As summer approaches, the United States is in the midst of its first really hopeful moment in the COVID-19 pandemic: Infections continue to plummet, hospitalizations are down, and roughly half the adult population has received at least one vaccine dose. Adolescents will soon also be able to roll up their sleeves and get immunized as well.
Whether all of that means the end of the pandemic is in sight is the big question. Many experts now believe herd immunity is not possible. However, a return to relative normalcy is.
“We may not be able to completely eliminate this virus, just given how many millions and millions of people around the globe are infected,” said Jonathan Grein, director of Hospital Epidemiology at Cedars-Sinai in Los Angeles. But, he said, we can reach a point where the severity of the disease is limited enough that people can engage in their normal lives with minimal risk.
So what will it take for us to get there?
First and foremost, widespread vaccination — both here in the U.S. and abroad. COVID-19 vaccines are the most important tool we have in bringing the pandemic to an end, but they’re not the only one. Here are five other factors that will help put the pandemic in our rearview mirror:
1. A clearer understanding of how long immunity lasts
Based on the best available data, experts believe immunity from the COVID-19 vaccines lasts for at least six months — and likely longer. But how long exactly? No one knows. Figuring that out will be critical to keeping the pandemic under control long-term.
“We need information on how long these vaccines are going to remain effective,” Grein said. “And if and when we need to get booster shots.”
Several studies are underway to find answers to these questions.
2. Expanded genetic sequencing
For the past few months, the global vaccination effort has been in a race against emerging variants that will shape the pandemic moving forward. So keeping a close eye on new variants is critical, particularly those that could make our current vaccines less effective.
The way to do that is through genetic sequencing to monitor how SARS-CoV-2 (the virus that causes COVID-19) changes over time as it transmits from person to person.
“Initially in the United States, our capacity to do widespread surveillance for variant strains was very limited,” Grein noted. However, it has improved.
He hopes that moving forward, genetic samples from people who test positive for COVID-19 will be frequently sent for sequencing to understand if there are any mutations or changes that may have an impact on immunity. “Part of that is also doing more targeted surveillance and identifying people that may have a ‘breakthrough’ infection who’ve been vaccinated,” Grein said.
Even though COVID-19 breakthrough cases among fully vaccinated people are rare, closely tracking those cases would help alert researchers and public health officials quickly if there is a more concerning variant on the rise.
3: Fast (and at-home!) testing
Maintaining access to fast and reliable COVID-19 testing in parts of the U.S. that already have it, as well as ramping up access in areas where it still lags behind, is crucial, according to Grein.
Rapid at-home tests would be helpful as well, said Nancy Bennett, director of the Center for Community Health and Prevention at the University of Rochester School of Medicine. She said they could help people “self-manage their illnesses.”
At this point, however, at-home testing kits have limitations, and tests are generally best when administered by a trained health care professional who can really get a good swab.
4. Expanded treatment options
Even with hospitalizations and deaths dropping, “we can’t forget about developing therapeutics and ways of managing disease,” Grein said — particularly if COVID-19 is something the world is likely to live with forever. It is essential that there be good tools to help people who get really sick.
The Food and Drug Administration has approved one drug, remdesivir, specifically to treat COVID-19. And clinicians now understand much more about how to keep the virus from spreading throughout the body of infected individuals through the use of antiviral medications.
But research into additional treatment options, which is ongoing, is necessary.
“We have more therapeutic options available to us now than we did at the beginning of the pandemic,” Grein said. “But we’re still pretty limited.”
5. A change in our culture’s approach to illness.
As the pandemic moves into its next phase, public health guidelines about when and where Americans have to mask up, how they can socialize and what they should know about travel are all changing.
The goal with all of these recommendations is to build more nuance back into our preventive strategies, so Americans continue to be vigilant in certain high-risk situations but ease up in others.
“One of the key strategies to controlling this pandemic is maintaining those infection prevention measures, particularly in high-risk settings,” Grein said. That means masking up, maintaining social distance and improving ventilation to the extent it’s possible in crowded indoor settings. But in outdoor — and now, most indoor — settings, the Centers for Disease Control and Prevention says it’s OK for fully vaccinated Americans to pretty much drop the masks altogether.
Broader societal shifts will be equally important in bringing the pandemic to an end, though harder to track and measure.
“Thinking about infection control — hand-washing, not sharing drinks, etc. — will be important forever,” Bennett said.
“We will also need to change our behaviors and our employment-related expectations and regulations to support everyone to stay home when they are sick,” she added. “Currently many Americans have no sick time coverage ― if they stay home, they do not get paid. We push kids and college students to attend class when they are sick. This is untenable when we are trying to prevent transmission of an infectious disease.”
These measures and changes may not be able to stop the coronavirus altogether, but they should help Americans get back to a pretty normal life when layered on top of widespread vaccination.
“I think it is likely that this virus will be with us forever, or certainly the foreseeable future,” Bennett said, adding that it’ll probably become endemic and be similar to the flu. “However at this time, COVID-19 is considerably more severe than influenza — and we must get the transmission down to very low levels to return to our lives.”
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.