All pandemics settle with less frequent oscillations: Dr Gagandeep Kang

For this wave, the descent has started and we hope that the tapering will be rapid. There is a lag of severe disease behind acute cases, but it is unlikely to be beyond the capacity of the health system.

Conclusively, we can say that prior exposure and vaccination helped in reducing severe disease. We have done better than many other countries with different age structures, infection histories and vaccination coverage. Is the omicron variant less severe than Delta? Based on the limited data on disease severity in unvaccinated, uninfected individuals, it appears a little less severe; but it is likely that the bulk of the reduction in severity is because of infection or vaccination.

Not really, we expected a situation more similar to South Africa than Europe or the US and it has played out that way, thankfully.

We know that it grew rapidly as a proportion of cases in Denmark, India and the UK, and is still growing. At the moment we do not have any evidence of either increased transmissibility or increased severity, but the question of whether it is increasing because of better immune escape needs to be investigated urgently.

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The consequences of a more rapid spread are that greater numbers of people will be infected or reinfected, which is always a concern for the clinically vulnerable. Also, we need to remember that a variant with increased immune escape could give rise to future, more concerning variants as well, so tracking is essential.

RNA viruses can mutate forever. We have the common cold coronavirus, which still mutates, but the question is how often will the mutations have clinical consequences? That is unpredictable.

There is still room for greater transmissibility and greater immune escape, and greater severity, but whether we will see a virus with all three attributes is unknown. All pandemics settle with less frequent oscillations. We are in the middle of a cholera pandemic — does the world know?

This needs a really long answer, but briefly, the vaccines we have now are great but are the first phase of vaccines. We need to either make new vaccines or have vaccination strategies that give more durable protection to the most vulnerable populations. I don't think we have reached the limit of the protection that vaccines can give us yet.