It Ain’t Over ‘Til It’s Over

By Lance Chilton

In a November 11 article in the New England Journal of Medicine, University of Michigan epidemiologist Arnold Montos argues that we must accept the likelihood that we’ll be dealing with the coronavirus (SARS-CoV-2) that causes COVID for a very long time, very much as we deal with influenza every year. “Flu” didn’t go away after the 1918-1920 pandemic, and COVID is unlikely, he believes, to disappear either. “Disappear” is exactly what the closely related SARS-CoV-1 virus (SARS stands for Severe Acute Respiratory Syndrome, CoV for Coronavirus) appears to have done, but it never reached anywhere near the death and destruction of its newer relative.

I guess the good news is that SARS-Cov-2 has caused far less disease and death than the last major pandemic–that of the so-called Spanish flu in 1918-1920. That pandemic, which appears to have begun in a military encampment in Kansas and then spread around the world, is estimated to have caused more than 50,000,000 deaths worldwide. The very-much-still-alive COVID pandemic has caused just over 5 million deaths around the world, to the extent we can trust countries’ ability and willingness to report. In the U.S., the 1918-1920 epidemic was estimated to have caused 675,000 deaths. That number was surpassed in September by the COVID scourge; U.S. COVID deaths now stand at more than 762,816 since 2020, with 5,169 in New Mexico as of November 13.

There was no influenza vaccine in 1918–it would not be available for another 20 years. People were encouraged or required to wear masks, which were shown to reduce influenza mortality by 50%; despite this, San Francisco’s Anti-Mask League pushed for repeal of a city ordinance requiring mask use. The Anti-Mask League denounced the mayor for the masking ordinance, just as modern-day “patriots” slander our governor for her well-considered public health proclamations.

Each year we get a flu shot because immunity to flu virus wanes over time and because the virus itself changes in ways that make previous vaccines ineffective. Montos suggests that a similar scenario is very likely with SARS-CoV-2. He cites recent evidence from the U.S., Canada, and the United Kingdom indicating a drop in protection over 6 months following vaccination. He speculates that the virus will continue to mutate, perhaps making a new variant more contagious and/or more deadly than Delta and less likely to be protected against by current vaccines.