What will happen to the third winter of the new crown epidemic?

  When the cold wave in the north struck, people suddenly realized that the winter of 2021 is coming soon. This is already the third winter in which the new crown virus has attacked humans.
  Compared with the plateau period when the global epidemic was at a high level last year, starting from late August 2021, the number of new confirmed cases worldwide began to decline steadily. According to statistics from Johns Hopkins University in the United States, in the week of August 29, there were more than 4.5 million new cases worldwide, but by October 17, the number of new cases per week had been less than 3 million.
  At present, in addition to the “moderate increase” in the number of new confirmed cases in Europe, the new crown epidemic in most parts of the world has continued the downward trend that began in August. Among them, the epidemics in the United States, India, Brazil, and the Philippines are all obvious. Decline, the largest decline in cases in Africa and the Western Pacific region.
  ”Will we have a surge like last winter this winter?” Ashish Jaha, Dean of the Brown University School of Public Health, asked himself in an article, “I think we can clearly say No.” Many experts are as optimistic as Ashish. They believe that although this cunning virus will not disappear soon, the worst period of the new crown pandemic has passed and there will be no significant surge this winter.
  So, has the turning point really come?
The retreating new crown and the re-wearing mask

  On October 4, the front page of the “New York Times” published an article “New Crown, Retreating.” At the beginning of the article, it read: “The new crown is retreating, and the reason is not clear… This change has been obvious enough, and it has lasted long enough, which deserves our attention.” The
  article stated that since September 1st, the United States The number of new daily cases dropped by more than one-third, and the number of hospitalizations dropped by about 25%. Since September 20, the daily death toll has fallen by 10%, which is the first continuous decline in the death toll since the early summer of this year.
  According to Lu Mengji, a Chinese-born virologist in Germany and a professor at the Institute of Virology at the University of Essen’s School of Medicine, to determine whether the Delta virus is “retreating”, not only the number of newly diagnosed cases, but also the hospitalization rate and mortality rate are more important. Two indicators. “Especially the hospitalization rate is the most important indicator for the entire evaluation, that is, to see whether the current and future medical service system can be supported.” He explained.
  According to the latest data from the Robert Koch Institute (RKI) of the German Federal Center for Disease Control and Prevention, on October 18, Germany reported 4,056 newly confirmed cases, and another 10 people died from the new crown, and the mortality rate was steadily decreasing. About 1,400 new crown patients are currently in the ICU, which is lower than the previous peak of 5,800.
  In the past seven days, 74.4 people out of every 100,000 people in Germany were diagnosed. If in the past, this might be a sign of social tightening. Because according to Germany’s previous epidemic prevention strategy, if the number of new diagnoses per 100,000 people in each state exceeds 50 in a week, prevention and control will be tightened. However, since August, Germany has announced that it will no longer use the number of new diagnoses as the number of new diagnoses. For the “brake” standard, Chancellor Merkel said: “Now, the more important thing is the hospitalization rate.” In
  Germany, only 1.92 people per 100,000 people per week are hospitalized due to the new crown, and the ICU hospitalization rate is 6.5%. “This figure is Very low.” Lu Mengji said. He further analyzed that the number of new cases per day in Germany is now 6,000 to 8,000. Last year it reached 30,000 at the peak. However, even if it reaches 20,000 to 30,000 this year, the number of hospitalizations will not be too much. This is mainly because of the vaccine. cover. Although vaccines cannot completely prevent breakthrough infections, they have a protection rate of more than 95% for severe cases. Therefore, the primary task of all countries is to continue to expand vaccine vaccination.
  Lu Mengji pointed out that from the perspective of the epidemic situation in Europe, there are currently two main trends: on the one hand, the number of new infections is still fluctuating, and some countries are climbing; on the other hand, the hospitalization rate and death rate in most countries are low. In the coming winter, the situation in Europe is generally optimistic.
  According to an unnamed American public health expert, the decline in the infection curve in the United States in the past two months has also benefited first from the expansion of vaccination. Driven by the Biden administration’s “vaccine injunction”, as of October 17, 189 million people in the United States had been fully vaccinated, accounting for 57% of the population, and about 65.9% of them had received at least one dose.
  The article “New Crown, Retreating” puts forward the so-called “mysterious two-month cycle” theory. Since the spread of the new crown at the end of 2019, the number of cases has usually surged for about two months, and then dropped for about two months. This trend can be seen around the world. For example, this year’s epidemic rose from late February to late April, then began to decline, continued to late June, rose again to late August, and has been declining ever since. This pattern is obvious in countries such as India, Indonesia, Thailand, the United Kingdom, France, and Spain. The article said that perhaps a reasonable explanation is that the biological characteristics of the virus and the changes in human social networks are caused together.
  The same is true for the spread of Delta variants. Chen Xi, associate professor of global health policy and economics at Yale University, found that, compared with the previous variants, Delta “will cause the epidemic to rise quickly and fall quickly” when infected in the population. However, the delta propagation curve in the United States has a longer plateau at the top of the slope than in the United Kingdom.
  ”This is because the US public health measures were not effective some time ago.” Chen Xi said. In June 2021, the number of new daily cases in the United States once dropped to a low level. However, with the vaccination, the CDC in the United States recommended that “people who are fully vaccinated do not wear masks” in May, and the epidemic has rebounded significantly. On July 27, the CDC changed its slogan and stated, “Regardless of the level of community transmission, people who are fully vaccinated can choose to wear a mask.” It also recommended that you wear a mask indoors in high-risk areas and when taking public transportation such as trains and airplanes. Masks must be worn, and all teachers and students, whether vaccinated or not, must wear masks indoors. Many states have also issued their own “mask injunctions.” A study by the US CDC in Kansas showed that when Governor Laura Kelly required 24 counties to wear masks mandatory since July, the number of new local cases decreased.
  ”So people put on masks one after another,” said the aforementioned American public health expert.
  The expert believes that after the beginning of school in September in the United States, although the virus has spread to a certain extent on campuses, it has not formed a trend of rebound. This is precisely because of the mandatory wearing of masks and other measures. According to his observations, in recent months, wearing masks in certain places has gradually become a consensus and habit of Americans. He went to New York for meetings a few days ago and required to wear masks when taking trains and subways.
  This is completely different from the situation in the United States where there was a debate on whether to wear a mask at the beginning of the epidemic. After all, the world was completely changed by the new crown virus. In his view, even if the vaccination rate is getting higher and higher, with the opening up of society, the normalization of masks will inevitably become a trend until the epidemic is completely over.

