In this last article of our three-part “SARS-CoV-2 Coexistence” series, we’ll try to explore a possible long-term scenario.

If in the first article we addressed the scenario for the short-term, in the second article we looked at what may well happen during the medium-term. In a few years, SARS-CoV-2 could join the ranks of OC43, 229E, NL63, and HKU1; the four endemic seasonal Coronaviruses that cause a good portion of our common colds each year.

Essentially, our immune system, tweaked by vaccines, booster shots, and previous encounters with the Coronavirus, will be ready to defeat SARS-CoV-2 and its variants when we encounter it again, potentially blocking an infection or reducing it to a situation that causes no symptoms at all or perhaps just a cold.

Influenza and COVID-19

Over the long run, influenza and COVID-19 will coexist, and it won’t be easy to tell them apart. But it will be necessary to do so, in order to maintain an acceptable degree of surveillance on the spread of variants, and for the production of effective vaccines against either infection.

We’re in fact talking about two completely different viruses; influenza is caused by viruses of the Orthomixoviridae family. There are 4 types, but the most common ones are types A and B, which are responsible for traditional flu symptoms.

COVID-19 is caused by SARS-CoV-2 that is a new Coronavirus. This new name distinguishes it from the Coronavirus (already known as SARS-CoV-1) that in 2002, spread throughout 33 countries in eight months and had a lethality of approximately 10%. The term SARS stands for Severe Acute Respiratory Syndrome, to both represent and summarize the effects of the virus.

Maintaining a high level of surveillance on the spread of the influenza virus and SARS-CoV-2 will be critical, in order to intercept any other viruses that might make the species leap (as happened to the new Coronavirus in 2019). In addition, we shouldn’t forget that influenza itself is already a dangerous infection that causes about 460 direct deaths per year in Italy and between 4,000 and 10,000 indirect deaths per year. Indirect deaths mean that the person dies from pulmonary or cardiovascular complications related to the flu.

However, many experts think that SARS-CoV-2 could evolve favorably (i.e. in a positive direction). That is, it’s possible that the Coronavirus may mutate in ways that favor its spread but not its dangerousness, so that it becomes a virus that causes colds for the vast majority of us.

What could be the collateral damage?

In the next three-to-five years, we’ll not only have to worry about how SARS-CoV-2 evolves, whether immunization will still be active, or whether other viral strains will appear. We’ll also have to deal with the economic situation, psychological distress, and the radical change in our lifestyles.

The economy is already suffering greatly today, with the forecast of total or (continued) widespread lockdowns that we’ll have for the next few months, the impact on the household economy will not be over during the short-term.

Psychological issues are already being experienced and are evident in our changing related behaviors. The most common feelings among these are those of insecurity, confusion, emotional isolation, fear of stigma between guilt for being the cause of contagion and being ostracized for fear of the “causer of the plague”.

The change to our lifestyles, especially the confinement in closed places, in addition to psychological discomfort is leading to a general decrease in physical activity and exposure to the sun, with damage that we’ll see in the coming years — with a corresponding increase in obesity and cardiovascular risk.

We can “influence” our future

In the end, our future depends very much on how we are living in the present, which should be lived in compliance with the rules that protect the community, but with eyes wide open about our well-being, that only we know (and have a duty to protect).

This post is also available in: Italiano


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