March 2022, ScientificAmerican.com 79COVID Is
Here to Stay
C
OVID- 19 wIll cOntInue In panDemIc fOrm, surging in one or more
regions and disrupting daily life, until the world reaches herd
immunity. With that, most scientists say, the SARS-CoV-2 virus
will become endemic—always present but transmitted among people
at modest, predictable rates. After several years the infamous 1918 influ-
enza pandemic made that transition, and the virus is still circulating,
104 years later, in mutated strains. Almost all influenza A infections
since 1918 have descended from that strain.
As the endemic stage arrives, people of all ages will be eligible for the
COVID vaccine, and hospitals and pharmacies will be well supplied with
effective treatments for infection. At that point, it might be wise for pub-
lic health officials to treat COVID as a respiratory disease that is more
dangerous than a cold, similar to how we handle influenza and cytomeg-
alovirus (CMV)—by evaluating distribution of a seasonal vaccine, track-
ing hospitalization rates and educating the public about current risk. We
don’t yet know if COVID will lead to higher rates of long-term complica-
tions than those diseases do, so other precautions may be necessary.
In this future, routine testing might become part of everyday life.
People with imperceptible symptoms who test positive would know to
wear masks and isolate from others. If we could develop similar tests for
influenza and CMV and make them cheaply available to everyone, every-
where, society could end up even safer against infectious respiratory
diseases than it was before COVID arrived.
Even if COVID cases declined significantly, it’s unlikely the virus
would burn out. As long as it was still spreading in animals, it could
spill over into humans at another time. Nature is always surprising us.
A future, reemergent SARS-CoV-2 could be either less or more transmis-
sible, less or more lethal. The Omicron variant that spread this winter
taught us to expect the unexpected. Our world still has much to do to
become better prepared for new variants—as well as whatever novel
virus emerges next.
Christine Crudo Blackburn is an assistant professor of security studies at Sam Houston
State University.How do we live with it?
By Christine Crudo Blackburn