Even after COVID-19 cases have fallen from their current record levels, the United States – let alone the world – is unlikely to be able to completely eliminate the coronavirus that causes them.
But the day will come when it will no longer be a pandemic, cases no longer run out of control, and hospitals are unlikely to overwhelm patients.
Many experts predict that the spread of the coronavirus will end up looking more like that of the seasonal flu.
The United States may have passed the peak in Omicron cases towards the end of January, some experts say.
In even more welcome news, 2022 could be when the coronavirus becomes “part of our history and it comes and goes,” Dr Ofer Levy told CNN’s Alisyn Camerota this week.
“I think it’s likely that we will see this wave come and go and spring and summer are shaping up to be much better than they are today,” said Dr. Levy, director of the Precision Vaccines program at Boston Children’s. Hospital.
â€œThere will be fewer cases, and again, next fall and winter we will see a spike in viral disease, coronavirus, flu and the like, but it will be more like an endemic cycle.
“It will be a better winter, just like this winter, with all the challenges, is even better than the previous winter.”
But this coronavirus changes and surprises frequently – and there is no official benchmark for when the pandemic is over and when a new normal has begun.
â€œThere isn’t even a measure to say something is an epidemic or a pandemic. It’s all in the eye of the beholder – and it’s part of the problem, â€Dr. Arnold Monto, professor of epidemiology at the University of Michigan and interim chair of the Food Advisory Board on Vaccines and Related Biologics and Drug Administration of the United States, told CNN in November.
â€œSo this is not all rule based. It’s usually based on what you need to do to control the outbreak, â€Monto said.
“What is so different here is that our vaccines are much more effective than what we usually see.”
That’s the good news, according to Dr. Monto. The bad news comes with the power of the virus to change and evolve.
No one can predict what the future of COVID-19 might look like – and the emergence of coronavirus variants, like Delta and Omicron, has changed the trajectory.
â€œWith the change in the modes of transmission, as the variants have emerged – I call it a parade of variants – we are now seeing much more extensive transmission and a much more uniform spread globally. This makes declaring the end of the pandemic more difficult, â€said Dr Monto.
â€œBecause the whole pattern of propagation has changed, and there may still be pockets that haven’t really gone through the kind of waves the rest of the world has gone through. “
Dr Monto and other public health leaders predict that in the future the world could follow the spread of SARS-CoV-2, the coronavirus that causes COVID-19, in the same way as surveillance of seasonal flu.
â€œWe don’t know if we’re going to see this kind of seasonal pattern with SARS-CoV-2, but it reminds us that most of our respiratory viruses start to behave like seasonal events,â€ Dr Monto said.
â€œThere is precedent for a very seasonal pattern for some of the coronaviruses that have infected people,â€ he added.
â€œIf SARS-CoV-2 starts behaving like this, we don’t know, but at least it gives us a scenario that it could start behaving like this. “
As Dr Monto said, we have to ‘wait and see and hold our breath’ to find out what an endemic phase of the coronavirus might look like.
Endemic means that a disease has a constant presence in a population but does not affect an alarming number of people, as is typically seen in a pandemic.
Even in early 2020, as the pandemic only intensified, World Health Organization officials predicted that the new coronavirus “could become another endemic virus in our communities” and never go away.
â€œWhen you think of pandemics you are in the pandemic phase, then you have a deceleration phase, then you have a control phase, then hopefully you will have elimination and maybe eradicationâ€, Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the U.S. Senate Committee on Health, Education, Work and Pensions at a hearing in November.
“What we hope to achieve is a level so low that even if it is not completely eliminated, it does not have a major impact on public health or on the way we lead our lives,” said the Dr Fauci.
â€œSo if we get more people around the world vaccinated and more people vaccinated now, hopefully within a reasonable timeframe, we’ll get to this point where there can sometimes be ups and downs in the background, but it will not dominate us. it’s working right now.
Even as COVID-19 cases reach new heights, federal health officials have been considering how to measure the end of the pandemic and continue to track the coronavirus once it becomes endemic.
To move from a pandemic to an endemic, the nation must develop immunity to the coronavirus – which means many more people need to be vaccinated, Dr. Philip Landrigan, a pediatrician and epidemiologist at Boston College, told CNN in November. .
With some still refusing to be vaccinated against COVID-19 and some refusing to wear masks, the transition could take longer.
About 91% of Australians over 16 have received two doses of the vaccine. About 94 percent received their first jab.
Dr Landrigan, who worked at the CDC for 15 years, says a population needs more than 80, if not 90% immunity, either through infections or after being vaccinated.
To control the spread of the measles virus in the American population, for example, “we had to increase the immunity rate above 95%, and even then we had sporadic epidemics.”
“These outbreaks usually happen when you have a bunch of people in a particular place who are not immune and all of a sudden the virus is introduced because a traveler came in with the virus – and bang, you have 20 cases of. measles in a city, â€said Dr Landrigan.
â€œBut it’s not an epidemic. It is an epidemic against a background of almost no cases or scattered endemic cases. “
Health officials know the work needed to improve immunization rates.
The CDC recommends that almost everyone 6 months and older get a flu shot each year.
But during the 2019-20 flu season, only about half of those people – 51.8% – made it, according to the CDC.
The agency estimates that the flu caused an estimated 12,000 to 52,000 deaths each year between 2010 and 2020.
The coronavirus has killed more than 800,000 people in the United States so far.
Going forward, the battle to contain the virus each year could be a lot like the annual fight against the flu.
â€œWe’ve been thinking a lot about what an endemic phase looks like and what data we need to collect during that phase. Certainly right now we are collecting data on cases, hospitalizations, deaths, â€CDC director Dr. Rochelle Walensky said at the Senate committee hearing in November.
â€œThe question is: what will be our best measures in the future? And probably model it on the flu.
The CDC works with health departments, laboratories, hospitals, and healthcare providers to track diagnosed flu cases, determine which flu viruses are circulating, and measure the impact of those viruses on hospitalizations and deaths.
One idea is that when the coronavirus becomes endemic, a similar tracking system could be used to monitor the pathogen.
â€œWe could deal with the cases like we do with the seasonal flu, where we can say we know we’re going to see a number of cases in the winter season, and we can have the right staff, we can have the right ones. supplies are ready, and we’re ready to deal with them, as opposed to the surges we’ve been facing here, â€Dr. Stephen Parodi, national infectious disease manager for Kaiser Permanente, told CNN in November.
â€œI’m still on the phone talking about: what is our capacity in intensive care beds? What supply chains do we need to deliver patient care? Do we have enough medicine? ‘ “said Dr Parodi.
“We still have a lot of work to do to get to where we want to be, and I think we’re going to see that transition in the year 2022. But for some places, where there’s less immunity, it’s fine. be longer Course. “
Even the flu is unpredictable, and doctors have seen a lot of it over the years.
â€œWe know there are going to be cases,â€ Dr Monto said.
â€œWith the flu, we have already experienced influenza pandemics. So we usually know the way they behave. This is an evolving situation with a completely new pathogen.