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<\/a><\/p>\n\u201cThe virus keeps raising that bar for us every few months,\u201d said Akiko Iwasaki, a professor of epidemiology at Yale School of Medicine. \u201cWhen we were celebrating the amazing effectiveness of booster shots against the delta variant, the bar was already being raised by omicron.\u201d<\/p>\n
\u201cIt seems like we are constantly trying to catch up with the virus,\u201d she said.<\/p>\n
It\u2019s sobering for a world that\u2019s been trying to move on from the virus with a new intensity in recent months. But the outlook isn\u2019t all gloom. Anti-viral medicines are hitting the market, vaccines are more readily available and tests that can be self-administered in minutes are now easy and cheap to obtain in many places.<\/p>\n
Nevertheless, scientists agree it\u2019s too soon to assume the situation is under control.<\/p>\n
In six months\u2019 time, many richer countries will have made the transition from pandemic to endemic. But that doesn\u2019t mean masks will be a thing of the past. We\u2019ll need to grapple with our approach to booster shots, as well as the pandemic\u2019s economic and political scars. There\u2019s also the shadow of long Covid.<\/p>\n
Is Covid-19 Here to Stay?<\/strong><\/p>\n \u201cThere is a lot of happy talk that goes along the lines that omicron is a mild virus and it\u2019s effectively functioning as an attenuated live vaccine that\u2019s going to create massive herd immunity across the globe,\u201d said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston.<\/p>\n \u201cThat\u2019s flawed for a number of reasons.\u201d<\/p>\n Experts now believe that the virus will never go away entirely, and instead will continue to evolve to create new waves of infection. Mutations are possible every time the pathogen replicates, so surging caseloads put everyone in danger.<\/p>\n The sheer size of the current outbreak means more hospitalizations, deaths and virus mutations are all but inevitable. Many people who are infected aren\u2019t making it into the official statistics, either because a home test result isn\u2019t formally recorded or because the infected person never gets tested at all.<\/p>\n Trevor Bedford, an epidemiologist at Fred Hutchinson Cancer Research Center in Seattle known for detecting early Covid cases and tracking the outbreak globally, estimates that only about 20% to 25% of omicron infections in the US get reported.<\/p>\n With daily cases peaking at an average of more than 800,000 in mid-January, the number of underlying infections may have exceeded 3 million a day \u2014 or nearly 1% of the US population, Bedford estimates. Since it takes five to 10 days to recover, as much as 10% of people in the country may have been infected at any one time.<\/p>\n He\u2019s not alone in projecting astronomical numbers. At the current infection rate, computer modelling indicates more than half of Europe will have contracted omicron by mid-March, according to Hans Kluge, a regional director for the World Health Organization.<\/p>\n Meanwhile, a sub-variant known as BA.2 is spreading rapidly in South Africa. It appears to be even more transmissible than the original strain and may cause a second surge in the current wave, one of the country\u2019s top scientists said.<\/p>\n And just because you\u2019ve already had the virus doesn\u2019t mean you won\u2019t get re-infected, as Covid doesn\u2019t confer lasting immunity.<\/p>\n New evidence suggests that delta infections didn\u2019t help avert omicron, even in vaccinated people. That would explain why places like the U.K. and South Africa experienced such significant outbreaks even after being decimated by delta. Reinfection is also substantially more common with omicron than previous variants.<\/p>\n \u201cWith omicron, because it has more of an upper respiratory component, it\u2019s even less likely to result in durable immunity\u201d than previous variants, Hotez said. \u201cOn that basis, it\u2019s incorrect thinking to believe that this is somehow going to be the end of the pandemic.\u201d<\/p>\n Preparing for New Variants<\/strong><\/p>\n Preparing for the next Covid strains is therefore vital.<\/p>\n \u201cAs long as there are areas of the world where the virus could be evolving, and new mutants arriving, we all will be susceptible to these new variants,\u201d said Glenda Gray, chief executive officer of the South African Medical Research Council.<\/p>\n Lockdowns and travel curbs aren\u2019t going away, even if they are becoming less restrictive on the whole.<\/p>\n \u201cThe things that will matter there are whether we are able to respond when there is a local surge,\u201d said Mark McClellan, former director of the US Food and Drug Administration and director of the Duke-Margolis Center for Health Policy. \u201cMaybe going back to putting on more masks or being a little bit more cautious about distancing.\u201d<\/p>\n Inoculation is still the world\u2019s primary line of defense against Covid. More than 62% of people around the globe have gotten at least one dose, with overall rates in wealthy countries vastly higher than in developing ones. At the current pace, it will take another five months until 75% of the world\u2019s population has received their first shot.