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Covid-19 is here to stay

It's highly unlikely that the United States, let alone the world, will be able to completely eliminate the coronavirus that causes Covid-19. But there will come a day when it's no longer a pandemic, when cases are no longer out of control and hospitals aren't at great risk of overflowing with patients. Many experts predict the spread of coronavirus will look and feel more like seasonal influenza.

No one can predict what the future of Covid-19 could look like -- and the emergence of coronavirus variants, like Delta, has shifted the trajectory. With the change in transmission patterns, as the variants have emerged -- I call it a parade of variants -- we now see much more extensive transmission and much more uniform spread globally. This makes declaring the end of the pandemic more difficult.

Endemic means that a disease has a constant presence in a population -- but it's not affecting an alarmingly large number of people as typically seen in a pandemic. The battle to corral coronavirus every year may look very much like the annual fight against the flu.

It's clear that SARS-CoV-2 is very successful at finding new people to infect, and that people can get infected after vaccination. For these reasons, the transmission of this virus is not expected to end.

What will our future with COVID-19 look like?

Given the considerations discussed above and what we know about COVID-19 so far, many scientists believe that the virus that causes COVID-19 will likely settle into endemic patterns of transmission. But our inability to eradicate the virus does not mean that all hope is lost.

Our post-pandemic future will heavily depend on how the virus evolves over the coming years. SARS-CoV-2 is a completely new human virus that is still adapting to its new host. Over time, we may see the virus become less pathogenic, similar to the four coronaviruses that cause the common cold, which represent little more than a seasonal nuisance.

How will we know if and when SARS-CoV-2 becomes endemic?

Four seasonal coronaviruses circulate in humans endemically already. They tend to recur annually, usually during the winter months, and affect children more than adults. The virus that causes COVID-19 has not yet settled down into these predictable patterns and instead is flaring up unpredictably around the globe in ways that are sometimes difficult to predict.

Once rates of SARS-CoV-2 stabilize, we can call it endemic. But this transition may look different based on where you are in the world. For instance, countries with high vaccine coverage and plentiful boosters may soon settle into predictable spikes of COVID-19 during the winter months when the environmental conditions are more favorable to virus transmission. In contrast, unpredictable epidemics may persist in regions with lower vaccination rates.

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