THE STATE OF COVID-19: Two Years Later
By: Marvin S. Hausman, MD – Mar 11, 2022
On this day two years ago, the World Health Organization (WHO) declared COVID-19 a global pandemic. Every aspect of our lives, our economy, our society, and our world has been affected – some in small ways, others in large ways – by the SARS-CoV-2 virus.
March 11, 2020 is a day that none of us will soon forget and likely one that history will remember long after we are gone. While it might not be a happy day, it is an important one. To mark the occasion of our entrance into Year Three of this pandemic, I want to look back at where we’ve been, take stock of where we are, and assess where we are headed.
To guide you through this tour of the last two years of COVID-19, I have divided this article into three sections:
- The state of the virus
- The state of the vaccines
- Year three begins
Let us start by looking at the virus itself.
The State of the Virus
To evaluate the state of the virus, we need to look at four key factors:
According to the most recent data from the WHO, COVID-19 has infected nearly 450 million people worldwide since the virus was first detected. In just the past 24 hours, over one million people were infected with the SARS-CoV-2 virus.
While infection rates are dropping right now, we must not assume that this momentary slowdown is anything other than temporary. The infection history of this virus underlines this point.
The pattern is clear: COVID-19 infections come in waves. As you can see, we are on the back end of the largest outbreak of the virus in its history. Only time will tell if the magnitude of future outbreaks matches omicron’s or the smaller, previous peaks.
Maria Van Kerkhove, an official at the WHO, recently stated, “The next variant of concern will be more fit, and what we mean by that is it will be more transmissible because it will have to overtake what is currently circulating.”
Van Kerkhove went on to warn against putting stock in theories that claim COVID-19 will continue to mutate into weaker and weaker strains. There is absolutely no evidence of this and, as I will highlight in just a moment, omicron was not a “weaker” strain.
The evidence we have points to a consistent pattern. Cases of SARS-CoV-2 surge twice per year: Once around the summer and once in the winter. The graph of cases in America is nearly identical to pattern seen globally:
There is not enough data currently available to tell us definitively if these surges are due to specific aspects of the virus itself, or our collective cycle of restrictions followed by a period of relaxed safety standards which is, in turn, followed by a spike in infections and the cycle repeats.
With a near-nationwide elimination of vital safety standards coming on the heels of the State of the Union, we appear to be headed into yet another period of relaxation. This decision runs counter to the science and is likely to make matters worse.
The death toll from this virus has been staggering. According to the WHO, over 6 million people across the world have died from COVID-19. The pattern of deaths matches the pattern of infections but with less modulation in amplitude.
The graph shows that the highest mortality came between November 2020 and March 2021, before the vaccines were available. This winter (November 2021- March 2022), however, we experienced one of the largest spikes in COVID-19 deaths in over nine months.
The situation in the United States is similar:
As you can see, we just came through the second largest wave of COVID-19 deaths since the beginning of the pandemic. Included in that wave, is the largest single-day death toll of the entire pandemic: 4,128 reported COVID-19 deaths on February 1, 2022.
The epidemiological community is quick to point out, as well, that the actual number of COVID-19 deaths is likely much higher than the reported number of deaths. The number of lives lost gets even worse when we look at the excess mortality caused by this pandemic:
In epidemiology, excess mortality is considered more thorough than confirmed COVID-19 deaths as it measures the entire impact of the pandemic. Excess mortality measurements capture not only the confirmed deaths, but several other factors, including:
- COVID-19 deaths that were not correctly diagnosed
- COVID-19 deaths not accurately reported
- Deaths from other causes that are attributable to the overall crisis of the pandemic.
We do not have enough data on this pandemic to accurately ascertain how many more waves and cycles we have yet to face.
Viruses mutate to survive. These mutations – or variants – are adaptations to the environments in which the virus lives. So long as the virus can find good hosts, the virus will spread. And like a race car at a pit stop, a virus uses its host-time to improve its chances of future success.
Due to a wide array of factors – poor national policy, rampant misinformation, wide-spread apathy, and a very tricky virus, to name just four – we were unable to stop the spread of SARS-CoV-2 in any lasting way. The virus has had the upper hand this entire time thanks, in part, to its ability to rapidly adapt.
