Experts: Completely eliminating COVID an ‘unrealistic expectation’

The pandemic may slow and lives may revert to some semblance of normalcy, but experts say the coronavirus will likely never go away.

As vaccine efforts continue, recently surpassing more than 50 percent of Connecticut’s adult population, public health experts warn that even if nearly all adults get inoculated, the COVID-19 virus will remain.

“In the scientific community, there's a strong consensus that we won't be able to eradicate the virus entirely,” said David Banach, an infectious disease physician and hospital epidemiologist at UConn Health.

Banach said that while the point of vaccines is to reach population immunity and stop transmission of the virus, global immunity may not actually be achievable.

“The general feeling is that we won't be able to achieve that with this virus, at least in the near future,” he said. “Respiratory viruses like this, they spread very easily. I think there's a feeling that globally, we won't be able to get enough of the proportion of the population vaccinated.”

Imagine pockets of coronavirus flaring up in various parts of the world. In much of the United States, and particularly in states like Connecticut, “vaccine coverage is very high,” Banach said. “But for us to achieve that across the entire world is a difficult or unrealistic expectation.”

Harvard epidemiology professor Marc Lipsitch said something similar during a recent Stanford University panel discussion. Population immunity on a small scale might be possible, but globally? It’s not likely, he said.

“This virus is going to continue to circulate,” he said. “Global coverage is clearly going to be low and slow. The projections for distribution of doses, in the coming months, is in the hundreds of millions of dose range for a planet of billions of people. It’s just not going to be adequate.”

Vaccination will make a difference. “If we're 99 percent protected through vaccination, that's going to be very different than if we're, let's say, 60 percent,” said Rick Martinello, director of infection prevention at Yale New Haven Health.

The less opportunity there is for viral replication, the less chance there is for the coronavirus to mutate into more hostile variants.

“This virus, as long as it's present on earth, and being transmitted between man and beast, there is going to be that viral evolution,” Martinello said. “Now, the fewer individuals getting sick, the slower that evolution will be, because there's less replication and there's less opportunity for that virus to evolve.”

Unlike a disease like polio, the coronavirus can infect and circulate among animal populations. That means, Martinello said, complete and total annihilation of the virus is not really possible.

“We know that animals can get infected with this virus, dogs, cats, tigers, gorillas, and there's wild animals getting sick with it that we're just very unaware of right now,” he said. “That really creates a situation where this virus is not going to be eradicated from the earth anytime soon. So what's going to happen is, it's going to continue to spread.”

Martinello said the coronavirus may just become one of several possible diagnoses doctors need to consider, like RSV or strep, “another issue that when people get sick with a fever and a cough, it's something else that their physicians will have to think of in the differential diagnosis.”

“The way I would think of it is, SARS-CoV-2 becoming more similar to how we think of flu and other respiratory viruses, where it is going to become part of our normal repertoire of illnesses,” he said.

Like the flu, there may be a seasonality component to the coronavirus, causing outbreaks in the spring, perhaps, though Martinello said the seasonal dynamics of the virus are not yet fully understood.

“At this point, we really don't know anything about its seasonality,” he said. “I think that's going to take years for us to really understand whether or not there's going to be any seasonality to it.”

If the coronavirus will be around for the foreseeable future, the outcomes from an infection may improve. So far, breakthrough infections have been, for the most part, much milder.

“Vaccines will help mitigate the effects, the hospitalizations, the deaths, but the virus will still be in the community,” Banach said.