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COVID-19 May Never Go Away — With Or Without A Vaccine

Originally published on August 11, 2020 10:39 am

Humans have never been particularly good at eradicating entire viruses, and COVID-19 might not be any different.

More than 19 million people have tested positive for the coronavirus globally, and at least 722,000 have died. In the U.S., nearly 5 million people have tested positive and more than 160,000 have died. While scientists are racing to find a cure for the virus, there's a chance COVID-19 will never fully go away — with or without a vaccine.

But that doesn't mean everyone will have to self-isolate forever.

Vineet Menachery, a coronavirus researcher at the University of Texas Medical Branch, told NPR's Weekend Edition that one of the more likely scenarios is that the spread of COVID-19 will eventually be slowed as a result of herd immunity. He said that he'd be surprised "if we're still wearing masks and 6-feet distancing in two or three years" and that in time, the virus could become no more serious than the common cold.


Interview Highlights

On why it is so hard to eradicate this virus

The first thing to remember is that we haven't been successful at eradicating many viruses at all. Really the lone exception is smallpox, but many of these viruses exist not only in the human population but in animal populations. So coronaviruses may be removed from the human population, like SARS coronavirus in 2002, but we know that those viruses or viruses that are similar to it still exist in nature and at any time they may gain the tools to reemerge in humans again.

On the outlook for COVID-19 immunity as more people are exposed to the virus

So it's still up in the air. COVID-19 is really unique in a couple of different ways. One, like the common cold coronaviruses, it spreads very easily, but unlike those, this causes this severe disease. What we know about the common cold coronaviruses is that the immunity to those don't actually stay that long. So what is not clear is if immunity will wane over time and that in two or three years you could be exposed and get this virus again. Similar to how you could get the common cold coronavirus every few years.

On the other end of that, viruses like SARS and MERS, if you get those infections and you overcome them and you recover, generally your immune response lasts a long time. So what we don't know with COVID-19 is which of these two poles it may end up at.

On what he predicts for the future for COVID-19

I'd be surprised if we're still wearing masks and 6-feet distancing in two or three years. I think the most likely outcome is that we'll eventually get to herd immunity. The best way to get to herd immunity is through a vaccine and some certain populations who have already been exposed or will be exposed.

And then the expectation I have is that this virus will actually become the next common cold coronavirus. What we don't know with these common cold coronaviruses is if they went through a similar transition period.

So, say something like OC43, which is a common cold coronavirus that was originally from cows. It's been historically reported that there was an outbreak associated with the transition of this virus from cows to humans that was very severe disease, and then after a few years, the virus became just the common cold. So in three to five years it may be that you're still getting COVID-19 in certain populations of people or every few years, but the expectation is hopefully that it'll just be a common cold and it's something that we can just each deal with and it won't lead to hospitalization and the shutting down of society.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

LULU GARCIA-NAVARRO, HOST:

COVID-19 is probably never going to go away, with or without a vaccine, but that doesn't mean the future will be quite as terrifying as the present is. We are joined now by Dr. Vineet Menachery. He is a coronavirus researcher at the University of Texas Medical Branch, and he explains how we will adapt to this coronavirus moving forward has a lot to do with immunity.

Welcome to the program.

VINEET MENACHERY: Thank you.

GARCIA-NAVARRO: So why is it so hard, first of all, to eradicate this virus - specifically coronaviruses?

MENACHERY: The first thing to remember is that we haven't been successful at eradicating many viruses at all. Really, the lone exception is smallpox. But many of these viruses exist not only in human populations, but in animal populations. So coronaviruses may be removed from the human populations, like SARS coronavirus in 2002, but we know that those viruses or viruses that are similar to it still exist in nature. And at any time, they may gain the tools to reemerge in humans again.

GARCIA-NAVARRO: As more people become exposed and build up their immunity against this coronavirus, how will that affect the trajectory of the pandemic? What do you predict with immunity for COVID-19?

MENACHERY: So it's still up in the air. COVID-19 is really unique in a couple of different ways. One, like the common cold coronaviruses, it spreads very easy. But unlike those, it causes this severe disease. What we know about the common cold coronaviruses is that the immunity to those don't actually stay that long. And so what is not clear is if immunity will wane over time and that, in two or three years, you could be exposed and get this virus again, similarly like you get common cold coronaviruses every few years.

On the other end of that, viruses like SARS and MERS - if you get those infections and you overcome them and you recover, generally, your immune response lasts a long time. And so what we don't know with COVID-19 is which of these two poles it may end up at.

GARCIA-NAVARRO: So I guess that raises questions, first of all, about a vaccine - how effective it'll be, what kind of immunity we'll get from a vaccine. And the scenarios would be we might get a vaccine that would be something that we would take yearly, like a flu vaccine, or maybe it would be more akin to vaccines that would give you one shot and then you're immune for life. Are those the sort of two options?

MENACHERY: Yeah. I mean, I think there's probably somewhere in between. I think you're looking at a vaccine that - maybe it's not every year, like the flu vaccine, but it may be something like tetanus or those vaccines that you get every two or three years, maybe, or four or five years to boost that immunity that you already have. That would be my expectation on that.

GARCIA-NAVARRO: So I guess this is the big question. I'm going to ask you to do something that I think doctors don't like to do and scientists don't like to do, which is look into the future. Three to five years from now, will we be wearing masks, keeping 6 feet apart? How will we have to change our behavior to coexist with this virus that isn't going to go away?

MENACHERY: Well, you're right that it's not fun to speculate on that 'cause it's easy to be proven wrong. I'd be surprised if we're still wearing masks and 6-feet distance in two or three years. I think the most likely outcome is that we'll eventually get to herd immunity, and the best way to get to herd immunity is through a vaccine and some certain populations who have already been exposed or will be exposed.

And then the expectation I have is that this virus will actually become the next common cold coronavirus. What we don't know with these common cold coronaviruses is if they went through a similar transition period. So say something like OC43, which is a common cold coronavirus that was originally from cows - it's been historically reported that there was an outbreak associated with the transition of this virus from cows to humans that was very severe disease. And then, after a few years, the virus became just the common cold.

And so in three to five years, it may be that you're still getting COVID-19 in certain populations of people or, you know, every few years. But the expectation is hopefully that it'll just be a common cold and it's something that we can each deal with and it won't lead to hospitalization and, you know, the shutting down of society.

GARCIA-NAVARRO: Dr. Vineet Menachery is a virologist at the University of Texas Medical Branch, and he focuses on coronaviruses.

Thank you very much.

MENACHERY: Thank you. Transcript provided by NPR, Copyright NPR.