More than two years into the pandemic, much of the U.S. has rolled back restrictions and mask requirements in an attempt to regain some sense of normalcy.
But even as case counts rise and ebb — about 66% of the U.S. population is now fully vaccinated, according to Our World in Data — public health experts and scientists warn that the pandemic is far from over.
During a Johns Hopkins Bloomberg School of Public Health webinar this week, associate professor of epidemiology David Dowdy and professor of epidemiology Priya Duggal discussed their expectations for the next phase of the pandemic. Here are 5 takeaways.
1. Cases are rising again. Recent weeks have brought a slight uptick in COVID-19 case counts across the U.S., including in areas that had previously dodged high infection rates, such as Puerto Rico and Vermont. Despite the lifting of many pandemic restrictions, the Biden administration recently warned that the nation can expect a large wave this fall – with up to 100 million infections and more deaths.
2. Long COVID is real. About one-third of people who’ve been infected with the virus have experienced what’s known as long COVID, according to Duggal. The World Health Organization defines long COVID as new or persistent symptoms three months after initial infection that last for two months or more.
Who’s at risk? Initial research shows that anyone could be vulnerable. “Global studies indicate that both men and women, all races, those hospitalized and not hospitalized, those with mild, moderate and severe infections, with or without comorbidities, and all ages are at risk,” Duggal said. “Given this, it means no one gets a free pass.”
Research shows that about 3% to 5% of people infected with COVID-19 end up developing long-term symptoms that make them feel like they can’t function normally, she addedt. Symptoms now include mobility issues and even disability, such as having trouble walking short distances or going up a flight of stairs.
“There’s no specific long COVID treatments, partially because we don’t know the mechanism of long COVID,” Duggal explained. “If it’s extra virus, perhaps antivirals will work and should be considered in trials. If it’s an immune response reaction, how do we control that initial immune response to be strong enough to keep you out of the hospital, but not so strong to give you long-term symptoms?”
3. Cases appear to be getting milder overall. Despite the uptick in cases and expectations of additional surges, COVID-19 infections appear to be getting milder. That’s because the population has begun to develop immunity against severe infection, due to vaccination, antivirals and previous infections, Dowdy pointed out.
During subsequent surges, Dowdy expects deaths to increase by 10% to 25% – but doesn’t necessarily expect them to skyrocket.
“Rates of hospitalization and deaths are climbing only gradually, suggesting the average case of COVID-19 is getting milder,” he explained. “It appears we’re entering another phase of the pandemic, where vaccinated people are experiencing milder infections. But cases are still rising, and we can anticipate a large wave in the coming months.”
4. COVID-19 as a disease will never be over. An eventual return to normalcy may be on its way, but experts agree the virus will never be fully defeated. Instead, scientists are holding off on proclaiming that we’ve reached an endemic state. In other words, the world is still in the pandemic phase and may remain so for quite some time.
“COVID-19 as a disease is not going to be over, just like influenza isn’t going to be over, nor is HIV,” Dowdy said. “When should we consider this to no longer be in a pandemic phase? I personally think that could be reasonably considered when the burden of illness is along the same lines as that of all other infectious diseases, like the flu. That’s a reasonable benchmark, but we’re not there yet.”
5. Researchers hope to make a dent in long COVID before too long: There’s still plenty left to learn. Johns Hopkins has launched its COVID Long Study, which aims to enroll 25,000 people in the U.S
“We’re interested to see what those symptoms are, such as the loss of sense of smell for six months or longer,” Duggal said. “[We’ve also identified] new cardiac outcomes like congestive heart failure. We’re trying to understand what is happening, and hope to have initial results on mobility and disability this summer.”
The National Institutes of Health has also launched a study examining long COVID.