Is COVID-19 Over?

Recent Flu Outbreak Raises Concern

COVID-19 caused significant disruptions during its peak in 2020. The pandemic affected not only health concerns but also economies and social fabric. Although COVID-19 infections may not be the primary focus for many people now, recent flu outbreaks are a stark reminder that the battle against this deadly and ever-changing virus continues. EBR’s Dr Brook Genene examines Ethiopia’s new COVID-19 variants, highlighting the need for ongoing monitoring and vigilance.

Wendante Gebregziabher, a 34-year-old man in Addis Ababa, started noticing flu-like symptoms at the start of September. He experienced shortness of breath, a dry cough during nighttime, a severe headache, sore throat, ear pain and a runny nose. “I decided to see a Doctor because the illnesses worsened,” he told EBR. Wendante received Vitamin C, SNIP [Sniff Nasal Inspiratory Pressure], and cough syrup. “After that, I took a homemade remedy, which involves steaming with hot water, garlic & ginger”. Many in Ethiopia use This typical homemade remedy to treat flu and similar illnesses.

Wendante’s experience isn’t an isolated incident. Recently, many people have experienced flu-like symptoms in the capital. The infections, however, tend to last longer and are more severe than previous flu symptoms that occur seasonally.

These recent rises in infections have taken people back to the summer of 2020 when everyone was on high alert to protect themselves from COVID-19. Even though COVID-19 seems a relatively distant memory, these recent infections with flu-like symptoms have caused a shock wave of alarm in the health system. COVID-19 is no longer a pandemic that keeps people at home and isolated. But that doesn’t mean the pandemic has been entirely eradicated from the face of the earth.

According to World Health Organization (WHO) data, in the four weeks between July 22 and August 18, the number of positive COVID-19 cases in Africa increased from 2.1% to 3.2% across 19 countries. The WHO, a global health authority, plays a crucial role in monitoring and reporting such data, providing a comprehensive view of the pandemic’s status. In Ethiopia, there has been an increase in positive cases from 4.4% to 12.1%, making the country one of the two countries in the continent. Senegal, showing a rise of 2.5% in positive COVID cases, keeps the alarm ringing high.

Usually, when there are seasonal changes, respiratory sickness becomes common. One of the reasons for these changes can be attributed to the mutation of viruses, i.e., the changing of the structure of a gene, resulting in a variant form that may be transmitted to subsequent generations, caused by the alteration of single base units in DNA, or the deletion, insertion, or rearrangement of larger sections of genes or chromosomes. According to experts, it is the only way new variation enters the species, and change in social networks means the starting of schools and holiday celebrations.

During these seasons, epidemiologists pay close attention to “influenza-like illness” (ILI). Healthcare providers also record the number of patients who present to their office with ILI symptoms, which include fever, cough, and sore throat. This illness encompasses multiple viruses, one of which can be COVID-19.

“The recent prevalence of flu is very similar and a reminder of the COVID-19 pandemic,” states Dr. Samuel Girma, an internist at Lancet General Hospital in Addis Ababa. “Whenever there is a respiratory illness these days, we compare it to COVID-19”, he told EBR.

The global health community is grappling with a lingering question: Has the COVID-19 pandemic ended? While the initial surge of cases and overwhelming hospitalizations has subsided, the virus persists. Ongoing outbreaks, new variants, and the potential for future waves highlight the ongoing challenge of eradicating COVID-19. The pandemic’s lingering presence underscores the need for continued vigilance, scientific research, and global cooperation to mitigate its impact and safeguard public health. That’s why public health experts still insist on comprehensive and updated knowledge regarding various COVID-19 signs and symptoms, differential diagnosis, selection and administration of suitable pharmacotherapy regimens based on disease severity and stages. In addition, it is essential to detect and differentiate “long COVID”, a condition where COVID-19 symptoms persist for an extended period, and its related complications.

Although the recent surge in reported cases of COVID sends a wave of reminders about the need to be cautious, the overall trend of the pandemic shows a declining trend. The decline in reported cases is due to the massive vaccination programmes worldwide. However, due to the newly emerging SARS-CoV-2 variants around the world, especially the Omicron variant and its several lineages, the necessity of boosted immunity and administration of freshly developed bivalent or monovalent mRNA-based COVID-19 vaccines as booster shots should be highlighted to avoid further new COIVD-19 waves occurrence, according to Ghasemiyeh, P., Mohammadi-Samani, S, researchers who work at the Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences in Iran. The two researchers published research on lessons learned during the past four challenging years of the lethal pandemic, which caused millions of people to lose their lives around the world.

Four years of COVID-19 have shown that many respiratory illnesses can be controlled because of personal hygiene and sanitation changes. Dr Samuel recalls how, during the peak of the COVID pandemic, other respiratory diseases showed a decrease in prevalence. “This was a result of people taking extra care to protect themselves from infection,” he explains. This underscores the importance of personal hygiene and the role of vaccination in controlling the spread of respiratory illnesses.

Recent studies suggest that a loss of taste is a common symptom of COVID-19 infection. Individuals who already have chronic respiratory conditions, such as asthma or Chronic Obstructive Pulmonary Disease(COPD), a progressive lung condition that makes it difficult to breathe, may experience significantly worse symptoms if they contract COVID-19. This is due to the added strain on their respiratory system. COPD patients often have a persistent cough, shortness of breath, and wheezing.

“Usually viruses give way to superimposed bacterial infections, and patients tend to come later in their illness,” Dr Samuel says. He explains that findings of elevated White Blood Cells and other markers are increasingly common, while organ dysfunctions tend to be uncommon.

Since the similarities between COVID and Flu are striking, some physicians tend to manage the illness with antibiotics. However, antibiotics are ineffective against COVID-19. Unlike the flu, which can be caused by either a virus or bacteria, COVID-19 is caused by a virus. Antibiotics only target bacteria, making them useless in treating viral infections such as COVID-19.

That’s why Dr Samuel recommends conducting laboratory investigations.

Dr Micheal Daganchew, a Medical Doctor and Epidemiologist (MPH) who previously worked for the Carter Centre as Programme Coordinator, states that age groups and demographics at higher risk of different COVID-19 variants are the elderly, individuals who are immune-compromised, unvaccinated, with preexisting conditions or chronic illnesses, those with low socio-economic status and disadvantages and marginalized communities.

“Even though vaccines don’t guarantee complete immunity from COVID 19 and its many variants, they significantly impact disease progress and severity,” explains Dr Micheal.

He adds that vaccines allow the body to form antibodies and memory cells to fight future infections with ease, reducing the severity of the illness. Vaccines also lessen the severity and complications of the disease, although newer variants are known to evade antibodies. Booster doses are available to help cover the latest variants.

Vaccines provide lower infection risk, even with new highly transmissible variants. Long-term complications are less likely in vaccinated individuals. He adds that research for better vaccines is underway, leading to better efficacy and coverage of the new variants.

Wendante, who is feeling better, advises people to wear face masks in crowded places. He recalls the symptomatic period he went through as very challenging. He states that the flu felt different from the common cold he had endured before.

Although COVID is no longer a pandemic, healthcare professionals still recommend personal hygiene, such as frequent hand washing, wearing face masks, and avoiding large-scale events.

In the meantime, WHO has continued to monitor SARS-Cov-2 variants, the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), a strain of coronavirus that causes COVID-19, the respiratory illness responsible for the COVID-19 pandemic. It includes descendant lineages to track changes in prevalence and viral characteristics. Potential variants of concern, variants of interest, or variants under monitoring are regularly assessed based on the risk posed to global public health. EBR

13th Year • October 2024 • No. 134