There are chances that we witness a re-emergence of previous problems and even an uprise of new ones like fungus. This will be driven by a combination of early vaccine rollout (which, being directed first at those at greatest risk, should reduce deaths faster than cases), seasonality, increasing natural immunity, and stronger public-health response. This general point appears to be especially true for the Omicron variant.71Pfizer and BioNTech provide update, December 8, 2021. Sarun Charumilind is a partner in McKinseys Philadelphia office, Matt Craven is a partner in the Silicon Valley office, Jessica Lamb is a partner in the New Jersey office, Adam Sabow is a senior partner in the Chicago office, Shubham Singhal is a senior partner in the Detroit office, and Matt Wilson is a senior partner in the New York office. COVID-19: Data, NYC Health, September 21, 2020, nyc.gov. The timing of the end point will vary by country and will be affected by a number of factors: Consider the first and most crucial variables: the arrival of vaccines, their efficacy, and their adoption. In the process Millennials will hipsterfy suburbia, the urban fringe, and regional Australia. In the base case (25 percent more infectious; 25 percent greater immune evasion; 25 percent less severe disease), the COVID-19-related hospitalization rate in the United States could peak significantly higher in the next six months than in the past six. WebThis was followed by two schemes in Australia, which in 2022 were merged to form the Pacific Australia Labour Mobility (palm ) scheme. product_bot-arrowroot-huu-co-h-to-goodness-200g-474; product_bot-cacao-huu-co-sunfood-227g-132; product_bot-carob-huu-co-h-to-goodness-171; Hotline Support 0903.166.228. Antibody levels may wane after just two months, according to some studies, while a United Kingdom population-monitoring effort reported that antibody prevalence fell by 26 percent over three months.163F. We believe that those are all reasonable expectations, based on public statements from vaccine manufacturers and the results of surveys on consumer sentiment about vaccines.174Joe Myers, 3 in 4 adults around the world say they would get a COVID-19 vaccine, World Economic Forum, September 1, 2020, weforum.org. COVID data tracker weekly review, accessed August 15, 2021; Niharika Mandhana, From pandemic to endemic, Singapore creates model for living with Covid-19,, Alexis Madrigal, A simple rule of thumb for knowing when the pandemic is over,. Serial blood tests suggest that immunity may wane relatively quickly. Summary statistics, SeroTracker, September 16, 2020, serotracker.com. The market size was estimated to be worth USD XX Baby Boomers will act with a sense of urgency. One such indicator may be consumer behavior. Its likely that many more infections havent been detected. And public interest in vaccination appears to be similar too, even in countries such as France, where interest in vaccination was significantly lower than in other countries in the region but may now be improving.126Global attitudes: COVID-19 vaccines, Ipsos, February 9, 2021, ipsos.com; Yasmeen Serhan, The vaccine-hesitant man of Europe, The Atlantic, March 18, 2021, theatlantic.com. As at 3pm on 02 June 2022, a total of 7,341,978 cases of COVID-19 have been reported in Australia, including 8,612 deaths, and approximately 259,597 active Europe and the United States have entered the endemic stage of the COVID-19 outbreak: the virus is widespread, is significantly less fatal than it was in 2020, and is spurring only limited changes in public behavior. Duration of immunity matters, obviously; for instance, our modeling suggests that if natural immunity to COVID-19 lasts six to nine months, as opposed to multiple years (like tetanus) or lifelong (like measles), herd immunity is unlikely to be achieved unless adult vaccination rates approach 85 percent. On the other hand, if vaccine uptake is fast, New Zealand might achieve a longer-lasting vaccine-based herd immunity. Ann Danaiya Usher, The global COVID-19 treatment divide, National Institutes of Healths National Library of Medicine, February 24, 2022. While the winter of 2020/2021 in the Northern Hemisphere will be challenging, we are likely to see mortality rates fall in Q2 (or possibly late Q1) of 2021. While Australia is busy combatting the BA.4 and BA.5 Omicron strains, new data has emerged about the initial BA.2 outbreak. In our view, there are two important definitions of end, each with a separate timeline: The two ends are related, of course, but not linearly. This group includes countries such as Singapore that have been most successful in limiting mortality associated with COVID-19 to date.101From pandemic to endemic, July 1, 2021; Renju Jose, Sydney daily COVID-19 cases hit record high, more troops to enforce lockdown, Reuters, August 13, 2021, reuters.com. In 