Travelling, going to concerts, partying with friends – for a long time, such amusements were virtually impossible. Now, in year three of the Covid pandemic, life is feeling largely normal again for many people. Is the acute phase of the pandemic over now?
Corona has lost its terror for many people in the past few months. With the appearance of the omicron variant at the end of last year, the virus spread at a previously unknown speed and infected millions of people in Germany within a few weeks. However, most of them fell ill – if at all – only comparatively easily, also thanks to the vaccinations. So is the pandemic state of emergency of the past few years finally over?
Federal Minister of Health Karl Lauterbach has a clear opinion on this: “Unfortunately not from my point of view,” the politician tweeted on the occasion of the TV show with Sandra Maischberger.
Others see the situation much more optimistically. They assume that the pandemic is currently turning into an endemic. This term, which is often used somewhat imprecisely, describes a state in which the waves of infection flatten out and the effects of the infection process are therefore less serious, at least for a large part of the population. According to Friedemann Weber from the Justus Liebig University in Gießen, when it comes to the question of the endemic, it depends on whether you mean the disease Covid-19 or the Sars-CoV-2 virus.
An endemic state would be reached when there was no longer a strong accumulation of infections or diseases. “In the case of Covid-19, this could soon be the case, because immunity – acquired through vaccination and infection – protects against it quite well,” says Weber. “In the case of the virus, however, new variants are constantly being introduced, causing a rapid increase in the number of cases.” Basically, endemic does not automatically mean good. Because of course people can still get sick and die from Covid-19.
How things will continue in the coming months, how much the virus will concern us, depends, among other things, on how strong the immunity of the population is now. In other words, how many people have built up protection against further infection and/or serious illness via a previous infection or vaccination.
A model recently presented by scientists at the Robert Koch Institute (RKI) provides indications of the extent of immunity. According to this study, only seven percent of the people in Germany are immunologically naïve – i.e. neither vaccinated nor come into contact with the corona virus through infection.
In general, the larger the proportion of this group, the easier it is for the virus to spread. At seven percent, the chances of the virus spreading should already be considerably limited – even if it is not certain how well protected the other 93 percent are from further infection and illness.
However, the RKI researchers point out that the immunity achieved varies greatly from state to state, mostly due to the different vaccination rates. The figures determined also varied greatly in the age groups:
How the situation will develop in the coming months also depends on the further development of the virus. And that is difficult to predict. “Other viruses, such as influenza viruses, change more gradually and less erratically than Sars-CoV-2 in the past two years,” says Richard Neher, who researches the evolution of viruses at the Biozentrum of the University of Basel. “It is conceivable that Sars-CoV-2 will change more gradually and less dramatically in the future.” It is unclear whether and when this change will come.
Most experts consider the emergence of a “killer variant” as suggested by Federal Health Minister Karl Lauterbach to be rather unlikely. But even without an extremely immune-resistant and disease-causing variant, it has not been finally clarified how good – and how long-lasting – the immune protection achieved so far is in the population.
Experts assume that it generally increases with the number of contacts that create immunity – i.e. with the number of vaccinations or infections that have been passed. Fully vaccinated with a booster and at best a previous infection would therefore be best protected against serious illness. Unvaccinated people who have only been infected with omicron in the past few months may not be better off than completely immune-naive people in the coming autumn. Especially if your infection was only mild, some experts believe that the immune system may not have built up sufficient immune protection in the long term.
“If omicron-like variants still predominate in our country next autumn or winter, we can probably cope well with the number of immune naïves,” says immunologist Carsten Watzl, Secretary General of the German Society for Immunology. “If Delta-derived variants predominate, the group of immune-naïve is larger, and that could still pose problems.”
Virus evolution researcher Neher from Basel notes as an advantage that the immunity landscape in the population is becoming more and more diverse, since people have different vaccination and infection histories. “As diversity increases, variants that bypass the immunity of the majority of the population become less likely.”
Against this background, can one assume that overloading the healthcare system and intensive care units is a thing of the past? “As far as Covid is concerned, in my opinion yes, even with a new variant with a pronounced immune escape,” says Christian Karagiannidis, scientific director of the Divi intensive care register. “We would have to be very unlucky there.” However, burdens on the healthcare system are made up of the existing capacities and all the sick people. “We have to expect a significant wave of respiratory diseases in autumn/winter, such as the flu,” says the intensive care doctor.
It is extremely difficult to predict whether the measures will have to be tightened again in autumn, explains Hajo Zeeb from the Leibniz Institute for Prevention Research and Epidemiology in Bremen. “Very tough measures such as lockdowns should no longer be necessary, especially if further boosts are given over the summer.”
The infectiologist Marylyn Addo from the University Hospital Hamburg-Eppendorf assesses the situation in a similar way. She is currently not expecting new lockdowns because of the growing immunity to the virus. However, she assumes that lower-threshold measures such as the obligation to wear masks could return. “I assume that measures such as the obligation to wear masks will come back in winter – at least in public spaces and indoors, where it is difficult to keep your distance,” she told the “Rheinische Post”. “The coronavirus will be with us for years to come, but it could become endemic in 2023.”
