Feb. 23, 2021 -- When the first COVID vaccines arrived, people started talking about the “light at the end of the tunnel.” Then the post-holidays surge hit with record numbers of cases and deaths, virus variants emerged, and that light was feeling pretty dim. But now as cases and hospitalizations have dramatically dropped, are we finally getting close to the end of the tunnel?
How optimistic should we be that the end of the pandemic is truly, finally in sight?
Public health officials and researchers have predictions about when and how that end to the pandemic will come. Some see a serious chance for a return to some kind of normalcy in a matter of weeks. Others might wish that to be true, but believe we will still be living with the coronavirus for months to come.
For example, while top researchers said April could be the month we emerge from a long pandemic, Anthony Fauci, MD, the chief White House medical adviser on COVID-19, said this week Americans may still have to wear masks in 2022, but life will be sort of normal before then.
Here's a sampling of opinions about how optimistic we should be that the pandemic is nearing its end, and why:
Marty Makary, MD, a professor at Johns Hopkins University, predicted in a Wall Street Journal commentary, published Feb. 18, that the U.S. would reach herd immunity by April. He based this on a number of calculations, including a 77% drop in cases over the previous 6 weeks. That drop, he says, is due largely because "natural immunity from prior infection is far more common than can be measured by testing."
He estimates that testing captured only 10%-25% of all infections and that 55% of the population has natural immunity. When you add the number of people getting vaccinated -- as of mid-February, 15% of the population -- the immunity level rises. (Experts don't agree on what percentage of the population needs to have either been infected or vaccinated to reach herd immunity, with many citing 70% to 85% as the "magic" level.)
Epidemiologist Suzanne Judd, PhD, of the University of Alabama at Birmingham School of Public Health, said this week that it’s “possible” the country is nearing herd immunity. Her comments are based on a new Columbia University study -- which has not yet been peer-reviewed -- that suggests the actual cases in the U.S. could be 10 times more than the confirmed number of cases. If the study is accurate, nearly a third of the country has already been infected.
A report in The Atlantic carries the hopeful headline: "A Quite Possibly Wonderful Summer." Its author, too, cites cases declining more rapidly than experts thought they would, the rising vaccination rates, and less dread from some experts about the effect of viral mutations.
Not so fast, others say. "At this point, the virus is in control," Michael Osterholm, PhD, a University of Minnesota infectious disease specialist and member of President Joe Biden's COVID-19 advisory board, told CBS Minnesota on Feb. 20. And if a large segment of the population declines the vaccine, that would be bad news, he says. On the other hand, if many get the vaccine, "we could be in a really good place this summer, I think particularly by late summer."
While Fauci says masks may still be needed in 2022, on Feb. 21, he told CNN's Dana Bash on State of the Union that by the end of the year, "We're going to have a significant degree of normality beyond the terrible burden that all of us have been through over the last year." He says he agrees with Biden that by the end of the year, "we will be approaching a degree of normality."
We reached out to other experts, who are guardedly optimistic.
"I think there are unequivocal reasons to be optimistic about the pandemic," says Amesh Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security.
Highly effective vaccines that are already protecting millions are a main reason, he says.
"The key is to stay ahead of the virus and its variants by accelerating vaccination to the highest possible degree,” Adalja says.
Another reason is that the vaccines, even in the face of variants, are able to prevent serious disease, hospitalization, and death.
Adalja predicts a new normal.
"By late summer of 2021, in the U.S., many activities will be closer to normal," he says. "But the world will have changed, with more people attuned to the risks of respiratory infections, many completely adapted to online shopping, many who are wary of crowded situations, and many who continue to wear masks and social distance."
Optimism is a given, says William Schaffner, MD, a professor and infectious disease specialist at Vanderbilt University in Nashville. The question is how optimistic.
"The diminution in hospitalizations and cases that we are seeing now is a reflection of at least some herd immunity,” he says.
But, he says, "My notion is that this probably is very diverse across the country," with some regions still having very low immunity levels.
Even so, Schaffner says, "I think by the end of the summer or into November, we could have a near-normal Thanksgiving and subsequent holidays, if all goes well."
But some experts worry that too much optimism might result in people letting down their guard too early, giving up preventive measures like mask-wearing and social distancing. That explains the guarded optimism from many experts.
"If my colleague at Hopkins [predicting an April end], turns out to be correct, I would cheer," Schaffner says. "But it is always better to under-promise and over-deliver."