When (And How) Does COVID-19 End?

As the global vaccination campaign continues, we continue to have questions. Is it safe to mix and match different vaccines? When is the optimal time to get my second dose if I'm aiming to maximize the resulting immunity? And: Will COVID-19 ever end? Medcan's Medical Advisory Services team of expert physicians join host and CEO Shaun Francis to break down the latest information and provide need-to-know guidance. Featured in this episode is Medcan chief medical officer Dr. Peter Nord, clinical director of travel medicine Dr. Aisha Khatib and senior medical consultant Dr. Matthew Burnstein.   To enlist the services of Medcan's Medical Advisory Services, email [email protected].   https://www.eatmovethinkpodcast.com/podcast/ep-68-covid-conclusion   LINKS  Here are the preliminary results from the U.K. study on mixing and matching vaccines and the Spanish one, which both suggest combining doses may be safe.    Read the latest survey results from the International Air Transport Association that found 81 percent of people will feel confident about travelling again once they're fully vaccinated.    INSIGHTS  As noted by CEO Shaun Francis, World Health Organization guidance suggested that countries keep borders open, yet most countries are pursuing policies that are 180 degrees away from that. The MAS docs note that, while closing borders and limiting travel — like the bubble between the Atlantic provinces and in Australia — has been relatively effective in reducing the spread of COVID, it can only ever work as a temporary solution that buys time. "You can't keep the borders closed forever and just hope the virus goes away," says Dr. Nord. This is the time to boost vaccination rates and immunity, because, if not, infections will become widespread again as soon as the borders reopen. [Time code: 10:16] We're still not certain on the results of mixing and matching vaccines, but the early data look promising. A recent study from the U.K. analyzed what happens when AstraZeneca is first dose and Pfizer is the second. Preliminary results indicate that the vaccines remain effective, though there did seem to be an uptick of mild side effects, like fever and headaches, that last for a few days. A similar study conducted in Spain found a strong immunoglobulin response from mixing doses. "There's no reason to believe one can't safely combine vaccines," says Dr. Burnstein. "It's just that we don't have the real-world experience yet to prove it." [Time code: 12:49]   When will the world be ready to travel again? Potentially very soon, for people who have been fully vaccinated, at least. According to the International Airport Transport Association (IATA), most people feel safe about travelling after receiving both doses of the vaccine; more than 80 percent feel more confident about travelling with some kind of document that proves their vaccine status. Scottish travel agency Skyscanner has also found that people are more likely to travel to a country that also has a high vaccination rate. "People are looking for safety, and they're looking for that kind of immunity," says Dr. Khatib. "But we're just not quite there yet. I think it's going to take a little bit of time." [Time code: 16:02-20:16]   While vaccine-rich populations may be eager to travel soon, Dr. Khatib also reminds us that it will take much longer for the entire industry to bounce back. In fact, IATA estimates that travel rates won't fully return to pre-pandemic levels until 2023. This follows past travel trend lines during international crises: Global travel fell 30 percent during the SARS outbreak, then took about 11 months to recover; during the 2008 economic crash, travel dropped 50 percent and took 19 months to rebound. [Time code: 20:55] When's the best time to receive your second dose? Lots of discussion about that in Canada, where the wait has been extended from the manufacturers' initial guidelines. However, new trials with the AstraZeneca vaccine are indicating a stronger immune response if there's a slightly longer wait between doses, up to 16 weeks. "It's actually showing in the real world to be actually more protective, immune-wise," says Dr. Khatib. [Time code: 24:16]The good news is that all the COVID vaccines continue to be effective against new variants of concern, including the B.1.617, which originated in India. That said, it's estimated that just a single vaccine dose is only 33 percent effective against the B.1.617 variant, while there's about an 81% efficacy rate with both doses. "We're going to start to see a push to get those second doses out," to make sure we're better protected against emerging variants, explains Dr. Khatib. [Time code: 26:15]   So when does COVID end? "That begs the question of a fourth or fifth wave," says Dr. Nord. "Only when the globe literally has a 75 percent vaccination are we going to be able to see this thing die." Until then, there will likely continue to be flare ups, but at least we know we have health measures to address rising cases as vaccination efforts continue. "It will probably become like the cold or the flu," adds Dr. Khatib. "We just have to get it tamped by vaccination, but I don't think we can actually ever eradicate COVID-19 at this point." [Time code: 27:05]