A psychic who claims she saw the Covid-19 pandemic coming in 2018 is now warning of everything from political upheaval to a world war in the years ahead. 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 addition, boosters, full approval of vaccines (rather than emergency-use authorization), authorization of vaccines for children, and a continuation of the trend toward employer and government mandates and incentives for vaccination are all likely to increase immunity.99 Q&A: When might the coronavirus vaccines get full approval?, August 2, 2021; Covid vaccine mandates, August 9, 2021; From offices to restaurants, August 4, 2021. 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. Vaccine rollout and adoption are faster than expected, Natural immunity is significantly higher than realized, More-transmissible variants lead to higher rates of natural immunity, US Biologics License Applications (BLA) with full approval by March/April 2021 or earlier, Approximately 39 months for manufacturing, distribution, and sufficient adoption to reach herd immunity, Manufacturing/supply-chain issues slow rollout, More-infectious variants raise the threshold for achieving herd immunity, Vaccine prevents disease progression but does not meaningfully reduce transmission, 56 million for phase 1c: ages 6574 (through 3/31/21), 202 million for phase 1c: other (4/1/217/31/21), the arrival, efficacy, and adoption of COVID-19 vaccinesthe biggest drivers in the timeline to herd immunity, the level of natural immunity in a population from exposure to COVID-19; in our estimate, between 90 million and 300 million people globally may have natural immunity, potential cross-immunity from exposure to other coronaviruses, potential partial immunity conferred by other immunizations, such as the bacille CalmetteGurin (BCG) vaccine for tuberculosis, regional differences in the ways that people mix, which will produce different thresholds for herd immunity, continued improvement by governments in the application of public-health interventions (such as test and trace) that dont significantly limit economic and social activities, compliance with public-health measures until we achieve herd immunity, accurate, widely available, rapid testing that effectively enables specific activities, continued advancements in therapeutics (including pre- and postexposure prophylactics) for and clinical management of COVID-19, leading to lower infection-fatality ratiossubstantial progress has already been made through a combination of effective drugs, such as dexamethasone and remdesivir, and changes in clinical management, public confidence that there arent significant long-term health consequences for those who recover from COVID-19. A new dominant variant will receive a Greek-letter name, but until then we have created more descriptive names for our scenarios. Data on the availability of vaccine doses in the United States increase confidence that this is possible, but the slow start to the vaccine rollout reinforces that success is by no means guaranteed. It nevertheless helps illustrate the relative threat posed by the two diseases. Vaccine hesitancy makes it all the more difficult to reach the population-wide vaccination level rates that confer herd immunity. It's unclear at what price these changes come, in terms of increased risk to essential workers and their families. Both Dr Lydeamore and Dr Griffin said the introduction of bivalent vaccines, which can target two strains of the virus, was a helpful addition heading into 2023. Note that immunity against symptomatic disease (not any disease) is what we try to assess; we dont estimate a communitys threshold for herd immunity, as that would be driven by both symptomatic and asymptomatic infections. 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. 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. This is based on EUA of one or more high-efficacy vaccines in December 2020 or January 2021, as manufacturers are targeting166Pfizer and BioNTech to submit Emergency Use Authorization request today to the US FDA for COVID-19 vaccine, Pfizer, November 20, 2020, pfizer.com; Modernas COVID-19 vaccine candidate meets its primary efficacy endpoint in the first interim analysis of the Phase 3 COVE study, Moderna, November 16, 2020, moderna.com. 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). Generations mixing together after months of distancing. But as the more infectious Delta variant becomes more prevalent within a population, more people within that population must be vaccinated before herd immunity can be achieved (Exhibit 1). Age demographics will continue to be an important risk driver. 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. The pandemic didnt impact all of us in the same way. Pfizer and BioNTech to submit Emergency Use Authorization request today to the US FDA for COVID-19 vaccine, Pfizer, November 20, 2020, pfizer.com; Modernas COVID-19 vaccine candidate meets its primary efficacy endpoint in the first interim analysis of the Phase 3 COVE study, Moderna, November 16, 2020, moderna.com. The key factor is diminished mortality. 