Writing in The Atlantic, Andy Slavitt, a former senior advisor for the White House's coronavirus response, explains three potential developments that could help America get out of its "Covid rut" and turn the tide of the pandemic.
1. The virus could mutate at a slower, more predictable rate
The coronavirus has mutated numerous times over the last few years, resulting in the emergence of several new variants. Because these mutations have been difficult to predict, the virus has been difficult to combat.
"A virus of exactly the same rate of spread, immune-evasion properties, and severity as COVID-19 would be a lot more tolerable if it mutated at the rate of the flu and surged at more predictable times," Slavitt writes.
If the coronavirus were to begin acting more like the flu, which typically has predictable seasonal fluctuations, health officials could plan and develop once-a-year boosters that target a specific variant. So far, that is "essentially impossible," since a booster developed in March is likely to be out of date by October, according to Slavitt.
A slower, more predictable rate of mutation would also make it easier to develop ways to target the coronavirus, and people who are immunocompromised or at high risk of severe illness could be free from "continual anxiety and could participate more freely in the activities that bring them joy," he writes.
2. Accumulated immunity could make Covid-19 less severe
Even if the coronavirus continues mutating rapidly, the mutations may be less consequential as people accumulate immunity over time—both from vaccinations and prior infections. With these "layers of immunity," Covid-19 could result in less severe illness and "resemble something closer to the common cold," Slavitt writes.
Currently, some estimates suggest that around 90% of the U.S. population has either been vaccinated or infected by the coronavirus at some point. However, despite this level of immunity, hundreds of people are still dying from Covid-19 every day.
"For us to be at a better place, everyone—including older, frailer, and sicker people—will need to be able to live like the pandemic is over," Slavitt writes.
3. A nasal vaccine could stop infections in their tracks
According to Slavitt, the best care scenario for the pandemic "is one in which we don't need to worry about getting infected at all." Nasal vaccines may offer a path to this future.
Unlike current injectable vaccines, nasal vaccines would be able to generate mucosal immunity, which could "not only prevent us from getting sick" but also make it more difficult for the virus to "[take] root in the first place," Slavitt writes. In addition, he notes that a nasal vaccine could help those with needle phobia and may be administered without the help of medical professionals.
A nasal vaccine is likely still a few years from being reality, but more than a dozen such vaccines are currently in various stages of clinical research and testing. In addition, Slavitt says nasal vaccines "will need to be universally available at low cost and easy to ship around the world" to maximize the benefit for the public.
It may be months before 'good' news is apparent
According to Slavitt, throughout the pandemic, people have "seen enough good-news false starts to know that news can't be officially declared 'good' until months later." However, this does not mean that the pandemic will not improve over time.
"COVID-19 isn't the first and is hardly the worst virus to prey upon humans," Slavitt writes. "To be sure, many earlier pandemic-causing viruses circulated long beyond their acute initial phase, but the pandemic stages eventually ended, and the damage ebbed as scientists developed better treatments and vaccines and the human body adjusted."
"When will this happen with COVID-19?" he writes. "We'll know six months after it already has." (Slavitt, The Atlantic, 8/4)