By Spring, COVID Could Move into the Background, Evolve into a Manageable Illness

By Yehudit Garmaise

By spring, Mayor Bill de Blasio said this morning, after we get through a few challenging weeks of an Omicron spike, “COVID should be much less central to our lives, much more in the background, and much more like the flu, which just requires yearly shots.

“But we have got to get vaccination levels up everywhere.

“It's certainly possible that 2022 can be a transcendent year: if there is a real push to deepen vaccination across the board.”

“For reasons that no one really understands, COVID does seem to come in waves,” said Mitch Katz, MD, the CEO of Health + Hospitals, who described India’s dramatic cycles of high COVID rates. “[In India,] we saw very, very high rates of infection, hospitals running out of oxygen, horrible scenes that were so distressing to watch: and then less, and then less, and then less. 

“Nobody really understands exactly why you get the cycles.”

Weather, travel, and whether people follow safety protocols are some hypotheses, said Dr. Katz, who added, “But it's not really understood.

“It is clear, though, that COVID comes in waves.”

Scientists in South Africa, which had the earliest and best data on Omicron, “have already noticed that the [Omicron] wave is diminishing there, where it started, Dr. Katz said. “So, that's why we believe that Omicron is going to be quite severe in the sense of infections, not as severe in terms of hospitalizations.

“It will probably get worse before it gets better in terms of number of infections, but then we believe within mid-January, we'll start to see cases leveling off, and things return to our new normal.”

In the long-term, Dr. Katz said, “We will learn how to co-exist with the COVID virus, just as we've learned to coexist with the virus that caused the 1918 Spanish flu, which still circulates. 

“Humans have learned how to deal with it: Whether that means that we're going to need yearly immunizations is a likely possibility.

“The immunizations may need to change just as we change the flu vaccine formulations.

“We have a lot of hope for some of the new medications, which are likely to be approved by the FDA by the end of the year. With these medications we will be able, when someone tests positive, to be able to offer them a pill that they can take, which will markedly decrease the chance of serious illness.

“I think all of these things will eventually result in us being able to live with COVID. 

Dave Chokshi, MD, the city’s health commissioner, said “is crucially important for to understand is how important vaccination is, as well as hopefully additional treatments within the next few days to weeks. 

“For vaccination, what we do see is that people who are fully vaccinated do appear to have a significant protection against severe disease.”

In other words, people who are vaccinated have “significant protection against needing oxygen, hospital beds, and ventilators.”

“For people who remain unvaccinated: that's where I get the most worried about those severe outcomes. And so, today is the day, you heard it from me before, to run, don't walk, to start getting the protection that vaccination affords.”