Some scientists believe that the current wave of COVID-19 has peaked and that the pandemic, at least in the US, will ease into the winter months. But then what? Will the virus resurface next year?
STEVE INSKEEP, HOST:
What is the end game for COVID? Looks like we’re past the worst delta wave. Case levels are less than half what they were a few months ago. We reported on this program on projections that the number of new cases could continue to decline throughout the winter. But that’s just a projection, of course, and it doesn’t answer how the pandemic would end completely, if it ever does.
NPR global health correspondent Michaeleen Doucleff has asked, what happens next? Michael, good morning.
MICHAELEEN DOUCLEFF, BYLINE: Good morning, Steve.
INSKEEP: Let me start by asking if we can hope for a time when the coronavirus is effectively wiped out from the world as polio and smallpox are nearly eliminated?
DOUCLEFF: So that works if the virus is very stable over time – right? – its genetic sequence doesn’t mutate much like the measles. So if you get a vaccine, it can protect you for a long time. But not all viruses are like that. The flu, for example, mutates very quickly. And those mutations can reduce the effectiveness of the vaccine. And that is one of the reasons why you can get the flu again and again. So it really depends on how quickly SARS-CoV-2 mutates.
INSKEEP: Okay. How fast does that happen?
DOUCLEFF: Well, in the beginning, during the first year of the pandemic, things were looking good. It mutates very slowly. And then last December, right around the holidays – remember? – then everything changed.
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BILL WOLFF: This is NBC Nightly News.
LESTER HOLT: Tonight’s race to stop a new, highly contagious strain of coronavirus.
UNKNOWN ANCHOR #1: Tonight, London locked down – scientists there believe this variant…
UNKNOWN ANCHOR #2: More countries are detecting this new, highly contagious strain of the disease.
INSKEEP: You know, when this happened, when the news broke, it intuitively made sense to me because I knew it had infected so many millions of people that the virus had a lot of opportunities to evolve.
DOUCLEFF: Yes, that’s right. In South Africa, the UK, Brazil, it suddenly seemed that SARS-CoV-2 was mutating a lot. Recently, scientists at the University of Washington developed a new method to measure how quickly it mutates or evolves. Katie Kistler was part of that study. And she says she was amazed at how quickly this virus is changing.
KATIE KISTLER: By the end of 2020, that evolution is really starting to accelerate to a rate that’s remarkably high right now — about four times higher for SARS-CoV-2 than for seasonal flu.
DOUCLEFF: And don’t forget that the flu changes so quickly that people can be vulnerable to it every year. So right now SARS-CoV-2 changes four times faster than the flu.
INSKEEP: Wow. Does this mean that COVID will just keep coming back and back and back in different versions like the flu does?
DOUCLEFF: That is the leading hypothesis at the moment. I talked about it with Dr. Abraar Karan of Stanford University. He is an infectious disease specialist. He says exposure to this virus will essentially be unavoidable.
ABRAAR KARAN: So I think everyone will be exposed to the SARS-CoV-2 virus. It’s a matter of when that will be. And another question is whether you are exposed if you are fully vaccinated or if you are not vaccinated.
DOUCLEFF: So now, Steve, this is the key. The SARS-CoV-2 virus will probably never go away. But as Karan pointed out to me, COVID the disease, the extreme illness that puts a lot of people in the hospital, that could go away. And here’s why. COVID is caused by a type of coronavirus. And the US has had many coronavirus outbreaks in the past. I’m talking about massive outbreaks, year after year, for decades. And people barely noticed them. I probably didn’t notice, did you?
INSKEEP: I didn’t, no.
DOUCLEFF: No. And that’s because these other coronaviruses usually cause only a mild cold. So there are four. And every year, one or more of them move across the country — through schools, churches, offices — and make people sick.
Rachel Eguia is a biologist at the Fred Hutchinson Cancer Research Center. She says you’ve probably caught these viruses a dozen times in your life.
RACHEL EGUIA: It is well known that you can get re-infected with them every few years. And so we wondered, is that the same story for, you know, this new coronavirus, this SARS-CoV-2?
INSKEEP: I think I’m starting to understand this. The realistic hope here is not that the virus will disappear from Earth, but that we will mitigate its effects.
DOUCLEFF: Yes. That’s exactly right. And some scientists are beginning to think that, over time, COVID could turn into something akin to a kind of disease like these other coronaviruses — a seasonal cold or a flu-like illness.
Rustom Antia is one of the scientists who thinks so. He is a computational biologist at Emory University. And for a year and a half, he and his colleagues have been using data from these other coronaviruses to try to predict how COVID will behave in the long run.
INSKEEP: Okay. What is his best prediction?
DOUCLEFF: He thinks COVID will become a flu-like illness if two things happen. First, immunity to serious diseases must last for a long time. So after a certain amount of exposure — a few natural infections or two or three doses of the vaccine — you might still get infected, but you’re not likely to get really sick and end up in the hospital.
INSKEEP: Okay. So it actually depends on our body. Do we know if our immunity will protect us for a long time, whether we got it from an infection or from the vaccine?
DOUCLEFF: Yes. That is what everyone is eagerly waiting for. After the vaccine, it seems that immunity lasts for at least six months so far for healthy adults. But Antia says it’s unclear at this point how long that critical immunity will last for people who are more at risk for serious illness.
RUSTOM ANTIA: What we don’t know right now is for older individuals, like me, and older people, how often we need to be vaccinated for the vaccine to build our immunity so that when we get infected naturally, it’s not serious.
DOUCLEFF: So with that long-term immunity, the vast majority of the population would theoretically be protected from severe COVID. And that would really leave only one population unexposed. Can you guess which one that is?
INSKEEP: Brand new people – newborns.
DOUCLEFF: Yes, exactly – young children. But remember, Steve, so far, COVID has been relatively mild in children. And as long as that continues, children can become infected early on when they are young, build up their immunity and then be protected from serious illness as adults. So in theory everyone around the world would be protected. Now, building up this immunity across, you know, the entire population can take a long time. We’re talking maybe years. And that’s why it’s so important for people to get vaccinated, because it can speed up this process and turn COVID into an illness that could potentially resemble a mild flu or even a common cold.
INSKEEP: Hey Michaeleen, thanks for this glimpse of what our future could be – would really appreciate it.
DOUCLEFF: Thank you very much, Steve.
INSKEEP: That’s NPR global health correspondent Michaeleen Doucleff.
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