The late and unlamented epidemic was an exercise in misapprehension. My subject is to explain its brief course as a preparative against the next respiratory virus that achieves epidemic proportions. COVID-19 lasted about three years, just as did the flu pandemic of a century earlier. However, it was far less lethal than its predecessor, killing mainly the infirm with serious pre-existing medical conditions. The older any cohort, the higher the incidence of co-existing morbidity. Hence, the highest mortality from COVID-19 in the elderly.
Covid moved to the background, not because of anything the medical profession did, rather it assumed the status of the annual flu infections because the strain of a respiratory virus that evolves after repeated passage from one person to another is less lethal and more contagious. Hence the relatively brief span during which the virus will kill a lot of those who contract it. Thus, the duration of an epidemic due to a respiratory virus will always be relatively brief depending on the rapidity of its transition from high lethality to low. Unfortunately, many people will die during this transition period.
The Covid epidemic ended not because of medical intervention, but because the virus changed. This is an important lesson on how to treat the next outbreak due to a respiratory virus.
Respiratory viruses are difficult to fight with vaccines as they mutate so rapidly that by the time a vaccine is developed and ready for dissemination the virus has changed such that the vaccine is likely to be weakly effective or ineffective. A better strategy would be to develop antiviral drugs that could treat people with a new form of viral pneumonia and not to focus on a vaccine that would likely not save the most vulnerable. The next pandemic may be caused by a virus that is not as selective as Covid. Young people died in the Flu Pandemic of 1918-1920.
Consider HIV infection. The virus was identified about 40 years ago. We still have no vaccine against it, but we do have effective antiviral treatments. Of course, this is not a respiratory virus, but it serves as a model for combating a new virus.
The medical leadership in charge of defeating Covid focused almost exclusively on getting an effective vaccine rather than developing new antivirals. This was a strategy certain to fail against a rapidly mutating virus. It’s also the reason the annual flu vaccine is weakly protective or sometimes ineffective. Data from the National Health Service in the UK show no reduction in hospitalizations or mortality from the flu vaccine.
Not only was the medical leadership in charge of devising the best approach to the pandemic on the wrong path they were hostile to those who advocated for the development of effective antivirals. In an ironic twist of fate, those whose views were stifled are soon to be in charge of the institutions that will compose the strategy for the next pandemic.
In summary, the Covid pandemic subsided not because of vaccines, but because it is the natural history of respiratory viruses fairly rapidly lose their lethality. The subtype of the H1N1 virus that caused the Flu Pandemic of 1918-1920 is innocuous today. The challenge of the next pandemic will be to treat afflicted patients with effective antiviral drugs as soon as the new pathogen is identified. Millions of patients died from Covid while our attention was aimed at a vaccine. By the time it was available, the plague was already subsiding. Shutting down society and all the other attendant foolishness that was implemented without evidence of effectiveness made the disease worse not better.
Following the science is still a good idea even if we didn’t do so the last time. Also, medical experts should restrict their advice to medicine. Interventions that go far beyond medicine should be left to those with better knowledge of their effects.
