On October 21, 2021, PfizerBioNTech announced results from a randomized controlled trial of third doses of its COVID-19 vaccine; protection was restored to the levels seen in earlier trials after the second dose.73Pfizer and BioNTech announce Phase 3 trial data showing high efficacy of a booster dose of their COVID-19 vaccine, Pfizer, October 21, 2021. "We perhaps overdid it early on, so the risk perception was too high. "I think that the practicality and the feasibility outweighs any potential benefit of implementing those sort of measures," Dr Griffin said. Pfizer vaccine efficacy could be a game changer, Cornell University, November 8, 2020, government.cornell.edu. But its now being taken over by strains BA.4 and BA.5, which are proving to be far more transmissible, and possibly more deadly. Get The New Daily free every morning and evening. Lockdown: Boris Johnson unveils plan to end England restrictions by 21 June, February 22, 2021. Covid-19 vaccine: First person receives Pfizer jab in UK, BBC, December 8, 2020, bbc.com/news. At a cash rate of 3.6 per cent, most Australians will be just fine. Most serious cases of COVID-19 would occur in unvaccinated people. In this article, we review developments since our March update, offer a perspective on the situation and evidence as of this writing, and present our scenario-based analysis of when a transition toward normalcy could occur. Juliet R. C. Pulliam et al., Increased risk of SARS-CoV-2 reinfection associated with emergence of the Omicron variant in South Africa, medRxiv, December 2, 2021. 2Timeline to functional end is likely to vary somewhat based on geography. This does not account for other vaccines that are likely to become available, including those approved in other markets (for example, Oxford-AstraZeneca) or others that are likely to report clinical trial data in the first quarter of 2021 (including Johnson & Johnson and Novavax). Fifth, and most concerning, variants that reduce the efficacy of vaccines or the benefits of natural immunity may spread widely. Treasury is estimating a historical surge in net migration, but several factors including changes to COVID policy settings make the prediction seem far-fetched. We have written previously about two endpoints for the COVID-19 pandemic: a transition toward normalcy, and herd immunity. Jason Gale and John Lauerman, How does Omicron challenge the treatments for Covid?, Bloomberg, December 9, 2021. Merck and Ridgeback Biotherapeutics provide update, November 26, 2021; Pfizers novel COVID-19 oral antiviral treatment candidate, November 5, 2021. Merck and Ridgeback Biotherapeutics provide update, November 26, 2021. COVID-19 cases and 7 day rolling Under the Omicrons twin scenario, a variant that evaded prior immunity (including from Omicron) but was otherwise similar to Omicron in transmissibility and severity of disease might cause a wave of disease broadly similar to the one we have recently experienced, though perhaps slightly worse if the public response to it is even more muted and if vaccine-conferred immunity has waned. Highly skilled workers kept their jobs and many industries saw big profits while lower-skilled workers lost their jobs at high rates. In this extract from Pandemedia, The Australian Financial Reviews Patrick Durkin explains how his coronavirus experience began with a car race. For an example of a low-end estimate, see Max Fisher, R0, the messy metric that may soon shape our lives, explained,, Frank Ball, Tom Britton, and Pieter Trapman, A mathematical model reveals the influence of population heterogeneity on herd immunity to SARS-CoV-2,. SARS-CoV-2 Transmission. Higher scores mean that more people have immunity and that the community has greater protection against symptomatic disease. The worst-case scenarios were avoided. Delta variant: What we know about the science, US Centers for Disease Control and Prevention, August 26, 2021. SARS-CoV-2 variants of concern and variants under investigation in England: Technical briefing 31, UK Health Security Agency, December 13, 2021. Pfizer and BioNTech provide update, December 8, 2021; Khristopher J. Brooks, CEOs and scientists on whether existing vaccines will work against Omicron, CBS News, December 8, 2021. Sufficient doses are likely to be available to vaccinate high-risk populations in the United States in the first half of 2021. We model this with an assumption in line with the approach taken by the Institute for Health Metrics and Evaluation (IHME): if there were an effective vaccination immunity of 50 percent and an effective natural immunity of 90 percent, the multiplicative assumption would suggest a combined hybrid immunity of 95 percent, since 1 (1 50 percent) (1 90 percent) = 95 percent. "So, I expect a lot of the decisions to be slightly further behind, rather than really proactive like they were over the past 18 months.". They might also have different outlooks for the next few months if their collective immunities are waning quickly or slowly. If the variants turn out to be a minor factor (they only reduce vaccine efficacy modestly, or they dont spread widely), then herd immunity in the second half of the year is likely for both countriesand is more likely in the third quarter than the fourth. 