Return to normal life

  In the UK, the number of new diagnoses in the past two months has been “seesaw” rather than declining. But Sarah Jones, an immunologist and infectious doctor at the University of Oxford, also observed that, unlike last year, among the new crown patients admitted this year, the proportion of patients with severe illness that require ICU has decreased.
  A set of data provided by the British Financial Times shows that the weekly mortality rate in the UK is now six times the continental average, and the hospitalization rate is three times that of other major European countries. At present, the cumulative number of confirmed diagnoses in the United Kingdom ranks second in the world, second only to the United States.
  Public health experts accused the UK’s decision to end the mandatory wearing of masks and suspend the issuance of vaccine certificates as reasons for the worsening of the epidemic in the UK. On July 19, British Prime Minister Boris Johnson announced the cancellation of most social control measures. This day is called “Freedom Day”. For Britain, which is welcoming the winter, Lu Mengji thinks this is almost a “streaking”.
  Martin McGee, professor of public health at the London School of Hygiene and Tropical Medicine, UK, pointed out that the UK should immediately start the “Plan B”, including wearing masks indoors, maintaining social distancing, stay-at-home orders and vaccine injunctions. As France, Italy, and other countries have done, “It really doesn’t take a big fight to contain the rebound of the epidemic,” he said.
  In Spain, it is still mandatory to wear masks in schools. In Italy, nightclubs have strict restrictions on the number of people, and vaccination certificates must be provided to enter. There are basically no restrictions on daily life in Germany. Travel, entertainment and service industries have been opened up. Football stadiums are re-allowed for spectators to enter. There is no longer a limit on the number of people at private gatherings, but it is still stipulated in public transportation and relatively closed spaces. Wearing a mask is “the few remaining control measures”, but it is very effective in controlling the epidemic, Lu Mengji explained.
  A survey commissioned by the German Robert Koch Institute (RKI) at the beginning of the month estimated that about 80% of citizens have actually received two injections, which is higher than the official report of about 65%. However, Germany has never forced vaccination, but since October 11, the new crown test is no longer free, and people who have not been vaccinated must undergo rapid tests on a regular basis. It costs about 15 euros each time. In Germany, all bars, restaurants, and movie theaters allow only people who have recovered, been vaccinated, or have a negative nucleic acid test. “This is actually forcing people to get vaccinated.” Lu Mengji pointed out.
  In the past two months, many countries in the world have tried to return to normal life.
  The United States will lift travel restrictions on 33 countries and regions, including China, India, Brazil, the United Kingdom, and most EU countries, from November 8th, and also liberalize travellers entering the United States by land and sea. This means that Canada-U.S. and Canada-Mexico borders have reopened.
  From November 1, New South Wales, Australia will allow fully vaccinated people to enter, without hotel isolation and home isolation. It is expected that the travel ban across the country will be lifted by mid-December at the latest.
  Singapore, where nearly 85% of the population has been fully vaccinated, is one of the countries with the highest vaccination rate in the world and one of the countries in the world that has the most strict prevention against the new coronavirus. Prior to this, Singapore had maintained a single-day increase of less than double digits with a blockade policy, but starting from August 10, it began to unblock it in four stages. Singapore Prime Minister Lee Hsien Loong said: “… In Singapore not long blockade of the blockade will not be successful, but costly we will not return to normal life, not social, not to reopen the border, unable to restart the economy,”
  ”let go”, the Singapore outbreak immediately Rebound. Within a month of September, the number of new diagnoses in a single day in Singapore rose from more than 300 to more than 3,000. But unblocking is still on the way. At present, Singapore has allowed international travelers holding “vaccine passports” from some countries to enter the new country, but the regulations on entry testing are stricter than those in Europe and the United States.
  The opening up of Asia is generally lagging behind that of Europe and the United States, but some Asian countries that rely heavily on tourism are also opening their doors recently. Both Thailand and Nepal require the provision of vaccine certificates and nucleic acid to enter the country. Bali also requires an additional 5 days of quarantine.
How is this winter?

