The Future Disease Burden of Pandemic Covid-19 for Individuals, Communities, and Society

Abstract

Pandemic Covid-19 has exposed tension between personal choice and public health policy. Vaccination has damped pandemic inertia in the U.S., but emergence of highly infectious variants such as delta and omicron has increased infection of fully vaccinated people. This worrisome trend justifies vaccine booster eligibility and access for all vaccinated people in a timeframe responding to waning protection. In restricting booster eligibility, US FDA and CDC statements indicate failure to consider that SARS-CoV-2 might be persistent, meaning that it might remain dormant in immune-privileged “refugia” such as the central nervous system of previously infected people, even if their Covid-19 symptoms had been mild or non-existent. Opportunistic re-activation of dormant viruses can cause severe illness, as in childhood chickenpox producing adult shingles decades later. External re-infection is unnecessary. Consistent with the “precautionary principle,” the overriding FDA and CDC public health priority should be to prevent as many SARS-CoV-2 infections as possible, not tolerate them, assuming optimistically that they will not impose major public health and associated economic burdens in the future. We naturally have focused upon our tragic past losses. We also must focus upon the future, learning from Covid-19 to manage pro-actively the inevitable next pandemic.

About the author

Dr. Michaels is President of Schenectady, New York-based RAM TRAC Corporation, and a toxicologist specializing in assessment and management of risks to public health potentially posed by environmental contaminants. Over the past decade he has been involved with many issues, including: effects of lead (Pb) on children’s health in Flint, Michigan ; effects of perfluoroalkyl substances (PFAS) near Saint-Gobain Performance Plastics in Hoosick Falls, New York and near Chemours Fayettevllle Works in North Carolina ; and Hudson River PCB dredging by General Electric . His interest in virology and immunology began during a brief but intense stint at the Neurovirology Laboratory at the Mt. Sinai Medical Center in New York City. Dr. Michaels has a strong reputation for objectivity, having served national and international Fortune 500 clients; Federal, State and Municipal governments; and public interest organizations such as the Natural Resources Defense Council (NRDC).

Dr. Michaels consulted for the U.S. Congress Office of Technology Assessment (OTA) on Love Canal (New York). For years he chaired the State of Maine’s Scientific Advisory Panel. For 20 years he chaired the Certification Review Board of the Academy of Board Certified Environmental Professionals (ABCEP). “Dr. Bob” also has been Secretary of NFPA’s Committee on Classification and Properties of Hazardous Chemicals, Board Member of the National Association of Environmental Professionals, and Member of the Editorial Advisory Boards of Springer-Verlag and Cambridge University Press scholarly journals. He earned his doctorate at SUNY/Stony Brook in 1979, and in 2004 was awarded ABCEP’s Kramer Medal.