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Feature Covid Unanswered Questions

Is covid-19 settling into a pattern?

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o2183 (Published 15 September 2022) Cite this as: BMJ 2022;378:o2183

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COVID-19 Pandemic, increasing ‘unanswered questions’ and the pandemic trajectory: Any envisioned terminus for the ‘evolving pandemic chameleonic reality?

Dear Editor

The ‘COVID-19 Pandemic Chameleonic Reality’ has been highlighted in previous ‘Communications’[1,2]. Several aspects of the ‘COVID-19 Pandemic’ are involved in this ‘Chameleonic Reality’. The recent ‘Communication’ focused on the possible ‘Settled COVID-19 Pandemic Pattern’[3]. With the ‘Chameleonic Reality’ reflecting several ‘COVID-19 Pandemic Specifics Transmutations’, the ‘SARS-CoV-2’ has been able to sustain its spread, proliferation, replication and mutation with emergence of ‘Variants and Sub-Variants’ and possible ‘COVID-19 Pandemic Trajectory’ from a ‘Pandemic’ to an ‘Endemic Infection’. The ‘COVID-19 Pandemic Undergirding Denominator’ is the ‘Rapidly Evolving Unresolved Works in the Work’ and ‘Increasing Unanswered Questions’ as disposed in the recent ‘Communication’[3] and several other ‘Communications’ by this Author[1,2,4-20].

The thrust of this ‘Communication’ is to focus attention on the continued emergence of ‘SARS-CoV-2 Variants and Sub-Variants’ with a seemingly evolving ‘Pattern’ of ‘2 to 3 Waves Per Annum’ over the two years of the ‘COVID-19 Pandemic’ with ‘Specific Variants’ assuming the ‘Dominant Driving Force’ of the ‘Different Pandemic Waves’ with varying ‘Transmissibility’ and ‘Immune Escape’[3]. The ‘Pandemic Waves’ are defined by several factors: ‘Transmissibility and Immune Escape Capacity of the SARS-CoV-2 Variants/ Sub-Variants’, ‘Extant Public Health Prevention Interventions’ and ‘Strict Implementation and Compliance’, ‘Population Vaccination Coverage and Herd Immunity’, ‘Waning Vaccine Immunity and Population Protection’, ‘Population Diversity’, ‘Population Health and Social Disparity’, ‘Inverse Equity Hypothesis and Public Health Interventions’ etc[3]. It is suggested that ‘Newer Variants’ seem to ‘Outcompete’ the ‘Older and Previous Variants’ for the ‘Pandemic Wave Dominance’[3]. Some possible ‘Evolutionary Variant Gene Swapping’ is reportedly responsible for the suspected ‘Deltacron’ (From Delta and Omicron Variants’[21].

Part of the difficulty in the ‘COVID-19 Pandemic Control’ is the unsatisfactory ‘Vaccine Efficacy’ as the current ‘COVID-19 Vaccines’ are reportedly derived from the ‘Original SARS-CoV-2 Wild Variant’[3]. With varying degrees of ‘Vaccine Efficacy’ against the various ‘Variants and Sub-Variants’, the persistence of ‘Infection’, ‘Transmission’ and ‘Pandemicity-Endemicity’ will be an uncomplimentary ‘Done Deal’. The world; as an urgent imperative, needs to address the ‘Rapidly Evolving Unresolved Works in the Work’ and indeed proffer ‘Solutions’ to the ‘Increasing Unanswered COVID-19 Pandemic Questions’.

This brief ‘Communication’ is a modest ‘Contribution’ to the ‘Unresolved COVID-19 Pandemic Questions Conversations’ which should hopefully excite ‘Contemporary Discourse’ towards achieving successful ‘COVID-19 Pandemic Control.

