In January, when the oral treatment for COVID-19 began to be marketed, a district office official is receiving medicine from a pharmacist to deliver to a patient at a dedicated pharmacy.
Attention is focusing on the autonomy of indoor masks, the last gateway to daily return to the New Year in 2023. As the COVID-19 virus continues to mutate toward high immune avoidance and strong transmission power, it is difficult to predict the size of the epidemic or mutation that will be prevalent in each country around the world. The quarantine authorities are also agonizing over the situation in which they have to decide to lift the obligation at the request of some local governments and the people.
In addition to the commonality that the Spanish flu (H1N1) is caused by the highly mutated RNA virus, there are many similarities in the form of transmission and the progress of the epidemic with the COVID-19. Therefore, it can be an important clue to predicting the COVID-19 situation. The Spanish flu was similar in severity to the existing flu, but in the aftermath of World War I, it spread rapidly through a dense and non-distancing army and evolved into a highly toxic virus during the incubation period. Since then, it has spread to each country through war, causing a "second pandemic" with a high mortality rate. The "third pandemic" infected more than one-third of the world's population as the virus was converted into a general flu form with weakened toxicity, and caused more than 50 million deaths in the process of forming collective immunity. The Spanish flu was indigenous to the general flu as a group immunity caused by infection in four years without a vaccine or treatment.
The situation of COVID-19 by country was different. South Africa had a low vaccination rate of 33%, and the official confirmed case was 7% of the population, but the size and duration of the epidemic were shorter than delta mutations due to the acquisition of natural immunity by infection. In India, Europe, and the United States, where the ratio of infected people and deaths was high in the early stages of the outbreak, the rate of COVID-19 confirmed cases is currently steadily decreasing. On the other hand, countries such as Korea, Taiwan, and Japan, where the incidence and fatality rate of confirmed cases were very low due to wearing masks and distancing, have a very high vaccination rate, but are classified as countries with high confirmed cases after Omikron.
Through a series of cases, COVID-19 can also be expected to be indigenous to collective immunity caused by infection. In fact, in a November 2022 survey of antibody rates in the United States, 94% were confirmed to have been infected more than once. It can be seen that in March 2022, the UK also gained natural immunity as 82% of elementary school students with a 0.4% vaccination rate were infected. Considering that 54% of Koreans were infected, but about 20% were not reported in the antibody test in August, the natural infection rate is estimated to be around 75 to 80%. In Korea, COVID-19 is likely to repeat the wave-type epidemic centered on the uninfected until group immunity, and the number of confirmed cases is likely to increase mainly in high-risk groups with low infection rates.
If so, how should we respond to this situation? The administration of antiviral drugs is one of the ways to respond. Coronavirus causes organ damage through cloning after invading the human body, so even if you are infected with antiviral drugs, you can manage it like the flu by suppressing replication.
Currently, when the flu is diagnosed, antiviral drugs are prescribed regardless of age to reduce symptoms and aftereffects, so daily life is not suspended even if you catch the flu. However, COVID-19 has been nearly a year since antiviral drugs began to be administered, but the prescription rate is only 30%. Damage caused by low prescription rates can be confirmed everywhere. People under the age of 60 and severely ill with underlying diseases are also experiencing cases of worsening or dying as a serious patient because they are not prescribed even if the patient wishes to, even though there is an antiviral drug that can be replaced if there is a taboo drug. Even when more than 70% of the people are expected to have natural immunity, the quarantine period is maintained for 7 days, while antiviral drugs are limited to within 5 days of symptoms, so it is still impossible to prescribe after quarantine. It is necessary to think about measures such as simplifying the prescription process of paxrovide, reggaebrio, and remdesivir, which are approved only for high-risk groups, like flu, or allowing medical staff to record the reason even if they do not prescribe it.
Writer: John Lee
Comments