The year is ending and the pandemic did not go away in 2022

The year 2022 marks two years since the World Health Organisation (WHO) declared a pandemic and despite the progress of anti-Covid vaccination globally, the health body is still reluctant to lift the health alert because transmission remains high.

At the time, Tedros Adhanom declared that the coronavirus is here to stay among humans and it is not known for how long, nor what more surprises it will give virologists due to its incessant capacity for mutation.

Precisely, the head of the WHO declared the pandemic on 11 March 2020, making it one of the most critical moments for the health of humanity. A new virus that science and the intelligence of human beings were confronted with in a surprising way.  

To date, according to the WHO, globally some 642,924,560 people have been infected and 6,625,029 people of all ages, social, economic and religious backgrounds have died.

Today, Europe is the epicentre of Covid-19 infection with some 266,466,566 cases, followed by the Americas with 182,707,356 cases and the Western Pacific with 100,439,654 cases.

By country, the United States has the largest number of people infected by coronavirus, with an estimated 98,072,469 people. It is followed by India, with 44,674,439 infected people, and France, with 37,252,086 people.

Paradoxically, China, considered ground zero for the coronavirus (something that Xi Jinping's government denies), claims that of its large population - more than 1.412 billion inhabitants - only 1.88 million people have been infected by the coronavirus so far and 5,235 have died from it.  

Of all the countries in the world, China remains closed to foreign tourism and it was only after several weeks of citizen protests against the strict Zero Covid policy that President Jinping ordered -a couple of weeks ago- a relaxation of controls allowing internal travel between provinces; eliminating the blocks of buildings designed to confine people by gender and age after thousands of complaints of human rights violations, creating a kind of ghettos for the sick; the elimination of tests every three days for workers; it will no longer be necessary to show the QR code to enter public spaces and the semi-confinement of several cities such as Beijing is lifted.

To date, virologists and public health experts have yet to find a concrete answer as to the origin of SARS-CoV-2, although most agree on the possibility that it is zoonotic.

The WHO warns that this new coronavirus has never before been detected or identified in humans. The first case appeared at the end of December 2019 in the Chinese province of Hubei, in its capital Wuhan.

Information on the virus warns that it is "highly transmissible" and coughing and sneezing are believed to be the most common routes of transmission, and it is also spread by droplets expelled into the air by infected people.

No vaccine has yet been found to stop an infected person from becoming contagious, hence the recommendation for quarantines, in people who test positive and in their contact groups.

According to Our World in Data, to date 12.9 billion full doses (two doses) of anti-Covid sera have been administered, and this year the WHO and PAHO have set a goal of immunising 70% of the world's population with one dose. This is a challenge that the Geneva-based agency has met. 

While the United States and Europe were the first to start vaccinating since last year, Latin America is the world region with the highest immunisation rate in the percentage of the population with at least one dose: Latin America (86%); Asia (78%); North America (76%); Europe as a whole (69%); Oceania (68%) and Africa (32%) is the furthest behind. 

In terms of available vaccines, twelve are manufactured by various laboratories: Cansino, Pfizer-Biontech, COVAX, Oxford AstraZeneca, Sputnik V, Sputnik Light, Sinovac, Sinopharm, Janssen by Johnson & Johnson, Moderna, Novavax and Abdala.

The European Medicines Agency has given its authorisation for four vaccines available to the EU population: Pfizer BioNTech, Moderna, AstraZeneca and Janssen. No Chinese, Russian or Cuban vaccines have been accepted.

In Mexico, those approved are: Pfizer-BioNTech, Cansino, COVAX, AstraZeneca, Sputnik V, Sinovac, Janssen and Moderna; in the United States, the FDA approved four laboratories such as: Pfizer-BioNTech; Moderna; Novavax and Janssen.  

Russia and China have their own sera. The former, with Sputink V, was the pioneering patented coronavirus vaccine developed with incredible speed (five months); the government of dictator Vladimir Putin presented it to the world on 11 August 2020, and a year later a Sputnik Light version emerged.

In China, it is inoculated with Sinovac, Sinopharm and CanSino. And since last October, the Chinese health authorities have given the green light to the world's first inhaled vaccine against Covid-19, an innovation of CanSino Biologics, the Chinese pharmaceutical company that has tested several samples of people in Mexico, Pakistan, Hungary, Argentina and Malaysia.

