ST HELENA LIVING WITH COVID-19 Bulletin
1: WHAT IS SARSCoV2 (COVID-19) CHIEF MEDICAL OFFICER, DR PETER MOSS
Dr Peter Moss, has been a consultant in infectious diseases since 1999. He has worked within the full range of infectious diseases, and was the Director of Infection Prevention and Control for more than 10 years. Since 2020 much of Peter’s time has been devoted to managing patients with COVID-19.
Peter will be issuing a series of bulletins to help inform the public of the medical background of COVID-19. The bulletins are aimed to help provide reassurance and advice to the community during the transition and whilst eventually ‘Living with COVID’.
Towards the end of 2019 in China a previously unknown virus spread from animals to humans (probably through livestock markets). This virus, later to be named Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV2), spread rapidly round the world causing an illness named Coronavirus Infectious Disease 2019 (COVID-19).
This illness caused severe lung problems in many of the people who caught it, and caused millions of deaths around the world in 2020-21. St Helena was one of the few places to remain isolated from SARS CoV2, and has fortunately been spared from the harm caused by COVID-19.
During the past two years there has been a huge shift in the way that SARS CoV2 affects people. The virus itself has changed to become much less harmful. This is normal as ‘new’ viruses adapt to humans: over time variants of the virus which do less damage to the host tend to replace the more harmful forms. The strain of the virus that we are seeing at the moment (‘omicron’) is much less likely to cause serious illness than earlier forms. People have also now got much better immunity to the virus, partly through having been exposed to infection, and partly through immunisation (being vaccinated). Highly effective vaccines have been developed and rolled out rapidly around the world: St Helena has been particularly successful in getting people fully immunised, and as a result most of the population of the island is well protected. SARS CoV2 is not nearly as dangerous an infection as it used to be.
Most vaccinated people who catch the virus now, only experience a very mild illness (and many may not have any symptoms at all). It is now extremely unusual for people with COVID to need to be admitted to hospital, and even those that do need to be admitted, usually make a full recovery. When SARS CoV2 first became a major health problem in 2020, we were worried that people with other health problems (diabetes, heart disease, asthma, etc.) might be particularly at risk from severe illness if they caught the virus. We now know that if you have been vaccinated, and catch the omicron strain of the virus, these other illnesses make you no more at risk of severe COVID than anyone else. There are still a handful of rare illnesses (mainly those affecting the immune system) which may put people at increased risk of severe COVID, but for most, who were previously told they were more at risk than normal from COVID, this is no longer the case.
Having had limited access to and from the rest of the world for the last two years has allowed St Helena to prepare for the arrival of the infection, and given the virus time to become less dangerous. As a result, the harm caused by SARS CoV2 on the island should be far less than in most other parts of the world, as seen on the Falkland Islands, where there has been spread of COVID-19 however far less severe symptoms for most who have contracted the disease, and no need for hospitalisations.
DR Peter Moss, MD FRCP DTMH
Chief Medical Officer, Health Services Directorate