<\/p>\n Uneven Access to Vaccines<\/strong><\/p>\n But studies show one or two injections don\u2019t ward off the pathogen. The best bet at this point is a booster shot, which triggers the production of neutralizing antibodies and a deeper immune response.<\/p>\n People inoculated with more traditional inactivated vaccines, such as the widely used shots from China\u2019s Sinovac Biotech Ltd., will need at least two boosters \u2013 preferably with different vaccines \u2013 to control the virus, Yale\u2019s Iwasaki said.<\/p>\n In the next six months, more countries will contend with whether to roll out a fourth shot. Israel has started and the U.S. backs them for vulnerable people, but India is pushing back and refusing to \u201cblindly follow\u201d other countries.<\/p>\n How we\u2019ll know when the Covid-19 crisis is over<\/strong><\/p>\n While the virus won\u2019t be overwhelming hospitals and triggering restrictions forever, it\u2019s still unclear when \u2014 or how \u2014 it will become safe to leave on the back burner.<\/p>\n Experts Bloomberg News spoke to agree that in developed countries including the US and much of Europe, the virus could be well in hand by mid-2022. There will be better access to pills such as Pfizer Inc.\u2019s Paxlovid, rapid antigen tests will be more readily available and people will have become accustomed to the idea that Covid is here to stay.<\/p>\n Robert Wachter, chair of medicine at the University of California, San Francisco, puts the odds at 10-to-one that by the end of February, most parts of the US and the developed world will no longer be struggling with severe outbreaks. Vaccinations and new treatments, widespread testing and immunity as a result of previous infections are helping. Countries like Denmark are getting rid of all pandemic restrictions despite ongoing outbreaks.<\/p>\n \u201cThat is a world that feels fundamentally different from the world of the last two years,\u201d he said. \u201cWe get to come back to something resembling normal.\u201d<\/p>\n \u201cI don\u2019t think it\u2019s irrational for politicians to embrace that, for policies to reflect that.\u201d<\/p>\n When Will the Pandemic End?<\/strong><\/p>\n Elsewhere in the world, the pandemic will be far from over.<\/p>\n The threat of new variants is highest in less wealthy countries, particularly those where immune conditions are more common. The delta mutation was first identified in India while omicron emerged in southern Africa, apparently during a chronic Covid infection in an immunocompromised HIV patient.<\/p>\n \u201cAs long as we refuse to vaccinate the world, we will continue to see new waves,\u201d Hotez said. \u201cWe are going to continue to have pretty dangerous variants coming out of low- and middle-income countries. That\u2019s where the battleground is.\u201d<\/p>\n Amesh Adalja, senior scholar at the Johns Hopkins University Center for Health Security in Baltimore, sees the pandemic continuing into 2023 for parts of the developing world.<\/p>\n \u201cFor me, the transition from pandemic to endemic is when you\u2019re not worried about hospitals getting crushed,\u201d he said. \u201cThat will happen in most Western countries in 2022, and it will take a little bit longer for the rest of the world.\u201d<\/p>\n In parts of Asia, public health officials aren\u2019t even willing to consider calling the end of the pandemic.<\/p>\n While most of the world now seeks to live alongside Covid, China and Hong Kong are still trying to eliminate it. After spending much of 2021 virtually virus-free, both places are currently dealing with outbreaks.<\/p>\n \u201cWe do not possess the prerequisites for living with the virus because the vaccination rate is not good, especially amongst the elderly,\u201d said Hong Kong Chief Executive Carrie Lam. \u201cI could not stand seeing a lot of old people dying in my hospitals.\u201d<\/p>\n Harsh virus restrictions including border closures and quarantines may well be in place until the end of 2022, though the higher contagiousness of the new variants is making that harder to maintain, as Hong Kong\u2019s current challenges show. Walling out the virus completely, like a swathe of countries did early in the pandemic, may no longer be possible.<\/p>\n With so much of the world still mired in the pandemic, virus-related dislocations will continue everywhere.<\/p>\n The immense strain on global supply chains is only worsened by workers sickened or forced to quarantine as a result of omicron. The problem is especially acute in Asia, where much of the world’s manufacturing takes place, and means global concerns about soaring consumer prices are unlikely to disappear any time soon. China\u2019s increasingly vehement moves to keep quashing Covid are also becoming disruptive.<\/p>\n With many countries only partially open to visitors, international travel is still very far from what we considered normal in 2019. Hospitals and health care systems around the world face a long, slow recovery after two years of monumental pressure.<\/p>\n