THE COVID ENDGAME: PREDICTIONS ON THE FUTURE OF VACCINES, SCHOOLS, MEDIA, SCIENCE, & MORE Vinay Prasad, MD, MPH Recently my Twitter feed filled with news about a boat lodged in the Suez canal. The New York Times Magazine ran a long story on whether artificial intelligence can help us ascertain if coffee is indeed good for us. I breathed a sigh of relief, perhaps COVID-19 is winding down. The media is returning to their favorite, hard hitting stories. Of course, I am not a fortune-teller, but in this essay, I want to take an educated guess as to how the next year might play out. Like most predictions for this pandemic, don't be surprised if my estimates are wildly off, and don't hold it against me. After all, we didn't do that for anyone else.
Vaccines I have been amazed by the speed with which vaccines were developed and their efficacy. I am a long-standing critic of the pharmaceutical industry, but on this occasion, I give them credit. Job well done. As I type this, 90 million Americans have received at least one dose of the vaccine. An additional 30 million Americans have had documented infections with COVID-19 and recovered. Some additional fraction have had undocumented infections and recovered. The fraction of people susceptible to COVID-19 is shrinking by the minute, and that's good news. I expect more stories in the media to be about green tea, blueberries, red wine, and dark chocolate to make up for the fall in COVID-19 coverage.
Schools In contrast with the brisk pace of vaccination, schools remain a struggle. Previously, Vladimir Kogan and I highlighted the urgent need to reopen in-person public schools. CDC guidance from just a few weeks ago recommended six feet of distance between students and reopening based on the community level of spread. Vlad Kogan and I investigated the data for both these claims, which would hamstring school opening. We found the recommendations to have no good support whatsoever. Amazingly, the CDC has agreed, and rescinded both of these policies, which pave the path to reopening schools. 26
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I don't know what the future will hold, but I suspect that the moment kids get even a foot in the classroom, the dialog will shift. Teachers will remember why they love teaching. Kids will remember why they love school, and parents will feel a weight lift from their shoulders. Once the dam is cracked, it will open wide. I hope that shortly, schools around this nation will return to normal. The sooner the better, and once schools are open, we will have to survey the damage done to the kids, and work to mend it.
A Glorious Summer More and more vaccination, warmer weather, and a public that cannot sustain any more restrictions mean we will have a vibrant and joyous summer. Parties, dinners, parks, the beach — I suspect we will see an outpouring of socializing. A summer of revelry may help heal the wounds of the past year, and just might relax some folks.
COVID-19 Outbreaks I suspect that COVID-19 will never be gone. It will return in bursts in the fall and winter for years to come. I suspect it may concentrate in nursing homes and care facilities, despite high levels of vaccination. It will also spread in pockets of the country where folks are reluctant to be vaccinated. It will take a few winters before it loses the urgency and anxiety of 2020, and when a patient is admitted in the winter time, we may merely ask, "is it flu or COVID-19?"
The Pundits COVID-19 unleashed a broad swath of pundits. Many had never been in the limelight, a few have come to love it, and others (the wise ones) have started to hate it. I suspect that many COVID-19 pundits will pivot. Their expertise will shift to issues of nutritional epidemiology, exercise, gun violence, or other public health topics that retain national interest. Many others, particularly those with extremely specialized training, will be unable to pivot. I suspect we will hear less of them. I am OK with that. WWW.SFMMS.ORG