There have been over 1,600 lineages of SARS-CoV-2 thus far. The WHO has currently designated five Variants of Concern (VOC): Alpha, Beta, Gamma, Delta, and Omicron. In addition, the WHO has two Variants of Interest (VOI: Lambda and Mu), three Variants Under Monitoring (VUM), and seventeen formerly monitored variants.
SARS-CoV-2 is doing everything it can to survive and thrive. The most recent variant – or subvariant – of concern is BA.2. The subvariant BA.2 is still classified as Omicron by the WHO at this time and is now present in all fifty states.
The United States has just come out of the most contagious and second deadliest wave of COVID-19 we have ever faced. This should give us pause. It should make us want to remain vigilant in order to keep the next wave from being even worse. And yet, we are – as the cycle continues – relaxing our safety measures yet again.
The State of the Vaccines
As soon as this pandemic began, exactly two years ago, the scientific community moved at record speed to create vaccines and they succeeded. In less than a year, three vaccines were available in the United States. Soon after, the number of globally available vaccines was even larger.
As of this writing there are two fully authorized vaccines in America: Pfizer and Moderna. Pfizer is fully authorized in a total of ten countries and Moderna in five. The Johnson & Johnson vaccines is still authorized in the USA via emergency use authorization (EUA) and fully authorized in three countries.
Globally there are a total of nine vaccines recognized by the WHO with five others currently under consideration.
In short, the scientific community did a remarkable job in an astonishingly short amount of time. Thanks to their efforts, over 63% of the world’s population has received at least one does of the vaccine. 10.9 billion doses have been administered globally, and 18.29 million are now administered each day.
In the United States, over 216 million people have been fully vaccinated against COVID-19 or 65.1% of the population.
But the vaccines did not bring about the end of this pandemic. I would like to highlight three reasons why.
Misinformation (and disinformation) quickly led to the stagnation of vaccinations rates in much of the western world. Ironically, the countries with the most vocal opposition to the vaccines are also the ones with the easiest access to vaccines.
Vaccines have not been adopted equally nor have they been administered equally. In the United States, there is a difference of 30% between our most vaccinated state (Vermont at 80.4%) and our least vaccinated (Alabama at 50.4%) when looking at all ages currently eligible for vaccines. Worldwide, the difference is even worse:
Only 13.6% of the people in low-income countries have received even one dose. The reality of this pandemic is that vaccines have not been made available to enough people.
The vaccines are not perfect. They do not last forever. They require booster shots. All the data, however, points to the fact that the vaccines – especially the fully authorized ones – are extremely effective at retarding the spread of the virus, decreasing hospitalizations, and reducing deaths.
If we want to stem the tide of this pandemic – and end the cycle of restrictions followed by relaxations followed by an epidemic – we must increase access to vaccines and increase the number of vaccinated people. We also must continue the safety regulations and protocols that have kept so many safe for so long. Now is not the time to let our guard down.
Future variants could be more contagious and perhaps deadlier. Misinformation is still rampant. Vaccines are still not where we need them to be. We still do not know how long vaccination protection lasts. We are just now coming out of the largest wave of SARS-CoV-2 infections in the history of this pandemic, and we have relaxed our safety standards yet again.
Year Three Begins
Los Angeles just ended its indoor mask mandate. The NFL abandoned all COVID-19 safety protocols. The CDC recently relaxed its safety recommendations. In the state of the union, the president said that COVID-19 no longer needs to “control our lives.”
Looking at all this you might think the pandemic is over. We have not beaten COVID-19. The nicest way to describe the situation at the start of year three is that we are being dangerously optimistic. The more cynical view is that we have simply given up.
The facts and the data point to a continuation of the cycle I have describe already. The virus – and its variants – come in waves. We do not know precisely if these waves are caused by the virus or by our repeated belief that this new lull will be permanent. And we likely will not know unless we stop relaxing our standards every time a wave ends.
We know how to fight COVID-19. Masks work. Social distancing works. Proper sanitation works. Not traveling unnecessarily works. Vaccines work. Tests work. We are simply no longer choosing to do what works. Just like we did last summer.
What should we do? To answer that question, we must look at it from two perspectives:
- Individual Actions
- National Plans
When it comes to what you should do as an individual right now, my mantra for the present moment would be the same as it was last summer:
Remain calm, remain cautious, remain vigilant.
