Our analysis offers some scenarios to understand potential outcomes. All rights reserved. In the United States, COVID-19 hospitalization and mortality rates in June and July were nearing the ten-year average rates for influenza but have since risen. Note that immunity against symptomatic disease (not any disease) is what we try to assess; we dont estimate a communitys threshold for herd immunity, as that would be driven by both symptomatic and asymptomatic infections. to advise boosters for most Americans 8 months after vaccination, New York Times, August 16, 2021, nytimes.com. While many people in the United States are growing comfortable living alongside COVID-19, the average number of daily deaths still runs at two to four times the long-term average for influenza, and its higher on a seasonally adjusted basis.5Coronavirus in the US: Latest map and case count, New York Times, July 5, 2022; Past seasons estimated influenza disease burden, US Centers for Disease Control and Prevention, accessed July 24, 2022. Levels of natural immunity from prior infection vary within the European Union but are generally in the same range as in the United Kingdom and the United States.125SeroTracker, last accessed March 15, 2021, serotracker.com. 22Effectiveness of a Third Dose of mRNA Vaccines Against COVID-19Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance VISION Network, 10 States, August 2021January 2022, Centers for Disease Control and Prevention, January 28, 2022, cdc.gov. Reported Total Both 7,727,905 reported COVID-19 deaths On the other hand, if vaccines are efficacious but distributed only to adults, who comprise only 76 percent of the US population,157Age and sex composition in the United States: 2019, US Census Bureau, accessed November 15, 2020, census.gov. The pandemic reminded us of how hard it is to predict the future. Women will return to work within a year of childbirth in high numbers. As long as Omicron remains the dominant variant, there is reason for relative optimism. the move from some countries to place entry restrictions on people travelling from China afterthe powerful nation's decision to open its borders, PCR testing will be prioritised for the most vulnerable, in a bid to ensure their access to antivirals is fast-tracked, Experts estimate only 10 to 25 per cent of positive cases are being reported in Australia, said the national plan involved funding for research to help better understand long COVID, How Australians with COVID-19 are spending Christmas, Long COVID symptoms are shifting as new variants bring new challenges, Are you eligible for COVID-19 antiviral medication? Europe splits on Omicron response,. But a number of other factors could delay the timelines beyond those described, including unexpected safety issues emerging with early vaccines, significant manufacturing or supply-chain delays, continued slow adoption, further mutation, or a shorter-than-anticipated duration of vaccine-conferred immunity. Lockdowns pulled functions from outside the home into the home. Existing vaccines may protect against the Brazilian coronavirus variant, University of Oxford, March 18, 2021, ox.ac.uk. The proportion of the population with effective immunity from prior COVID-19 infection is estimated from historical, reported, age-stratified death data. The proportion of unvaccinated people with past infections in a country is roughly correlated with its overall COVID-19 mortality, since unvaccinated but infected people have been at greatest risk of bad outcomes. While vaccinations have been reducing the risk of severe illness, research is still unfolding into long COVID. If you look at the middle of April, lets just say two months ago, we were averaging about 30 deaths a day, right? In fact, we can do better: 1. This article was edited by Mark Staples, an editorial director in the New York office. Australias largest generation reaches the family The US has topped 500,000 daily cases andreduced its isolation period, records are being smashed in Europeas many countries increase restrictions,Israel is attempting an uncharted fourth vaccination shot. although some regions may come close to it. Last week, Andrews flagged the vaccinated economy, QR codes and isolation requirements for close contacts of Covid-19 cases could be scrapped after the latest outbreak peaked. The analysis is quite sensitive to public-health interventions and behaviors. Past estimates and COVID-related resources will Its an important distinction because what will drive herd immunity is reduction in transmission. even though inequalities in global vaccine access have meant that few there have received three doses, and most have not yet received a single dose. But it is possible that evolution will not produce epidemiologically significant new variants. Even later herd immunity remains possible if other challenges arise, especially vaccine safety concerns or ambivalence to vaccination following a transition toward normalcy. Ben Adams, Merck has better luck with 2nd COVID-19 drug attempt as it sees a positive in early molnupiravir data, Fierce Biotech, March 8, 2021, fiercebiotech.com. Generations mixing together after months of distancing. Their task will be determining what burden of disease is low enough to warrant lifting of public-health restrictions, and how to manage the public-health impacts of endemic COVID-19. Working from home is here to stay but exclusively virtual working arrangements will remain the exception. Since home tests became more widely available, in late 2021, consumer purchases of them have risen in line with waves of COVID-19 cases, prefiguring rises in deaths attributable to the disease (Exhibit 1). Some have suggested that particular populations, such as those who are immunocompromised due to HIV or other causes, are disproportionately at risk of incubating new variants.41Lawrence Corey, Chris Beyrer, Myron S. Cohen, Nelson L. Michael, Trevor Bedford, and Morgane Rolland, SARS-CoV-2 Variants in Patients with Immunosuppression, The New England Journal of Medicine, August 5, 2021, nejm.org. What role will antibody treatments play? Raising vaccination rates will be essential to achieving a transition toward normalcy. We should be focusing more on interventions that are sustainable that is, ones that we can maintain as we get back to living our lives normally. Given the likely timing of herd immunity in various geographies and the uncertain duration of protection