  As the global coverage of vaccines continues to increase, people are more and more impatient to know the answer to a question: when will the new crown epidemic completely end?
  The joint research team, which is dedicated to providing fashion trend consultation for the US CDC, has just announced their ninth round of models. The latest model predicts the pandemic curve in the next six months in the United States. The researchers pointed out that the most likely situation is that it will not happen. Surge in winter. By March 2022, daily new infections across the United States may drop slowly and steadily from approximately 140,000 in September to approximately 9,000 per day, and the death toll may decrease to less than 100 per day.
  But the above-mentioned ideal picture has two premises: one is that the vaccine for children aged 5 to 11 years old is approved, and the other is that there will not be another new variant with strong spreading power like Delta. There is no need to worry too much about the first point. For the second point, the current mainstream view in the scientific community is that the probability of new variants is very low. However, experts are “optimistic but cautious” when discussing this issue.
  Lu Mengji explained that the basic infection rate (R0) of Delta is about 5, that is, one virus carrier can infect 5 people. This is a very high number, except for measles, which has an R0 of 20, which is the basic transmission of most infectious diseases. The numbers are all less than 5. Therefore, it is generally unlikely that another variant with “such a high transmission power” will appear based on the biological characteristics of the coronavirus. The new crown virus has spread around the world for so long, and the last super-virulent strain produced by “natural selection” is only Delta. And whether in India, South America or the United Kingdom, the selected epidemic mutant strains are only “making a fuss on improving the transmission power”, rather than enhancing the breakthrough ability of human immunity.
  Regarding the true mutation of the new crown, a popular view is that the new crown may become “flu-like” in the future, and the vaccine will be given once a year. But Lu Mengji said that this view is wrong. This is because the new coronavirus and influenza virus are “two completely different organisms.” The reason why the influenza vaccine is given once a year is because the influenza virus recombines its genes every year to become a “new virus.” If the genetic modification rate of the influenza virus is 100%, the new coronavirus is only 5%-10%.
  Therefore, in Lu Mengji’s view, the most important thing at the moment is to increase the vaccination rate as soon as possible, so that even if there are new variants, as long as the population has formed an “immune barrier”, it will not be affected by the early stages of the epidemic. “It is not ruled out that there may be mutant strains that have a breakthrough in the immune barrier, but we look at the past coronavirus epidemic history, this kind of mutation is only possible in a long time span, at least more than a few decades.” He Added.
  The appearance of Delta has changed some old perceptions. At present, experts have basically reached a consensus: vaccines alone can never form “herd immunity”, and the final path must be the “parallel progress” of vaccines and natural infections. Timo Ulrichs, professor of epidemiology at Arken University in Germany, reminded people that herd immunity does not mean stopping the spread of the virus once and for all. In the future, it is more likely that small-scale outbreaks will occur again and again. “These outbreaks It should be controllable and a gentle process,” he said.
  Lu Mengji also pointed out that there is one thing that needs special attention this winter: the confluence of the new crown and influenza may bring additional burdens to the medical systems of various countries. He explained that there are new variants of influenza every year, and influenza vaccines in the northern hemisphere are generally determined based on the epidemic status in the southern hemisphere, and the virus strains that may circulate this year are predicted. However, due to strict epidemic prevention and control in Australia, no flu has formed, which brings uncertainty to this year’s forecast, which “may exacerbate the influenza epidemic in the northern hemisphere.” He said.
  However, given that the new coronavirus always surprises humans time and time again, these predictions are also variable. But no matter what, in Lu Mengji’s view, after 2022, people need to start to rethink what is meant by “the end of the pandemic.”

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