7. As opposed to the basic reproduction number, which was used at the start of the pandemic, the Reff (effective transmission number) assumes that people have some immunity to the virus either from being vaccinated or having already been infected. Unless these countries choose to maintain their border restrictions (such as hotel-based quarantine) indefinitely, they might accept the risk of endemic COVID-19 after governments determine that a sufficient portion of the population is vaccinated.102 Salma Khalik, Moving from Covid-19 pandemic to endemic: Singapores strategy and how it can unfold, Straits Times, July 3, 2021, straitstimes.com; Peter Collignon, Australia must eventually face reality: Live with Covid or become a hermit nation, Guardian, June 15, 2021, theguardian.com. Many countries are hoping that a vaccine will do the bulk of the work needed to achieve herd immunity. Some (not all) of these changes will stick. Globally and nationally, the epidemiological and public-health situation remains dynamic, and the prospects for each country group are subject to uncertainty. Its really important for everyone to lead a healthy, positive lifestyle, she said. 9116. The booster campaigns of the six countries shown in Exhibit 3 have primarily utilized mRNA vaccines. But several uncertainties could temper the optimism, starting with the duration of immunity. WebThe Consumer Price Index (CPI) rose 1.9% this quarter. Leslie Josephs and Robert Towey, Covid vaccine mandates sweep across corporate America as delta variant spurs action, CNBC, August 9, 2021, cnbc.com; Alexis Benveniste, From offices to restaurants, companies are requiring proof of vaccination, CNN, August 4, 2021, cnn.com. That approach has kept the number of deaths caused by COVID-19 low. The Delta variant of SARS-CoV-2, also called B1.617.2, emerged in late 2020 and has since spread rapidly around the world. 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. Here's where you can find it, Timely reminder: How to respond if you test positive to COVID-19. Subvariants of Omicron, especially BA.5, have challenged the world with ever more transmissible versions of the virus. These scenarios only show us we can achieve in 2022 without stretching ourselves too much. He said improving antivirals which are most effective at reducing severe illness when taken shortly after an infection beginswould also help. This potential delay represents a call to action for policy makers, both in terms of the pace of the vaccine rollout and how new strains are managed. David Heymann, the chairman of the World Health Organizations Strategic and Technical Advisory Group for Infectious Hazards, noted in December that endemicity may be the destiny of this virus.146Melissa Davey, WHO warns Covid-19 pandemic is not necessarily the big one, Guardian, December 29, 2020, theguardian.com. Countries like New Zealand have avoided significant COVID-19-associated mortality but appear to be further from herd immunity because so few New Zealanders have infection-driven immunity to SARS-CoV-2. But he pointed to a number of potential factors. Parts of the European Union have recently faced setbacks: fewer doses in arms than in the United Kingdom or United States, a new wave of cases, and new lockdowns. The R0 value for COVID-19 is under debate, with estimates ranging from two to four. the first and more important of the pandemics two endpoints. In NSW over the past seven days, it has skyrocketed. One step toward this endpoint could be shifting the focus of public-health efforts from managing case counts to managing severe illnesses and deaths. He said he did not agree with the move from some countries to place entry restrictions on people travelling from China afterthe powerful nation's decision to open its borders. China's move away from its aggressive suppression strategy. Both Pfizers and Modernas would be two-dose vaccines, necessitating rigorous follow-up for series completion. The Pfizer trial has enrolled some children (ages 12 and older), but efficacy in those under 18 remains unclear. and is now declining just as quickly. Theyre hoping theyll be able to get it approved around August When that comes out, it will definitely be worthwhile.. Its possible that regular revaccinations would be required to maintain immunity, and ongoing surveillance for COVID-19 will be required. 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 some places, such as Mumbai and New York City, subpopulation antibody-positivity rates range up to 50 percent.3Not all serosurveys have used random-sampling methodologies. As cases decline, our analysis suggests that the United States, Canada, and the European Union could restart the transition toward normalcy as early as the fourth quarter of 2021, provided that the vaccines used in these countries continue to be effective at preventing severe cases of COVID-19. The Omicron variant is spreading rapidly. BioNTech: watchdogs' requirements may defer planned launch of Omicron shot, Reuters, January 25, 2022, reuters.com. 