After so long, what would a possible end to the pandemic look like? For the United States, top experts formulate scenarios for such a happy event. How likely is this to happen and how close is that end?
By November 2021, most Americans will have received two doses of the vaccine, which, while not a miracle in terms of effectiveness, will be fought in most cases.
Meanwhile, people continue to wear masks and avoid large gatherings, and Covid-19 figures are steadily declining, of course, after a series of surges at the beginning of the year.
Eventually, as more and more people develop immunity through exposure and vaccination, and as treatments become more effective, Covid-19 retreats to a common disease that people experience every winter.
“It will take two things to keep this virus under control: hygiene measures and a vaccine. And you can’t have one without the other, ”says Paul Offit, director of the Center for Infectious Disease and Physician Education at the Children’s Infectious Diseases Division at Philadelphia Children’s Hospital.
This is what the future looks like, transmitted by Politico, presented based on interviews with 11 high-level experts who think about the evolution of these microscopic particles SARS-CoV-2 every day.
The end of the pandemic will be an evolution, not a revolution. The vaccine is just one of the tools
All this evolution contradicts the hypothesis that underlies Trump’s many proclamations: that life will return to normal immediately after the administration of a vaccine.
“I don’t see the end of this pandemic as a definite point: this is the day, the pandemic is over today,” explains virologist Angela Rasmussen. “I see this as a process that will take a long time, maybe even years.”
Experts’ estimates of the chronology vary, but it seems that there is some agreement that the virus could be in decline and under control by the second half of 2021 and that the company could return to “normal” pre-Covid within two years.
“I said November 2021,” predicts Zeke Emanuel, a former Obama adviser and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania.
“I think we will have enough collective immunity to have a steady decline.”
Herd immunity is the point at which so many people are immune that the virus can no longer spread widely.
The exact timing, of course, is uncertain – an evasive future based on a number of known unknowns, such as how many people will continue to wear masks and keep their social distance or whether Covid-19 rapid tests will be widely available and properly conducted.
And then we can talk about what epidemiologist Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota, calls “the word of a trillion dollars a day with this disease”: immunity. How long will, on average, immunity to natural infection and vaccine last?
“We can get herd immunity with vaccination,” he says. “The question is how long we can stay there. I mean, if we get to, say, 75% or 80% immune projection, would the numbers stay that way if we didn’t do something else? ”.
Perhaps this is the most important thing to understand about the pandemic right now: although experts can make the best assumptions, there is no certainty about the future of Covid-19.
Before the vaccine: “Masks and distance”
The pandemic is far from over. It’s not even in decline. Cases of Covid-19 are on the rise in many states, and in just one day this week, the United States has seen more than 40,000 new cases and more than 1,000 deaths.
Experts do not expect the figures to improve much as people move indoors for fall and winter.
The key, then, to making sure society finds a degree of normalcy in the meantime, continues to be “masks and distance,” says Emily Landon, chief infectious disease epidemiologist at the University of Chicago Medicine. This means avoiding places like restaurants where you can’t wear a mask indoors.
“Masks and distance really work,” she says.
The vaccine arrives: Chaos is expected
While many experts see value in strategies such as extended testing, most agree that finding a functional vaccine will be the biggest step on the road to normalcy.
And, given the urgency around the world, one or more vaccine approvals are likely to take place at the end of the year or early next year.
“At best, we get a few vaccines that work by December,” says Landon. It could take longer. Larry Corey, who coordinates clinical trials with US-funded vaccines, estimates that the first Phase III results in the US will not be available until February.
Getting a vaccine for the American people is a problem – and a colossal one. Pharmaceutical companies and the US government are expected to produce, distribute and administer approximately 660 million doses of vaccine next year, as the most distant vaccines in the studies require two doses per person. “A little chaos” is expected.
According to the US government, hundreds of thousands of doses have already been taken. But recent guidance from the Centers for Disease Control and Prevention indicates that only a few million doses of two top-notch vaccines – believed to be candidates by Moderna and Pfizer – will be available in the beginning to be offered to essential workers and more vulnerable in society.
Many experts, including the CDC director, predict that vaccines may be widely available as early as late spring or summer.
After vaccination: “We have to wait to prove it works”
It’s 2021 and you’ve just received the two doses. What happens next will largely depend on two factors: how effective the vaccine is and how many people receive it.
The goal is for the vaccine to be effective and widespread enough for the population to reach the herd immunity threshold – the point at which, theoretically, people can safely take off their masks and participate in large events.
Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, went through the calculations: “The formula would say that about two-thirds of the population should be vaccinated if the vaccine is 75% effective against the spread of the virus.”
If the vaccine is less effective than that, a larger percentage of the population needs to be vaccinated to get closer to immunity.
Experts are not optimistic that these first-generation vaccines will be extremely effective in preventing transmission.
“The likelihood of us hitting ourselves for the first time is very low,” says Michael Kinch, director of the Centers for Research in Biotechnology Innovation and Drug Discovery at the University of Washington in St. Louis. Louis.
“If you actually immunize yourself above this immunity threshold, then it means you can get back to business as usual,” says Cobey. “But this assumes that you have the vaccine distributed fairly evenly among the population. And vaccines are almost never evenly distributed. “
But this is not a cause for panic.
Any vaccine will be very helpful in keeping the pandemic under control.
Fifty percent effectiveness is not such a small number. But it will not allow people to go to the theater or relax immediately in their favorite bar.
“I’m not sure people understand that,” says Offit. “What worries me in this regard is that people would think: Super. I’m vaccinated. I’m fine. I can get involved in a high-risk activity. And that would immediately bring us back to where we are. ”
If rates go down, says Landon, “then say, OK, I think we can allow people to eat inside restaurants. And then the rates stay low, even if you invited people back to restaurants. “
It will probably be years before the pandemic is set aside
This process will take much longer internationally. A coalition of international organizations – GAVI, the Center for the Preparation of the Epidemic and WHO – aim to purchase and deliver 2 billion vaccines to the world’s most vulnerable by 2021.
But Oxfam recently warned that 61% of the global population will not have the vaccine. until at least 2022. Rich countries do not facilitate equitable access: according to Oxfam, rich countries, which make up 13% of the world’s population, have already booked more than half of the top candidates.
Emanuel anticipates that countries will open international travel as they receive and implement vaccines, but that “it will take a few or three years to truly achieve a full return to pre-Covid normalcy” in international travel.
Perspective over the years
The world will probably live with Covid-19 forever, even after immunization. “I think a lot of people seem to think that vaccines automatically eradicate viruses,” says Rasmussen. “I don’t.” So far, only two viruses have been officially eradicated.
But many experts believe that if vaccination rates are high enough, Covid-19 of the future will be easy to manage, routinely, just another virus to which most people will have some degree of immunity.
Part of this protection will come from natural infection and exposure to disease; and some of them will come from vaccination.
Perhaps, in the face of this calculation, large portions of American society will decide not to follow the inexorable path back to “normal.” Maybe masks will become the norm in winter, when coronaviruses spread more easily.