The legacy of COVID: What don’t we know about the virus five years later

Five years ago, the first case of COVID was reported in Saskatchewan.

Over the following months and years, medical experts and scientists became familiar figures, and regular people learned about new concepts like social distancing, R0 factors and PPE.

Read More:

• Doctors thrust into COVID-19 celebrity reflect on backlash, threats and Thank You letters
• Uptake of COVID-19 booster shots has plummeted. Here’s why scientists are concerned
• ‘The fire is still lit’: How COVID-19 and its aftermath sparked a new era for labour

Now, many researchers have gone back to their normal work, and the province’s chief medical health officer is no longer addressing the public in daily news conferences, but Dr. Darryl Falzarano said the work to understand more about the virus has not stopped.

Falzarano is a principle scientist at the Vaccine and Infectious Disease Organization (VIDO) at the University of Saskatchewan.

In 2020, COVID-19 was declared a pandemic by the U.N.’s World Health Organization. Now, Falzarano described the virus as endemic – meaning it’s found everywhere, all the time, at different levels.

“The virus itself, of course, has evolved, and how we interact with it has evolved as well,” he said.

The case fatality rate was much higher than it is now, and Falzarano said case severity may have decreased, though he said there are a lot of factors at play into that determination, so it’s not a final conclusion.

At first, Falzarano said the virus mutated quickly, resulting in the different variants like Alpha, Beta and Delta. The current strain of the virus has been designated Omicron, and he said everyone is watching and waiting to see what happens next.

“Do we stay stuck on Omicron? The current lineage that we’re in, it keeps making mutations but it’s not undergoing a huge amount of change (to make) all of us newly susceptible to maybe more severe disease,” explained Falzarano.

He said it’s really hard to know whether a new version will develop, though he said it’s unlikely.

The current plan of attack in Canada is treating COVID like a seasonal illness. Vaccines are ordered in the fall and, in Saskatchewan, are promoted and offered through a vaccination campaign that runs from October 15 to March 30.

However, Falzarano said the data right now doesn’t support COVID only being a seasonal illness, as it’s showing peaks at different times of the year, including the summer.

He said several factors could affect seasonality, like vaccine immunity waning from fall to the following summer. Falzarano said it’s possible that five years isn’t enough time to determine seasonality, and the virus could evolve further in the next five years.

“That remains to be seen, and our strategy for dealing with them and when vaccine rollout should be, that’s going to have to still be, I think, figured out,” he said.

It seemed everyone was working on COVID vaccines five years ago, but now many scientists have returned to their previous work and COVID vaccines are developed like flu vaccines – tailored to the subvariant expected to be dominant in a particular season.

But some, like VIDO, are looking to build something more broad.

“What people want to do is have more broadly protective vaccines, so one vaccine wouldn’t have to be updated constantly. At least not on a yearly basis,” said Falzarano.

He explained that VIDO is working on something similar: a single vaccine antigen containing four different components.

Falzarano said there are still many things researchers don’t know about COVID-19, which would be critical to developing better vaccines.

“You would think at this point, five years (of) intensive research, everyone around the world working on this – we don’t know very good how we’re protected, what kind of protection provides protection in the lungs versus protection from us just getting an upper respiratory tract infection. And the other thing, the durability. How long we’re protected and why,” he said.

And, Falzarano said, research has become harder because nearly everyone has a complicated and unique immunological response to the virus, which can depend on exposure, whether or not they were vaccinated, and with which vaccines.

COVID infections are trending down in Canada. In Saskatchewan, as of February 22, 14.1 per cent of the province had been vaccinated for COVID-19, according to the Ministry of Health, while 20.5 per cent had been vaccinated against influenza.