The United States is finally seeing some positive signs after a frenetic few weeks when the Omicron variant of the coronaviruses seemed to affect everyone.
The Omicron variant of the H1N1 virus is unique to the United States, so many hope that the surge will be the last big battle with it.
The variant fell off quickly after spiking in South Africa and Britain. In Boston and San Francisco, there are declining virus levels in sewage. On Monday, the top European regional official of the World Health Organization suggested that Omicron could offer hope for stabilization.
The Biden administration's top adviser on the Pandemic said on Sunday that things are looking good.
What is driving the optimism? The idea is that by the time the coronaviruses find a foothold in our communities, so many people are gaining immunity through Omicron that they will be gone.
The course of the virus in the United States appeared more complicated and less rosy in interviews with more than a dozen epidemiologists, immunologists and evolutionary biologists.
They said that Omicron brings us closer to the end of the epidemic. There is reason to hope that hospitalizations and deaths will follow the current surge in infections.
The path to normal may be short and direct, the goal just a few weeks away, and the surge may become a thing of the past. It may be long and bumpy, pockmarked with outbreaks over the coming months as the virus continues to find footing.
It is not likely that the coronaviruses will disappear completely, according to many scientists. There are a number of reasons why the population's immunity against the virus will be imperfect.
"Maybe there was a short while where we could have reached that goal, but at this point, we are well beyond that."
The coronaviruses is likely to become endemic in the US, a milder illness that people must learn to live with and manage.
The future depends on a wild card. At the end of November, Omicron appeared. Some researchers think that other variant are coming because too little of the world is vaccine free. Some may be both highly contagious and have a knack for short-circuiting the body's immune defenses.
Anne Rimoin, an epidemiologist at the University of California, Los Angeles, said that the ending is not written yet.
The United States reported more than 650,000 new cases a day as of Wednesday, down from more than one million two weeks ago. On average, deaths have risen by more than 2,300 per day, but hospitalizations have fallen by about 155,000 per day.
As those numbers fall, many Americans may be able to return to their normal lifestyles. By the spring of the Northeast, and possibly later in other regions, many Americans may go to work without a mask, send their children to school, and socialize with family and friends.
Those at high risk from Covid would need regular boosters tailored to the latest variant.
If we could keep people out of the hospital and not get sick, I think we could get back to normal, according to a Rockefeller University immunologist.
In the long run, coronaviruses that cause the common cold would not become seriously ill, as many of us might experience a mild infection every few years.
The idea of Omicron as the last stand of the coronaviruses holds enormous appeal. Everyone wants it, every scientist hopes for it. Americans would need to be smart and lucky to get there.
An endemic virus does not mean a threat. Tuberculosis is endemic in India and other countries, and kills more than a million people each year. Measles is endemic in African countries. The virus constantly circulates at low levels and can cause large outbreaks.
The coronaviruses becomes a negligible threat if 70 percent of the population isvaccinated.
The higher the percentage of people who are vaccine free, the more likely they are to reach the threshold. Scientists revised the level to 90 percent after the Alpha variant surfaced.
The immunity that the country has over time is a factor in how big of a threat the coronaviruses remains. It is a difficult assessment to make.
There are millions of people in the United States and other countries who have no protection from the virus. Only half of eligible Americans have received booster shots to prevent Omicron infections.
Scientists don't know much about the strength or duration of immunity left by an Omicron infection, and they do know that the protection against infections conferred by vaccines fades after a relatively short period. Over a longer period, the protection against hospitalization and death remains strong.
If the population's protection against the virus is weak, Americans may experience large-scale epidemics that will flood hospitals for years. People would have to line up for coronaviruses shots in the fall in order to contain them.
The number of people who are vulnerable to the virus will change over time. Young people will age into higher risk groups if they develop conditions that put them at risk.
Whether it is because of evolution, waning or population turnover, we have an influx of susceptibility which allows for future transmission.
The lack of widespread vaccination in the United States and worldwide, along with the uncertainty regarding the strength of immunity left behind by Omicron, opens the door to the possibility of new variant. Someday, one of them may be able to dodge immune defenses as well as Omicron.
Omicron is an example of what Covid-19 looks like.
Moderna has begun a study of a booster shot designed to fight Omicron. The day before, Pfizer and BioNTech launched a study of their own Omicron-specific shot.
Vaccines and infections do not offer sterilizing immunity, meaning that the protection they offer appears to weaken over time. The protection gained from a Delta or Omicron infection may not be as effective as it could be.
Each new variant of the virus develops from the one before it. Alpha, Delta and Omicron are the three riskiest versions of the coronaviruses. The coronaviruses was not building on previous work, so to speak.
The coronaviruses that can sidestep immune defenses will be favored by evolution as more and more people arevaccinated.
We could get another variant out of the blue that responds to a selection pressure that we hadn't thought about, or with a different kind of variation that we didn't put together.
Contrary to popular belief, the coronaviruses is not guaranteed to become milder over time. If the host dies before the virus is passed on to others, it will be less virulent. The coronaviruses are not true.
Jeffrey Shaman is an epidemiologist at Columbia University.
Even if the next variant is mild, a highly contagious variant may still wreak havoc on the health care system.
Bill Hanage is an epidemiologist at the Harvard T.H.
The future will be dependent on our risk tolerance, both as individuals and as a nation. The flu has been with humans for hundreds of years.
Older adults, children under age 5, and those with weaker immune systems are most at risk from the flu.
The rest of the population takes no precautions. Businesses and schools don't require negative tests for people who have had the flu, and people don't wear masks. Half of adults in the US choose to be vaccine free each year.
Public health officials are wrestling with what normal should look like, including which trade-offs are acceptable. They acknowledge that trade-offs are coming.
We don't know what level of control we're aiming for.
A group of former advisers to President Biden called on the administration to plan for living with the coronaviruses and the flu long term. They argued that the administration should set targets for the number of hospitalizations and deaths that would prompt emergency measures.
Americans should be prepared for living a bit longer with something short of the best because of how frequently the coronaviruses upended expectations.
We all want this to be over, but I think we need to be a little more flexible in our approach.
He said that they don't know.
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