Experts: autumn wave likely next year, letting go of all measures is no longer possible
Have enough people been vaccinated in the Netherlands, so that we can manage without corona measures? That was the question at the end of the summer. We now know the answer: even with a vaccination coverage of 86 percent, with vaccines that provide excellent protection against hospital admissions, an autumn wave turned out to be unavoidable.
But what does that mean for next year? Can we still do without measures in the winter? The NOS asked nine epidemiologists and immunologists to look ahead.
Professor of epidemiology Mirjam Kretzschmar was curious this summer what would happen if the measures were released. The result was disappointing. "I expected that we would have another wave, but not that it would rise so quickly." As a result, she has become more gloomy about next year.
Epidemiologist Luc Coffeng shares this feeling. When he got on the train in the morning this week, he thought: those mouth caps could become the norm in the Netherlands. "The virus just keeps circulating. I count on the virus to teach us that we have to adjust our behavior or take measures."
Both now assume that we will have to deal with a corona wave again next autumn. Most other experts agree with them. "I wouldn't know why not," said epidemiologist Alma Tostmann. "And such a wave always eventually leads to a wave of hospitalizations."
But will a higher vaccination rate and natural immunity be enough to let everything go next fall? No, most experts think. "We have few examples of successfully eradicating a respiratory infection," said Coffeng. Infectious disease modeler Marino van Zelst is even more pessimistic: "I am not yet convinced that the virus will only flare up in the autumn. That could also happen in the summer."
The only person who really thinks otherwise is epidemiologist Frits Rosendaal. "With the Spanish flu, it was also largely over after three waves. It came back every year, but without disrupting society. If enough people have been infected or vaccinated, the reservoir is a lot emptier. The virus will then only progress slowly. around because it can find few people to infect." With the current high number of infections, he believes that balance could already be achieved after this wave.
Van Zelst thinks this is an illusion, because people probably will not remain immune for a long time. "My housemate has been infected, vaccinated twice and now infected again," he explains by way of illustration.
No one is talking about achieving herd immunity anymore, because it has now become clear that this has become unfeasible. "The delta variant is too contagious. And the vaccine protects too little against infections," concludes Tostmann. "If everyone is now vaccinated, we will have an immunity level of 50 percent, while with the delta variant we need a much higher percentage," she calculates.
Even if everyone is vaccinated, the virus will still circulate. Although that will make a huge difference in the number of hospital admissions.
Everyone a booster shot
Professor of immunology Marjolein van Egmond is slightly more optimistic than most of her colleagues. She is still taking into account a favorable scenario, in which everyone can receive a booster shot next summer. As a result, people make new antibodies, so that a new wave of infections can be prevented.
But she's not sure if that's realistic. "How long do those antibodies remain? Eventually it goes down again." Moreover, she believes that poor countries should first be given the opportunity to vaccinate, before rich countries give everyone a booster.
For epidemiologist Quirine ten Bosch, the booster shot is the only thing she can think of that could theoretically make a difference in the coming year. But then a booster shot should boost the immunity very well.
"Ultimately, the virus will probably become endemic. It will remain in society, with a very small revival in the winter and then it will be gone again in the summer." She does not dare to predict whether that balance will be found in the coming year.
And so certain basic guidelines also seem necessary next autumn. According to Van Els, it makes a lot of difference how we behave in the cold months. "We still shouldn't shake hands. Don't go to work if you have complaints. Keep your distance where possible. And working from home must be institutionalized in a thoughtful way," she sums up.
Field epidemiologist Amrish Baidjoe: "We have to learn to live with the virus. That does not mean that we should just let go of the virus. But we have to normalize certain things. In countries where there are more frequent virus outbreaks, it is much more common to stay at home if you have a cold or a cold. wearing a mouth-nose mask. That requires a culture change."
These measures can ensure that the R-number remains below 1 and that the virus does not flare up again in the autumn. But that is complicated, thinks Tostmann, because you ask people to follow guidelines in a disciplined way, without the virus spreading. "It takes quite a bit to get everyone on board to do something against something you don't see."
According to Baidjoe, that is the big challenge at the moment. "We have to start thinking about this so that we don't yo-yo from wave to wave. That breaks up society, because you don't give people perspective. They then become resistant to the measures. They become recalcitrant. That's when things really go wrong."
Mutations
And then there's the 'elephant in the room', the subject that nobody prefers to think about but that always plays a role in the background: the possibility of a mutation of the virus that is more contagious than the current delta variant.
"If we are lucky, it will stay here, because the virus cannot mutate further. If we are unlucky, there will be a variant that our vaccines do not work against," says Van Egmond. That is why, according to her, it is crucial what to do about infections in poor countries. "We really need to invest there. Ultimately, that's in our own interest, so that some mutation doesn't come our way."
Because all experts agree on one thing: if that more aggressive mutation happens, all models and predictions can go in the trash.
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