2019 Novel Coronavirus (CoVID-19): Part XXVII
2019 Novel Coronavirus (2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019), COVID-2019 Pandemic:

 

November 28, 2021 update Part 27
Paul Herscu ND, MPH
Herscu Laboratory 

 

Entering the last phase of the COVID-2019 Pandemic:

A short piece

 

Hello and welcome. Here’s a short piece to answer all the emails and phone calls from colleagues and patients. The news is scary right now. As you are aware, a new more prominent variant, named Omicron was found, and has dozens of mutations. It seems to outcompete the Delta virus which has been the current dominant mutated variant. The news is daunting since countries are beginning to shut down from the news. WHO issued dire warnings and travels bans are in place. And added to this is the sad coincidence that there are numerous regions in the world with increased incidence of Delta COVID. In some places these are the worst outbreaks of the virus since the pandemic began. 

 

Let me start by saying, again, and perhaps sounding oddly, and pretty much opposite to what we are hearing today, that the pandemic will be over by sometime in April. Again, as written elsewhere, this does not mean that the virus is gone, it is going to be with us for the foreseeable future. Simply, the pandemic will be called off, and switched to more confined outbreaks, depending on local conditions. I know this flies in the face of everything you are hearing right now. We discussed most of this from the start. And I will describe it more fully when describing the fifth and final phase of the pandemic which we are almost entering (and I know how odd that sentence must sound, in the face of the news). A brief recap:

1.     Viruses mutate.

2.     This virus mutated in such a way as to make us ill.

3.     The illness in terms of severity was quiet high. Reaching, officially, over 3% mortality rate at the beginning.

4.     However, as discussed, viruses continue to mutate.

5.     I strongly believe in coevolution. I believe that both we and the virus change, and while that change might move towards being worse, I believe that in fact the mutations will eventually actually move towards accommodating each other, making the virus less lethal.

6.     Specifically, I thought that the mortality rate will drop to as low as 0.5%, worse than the seasonal flu, but not horribly so. The thing to do is to keep as many people alive until then.

7.     One point we discussed, in January, February, of 2020, and onwards, was that this mutational change towards improvement would take a year, a decade or a century. And until then, the choice is either to make us healthier, changing us, in some fashion to make it less lethal, which we do with all the lifestyle and natural medicine interventions articulated earlier. But also, I mentioned that another way forward is to change the virus itself. And specifically, this falls in the D.O.D. camp, funding research to change the virus with the goal of making it less lethal. I think I said in classes, I would not be surprised to wake up and find that mutations in the virus have made it all of the sudden less lethal. Importantly, a positive mutation has to be more transmissible than other variants to outcompete them.

 

Where are we now? This variant has dozens of mutations, over 50, depending on when you start counting. There are essentially only two ways that this can happen in this short a time. The one most mentioned is having the virus infect a patient who for some reason cannot get rid of the virus and at the same time the virus does not kill the patient. It is a sort of stalemate. And during that time the virus keeps mutating, over and over and over. And over a period of time, a single individual can harbor many, many mutations throughout the virus. This seems to be what we’re seeing with the Omicron variant. I wrote about this as a patient once came to me with positive COVID tests and symptoms and he was pretty ill, but for months, staying positive, fevered etc. I thought the virus he harbored should be examined carefully as the highest likelihood of multiple mutations existed in these sorts of patients. I remember reading about one patient who did get tested and that is what they found. You can read about that here, from early in 2021. Perhaps that is the case too with Omicron. 

 

The other way mutations can happen is by scientists manipulating the viral code to improve transmissibility AND at the same time, add other mutations to make the virus less lethal, less burdensome, more like a cold or typical upper respiratory infection. Eventually this will happen, but with the right selective pressures this can be accelerated by science. Here, I doubt anyone would take credit for it. More likely you wake up one day and you find that the virus has mutated in many way and is now not so dangerous. 

 

Here is what I am hoping for, and what I think we are going to find. Omicron variant will be more infectious. And while it might have a higher morbidity rate, hopefully, ‘surprisingly’ I think it will be less severe. As a consequence, many more people get sick, but a smaller percent suffer and die. 

 

And that is one way we walk out of the pandemic. I know I said last time my timeframe for the end of the pandemic is December to May, but actually, with this current variant, it has moved up to December to April. And still to be clear, the virus will still be here, but the pandemic will not. And with that change, national lockdowns and mandates will drop away. 

 

What we do with vaccines and boosters is still pretty clear to me. Tricky moment in terms of these, and hard to write about it here, but still pretty clear. I will write about the last phase of this pandemic in the next post, which should be in the next few weeks, as we enter the last phase. 

 

Until then,

Kindest regards,

Paul Herscu, ND, MPH