Those fears were borne out as Covid-19 soon led to a surge in infections and deaths around the world. Since then, COVID-19 has claimed an estimated 300,000 lives in the United States alone. The persistence of the post covid fog has rendered some once effective treatments useless. Many Americans have followed suit this year, going maskless and living closer to pre-pandemic normal.
But the coronavirus is still around, killing nearly 300 people a day and infecting tens of thousands in the U.S. alone. From variants, vaccines and treatments to covid fatigue in Washington and what the changes might mean as we approach the fourth year of the pandemic.
Before the omicron, the global evolution of coronaviruses was wild and unexpected. Looping through the Greek letters -- alpha, beta, epsilon, delta -- new variants appear in different parts of the tree. Each new major variant largely replaces the old as the virus finds new ways to infect people and evade defenses.
The evolution of the omicron itself is not dissimilar to the evolution of the delta from its emergence to the omicron, says Stephen Goldstein, a virologist at the University of Utah. No new, unexpected variant has emerged and replaced the omicron.
In the absence of new competition, the omicron's branches become a bunch of letters and numbers—BA.1, BA.2, BA.5, XE, XBB, BQ.1. So far, these sub-variants have not made the huge leap in transitivity that delta or the original omicron have. But they become better at circumventing existing immunity.
The immune environment is obviously very complex right now because we've had people who have been infected with different versions of the post covid fog and have been vaccinated different times, factors that could explain why we're seeing a soup of mutations rather than a single dominant mutation.
In the US, BQ.1 and BQ.1.1 are now the most common subvariants, with BA.5 in decline. According to lab studies, BQ1.1 is one of the most antibody-evasive variants to date, raising concerns that it could fuel a surge in infections and hospitalizations.
Scientists cannot say how long the tiny stages of SARS-CoV-2 evolution will last. "Right now, we're seeing more of a gradual evolutionary pattern, like we've seen with the flu," Goldstein said. "Whether this is going to be permanent, or are we going to have another burst of evolution, honestly, I don't know," he said. "I think it's possible we'll see another leap in the future, but maybe not every few months."
The effects of antiviral drugs remain as imperfect as ever. But antibody therapies, once highly effective at reducing the risk of hospitalization, are losing their luster as the coronavirus develops around them.
Paxlovid, molnupiravir, and remdesivir, target parts of the virus that change more slowly, so their effectiveness hasn't changed much. Molnupiravir remains largely a dud. Remdesivir is more helpful, but the hassle of giving it by infusion for several days blunts its real-world impact. Paxlovid is still a star, but even that has a mixed record.
If taken early, the drug protects those at highest risk of severe illness from the worst outcomes, reducing the risk of death in people 65 and older by nearly 80 percent. But Paxlovid can have annoying side effects, including a persistent metallic taste, and interacts with a long list of other commonly used drugs.
The effects of brain fog on patients are persistent. According to the How To Get Rid Of Long Covid-19 Brain Fog? paper, symptoms can persist for quite a long time. post covid brain symptoms tend to peak within a few months of contracting COVID-19 and usually improve over time.