from vaccines (both duration of immune response and efficacy versus new variants), it is likely that some measures such as booster vaccines are likely to be required indefinitely. While data indicate that the most likely scenario is to reach this state on the timelines described above, five risks could delay progress. While the European Union, the United Kingdom, and the United States have had broadly similar COVID-19 experiences, other parts of the world look very different. These therapeutics, including both small-molecule and antibody treatments, have helped blunt the incidence of severe disease in places where they are widely available. Studies have shown that countries that require bacille CalmetteGurin (BCG) vaccinations for tuberculosis correlate with lower rates of COVID-19 infections and related deaths, normalizing for certain key factors (such as epidemic stage, development, rurality, population density, and age structure).6Martha K. Berg et al., Mandated Bacillus Calmette-Gurin (BCG) vaccination predicts flattened curves for the spread of COVID-19, Science Advances, August 2020, Volume 6, Number 32, advances.sciencemag.org. Beyond the cancelled plans and missed Christmases, we don't really have a way to judge the real damage done by the poor testing situation. Twelve months later, the end of the pandemic is in sight for some parts of the world. then higher vaccine coverage ratesapproximately 60 to 85 percentcould be required to achieve herd immunity. April 27, 2023 - 3:40PM. It's a big shift from the first few years of the pandemic, where the gold-standard PCR testing was available to everyone in the community in an attempt to identify every case and send rings of contacts into quarantine. 9116, academic.oup.com. In such places, until herd immunity is reached, COVID-19 might be analogous to measlesnot a day-to-day threat to most people, but a persistent risk. Pfizer and BioNTech conclude Phase 3 study of COVID-19 vaccine candidate, meeting all primary efficacy endpoints, Pfizer, November 18, 2020, pfizer.com. Sarah Zhang, Omicrons explosive growth is a warning sign,. Digital cash, digital ID. And as we have written previously, every society must do four things to manage COVID-19 effectively during the endemic phase: A new variant may yet trigger another chapter in the COVID-19 pandemic and societies must be prepared to respond if and when that happens. Third, the duration of vaccine-mediated immunity may prove shorter than anticipated, making it hard to reach the necessary threshold for simultaneous immunity. A number of Australian states, territories, and cities have implemented lockdowns in response to the pandemic. The other variables will also have much to say about the timeline to reach herd immunity (see sidebar, Key factors affecting the timeline to herd immunity). Pfizer and BioNTech to submit Emergency Use Authorization request today to the US FDA for COVID-19 vaccine, Pfizer, November 20, 2020, pfizer.com; Modernas COVID-19 vaccine candidate meets its primary efficacy endpoint in the first interim analysis of the Phase 3 COVE study, Moderna, November 16, 2020, moderna.com. South Australia and Tasmania, too, have an established surge. Professor Esterman said the raised Reffs are due to highly transmissible new sub-variants of the virus sweeping through the country. Some are debating a strategy that would combine annual flu and COVID-19 boosters in the autumn.8Official sees strong possibility Covid shots will be given every autumn, Bloomberg, February 22, 2022. "It's hard because it doesn't have an enormously robust diagnosis," Dr Lydeamore said. (For more on the potential for a faster resolution of the COVID-19 crisis in the United States, see An optimistic scenario for the US response to COVID-19.) Estimated case-detection rates range from 3:1 to 10:1.2Charlie Giattino, How epidemiological models of COVID-19 help us estimate the true number of infections, Our World in Data, August 24, 2020, ourworldindata.org; Hazhir Rahmandad, John Sterman, and Tse Yang Lim, Estimating COVID-19 under-reporting across 86 nations: Implications for projections and control, medRxiv, August 3, 2020, medrxiv.org. Beyond that, a more realistic epidemiological endpoint might arrive not when herd immunity is achieved but when COVID-19 can be managed as an endemic disease. The long tail of the curve shows falling probabilities to Q3 2023 and beyond. The exhibit also shows how much more stringent those measures would need to be to potentially prevent the disease burden from exceeding the burden of Delta. Merck and Ridgeback Biotherapeutics provide update on results from MOVe-OUT study of molnupiravir, an investigational oral antiviral medicine, in at risk adults with mild-to-moderate COVID-19, Merck, November 26, 2021; Pfizers novel COVID-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of Phase 2/3 EPIC-HR study, Pfizer, November 5, 2021. Pfizer announces additional Phase 2/3 study results confirming robust efficacy of novel COVID-19 oral antiviral treatment candidate in reducing risk of hospitalization or death, December 14, 2021. The Pfizer trial has enrolled some children (ages 12 and older), but efficacy in those under 18 remains unclear. variant continues to spread around the world as coronavirus pandemic enters 2021, Washington Post, Jan 2, 2021, washingtonpost.com.143Carl Zimmer, U.S. and more large employers in the United States implementing vaccine mandates.93 Leslie Josephs and Robert Towey, Covid vaccine mandates sweep across corporate America as delta variant spurs action, CNBC, August 9, 2021, cnbc.com; Alexis Benveniste, From offices to restaurants, companies are requiring proof of vaccination, CNN, August 4, 2021, cnn.com. Frauke Muecksch, Zijun Wang, Alice Cho, et al., Increased potency and breadth of SARS-CoV-2 neutralizing antibodies after a third mRNA dose, BioRxiv, February 15, 2022, biorxiv.org. The approval, in at least one country, of vaccines made by Pfizer and BioNTech, Moderna, Oxford and AstraZeneca, Sinopharm, Serum Institute, Bharat Biotech, Gamaleya, and others within a year of viral sequencing smashed all records for development timelines. UK case counts may fluctuate and targeted public-health measures may be reinstated, but our scenario analysis suggests that the countrys renewed transition toward normalcy is likely to continue unless a significant new variant emerges. The Stats Guy: 22 predictions of what 2022 holds for Australia 1.