The novel coronavirus may never be eradicated, but two epidemiologists in the Dornsife School of Public Health author a guest post that gives us hope.
Many scientists believe that SARS-CoV-2, the virus responsible for COVID-19, will become “endemic.” It will seasonally circulate in a similar fashion to the other common respiratory viruses, such as those that cause the common cold or flu. If this bears out, there will not be a true end to the pandemic (with accompanying ticker tape parade down Broad Street), but a gradual transition, to an illness that we will have to live with.
This should not come as a complete surprise, as this is the world we have always lived in. History offers many examples of scourges that have become endemic in human populations. Flu is one example. After the last pandemic, in 2009 with the H1N1 strain, the virus became seasonal. Some seasons it is more prevalent than others and our flu vaccines are adjusted accordingly.
In 2016, Zika virus became globally infamous. While it never achieved pandemic status (it was a “public health emergency of international concern”), the massive scale-up in resources and surveillance enabled its long-term management. Likewise, HIV first emerged in the U.S. in the late 1970s and early 1980s, with the recognition of the disease it causes, AIDS. Now we have a robust surveillance program to identify new cases of HIV and many therapeutic medicines that are highly effective.
The most pressing challenge is the need for ample guidance and re-assurance for living alongside SARS-CoV-2, locally and nationally. Public health and the health care system in Philadelphia and elsewhere must address the fear and anxiety that has accompanied the pandemic response. This is where our colleagues in fields such as mental health, health communication, government, and the media are vital. If the public has become institutionalized to a pandemic mindset of our own doing, we share in the responsibility to undo and mitigate the collateral damage that has occurred. As mentioned earlier, lessons abound from diseases that have captured worldwide attention that we now live with: Zika, HIV, H1N1 influenza.
What will this look like? There will be ongoing refinement of therapies, including vaccination, as well as continued tracking of cases. Health care workers have gotten much better at treating and managing COVID-19. Mortality is down, despite cases going up. We also have a highly effective vaccination, one of the true marvels of the pandemic, which is available to everyone aged 16 and older, with even younger people likely eligible soon.
Yet there are many unknowns. How many people will choose to vaccinate? How effective are the vaccines in the long run? How often will we need “booster” shots? Will we see an ebb and flow of COVID-19 in the colder, dryer months, or will it be with us year-round? We do not know the answers to these important questions, but scientists around the globe are looking for answers.
The good news is we are not flying blind. Public health has decades of experience conducting surveillance programs for other infectious diseases. We are all familiar with the seasonal flu vaccination drives. Perhaps COVID-19 will follow a similar model — potentially being combined with the flu shot as a single respiratory illness prophylactic.
Should these predictions bear out, and COVID-19 proves to be another infectious disease that we live alongside, we all share in the responsibility for managing the risk moving forward. Tried and true approaches, including washing your hands and staying home when you are sick, go a long way toward reducing infectious disease transmission. While vaccine delivery is still ramping up, it is crucial to continue to reduce the number of new infections. The fewer infected people there are, the less likely mutations will arise that will further set us back.
Eventually, we can return to normal without indefinite social distancing and limitations on gathering, shuttering of businesses and perpetual masking. There is no absolute date when this will happen; but we are closer today than we were yesterday, thanks to vaccination and immunity.
This summer it will be tempting to conclude that the pandemic is behind us. This likely will not be the case. Rather, we need to recognize COVID-19 is a risk that we will have to live with, but fortunately, it is one we are all getting better at managing.
Neal D. Goldstein, PhD, is an assistant research professor and Michael LeVasseur, PhD, is an assistant teaching professor, and both are infectious disease epidemiologists and faculty members in the Dornsife School of Public Health.
Media interested in speaking with Goldstein or LeVasseur should contact Greg Richter, News Manager, at firstname.lastname@example.org or 215-895-2614.