"What Our Future Looks Like in a Post-Pandemic COV

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Experts say COVID-19 will likely continue to fade in the United States, but the disease probably will not disappear.
They expect COVID-19 could be similar to the influenza virus that re-emerges every year in a slightly different form.
They say there are still many unknowns about the novel coronavirus that causes COVID-19, including how often it will mutate.
Though the COVID-19 pandemic is starting to fade in the United States, it’s unlikely that the novel coronavirus is going away, at least for the near future.

As case rates drop and more people become vaccinated, COVID-19 will likely transition from a pandemic – the worldwide spread of a new disease – to an endemic phase, where the virus is always present in the population in some form, albeit under controllable levels, experts say.

“It’s likely that it will become endemic because people carry it without knowing or showing symptoms, and some people have diminished immunity that will continue to make them susceptible even post-vaccination,” said Gerald Commissiong, CEO of Todos Medical, Ltd., a COVID-19 screening and testing company.

“Combined with the likelihood of waning immunity and emerging variants, we should expect that COVID-19 is a virus that will be with us for the long haul,” Commissiong told Healthline.

What about herd immunity?
Herd immunity – the level at which enough of the population is vaccinated that the disease can no longer spread and fades away – may be elusive for COVID-19.

Many experts think the United States will need at least 70 percent of the population to be immunized to achieve herd immunity, although it’s not certain yet what level will need to be achieved.

“We don’t know really what the required level of herd immunity is to keep COVID-19 out of circulation,” said Dr. Susan Kline, MPH, an infectious disease physician with the University of Minnesota Medical School and M Health. “For some diseases, a much higher level of vaccination is required to keep the disease from breaking out, e.g., measles, where it is estimated that 95 percent of the herd must be vaccinated or immune to keep the disease under control.”

While measles is caused by a different virus from coronavirus, it’s telling that even this virus that sees high childhood vaccination rates still emerges occasionally among regional populations with lower vaccination rates.

A similar dynamic could likely emerge with COVID-19.

“We don’t need to look very far to see what happens when there are low vaccination rates in populations,” Dr. Beth Oller, a family medicine physician in Kansas, told Healthline. “Measles is still a common disease in many parts of the world. The [Centers for Disease Control and Prevention] reported 1,282 measles cases in 31 states in 2019. This was the greatest number of cases reported in the U.S. since measles was eliminated from the country in 2000, and we came close to losing our measles elimination status.”

Ultimately, this means people will need to be mindful of their behavior and should not expect a total return to pre-pandemic behavior.

Instead, experts say we should endeavor to continue to observe masking and physical distancing protocols in groups of unfamiliar people and take a cautious approach to mingle with larger groups.

“If people forgo these precautions, this threatens the delicate and shifting balance of the herd,” Dr. Elizabeth Wang, an infectious diseases physician at the University of Maryland St. Joseph Medical Center, told Healthline. “For example, if a person pre-vaccination used to only interact with one person on a daily basis, he now believes post-vaccination he can meet 10 people without masking. How many people he’s meeting changes the entire herd immunity equation. If his social behavior once again begins to promote the spread of the virus, a higher percentage (more than 70 percent) will now need to be vaccinated in order to achieve herd immunity.”

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COVID-19’s unique challenges
There’s still a lot of unknowns when it comes to how often COVID-19 might mutate and how frequently people might require booster shots of the vaccine, among other issues.

“Influenza is somewhat predictable in how it changes yearly, so yearly flu vaccines can be mostly predicted – and there are vaccines on the horizon for influenza that may not need to be given yearly,” Dr. Jill Foster, a pediatric infectious disease physician with the University of Minnesota Medical School and M Health Fairview, told Healthline. “COVID, however, has demonstrated remarkable ability to mutate and change how easily it spreads and how severe disease is.

“For a while, it will be a race of vaccine coverage for it against the variants. So far, we’ve been winning, but one bad variant that spreads easily, causes severe disease, and evades vaccine, and we’ll be set back by months,” she added.

Written by Christopher Curley on June 3, 2

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