COVID in 2023: Why it is more difficult to predict virus trends after three years

So how will the pandemic feel in 2023? Given the many unknowns, this question is in some ways impossible to answer. In the early 2020s, the scientific community was focused on determining key parameters that can be used to estimate the severity and extent of the virus’ spread. Now, the complex interplay of Covid variants, vaccinations and natural immunity make that process far more difficult and less predictable.

But that doesn’t mean there is room for complacency. The proportion of people who become infected has changed over time, but the figure has not fallen below 1.25% (or one in 80 people) in England for the entirety of 2022. COVID is still with us, and people are getting infected again and again.

Meanwhile, the number of people self-reporting long-term COVID symptoms in the UK is around 3.4%, or one in 30 people. And the cumulative risk of getting COVID over a long period of time increases the more times people are reinfected with COVID.

The UK health system is under immense pressure, with pre-Covid waiting times rising enormously during the pandemic.

Why COVID Projections Have Been Hard

Simple models could be used to project the number of COVID cases and the potential impact on the population, including health care demands, during the early days of the pandemic.

Relatively few variables were needed to produce the first estimates. This was because there was one main variant of COVID, the original strain, to which everyone in the world was susceptible.

But now, those simple notions no longer hold. Most of the world’s population is estimated to have had COVID and there are significant differences between individual levels of protection in terms of which vaccines and how many doses people have received around the world. In total, 13 billion vaccine doses have been given – but not equally.

The modeling also works well when people act in predictable ways, be it normal, pre-pandemic behavior, or times of severe social restrictions. The modeling becomes more complex as people adapt to the virus and make their own assessments of the risks and benefits of behaviour.

Lack of monitoring also makes modeling more difficult. This was a priority during the peak of the emergency response to COVID, which included tracking people with the virus and monitoring variants. This allowed new forms such as Omicron to be quickly identified and responses formulated.

The UK in particular plans to produce two million COVID sequences by February 2022, accounting for one-quarter of the world’s genome sequencing output. But sequencing activity has subsequently decreased, which may increase the time it takes to identify new variants of concern.

the pandemic is not over

There are large differences across the world in pharmaceutical and non-pharmaceutical interventions, for example the use of masks, COVID testing and building ventilation. As governments loosen and periodically re-tighten their responses to respond to dynamic medical and societal pressures, there is a risk that variants may emerge that escape some of the defenses built in by the population .

The next phases of the pandemic will also be affected by the behavior of the people. For example, how much do we work from home and whether we reduce our social interactions when we are contagious.

There is no certainty that new versions of the effect will emerge in the order of Delta or Omicron, but it is possible. If this happens, it is important that plans are in place to respond in the context of declining interest in COVID and resurgent misinformation and misinformation.

After 2023 – The Next Pandemic

It is fair to ask how much has been learned during the COVID pandemic to improve the response to the next pandemic.

During this pandemic, we have often seen short-term national interests take precedence, with vaccine equity focusing on national responses while the long-term global availability of vaccines is discounted. While laudable initiatives like Covax were established, which was envisioned to provide equitable access to COVID vaccines and treatments, the challenge is to create incentives for nations to cooperate to reduce long-term global risks.

As with any political response, the priorities of the emergency phase can easily be forgotten, such as the ability of governments to manufacture vaccines. The sale of the Vaccine Manufacturing and Innovation Center by the UK government is an example. The ability to quickly develop and produce vaccines will position us well for the next pandemic, but these priorities now have to compete against others that are more immediate or politically expedient.

The UK’s Covid inquiry is set to be presented with thousands of pages of evidence, with many submissions giving clear, self-contained accounts of “lessons learnt”. Putting those lessons into practice is another matter entirely. (conversation)