by Ross Pomeroy

 

It may not be today. It may not be tomorrow. It may not be next week. It may not be this month, when the rapid ascension of the Delta variant in the United States could send confirmed daily case counts spiking to 200,000 or more before settling down again. It may not even be next year. But someday, you will almost certainly be infected with the SARS-CoV-2 coronavirus.

This uncomfortable fact may come as a surprise to many Americans, particularly to those who have spent hours sanitizing surfaces and groceries, who have dutifully adorned a mask even when not required to do so, and who have made the simple, science-backed decision to get vaccinated. SARS-CoV-2 has already spread around the world, infecting hundreds of millions or more. The genie is out of the bottle, and it is not going back in.

“We will be dealing with this virus forever,” Dr. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, said in an interview one year ago.

Osterholm has been a sage throughout the pandemic, and his words then remain prescient now.

“Effective and safe vaccines… will be very important, even critical tools, in fighting it,” he said. “But the whole world is going to be experiencing COVID-19 ‘til the end of time. We’re not going to be vaccinating our way out of this to eight-plus billion people in the world right now…. We’ve really got to come to grips with actually living with this virus, for at least my lifetime…”

Since speaking those words, Osterholm hasn’t changed his mind.

“Eradicating this virus right now from the world is a lot like trying to plan the construction of a stepping-stone pathway to the Moon. It’s unrealistic,” he told Nature in February of this year.

Olsterholm’s view now represents the consensus of scientific opinion. In January, Nature surveyed more than 100 experts working on the coronavirus about whether the virus could be eradicated. Nine out of ten said that it is “likely” or “very likely” that the coronavirus will continue to circulate amongst the human population as an endemic infection. Most see it becoming something like the flu, for which we will require yearly vaccinations to be protected, or joining the ranks of other coronaviruses to cause respiratory infections that collectively fit under the title of the “common cold”. In the latter scenario, people may get reinfected multiple times over their lives. This theory seems the most likely to play out.

“The virus sticks around, but once people develop some immunity to it — either through natural infection or vaccination — they won’t come down with severe symptoms… Scientists consider this possible because that’s how the four endemic coronaviruses, called OC43, 229E, NL63 and HKU1, behave,” Nicky Phillips wrote for Nature.

In either of these scenarios, it’s extremely likely that you will eventually be infected. Adults get the flu about once every five years. Many times they are unaware, because the infection is asymptomatic. By the time children are roughly three years old, 65% will have been infected with coronavirus 229E. It’s reasonable to predict that some years down the road, SARS-CoV-2 will be just as, if not more, prevalent. Even the vaccinated will likely be infected at some point, and that’s okay.

There was some hope that the incredibly effective vaccines we have, particularly BioNTech/Pfizer’s and Moderna’s mRNA shots, would grant sterilizing immunity, preventing infection altogether. And studies suggest that they do, surprisingly well. But it seems that this form of immunity wanes over time and lessens versus new variants, particularly the Delta variety that’s been all over the news of late. The good news is that the vaccines remain extremely protective against severe disease, hospitalization, and death. If and when booster shots are available, we’ll be able to refresh our immunity.

The knowledge that a SARS-CoV-2 infection is essentially inevitable might be, for some, panic-inducing, perhaps prompting a desire to live a bubbled life. It shouldn’t. That’s because we have the tools to be free from both fear and, for the vast majority, harm: America’s remarkable arsenal of safe and effective vaccines. Again, even if the vaccines don’t prevent infection, that’s okay! As of July 26th, less than 0.004% of fully vaccinated people experienced a breakthrough case resulting in hospitalization and less than 0.001% died from the disease, according to the latest data from the US Centers for Disease Control and Prevention.

As Dr. Osterholm said in May, “For vaccinated individuals, in a private home or wherever, party hard. Enjoy it. You’ve earned it. You can feel safe in doing that, and that’s what we need to help people understand.”

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Ross Pomeroy contributes to RealClearScience.


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