2022 a higher share of workers in their 60s and early 70s will remain in the workforce in a part-time capacity. The decision to make rapid antigen tests free in only limited cases apparently to allow the "private market" certainty to order more stock, according to Morrison won't see supplies increased in the short-term to fill the gap. This is likely, but has not yet been proven at scale.137Sabin Russell, Vaccines stop COVID-19 symptoms, but do they stop transmission?, Fred Hutch News Service, December 16, 2020, fredhutch.org. The principal challenge we have in Australia at the moment, as is seen in the United States and the United Kingdom, in France, in Germany, in Italy, right across When we refer to herd-immunity timelines for a country, we mean the point at which the entire nation or a significant portion reaches herd immunity. Coronavirus (COVID-19) deaths, Our World in Data, July 5, 2022. WHO Coronavirus (COVID-19) Dashboard, World Health Organization, February 2022, covid19.who.int. Working from home is here to stay but exclusively virtual working arrangements will remain the exception. Receiving a text revealing you have tested positive to COVID is a big moment, filled with uncertainty about what is to come. doses for 80 percent of the global population, An optimistic scenario for the US response to COVID-19. They might also have different outlooks for the next few months if their collective immunities are waning quickly or slowly. As Australia battles its latest COVID-19 wave, many will be hoping 2023 is the year the pandemic "ends", the year that weighing-up exposure risks, mask use, skipping social events due to that tickle in the throat, can all be put behind us. We might then expect to see a seasonality-driven wave of disease next fall and winter, but hospitalizations would likely peak well below the level of the wave we just experienced. Tracking coronavirus vaccinations around the world,, Sarah Zhang, What if we never reach herd immunity?,. Estimates of immune protection against symptomatic infection and the rate at which vaccine-based immunity wanes are based on medical literature describing mRNA vaccines. COVID-19 Consumer Healthcare Insights, June 2021. FDA approves first COVID-19 vaccine, US Food and Drug Administration news release, August 23, 2021, fda.gov. SeroTracker, Public Health Agency of Canada, accessed 1/12/21, serotracker.com. but public-health responses to Omicron have typically been less forceful than those of prior waves with similar disease burdens. When confidence is restored, people will again fill bars, restaurants, theaters, and sports venues to full capacity; fly overseas (except for the highest-risk populations); and receive routine medical care at levels similar to those seen prior to the pandemic. Older people are generally more willing to be vaccinated than the general population. Our own analysis supports the view of others that the Delta variant has effectively moved herd immunity out of reach in most countries for now,83 Christie Aschwanden, Five reasons why COVID herd immunity is probably impossible, Nature, March 18, 2021, nature.com. Enter a new variant, faster than any we've seen to date, and a lot can change in a matter of weeks. The curve rises sharply from Q1 2021 to a peak between Q3 and Q4 2021. Based on a range of likely vaccine scenarios and the fact that those with prior exposure to SARS-CoV-2 will still be eligible for vaccination, every ten percentage-point increase in seroprevalence could roughly translate into a one-month acceleration of the timeline to the epidemiological endpoint. The short answer is that the latest developments serve mainly to reduce the uncertainty of the timeline (Exhibit 1). The R0 value for the Delta variant (the number of people who can be expected to contract a disease by a single infected person) has been estimated at 5 to 8 by the US Centers for Disease Control and Prevention. Among high-income countries, cases caused by the Delta variant reversed the transition toward normalcy first in the United Kingdom, where a summertime surge of cases led authorities to delay lifting public-health restrictions, and more recently in the United States and elsewhere. The world will praise Australia for its handling of COVID. The arrival of herd immunity wont mean a complete end to all public-health interventions. Pfizer and BioNTech conclude Phase 3 study of COVID-19 vaccine candidate, meeting all primary efficacy endpoints, Pfizer, November 18, 2020, pfizer.com. Some recent studies suggest that a significant number of people who havent contracted COVID-19 have cross-reactivity in specific immune cells (T cells). The recent authorization of COVID-19 vaccines for children as young as six months is also an important step.10Coronavirus (COVID-19) update: FDA authorizes Moderna and Pfizer-BioNTech COVID-19 vaccines for children