BA.5 appears to [be] infecting the lungs, whereas the BA.2 mainly infects the upper airways. Three factors lead us to believe that timelines for herd immunity and transition toward normalcy in the United Kingdom will be similar to those in the United States. but we dont yet know their efficacy, duration of protection, or the policies that will be set around fourth doses. which could have contributed to higher seroprevalence to begin with. However, he said, it would pose a big challenge for epidemiologists. Immunity can only partly predict the burden of disease at any point in time. Their behavior and effects, regarding these characteristics, will determine the extent to which they displace existing variants and affect the prospects for reaching the end of the pandemic. Frauke Muecksch, Zijun Wang, Alice Cho, et al., Increased potency and breadth of SARS-CoV-2 neutralizing antibodies after a third mRNA dose, BioRxiv, February 15, 2022, biorxiv.org. Re-engaging the community with vaccination messages will also be important next year. Achieving some degree of consensus on public-health measures will likely be an important step toward controlling an Omicron-driven wave of disease. Evidence suggests that both natural and vaccine-induced immunity wane over time, particularly against infection.31Daniel R. Felkin, Melissa M. Higdon, Laith J. Abu-Raddad, et al., Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: results of a systematic review and meta-regression, The Lancet, February 21, 2022, thelancet.com. COVID-19 deaths on the rise: Epidemiologists grim prediction for Australia, Not so fast: Tony Abbott calls for the Voice referendum to be cancelled, The night I cooked schnitty for Barry Humphries, actual number of virus cases at the peak of the Omicron wave was likely double, Omicron wave cases double reported: Study. Delta-cron (Omicrons twin) and Milder-cron scenarios we described in our March 2022 update remain a reasonable summary of the range of possibilities for the impact of future variants. The timelines will vary based on differences in vaccine access and rollout and in levels of natural immunityand potentially, in levels of cross-immunity and previous coverage of other vaccines, such as the BCG vaccine. National cabinet encourages wearing masks to combat COVID-19. Well-executed distribution of effective vaccines will still be paramount. As countries transition over time to managing COVID-19 as an endemic disease, the world may reach a long-term state of disease prevention similar to that seen with the flu, with annual or twice yearly booster doses. There is no evidence of higher case fatality with either new strain, but there are fears that new strains may affect how antibodies bind to the virus and may reduce the efficacy of vaccines or antibody treatments developed over the past few months. Just as the risk of flu is considered normal, so too might the risk of COVID-19. Here, as in other regions, the timing of access to vaccines will be the biggest driver of the end of the pandemic. This article presents a new analysis of a range of scenarios based on the infectiousness, immune evasion, and severity of disease caused by the Omicron variant. Clinics have been set up around Australia dedicated to supporting patients suffering from the condition, but funding for many of them is not certain. 14. COVID data tracker weekly review, accessed August 15, 2021; Niharika Mandhana, From pandemic to endemic, Singapore creates model for living with Covid-19,, Alexis Madrigal, A simple rule of thumb for knowing when the pandemic is over,. Sarun Charumilind is a partner in McKinseys Philadelphia office, Matt Craven is a partner in the Bay Area office, Jessica Lamb is a partner in the New Jersey office, Adam Sabow is a senior partner in the Chicago office, Shubham Singhal is a senior partner in the Detroit office, and Matt Wilson is a senior partner in the New York office. Patrick Knox and Laura Gesualdi-Gilmore The Sun 3 min read December 30, 2021 - 9:00AM Measurements like it can help inform both individual behavior and public policy during the next chapter of the COVID-19 pandemic. As ever, different parts of the world will experience the coming phase differently. 10. But a number of other factors could delay the timelines beyond those described, including unexpected safety issues emerging with early vaccines, significant manufacturing or supply-chain delays, continued slow adoption, further mutation, or a shorter-than-anticipated duration of vaccine-conferred immunity. A year before the pandemic took a hold, British astrologer Jessica Adams, 56, predicted a virus would disrupt the world and flagged a key date January 10 - when the first Covid patient died. In such places, until herd immunity is reached, COVID-19 might be analogous to measlesnot a day-to-day threat to most people, but a persistent risk. Jacqui Wise, Covid-19: Pfizer BioNTech vaccine reduced cases by 94% in Israel, shows peer reviewed study, BMJ, February 25, 2021, Volume 372, Number 8282 bmj.com; Benjamin Mueller, Vaccines sharply cut coronavirus hospitalization, U.K. studies show,. Xer leaders introduce generous parental leave policies and continue to fight