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COVID-19 The end



Scientists: coronavirus will not go away anymore

Concerned scientists all say that the disease will not go away, or that the disease will become endemic. We have to learn to live with it, they say, as with other viruses. "Corona has to leave the country," said State Secretary Blokhuis of Health recently. Is that realistic?
No, say all the scientists surveyed. "This is not realistic, given the number of undetectable infections and because new introductions from surrounding countries continue to occur," says epidemiologist Quirine ten Bosch. "The virus will continue to circulate worldwide and therefore come back", says microbiologist Marc Bonten.
Virologist Ann Vossen states that it is highly unlikely that "sterile immunity" is formed: an immune response in such a way that a pathogen does not enter the body. "Not after an infection as well as after vaccination, so the virus will continue to circulate from person to person."
"According to epidemiologist Christian Hoebe, there are" new capillaries "ready every year: the 180,000 children born in the Netherlands every year.


If this virus becomes endemic, what will it look like?

This is a very likely scenario, according to all the scientists surveyed. "The fact that the virus becomes endemic also means that everyone will come into contact with it and will be able to build up partial defenses. As a result, the effects may diminish in severity and move towards a normal respiratory virus," says microbiologist Paul Savelkoul.
"The extent to which we suffer will be different if a large part of the population is immune," says epidemiologist Alma Tostmann. "Depending on how long the immunity lasts, we may flare up every year or every few years."
People will always get covid-19, microbiologist Alex Friedrich thinks. "Especially people with a reduced resistance, as a secondary disease. A cancer patient who also gets covid-19 or a heart attack due to Sars-CoV-2. And sometimes an outbreak, especially in institutions with groups of very susceptible people." Do we get severe and mild 'corona years', just like with the flu?
According to the experts, SARS-CoV-2 will be similar in behavior to the flu virus. But there are caveats. "Such a comparison is not wrong, but it is still premature. What it will mean for the burden of disease or the IC, for example, can still be quite substantial. And you have to organize the care accordingly," says microbiologist Heiman Wertheim.
"Assuming that the virus is seasonal like other coronaviruses, we get a wave every year, as with influenza. In fact, that's called epidemic, not endemic," says epidemiologist Frits Rosendaal. If SARS-CoV-2 turns out not to be seasonal, it will keep circulating all the time: endemic.
"It could indeed develop in a similar way to influenza, but the question is whether this will happen every year with infections. Maybe at first, but we don't see the other coronaviruses every year," says virologist Bert Niesters. "Because of the increasing immunity, we will suffer less from it every season. In bad years, the virus will lead to peaks, just like with flu," says microbiologist Andreas Voss.
Field epidemiologist Amrish Baidjoe also considers this possible. "But it depends a lot on the level of circulation of the virus and the number of animal reservoirs." Pediatrician and epidemiologist Patricia Bruijning warns of a major genetic change. "This could be accompanied by relatively more (serious) infections. It remains important to develop vaccines in order to always have an answer."


Do we have to be vaccinated every year and do the vaccines have to be adapted to new virus variants?

Virologist Menno de Jong thinks it is best to vaccinate the risk groups every year before the 'season', just as with the flu. "Unless it turns out that the impact of endemic circulation is not significantly different from the other seasonal coronaviruses, and vaccination may not be more cost-effective," he added.
Much is unclear. The vaccines are so new that no one knows how long they protect against covid-19. "Nor do we know how many neutralizing antibodies are needed for protection and what role other immune mechanisms - non-neutralizing antibodies and T cells - play," says vaccinologist Anke Huckriede.
According to immunologist Dimitri Diavatopoulos, 'booster vaccinations', a kind of booster shot, may be needed in due course, as with other vaccines. "To be honest, it seems unlikely to me that this is necessary every year."
Virologist Mariet Feltkamp considers annual adjustment of the vaccines unnecessary. There are too many differences with the flu for that. "There are several influenza virus strains in circulation that are naturally highly prone to mutate. The vaccines are adjusted annually to this. Corona is now one strain with the necessary variants. The current corona vaccines and some ad-hoc adjustments are a strong asset. against all circulating SARS-CoV-2 variants. "
Vaccinologist Cecile van Els thinks differently: "It is already clear that adaptation of vaccines to new dominant virus variants will be necessary, this is also being worked on."


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