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. What does it hold in store? Despite his grim outlook on COVID-19 deaths, Professor Esterman said its not all doom and gloom. "The danger will be that, if a variant emerges somewhere that can be anywhere in the world that is more severe, starts to put more people in hospital or increase mortality, that's when the real risk comes in for the next 12 months.". We will add a perspective for other parts of the world, including the rest of Western Europe, in future updates to this article. COVID-19 vaccinations in the United States, The Centers for Disease Control and Prevention, February 23, 2022, covid.cdc.gov. This comparison should be qualified, insofar as the burden of COVID-19 is dynamic, currently increasing, and uneven geographically. COVID-19 deaths on the rise: Epidemiologists grim prediction for Australia, Not so fast: Tony Abbott calls for the Voice referendum to be cancelled, The night I cooked schnitty for Barry Humphries, actual number of virus cases at the peak of the Omicron wave was likely double, Omicron wave cases double reported: Study. They estimate that the proportion of infected people was at least twice as high as indicated by cases reported to authorities by the end of February 2022. 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. University of South Australia professor of biostatistics Adrian Esterman told The New Daily on Monday that COVID-19 deaths were slowly rising as governments wound back public health measures, and would likely average 50 a day by the end of July. As Exhibit 3 shows, Pfizer and Moderna are expected to deliver sufficient vaccine doses to vaccinate all high-risk Americans during the first half of the year. As the name implies, a transition will include a series of steps that will gradually normalize aspects of social and economic life. Companies have indicated that modified or new vaccines could be available in a few months, though the scale and global availability are unclear.58Pfizer and BioNTech provide update, December 8, 2021; Khristopher J. Brooks, CEOs and scientists on whether existing vaccines will work against Omicron, CBS News, December 8, 2021. Covid pandemic: Biden eyes 4 July as Independence Day from virus, BBC, March 12, 2021, bbc.com. Our estimates of three to eight months for manufacturing, distribution, and adoption of sufficient vaccine doses to achieve herd immunity remain unchanged, and suggest that the milestone may be reached between July and December 2021. While an initial course of all WHO-approved vaccines continues to provide strong protection against severe illness and death, the rate of breakthrough cases increases meaningfully as time passes, indicating that protection declines with time. If T-cell cross-reactivity provides meaningful immunity, it would offer significant progress toward herd immunity. As in previous waves, lower-income countries and those with younger populations were somewhat protected,25Nurith Aizenman, Africa may have reached the pandemic's holy grail, NPR, January 28, 2022, npr.org. COVID data tracker, Centers for Disease Control and Prevention, last accessed March 20, 2021, cdc.gov; Weekly U.S. influenza surveillance report, Centers for Disease Control and Prevention, last reviewed March 19, 2021, cdc.gov. Expect quite a bit of spending out of this cohort. Variant prevalence is taken from Outbreak.info, which summarizes the data uploaded to GISAID. The other variables will also have much to say about the timeline to reach herd immunity (see sidebar, Key factors affecting the timeline to herd immunity). Only two measures will be looked at: deaths per million and the vaccination rate. (Exhibit 2). We see four plausible scenarios for vaccine efficacy and adoption, illustrated in This article was edited by Mark Staples, an executive editor in the New York office. Given all of these variables, where do we net out? 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. While COVID-19 reinfection is documented but rare, there are now population-level studies that question the durability of immunity. The biggest risk to a countrys ability to do this would likely then be the emergence of a new variant that is more transmissible, more liable to cause hospitalizations and deaths, or more capable of infecting people who have been vaccinated. Factors that could influence actual outcomes include: The surge of COVID-19 cases resulting from the spread of the Delta variant and from vaccine hesitancy brought a sudden, tragic end to the transition toward normalcy that some countries had begun to make. 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?,. The authors wish to thank Xavier Azcue, Brian Hencke, David Meredith, Michalis Michaelides, Anthony Ramirez, Virginia Simmons, Konstantinos Tsakalis, and Lieven Van der Veken for their contributions to this article. It's a big shift from the first few years of the pandemic, where the gold-standard PCR testing was available to everyone in the community in an attempt to identify every case and send rings of contacts into quarantine. Over the past couple of months, the number of tests bought from one online retailer has been rising, which may reinforce the impression that the United States is entering a period of sustained case growth. Beyond that, a more realistic epidemiological endpoint might arrive not when herd immunity is achieved but when COVID-19 can be managed as an endemic disease. Virus-neutralizing antibodies could also confer