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I sometimes think back to a phone call with a friend in the spring of 2020. Business was down and pundits were upbeat: it really seemed possible that in the middle of summer this would finally be over. The last couple of months, I said to my friend, will they seem, from a summer’s point of view, like a strange dream? When, in three months, the bars fill up and the mask factories close, what will we do with the memory of spring? What my friend said something like: who knows, hard to say. And then we talked about something else. And then the pandemic continued for another eighteen months. And now here we are, and it’s still the pandemic, and while things are infinitely better than they were a year ago, the point is, we still wear masks on the subway. So: when, exactly, can we really claim to have licked this thing? What measures, what facts on the ground, will determine when we can fully return to normal? For this week Giz asks, we contacted a number of experts to find out.
Associate Professor, Epidemiology, University of Michigan
The uncertainty is really too great to put a specific date on it, although it’s pretty clear that we still have a long way to go. As for how it ends, while I would love to see us hit ‘COVID zero’, at this point I would expect that we are heading towards endemic, probably seasonal, transmission where most of the people have been vaccinated or have some degree of immunity due to a previous infection and therefore infections tend to be less severe. This makes adherence to prevention strategies such as masking and vaccination (and expanding global access to vaccines!)
As for the criteria, I would expect the pandemic to be considered ‘over’ when cases, hospitalizations and deaths from Covid-19 are systematically reduced to relatively low and manageable levels. In terms of numbers, this will likely vary from country to country, but we could see something similar to what we would normally see from the flu, which causes around 12,000 to 61,000 deaths per year in the United States. (compared to 375,000 deaths caused by COVID-19 in the United States in 2020, and about 295,000 more to date in 2021).
It is important to emphasize that different places are likely to reach the end of the pandemic at different times (depending on access / uptake of vaccines, social distancing and other mitigation measures, etc.), and that even when the pandemic is ‘over’, we still have to grapple with many of its longer term effects, be it Long Covid, impacts on mental health, issues of misinformation and mistrust , or economic consequences.
Emergency physician and professor of public health at George Washington University, and author of Lifelines: a doctor’s journey in the fight for public health
I don’t think we as a society have defined what ending the pandemic would mean. Will it be “over” when there are no more cases of Covid-19? Will it be “over” when hospitalization rates are such that we no longer fear overloading our health care system? Will it be “over” when the number of deaths drops below a certain number? Either way, I think most people would agree that we are far from the threshold below which Covid-19, the worst public health crisis of our lives, is no longer a pressing concern. I don’t think we’re going to reach that level of stability anytime soon. Of course, this will not happen until young children are still eligible for the vaccine; nor when many people around the world, including the most vulnerable among us, do not have access to the vaccine. At some point, we’ll need to come to a new understanding of what it might mean for this pandemic to reach a steady state, where it’s no longer a priority in each of our decisions. But we are far from that point now.
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Principal investigator at the Johns Hopkins Center for Health Security with expertise in infectious diseases, intensive care (ICU) and emergency medicine
This pandemic will be over in a global sense when most countries around the world are able to treat Covid-19 like other respiratory viruses they face year after year. SARS-CoV2 is an efficiently spreading respiratory virus with a broad spectrum of symptoms that circulates in a host animal – it cannot be eliminated or eradicated. The goal is to suppress its ability to cause widespread levels of serious illness, hospitalization and death. This is best achieved by vaccinating those most at risk for complications so that cases are decoupled from hospitalizations, but there will still be a baseline of cases, deaths, and hospitalizations. Natural post-infection immunity also plays an important role, but this is not the optimal way to tame the virus. The pandemic will eventually transition to a state of endemicity and the post-pandemic world will be a world in which Covid-19 still exists but in a much more manageable setting.
Professor and President of Epidemiology at UC Berkeley
The honest answer is that no one can know for sure, partly because of the unknown future of variants that may escape vaccine-induced protection, and partly because it is not yet known when we will get vaccinated. a greater proportion of the world’s population. But the future is most likely one in which SARS-CoV-2 regularly circulates in the human population and becomes more of an endemic infection / disease, with perhaps a seasonal pattern to influenza. I think this scenario won’t be with us for at least 12-18 months.
Dean of the Milken Institute School of Public Health and Professor of Environmental and Occupational Health at George Washington University
The job of producing enough vaccine and putting it on everyone’s arms, while exceeding the virus’s ability to mutate, is not quick. I think it will take at least a year before the pandemic is over, and that is extremely optimistic. The inequalities involved in vaccine production and the degree of resistance we see to vaccination mean that it could be a few years before it actually ends.
It’s humiliating. In the first place, our knowledge of coronaviruses just wasn’t as good as it should have been. We didn’t predict how quickly this might change. During this time, our knowledge of human behavior was, as we are learning, imperfect. We did not anticipate the levels of miscommunication we would face, nor the lack of scientific knowledge. People know that some vaccines use mRNA, but if you don’t know enough about the genetics or the science involved, it can end up being scary rather than reassuring. People are starting to take a dip – “Well, what does that do to you? – without understanding how genetics work. It’s understandable to me that people have these worries or fears, but it leads to huge hesitation about vaccination. It’s a shame because science tells us that mRNA does not alter the DNA of the body in any way.
Then, of course, there is the problem of developing a vaccine for children, which has proven to be more daunting than I ever thought, as a pediatrician. The virus is still circulating among children, and that is keeping this pandemic alive, because as long as children are circulating the virus, we will see more breakthrough infections in the adults around them.
We will know this pandemic is over when we no longer see excessive death rates from Covid on a daily basis – around the world, not just in the United States. The only thing we know is that this pandemic will not be over until Covid is circulating somewhere in the world. This does not mean that we have to eliminate all cases. What we might end up with is a situation where – through population immunity, or a mutation, or (more likely) both – the virus ends up looking more like the common cold or the annual flu, where we certainly need to pay attention to it. , maybe as seasonal transmission every winter, and have to vaccinate people every year, but we don’t have these very high death rates anymore.
Have a question for Giz Asks? Write to us at [email protected].
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