COVID-19: The New Normal 3 Years After Pandemic Declaration

On March 11, 2020, the World Health Organization (WHO) took the historic step of declaring a global pandemic as a result of the rapid spread of an unfamiliar and potentially deadly coronavirus that would be named SARS-CoV-2, or COVID-19.

Three years following that declaration, the pandemic has eased quite a bit, thanks in large part to widely available vaccines that can significantly reduce the severity of symptoms. But much remains uncertain, including the impact of “long COVID,” referring to lingering symptoms several months following initial infections. And there are questions about future variants, which vaccine makers are taking into consideration with updated formulas.

In the new Baptist HealthTalk podcast, COVID-19: Three Years Later, Baptist Health experts evaluate the impact of the pandemic and its current status.

Jonathan Fialkow, M.D., Chief Population Health Officer for Baptist Health and chief of cardiology at Baptist Hospital.

“Maybe you've had it,” said Jonathan Fialkow, M.D., chief of cardiology at Baptist Hospital and Chief Population Health Officer at Baptist Health, the host of the podcast. “Maybe you've had someone near and dear to you die from it, or you're dealing with long-term effects from it. It was a pandemic that impacted each and every one of us. Three years ago, COVID-19 was declared a global pandemic by the World Health Organization. Over 6.5 million have died from it, with 1.1 million of them right here in the United States. Is it over? No. But as we learn to live with the new normal, what's ahead of us?”

Dr. Fialkow’s guest is Samer Fahmy, M.D., Chief Medical Officer at Boca Raton Regional Hospital, part of Baptist Health, and associate professor and associate of Clinical Affairs at Florida Atlantic University.

“The pandemic has taken a turn for the better throughout the last three years as we've seen on the ground level at the hospitals,” explains Dr. Fahmy. “Initially when we started in 2020, the majority of patients that were presenting to the hospital with COVID symptoms were very ill. People were with pneumonia in both lungs -- people that were extremely short of breath with extremely low oxygen levels, many of them requiring intubation, being on a respirator in the ICU for weeks at a time. And our mortality rate, the number of people that were dying from COVID, was very high.

Samer Fahmy, M.D., Chief Medical Officer at Boca Raton Regional Hospital, part of Baptist Health, and associate professor and associate of Clinical Affairs at Florida Atlantic University.

 

“As the pandemic has progressed and as we've seen newer variants come about, those newer variants tend to have higher levels of transmission -- so it's easier to transmit them from one person to the next. But the fortunate part is that the disease has gotten milder and milder over the last two-and-a-half or three years or so.”

Here are some Q&A highlights from the podcast: COVID-19: Three Years Later:

Dr. Fialkow: “What generally would you say are the big takeaways that you have seen about what we've learned in three years regarding COVID as a pandemic and as a virus itself?”

Dr. Fahmy: “The people that are currently impacted with COVID-19 -- if you're healthy, if you're young -- typically you're not going to get severe symptoms. And we used to see those people getting severe symptoms a couple of years back. But now the folks that are getting really sick with it are the ones that have significant medical problems: A predisposing condition; people that have a weaker immune system; or the 75 and older groups, which tend to be more vulnerable … But unfortunately, COVID is still among us and it's still here and it's still spreading. And I know anybody listening to this probably has a family or friend who has been impacted by COVID, even in the last month or two. So it's still here. It's still a problem we have to address. But it has gotten milder.”

Dr. Fialkow: “What do you think is the role of the natural immunity … how much of the less severe aspects of COVID is because so many people have had COVID?”

Dr. Fahmy: “I think it's something everybody thinks about. There were recent studies about a year back that demonstrated that natural immunity from COVID-19 was as effective as vaccinations. So that was encouraging because the goal with getting a virus stopped or slowed is to get a combination of vaccination and natural immunity up to a critical mass -- up to a certain level where the virus doesn't have a chance to transmit as much. Now, if the virus was the original strain and everybody got immunity or a vaccine to that original strain, I think we would be in a great place because the majority of the population would be there.

“But the problem is just like our experience with HIV back in the 1980s, and just like our experience with influenza even up until today, viruses mutate and they mutate at different rates, and that rate of mutation makes it evade either some of the vaccination that were initially offered or some of the natural immunity that we initially had. But the best place to be is to be somebody who's caught it, recovered from it, and gotten vaccinated. And that seems to provide the best level of protection.”

Dr. Fialkow: “Talk a little bit about what we know about what has been termed ‘long COVID.’ What is it? And what is it not? And how are we handling it to the best of our abilities in the medical community?”

Dr. Fahmy: “Long COVID has been really recognized since the third quarter or toward the second half of 2020 for patients that ended up getting COVID. Some of the symptoms of COVID lingered on for longer than expected. Even after they recovered, they no longer had fevers; they no longer had the pneumonia that they had with COVID; (and) they no longer had the cough. But things like shortness of breath persisted, or things like generalized fatigue, or anxiety, or rapid heart rate, or you feel like your heart is racing…

“If they were vaccinated, they're less likely to get long COVID. That was the initial thing. So, with vaccines, you're less likely to have severe symptoms and we're seeing severe symptoms leading to long COVID -- more than mild symptoms. (Long COVID) has been a hard entity to define -- although there's no doubt that there are patients that are suffering from those symptoms for an extended period of time after recovery.”