How to End the Pandemic

William A. Haseltine | 31 July 2021
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Even with effective vaccines, the coronavirus and its new variants will continue to subject us to successive epidemic waves. Returning to normal life ultimately will require a multi-layered strategy featuring vaccines, prophylactics, public-health measures, and deeper global cooperation.

The United States has now entered its fifth wave of COVID-19 infections. In each one, the country has paid a high price for doing far less than it could. In the first wave, lockdowns and other restrictions were spotty. Then came untested and unproven treatments. With the vaccine rollout, new infections were pushed down substantially, but now the Delta variant has started pushing them back up in unvaccinated populations.

At each stage, the SARS-CoV-2 virus that causes COVID-19 was underestimated. From what we know of its ability to adapt and thrive through random mutations, there is only one viable option for long-term disease control: a strategy that combines a rapidly growing arsenal of vaccines and antiviral drugs with strong public-health measures and deeper global cooperation.

Vaccines won’t work for everybody. In the best-case scenario, against the original wild-type virus, vaccines still fail about 5% of the time. And the Delta variant has proven more adept than previous strains at breaking through vaccine protections. Even if the entire US population was vaccinated, 17.5 million Americans would still be at risk of infection and disease if exposed to the virus.

Moreover, there are substantial populations of people with underlying conditions that diminish vaccine efficacy; these include organ-transplant recipients, people taking immunosuppressant drugs, cancer patients, and a fraction of the elderly population. And like the protection offered by the annual influenza vaccine, early evidence suggests that vaccine-induced immunity against COVID-19 may fade over time.