Emerging from COVID: Balancing hope, caution

In a statement on the 15th meeting of the International Health Regulations Emergency Committee on the COVID-19 pandemic held on May 4, 2023, World Health Organization director general Tedros Adhanom Ghebreyesus concurred with the recommendations of the committee regarding the ongoing pandemic. He thereafter declared that “COVID-19 is now an established and ongoing health issue which no longer constitutes a public health emergency of international concern.” This declaration came about because of the trends around the world, including dramatically decreasing deaths and declining hospitalizations and intensive care unit admissions for COVID-19. These in turn have been brought about by the high level of immunity to SARS-CoV-2 from a combination of vaccination and natural immunity from acquiring the disease. While this declaration does not mean the pandemic is over, this is certainly welcome news and may be seen as a beacon of light at the end of a dark tunnel spanning more than three years.

But while this is certainly a time of hope, we must ensure that we don’t fall into the trap of complacency.

The COVID-19 pandemic spread with unprecedented speed, brought about by the ease of travel throughout the world as well as the transmissibility of the virus. But also unprecedented was the speed by which various vaccines were developed. This is one time the scientific world and regulatory bodies proved that if they got their act together, they could move mountains. If not for these vaccines being churned out as fast as they were, the deaths due to COVID-19 might have reached the estimated 50 million that occurred during the 1918 H1N1 flu pandemic. It could have been more. Then the Omicron variant emerged; and by God’s grace it is a variant that, while more transmissible and immune evasive, causes much milder disease than the original or Delta strains, save of course for the highest risk and vulnerable among us. The bolder writers even went on to refer to Omicron as nature’s vaccine as it infected countless individuals without rendering them gravely ill yet giving them some natural immunity.

We are certainly in a much better place now than we were three years ago. But how should we navigate this period in the life of a pandemic we hope is seeing its final months? A study of pandemics of the past will show that some of them burn out, some fade away, but very few disappear totally. How might the COVID-19 pandemic end?

Japan has already downgraded COVID-19 to the level of the seasonal flu which is the long-term aftermath of the deadly flu pandemic of 1918. And I believe it may indeed become such. This means that we should expect the SARS-CoV-2 virus to remain with us for many, many years, mutating constantly as viruses do. We should expect waves of COVID-19, with cases rising especially in the cold months and being more likely to cause more severe illness in those above 65 years old, in the immunocompromised, and in those with comorbidities like diabetes mellitus, hypertension, gross obesity, etc. Like the flu, our health experts might eventually recommend yearly shots for the elderly and vulnerable based on the predominant strains of the virus detected. This may happen, this might not.

Regardless of how the pandemic will end, it is incumbent upon all of us to live responsibly with the SARS-CoV-2 virus. The key word is “responsibly.” Respect your fellow human beings and never underestimate the virus. The rules are simple, and we learned them during the pandemic. If you are sick or feel sick, stay home. Get tested if possible. As a courtesy to others, cover your mouth and nose when you sneeze. Throw used tissue paper in the waste basket as soon as possible. Avoid close contact with people who are sick. If you are exposed to someone with COVID-19, wear a mask around others until you are sure you are clear. Wash your hands and avoid touching your eyes or mouth. Get vaccinated. If you are a high-risk person, then get boosted and stay up to date with boosters. And make the mask your friend. While mask-wearing is optional, do have it on hand when entering very crowded places or when people are coughing around you. Do wear a mask as well when it is you who have a cough. Simple respect, common sense, and courtesy are what we need.

We should move forward and stop the scare tactics as far as COVID-19 is concerned. We need not and should not let COVID-19 disrupt our lives any longer. There are many other diseases that we need to attend to; diseases that cause much more disability and death than COVID-19; diseases that had to be put in the back room for the last three years. But while moving forward we need to make sure we balance freedom with responsibility, hope with caution.

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Dr. Minguita Padilla is co-convenor of Doctors for Truth and Public Welfare. She is founder of the Eye Bank Foundation and served as head executive staff of the Philippine Health Insurance Corp. She has received multiple awards for her work on the prevention of blindness, community service, and curbing insurance fraud.