Pandemics do eventually end, even if\u00a0omicron\u00a0is complicating the question of when this one will. But it won\u2019t be like flipping a light switch: The\u00a0world\u00a0will have to learn to coexist with a virus that\u2019s not going away.<\/p>\n\n\n\n
The ultra-contagious omicron mutant is pushing cases to all-time highs and causing chaos as an exhausted world struggles, again, to stem the spread. But this time, we\u2019re not starting from scratch.<\/p>\n\n\n\n
Vaccines\u00a0offer strong protection from serious illness, even if they don\u2019t always prevent a mild infection. Omicron doesn\u2019t appear to be as deadly as some earlier variants. And those who survive it will have some refreshed protection against other forms of the virus that still are circulating \u2014 and maybe the\u00a0next mutant\u00a0to emerge, too.<\/p>\n\n\n\n
The newest variant is a warning about what will continue to happen \u201cunless we really get serious about the endgame,\u201d said Dr. Albert Ko, an infectious disease specialist at the Yale School of Public Health.<\/p>\n\n\n\n
\u201cCertainly COVID will be with us forever,\u201d Ko added. \u201cWe\u2019re never going to be able to eradicate or eliminate COVID, so we have to identify our goals.\u201d<\/p>\n\n\n\n
At some point, the World Health Organization will determine when enough countries have tamped down their COVID-19 cases sufficiently \u2014 or at least, hospitalizations and deaths \u2014 to declare the pandemic officially over. Exactly what that threshold will be isn\u2019t clear.<\/p>\n\n\n\n
Even when that happens, some parts of the world still will struggle \u2014 especially low-income countries that lack enough vaccines or treatments \u2014 while others more easily transition to what scientists call an \u201cendemic\u201d state.<\/p>\n\n\n\n
They\u2019re fuzzy distinctions, said infectious disease expert Stephen Kissler of the Harvard T.H. Chan School of Public Health. He defines the endemic period as reaching \u201csome sort of acceptable steady state\u201d to deal with COVID-19.<\/p>\n\n\n\n
The omicron crisis shows we\u2019re not there yet but \u201cI do think we will reach a point where SARS-CoV-2 is endemic much like flu is endemic,\u201d he said.<\/p>\n\n\n\n
For comparison, COVID-19 has killed more than 800,000 Americans in two years while flu typically kills between 12,000 and 52,000 a year.<\/p>\n\n\n\n
Exactly how much continuing COVID-19 illness and death the world will put up with is largely a social question, not a scientific one.<\/p>\n\n\n\n
\u201cWe\u2019re not going to get to a point where it\u2019s 2019 again,\u201d said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. \u201cWe\u2019ve got to get people to think about risk tolerance.\u201d<\/p>\n\n\n\n
Dr. Anthony Fauci, the top U.S. infectious disease expert, is looking ahead to controlling the virus in a way \u201cthat does not disrupt society, that does not disrupt the economy.\u201d<\/p>\n\n\n\n
Already the U.S. is sending signals that it\u2019s on the road to whatever will become the new normal. The Biden administration says there are enough tools \u2014 vaccine boosters, new treatments and masking \u2014 to handle even the omicron threat without the shutdowns of the pandemic\u2019s earlier days. And the Centers for Disease Control and Prevention just reduced to five days the time that people with COVID-19 must stay in isolation so they don\u2019t sicken others, saying it\u2019s become clear they\u2019re most contagious early on.<\/p>\n\n\n\n
India offers a glimpse of what it\u2019s like to get to a stable level of COVID-19. Until recently, daily reported cases had remained below 10,000 for six months but only after a cost in lives \u201ctoo traumatic to calculate\u201d caused by the earlier delta variant, said Dr. T. Jacob John, former chief of virology at Christian Medical College in southern India.<\/p>\n\n\n\n
Omicron now is fueling a rise in cases again, and the country in January will roll out vaccine boosters for frontline workers. But John said other endemic diseases, such as flu and measles, periodically cause outbreaks and the coronavirus will continue to flare up every so often even after omicron passes through.<\/p>\n\n\n\n
Omicron is so hugely mutated that it is slipping past some of the protection of vaccinations or prior infection. But Dr. William Moss of Johns Hopkins Bloomberg School of Public Health expects \u201cthis virus will kind of max out\u201d in its ability to make such big evolutionary jumps. \u201cI don\u2019t see this as kind of an endless cycle of new variants.\u201d<\/p>\n\n\n\n
One possible future many experts see: In the post-pandemic period, the virus causes colds for some and more serious illness for others, depending on their overall health, vaccine status and prior infections. Mutations will continue and might eventually require boosters every so often that are updated to better match new variants.<\/p>\n\n\n\n
But human immune systems will continue to get better at recognizing and fighting back. Immunologist Ali Ellebedy at Washington University at St. Louis finds hope in the body\u2019s amazing ability to remember germs it\u2019s seen before and create multi-layer defenses.<\/p>\n\n\n\n
Memory B cells are one of those layers, cells that live for years in the bone marrow, ready to swing into action and produce more antibodies when needed. But first those memory cells get trained in immune system boot camps called germinal centers, learning to do more than just make copies of their original antibodies.<\/p>\n\n\n\n
In a new study, Ellebedy\u2019s team found Pfizer vaccinations rev up \u201cT helper cells\u201d that act as the drill sergeant in those training camps, driving production of more diverse and stronger antibodies that may work even if the virus changes again.<\/p>\n\n\n\n
Ellebedy said baseline population immunity has improved so much that even as breakthrough infections inevitably continue, there will be a drop in severe illnesses, hospitalizations and deaths \u2014 regardless of the next variant.<\/p>\n\n\n\n
\u201cWe are not the same population that we were in December of 2019,\u201d he said. \u201cIt\u2019s different ground now.\u201d<\/p>\n\n\n\n
Think of a wildfire tearing through a forest after a drought, he said. That was 2020. Now, even with omicron, \u201cit\u2019s not completely dry land,\u201d but wet enough \u201cthat made the fire harder to spread.\u201d<\/p>\n\n\n\n
He foresees a day when someone gets a coronavirus infection, stays home two to three days \u201cand then you move on. That hopefully will be the endgame.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
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