“Beginning of the End” Means Something Different For Us
A microbiologist and theologian, OCTA Research Fellow Fr. Nicanor Austriaco Jr. said that omicron may become a “natural vaccine.” For him, omicron could be the variant to infect large populations, give them antibodies, and push the country to normalcy. He added that omicron signals the beginning of the end — a phrase I’ve encountered many times recently while researching about this particular variant.
These insights come from an idealistic standpoint. “It [omicron] is spreading so rapidly, what you will expect is it will run out the food sooner,” Austriaco said. “And when it runs out of food, it will begin to crash — which is why you see in South Africa, the numbers are crashing. In London, the numbers are beginning to fall only because, once it spreads like wildfire, and when all the trees are burned, there’s nowhere for it to go. So it begins to crash.”
What he’s saying is that Omicron could help in propagating population immunity through infections. This, in turn, could help “stabilize our societies and should allow us to reopen,” he added.
Comparing omicron to wildfire and people to trees is appropriate. Forest fires can be beneficial up to a certain extent — that is if the fire is controlled. Forest fires can clear the forest floor of debris, get rid of unwanted weeds, and open up the forest to more sunlight, which benefits the trees and all the lives dependent on it. But uncontrolled wildfires are a different scenario altogether, which can damage entire ecosystems and leave populations vulnerable. Which one is more applicable to the Philippines, if the metaphor is to be extended?
I submit that Austriaco is not entirely wrong though. As data from around the world show, the cases are spiking like never before. In the Philippines alone, 1 out of 2 tests recorded is coming out positive. And the projections are saying that a lot more people will get sick in the coming days. Most of these people will survive. If we also consider the scenarios in other countries, it also seems that not a lot of those infected will perish.
But his proposition is only partly correct for everything that wasn’t considered in the conversation. As cases rise, hospitalizations and deaths will also rise proportionally. Some of those hospitalized will survive unscathed, while some of them will develop Long Covid and other yet-to-be-understood illnesses that arise or linger post-infection. Moreover, more patients hospitalized mean a healthcare system swamped with COVID-19 cases, which could result to a healthcare system that will be forced to turn away patients (COVID-related or not), which leads people to lose access to care, which leads to illnesses getting worse, which leads to disablements and deaths. These are the learnings we had in past surges, and logic tells us to comprehend our current situation in the same way. Are we to forget these possibilities in exchange for optimism?
It’s also wishful thinking that the antibodies one develops from Omicron will afford perfect immunity against future variants. Getting infected may make us less “immunologically naïve,” but the protection from antibodies may be weak and brief. And this assumption is not farfetched considering how people who’ve both had the virus and vaccines can still get infected or re-infected. We don’t even know with utmost certainty if these antibodies work against existing variants like Delta (which still account for a percentage of current infections globally).
There’s also that possibility of new, more virulent mutations arising. And who can predict the nature of these mutations, when even researchers who follow the virus cannot predict how things will turn out? Will they be highly infectious but less severe like Omicron? Or will they be at least as deadly as Delta? Until mutations emerge and infect enough people, the data will not be enough. And we can only hope that the data will never be enough, as that would mean that the mutation has already wreaked havoc on enough people. It’s also worth noting that COVID-19, which is a derivative of SARS, is a novel virus, which means that although our knowledge has advanced significantly, we still do not have the level of mastery to be able to say that it is within our control.
We (somehow) got lucky with Omicron because it is less severe. But less severe does not mean the suffering is nonexistent or even negligible. Omicron is less severe as getting infected with Omicron instead of Delta is like getting shot in the leg instead of getting shot in the stomach — you will likely recover than die, but the bottom line is that you still got shot, have a bullet that’s seared into your flesh, and the possibility of disablement and death is not entirely out of the picture.
I agree, however, that Omicron is the beginning of the end, although not in the way Austriaco is proposing. Omicron is the beginning of the end because like John Hopkins’ Yascha Mounk wrote in the Atlantic, there is no longer an appetite for “large-scale social interventions” that characterized the COVID-19 pandemic as we knew it. The government’s response has also gone from trying/pretending to control the curve to simply coping with the pandemic as it unfolds. The bahala na mentality is so pronounced that until now there’s still denial on why mass testing, a basic tenet of pandemic response, should even be implemented amid a record-breaking number of cases. There are also not many conversations that we know of on the legislative or executive level about hard lockdowns, disallowing gatherings, or shuttering businesses. Restaurants, gyms, and malls remain open, public transportations are operational, and, unless you are unvaccinated, you are not exactly banned from going out. This could be the obvious effect of a pro-economy stance in place, but I have reason to believe that this is also because the collective demand for stronger interventions has gone down.
