We’re in the Transitional Phase for COVID-19, Now What?

In his excellent book, From Killer to Common Cold: Herd Protection and the Transitional Phase of COVID-19, Dr. David Graham lays out the upcoming evolution from pandemic to endemic for SARS-CoV-2 virus. Although published months ago, the book has proven to be right on with how the virus is progressing and we now find ourselves in the transitional phase of the pandemic. The virus is transitioning from a global pandemic to one where it will live forever (until we can eradicate it) in the worldwide human population.

What is the Transitional Phase of SARS-CoV-2?

Dr. Graham and I have discussed the evolution of the COVID-19 pandemic in previous shows. We first spoke about how the pandemic will end, how it transitions to endemic, the evolution and nature of coronaviruses, and now how this entire transitional phase turns out. The discussion today recognizes that we have now definitely entered the transitional phase where the virus is starting to lose its foothold. There is now a race between the virus and uninfected individuals getting vaccinated. Once the virus moves out of this deadly phase of affecting new immune systems, it will become more benign. If we look at past coronaviruses that made the jump into humans (most recently OC43 in the late 1800s) we can guess that it will soon just become another ordinary cold for most people.

What Vaccines Will and Will Not Do

One thing is fairly certain, we will not eradicate this virus any time soon. In fact, the multitude of variants in existence and the ability of other coronaviruses to evade our immune system after time will allow SARS-CoV-2 to persist forever in humans. We will continue to infect others whether or not we have the vaccine. Immunity will wane and because there is so much SARS-CoV-2, we won't be able to dodge it forever. Most adults and children will end up seeing this respiratory virus many times again in our life times. SARS-CoV-2 will become endemic and circulate in the respiratory tracts of children and adults but we will all build up natural immunity to prevent us getting anything more than a bad cold.

Why is No one Talking About the Transitional Phase?

Well, it turns out that scientists are starting to introduce the idea that we can't stop SARS-CoV-2. We can only hope to contain the bad effects like ICU stays, death, and hospitalizations. We have to start getting the public to recognize that COVID-19 will be around and will just be less deadly. We have to learn to deal with the virus and accept that it isn't going away. We need to start having realistic and rational discussions about the trade-offs with school reopening in the cities and beginning to regather. We need to set out realistic expectations for the presence of COVID-19 living with a very small chance of risk since we can never eliminate its presence.