Paton hedged her forecast, saying many unknowns could improve or worsen the pandemic, including vaccination rates, new variants and people’s behavior.
Twenty-two months after the coronavirus pandemic arrived in Ohio and heading into the third calendar year dealing with the virus, health officials are loath to make predictions. The Dayton Daily News asked area health experts what factors would influence the course of the pandemic and what reaching the end might look like.
“We will continue to see waves of COVID-19 infections throughout 2022 until our vaccination rates really catch up and people ... stay on top of getting their booster shots,” said Sarah Hackenbracht, president and CEO of the Greater Dayton Area Hospital Association.
Timothy N. Crawford, an epidemiology and biostatistics professor at Wright State University, said the pandemic does not have to get worse.
“Getting vaccinated, boosted for those who are fully vaccinated, and masking indoors are ways that we can curtail the potential surge,” he said. “If we continue to ignore these strategies, then yes, it will get worse before it gets better.”
Why were initial predictions wrong?
At the beginning of this pandemic, experts looked back at historical pandemics for signs of how long this one would last, but they took into account our modern advancements.
“They were predicting that it would be two to three years, and it would go in cycles,” Clark County Health Commissioner Charles Patterson said. “For some reason, we thought with all of our technology, with all of the might of the world being brought to this, we could bring this to its knees much quicker. That was before the politics, that was before the vaccine hesitancy.”
Even though safe and effective coronavirus vaccines were developed in record time, getting shots into arms has not proved seamless, both in the U.S. where vaccines are plentiful but many don’t want them and parts of the world that haven’t received enough doses yet.
“We weren’t successful in mitigating this when we actually had the tools to do so,” Patterson said. “We’re still going to go through those multiple waves.”
What does endemic mean?
The world will likely never get rid of COVID-19, or at least not anytime soon. Only one disease (smallpox) has ever been eradicated and that took nearly 200 years after a vaccine was developed.
“From the onset, when people said we’re going to try to eradicate this, that was a misnomer,” Darke County Health Commissioner Terrence Holman said. “In today’s society, there’s no way you’re going to eradicate a disease like this that can spread rapidly. And you can only hope to control it through vaccinations.”
Early on in the pandemic, health leaders talked about how we could reach herd immunity after we got a vaccine.
“The vaccines tend to get rid of the more severe disease and death, but you can still get the disease and spread it,” Paton said. “So we’re not going to eradicate this disease. And because we’re still transmitting it, it’s just going to be part of our world.”
So that dashes hopes of eliminating the disease, but the world can still mitigate COVID-19, turning the disease into one that’s endemic instead of a pandemic.
“An endemic illness is one that is relatively low severity that is constantly circulating throughout a community or the world,” Paton said. “Maybe there will be surges here and there in different areas, just like we see with other diseases like the flu.”
What factors could make the course of the pandemic better or worse?
“There are a lot of caveats, which makes it hard to predict what’s going to happen,” Paton said.
How many people get vaccinated locally and around the world is a big factor, she said. Crawford expressed hope that vaccination rates could be aided somewhat in 2022 by the approval of a coronavirus vaccine for the last ineligible age group, children under 5 years old.
On Friday, Pfizer announced that its vaccine trials in 2- to 4-year-olds produced a weaker immune response than anticipated, possibly delaying authorization. Nanette Cocero, global president of Pfizer Vaccines, said during an investor call Friday that she expects COVID will transition to an endemic state by 2024.
As long as populations with low vaccination rates persist, the coronavirus will have room to mutate into a new variant. Global vaccine distribution has been uneven, Paton pointed out. For example, less than 10% of Africans are vaccinated against COVID-19.
New variants could be bad or good for the course of the pandemic, Paton said. For example, early studies indicate the latest variant, Omicron, may be more transmissible, possibly even causing more reinfections (that’s a negative); but it also might cause less severe illness (that’s a positive) when compared to previous variants. A variant could also appear that vaccines don’t work as well against.
Public health officials expressed hope that the development and approval of new treatments could also give us new tools to fight COVID-19.
“More and better treatments will be arriving next year to help us avoid serious illness and death from COVID-19 infections,” Montgomery County Health Commissioner Jennifer Wentzel said.
Improving access to testing in America, including the Dayton-area, such as by providing home test kits, could also slow the spread of COVID-19, Crawford said.
Lastly, people’s behavior and how well they follow precautions like masking and distancing has a big influence on the spread of the disease.
“In the U.S. and Ohio, there are conflicting public health and social measures. They’re different in different places, they change all the time, and we can’t predict when and if they’re going to change for the better or for the worse,” Paton said. “And we also have more pandemic fatigue so people are more tired of changing their habits back and forth, too.”
How the pandemic ends is up to us.
“I feel like everybody should just get (COVID-19). We build up these antibodies and then we can move on,” said Lindsey Martin. The 30-year-old Daytonian was skeptical of the coronavirus vaccine, but she ended up getting it earlier this month in order to see family at Christmas.
This point of view is one that health leaders vehemently disagree with. The large number of hospitalizations and deaths that path out of the pandemic would incur is not an attractive option, Crawford said.
“There is no guarantee that when an individual is exposed to the virus that the disease would be mild,” he said. “This strategy would lead to more COVID-related deaths and overwhelm the hospital system. As hospital beds are being taken by those with COVID, individuals who need care for reasons unrelated to COVID may not get the care needed because of no space available. This could lead to even more deaths.”
We have the tools — vaccines, masks and other precautions — to end the pandemic, Crawford said, and we should use them.
Paton predicts that after COVID-19 is downgraded from a pandemic to an endemic illness, it will follow a seasonal pattern with occasional surges or outbreaks, similar to the flu.
“Then we will be able to use our public health or social measures to help in those situations,” she said. “I think there will be some people that will adopt mask wearing as a normal part of preventing seasonal disease. I am pretty sure I’m going to be wearing masks in future winters and during surges.”