We have learned to co-exist with the virus, as sad as that may sound. It has become instinctive for us to raise or lower our guards depending on the number of cases and on the events within our vicinity. For example, when the cases went down last year, many of us also felt safer to go out and see other people — gather and socialize as humans do. But when we saw the steep increase in cases in the past two weeks, we instinctively responded on our own. We canceled flights, delayed trips to the mall for leisure, opted for eating at home than dining in, asked for work-from-home set-up, etcetera. We had the instinct to fortify our external defenses. We stocked up on supplies, bought masks, vitamins, and over-the-counter medicine in advance, stayed at home when we can, and checked up on loved ones. We have developed a sense of cooperation, whether as a form of altruism within communities or just because we know we’re mostly on our own. Either way, we did these things to avoid the worst outcomes of the virus and in hopes that the cases will go down and we can go out again.
You, as someone who has lived in this pandemic, likewise already know that every activity, from riding a jeepney to dining in a fast-food chain to going on a vacation, has its corresponding risks. What risks you are willing to accept largely depends on you and your level of risk-aversion. But if omicron upends society the way Delta did, I am also certain that we will respond accordingly. If omicron leads to a collapsing healthcare system, the demand for stricter interventions will also likely increase. That’s just the obvious reaction of a people sharing one reality.
This doesn’t mean, however, that the pandemic as a public health phenomenon is soon to be over. Scientists can decide on that. As Sigal Samuels of Vox and experts have pointed out, however, the end of the pandemic as a public health crisis is still not in sight largely because we are not vaccinating enough people around the world to reach global herd immunity that would block the virus from mutating. This brings another important counterargument to Omicron as a Natural Vaccine proposition: as long as there is no vaccine equity (and equity in healthcare in general), allowing populations, unvaccinated or otherwise, to simply be exposed to the virus could lead to catastrophic outcomes.
Endemicity, the state at which a disease becomes endemic, may be reached by this year, according to Dr. Fauci, the chief medical advisor on COVID-19 to the White House. But “endemic” can mean many different things. First is that a disease is endemic not because it is entirely gone but because we know we can control it, more or less. The virus is still circulating in parts of the global population, but deaths and hospitalizations have gone down, people are immunized, and we readily have installed barriers against virus-related catastrophic events.
The second one is that a disease is endemic because our social and moral meters already tell us that a certain level of suffering is within acceptable limits. Are 100 deaths due to COVID-19 per year okay? How about 1,000? 10,000? This is the difficult part, but nonetheless a reality we have to contend with.
Lastly, a disease is endemic because it is already contained in certain pockets of the globe, which also means that it is still causing suffering in some. Take tuberculosis for example. It is not a pandemic, but it infected 10 million and killed 1.5 million people worldwide in 2020. Two-thirds of these cases are concentrated in eight countries: India, China, Indonesia, Philippines, Nigeria, Bangladesh, and South Africa. Or malaria: 241 million cases and 627,000 deaths in 2020. 95% of cases and 96% of deaths occurred in Africa.
Even if the World Health Organization reclassifies COVID-19 as endemic, that doesn’t mean that the suffering brought about by the virus will completely dissipate. As we have seen in recent pandemics, public health crises do not affect regions, countries, and even communities evenly. Have we done enough as a country to tilt the scale a little bit more to our favor?
The better question then is not really if omicron is the beginning of the end — it certainly isn’t for the pandemic’s public health dimension. At this point, and considering our situation, what we should be asking first is what does the end looks like specifically for the Philippines. What are our own social and moral meters? How do we proof our infrastructures to deal with potential surges in the future as the one omicron brought? And the most inconvenient yet important question: how many illnesses, disabilities, and deaths per year from COVID-19 is comfortable for us? It’s agreed that the virus will not disappear entirely, at least not in the near future, so to be able to answer these questions is to pave the way for the end we are talking about.
We are in a better place now compared to 2020 and 2021. We are not entirely back to zero, although it certainly feels that way sometimes. We know the modes of transmission of the virus. We have vaccines and booster shots. We even have medication against COVID-19 now (who would have thought!). Thinking that this is the beginning of the end, however, is a little misguided for its idealism.
It may look like it’s ending for other countries (and socioeconomic classes), but the pandemic rages on for many of us. The threat of another mutation is still there. People are still being sent to hospitals and dying.
And even if Omicron is the last variant (it won’t be), will we be ready to declare the “end” of this pandemic in sync with others? As the world reopens, the best-case scenario is we’ll have the virus under control. The worst and more likely scenario, however, is that we will be left with the virus circulating within our territories — sending people to hospitals and graves — all because we’re not equipped with the right tools and we didn’t improve our infrastructures enough to address our own needs. If this happens, the next few years will feel less like the good ol’ pre-pandemic years and a lot more like that painful summer of 2021.
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Written by JP Campos