for equal pay. We model this with an assumption in line with the approach taken by the Institute for Health Metrics and Evaluation (IHME): if there were an effective vaccination immunity of 50 percent and an effective natural immunity of 90 percent, the multiplicative assumption would suggest a combined hybrid immunity of 95 percent, since 1 (1 50 percent) (1 90 percent) = 95 percent. The order and pace of these steps will vary by geography. The Delta variant of SARS-CoV-2, also called B1.617.2, emerged in late 2020 and has since spread rapidly around the world. But with herd immunity, population-wide public-health measures can be phased out. 9. Improved estimates of seroprevalence are increasingly available for many regions. The initial evidence indicates that the efficacy of these therapies is unlikely to be reduced by the mutations present in the Omicron variant.67Jason Gale and John Lauerman, How does Omicron challenge the treatments for Covid?, Bloomberg, December 9, 2021. Millennials continue on to family-sized houses. Its much too soon to declare victory, however. This might occur if vaccines proved less effective in preventing severe disease, and could lead to the worst wave yet for many locations. Andrews told reporters in Wangaratta on Tuesday: The seven day average is very pleasingly coming down, so that says to me that the peak has come and gone. In this article, well explain the criteria that will be key factors in determining when each is reached. Science brief: Background rationale and evidence for public health recommendations for fully vaccinated people, Centers for Disease Control and Prevention, last updated March 8, 2021, cdc.gov. The results of these scenarios for the United States are shown in Exhibit 1. This is likely, but has not yet been proven at scale.137Sabin Russell, Vaccines stop COVID-19 symptoms, but do they stop transmission?, Fred Hutch News Service, December 16, 2020, fredhutch.org. Strong public-health measures will remain critical to saving lives during this period. On the last day of December, that was starting to look optimistic, with the 20,000 mark already broken, well ahead of that pace. The shift from a zero-COVID-19 goal to an endemic, low-burden goal may be challenging for some countries. And the initial rollout of vaccines has been slower than hoped in many places.135Michelle R. Smith, Governors scramble to speed vaccine effort after slow start, Associated Press, January 6, 2021, apnews.com. Mortality risk of COVID-19, Our World in Data, ourworldindata.org. Based on our reading of the current state of the variables and their likely progress in the coming months, we estimate that the most likely time for the United States to achieve herd immunity is the third or fourth quarter of 2021. An epidemiological end point will be reached when herd immunity is achieved. Just a couple of weeks ago, a pharmacy in north-west Sydney was selling a five-pack rapid antigen test kit for $50. Age demographics will continue to be an important risk driver. The R0 value for COVID-19 is under debate, with estimates ranging from two to four. Omicron is already among the most infectious human viruses known to science.40See Exhibit 1. even though inequalities in global vaccine access have meant that few there have received three doses, and most have not yet received a single dose. New COVID-19 cases worldwide, Johns Hopkins University & Medicine, February 20, 2022, coronavirus.jhu.edu. Professor Esterman said there is also hope that Australias youngest will soon be able to get vaccinated against COVID-19, with children under five now eligible to receive their first dose in the US. SARS-CoV-2 and Surface (Fomite) Transmission for Indoor Community Environments. 22. In the pessimistic scenarios, the peak number of hospitalizations for COVID-19 could be much higher in the next six months than in the past six months, whereas in the optimistic scenario, the number would be higher but similar to that seen in the second half of 2021, as waning immunity causes ongoing disease from a combination of the Delta and Omicron variants. In any scenario for the future of the COVID-19 pandemic, much depends on the ways in which societies respond. Natural immunity to SARS-CoV-2 The end of Europes pandemic may come somewhat later, and other countries outlooks will depend on several variables. Exhibit 1 assumes a US public-health response similar to that seen during the Delta wave. As part of Australia's COVID-19 plan for 2023, PCR testing will be prioritised for the most vulnerable, in a bid to ensure their access to antivirals is fast-tracked. Some countries in this group, such as Australia, have recently faced a Delta-driven surge in cases, but in absolute terms the burden of disease remains low relative to other countries. The short term will be hard, but we can reasonably hope for an end to the pandemic in 2021. Estimated case-detection rates range from 3:1 to 10:1.2Charlie Giattino, How epidemiological models of COVID-19 help us estimate the true number of infections, Our World in Data, August 24, 2020, ourworldindata.org; Hazhir Rahmandad, John Sterman, and Tse Yang Lim, Estimating COVID-19 under-reporting across 86 