down to 6 months of age, US Food and Drug Administration, June 17, 2022. Most countries have deferred the hope of achieving herd immunity until the arrival of a vaccine. Rest of the world. But so far, they havent fundamentally changed the dynamics of the pandemic, because there hasnt been a step change decline in immunity, as seen during the winter, when Omicron first emerged. It could be a day after we publish this update, or six months , or years from now. More data are likely to emerge on this in the weeks ahead. But case counts matter primarily because people are dying from the disease and because those who survive it may suffer long-term health consequences after infection. EU Digital COVID Certificate, European Commission, accessed August 15, 2021, ec.europa.eu; Covid passports: How do they work around the world?, BBC News, July 26, 2021, bbc.com. Weve always knownofficial COVID case data didn't capture the full scope of transmission, but 2022 was the year that Australia lost grip of just how big an underestimate it is. Other authors have compared the burden of COVID-19 with that of other diseases, such as influenza, as a way to understand when endemicity might occur.97Alexis Madrigal, A simple rule of thumb for knowing when the pandemic is over, Atlantic, February 23, 2021, theatlantic.com; Stephen M. Kissler et al., Projecting the transmission dynamics of SARS-C0V-2 through the postpandemic period, Science, May 22, 2020, Volume 368, Issue 6493, pp. Charlie Giattino, How epidemiological models of COVID-19 help us estimate the true number of infections, Our World in Data, August 24, 2020, ourworldindata.org; Hazhir Rahmandad, John Sterman, and Tse Yang Lim, Estimating COVID-19 under-reporting across 86 nations: Implications for projections and control, medRxiv, August 3, 2020, medrxiv.org. They have seen continued success, recording higher case counts but few deaths. However, the future uptake of boosters is a significant unknown. In a pandemic of medical misinformation, how do you deal with conspiracy believers? 6. To achieve that, we will need to see significant progress on the epidemiological end point, including an effective vaccine receiving Emergency Use Authorization approval during the fourth quarter of 2020 or the first quarter of 2021, followed by a smooth rollout and adoption by high-risk populations. However, it is possible that areas with higher seroprevalence may also have higher thresholds for herd immunity, because their populations may mix more,162Anthony Ives and Claudio Bozzuto, State-by-state estimates of R0 at the start of COVID-19 outbreaks in the USA, MedRxiv, May 27, 2020, medrxiv.org. It nevertheless helps illustrate the relative threat posed by the two diseases. Frauke Muecksch, Zijun Wang, Alice Cho, et al., Increased potency and breadth of SARS-CoV-2 neutralizing antibodies after a third mRNA dose, BioRxiv, February 15, 2022, biorxiv.org. Source: Bloomberg; DC; HHS; Moderna; Pfizer; Reuters; WSJ. 18. The availability of effective monoclonal antibodies, dexamethasone, and other treatments and the use of nonpharmacological interventions, such as proning, have meaningfully increased the chances of survival for those with access to high-quality healthcare.64Stephan Ehrmann et al., Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: A randomised, controlled, multinational, open-label meta-trial, Lancet: Respiratory Medicine, December 1, 2021, Volume 9, Number 12; Peter Horby et al., Dexamethasone in hospitalized patients with COVID-19, The New England Journal of Medicine, February 25, 2021. Immunity protects individuals and reduces risk for people in the community around them by reducing rates of onward transmission. Every day matters. WHO and others have raised important concerns about the appropriateness of high-income countries offering booster doses of COVID-19 vaccines while so many in the world have not received initial vaccination, but the benefits of a booster dose to an individual patient are increasingly clear.74COVID-19 virtual press conference: 8 December 2021, WHO, December 8, 2021. One consequence is that the vaccines contribution to population-wide herd immunity will depend on adults, at least until vaccines are approved for use in younger populations. (Exhibit 1). While the situation looks somewhat better in parts of the Southern Hemisphere, much of Europe and North America is in the midst of a fall wave, with the prospect of a difficult winter ahead. Data from the US Centers for Disease Control and Prevention also suggest that vaccinated people who become infected with the Delta variant may transmit it efficiently.86 Delta variant, August 6, 2021; The war has changed: Internal CDC document, July 29, 2021; CDC internal report, July 30, 2021; The Delta variant isnt as contagious, August 11, 2021. Airline passenger volumes in the United States are much