The Covid Calamity, the Human Life, and the Surviving Hope

Introduction - Ongoing Covid-19 Calamity: As a disease, COVID-19 is still in the pandemic phase because infections continue to increasingly occur world-wide and various population groups are still susceptible. It is likely that the SARS-CoV-2 will not be eradicated but become endemic and continue to circulate and cause infections in pockets of the global populations for years to come. It may evolve into more transmissible and virulent forms with novel mutations and variants, and associated factors may worsen the overall scenario with involvement of newer population groups and world regions. Mutations, Variants and Immune Escape: The unabated prevalence increases risk of mutations, as the virus has more chances to mutate. Further, in areas where the incidence rates are high, selection pressures favour the emergence of variants that evade neutralising antibodies. Furthermore, as population groups receive vaccination, immune pressure is conjectured to facilitate and speed up the emergence of such variants by selecting for escape mutants. In due course, these selected variants would replace previous versions of the virus propelling the pandemic or the endemic disease later on. Associated Uncertainties with SARS-CoV-2: There are various associated uncertainties with the SARS-CoV-2 virus and the disease it causes. Due to evolving genomic changes, the virus elicits erratic and labile immune response. Simultaneously, the host factors are highly variable and largely uncontrollable. Further, the control measures and available vaccines for COVID-19 may not reduce the prevalence of infections drastically for multiple reasons. These epidemiological drivers would lead to persistence of the virus and endemicity of the disease interspersed by periodic outbreaks and re-emergence. The Human Life during Covid-19 Pandemic: With COVID-19 becoming an endemic disease, the SARS-CoV-2 virus would be first encountered during childhood, typically causing mild manifestations or none. The population groups will develop some immunity through natural infection or vaccination and may not suffer with severe illness, except in those with comorbid conditions or immune-compromised states, and the disease course would depend on evolving variants, efficacy of vaccines, and nature of immunity to the virus. The herd immunity against SARS-CoV-2 may remain a myth and with individual immunity being labile and waning after 6-8 months, booster doses of updated vaccine will be required at regular intervals. Future Scenario and Search for Solutions: To mitigate the spread of SARS-CoV-2 virus, various countries have implemented a wide range of control measures from time to time and likely to resort to, in future as well. There is need for genotyping and genomic sequencing capability for quick and effective utilization of epidemiological data. Simultaneously, the large deployment of COVID-19 vaccines under way needs a rapid and effective global effort. The next-generation vaccines may stimulate T cells effectively, apart from generating antibodies against the virus, and there is possibility of designing a universal coronavirus vaccine or pan-virus vaccine for immunisation against multiple variants and strains. On the therapeutic side, use of probiotics as adjuvant therapy may Improve the prognosis and clinical outcomes in COVID-19.