කාට කියන්න ද?
මේ මෙවර නේචර්
සඟරාවේ සංස්කාරක සටහන හා 2021 වසරේ
එම සඟරාවේ පළ වූ ඒ සමග බැඳුණු ලිපි කිහිපයකුයි. නේචර් සඟරාව ලංකාවේත් විිද්‍යාඥයන් යැයි කියා
ගන්නන් අතර සම්භාව්‍ය විිද්‍යා සඟරා දෙකෙන් එකක් ලෙස සැලකෙනවා. අනෙක සයන්ස්.
මේ සටහනෙන්
කියැවෙන්නේ කොවිඩ් සමහ ජීවත් වීමට අප පුරුදුවිය යුතු බවයි. ලිපි අවසානයේ කියන්නේ
ආණ්ඩු විද්‍යාඥයන්ගේ මග පෙන්වීම් හා අවවාද අනුව කටයුතු කළ බවයි!
කාට කියන්න ද?
Nature
EDITORIAL
10 January 2022
COVID is here to stay: countries must
decide how to adapt
The Omicron variant has laid bare the need to live with a
disease that throws up an ever-changing set of challenges.
As we enter the third year of the pandemic, countries need to
find ways of living with SARS-CoV-2 while minimizing its harms. Credit: Rodrigo Paiva/Getty
From a pandemic perspective, 2022 seemed poised to begin with a
hefty dose of déjà vu, with COVID-19 cases on the rise in many countries in the
lead-up to the new year. Meanwhile, a new coronavirus variant seemed poised to
overwhelm health-care systems amid fears that vaccines — from first
inoculations to boosters, depending on the country — could not be rolled out
quickly enough to stem the impending tsunami of infections.
The welcome news that surges of the Omicron variant are
associated with less severe disease in adults than are preceding variants of
SARS-CoV-2 suggests that some of pandemic modellers’ worst-case scenarios will
not come to pass. But life has again been disrupted. Widespread absences due to
coronavirus infections have left hospitals in many countries understaffed,
forced schoolchildren to return to remote learning, and limited global
mobility. And even if a relatively small percentage of those infected require
hospitalization, sky-high infection rates across large populations mean that
many people will still face life-threatening disease and long-term disability.
This is particularly true for the unvaccinated — a group that includes a large
proportion of the world’s population, especially children.
For those who had hoped that 2021 would be the year that put the
pandemic in the past tense, it was a harsh reminder that it is still very much
present. Rather than laying plans to return to the ‘normal’ life we knew before
the pandemic, 2022 is the year the world must come to terms with the fact that
SARS-CoV-2 is here to stay.
The coronavirus is here to stay — here’s what that means
Countries must decide how they will live with COVID-19 — and
living with COVID-19 does not mean ignoring it. Each region must work out how
to balance the deaths, disability and disruption caused by the virus with the
financial and societal costs of measures used to try to control the virus, such
as mask mandates and business closures. This balance will vary from one place
to another, and with time, as more therapies and vaccines become available —
and as new variants emerge.
The emergence of the Omicron variant last November highlighted
the ongoing challenges of life with SARS-CoV-2. Some countries were already
facing surges in the highly transmissible Delta variant, but vaccines and prior
infection conferred relatively high levels of protection against Delta,
particularly against severe disease. Many researchers — and a fair few
politicians — hoped that future waves would be less disruptive, thanks to the
build-up of immunity in populations that would keep viral circulation in check
and protect most people from the severe manifestations of disease that drain
health-care resources.
It was expected that mutations in the viral genome would slowly
chip away at this immunity, particularly its ability to stop viral
transmission. But Omicron dealt a swifter and more serious blow to immunity
than predicted. It is now clear that SARS-CoV-2 reinfections are more common,
and that some of the most widely used COVID-19 vaccines have faltered in the
face of the variant. Existing vaccines, developed against an earlier variant,
now require a booster to provide substantial levels of protection against
infection.
How COVID vaccines shaped 2021 in eight powerful charts
But the news has not all been grim. Vaccines, particularly when
boosted, still seem to provide substantial protection against severe disease
and death. Early data from animal studies suggest that Omicron might generate a
different pathology compared with previous variants, causing greater infection
of the upper respiratory tract and less infection in the lungs. Data from several countries suggest that the
variant is associated with less severe disease, although whether this is due to
the variant itself or widespread pre-existing immunity requires further study.
Countries have charted a variety of courses through the latest
surge. Many with the resources have accelerated the distribution of vaccine
boosters, but many others do not have this luxury. Some countries have
reinstituted lockdowns, whereas others are holding back, waiting to see the
extent to which climbing infection rates affect hospitals.
With infection rates soaring around the globe and many countries
still unable to access adequate vaccine supplies, more SARS-CoV-2 variants of
concern will continue to emerge. And, as Omicron has illustrated, the ability
to predict what course those variants will take becomes more difficult as the
complexities of viral evolution and pre-existing immunity complicate the models
that have previously been used to anticipate the course of the pandemic. Now
modellers need to factor in the effects of vaccines, previous infections,
waning immunity over time, booster shots and viral variants — and, as the year
progresses, they will also have to consider the impact of emerging antiviral
treatments.
But what is clear is that the hope that vaccines and prior
infection could generate herd immunity to COVID-19 — an unlikely possibility
from the start — has all but disappeared. It is widely thought that SARS-CoV-2
will become endemic rather than extinct, with vaccines providing protection
from severe disease and death, but not eradicating the virus.
The fight to manufacture COVID vaccines in lower-income
countries
As Omicron and other variants have shown, this only adds to the
urgency with which vaccines must be distributed to countries that currently
lack supplies. Efforts are under way to bolster vaccine production in countries
such as South Africa, which have not historically been centres for vaccine
manufacturing. These and other efforts to boost global access to vaccines
remain in the best interests of all countries: devastating variants are
particularly likely to emerge and seed blazing outbreaks in regions with low
vaccination rates, and their spread will be further exacerbated where levels of
testing and genomic surveillance are also low.
Fortunately, 2022 is poised to add to our defences against the
pandemic. New vaccines — such as protein-based vaccines, which might cost less
and have less-stringent storage requirements than mRNA vaccines currently do —
will become more widely available. In December, the World Health Organization
approved the long-awaited protein vaccine made by Novavax in Gaithersburg,
Maryland, for emergency use. Ongoing clinical trials will establish whether
upcoming vaccine candidates that target specific coronavirus variants, or that
can be inhaled or taken orally rather than injected, will also be useful. Several
nasal candidates are in clinical testing, including one from CanSino in
Tianjin, China, and another developed by AstraZeneca in Cambridge, UK.
Meanwhile, new antiviral drugs, formulated in tablets that can
be easily administered early in the course of infection to reduce the chance of
serious disease and death, offer another approach against COVID-19. In the past
few months, some countries have authorized the use of two such drugs:
molnupiravir, made by Merck in Kenilworth, New Jersey, and Ridgeback Biotherapeutics
in Miami, Florida; and Paxlovid, made by Pfizer, based in New York. Data from
pivotal clinical trials of other candidates are expected in the coming year.
All of these will expand the world’s capacity to manage
SARS-CoV-2 outbreaks. They are cause for hope and optimism, but with a hefty
dose of realism: the virus will continue to circulate and change, and
governments must continue to rely on the guidance and advice of scientists. We
will not always be able to predict the virus’s path, and we must be ready to
adapt with it.
Nature 601, 165
(2022)
doi: https://doi.org/10.1038/d41586-022-00057-y