closer to prepandemic levels than they were a year ago48TSA checkpoint travel numbers (current year versus prior year(s)/same weekday), Transportation Security Administration, tsa.gov. Long-term drivers for expanded demand remain Populous emerging markets are still likely to want more air services Return to growth post-COVID but at a lower level Global RPKs forecast to be 32%-41% below expected levels in 2021 Global RPK medium term scenarios Pre-COVID forecast Current baseline COVID setback scenario risk that It took longer than ideal for NSW to put its foot down, and for Queensland and South Australia to back down. Yet the past two weeks have brought renewed hope, headlined by final data from the Pfizer/BioNTech150Pfizer and BioNTech conclude Phase 3 study of COVID-19 vaccine candidate, meeting all primary efficacy endpoints, Pfizer, November 18, 2020, pfizer.com. But it seems likely that purchases of tests (like online searches of flu near me) are an indicator and could provide some advance warning of future waves of the disease. These factors include the following: Herd immunity requires that enough people be simultaneously immune to SARS-CoV-2 to prevent widespread ongoing transmission. Europe splits on Omicron response, New York Times, December 20, 2021.28Michael Ollove, Amid Omicron Uncertainty, States Resist New Mandates, PEW, December 10, 2021, pewtrusts.org. Herd immunity will represent a more definitive end to the pandemic. The biggest overall risk would likely then be the emergence of a significant new variant. Despite more than 35,000 cases a day across the nation, experts presume we're seeing the tip of the iceberg. Perhaps the escalation was most marked in Queensland, with its newly reopened border no longer protecting it from the surge. Case controllers. Most importantly, we will remain an optimistic and forward-looking people. That third dose is critical. We have previously written about herd immunity as a likely epidemiological endpoint for some countries, but the Delta variant has put this out of reach in the short term. As countries transition over time to managing COVID-19 as an endemic disease, the world may reach a long-term state of disease prevention similar to that seen with the flu, with annual or twice yearly booster doses. product_bot-arrowroot-huu-co-h-to-goodness-200g-474; product_bot-cacao-huu-co-sunfood-227g-132; product_bot-carob-huu-co-h-to-goodness-171; Hotline Support 0903.166.228. Nick Paul Taylor, Novavax COVID-19 vaccine 90% efficacious in phase 3, but protection plummets against one variant, Fierce Biotech, January 29, 2021, fiercebiotech.com. Given all of these variables, where do we net out? For an example of a low-end estimate, see Max Fisher, R0, the messy metric that may soon shape our lives, explained, New York Times, April 23, 2020, nytimes.com. Get The New Daily free every morning and evening. Carl Zimmer, U.S. During the anticipated period, the Australia infection control market in is anticipated to expand significantly. 9116. But for now, fewer of us need to get testedand, according to Morrison, that's cause to relax. What scientists know so far,. Even fortress WA wasn't safe, though it has kept its numbers in single figures for now. Herd immunity will also require vaccines to be effective in reducing transmission of SARS-CoV-2, not just in protecting vaccinated individuals from getting sick. If even only a small percentage of those get severely ill, end up in hospital or die, theyre still big numbers and thats what were seeing. Strong public-health measures will remain critical to saving lives during this period. Collectively, these treatments and changes in clinical practice have lowered mortality for those hospitalized by 18 percent or more.155Leora Horwitz et al., Trends in COVID-19 risk-adjusted mortality rates, Journal of Hospital Medicine, October 2020, journalofhospitalmedicine.com. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. The current upheaval to our everyday existence and quality of life is not new the world is cyclic, with multiple reawakenings over the centuries. NSW and Victoria on track to scrap Covid isolation rules for household contacts within days. Expect more vacancies on your local main street. Steps may include a return to fully in-classroom education, fewer restrictions on the operations of bars and restaurants, more gatherings with larger groups of people, the reopening of offices, and fewer prohibitions on interregional or international travel. He said the Reff, a key metric used to measure transmission, is up in almost all states. While we all wish that level could be zero, eliminating the disease is not feasible for any country with open borders. Despite his grim outlook on COVID-19 deaths, Professor Esterman said its not all doom and gloom. Of these deaths, 4,547 occurred in 2022 more than double the 2,239 deaths