REFERENCES
1. Eregie C.O. COVID-19 Pandemic, SARS-CoV-2 Transmission and Pandemic Control Interventions: The Unrelenting Bothersome Chameleonic Reality of COVID-19 Pandemic Specifics. https://www.bmj.com/content/377/bmj.o1408/rr of 5th July 2022
2. Eregie C.O. COVID-19 Pandemic, still evolving manifestations and Long Covid: Appreciating the ‘Chameleonic COVID-19’ for better ‘COVID-19 Pandemic Control’. https://www.bmj.com/content/378/bmj.o1887/rr-0 of 13th August 2022
3. Looi M. Is covid-19 settling into a pattern? BMJ 2022; 378:o2183
4. Eregie C.O. COVID-19 Pandemic: The difficult unresolved increasing challenges in weathering the storm. https://www.bmj.com/content/368/bmj.m1199/rr-10 of 31st March 2020
5. Eregie C.O. COVID-19 Pandemic: Still on the difficult unresolved increasing challenges in weathering the stor’. https://www.bmj.com/content/368/bmj.m1199/rr-13 of 2nd April 2020
6. Eregie C.O. COVID-19 Pandemic: Further perspectives on the difficult unresolved increasing challenges in weathering the storm. https://www.bmj.com/content/368/bmj.m1199/rr-16 of 5th April 2020
7. Eregie C.O. COVID-19 and face masks use: Limitless matters for extant conversation. https://www.bmj.com/content/369/bmj.m2030/rr-0 of 11th June 2020
8. Eregie C.O. COVID-19 Pandemic and social distancing: more work in the works to be there. https://www.bmj.com/content/369/bmj.m2010/rr-1 of 12th June 2020
9. Eregie C.O. COVID-19 Pandemic Interventions: Lockdown is not lockout; avoid interventional precocity with easing lockdowns. https://www.bmj.com/content/369/bmj.m2202/rr-4 of 14th June 2020
10. Eregie C.O. COVID-19 pandemic and stratified shielding: some more matters for the works. https://www.bmj.com/content/369/bmj.m2063/rr-2 of 18th June 2020
11. Eregie C.O. COVID-19 and the quadruple-barrel tragedy: matters still evolving for the works. https://www.bmj.com/content/369/bmj.m2197/rr of 19th June 2020
12. Eregie C.O. COVID-19 Pandemic, SARS-CoV-2 antibodies and testing: Still searching for more facts. https://www.bmj.com/content/369/bmj.m2584/rr of 16th July 2020
13. Eregie C.O. COVID-19 Pandemic and the Value of Antibodies Testing: Still More Matters in the Works. https://www.bmj.com/content/370/bmj.m2655/rr-1 of 14th August 2020
14. Eregie C.O. COVID-19 Pandemic and COVID-19 Vaccinations: Beyond the ‘Vaccines Marathon Finish Line’; The Unfolding ‘Works in the Work’. https://www.bmj.com/content/372/bmj.n24/rr-1 of 20th January 2021
15. Eregie C.O. COVID-19 Pandemic, beyond the ‘Vaccines Marathon Finish Line’ and ‘Post-Vaccine Approval Programmatic Haze’: The Evolving ‘2nd Dose Uncertainties’. https://www.bmj.com/content/372/bmj.n18/rr-12 of 24th January 2021
16. Eregie C.O. COVID-19 Pandemic, beyond the ‘Vaccines Marathon Finish Line’ and ‘Post-Vaccines Approval Programmatic Haze’: The evolving ‘2nd Dose Uncertainties’; still more unfolding ‘Matters in the Work’. https://www.bmj.com/content/bmj.n18/rr-13 of 27th January 2021
17. Eregie C.O. COVID-19 Pandemic, COVID-19 Vaccines and Boosters: More Unresolved Evolving Matters in the Works. https://www.bmj.com/content/375/bmj.n3011/rr of 17th December 2021
18. Eregie C.O. Covid-19 Pandemic, Reinfection, Reactivation and COVID-19 Rebound: Efficacy of Covid-19 Pharmaceutical and Non-Pharmaceutical Interventions; The Imperative to Guard Against Interventional Precocity in Downing Guards. https://www.bmj.com/content/377/bmj.o1365/rr of 15th June 2022
19. Eregie C.O. COVID-19 Pandemic, COVID-19 Vaccines and Rapidly Transmuting SARS-CoV-2 Variants/ Sub-variants: The Quest for Pan-Sarbecoviruses Vaccine Variants; A Further Imperative to Guard Against Global Interventional Precocity in Downing Guards. https://www.bmj.com/content/377/bmj.o1257/rr-0 of 17th June 2022
20. Eregie C.O. COVID-19 Pandemic, COVID-19 Vaccines and Post-Vaccination Myocarditis and Pericarditis: Implications of ‘Piecemeal Emerging COVID-19 Vaccine Information’ for Population Trust and ‘Vaccine Hesitancy’. https://www.bmj.com/content/378/bmj.o1554/rr-0 of 9th August 2022
21. Mahase E. Covid-19: What do we know about the delta omicron recombinant variant? BMJ 2022; 378:o792

Professor Charles Osayande Eregie,
MBBS, FWACP, FMCPaed, FRCPCH (UK), Cert. ORT (Oxford), MSc (Religious Education),
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria,
Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria,
UNICEF-Trained BFHI Master Trainer,
ICDC-Trained in Code Implementation,
*Technical Expert/ Consultant on the FMOH-UNICEF-NAFDAC Code Implementation Project in Nigeria,
*No Competing Interests.

Competing interests: No competing interests

27 September 2022
CHARLES OSAYANDE EREGIE
MEDICAL DOCTOR
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria and Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria
Institute of Child Health, University of Benin, PMB 1154, Benin City, Nigeria.