On the way to the eighth wave, when can we consider the pandemic over?

• Viral calendar The respiratory syncytial virus and influenza A are brought forward in a winter that will have more "respiratory processes"

• Spikes Omicron variants BQ.1 and B.Q1.1 will increase Covid cases this fall

• New wave of Covid in Europe Germany asks for the return of the mask and France resumes the flu vaccine

• Covid zero in China The extreme never-ending story in the only country follows the indications of the WHO in the exhaustive surveillance of the virus

When will the pandemic end?

According to Biden, he already did it a few weeks ago, but the World Health Organization (WHO) has only dared to anticipate that the end "is in sight."

It is true that the current situation, with the cases on the rise (despite the fact that the majority escape from the records), does not invite the optimism that Biden and the WHO showed in mid-September, but in any case

.

Because that will never happen.

And it will not happen because, in reality, nobody declared its beginning either.

"There is no formal declaration of the start or end of the pandemic", explains Antoni Trilla, head of the Preventive Medicine and Epidemiology Service at the Hospital Clínic de Barcelona,

, it is what was done with covid, ebola and zika, but 'pandemic' is an epidemiological term that the WHO uses to describe it".

That declaration allows the WHO to put in place a series of coordination mechanisms and to mobilize funds to manage a situation that it considers a global health threat, but nothing more.

In other words, the most it can do, and it will do so in due course, is to withdraw that consideration of a public health emergency, but it does not seem likely that it will do so in the current situation.

Covid and new wave, one more virus in autumn and winter?

Formal statements aside, is there any specific criteria that allows us to determine where we are?

From the beginning we have followed the evolution of the pandemic through different statistical parameters such as the number of cases or deaths, but again

.

After all, the flu has been going on for a couple of years without giving much of a note and no one has dared to consider it gone.

And in both cases

, which is what finally causes the crisis.

In addition,

.

The main agencies that are responsible for collecting statistics feed on local data, and countries have long since modified the frequency and even the type of information they offer.

"Now that we don't isolate anyone, it doesn't make sense to test anymore," explains Salvador Peiró, an epidemiologist and researcher at Fisabio-Public Health, "sentinel systems have to do tests a bit randomly, monitor, to get an idea of ​​how things are going." ".

The current rebound is evident, but also logical after the return to classes and work, in combination with the drop in temperatures and the return to indoor spaces.

But even

(Spain, for example, only collects new cases of people over 60 years of age since the end of March)

it has simply been adjusted to a reality that fortunately is less worrying.

The greatest danger of this lack of protagonism is probably that without the focus, a good part of the funding is also withdrawn and therefore research is slowed down.

Although money also causes competition between research centers and that sometimes has somewhat crazy results.

"A thing appears that we jokingly call an 'epistemic leap'," explains Peiró, "which are research groups that are experts in something but not in covid, for example, and that go on to work on covid quite unsuccessfully. The amount of money lost in dumb research is sky high".

The epidemiologist exemplifies this problem with the open trials on hydroxychloroquine,

Risk of a variant that marks a new turning point

What dangers lie in wait for us regarding the virus?

What do we have to monitor through these increasingly selective statistics?

Experts insist that

and therefore we cannot lower our guard completely.

"Right now everything is BA.5, ómicron", explains Salvador Peiró, "in Spain, throughout Europe and practically throughout the world".

Variants continue to appear but in practice none have succeeded in displacing the BA.5, at least so far.

And that is good because many of those that have appeared later and without succeeding in imposing themselves had mutations that allowed them a better escape from vaccines.

What would happen if those dreaded new variants didn't emerge?

He peiró points to a

.

But in any case he pays attention to the point of view of the host, who thanks to vaccines is increasingly prepared to deal with the virus in (almost) all its forms.

Hence the importance of booster

, but not so much in the entire population, says the researcher, but

, the most vulnerable.

In them, the protection conferred by the vaccines lasts less time and, in addition, in many cases they have not been infected, so they do not have the immunity conferred by having passed the disease.

They have protected themselves and they have been protected more because they are at greater risk of suffering from the severe form of the disease, and this continues to be the case even with up-to-date vaccinations.

The other winter viruses, a rebound after two years without infections?

From then on, predictions for the short-term future must necessarily consider several scenarios, and in many of them

.

After two years absent, largely due to the measures used to protect us from Covid (masks, ventilation, travel reduction...) everything points to the fact that this year it could make its big comeback.

If when talking about covid we look at the

that we are raising against it,

.

On the one hand,

to the point that the younger age groups do not even remember in many cases.

On the other hand, the flu vaccine is much less effective than those developed against covid.

It is also based on the strains in circulation and after two years of low incidence, finding the correct ones is complicated.

For all these reasons ,

, those that protect us from all respiratory infections,

, and in this sense one of our pending subjects is the issue of air quality.

Peiró recalls that the 80% subsidy for changing the cooling towers was a fundamental thrust against legionella, and he believes that similar measures should also be invested in the face of the flu and covid.

Let's go back to the initial question, when can we then consider the pandemic over even if no one formally declares it?

Antoni Trilla

remembers what happened in the other great recent pandemic, the

there weren't so many dead) and people went back to their normal lives.

"The pandemic ends when people think it's over

," says the epidemiologist, although he adds that reality will probably accompany that statement with about six months of delay.

But we can no longer wait not only for a formal declaration, but also for the virus to be extinguished.

"The original influenza virus of 1918 and 1919 and its descendants have reached us up to now," says Trilla, "the virus has not disappeared, at least not completely, it continues to exist."

And with covid something similar will happen.

"This is not over," continues Trilla, "it probably won't end,

, but I sincerely believe that the alert or emergency situation is."

Although she clarifies that the same path can be back and forth.

In any case, there is consensus that we have already passed that critical phase, and even in full recovery, the general perception is that we have (more or less) returned to normal.

"When Biden says that the pandemic is over," Peiró points out, "I think he's right in the sense of the great pandemic, those waves, those mortalities... it's over. And

".

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