Covid-19: from ticking time bomb to mild inconvenience
A leading virologist weighs in on the discussion of whether all those prevention measures and the push to get vaccinated were over the top
The past few weeks have seen increasing online discussion as to whether Covid-19 is now a mild disease and whether the initial response, in particular the prevention measures and vaccine distribution, was excessive. Prof Dr Yong Poovorawan, head of the Centre of Excellence in Clinical Virology at the Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, addressed this issue in a Facebook post, stating that times and circumstances have changed, making direct comparisons impossible.
“We cannot compare the situation during the first two years of the outbreak to that in the fourth or fifth year. The disease has significantly diminished in severity due to the evolution of the virus itself and the immunity humans have developed from vaccines and infections. As a result, the disease is now much less severe compared to the early stages of the outbreak,” Dr Yong wrote.
Historically, pandemics tend to follow this pattern. For example, during the Spanish flu outbreak over 100 years ago, which claimed 20-40 million lives worldwide and 80,000 lives in Thailand – despite Thailand's population being only 8 million at the time – the disease was most severe in its first year. After the outbreak, the virus persisted but evolved into the seasonal flu, H1N1.
Similarly, in the first two years of the Covid-19 outbreak, the disease was severe, with a fatality rate of about 1% in Thailand, resulting in over 30,000 deaths. Over time, however, the virus weakened, and people developed immunity, allowing us to coexist with it. Today, it resembles a common respiratory illness.
In the first year of the Covid-19 outbreak, pneumonia cases were very high. Hospitals prioritised patients with pneumonia, while less severe cases were managed in field hospitals. ICUs were overwhelmed, and there was a significant push to develop ventilator technology. Since then, the virus has evolved and the disease has continually decreased in severity.
This year, Covid-19 can be considered resolved, though the virus remains with us and will persist indefinitely. Contributors to social media have raised concerns about whether the response to the disease was excessive, with claims that vaccination efforts were unnecessary for a mild illness. However, comparing the current situation to the early stages of the pandemic is inappropriate.
Dr Yong noted that in the first year of the pandemic in Thailand, the fatality rate was 1%, comparable to the Spanish flu. Had we done nothing and allowed the virus to spread unchecked, as was the case a century ago, Thailand could have seen 600,000 deaths, representing 1% of the population. The disease would have eventually subsided, but at a significant cost.
“Therefore, as time and circumstances change, we cannot compare current events to the first or second year of the outbreak,” Dr Yong concluded.