It is not the only laboratory that has explored the nasal route, and there are other pharmaceutical companies in various parts of the world experimenting with this option. What would be the second generation of coronavirus vaccines is intended to focus on cutting off transmission of the virus, from one person to another or others, by fully immunising the carrier. To date, vaccines only prevent a severe form of the disease in order to reduce mortality. 

An Ipsos Global Health Service Monitor study on the impact of the pandemic on the world's health care systems reveals the enormous fragility of primarily primary care and emergency rooms.

Globally, three out of five people consider their respective health systems to be overburdened, according to a sample of 23,500 adults in 34 countries.

In terms of satisfaction with the quality of health services, only two Arab countries scored highest: Saudi Arabia with 79 and the United Arab Emirates with 77%.

Among Westerners, Belgium and Switzerland both scored 69% and the United States 66 %, followed by China with 64 % & and India with 60 %.

The lowest rated, those where people see the lowest quality in their healthcare system, are: Italy with 34%; Mexico and Brazil both with 29 %; Peru and Romania with 21%; and both Hungary & Poland with 14 %.

Of all infections, according to Ipsos, the biggest health problem remains Covid-19, although fewer and fewer resources and staff are being allocated to care for those affected.

Operative delays are also evident in all countries with a long waiting list for all non-urgent surgeries interrupted throughout 2020 and 2021 as the massive outbreak of coronavirus infections overwhelmed primary care, emergency rooms and intensive care units.

The WHO director has been recommending for several months that countries' health services invest more in health spending, accelerate surgical interventions and resume severely depleted prophylactic mental health care services.  

"World leaders must act swiftly and decisively to invest more in life-saving mental health programmes, during the pandemic and beyond," said Adhanom.

Services for "mental, neurological and substance use conditions were the most disrupted of all essential health services" and this will have a social impact.

This sense of disruption is backed up by the Ipsos survey, with 36% of respondents ranking it as a top concern, up from 31% the previous year; and it means that mental health is ranked as a more important health problem than cancer (34%) for the first time in these annual Ipsos reports. 

In the United States, the Centers for Disease Control and Prevention (CDC) in its annual report stressed that there are diseases that cannot be neglected because the priority remains the focus of the pandemic and that prevention is being neglected.

The public health agency recalled that in the United States, Chagas disease affects more than 300,000 people annually and that this parasitic infection, if not treated in time, can cause heart failure, stroke and death. It can also be transmitted from mother to foetus.

There is also the case of Central America with acute febrile illness (AFI) caused by multiple pathogens and whose study requires prior analysis in laboratories.

In countries such as Pakistan, it has been necessary to strengthen vaccination campaigns against polio, measles and rubella; the polio virus, which seemed to have been eradicated worldwide, has returned with several outbreaks detected in several countries, precisely since the pandemic.

Experts from the Stop Transmission of Polio programme in the Philippines have boosted 7 million children against polio and more than 9 million children have been vaccinated against measles and rubella.

Much more widespread is the problem with diphtheria caused by the bacterium Corynebacterium diphtheriae detected in 154 countries this year. Mostly in European countries, with 232 cases, about 100 of them in Germany.

The European Centre for Disease Control and Prevention warns of resistance to oral and parental antibiotics in patients diagnosed with diphtheria, mainly children. This toxin causes severe respiratory disease and swollen glands and if not treated in time causes death-

Another outbreak that the WHO is monitoring is Streptococcus A, which has already claimed the lives of fifteen people in the UK, half of them children under the age of ten, and which has also been spreading to other countries.

This infection is caused by a group of Streptococcus bacteria and triggers skin infections, attacks the lungs, blood and muscles and causes high fevers and severe muscle pain.

In other countries, such as Spain, in addition to these outbreaks of diphtheria and streptococcus, a series of contagions are once again causing the health system to collapse due to the presence of patients ill with coronavirus, influenza and bronchiolitis. Basically, it is being seen in two age groups: in children from zero to twelve years of age and in older adults from 60 years of age onwards.

More than a few virologists in Europe are advising a return to the use of face masks to stop the transmission of viruses and bacteria through droplets and nasal secretions as well as sneezing and breathing. Only in a few countries is it still compulsory to wear a mask on public transport, in a pharmacy, hospital or doctor's surgery. It is not compulsory anywhere else and would seem to be very necessary at a time when the festive season brings crowds of people to shopping centres, restaurants and public roads. The pandemic has not gone away yet....