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. "In order for us to go from the pandemic phase to an endemic phase, the virus has to be widespread.". The timing of such a transition will depend on the progress toward herd immunity, as previously detailed (since more people with immunity means fewer deaths and long-term health consequences), and on the effectiveness of a countrys public-health response. The pace at which governments relax public-health measures will be critical. Could the same happen in the U.S.?, Fortune, August 3, 2021, fortune.com. 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. As we are are cocooning more, Bunnings, Barbecues Galore, Harvey Norman and co will be doing well! 3. Some (not all) of these changes will stick. The pace of vaccine rollout varies among the countries, but in many cases reopening of borders may not begin until 2022, dependent in part on public-health outcomes for countries in other groups.103 Frances Mao, Fortress Australia: Why calls to open up borders are meeting resistance, BBC News, May 26, 2021, bbc.com; Meena Thiruvengadam, New Zealand to keep its borders closed through the end of 2021, Travel and Leisure, August 12, 2021, travelandleisure.com. Whether because Omicron is more infectious or has greater ability to evade the immune system, or both, it quickly became the dominant variant in South Africa.52Genomic epidemiology of novel coronavirus - Africa-focused subsampling, Nextstrain, December 11, 2021. The UK Health Security Agency recently summed up its view: Early estimates of vaccine effectiveness (VE) against symptomatic infection find a significantly lower VE [against] Omicron infection compared to Delta infection. If T-cell cross-reactivity provides meaningful immunity, it would offer significant progress toward 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. While countries such as Israel have shown what is possible, the United States has fallen behind its targets.144Coronavirus: Israel leads vaccine race with 12% given jab, BBC, January 3, 2021, bbc.com.145Michelle R. Smith, Governors scramble to speed vaccine effort after slow start, Associated Press, January 6, 2021, apnews.com. But for now, fewer of us need to get testedand, according to Morrison, that's cause to relax. So, as we consider future waves, two critical questions remain about the duration of protection: how significantly will immunity wane? John Farley, FDA updates on Paxlovid for health care providers, US Food and Drug Administration, May 4, 2022. Margaret Keenan, a British nonagenarian, made history on December 8 by becoming the first person to receive the Pfizer-BioNTech vaccine for SARS-CoV-2 outside a clinical trial.133Covid-19 vaccine: First person receives Pfizer jab in UK, BBC, December 8, 2020, bbc.com/news. Pfizer Shares In Vitro Efficacy of Novel COVID-19 Oral Treatment Against Omicron Variant, Pfizer, January 18, 2022, Pfizer.com. Baby Boomers will act with a sense of urgency. COVID infections soared in January thanks to the original Omicron variant, with states around the country reporting a combined 150,702 new cases on January 13. Its probably several times that number of cases.. Note that the values shown define ranges of immune protection against symptomatic infection, since that is the metric most of the published literature uses. F. Javier Ibarrondo et al., Rapid decay of anti-SARS-CoV-2 antibodies in persons with mild COVID-19,, Rebecca Cox and Karl Brokstad, Not just antibodies: B cells and T cells mediate immunity to COVID-19,, Katie Thomas, New Pfizer results: Coronavirus vaccine is safe and 95% effective,. That would mean that between around 90 million and 300 million people around the world have some immunity to SARS-CoV-2. Increasing the uptake of effective therapeutics is an important step for governments as they continue the transition toward managing endemic COVID-19. Second, a new, immunity-evading variant could upend this relatively optimistic story at any time. The R0 value for COVID-19 is under debate, with estimates ranging from two to four. The primary sources used to inform our assumptions on the effectiveness of vaccines and past infection in conferring immunityand how that effectiveness changes over time and for different variants include the following: This information, combined with estimates of when infections and vaccinations took place, enables us to create the McKinsey COVID-19 Immunity Index, showing fluctuations in degrees of protection over time (see sidebar, Description of methods for the McKinsey COVID-19 Immunity Index). The risk that COVID-19 poses to a community at any point in time is a function of the immunity of its members. What role will antibody treatments play? April 27, 2023 - 3:40PM. In most places, the worst of the Omicron wave has passed leading some locations to loosen public-health measures to a degree not seen in almost two years. In just 10 months, the cost of servicing an average $600,000 mortgage will have risen by more than $14,000 per year once those rate hikes are fully passed through. "If this sort of trend continues, then that's good news for us, in that it's just becoming moretransmissible, it's not becoming any more severe," he said. 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?,. Finally, an economic threshold for endemic COVID-19 will come when epidemiology substantially decouples from economic activity and secondary economic effects largely resolve. More detail is shown in Exhibit 1 below. If they fail to do so, regional house prices will continue to rise sharply. These are my 22 predictions for 2022. 