More than five years after the first cluster of COVID-19 cases emerged in Wuhan, China, the virus continues to evolve, leaving behind unanswered questions and a legacy of global disruption. The pandemic reshaped public health policies, exposed systemic inequities, and brought groundbreaking advances in vaccine development.

Origins of the Virus Remain Unclear

The origins of SARS-CoV-2, the virus causing COVID-19, remain uncertain. While scientists believe it likely originated in bats and was transmitted to humans through an intermediary species such as raccoon dogs or civet cats, this theory remains unproven. Speculation about a potential laboratory leak in Wuhan has further fueled political tensions.

The World Health Organization (WHO) recently urged China to share more data, calling transparency a “moral and scientific imperative” to help prevent future pandemics. However, experts caution that the true origin may never be definitively established.

Global Death Toll and Vaccination Efforts

The pandemic’s death toll remains staggering. While the WHO reports over seven million deaths worldwide, the actual number is estimated to exceed 20 million. Vulnerable populations, especially older adults, continue to account for a significant proportion of fatalities.

Despite these losses, the rapid development of COVID-19 vaccines has saved tens of millions of lives. The introduction of mRNA vaccines by Pfizer and Moderna in less than a year marked a scientific milestone, with more than 13 billion doses administered globally since 2021.

Vaccines have proven effective in reducing severe illness, hospitalizations, and deaths, though their protection against mild infections wanes over time. Researchers are working on next-generation vaccines, including nasal options, to better prevent infections.

Variants and Virus Evolution

The virus has continually mutated, with the omicron variant and its subvariants dominating since late 2021. Currently, KP.3 and a hybrid strain, XEC, are the primary variants in Europe. While these variants remain highly transmissible, existing vaccines and treatments have shown efficacy against them.

Long COVID: A Lingering Concern

Millions globally continue to grapple with long COVID, a condition characterized by persistent symptoms such as fatigue, brain fog, and cardiovascular issues. While vaccination reduces the risk, the root cause of long COVID remains unclear, complicating efforts to develop effective treatments.

Emerging research suggests remnants of the virus may linger in some patients’ bodies, offering clues but no definitive answers.

Looking Ahead

As humanity adjusts to a world where COVID-19 is no longer a leading cause of death but still a public health concern, the focus remains on monitoring variants, improving treatments, and addressing the long-term effects of the virus.

“The virus is still with us,” said WHO Director-General Tedros Adhanom Ghebreyesus. “We cannot talk about COVID in the past.”

The number of cancer patients in England receiving an early diagnosis has reached an all-time high, reflecting a significant rise in screenings, according to new data from the National Health Service (NHS).

Between September 2023 and August 2024, 58.7% of approximately 206,000 cancer cases in England were detected at stages one or two, the NHS report revealed. This represents an additional 7,000 cases diagnosed early compared to pre-pandemic levels. Early detection often allows for more effective treatment before the disease spreads, improving patient outcomes.

“Lives are saved when cancers are caught early – and following a major drive on early detection in recent years, it’s really encouraging to see more people than ever are now being diagnosed at an earlier stage,” said Cally Palmer, NHS England’s national cancer director.

Screening Uptick and Survival Rates

Screening campaigns have played a crucial role in this improvement. Over 3 million people underwent urgent cancer checks between November 2023 and October 2024, marking an increase of 100,000 from the previous year and over 700,000 compared to pre-pandemic levels.

Despite these advances, overall cancer survival rates in England remain slightly below the European average. Data from Cancer Research UK indicates that 47% of men and 53% of women in England survive at least five years after a cancer diagnosis, compared to 50% and 58%, respectively, across Europe.

The NHS aims to diagnose 75% of cancers at stages one or two by 2028. To achieve this, efforts are focused on expanding screenings and encouraging early testing, particularly among individuals with higher genetic or lifestyle-related risks.

Challenges in Data and Equity

However, gaps remain in diagnosis-stage data. A report by the Nuffield Trust found that 34% of cancer cases in January 2023 lacked information on their stage at diagnosis, complicating efforts to fully understand trends and outcomes.

Additionally, disparities persist between socioeconomic groups. People living in affluent areas are more likely to receive early diagnoses and have better survival rates compared to those in deprived regions, highlighting ongoing inequities in healthcare access and outcomes.

Faster Diagnoses and New Treatments

Efforts to improve the speed of diagnosis are also underway. In March 2024, 77.3% of patients who were urgently referred or screened for cancer received a diagnosis or had cancer ruled out within 28 days.

“With new treatments being made available all the time, we will continue to do all we can to get people seen and treated for cancer as early as possible,” Palmer emphasized.

As England strives for earlier diagnoses and better outcomes, the NHS’s focus on expanding screenings and reducing disparities remains pivotal in combating cancer nationwide.

Air pollution continues to pose a significant public health threat across Europe, with fine particulate matter (PM2.5) contributing to approximately 239,000 premature deaths in 2021, according to the European Environment Agency (EEA). The impact of air pollution varies widely across the continent, with Central and Eastern Europe bearing the brunt of the health burden.

Fine particulate matter, including dust, smoke, and soot, is linked to numerous health problems such as lung cancer, heart and respiratory diseases, stroke, and poor birth outcomes. Among older adults aged 65 and above, it accounts for about 4% of all deaths. Exposure to nitrogen dioxide (NO₂), largely driven by traffic and industrial emissions, led to an additional 48,000 deaths in the same year.

Efforts to address these issues intensified in 2021 when the World Health Organization (WHO) revised its air quality guidelines, setting stricter thresholds for PM2.5 and NO₂ concentrations. This month, the European Union implemented new air quality rules aiming to align closer with WHO standards by 2030. These measures include monitoring pollutants like black carbon and ammonia, marking what experts describe as a critical intervention for public health.

Mark Nieuwenhuijsen, director of the urban planning, environment, and health initiative at the Barcelona Institute for Global Health, called the EU plan “one of the biggest public health interventions for a generation.”

Regional Variations in Impact

A report by the European Commission and the Organisation for Economic Co-operation and Development (OECD) highlighted stark regional disparities. Central and Eastern Europe reported the highest death rates linked to PM2.5, attributed largely to residential coal burning and agricultural emissions. Northern Italy, Poland, and the Czech Republic are among the regions most affected.

Meanwhile, NO₂-related mortality was highest in major urban centers and capital cities in Western and Southern Europe, driven by vehicle traffic and industrial activities.

Environmental epidemiology professor Zorana Jovanovic Andersen noted that these disparities align closely with socioeconomic factors, underscoring the divide between eastern and western Europe.

Progress and Challenges

The EU directive allows citizens affected by pollution-related health issues to take legal action against non-compliant governments. While the EU is on track to reduce PM2.5-linked deaths by 55% by 2030, scientists warn that air pollution remains a growing threat, intertwined with climate change, noise pollution, and a lack of green spaces.

“We know how to reduce air pollution, and many countries are leading,” Andersen said. “But there are new challenges, so we need to regulate air pollution—the old problem.”

With its wide-reaching health and environmental implications, air pollution remains a top priority for policymakers seeking to protect public health across Europe.