A nurse at a COVID hospital in Toretsk. Foto: Emil FIltenborg.

Everything looks good, but the pandemic is far from over – not in Ukraine, and not in the rest of the world.

It looks good. In the Northern Hemisphere, we have summer and sunshine. At least some of the time. Cultural life is starting to be a thing again, and in Kyiv people are sitting outside cafés, restaurants and bars socializing; enjoying life, drinks and food. Just like before.

But today, in Foreign Affairs, several influential epidemiologists are writing a rather depressing forecast. Their main message is, that the pandemic is far from over – the whole world is still under direct threat of COVID19. Possibly, the threat is even worse now than in the end of 2019, they argue.

“It is time to say it out loud: the virus behind the COVID-19 pandemic is not going away. SARS-CoV-2 cannot be eradicated, since it is already growing in more than a dozen different animal species. Among humans, global herd immunity, once promoted as a singular solution, is unreachable,” they write:

“As a result, the world will not reach the point where enough people are immune to stop the virus’s spread before the emergence of dangerous variants – ones that are more transmissible, vaccine resistant, and even able to evade current diagnostic tests. Such super variants could bring the world back to square one. It might be 2020 all over again.”

Why bother

But why bother? Well, the article points out three main reasons for the pandemic to be an almost permanent problem. Firstly, poorer countries with lacking access to vaccines will never have heard immunity. This problem is emphasized by countries, where people are reluctant or unwilling to let themselves be vaccinated.

Thirdly, one of the solutions to the problem – and a intrinsic problem when not employed – is a systematic, broad track and trace program, that catches outbreaks early on, warns people of recent contact with carriers of the disease and allows the authorities to react timely to upcoming challenges.

All of these three things are very real difficulties in Ukraine. Vaccinations are unpopular among the Ukrainians and has been so even before the pandemic. This has previously made Ukraine one of the hotspots for measles. Even today, procurement of vaccines is difficult for Ukraine because of the countries relatively low budget.

Secondly, the testing system in Ukraine is not connected with any publicly available tracing system. Also, the amount of testing is largely insufficient if the goal is to say anything reliable about where the disease is spreading and to what degree the virus is spreading in the country both regionally and nationally.

For instance, on Monday, 33,355 PCR tests were conducted in Ukraine. If they were evenly distributed among the 24 oblasts or regions of Ukraine, there would only be around 1400 tests for each region.

According to a research paper from the American College of Cardiology, the “the false-negative rate for SARS-CoV-2 RT-PCR testing is highly variable: highest within the first 5 days after exposure (up to 67%), and lowest on day 8 after exposure (21%).”

Meaning, that not all of these tests will show the right results, which in turn means that the number of tests need to be higher to counteract the false negatives.

Possible outcome

If you follow the argument of the article in Foreign Affairs, a country with Ukraine could be a threat to global health, but the country also risks being incapacitated by the pandemic for a long time. The recent strains of the coronavirus remains largely harmless compared to other similar viruses.

However, the authors argue, with half a million new daily cases worldwide and the literally billions of cells mutating, a new strain of the virus is bound to emerge. This might be a more severe, transmissible or vaccine resistant strain that might turn out to send us back to square one. As they write: “It might be 2020 all over again.”

“Each infected person harbours hundreds of billions of virus particles, all of which are constantly reproducing. Each round of replication of every viral particle yields an average of 30 mutations. The vast majority of mutations do not make the virus more transmissible or deadly. But with an astronomical number of mutations happening every day across the globe, there is an ever-growing risk that some of them will result in more dangerous viruses, becoming what epidemiologists call ‘variants of concern.'”

This outlook might be pessimistic, but it is a reasonable list of arguments to be considered for anyone who is about to make any future plans involving business, travel or other things that might be sensitive to a new round of the pandemic.