immunity but are less likely to be deployed at sufficient scale to achieve herd immunity in large populations. According to federal health department data as of 18 April, 6,786 people have died of Covid-19 in Australia since the beginning of the pandemic. Herd immunity is not the same as eradication. South Australia and Tasmania, too, have an established surge. Note that the values shown define ranges of immune protection against symptomatic infection, since that is the metric most of the published literature uses. Those results have generally been achieved through a combination of moderately effective interventions rather than a single big bang (Exhibit 3). The short term will be hard, but we can reasonably hope for an end to the pandemic in 2021. A basic formula for estimating that threshold is one minus the reciprocal of the basic reproductive number.7The basic reproductive number (R0) is a measure of contagiousness or transmissibility. The researchers estimate that at least 17 per cent of Australian adults had been infected with SARS-CoV-2, the virus that causes COVID-19, by the end of February During the anticipated period, the Australia infection control market in is anticipated to expand significantly. Nor is it clear yet what the approval standards might be for multi-valent vaccines. Well get down to very, very few rules very soon and thats not a credit to anybody other than every single Victorian whos got a first dose or a second dose and the 66% of people whove got a third dose [of a Covid-19 vaccine], he said on Tuesday. Hannah Ritchie et al., Coronavirus (COVID-19) vaccinations, Our World in Data, last accessed March 15, 2021, ourworldindata.org. 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. The United Kingdoms experience nevertheless suggests that once a country has weathered a wave of Delta-driven cases, it may be able to resume the transition toward normalcy. The question of disease severity is more complicated. If the experience of South Africa were to be repeated elsewhere, we could see a continued rapid increase in the number of COVID-19 cases as Omicron is established. Beta and Gamma have also affected the trajectory, but to a lesser degree; their evolutionary advantage was not great enough to become globally dominant.39Tracking SARS-CoV-2 variants, World Health Organization, who.int. Some of those measures (such as full lockdowns and restrictions on certain industries) have significant social and economic consequences, and others (such as testing and tracing), while expensive, dont. "Australia, as a neighbour there, really has a responsibility to help with the infrastructure and with the messaging and to try [to]get those populations vaccinated," he said. Caution is still warranted. Copyright 2023 The New Daily. At this point, significant, ongoing public-health measures are not needed to prevent future spikes in disease and mortality (this might be achieved while there are still a number of people in particular communities who still have the disease, as is the case with measles). Yinon M. Bar-On et al., Protection by a fourth dose of BNT162b2 against Omicron in Israel,, Alasdair P. S. Munro et al., Safety, immunogenicity, and reactogenicity of BNT162b2 and mRNA-1273 COVID-19 vaccines given as fourth-dose boosters following two doses of ChAdOx1 nCoV-19 or BNT162b2 and a third dose of BNT162b2 (COV-BOOST): A multicentre, blinded, phase 2, randomized trial,, Ori Magen et al., Fourth dose of BNT162b2 mRNA Covid-19 vaccine in a nationwide setting,, Victoria Hall et al., Protection against SARS-CoV-2 after Covid-19 vaccination and previous infection,, Freja C. M. Kirsebom et al., COVID-19 vaccine effectiveness against the Omicron (BA.2) variant in England,, Nick Andrews et al., Covid-19 vaccine effectiveness against the Omicron (B.1.1.529) variant,, Mark Stegger et al., Occurrence and significance of Omicron BA.1 infection followed by BA.2 reinfection,, Heba N. Altarawneh et al., Protection against the Omicron variant from previous SARS-CoV-2 infection,, Timothy A. Bates et al., Vaccination before or after SARS-CoV-2 infection leads to robust humoral response and antibodies that effectively neutralize variants,, Bobby Reiner, COVID-19 model update: Omicron and waning immunity, Institute for Health Metrics and Evaluation (IHME), December 22, 2021, Gayatri Amirthalingam et al., Serological responses and vaccine effectiveness for extended COVID-19 vaccine schedules in England,, Julia Stowe et al., Effectiveness of COVID-19 vaccines against Omicron and Delta hospitalisation: Test negative case-control study,, Mark G. Thompson et al., Effectiveness of a third dose of mRNA vaccines against COVID-19associated emergency department and urgent care encounters and hospitalizations among adults during periods of Delta and Omicron variant predominance,, Jessica P. Ridgway et al., Rates of COVID-19 among unvaccinated adults with prior COVID-19,, Stefan Pilz et al., SARS-CoV-2 reinfections: Overview of efficacy and duration of natural and hybrid immunity,, Anna A. Mensah et al., Disease severity during SARS-COV-2 reinfection: A nationwide study,. While the European Union, the United Kingdom, and the United States have had broadly similar COVID-19 experiences, other parts of the world look very different. 