Coronavirus
Learning from Omicron How to Live With the Virus in the New Year
How SARS-COV-2 evolves over the next months will determine what the end of the pandemic looks like and what kind of life will follow ー a glance into the crystal ball for 2022.
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There's a new villain in town, and it goes by the name Omicron. The emergence of this new coronavirus variant has triggered global alarm and pushed governments around the world to tighten their borders and speed up booster shots.
Meanwhile, scientists are still trying to answer basic questions about how bad the impact will be.
The rapid spread of Omicron in South Africa, where it was first detected, shows that it has a fitness advantage over other variants like Delta. Omicron has found a way to dodge immunity, so it can reinfect people who have already been infected with an older virus version. Needless to say, this also spells trouble for vaccine effectiveness.
Omicron has spooked experts because the variant has more than 30 mutations in the spike protein, which is the lockpick used by the virus to enter a human cell. Because the spike protein is unique to SARS-CoV-2, vaccines are using it to induce immune responses against the virus. As the American scientist Peter Hotez once put it: “Each epidemic has its own little shop of horrors that you have to sort out.”
So, with Omicron around, what can we expect of 2022?
Progress in Understanding
Let’s take a look into the rear view mirror first. At the beginning of the pandemic, evolutionary biologist Jesse Bloom gazed into the future of SARS-COV-2 and predicted that the virus would become endemic, not eradicated. His prediction is now looking a lot more certain.
Bloom saw the seasonal coronavirus 229E as a model of how SARS-COV2 might eventually evolve. One of the seven human coronaviruses, 229E is associated with a variety of respiratory symptoms, ranging from the common cold to deadly pneumonia and bronchiolitis. The endemic virus infects people repeatedly throughout their lives, because the virus constantly evolves to evade immunity.
Similar to the other four endemic human coronaviruses, Omicron has evolved to have its spike look different from the other variants, meaning that previous infections and vaccinations are not so effective. As a result, Omicron might be our first taste of what “endemic SARs-CoV-2” looks like with the evolution of the spike that invades immunity. “It is likely we all must get it a number of times over the coming years,” the British biomathematician Ewan Birney, who is director of the European Bioinformatics Institute, recently wrote on Twitter.
There is no reason to believe, however, that the virus’s path to becoming endemic will be smooth. Omicron certainly shows us it is going to be a bumpy ride, as the virus will most likely continue to mutate and to cause new outbreaks and epidemics of various sizes, like influenza does every winter season.
Consequently, our pre-pandemic life is not coming back. Here is a glimpse into what the future might hold.
Focus on Curing the Disease
With the virus here to stay, curing COVID with antiviral medicines will play an important role in the coming years. At the moment, however, COVID drugs are still in their early stages, and setbacks will be common ー especially given the arrival of new virus variants.
One example is provided by research into monoclonal antibodies produced by pharmaceutical companies Eli Lilly and Regeneron. In a first study, the drugs, which are used to treat patients at an early stage of infection, had zero effect on Omicron.
Smarter Lockdowns are Coming
Better medication does not mean the end of countermeasures to fight the virus. However, our arsenal of weapons will be more precise.
Take lockdowns, for example. They were a blunt but effective tool in COVID-19 control. But two years into the pandemic and with many people vaccinated, the acceptance of drastic methods is waning. Instead of coercive measures, smart technology will be used to mitigate or prevent local outbreaks.
In urban areas, wastewater monitoring could become a key strategy in predicting infection surges. Because a surge of virus detection in wastewater always predates a surge in cases, it is already one of the most powerful approaches to monitoring COVID spread.
Wastewater monitoring can easily be combined with mobility data from cell phones. As such, this could serve as a strategy to develop more flexible policies that limit transmission without requiring large-scale quarantine.
According to data analysts, mobility networks represent patches that people mostly stay within. Olha Buchel, who studies COVID and mobility data for the US at the New England Complex Systems Institute in Cambridge, Massachusetts, explains that restricting commutes between low and high risk patches can be used to control the spread of coronavirus across various areas and help governments to control the pandemic. Working with those patches, smart lockdowns and quarantines “should eliminate most of the long-distance movements and make them more localized”.
Cell phone data represents one way to use technology to fight the pandemic. South Korea is already testing the use of artificial intelligence, facial recognition and closed circuit video cameras to track the movement of people infected with the coronavirus. The system can simultaneously track up to ten people in five to ten minutes, cutting the time spent on manual work for health authorities to trace one person. Concerns about the invasion of privacy will probably make it a non-starter in many places, but some countries might adopt it as a useful tool to better monitor quarantining travelers.
Airborne Transmission
At the start of the pandemic in early 2020, Japan was one of the first countries to focus on airborne transmission of the virus. While droplet infections happen through direct, close contact, an airborne virus remains in the air for longer periods of time and travels over longer distances.
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However, there has been significant reluctance by scientists, international organizations and governments to confirm that the virus is spread by tiny aerosol droplets and not by bigger droplets. It's easy to see why. Admitting to SARS-COV2 being airborne has huge and wide ranging implications ー from labor safety, building codes, public transport rules, cleaning routines in hotels and so on, to elevator manners and other social norms.
Still, we will need to adapt, even if it is going to be expensive.
