After the pandemic: perspectives on the future trajectory of COVID-19

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After the pandemic: perspectives on the future trajectory of COVID-19
08 July 2021
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After the pandemic: perspectives on the future trajectory of COVID-19
Viral infection
Abstract
There is a realistic expectation that the global effort in vaccination will bring the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic under control. Nonetheless, uncertainties remain about the type of long-term association the virus will establish with the human population, particularly whether the coronavirus disease 2019 (COVID-19) will become an endemic disease. Although the trajectory is difficult to predict, the conditions, concepts, and variables that influence this transition can be anticipated. Persistence of SARS-CoV-2 as an endemic virus, perhaps with seasonal epidemic peaks, may be fueled by pockets of susceptible individuals and waning immunity after infection or vaccination, changes in the virus through antigenic drift that diminish protection, and reentries from zoonotic reservoirs. Here, we review relevant observations from previous epidemics and discuss the potential evolution of SARS-CoV-2 as it adapts during persistent transmission in the presence of a level of population immunity. Lack of effective surveillance or adequate response could enable the emergence of new epidemic or pandemic patterns from an endemic infection of SARS-CoV-2. There are key pieces of data that are urgently needed in order to make good decisions. We outline these and propose a way forward.
Vir Biotechnology, San Francisco, CA, 94158, USA
Amalio Telenti, Ann Arvin, Phil Pang & Herbert W. Virgin
Department of Integrative Structural and Computational Biology, Scripps Research, La Jolla, CA, 92037, USA
Amalio Telenti
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA
Lawrence Corey
Humabs Biomed SA, a subsidiary of Vir Biotechnology, 6500, Bellinzona, Switzerland
Davide Corti
Departments of Medicine, Molecular Microbiology, Pathology and Immunology, and the Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, 63110, USA
Michael S. Diamond
Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
Adolfo García-Sastre
Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
Adolfo García-Sastre
Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
Adolfo García-Sastre
The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
Adolfo García-Sastre
Department of Microbiology and Immunology, Tulane University, New Orleans, LA, 70112, USA
Robert F. Garry
Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Life and Environmental Sciences and School of Medical Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
Edward C. Holmes
Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, 63110, USA
Herbert W. Virgin
Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, 75390, USA
Herbert W. Virgin
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Ann Arvin
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Lawrence Corey
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Davide Corti
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Michael S. Diamond
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Adolfo García-Sastre
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Robert F. Garry
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Edward C. Holmes
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Phil Pang
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Herbert W. Virgin