It has been five years since the World Health Organization (WHO) declared COVID-19 a pandemic in March 2020, a decision that would alter the course of history.

For South Africans, like billions of others around the globe, the pandemic brought life to a standstill. From stringent lockdown restrictions to mask mandates and curfews, the "new normal" became a phrase that defined our collective experience.

But as we look back, with the benefit of time and science, one question looms large: Are we any closer to truly understanding COVID-19?

When COVID-19 first emerged, it was shrouded in mystery. Scientists raced to understand its origins, transmission, and effects.

Social media quickly became a double-edged sword: a platform for sharing vital information but also a breeding ground for misinformation.

In South Africa, public health measures, including one of the strictest lockdowns in the world, were implemented to slow the spread of the virus.

For many, this meant job losses, school closures, and isolation all of which had profound social and economic consequences.

Fast forward to today, and while much has been learned, the virus continues to surprise us. Variants such as Delta, Omicron, and their sublineages have taught us that COVID-19 is as much an evolutionary lesson as it is a public health challenge. But the question remains: Have we done enough with the lessons we've learned?

What we know about COVID-19 today

1. The virus is here to stay.

COVID-19 is no longer viewed as a crisis but rather as an endemic virus like influenza. This means it is expected to circulate in the population for years to come.

According to the South African Department of Health, while infection rates have stabilised compared to the pandemic's peak, periodic surges still occur, particularly during winter months.

Experts, such as Dr Glenda Gray of the South African Medical Research Council, emphasise that the virus has taught us to adapt. "We’ve gone from trying to eradicate it to learning how to live with it," she said in the anniversary of South Africa’s Covid19 initial lockdown. This shift in mindset has been critical in shaping global and local health strategies.

2. Vaccines as our most powerful tool even though new evidence is coming forward about rare side effects emerging

One of the pandemic's most significant achievements is the rapid development of COVID-19 vaccines. Five years later, vaccines remain the cornerstone of the fight against the virus.

Over 40 million doses have been administered in South Africa since the rollout began in early 2021. Despite vaccine hesitancy in some communities, the numbers show a robust uptake, especially among older adults.

However, the question of booster shots remains contentious. While wealthier countries have embraced multiple booster campaigns, many South Africans are skeptical of the need for repeated doses. A 2023 study by the Human Sciences Research Council revealed that 38% of South Africans feel "vaccine fatigue," leading to slower booster uptake.

Showing us that we still have a long way to go to understand everything about the pandemic, is a recent peer-reviewed study that revealed rare occurrences of heart, brain and blood disorders associated with Covid vaccines from companies such as Pfizer, Moderna, and AstraZeneca.

While these side effects are rare, it is worth noting, and doing further studies. The study found rare cases of myocarditis, which in basic terms is the inflammation of the heart. Cases of myocarditis were identified after the administration of Pfizer-BioNTech’s and Moderna’s mRNA vaccines, with the highest rate observed after the second Moderna dose.

Another heart condition called pericarditis showed an increased risk in those who received a third dose of AstraZeneca’s viral-vector vaccine, as well as specific doses of Moderna’s vaccine. Pericarditis refers to the swelling and irritation of the thin, sac-like tissue surrounding the heart.

The risk of developing the rare autoimmune disorder Guillain-Barre syndrome was also higher among those who received AstraZeneca’s vaccine, compared to the expected rate, in addition to an increased risk of blood clots.

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5 years on: What's the real truth about Covid-19?