The flu is back (multiple strains) - the Indian subcontinent from Pakistan through Bangladesh has seen the return of influenza alongside the rapid disappearance of covid-19.
Nearly 1/4 of the Earth's population reside within these four nations, each reporting high seroprevelance from natural infection and low rates of vaccination.
The evidence appears to indicate that natural infection can end a pandemic - but not vaccination (see Singapore).
None of these nations have fully vaccinated even 25% of their population and yet Covid is disappearing and the flu has returned.
It seems that the only way past a pandemic is through it - by natural infection.
In Bangladesh, the current estimate is that 70-80% of the population has already been infected and are thus immune:
daily-sun.com/post/581332/Co…
In India, nearly every state (outside of Kerala, which accounts for essentially all recent infections) report seroprevelance greater than 70%:
ndtv.com/india-news/95-…
In Pakistan, 36% of the population had antibodies by early summer of 2020, which is likely why they did not have as large a Delta wave - and why the flu returned to earliest here.
pubmed.ncbi.nlm.nih.gov/32940328/
Despite reporting the highest levels of seroprevelance from natural infection in the world, none of these nations have reported significant mortality compared to Europe and the Americas with implied IFRs ranging from 0.01% to 0.04% in this region, far below rates seen in the West
Why have so few died in the Indian subcontinent even though nearly everyone in this region has been infected? Youth, lack of obesity, and perhaps pre-existing immunity are the most likely answers (95% of those infected reported no symptoms at all).
aku.edu/news/Pages/New…
It truly does appear to be the case that having 80% of the population infected ends the pandemic (India, Nepal) where-as vaccinating 80% does not (Singapore) and the best indicator to watch out for is the return of the flu.
With that in mind... positive news from South Africa, as well:
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