As individuals, we must take charge of your own safety. Each of us must be our own advocate. Given that future variants could potentially be more contagious than omicron, I would highly recommend that you still practice standard pandemic safety:
- Wear a mask.
- Wash your hands.
- Social distance.
- Steer clear of crowds.
- Sanitize high-contact surfaces.
- Refrain from unnecessary travel.
- Quarantine if you are sick.
- Get tested if you have symptoms or think you may have been exposed.
Right now, there is still so much to lose, and we are still studying the long-term effects of infections (and the findings are troubling). Children are still not vaccinated in large numbers. Infants cannot get vaccinated. And people who, due to serious medical conditions, can’t get vaccinated are still quite vulnerable. It is up to us to protect them.
I cannot endorse the nationwide relaxation of the safety standards. I literally wrote the same thing last summer, amongst the clamor for a return to “normal.” Then came delta and omicron.
We should not voluntarily place ourselves in a more vulnerable position. We must learn from our past mistakes.
We can and must do better. The CDC should return to the safety precautions that have helped us get to where we are. We will need them to get to where we want to be: which is, safely, back to normal. We are not there yet. Despite all statements to the contrary.
We also need – still need – a more robust national plan. During the first two years of the pandemic, each state had to fend for itself. Now, as we begin year three, the new guidelines basically put the burden on the individual.
We need leadership from our federal government. We need policies that follow the science not the national mood. We need clear guidance and a comprehensive system for dealing with the virus.
We need leadership from our national media as well. Far too often during this pandemic, the press has been focused on the politics and not the science. On the policies and the disagreements and not on the facts.
Much like our national political leaders, our leaders in the media have abdicated their responsibilities and placed the burden on us as individuals. It is now up to us to find the facts. To “do the research.” Just like it’s now up to us to assess our local risk conditions.
The pandemic is not over. It’s not too late, either. It cannot be up to each of us to do the work of our leaders. We need them to do what they are supposed to do: lead. And we need it now more than ever.
The Bottom Line
Pandemics and epidemics are supposed to leave marks. Yellow fever and malaria gave us screens on our windows and doors. Typhoid and cholera gave us access to clean water and better sewer systems. The Spanish Flu gave us massive improvements in public health. What will the mark of COVID-19 look like?
Without a cohesive, coherent national policy based on science, and a national media that helps us understand the facts, we may never be able to arrive at a point of consensus necessary to make a collective, permanent, positive change.
COVID-19’s mark might just be that it doesn’t leave one. That we were incapable of grasping the severity of the situation long enough to understand what needed to change.
In northern regions, where the winter is long and harsh, they have a term – “Fool’s Spring” – that perfectly captures this moment in our national psyche. There comes a time, usually in Februrary or early March, when the weather warms and the snow begins to melt. In that moment, the people who know better watch as the “fools” remove their storm windows, take off their snow tires, and put their winter clothes in the attic; thinking that spring has arrived, and winter is at an end. But the people who know better, understand that this moment is a brief respite before winter returns.
We are in a national “fool’s spring” right now. Rushing to declare the end of this pandemic, when the people who know better are saying, “This isn’t over yet.”
Marvin S. Hausman, MD, is an Immunologist and Board-Certified Urological Surgeon. He has more than 30 years of drug research and development experience with various pharmaceutical companies, including Bristol-Myers International, Mead-Johnson Pharmaceutical Co., E.R. Squibb, Medco Research, and Axonyx. Dr. Hausman co-founded Medco Research, which in the 1980s became one of the top contract research organizations (CRO) and a successful pharmaceutical company. At Axonyx, Dr. Hausman successfully licensed in and developed inhibitors for acetyl and butyrylcholinesterase and the drug Posiphen®, a compound that inhibits synthesis of amyloid precursor protein (APP). Dr. Hausman has done residencies in General Surgery at Mt. Sinai Hospital in New York and in Urological Surgery at UCLA Medical Center. He received his medical degree from New York University School of Medicine.
*DISCLAIMER: This information should not be considered comprehensive and is not a substitute for discussing these matters with your doctor or medical professional. Please consult with your insurance company, your doctors, and all applicable health professionals for personalized advice and information regarding COVID-19 and your health.
**NOTE ON DATA: All data, statistics, and graphs in this article are accurate as of March 8, 2022.