“If we manage it the way that we manage it now, then most people will get infected with it at least a couple of times a year,” Kristian Andersen, a virologist at the Scripps Research Institute in San Diego, told her. “I would be very surprised if that’s not how it’s going to play out.”
But it’s not all bad news. Because of the increasing prevalence of vaccine- and infection-induced immunity, along with the advent of new treatments, case rates and death rates are no longer as tightly correlated as they once were. The rate of severe illness may also be lower than official numbers imply, since many Covid infections are most likely going undercounted because of at-home rapid tests. And for vaccinated people, an Omicron infection may trigger an immune response that confers protection against a broad range of variants, two new studies suggest.
After Omicron? As Ewen Callaway writes in Nature, previous variants of concern — including Alpha, Delta and the initial incarnation of Omicron — all emerged independently from distant branches of the coronavirus’s genetic tree. But Omicron seems to be following a different pattern, evolving new subvariants that partly evade immunity with relatively minor genetic changes.
If that pattern continues, the coronavirus’s trajectory “could come to resemble that of other respiratory infections, such as influenza,” Callaway writes. “In this scenario, immune-evading mutations in circulating variants, such as Omicron, could combine with dips in population-wide immunity to become the key drivers of periodic waves of infection.”
Some scientists, though, say the prospect of a different variant — a more competitive descendant of Delta, say — shouldn’t be discounted. And regardless of the variant or subvariant in question, if the virus is able to keep evolving to reinfect people, it’s “not going to simply be this wintertime once-a-year thing,” Jeffrey Shaman, an epidemiologist at Columbia, told The Times. “And it’s not going to be a mild nuisance in terms of the amount of morbidity and mortality it causes.”
How should governments and the public respond?
In the short term, with cases on the rise, protecting the vulnerable has become an even more urgent concern. As my colleague Sarah Wildman writes, returning to “normal” still isn’t possible for millions of Americans with compromised immune systems and those who live with them. That population includes Wildman and her 13-year-old daughter, who received a liver transplant as part of her cancer treatment in March 2020.
“If we don’t want to push, at minimum, seven million Americans and their family members to consider avoiding flights and theaters and schools and trains,” she argues, Americans will need to create a new normal, “one that recognizes that everyone deserves the chance to participate in daily life.”