As many countries are either coming out of one wave of coronavirus disease (COVID-19) infections or entering another, there are still major issues with the pandemic around the world. What is becoming clear is that there are mounting new or recurring issues that will affect the trajectory of the recovery. For some communities, recovery may become too shapeless and scattered to define for several more years. Latin America continues to go through its waves, with the Delta variant now in certain locales. There is increasing concern about contamination on buses and other modes of public transportation. This is unlike other parts of the world, where mass transit systems were deep cleaned before vaccine availability became the method of choice in fighting the pandemic. In Brazil, researchers are documenting the spread of the country’s second wave through contaminated buses and terminals. They collected samples from various surfaces in the public transport system in order to identify the presence of COVID-19. The highest risk of contamination was in bus terminals, with 48.7 percent of positive samples, followed by hospital surroundings (26.8 percent). Meanwhile, in South Korea, there are issues arising within the military about post-vaccination infections. A fully vaccinated navy officer last week tested positive for COVID-19, marking the first breakthrough infection reported in the military. A breakthrough case is when a person is diagnosed with the virus at least two weeks after receiving the full dose regimen. Health authorities earlier said South Korea had confirmed dozens of such cases among the general population. The latest cases raised the total number of infections reported among the military to 1,025. In Russia, as in many other countries, some soldiers have rejected the vaccine. Earlier this year, mandatory vaccinations were instituted due to the rise of pathogen cases in the Russian military. Now, the Ministry of Defense is giving booster jabs because of the Delta variant. The impact of infections among military personnel is likely to last a long time. Another emerging issue is known as “long COVID.” Evidence is mounting, from multiple countries and researchers, that even mild infections can lead to permanent changes in the brain, which affect everything from signaling to muscles and organs to cognition, memory and the organization of thoughts and ideas. Current numbers and trends indicate that long COVID will be another public health disaster. Dr. Theodore Karasik In America, while more than half of all adults are vaccinated, face mask and social distancing mandates are being relaxed, while pathogen cases and deaths are on the decline. However, the return to normality does not apply to the 10 to 30 percent of those infected who continue to experience debilitating symptoms months after being infected. Unfortunately, current numbers and trends indicate that long COVID will be another public health disaster. It is being found all around the world. Long COVID covers “a range of symptoms that can last weeks or months… (that) can happen to anyone who has had COVID-19.” The symptoms may affect a number of organ systems, occur in diverse patterns, and frequently get worse after physical or mental activity. Nobody knows the time trajectory of long COVID, so medical services and their systems will be challenged on top of other requirements. Compounding the difficulties of the recovery situation is the old debate on vaccine passports. Faced with a divergence of views, governments are taking very different approaches. In Europe, for example, seven countries started issuing the EU’s digital certificates at the beginning of June, with the bloc’s remaining nations — bar Ireland — doing the same from last Thursday. However, some countries and political factions are taking the opposite stance, strictly limiting the use of such documents or banning their development. This type of thinking will only ensure the pathogen and its issues drag on longer. The EU says it is working to make its digital vaccination certificate similar to other documentation in non-EU countries. The UK, for example, has a different system because of Brexit issues and reconciling this disconnect is important for economic recovery. The four vaccines approved for use in the UK are also approved in the EU, but there may be additional issues with full access. Recovery from the pandemic and dealing with the long-term problems of how the pathogen develops must trump politics. Militaries are facing their own challenges with the virus, but are still able to function with what appears to be no direct impact on operations. On a civilian level, impatience with COVID-19 issues will arise, perhaps unpredictably and unexpectedly. Vaccination is a positive and necessary part of daily life in the 2020s, especially when booster jabs become necessary depending on the severity of the next wave. The unvaccinated will continue to get squeezed. Meanwhile, in medical facilities and other related systems, the elongated curve on where long COVID will end up is another daunting issue for which there is currently no answer. Dr. Theodore Karasik is a senior adviser to Gulf State Analytics in Washington, D.C. Twitter: @tkarasik Disclaimer: Views expressed by writers in this section are their own and do not necessarily reflect Arab News" point-of-view