The COVID-19 pandemic marked a chilling, new chapter in American history, as its repercussions extended beyond public health and into the realms of politics and culture. In addition to the death toll (at the time of this writing, over 1 million in this country and nearly 6.7 million worldwide), the pandemic has created mass psychological trauma, fueled reactionary movements and even contributed to then-President Donald Trump's loss in the 2020 presidential election.
Now — more than two years after the pandemic reached America's shores, and almost three since COVID-19 was first discovered in China — the world is undoubtedly ready to move on. And 2022 was supposed to be the year that happened: three COVID vaccines were approved. Hundreds of millions were vaccinated. It seemed like herd immunity, high vaccination rates, and new bivalent vaccines might together be enough to stave off SARS-CoV-2.
But it wasn't. Indeed, as COVID-19 rates spike again this winter, 2022 will perhaps be remembered as the year that the public acted like the pandemic was over when it wasn't. President Joe Biden came down with COVID-19 in July, and suffered a "rebound" in August after the virus should have exited his system.
Public health experts agree that the world struggled to keep up with the virus, which has proven itself wily and adaptive to human efforts to stamp it out.
"Reliable data are always difficult to come by in low income countries, because they have few facilities in low income, especially rural areas; and reporting is spotty at best."
According to Dr. Georges Benjamin, the executive director of the American Public Health Association, one of the main COVID-19 developments from 2022 was that the SARS-CoV-2 virus kept mutating. There was a happy ending, though, as humanity's COVID-19 vaccines — despite being rendered somewhat less effective by subsequent mutations — were nevertheless durable enough to continue protecting people from severe illnesses.
"The virus has maintained its persistence in human populations. It continues to mutate in ways that maintain its infectivity just enough to maintain its viability," Georges wrote to Salon. Yet Georges attested to the vaccine's durability: "despite mutations, diagnostic tests and antivirals are still effective," he added.
Dr. Alfred Sommer, dean emeritus and professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, elaborated on the importance of the evolution of COVID-19 in 2022. Sommer homed in on one strain in particular — the BA.1 or Omicron strain.
"Probably the most important impact on [the COVID-19] disease was the evolution of the virus," Sommer wrote to Salon. "The present strains of Omicron are definitely more infectious than the earlier ones, but also less deadly. This is the natural history of most new viral outbreaks — assuming the initial strains don't wipe out the population (killing infected patients is not good for either the patient, or the virus, as it reduces its ability to spread)."
"We were not successful. COVID-19 has not been contained as I speak in early December 2022."
The good news is that it is easy to show that developed nations were able to keep omicron at bay. The bad news is that, when it comes to poorer countries, it is difficult for experts to really assess if things have gotten better in 2022.
"Reliable data are always difficult to come-by in low income countries, because they have few facilities in low income, especially rural areas; and reporting is spotty at best," Sommer told Salon. "But nearly everywhere, serious cases seem to be far fewer than during the early phase of the pandemic."
This is attributable to the vaccines — and their success was certainly not a given. Dr. Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California–San Francisco, wrote to Salon about how the vaccines managed to pull it off.
"The most important development was the creation and validation of multiple effective COVID-19 vaccines to fight the virus," Gandhi told Salon by email. "In fact, the prognosis for COVID-19 in 2022 is much improved as a result of immunity than in 2020 and 2021."
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For one thing, "vaccines outfitted with the 'wild-type' spike held their own against severe disease and hospitalization against the more immune evasiveness of Omicron and its subvariants." The spike protein refers to the little spikes that protrude from the exterior of the coronavirus in illustrations; these spikes are technically a type of protein that is crucial to the virus' ability to infect its host's cells.
Gandhi noted that "the protection from severe disease from prior infection or vaccination is a result of cellular immunity," or an immune response in which the immune system does not use antibodies. Because scientists expect neutralizing antibodies will become less effective in protecting people over time, even with updated vaccines, it is valuable to know that T-cells and other parts of the immune system can pick up the slack.
T-cells, as Gandhi explained, are a type of white blood cell that are generated in response to a pathogen — or, a harmless "fake" pathogen like a vaccine. A study published in Cell "showed that the Pfizer vaccine-induced T-cells respond to the omicron variant," Gandhi said; in other words, "the T-cells generated by the vaccine continue to bind and help kill the omicron variant, despite its heavily mutated spike protein."
One positive development in 2022 was that because of widespread vaccination and booster shots, deaths among the elderly and immunocompromised went down. "The high rates of boosting in South Korea among the country's elderly during the BA.1 [omicron] surge provided important protection against hospitalizations and deaths," Gandhi noted.
In an additional vindication for vaccines, research repeatedly found that people who had been vaccinated had stronger protection against COVID-19 than those who were not — and that people who had been both vaccinated and infected (including "breakthrough infections") had the strongest protection of all.
"In fact, the prognosis for COVID-19 in 2022 is much improved as a result of immunity than in 2020 and 2021."
If nothing else, the year 2022 demonstrated that vaccines and other science-based public health policies are successful at containing the pandemic even as the SARS-CoV-2 virus continues to mutate. Yet 2022 was also a reminder that the pandemic is still real, and it is a bad idea to assume that it is over.
Dr. William Haseltine, a pioneer in fighting HIV/AIDS and chair and president of the global health think tank Access Health International, pushed back on the idea that humanity's response to the virus had been "successful."
"We were not successful," Haseltine argued. "COVID-19 has not been contained as I speak in early December 2022. The pandemic is on the upswing around the world, most notably China, but also throughout Europe and United States and other countries."
He also pointed out that vaccinations, even when repeated frequently, "do a poor job at preventing infection, because of the fundamental nature of the virus and because of what we can at present do with our current technologies with vaccines;" although he noted that they "seem to protect, at least for some time, from serious disease and death."
"There is a remarkable reduction in serious disease and death in those who keep up to date, meaning every four to six months on their vaccines," Haseltine added. "The best vaccines for that are the mRNA vaccines, and I believe will be better vaccines coming along shortly."
Benjamin echoed Haseltine's words of warning.
"Excess deaths continues to grow globally overall," Benjamin wrote to Salon. "The lack of adequate vaccination worldwide is a continued problem."