Here’s How the Pandemic Finally Ends (Part 3, Politico)

 

“The years-long outlook: ‘They might get the sniffles’

“The world will probably live with Covid-19 forever, even after inoculation. ‘I think a lot of people seem to think that vaccines automatically eradicate viruses,’ says Rasmussen. ‘They don’t.’ To date, only two viruses have ever been officially eradicated. But many experts believe that, if vaccination rates are high enough, the Covid-19 of the future is going to be manageable, routine, just another virus that most Americans have some degree of immunity to. Some of that protection will come from natural infection and disease exposure; and some of it will come from vaccination. ‘It’s very likely that in a vaccinated population, [Covid-19] would do very little damage,’ says Krammer.

“If protection from vaccines is found to wane within a year or so, as some people fear, Americans might end up getting a yearly Covid-19 booster with their flu shot, which is what Landon predicts. Or, vaccines could get more durable over time. ‘The way we’ve seen other vaccines historically has been that you get proof of concept … that one can work and then you’ll get gradual improvements,’ says Kinch, who thinks we’ll see mediocre vaccines in the near future and a much better one in three to five years.

“There’s also been a lot of worry about how long immunity from disease lasts; some Covid-19 victims have already gotten reinfected with the virus, in at least one case severely. While the media will always seize on the most unusual, most sensational medical cases, many infectious disease specialists believe that, even if a person’s immunity wanes after infection—as it does for other coronaviruses—future infections, on average, are probably going to be weaker than the first.

“In fact, getting exposed to Covid-19 will be a crucial part of developing protection. ‘Eventually, you’ll have enough people who have … built up a little bit of immunity, whether that’s through vaccine or maybe you’ve been infected once. And then the next time you get exposed, it actually serves as a natural boosting event. It boosts your immunity instead of harms you,’ says Mina.

“‘Let’s say somebody turns 60 in five years,’ he games out. ‘They’re 55 years old now. They get a vaccine next year and maybe they get an exposure. By the time they’re 60, they might have had two or three exposures. And so they won’t be as at risk anymore when they’re 60 because they’ve now gained enough immune memory.’

“Krammer envisions that in the long term, people will get vaccinated or infected when they’re kids, building up more immunity through revaccination and re-exposure. ‘And by the time they are really in the high-risk group, which starts at 50, … they probably are not going to have a severe disease anymore, but they might get the sniffles,’ he says.

“At the same time, experts are crossing their fingers that treatments and therapies are going to get better, so that those few who do end up with severe cases are vastly more likely to live. An antiviral drug—which weakens a virus if you take it early enough—would be a game changer, says Landon, ‘but that’s some years away.’ And it will be important for scientists to keep delivering new drugs and treatments. ‘Maybe remdesivir plus convalescent plasma plus two new drugs in the future and rolling someone on their stomach might do the job until … the virus naturally develops resistance to one of them and now you’ve got to substitute in a new drug,’ says Kinch.

“Some believe there will continue to be deaths, though, as there are with flu every year. But how many deaths might just depend on what society is willing to passively accept. Last year, in the United States, the flu sent 740,000 people to the hospital and killed 62,000. ‘We’re comfortable with that; we let that happen,’ says Offit. ‘We go to sporting events, where it’s very possible we could catch the flu.’ Conversely, many people in Japan wear masks during flu season. Covid-19 will slowly but surely peter out, he says. ‘And then it’s a matter of what level of disease and death you’re comfortable with.’

“Perhaps, faced with this calculation, large portions of American society will decide not to follow the inexorable track back to ‘normal.’ Perhaps masks will become the norm in winter, when coronaviruses spread more readily, and handshakes won’t return. ‘I think there’s going to be a fundamental fear,’ says Kinch. ‘My grandparents lived through the Depression. And for the rest of their lives, even when they had money and some degree of financial security, they (to a degree) acted like they were living through the Depression. And that’s not meant [to be] gloom and doom,’ he adds. ‘The new normal will be fine, and we’ll get through it just fine. But I don’t think we’ll go back to January in my lifetime’” (Politico).

Elizabeth Ralph is deputy editor at Politico Magazine.