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Covid three years on…

Three years ago, on 11th March 2020, I had only just come back from India. There had been a lot of talk about the new disease; people on the flight were wearing masks, and I remember washing my hands more than usual.

It was a strange week; I tried to stay home for most of it. I attended a Plant Health Centre conference on Friday, 12th March 2020, where we talked about the year 2020 being named a Plant Health Year. It was the last in-person conference until another one in November 2021.

Although by 12th March the extent of the Covid pandemic was already clear, I did not expect that three years later it would still be one of the top mortality factors. Four days later, on the 16th, our University closed down. On the 23rd, the first lockdown started.

On 12th March 2020, I wrote my first Covid-related post on this blog. Three years on, this is how it aged:

What is this COVID-2019? I correctly described the virus and flagged up its ability to mutate. But, I did not envisage how important variants would be. Omicron, in particular, I consider a game changer.

How can I get it? I correctly identified person-to-person spread by coughing, although I also put a lot of emphasis on the transmission via touch and surface. It was not clear then that Covid is largely airborne and how important air quality is.

If it gets into my body, what is it going to happen to me? This was a relatively easy part, with SARS-CoV-2 similar to other viruses causing respiratory diseases.

But, I misjudged the level of impact of the virus on the organism, including pulmonary and cardiological complications. All these factors became only known months after March 2020.

Will I recover? I clearly identified age as one of the risk factors, but the %s were perhaps a bit off. What I completely missed was long-Covid – the long-term impact of infection on some organisms. Of course, I was not the only one to miss this part.

What is all the fuss, it is like the usual flu, isn’s it? A comparison to the flu has been a returning feature during the pandemic. Surprisingly (or perhaps not so surprisingly), the comparison is still being made. I flagged up three areas of difference:

  1. Higher reproductive rate, R. It has always been clear that – barring any measures to arrest its spread – SARS-CoV-2 is spreading faster than flu. Some people have claimed that Covid spreads as fast as flu, but they ignored all the effort going into slowing it down – lockdowns, self-isolation, masks. Thus, knowing how large R is for a “wild” virus is very difficult, if at all possible.
  2. Asymptomatic spread. It has been a big issue with Covid and the main reason why there was a need to test and to self-isolate. And, it remains a problem even now.
  3. Complication and death rate. Before the vaccination, Covid caused significantly more deaths per case than flu for all age classes (perhaps except the youngest); I have written about it in this blog. Vaccination has changed the picture and now the CFR/IFR for Covid is possibly similar to that of flu. But, with Covid we have every month a similar number of cases as flu in the worst month of the worst year.

Am I safe from COVID? I very clearly identified age and comorbidities as risk factors. I also predicted that most of us will catch it. In fact, it is estimated that on average every person in the UK had it at least twice; I am in that category.

That’s all panic and hoax; be honest, you have no idea this will happen. My main point was that we should play it safe, accepting that worst-case scenario might happen. There is now a lot of model-bashing in the news or in social media. I do not think this is right.

Yes, the models missed a lot of factors (like voluntary changes in behaviour) and, yes, the worst-case scenario was certainly “too worst-case”, but…

So it is dangerous after all, isn’t it? … I still stand by what I said then about the governments being in a panic mode and the need to respond, even by doing foolish things and exaggerating the risk.

What can I do protect myself and others? I argued for “simple” things, like avoiding crowds and strengthening the immune system (eat well, drink a lot of fluid). I overemphasised hand-washing and underemphasised air quality, but this reflected the WHO recommendations at a time.

What about face masks? I was quite sceptical about masks, changing the advice later. How efficient masks are as the population-wide method of control, is, I think, not clear, but they could work well for an individual.

Although I now rarely wear a mask, I completely respect those who do.

Is my government doing enough/too much? This is again another big topic these days, as WhatsApp messages of those in the government are being made available – in the UK, Italy, and other countries.

I fully expected “the governments to swing between different options as they face the biggest crisis since 2008″ and this is exactly what happened.

But, I think we need to be very cautious with applying hindsight to our judgement of the government decisions. Faced with an unprecedented threat about which we knew very little, the governments simply did not want to have a health system collapse on their watch.

Three years on, there are nearly 800 million confirmed cases, nearly 7 million confirmed deaths, and between 16 and 27 million estimated excess deaths. SARS-CoV-2 is now endemic in many countries, so it is not going away quickly.

Looking back is an important element of learning how to deal with it over the next years.