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. For more, see Eames, Fine, and Heymann, Herd immunity: A rough guide, pp. New COVID-19 cases worldwide, Johns Hopkins University & Medicine, February 20, 2022, coronavirus.jhu.edu. 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. Two skewed bell curves estimate when herd immunity will occur. A media law expertexplains, Hopes high that Australian drug may stop brain cell death after traumatic births, Autopsies begin on more than 100 bodies of Kenyan cult members, Fifth man charged over Sydney gangland shooting of Mahmoud Ahmad, Fijis former attorney-general Aiyaz Sayed-Khaiyum taken into custody over alleged abuse of office, Support overwhelms referee as alleged attacker jailed, NRL concedes knock-on error on crucial golden point call for Raiders. Because more-transmissible variants raise herd-immunity thresholds, there will also be less tolerance for low vaccine effectiveness. And the initial rollout of vaccines has been slower than hoped in many places.135Michelle R. Smith, Governors scramble to speed vaccine effort after slow start, Associated Press, January 6, 2021, apnews.com. Since home tests became more widely available, in late 2021, consumer purchases of them have risen in line with waves of COVID-19 cases, prefiguring rises in deaths attributable to the disease (Exhibit 1). It ricocheted across social media, on front pages and out of the mouths of dads deprived of more days on the couch in front of the cricket. He said vaccines would remain Australia's "main defence" against the virus and the community should expect regular COVID-19 vaccinations into the new year. 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. 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. And this will have an impact on hospitalisations because of the sheer numbers, he said. WebThis was followed by two schemes in Australia, which in 2022 were merged to form the Pacific Australia Labour Mobility (palm ) scheme. Please try again. The stock of working holidaymakers in Australia increased from 40,912 at end June 2022 to 136,621 at end March 2023. This economic definition is related to the individual behavior definition, but may take longer to reach because those secondary effects, including supply chain imbalances, labor market disruptions, and global asymmetries affecting travel and trade, may linger. 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. A joke bounced around the country last week. Immunity each day is considered with respect to the dominant variant in circulation in the population in each country. doses for 80 percent of the global population, An optimistic scenario for the US response to COVID-19. As populations get closer to this state, it may be helpful to introduce some nuance to what we mean by the term. Exhibit 2 shows potential outcomes if more stringent public-health measures were to be employed in the United States; this could lead to a disease burden that is similar to or only moderately worse than seen in the past six months, depending on the characteristics of the virus. But for now, the pandemic phase looks to be ending. Once the threshold is reached, the whole population is protected. In its final study, Pfizer reported that PAXLOVID reduced risk of hospitalization or death by about 89 percent for high-risk patients and about 70 percent for standard-risk patients.66Pfizer announces additional Phase 2/3 study results confirming robust efficacy of novel COVID-19 oral antiviral treatment candidate in reducing risk of hospitalization or death, December 14, 2021. COVID raised the bar! While vaccinations have been reducing the risk of severe illness, research is still unfolding into long COVID. Higher scores mean that more people have immunity and that the community has greater protection against symptomatic disease. There have been no Omicron-related deaths reported thus far.62Epidemiological update: Omicron variant of concern (VOC) data as of 12 December 2021 (12.00), ECDC, December 12, 2021. NSW Health Minister Brad Hazzard suggested on December 15 just 18 days ago, when the state recorded 1,360 cases a day that NSW should brace for 25,000 cases a day by the end of January. In addition, not all regions are adhering closely to manufacturer dosing protocolsfor example, delaying second doses or giving a first dose from one manufacturer followed by a second from anotherand the impact of that is unclear. Covid pandemic: Biden eyes 4 July as Independence Day from virus, BBC, March 12, 2021, bbc.com. But the fact of the matter is its still there. Get The New Daily free every morning and evening. WHO statement on AstraZeneca COVID-19 vaccine safety signals, WHO, March 17, 2021, who.int. Those results have generally been achieved through a combination of moderately effective interventions rather than a single big bang (Exhibit 3). Even when herd immunity is achieved, ongoing monitoring, potential revaccination, and treatment of isolated cases will still be needed to control the risk of COVID-19. The extraordinary progression weve already seenin just over two years four