Public Health

When & How Will COVID-19 End?

Khang T. Vuong, MHA
Khang T. Vuong, MHA12 Dec 2022

As nearly 50% of the world population is vaccinated against COVID-19, many people have begun to go back to a more normal way of life while still being thoughtful and aware of the risks COVID-19 brings.

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Current COVID-19 Situation

As of November 2021, COVID-19 cases are trending slightly upward. The 7-day average for COVID-19 cases in the United States is 80,885. 

Data from the Centers for Disease Control and Prevention shows that unvaccinated people are at a much greater risk than those who are fully vaccinated to test positive or die from COVID-19. Children ages 5 to 11 are now eligible for a COVID-19 vaccine after the F.D.A. authorized use of the Pfizer vaccine for this age group.

Omicron Variant

On November 26, 2021, WHO designated variant B.1.1.529 (Omicron) a variant of concern.

Researchers in South Africa and around the world are conducting studies to better understand many aspects of Omicron and will continue to share the findings of these studies as they become available.  

Transmissibility: It is not yet clear whether Omicron is more transmissible (e.g., more easily spread from person to person) compared to other variants, including Delta. The number of people testing positive has risen in areas of South Africa affected by this variant, but epidemiologic studies are underway to understand if it is because of Omicron or other factors.

Severity of disease: It is not yet clear whether infection with Omicron causes more severe disease compared to infections with other variants, including Delta.  Preliminary data suggests that there are increasing rates of hospitalization in South Africa, but this may be due to increasing overall numbers of people becoming infected, rather than a result of a specific infection with Omicron.  There is currently no information to suggest that symptoms associated with Omicron are different from those from other variants.  Initial reported infections were among university students—younger individuals who tend to have a more mild disease—but understanding the level of severity of the Omicron variant will take days to several weeks. 

How Vaccinations Impact the End of COVID-19

As of November 2021, 69 percent of people over 12 years old in the United States are fully vaccinated against COVID-19, and about 79 percent of adults have received at least one shot. 

Vaccine effectiveness studies provide evidence that mRNA COVID-19 vaccines offer similar protection in real-world conditions as they have in clinical trial settings, reducing the risk of COVID-19, including severe illness by 90 percent or more among people who are fully vaccinated.

COVID-19 Vaccine Booster Shots

According to the C.D.C., COVID-19 Vaccine booster shots are available for the following Pfizer-BioNTech or Moderna vaccine recipients who completed their initial series at least six months ago and are:

For the nearly 15 million people who got the Johnson & Johnson COVID-19 vaccine, booster shots are also recommended for those 18 and older and vaccinated two or more months ago.

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How Will COVID-19 End?

The COVID-19 pandemic can be considered “over” when there are very low levels of infections, hospitalizations and when everyone feels like they can lead a normal life by being in public without masks and attending live events without worry. Communities, states, and countries will reach an “end” at different times based on the population’s level of commitment to following guidelines and the area’s access to vaccinations. 

The Number of People Who Receive the COVID-19 Vaccine

According to Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), the number one factor determining how quickly we can end the pandemic is the number of people willing to get the vaccine. Teenagers and young adults or adolescents down to the age of 12 now have access to the vaccine. 

How Long Immunity from Vaccine Will Last

There are currently three authorized vaccines on the market in the U.S. - manufactured by Pfizer, Moderna, and Johnson & Johnson.

Studies have shown a steady decline of antibody levels among vaccinated individuals. Long-term follow-up of vaccine trial participants has revealed a growing risk of breakthrough infection. Records from countries such as Israel, the United Kingdom, and elsewhere show that COVID-19 vaccines are losing their strength, at least when it comes to keeping a lid on transmissible disease.

In order to combat waning COVID-19 immunity, booster vaccines are now available to those who are eligible.

Returning to Normal: The End of the COVID-19 Pandemic

While it’s essential to continue to be thoughtful of the risk COVID-19 may pose to you or your friends and family, many people have chosen to participate in “normal aspects” of life; such as eating dinner in a restaurant, traveling by plane, and gathering with vaccinated friends and family without masks. 

Deciding on when or if you should participate in these activities may be confusing or conflicting. These factors may help you determine your decisions:

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The Spread of COVID-19 in Your Community

It’s important to track the spread of COVID-19 in your community because the lower the rate, the lower the risk is. According to the C.D.C., a low transmission rate is generally fewer than ten new weekly cases per 100,000 people. Most of the country is well above that threshold, but parts of the San Francisco, Atlanta, Dallas, Houston, Los Angeles, Miami, New York, and Washington areas are below it. 

Hospitalizations vs. Cases

While it can be helpful to track the cases in your community, another important indicator is hospitalizations or deaths due to COVID-19. Hospitalization rates are correlated with the healthcare system’s capacity, ultimately leading to the number of deaths a community may face due to COVID-19.

It’s important to recognize COVID-19 treatments that can prevent hospitalization. Pfizer’s pill regimen reduces the risk of hospitalization by more than 80 percent. These treatments have the potential to turn COVID-19 into a normal virus rather than one that dominates life.

Risk of COVID-19 Illness

Everyone has different risk factors when it comes to contracting COVID-19. Most vaccinated people and children are considered low risk. However, many immunocompromised people are at a higher risk, which is also true among people in their 80s and 90s.

Therefore, those at greater risk may look to take more precautions, such as mask-wearing.

Benefit vs. Inconvenience 

For some, wearing a mask and communicating remote is not an inconvenience. However, for others, it poses multiple challenges. For example, for young children or those who are hard of hearing, mask-wearing can inhibit proper communication; this is the same for remote school or work; for some, it’s an ineffective strategy for collaboration or education.

Therefore, waiting until the pandemic “ends” to cancel these constraints may lead to a society dependent on the pandemic to continue living out our lives.

Bottom Line

COVID-19 vaccines are available for children ages 5 to 12 and adults. Booster vaccines are also available for eligible individuals. While it’s unclear when the pandemic will come to a complete end, it’s important to consider several factors when making decisions to live life somewhat normally.

Khang T. Vuong, MHA

Khang T. Vuong received his Master of Healthcare Administration from the Milken Institute School of Public Health at the George Washington University. He was named Forbes Healthcare 2021 30 under 30. Vuong spoke at Stanford Medicine X, HIMSS conference, and served as a Fellow at the Bon Secours Health System.