As Malta marks two years today since the first COVID-19 case was detected on the island, public health experts are finally observing what they believe to be a stabilisation of the pandemic.

“This is not the end of the pandemic,” epidemiologist Neville Calleja told Times of Malta.

“But in Europe we are looking at what we call a hyperendemic state, where the infections become stable, even though at a higher level. Even though there is still a potential threat to life, this is limited,” Calleja said.

He noted that in Malta, for instance, the positivity rate has climbed to around five per cent and remained unchanged in recent weeks.

While this figure is notably higher than it was before the Omicron variant hit, hospital admissions and death rates are stable and no major spikes have been reported, he said.

Countries, especially in Europe, have “invested in immune capital” either through infection or vaccination, meaning the population is becoming more immune to the virus, even if, at individual level, especially as the infection evolves from one variant to the next, to date it was vaccination that gave the best protection.

Malta’s first case was of a 12-year-old Italian girl who travelled to Italy and returned home to Malta after a few days.

Since then, much like the rest of Europe, the island has faced two shutdowns – one in March 2020 and another a year later – as well as measures that ranged from compulsory masking in all public places to a ban on flights and on all mass gatherings.

Omicron was a shift 

The arrival of the Omicron variant at the end of 2021 signalled a shift in the pandemic, not just in Malta but globally.

This highly infectious variant spread faster than previous ones but with the majority of the population vaccinated by then, fewer people experienced complications as a result of infection, even if the infection rate in Malta reached record highs this January. As a result, death rates remained relatively low.

However, while countries with a high vaccine uptake, including Malta, seem to have started to move on, Calleja said it was still premature to speak about the end of the pandemic.

“We don’t know when that will happen. We need to keep in mind that pandemics tend to last around five years, as was the case with the Spanish Flu for instance.

The roll-out of the vaccine has been the key moment in the two years since COVID first made an appearance here- Epidemiologist Neville Calleja

“What we have observed is that the winter does increase the burden of this disease, as with any other respiratory infection, even if the infection is not seasonal, as we have seen spikes in summer too."

“So going forward over the next six months, we hope to get a natural regression in the number of cases.

“What will happen next winter? I don’t know. But it seems that COVID-19 is now in the same pattern as the flu, even when it comes to the vaccine and when it needs to be administered,” he said.

It is likely the jab will need to be given at the start of the colder months, same as the flu vaccine, in order to protect people throughout the winter season, he added.

Disruptions possible

Despite the health authorities’ confidence that the pandemic is stabilising, major events – such as Russia’s invasion of Ukraine for instance – could still result in disruption.

Calleja pointed to the war-torn country as an example of a problematic situation in terms of a pandemic. The displacement and flow of people across borders increases the spread, he said.

With testing and vaccinating in Ukraine exceedingly difficult, if not impossible, it is likely that many of those moving to neighbouring countries are infected.

“The war could not have come at a worse time for Ukraine. There are other health threats the country faces, not just COVID. For instance, the country is also dealing with other diseases such as HIV and tuberculosis.”

And because of vaccine hesitancy, the country is not only struggling with COVID-19 but it also has cases of polio, he said.

Vaccine the game changer

Despite many attributing the shift in countries’ approach to the pandemic to the Omicron variant, Calleja is adamant the vaccine was the real game-changer.

Without it, he said, Omicron would have been just as problematic as other variants.

“Countries that have a low vaccine coverage still struggled with Omicron, just as they did with the Delta variant. Without the vaccine, Omicron would have been much worse,” Calleja said.

For the epidemiologist, the roll-out of the vaccine has been the key moment in the two years since COVID first made an appearance here.