We are heading towards the start of the third year of the COVID-19 pandemic, and many people want to know what the future holds. Will there be more variants? Will we need more vaccines? Will there be more dumb ideas about the disease?
Well, I’m not a pseudoscientist, so I not only don’t make, but also I certainly don’t believe in predictions about the future course of the COVID-19 pandemic. But I think I can write down some science-based thoughts of what we might see over the next few months.
Despite the claims of the anti-vaxxers, they work wonderfully. Unvaccinated individuals have an 11X higher risk of mortality compared to those who are fully vaccinated. And they almost eliminate hospital admissions.
But one thing that people fail to grasp — these vaccines were not developed to eliminate transmission. A fully vaccinated adult has an approximately 50% lower risk of getting infected or transmitting the virus. As we have experienced, there are breakthrough infections — and if we decide to go back to the way we behaved before the pandemic, you can expect that cases will increase once again, as we are observing right now across the world.
Despite all of this actual scientific data, people are resistant to the COVID-19 vaccines. For example, less than 60% of Americans are fully vaccinated. That means there is a reservoir for the SARS-CoV-2 virus which means there is more chance of another wave of COVID-19 and a continuation of the pandemic in the future.
My magic ball says that we’ll probably need to get more boosters for the next few years, maybe even wholly new vaccines. The evidence that they work is strong, and even appears that they reduce the risk of mortality and hospitalization from the Omicron variant.
The flu is back
Although not directly related to the COVID-19 pandemic, but it appears our moving away from public health measures, like isolation, face masks, and social distancing, is bringing back our annual nemesis, the flu. Flu activity, which had dropped to negligible levels during the 2020-21 flu season, seems to be back to pre-pandemic levels.
It’s not an official prediction, a flu + COVID-19 twindemic seems to be more likely than not during the 2021-22 winter.
The future of the COVID-19 pandemic — more variants
There is an old adage in virology — viruses cannot mutate if they do not replicate. And viruses usually cannot replicate in those who are immune because of vaccines. So, if there are wide swaths of areas that lack immunity to the disease, it becomes a place where new variants can arise.
There are big areas of the world with very low vaccination rates, and that’s not just parts of the developed world, like the anti-vaccine anti-science areas of the USA and other countries. Less than 10% of Africans are fully vaccinated meaning that it could be a major source of new variants during the upcoming few months.
We can expect new variants that may be more infectious, which may be more dangerous, and which may outfox previous immunity. And as long as the virus continues to circulate the probability of new variants increases with each new infection.
Of course, with new variants, low vaccination rates, and breakthrough infections, we are going to see more waves. A sixth wave is already hitting parts of Europe, and we can expect it worldwide during the next few weeks.
There may come a point where we just need to accept more waves until we vaccinate the world, something that doesn’t appear to be close at all.
I know that those of us with booster shots, like myself, think that we’re superhuman, but each new wave will result from a new variant, and no one knows whether some future variant will lead to a breakthrough infection. This may be the time to actually hide under a rock.
- Dyer O. Covid-19: Unvaccinated face 11 times risk of death from delta variant, CDC data show. BMJ. 2021 Sep 16;374:n2282. doi: 10.1136/bmj.n2282. PMID: 34531181.
- Wilder-Smith A. What is the vaccine effect on reducing transmission in the context of the SARS-CoV-2 delta variant? Lancet Infect Dis. 2021 Oct 29:S1473-3099(21)00690-3. doi: 10.1016/S1473-3099(21)00690-3. Epub ahead of print. PMID: 34756187; PMCID: PMC8554481.