What Will It Be Like To Live With Covid-19 Forever?

For 18 months, people around the world have been dreaming about an eventual end to the Covid-19 pandemic, and for a moment, it felt tantalisingly close.

Then the Delta variant spread and began tearing through the unvaccinated, and now, in the US at least, people are right back in the thick of it. Pockets of the country are crushing previous case records. Entire states have run out of hospital beds. The end of the tunnel, once again, feels very far away.

So when will the world exit crisis mode? Are we destined to live through an endless loop of surges, followed by lulls, followed by even greater surges?

Here’s what experts think life with Covid-19 will be like in the future.

A small group of experts think we still can eradicate COVID-19...

“We should not dismiss the possibility of eradicating Covid-19,” a team of researchers argue in a recent paper, published in BMJ Global Health, that has been generating a lot of headlines for its hopeful message.

The researchers say it is still possible to get global Covid cases to zero and keep them there until intervention measures are no longer needed. Up to this point, the World Health Organisation has only declared one human disease officially eradicated: smallpox.

Based on a scoring system they developed for eradicability, the study’s authors found it would be harder to eradicate Covid-19 than it was to eradicate smallpox, but ultimately easier to eradicate Covid-19 than polio. (It’s worth noting that polio isn’t officially gone: two of the three types have been eradicated, but the third still exists in Afghanistan and Pakistan.)

The researchers behind the study – which they emphasise is a “very preliminary analysis” – note that the primary challenges in eradicating Covid-19 globally are getting enough people vaccinated and ensuring the vaccines keep pace with the virus as it evolves.

Those are, of course, massive obstacles, but the researchers argue that it is too soon to throw in the towel. They call for national health agencies and the World Health Organisation to spend more time at least analysing the feasibility and “desirability” of eradicating Covid-19 (“desirability” basically meaning whether the costs are worth it), especially because there is “unprecedented global interest” in making this virus go away.

... but most think the Delta variant has made herd immunity impossible.

In the spring, HuffPost US spoke to several experts about whether herd immunity was possible, and one emphasised that where we are this autumn would tell us a lot about where we’re heading.

Well, autumn is almost here, and the picture is not great: only half the US population is fully vaccinated, while some other countries have vaccination rates below 1%. The Delta variant is said to be as contagious as the chicken pox.

“The vast majority of experts in the public health and epidemiology space really get the sense that – at this point, with the contagiousness of the delta variant and how prevalent Covid remains – herd immunity is not possible any longer,” Iahn Gonsenhauser, chief quality and patient safety officer at the Ohio State University Wexner Medical Center, told HuffPost this week.

“We would likely need to achieve such a high percentage of public immunity that’s likely not possible to achieve or sustain.”

Gonsenhauser hedges a bit, noting that some experts believe we could reach a point where Covid-19 basically fizzles out because everyone has either been vaccinated or caught the virus, conferring some level of immunity.

“If the virus continues to become more contagious, there’s potentially a point at which it burns itself out by running through the population that’s unvaccinated and leaving us with a very slim percentage of the population that’s still susceptible to support ongoing replication of the virus and its prevalence in the community,” Gonsenhauser says.

But he personally doesn’t think that scenario is likely, nor does he think the Delta variant is contagious enough to reach that point. And any version of that scenario would likely come with a profound human cost: thousands more people dead or with reduced quality of life, and further strain on a health care system that is already overwhelmed.

When we shift from ‘crisis mode’ to ‘a new normal’ depends on when people get vaccinated

While most public health and infectious disease experts are coalescing around the idea that Covid-19 isn’t going anywhere, they also think we’ll eventually be able to get back to relative normalcy.

“I think Delta coronavirus is here to stay. We’re not going to beat it – we’ll beat it back,” says John Bradley, medical director of the division of infectious diseases at Rady Children’s Hospital in San Diego.

Ultimately, Bradley believes Covid-19 is going to be a lot like the flu. It will continue to circulate around the US and world, and people will need regular boosters. For better or worse, people will come to accept it as a part of daily life.

“I think people will begin to think, ‘Well, Delta’s not so bad,’” Bradley says – in much the same way that people tend to think the flu is not so bad, even though it’s kills anywhere between 12,000 and 61,000 people a year in the US – and more than a thousand in the UK.

Peter Chin-Hong, a professor in the division of infectious diseases with the University of California, San Francisco, also predicts that we will eventually settle into “a new equilibrium” with “regional flares.”

“I do think it’s going to be around indefinitely, but that doesn’t mean we can’t live peacefully alongside it,” he says. It will take a “multi-faceted, multi-pronged” approach to help get us there, Chin-Hong says, including medicines that people at risk for the virus can take to help with prevention, as well as better treatment options for those who get really sick.

All three experts interviewed for this story say the absolute most important factor in when we’ll exit crisis mode is how quickly we can get people the world vaccinated. “Vaccination is our pathway out of this,” Gonsenhauser says. “With increases in vaccine uptake will come decreases in community prevalence, will come decreases in transmission, and will come a return to normalcy.”

There are a few small positive trends underway

The prospect of living with Covid-19 indefinitely sounds bleak, but experts say there is plenty to feel hopeful about, both now and in the future.

Gonsenhauser, for example, points to communities in hard-hit areas of Texas and Florida where people are pushing back against mask politics that lack any evidentiary basis. “We’re starting to see communities take things into their own hands, because they’re recognising the risk. They’re recognising the impact.”

And Chin-Hong notes that face masks, while certainly still divisive, have become an aspect of everyday life in a way that positions us better to adapt to other diseases when they arise. Children in particular, who’ve spent a good percentage of life living with Covid-19 and coping with major disruptions to their routines, might be quicker to respond to public health threats down the road.

“Right now we’re arguing and throwing barbs at each other as adults, but our kids are actually very resilient and plastic,” he says. “They will, when they grow up to be leaders in our society, have a very different paradigm about how to navigate the world.”

Rounding out the message of hope, Bradley urges people to reflect on how the scientific community has, over the past 18 months, risen to an unprecedented challenge. “This is a new virus. We see new viruses come out from time to time – that’s just life. That’s Mother Nature,” he said. “I want people to feel comfortable that the response of the research and medical community to this brand-new virus – sequencing it, figuring out what it does, coming up with a vaccine and some treatment – has just been miraculous.”