Do we suffer from severe and moderate “coronavirus years”, just like the flu?
According to experts, SARS-CoV-2 will behave similarly to the influenza virus. But there are caveats. “Such a comparison is not wrong, but it is still premature. What it will mean for the burden of disease or interstitial cystitis, for example, can still be very substantial. You have to organize care accordingly,” says microbiologist Hayman Wertheim.
“Assuming the virus, like other coronaviruses, is seasonal, we get a wave every year, as is the case with influenza. In fact, this is called an epidemic, not endemic,” says epidemiologist Fritz Roosendaal. If SARS-CoV-2 doesn’t appear to be seasonal, it will continue to spread the whole time: endemic.
Virologist Bert Nisters says: “It can actually evolve similarly to influenza, but the question is whether this will happen every year with infection. Maybe at first, but we don’t see other corona viruses every year.” “Because of the increased immunity, we will suffer less from it each season,” says microbiologist Andreas Voss. “In bad years, the virus will peak, just as with the flu.”
As field epidemiologist Amrish Bidjo sees this possible. But it depends a lot on the level of circulation of the virus and the number of animal reservoirs. Pediatrician and epidemiologist Patricia Bruegging warns of a major genetic change. “This may be accompanied by a relatively more (serious) infection. It remains important to develop vaccines in order to always have an answer.”
Should we be vaccinated every year and should vaccines adapt to the new viral variants?
Virologist Mino de Jong believes it is best to vaccinate high-risk groups every year before “season”, just as it is with influenza. “Unless it is clear that the endemic circulation effect is not significantly different from other seasonal corona viruses, and vaccination may not be more cost-effective,” he added.
Much is unclear. Vaccines are so new that no one knows how long they protect against coronavirus. “We also don’t know how many neutralizing antibodies are needed for protection and what role other immune mechanisms – non-neutralizing antibodies and T cells – play -” says vaccinologist Anke Huckriede.
According to immunologist Dimitri Diavopoulos, “booster vaccines,” a type of booster, may be needed at the appropriate time, as is the case with other vaccines. “Honestly, it seems to me that this is unlikely to be necessary every year.”
Virologist Mariette Feltkamp considers annual revision of vaccines unnecessary. There are so many differences with the flu. “There are many strains of influenza virus in circulation that are naturally prone to mutating significantly. Vaccines are adjusted annually for this. Corona is now one of the strains with the necessary variants. Current corona vaccines and some custom modifications have strong origins. Against all the circulating SARS-CoV-2 variants. “.
Vaccinologist Cecil Van Els thinks differently: “It is already clear that adapting vaccines to new dominant viral variants will be necessary, and work is underway on this as well.”
If Corona virus remains, should vaccination include the national immunization program?
Yes, scholars say. At least: for certain groups.
Epidemiologist Fritz Roosendaal is considering a vaccination program like influenza for the future, due to the combination of herd immunity, vaccines and disease mitigation. “So: Now vaccinate everyone over the age of 18 or even younger, because the epidemic has to be transmitted. Later only vaccination for protection, so only the old and the vulnerable.”
Microbiologist Mark Ponten says vaccination against COVID-19 for the elderly should be part of the national vaccination program. Vaccine specialist Cecil van Els agrees: “In the Netherlands, the influenza vaccine and pneumococcal vaccine are already offered to vulnerable groups. Obviously, the corona injection is also included.”
Does SARS-CoV-2 also affect healthcare?
Opinions differ on this. “More intensive care and infectious disease beds are urgently needed, especially in all major Dutch hospitals,” says microbiologist Alex Friedrich. “In UMCs, about thirty (isolation) infectious disease departments are needed, for existing infectious diseases and covid-19. These hospitals will receive (suspected) covid-19 patients from all over the region. For larger peaks, structural agreements with neighboring countries are important. To treat patients there. “
“IC capacity will continue to be expanded, as will capabilities in regular nursing wards,” says microbiologist Paul Safflkole. “Unless variables emerge that do not protect vaccines against them, I expect that we will be able to respond appropriately and in a timely manner against endemic SARS-CoV-2 virus in the future and that we will not have to expand IC capacity,” says epidemiologist Quirin Ten Bosch.
But not all scholars agree. “If the burden of SARS-CoV-2 is reduced, then the endemic virus will not have direct consequences on the ability of interstitial cystitis,” says Ann Vossen. “However, it would be desirable to make preparations to be able to expand the IC capacity faster than now in an emergency,” says vaccination specialist Anke Huckriede.
Immunologist Dimitri Diavopoulos says, “Investing in a national knowledge center for immunization and in self-production capacity is a better alternative. In other words, a kind of delta that works for immunization.”
Microbiologist Andreas Voss wants to limit the number of patient contacts through more electronic care. It also advocates for flexible employee training, so that they can be deployed in different departments. “To better address the next pandemic, we need to increase the capacity of IC, but also improve infection prevention in home care and nursing and care homes,” says virologist Bert Nisters.