recorded over the first two years of the pandemic. SeroTracker, last accessed March 15, 2021, serotracker.com. In contrast, some locations, such as Hong Kong,17Farah Master and Clare Jim, Hong Kong considers mass testing as COVID fight intensifies, Reuters, February 17, 2022, reuters.com. variant continues to spread around the world as coronavirus pandemic enters 2021, Washington Post, Jan 2, 2021, washingtonpost.com.143Carl Zimmer, U.S. The short-term solution will be for existing staff to work longer hours. Nor is it clear yet what the approval standards might be for multi-valent vaccines. SARS-CoV-2 will continue to exist. As long as Omicron remains the dominant variant, there is reason for relative optimism. The world is on pace to manufacture enough doses for 80 percent of the global populationor close to 100 percent of the adult populationby the end of 2021, but the distribution of these doses may continue to be asymmetric. The ongoing Delta-driven wave of cases in Europe has led a number of countries to accelerate their booster-dose rollout, with some discussing the timing of potential additional doses.75Alisa Odenheimer, Israel is preparing for possible fourth Covid vaccine dose, Bloomberg, September 12, 2021. Millennials continue on to family-sized houses. As for exactly why COVID-19 deaths are on the rise in Australia, Professor Esterman said it is very hard to say why. The Melbourne woman, 47, spent Christmas alone, and has been doing her best to isolate herself from her teenage son. Beyond the impatience that most feel to resume normal life, the longer it takes to remove the constraints on our economies, the greater will be the economic damage. Most serious cases of COVID-19 would occur in unvaccinated people. Almost two years into a pandemic that has claimed more than five million lives and affected billions more, people everywhere are finding it hard to summon the energy for another chapter in the story.51Charlie Giattino et al., Excess mortality during the coronavirus pandemic (COVID-19), Our World in Data, December 7, 2021. For the moment, however, scientists view these variants as simply more transmissible than Omicron. WHO coronavirus (COVID-19) dashboard, WHO, July 5, 2022. Ranges reflect the uncertainty around immunity levels and describe population averages. The emergence of Omicron led to tighter rules around travel in many countries, with some, such as England, also restricting domestic travel.76Prime Minister confirms move to plan B in England, United Kingdom, December 8, 2021. While the potential for a transition toward normalcy in just a few months is encouraging, many signs suggest that the next six to eight weeks will be difficult. making it possible to protect a group that comprises a significant share of the population in some countries. For example, the Delta variant, which remains dominant in most of the world, was significantly more transmissible than previously circulating variants were, showed limited incremental evasion of immunity, and caused moderately more severe disease relative to other variants.56Delta variant: What we know about the science, US Centers for Disease Control and Prevention, August 26, 2021. The risk that COVID-19 poses to a community at any point in time is a function of the immunity of its members. Dr Griffin said fatigue with the pandemic was a big part of that, which meant there was a need for balanced commentary to reinforce the measures Australians should still be taking to reduce risk. All rights reserved. variant continues to spread around the world as coronavirus pandemic enters 2021,, Michelle R. Smith, Governors scramble to speed vaccine effort after slow start,, Ken Eames, Paul Fine, and David L. Heymann, Herd immunity: A rough guide,, Sabin Russell, Vaccines stop COVID-19 symptoms, but do they stop transmission?,. We need to get that up to nearly 100%, he said, adding that people over 65 should get their fourth Covid jab as soon as possible. Exhibit 2 summarizes that knowledge, based on the published literature and values derived from it. In the United States, COVID-19 hospitalization and mortality rates in June and July were nearing the ten-year average rates for influenza but have since risen. Given the uncertainty, we have built a set of scenarios describing potential outcomes measured by hospitalization rate. So what should you do next? The US CDC recently announced a change in its masking guidelines that serves to significantly reduce the number of areas where masking is recommended.47Use and care of masks, Centers for Disease Control, February 25, 2022, cdc.gov. Gaining that confidence will require a continuation of the progress made to reduce mortality and complications, as well as further scientific study regarding long-term health consequences for recovered patients.
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