#16,969
While the world yearns for an end to our persistent COVID pandemic, history tells us that pandemics don't end abruptly on a given date, but often linger on with intermittent waves and elevated excess mortality for years.
Last month, in Our COVID Pandemic: How Long Can It Last?. we looked at the years following the 1918 and 1957 influenza pandemics, which featured significant recurrences long after the pandemic was declared `over'.
1957 H2N2 pandemic & post-pandemic waves - NEJM 2009
Although the popular narrative - promoted by pundits and politicians - is that COVID will eventually weaken (or our immunity will increase) so that it becomes an endemic `seasonal flu-like' threat, that is far from the only possible scenario.
In fact, it is just one of five contemplated in a new ECDC guidance document that takes the `long view' on how this pandemic may play out over the next 10 years.
Long-term qualitative scenarios and considerations of their implications for preparedness and response to the COVID-19 pandemic in the EU/EEA
Guidance
29 Aug 2022
There are a wide range of potential trajectories for the progression of the COVID-19 pandemic in the coming months and years. This document sets out a number of scenarios that are intended to be plausible, internally consistent, and coherent descriptions of possible futures.
Executive summary
The scenarios consider the epidemiological context that can generally anticipated in the EU/EEA from the summer of 2022 onwards. The timeframe for the scenarios is from 2022 to 2032. In publishing this document, ECDC does not ascribe a probability, nor suggest a higher likelihood of occurrence, for any of the scenarios described, which are not quantitative forecasts. The scenarios are based on the key variables of growth rate, disease severity and immune protection from severe outcomes.
The qualitative scenarios are not mutually exclusive; over the course of the next decade it is entirely likely that there could be a transition from one scenario to another, due to changes in the virus, the level of immunity in the population or variations in societal response. The coming years will require extreme vigilance should new, more severe or more transmissible variants of SARS-CoV-2 emerge.
The scenarios and the associated public health response priorities outlined in this document provide a potential framework for defining overall strategic objectives and actions for managing COVID-19 according to a range of possible trajectories in the future.
Such strategic objectives need to be agreed upon so that operational discussions on the implications for a wide range of public health activities can take place according to a common understanding.
The public health activities outlined in this document that need to be considered in preparing for potential future scenarios include, but are but not limited to, surveillance, risk communication, pandemic preparedness, early warning, vaccination, medical countermeasures, NPI measures and IPC measures.
Long-term qualitative scenarios and considerations of their implications for preparedness and response to the COVID-19 pandemic in the EU/EEA - EN - [PDF-523.1 KB]
While I certainly hope that scenario one - A Diminished Threat - is the one that lies ahead, we can't count on it. Nor can we assume that even if COVID retreats that we won't immediately be blindsided by another, potentially worse, global health emergency.
Given the likelihood that severe pandemics and regional epidemics will increase in the years ahead (see PNAS Research: Intensity and Frequency of Extreme Novel Epidemics), it is well past time to make pandemic preparedness (and prevention) a national priority.
Not that I expect it to happen, of course. We are notoriously bad at taking the `long view'.
But an old man can still wish.
