It will likely continue to fizzle and fade as it heads towards its third year, resurging with new variants and then waning in the face of vaccines, mitigation measures and human behavior. But even if the virus is never stamped out, immunity will improve and the world will eventually be able to live with Covid.
On that, experts generally agree. “The large majority of infectious disease specialists think, and have thought for many months, that SARS-CoV-2 is here to stay,” said Paul Hunter, professor in medicine at the University of East Anglia in the UK.
“Our grandchildren’s grandchildren will still be catching (the virus),” he said. But “Covid, the disease, will become part of our history as the infection morphs into just another cause of the common cold.”
There is, however, a far more pertinent question, the answer to which is frustratingly elusive: How long will it take to get there?
And that answer is not up to luck — it is, at least in large part, within our hands. Pandemics fade out of view as a result of human efforts like vaccine development, contact tracing, genomic analysis, containment measures and international cooperation. In short, the world has a toolkit to bring an end to the pandemic as quickly as possible.
The problem? Even after 20 months, those tools are not being put to best use. “This is the major issue: There was never a plan, (and) there still isn’t a plan at a global level,” said Andrea Taylor, assistant director of programs at the Duke Global Health Institute.
“We’re not good at dealing with global crises as a world — we don’t really have the infrastructure, or leadership, or accountability,” she added.
Some countries have fared better in the face of Covid than others. But to accelerate the endgame, countless experts — including Taylor — are calling for a new, global approach, particularly when it comes to vaccines, treatments and information sharing.
Such an effort is the best way to end the pandemic quickly, they say — and unless it happens, people in every corner of the world could still be living under a Covid cloud through 2022 and beyond.
“We knew ahead of time what would happen if we took this nationalistic approach, but we did it anyway,” Taylor said. “And we are now living with the consequences of that.”
The world’s key tool
If the world has an arsenal to help it end the pandemic, the most important weapon in it is an obvious one.
“The first tool that we have is the vaccine,” says Roberto Burioni, a professor of microbiology and virology at San Raffaele University in Milan, a high-profile commentator on Italy’s pandemic response.
The development of several vaccines, all highly effective in stopping severe disease and useful too in stemming transmission, was a world-first. The previous record to get a shot on the market was four years, but the Covid-19 pandemic ripped up all expectations and reset the gold standard in the field.
It is easy to see how crucial shots are to the concept of a Covid-19 endgame. “As more people get infected, vaccinated and reinfected, the severity of illness will gradually decline because of accumulating immunity — that is the theory,” Hunter said.
It is not enough to simply have a vaccine, though; it must be administered to as many people as possible, as many times as required.
Even in developed countries where the availability of shots is not an issue, gradually waning immunity, the transmissibility of new variants and pockets of vaccine skepticism have made clear that extremely high rates of coverage are needed to prevent waves of infections.
“What we should achieve is widespread immunization,” said Burioni. “One possible scenario is that, if we are able to vaccinate a huge majority of people, this virus will circulate but will not do much damage.”
As well as their continued efforts to encourage unvaccinated people to get a first dose, richer countries now have two main planks to their inoculation strategies: ensuring school-age children are vaccinated, and administering booster shots — as many as prove to be necessary to keep protection high.
“Vaccination of children could have a huge impact on the future,” Burioni said.
School-age vaccination rollouts are being ramped up in much of the world, and in the US, the Food and Drug Administration recently approved Pfizer’s vaccine for children aged 5 through 11.
And the UK announced a deal Thursday to purchase 114 million extra doses of the Pfizer jab for its 67 million citizens for 2022 and 2023. It is a move that many developed nations are expected to make as they prepare for a future where vaccines are administered on a semi-regular basis.
“We don’t know how many boosters we will need, but this is a problem of a logistic and an economic nature,” Burioni added.
That is the case, at least, in the world’s developed regions.
But the world has had ample evidence that the Covid-19 will remain a threat anywhere until it’s under control everywhere — and experts warn there is dramatic action needed to achieve that goal.
‘Feast or famine’
The emergence of the Omicron variant in sub-Saharan Africa, where vaccination rates are low, has underlined once more the importance of a strategy to vaccinate poorer nations.
The problem? There isn’t one, some experts warn.
“There was never a plan, and there still isn’t a plan, at a global level,” Taylor said. “It isn’t just pockets — huge swathes of the world have unacceptably low vaccine coverage.”
According to the World Health Organization (WHO), less than 8% of people in low-income countries have received at least one dose of the coronavirus vaccine. Meanwhile, 63.9% of people in high-income countries have received at least one shot, according to WHO.
In both the European Union and the United States, around 70% of people have received at least one shot, according to the European Centre for Disease Prevention and Control and the US Centers for Disease Control and Prevention (CDC).