From his unique vantage point, Dr. Mokdad can literally map how our desire to prematurely claim victory, rather than accept the virus’s continuance, has led us to throw off restrictions, with deadly effect. He just revised his projected body count for the United States upward, to at least 828,000 total pandemic deaths by Feb. 1, 2022. Masks, which so many Americans abandoned when it seemed the end of the pandemic was in sight, could still make a difference: If 95 percent of Americans wore a mask, his model projects roughly 56,000 fewer deaths by Feb. 1.
In the more distant future, Dr. Mokdad does not see “independence from a deadly virus,” to quote our president. “We would expect that the transmission will never go to zero,” Dr. Mokdad told me. “The virus is going to be with us for a long time” — meaning that deaths, and efforts to prevent them, could continue for years.
Serious people are now trying to plan for what living with SARS-CoV-2 will look like, a potentially bleak exercise but one also brimming with scientific promise.
An escape variant — one so infectious that it escapes our best mRNA vaccine defenses — is not a certainty, said the experts with whom I spoke. But it is not far-fetched, either, in part because of our slow pace at vaccinating the world. That worst-case scenario could “change the whole landscape,” said Dr. Eric Topol, a professor of molecular medicine at Scripps Research, putting us “back to square one, with masks and distancing our only defense.” But it can be avoided, he and others said.
Embracing the Covid-forever possibility is our best path forward, said Dr. Farrar of Wellcome. That mind-set is not only a crucial hedge against complacency, in which we settle for the good-enough defenses we have now. It could drive us to capitalize on the extraordinary scientific progress of the past year. In years to come, perhaps we could have the ultimate moonshot coronavirus vaccine, one that blocks transmission of all coronaviruses (a massive challenge because of their genetic differences).
The vaccine could be a single dose stored at a modest temperature, be “cheap as chips,” said Dr. Farrar, and be available to everyone in the world. We could have unlimited oxygen and protective gear in every hospital. With the right investment, says Dr. Farrar, we could even roll out a whole new time frame: release a genomic sequence on Day 1 of identifying it, develop a responsive vaccine within seven days and begin shots in arms within a month.
On Sept. 3, the Biden administration released a pandemic preparedness plan that, though somewhat less aggressive, calls for slashing the timeline for creating and scaling up a vaccine from under a year to under 100 days.