will last a lifetime and will forever scar some individuals and families.”

Just to keep from scaring ourselves witless, let’s remember that some of the manifestations (that translates to symptoms) aren’t likely to leave scars forever. No one seems completely sure of how wide and how deep the problem of long Covid will go. It scares the hell out of me, but there’s no point in getting so scared we can’t function anymore.

If, in fact, we ever did function (she said cheerily).

 

So when do we go back to normal?

England–or its government, anyway–has put off lifting the last of its lockdown rules. That makes the prime minister very sad. He wanted to let us know that we all live in paradise, have enough money to live well, and are at our ideal body weight. 

Yea, every last lumpy one of us.

The postponement came because multiple experts have been warning of a possible third wave. Last I heard, England’s R number–the rate at which the virus is spreading–was estimated to be 1.4. Anything above 1 means the number of infections is growing. The numbers aren’t high yet, but the direction’s not good. 

If we do have a third wave, it’s expected to be caused by the more transmissible and possibly more dangerous Delta version of Covid. The hope is that keeping those last restrictions for a while means there’ll be time to vaccinate more people, preferably with two doses of a vaccine, not just one. 

 

Vaccine updatelets

In the region at the center of Britain’s outbreak, vaccination numbers have dropped in the last month. I’d love to give you more detail, but the article’s behind a paywall on a site I don’t want to subscribe to, so it’s headlines only on this. 

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People working in care homes in England will have to get vaccinated in the next 16 weeks if they’re going to keep working with patients–or in some cases, keep working at all. The only exceptions will be people with a medical reason not to get the vaccine. No one knows how this will play out, but assorted organizations of medical professionals are opposing it.

The requirement may be extended to National Health Service staff.

“Compulsion is a blunt instrument that carries its own risks,” the British Medical Association said. An (unnamed) NHS boss said it was setting up a confrontation with staff “at a time when you’re denying them a decent pay rise but also saying how much you love them.”

Both fields already have staff recruitment problems. That have been made worse by Brexit. And low pay. And at least in the NHS, pandemic working conditions. 

In early June, 89% of NHS staff was at least half vaccinated and 82% fully vaccinated. In adult care homes, that was 83% and 68%. 

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A new vaccine, this one made by Novavax, has come through stage 3 trials showing 90.4% effectiveness against mild and moderate Covid and 100% effectiveness against severe cases. It was tested against the Alpha, Beta, and Gamma variants. The Delta variant overslept and missed the test.

Delta will receive a failing grade but will be eligible to take the test the next time it’s scheduled. A spokesperson for the variant said, “Delta has other priorities at the moment and will be in touch when its schedule allows. It has no further comment at the present time and will not take questions.”

The Novavax is a two-dose vaccine. 

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A small study dropped hints that a third Covid vaccine does might give transplant patients a better immune response. People with transplanted organs have to take drugs that suppress their immune systems in order to keep their transplants from being attacked by the aforesaid immune systems. Two doses don’t seem to be enough to rev up their Covid immunity.

A larger study is planned. In the meantime, the people who understand these things are feeling hopeful.