Home Office is Here to Stay
How to keep schools and universities open and safe, has already been a highly emotional and contested issue. Apart from mask mandates and online schooling in COVID hotspots, classrooms and corridors need to follow new air hygiene standards.
Stand-alone mobile portable air filters will likely not be the answer. Schools will need CO2 monitors and ventilation systems that constantly change and purify the air students breathe.
A study from Switzerland that looked at air quality in 150 classrooms concludes that in settings with poor air quality there were six times as many coronavirus cases as in regularly ventilated rooms.
Similar strategies need to be taken for offices. Open plan layouts might soon be history. Ventilation needs to be prioritized.
Air conditioning systems must be overhauled so that exhaust pipes and vents for fresh air intake are not next to each other. Future building safety will not only cover fires and earthquakes, but also infection control. Hybrid offices will become the new normal.
If COVID cases are surging in an area, office workers will be asked to work from home to reduce foot traffic into and out of a hotspot.
Residential buildings will also need an upgrade to make sure the virus does not spread through the whole building if one household is infected. Elevators need self cleaning properties ー maybe by using UV rays.
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New elevator etiquette will see people facing towards the wall, not towards the door any more. Talking will be off limits and considered rude.
Elevator rides are on the lower end of the scale of activities producing exposure risk. That cannot be said of international flights, however, where air circulation can infect passengers sitting rows apart. Air exchange will be important on planes, trains, and ships, to avoid the spread of infectious disease through indoor air systems.
Engineering solutions will be needed to clean air with UV light. Seating and cabin layout will have to change. Even then, carefree travel, as we used to know it, simply is not coming back.
The same goes for dining: Al fresco eateries and contactless food delivery are here to stay.
No End to Masks, but Better Masks are Coming
As the virus is airborne and vaccines will not give an overall protection, masks are here to stay. At the same time, we will see better quality options on the market, like FFP-2/N95 standard.
They will come with better designs and a better fit, in a wider range of sizes and shapes. Japan´s clothing company Uniqlo is launching its 3D mask series early in 2022. “The design incorporates a triple-layer structure with a filter, that facilitates breathing while still keeping individuals protected”, according to the firm.
This is just the start: masks will be the new underwear.
Vaccine Winners, Protests and Tourism
Vaccines will play a key role to fight COVID in the future. While there are still new vaccines being approved and tested, Moderna and Biontech (Pfizer) are emerging as the gold standard – the mRNA type vaccines are doing well at holding up against new variants.
The same cannot be said of vaccines made in China, Russia and India, which do poorly against new virus variants and will probably not be optimized easily. Therefore, China will continue to keep a tight grip on the virus situation at home, restricting movements of its citizens and keeping borders firmly shut for in- and outbound travel.
Countries who are wishing for Chinese tourists to come back, will not be in luck in 2022.
Unfortunately, vaccines and masks have become highly politicized topics in Europe and the United States. Fed by a variety of causes, the protests will not go away. On the contrary, protesters will become more radical. As the anti vaxx movement mobilizes its followers through channels like Telegram, it will be a nightmare to monitor.
There is no end in sight. Anti Vaxxers are starting to form parallel communities to shield themselves from government mandates and restrictions.
From dating to traveling and shopping, the non-vaxxed are putting up high walls between themselves and others, planning sabotage, terror attacks, trying to kill politicians or to overthrow the government. Dangerous times lie ahead.
Algorithm Changes for Fighting Misinformation
Conspiracy theories often develop during times of uncertainty and fear, as they provide explanations for otherwise unexplainable events. Thus, Western societies will have to do a better job at fighting misinformation and disinformation around COVID ー if they want to survive as democracies and uphold individual rights.
More work will be needed to reign in Facebook, Google and other big tech companies. If algorithms can be used to push lies for creating more user engagement for the sake of higher profits from advertisers, certainly the same mechanism can be employed to flag and filter out misinformation for the benefit of society.
Taking on social networks will be essential, as fighting misinformation at an early stage can prevent people going down the rabbit hole of dark theories.
Tackling Disinformation Head-on
Disinformation is a different beast and needs different strategies. Some analyses show that only a handful of accounts are responsible for the large majority of posts that promote powerful anti-vaccine and COVID-denial testimonies.
A new field of study is needed to identify accounts and the actors behind them, as social scientists Ryan Calo and Chris Coward from the University of Washington, Seattle argue. According to them:
It is an exercise in disentangling the motivations of the various actors, some innocent and sincere, others strategic. The warning signs for a disinformation campaign may, ironically, involve true information and reasonable opinion. This suggests a need for researchers to follow people and strategies, rather than individual content alone, and for legislatures to address the problem at the level of incentives.
The two academics also call for diplomatic and economic sanctions to address foreign disinformation campaigns.
It will not be a walk in the park, but rather an uphill struggle. In 2022, we need to brace ourselves for more protests and virus variants with new names, welcome vaccine boosters, new masks, less travel and more work from home.
We might all be tired of the virus, but the virus is not tired of us.
Author: Agnes Tandler
Agnes Tandler has been based in Japan since the start of the pandemic in 2020, where her reporting covers COVID-19 for a daily healthcare newsletter in Germany.
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