13. Many models predict thresholds of about 40 to 50 percent. We are more confident in this timeline for the United Kingdom than for the United States, given that the first has already experienced a wave driven by a more infectious variant, whereas the latter could still face one. Patrick Durkin BOSS Deputy editor. For an example of a high-end estimate, see Seth Flaxman et al., Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe, Nature, August 13, 2020, Volume 584, pp. WebA barrier on the state border of Queensland and New South Wales preventing interstate travel in April 2020 during the COVID-19 pandemic in Australia. Case controllers. Previous editions of this article invoked a comparison of the COVID-19 burden to that from other diseases such as flu. At the latest, the transition to normal will come when herd immunity is reached. Based on analysis of all sources cited. Prior natural infection with a different variant appears to provide only partial protection against Delta. More than a week since testing positive, Ms Spooner has beencareful to avoid spreading the disease. It nevertheless helps illustrate the relative threat posed by the two diseases. While initial data suggest that COVID-19 vaccines do block significant transmission,129Smriti Mallapaty, Can COVID vaccines stop transmission? Estimated case-detection rates range from 3:1 to 10:1.2Charlie 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. Its an important distinction because what will drive herd immunity is reduction in transmission. WebCHNH SCH GIM GI HAMPER 2022 Thng 12 20, 2022 Tags. The threshold for achieving herd immunity for COVID-19 is the percentage of a population that needs to develop immunity to disease to prevent sustained future transmission. Their task will be determining what burden of disease is low enough to warrant lifting of public-health restrictions, and how to manage the public-health impacts of endemic COVID-19. It took longer than ideal for NSW to put its foot down, and for Queensland and South Australia to back down. Data shows that more and more people have concluded that the health risks of COVID-19 are not significant enough for them to change their behavior, either because of their vaccination status, their youth, or a desire to move on from the pandemic.26Sarah Feldman and Catherine Morris, Omicron worries America, but not enough to precipitate change, Ipsos, December 14, 2021, ipsos.com. Both countries target low- to semi-skilled workers, mainly for seasonal agricultural and horticultural work. SARS-CoV-2 Infection-induced and Vaccine-induced Immunity. The main risk to that transition is a significantly different new variant that replaces Omicron as the dominant strain. Natural immunity to SARS-CoV-2 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. Deltas high transmissibility also makes herd immunity harder to achieve: a larger fraction of a given population must be immune to keep Delta from spreading within that population (see sidebar, Understanding the Delta variant). That's an approach that will continue in 2023, with a national COVID-19 plan outlining an approach based on an informed community taking the lead on protection, alongside vaccine supply certainty and a focus on taking the pressure off hospitals. Coronavirus (COVID-19) update: FDA authorizes monoclonal antibody for treatment of COVID-19, US Food and Drug Administration, November 9, 2020, fda.gov. Sara Jerving, Africa not on track for 10% COVID-19 vaccination rate by end of year, Devex, July 30, 2021, devex.com; Over half a billion COVID-19 vaccine doses administered in WHO South-East Asia Region as countries scale up vaccination efforts, World Health Organization, August 6, 2021, who.int. Increasing clarity on the availability of vaccine doses during the first half of 2021 in the United States improves the odds of an early transition toward normalcy. (For more on the potential for a faster resolution of the COVID-19 crisis in the United States, see An optimistic scenario for the US response to COVID-19.) Coronavirus (COVID-19) deaths, Our World in Data, July 5, 2022. WHO Coronavirus (COVID-19) Dashboard, World Health Organization, February 2022, covid19.who.int. On the other hand, if vaccine uptake is fast, New Zealand might achieve a longer-lasting vaccine-based herd immunity. In 1920, a world wearied by the First World War and sickened by the 1918 flu pandemic desperately sought to move past the struggles and tragedies and start to rebuild lives. The R0 value for COVID-19 is under debate, with estimates ranging from two to four. This might occur if vaccines proved less effective in preventing severe disease, and could lead to the worst wave yet for many locations. 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. 22. "I think we've had a strategy of extremes," Dr Griffin said. They are not intended to be predictive for any individual. Thats not the same as reducing transmission. The drugs are more likely to be effective if taken within five days of symptom onset,68Merck and Ridgeback Biotherapeutics provide update, November 26, 2021; Pfizers novel COVID-19 oral antiviral treatment candidate, November 5, 2021. requiring an efficient pathway from diagnosis to prescription and distribution.