strains in succession have become globally dominantmakes it dangerous to plan on a no new variant scenario. Nicholas Casey and Norimitsu Onishi, Crack down hard, or wait and see? Here's how likely you are to get it more than once, Charting the COVID-19 spread: Australia passes 10,000 coronavirus deaths, Sudan humanitarian crisis turning into a 'full-blown catastrophe', UN says, 'Every second is critical': Major upgrade to national emergency messages to receive more than $10m, Flood-prone communities demand better planning to protect life and property, Russian freight train derails after being hit by explosive device, governor says, Major route into the Kokoda track appears to have been blockaded amid tour operator feud, Tony Abbott mounts attack on Voice after spat with parliamentary committee, Baby with bowel obstruction died after hospital's failures, coroner finds, Violence and chaos erupt at the May Day labour union march in Paris. is blind to contagious new virus variant, scientists warn,, Coronavirus: Israel leads vaccine race with 12% given jab,, Melissa Davey, WHO warns Covid-19 pandemic is not necessarily the big one,, Apoorva Mandavilli, The future of the coronavirus? Given the uncertainty, we have built a set of scenarios describing potential outcomes measured by hospitalization rate. Most of our analysis in this series has focused on the United Kingdom and the United States, which continue to move down a similar path. 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. Stephan Ehrmann et al., Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: A randomised, controlled, multinational, open-label meta-trial,. 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. Original reporting and incisive analysis, direct from the Guardian every morning, 2023 Guardian News & Media Limited or its affiliated companies. April 27, 2023 - 3:40PM. 8469, science.sciencemag.org. Ideally, we will tighten building codes in Queensland to prepare for a major monsoon event that will occur sooner or later (or so my sources in the BoM tell me), purchase better firefighting equipment (again, I am being told we need more firefighting airplanes), and put systems in place to provide quick financial support for the victims of extreme weather events. We will consider timelines for other countries in forthcoming updates; they will vary based on the timing of access and distribution of vaccines and other factors. the first and more important of the pandemics two endpoints. Were moving away from the emergency response phase in terms of responding to Covid-19 and were transitioning to the disease control phase, which involves implementing more sustainable measures to control transmission. More-infectious strains of SARS-CoV-2 therefore raise the bar on herd immunity. The highest proportion of adults with the coronavirus antibodies was in Queensland (26 per cent), followed by Victoria (23 per cent), New South Wales (21 per cent) and Western Australia (0.5 per cent). On the other hand, ECDC also notes that it is too early to draw definitive conclusions on disease severity. The worst-case scenarios were avoided. While we dont yet know the full extent of waning immunity for Omicron, new evidence indicates that those who have received three doses of vaccine may benefit from medium-term protection.32Frauke 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. 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. 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,. Dr Lydeamore also said while next year would likely be an easier pandemic year for Australia, some of its neighbours in the Asia-Pacific region could be facing a year similar to Australia's 2022: marked by enormous strain on their health systems. Sarun Charumilind and Jessica Lamb are both partners in McKinseys Philadelphia office, Matt Craven is a partner in the Silicon Valley office, Adam Sabow is a senior partner in the Chicago office, and Matt Wilson is a senior partner in the New York office. On another front, there is hope that wider use of the oral therapeutics paxlovid and molnupiravir will further decrease the number of severe cases,36Pfizer Shares In Vitro Efficacy of Novel COVID-19 Oral Treatment Against Omicron Variant, Pfizer, January 18, 2022, Pfizer.com.37Merck expects COVID-19 pill molnupiravir to be effective against Omicron, Reuters, January 11, 2022, reuters.com. Countries with high rates of current immunity and widespread booster uptake will be better protected. Early 2022 will see the return of migration, albeit not yet at pre-pandemic levels. The most likely scenario we discussed in the December 2021 edition of this article has proved to be largely accurateOmicron is more infectious than any previous variant and evades the immunity provided by both prior infection and incomplete vaccination18Omicron Variant: What You Need to Know, Centers for Disease Control and Prevention, February 2, 2022, cdc.gov. Both the pace of case growth and the rapidly increasing share of Omicron among samples sequenced suggest that, through a combination of greater infectiousness and immune evasion, Omicron is spreading very quickly.60Sarah Zhang, Omicrons explosive growth is a warning sign, Atlantic, December 8, 2021.

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