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Covid-19 is now something we live with. It is also something people die of, although not in the numbers they would have if most New Zealanders had not taken all the necessary precautions from the start, from masking and social distancing to vaccinations and boosters.
In those circles where mortality and disease rankings are obsessed and argued over, the debate over whether it is “no worse than the flu” or a nefarious hoax dreamed up by unseen forces wanting to control your brain will doubtless go on for some time.
While this is happening, so too is research into the condition, and we continue to learn a lot about it. Not all of it is good news.
Perhaps the best news following the advent of the pandemic was the small miracle of the Covid vaccine itself. When Covid was at its height internationally, experts almost unanimously agreed there was absolutely no chance of a vaccination in fewer than two years. But while the experts were agreeing with themselves about that, a few scientists were actually doing the job and a safe, effective vaccine was on the market within 12 months.
That in itself was an historic achievement, showing a way ahead for how we might approach other serious medical conditions and proving that working together with a will – and enough money - can achieve extraordinary results.
The general public is now well aware that there are many types of Covid. At the start of the year the Ministry of Health reported that the XBB.1.5 variant of Covid-19, also known as “Kraken”, had been detected in New Zealand and that “the list of new sub-variants appearing within New Zealand is lengthy and growing”.
Two new variants have appeared recently: BA.2.86 (Pirola) and EG.5 (Eris). Experts are more concerned about the former given its high number of mutations.
Eris is here, but no cases of Pirola have been found in New Zealand so far, although experience and the recent lifting of our last pandemic restrictions make it likely it will turn up.
According to Yale Medicine, Pirola “has more than 30 mutations to its spike protein compared to XBB.1.5, a variant of Omicron that had been the dominant strain in the United States before being surpassed recently by EG.5.”
Medical experts are concerned that it could potentially evade immune defences both from natural infection and prior vaccination, infectious diseases specialist Dr Scott Roberts told Yale Medicine.
“When we went from [Omicron variant] XBB.1.5 to [Eris] EG.5, that was maybe one or two mutations,” he said. “But these massive shifts, which we also saw from Delta to Omicron, are worrisome.”
Roberts said the big question is whether Pirola will have the same exponential growth that Omicron did in terms of cases, but added that thanks to herd immunity and people getting their Covid vaccine boosters, the world is not as vulnerable to severe illness to Covid-19 as it was in 2020.
The World Health Organisation has confirmed that “the public health risk posed by EG.5 is evaluated as low at the global level,” but has also classified it was a “variant of interest”, due to its genetic changes giving it an advantage and its prevalence is growing.
Meanwhile, we have discovered, and some people are learning to live with, the grim reality of long Covid, in which the effects linger indefinitely in up to 10% of patients – which could mean around 40 million people worldwide.
Long Covid is not to be taken lightly. According to research published in Nature Review Immunology: “The disease burden spans from mild symptoms to profound disability, the scale making this a huge, new health-care challenge… evolving symptom list is extensive, multi-organ, multisystem and relapsing–remitting, including fatigue, breathlessness, neurocognitive effects and dysautonomia [problems with functions we don’t perform consciously, like breathing]. A range of radiological abnormalities in the olfactory bulb, brain, heart, lung and other sites have been observed in individuals with long Covid.”
University of Auckland researchers have “found the SARS-CoV-2 virus could activate both scientifically known health conditions such as cardiovascular disease and previously unknown health conditions, including Parkinson’s”.
Long Covid also presents some sufferers with cognitive issues or “brain fog”, affecting memory and concentration. “Blood clots triggered during the acute stages of viral infection could lead to lingering symptoms,” reported Science. Somewhat disingenuously, the report went on to say that the “study’s focus on unvaccinated people who had severe Covid-19 may limit relevance for the wider population”.
The last Covid-related restrictions here were lifted in mid-August. According to the government’s official Covid website, this was justified because “overall Covid-19 case rates, wastewater levels and hospitalisations [had] been trending downwards since the beginning of June and over the past month reported Covid-19 cases … hit their lowest since February 2022″.
Nevertheless, this has alarmed some – notably people with long Covid or compromised immunity, some of whom feel they are being hung out to dry so that the rest of the population – and the tourism industry – can “get on with our lives”.
These are the most obviously at-risk individuals, but no one ever got hurt by being cautious or wearing a mask. Everyone can still take responsibility for their own health by getting vaccinated, keeping up to date with boosters, wearing masks and avoiding crowds.
