‘Learn to live with the pandemic’: Physicians warn a vaccine may not prevent Covid-19 from becoming endemic

Small bottles labeled with a “Vaccine COVID-19” sticker and a medical syringe are seen in this illustration taken taken April 10, 2020.

Dado Ruvic | Reuters

LONDON — The development of a Covid-19 vaccine may not be enough to prevent the coronavirus from becoming endemic, infectious disease experts have warned, suggesting a better way for people to proceed would be to learn to live with the pandemic.

Dozens of candidate vaccines are currently in clinical evaluation, according to the WHO, with drugmakers and research centers scrambling to help bring an end to the coronavirus pandemic.

To date, more than 41 million people have contracted the virus worldwide, with 1.13 million related deaths, according to data compiled by Johns Hopkins University.

Many governments, too, have sought to help the Covid-19 vaccine race by providing funds to allow companies to scale up manufacturing even before drugs have been approved.

Dr. David Heymann, who led the WHO’s infectious disease unit at the time of the SARS epidemic in 2002-2003, believes some governments may be over-reliant on the development of a vaccine at a time when effective communication, diagnostic testing and outbreak containment activities are all critically important tools.

“The difficulty right now is that in many countries, they are looking forward to a vaccine which may or may not come, which may or may not be effective in the short or long term, and they are looking at possible therapeutic (options) which could solve many of the problems,” Heymann said during a webinar for think tank Chatham House on Wednesday.

“But, that’s not a good way to proceed at present … We have to learn to live with the pandemic.”

Minimum damage

The U.K.’s chief scientific advisor, Patrick Vallance, told the National Security Strategy Committee in London earlier this week that Covid-19 was likely to become as endemic as the annual flu.

This means the infection rate of the coronavirus, like other coronaviruses, will eventually stabilize at a constant level so that it becomes present in communities at all times.

Vallance also said that creating a vaccine from scratch took 10 years on average. The fastest vaccine ever developed was for mumps, and this took more than four years.

A man plays guitar under a empty Bethesda Terrace in Central Park in New York City on October 19, 2020. New York City is planning to set up mass vaccination sites once Covid-19 vaccines become available vetted by an independent state panel, Governor Andrew Cuomo said on October 18, 2020.

TIMOTHY A. CLARY | AFP via Getty Images

“One of the scenarios for this virus is that it does become endemic and it looks at present like that is going to happen — just like it happened four previous times when there was an emergence of a coronavirus into human populations that became endemic,” Heymann said, referring to the four common human coronaviruses.

“I think the answer is that, yes, this will become endemic,” he continued. “We shouldn’t just be trying to suppress this virus out of existence or trying to suppress it to a level that’s unrealistic. We have to be able to suppress it to a level where it causes minimum damage while at the same time entering a country and becoming endemic.”

Risk assessments

When asked how people can learn to live with the pandemic, Heymann replied: “Individuals must know how to do their own risk assessments, as they do for sexually-transmitted infections, as they do for tuberculosis, as they do for other infections.”

“They must do their own risk assessments and understand what measures they can take to prevent themselves from becoming infected and to prevent others from becoming infected,” he said. “It’s all about people understanding that this virus, if it is destined to become endemic, will become endemic no matter what we do. But we can slow that to a certain level that causes less disruption in our societies and lesser death.”

Commuters wearing a face mask or covering due to the COVID-19 pandemic, walk past a London underground tube train at Victoria station, during the evening ‘rus hour’ in central London on September 23, 2020.

TOLGA AKMEN | AFP via Getty Images

To protect yourself, the WHO recommends that people keep a distance of at least 1 meter from others, and disinfect frequently touched surfaces. It also advises cleaning hands thoroughly and often, and for people to avoid touching their eyes, mouth and nose.

“We know now that we are going to have to start living with this virus in a more chronic way — really, in the long term,” Dr. Olivia Tulloch, CEO of Anthrologica, a leading research-based specialist in applied anthropology in global health, said during the same Chatham House webinar.

Tulloch said people across many countries, particularly in the Northern Hemisphere, had been living with strict restrictive measures imposed on their daily lives for several months, with no sign of them ending anytime soon.

“And so, people feel fatigue and confusion and frustration to do with the measures that are being directed at them,” she continued. “We are putting a lot of resource into the science of vaccines but, in terms of social science, we have got a huge amount of work to do.”

It will also be important to understand the mechanisms that would be necessary to address those with a “high degree of hesitancy” if and when a vaccine becomes available, Tulloch said.

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