nations: Implications for projections and control, medRxiv, August 3, 2020, medrxiv.org. The United Kingdoms plan for reopening provides an example of the stepwise manner in which a transition to normalcy is likely to occur.132Lockdown: Boris Johnson unveils plan to end England restrictions by 21 June, February 22, 2021. NSW was hit by Omicron first, with cases rising from mid-December and escalating sharply just before Christmas. Estimates of increased vaccine coverage needed are based on R0 = 3.36-4.32, which is 4080% greater than R0 of 2.4. Government has no interest whatsoever in pushing house prices down. Based on analysis of all sources cited. Its a mixture of the old Wuhan strain and Omicron. More data are likely to emerge on this in the weeks ahead. Peter Loftus, Moderna is testing its COVID-19 vaccine on young children,. Nationwide commercial laboratory seroprevalence survey, Centers for Disease Control and Prevention, accessed November 15, 2020, covid.cdc.gov. While Australia will recover economically in 2022, a near-universal skills shortage will hold back economic growth. The United Kingdoms experience nevertheless suggests that once a country has weathered a Delta-driven wave of cases, it may be able to relax public-health measures and resume the transition toward normalcy.87 Sarah Zhang, Watch the U.K. to understand Delta, Atlantic, August 3, 2021, theatlantic.com. Others have also advanced this view; for an example, see Grady McGregor, Evidence mounts that Omicron is more infectious, less severe than Deltabut Fauci, other experts warn against premature optimism,, Ewen Callaway and Heidi Ledford, How bad is Omicron? When confidence is restored, people will again fill bars, restaurants, theaters, and sports venues to full capacity; fly overseas (except for the highest-risk populations); and receive routine medical care at levels similar to those seen prior to the pandemic. Professor Esterman said the raised Reffs are due to highly transmissible new sub-variants of the virus sweeping through the country. Can mutagenicity concerns in pregnant women for molnupiravir be managed to ensure patient safety while maximizing effective use of the drug? Beyond the cancelled plans and missed Christmases, we don't really have a way to judge the real damage done by the poor testing situation. Public-health authorities may therefore need to look at a wider range of indicators to support their planning and disease management efforts. And public interest in vaccination appears to be similar too, even in countries such as France, where interest in vaccination was significantly lower than in other countries in the region but may now be improving.126Global attitudes: COVID-19 vaccines, Ipsos, February 9, 2021, ipsos.com; Yasmeen Serhan, The vaccine-hesitant man of Europe, The Atlantic, March 18, 2021, theatlantic.com. If the variants turn out to be a minor factor (they only reduce vaccine efficacy modestly, or they dont spread widely), then herd immunity in the second half of the year is likely for both countriesand is more likely in the third quarter than the fourth. Levels of natural immunity from prior infection vary within the European Union but are generally in the same range as in the United Kingdom and the United States.125SeroTracker, last accessed March 15, 2021, serotracker.com. Having suffered a wave of cases caused by the Delta variant during June and the first few weeks of July, the country delayed plans to ease many public-health restrictions and eventually did so on July 19, though expansive testing and genomic surveillance remain in place. Subvariants of Omicron, especially BA.5, have challenged the world with ever more transmissible versions of the virus. He criticised a relaxation of policies on face masks and social distancing, which he said was sending the message to the general public that the pandemic was over. Causation hasnt been proven. First, up-to-date vaccination status, including a recent booster, proved to be especially important in protecting against Omicron21Effectiveness of a Third Dose of mRNA Vaccines Against COVID-19Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance VISION Network, 10 States, August 2021January 2022, Centers for Disease Control and Prevention, January 28, 2022, cdc.gov. Most of them gained it from contracting other coronaviruses, which primed their immune systems to react to COVID-19.5Nina Le Bert et al., SARS-CoV-2-specific T cell immunity in cases of COVID-19 and SARS, and uninfected controls, Nature, August 20, 2020, Volume 584, pp. 23Emma K. Accorsi, Amadea Britton, Katherine E. Fleming-Dutra, et al, Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants, January 21, 2022, jamanetwork.com.. Countries where a significant portion of those at risk had received three doses of vaccine, including at least one dose of mRNA vaccine, saw hospitalizations substantially decouple from cases.24New COVID-19 cases worldwide, Johns Hopkins University & Medicine, February 20, 2022, coronavirus.jhu.edu. The transition would gradually normalize aspects of social and economic life, with some public-health measures remaining in effect as people gradually resume prepandemic activities.