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Opinion by Richard Sternberg, M.D.
A return to normalcy after COVID?

It appears the summer surge of COVID-19 in the United States is abating.

Numbers are going down except in the hardest hit states. The average number of deaths last week was approximately 1,800 per day and the number of daily infections is about 100,000. These seem to be trending down but if they flare up again and represent averages over the long-term we are talking about 675,000 deaths per year. By comparison, in the United States, the flu kills somewhere between 10,000 and 50,000 people a year. If the flu pandemic of 1918 is any guideline, we should expect further surges with the number and severity of the surges dying out eventually.

This does not mean that we are going to get rid of COVID-19. It will be with us to stay since immunity with vaccinations or previous infections is clearly not permanent. There will still be breakthrough infections. Granted we have better treatment options now and possibly we can decrease the fatality rate to somewhere equivalent to that of the flu. COVID-19, in the form of mutations, will become endemic. This means it will persist in the population but with only a small percentage demonstrating symptoms at any one time.

Effectively this is what happened with the 1918 flu. Its descendants are still with us, but as a group we gained relative immunity by frequent exposures even while under the effect of the annual vaccinations.
Does this mean that we can become cavalier and accept it as part of our background environment and go about our daily business as we always have? Possibly, but there’s still work to be done.

In my opinion, as my regular readers well know, vaccination rates in the general population have to be higher, in the healthcare workers, it has to be almost 100%, and the vaccine has to become available for children. While there have been cases of severe reaction to the vaccine, this has been so extremely low, that every time this happens to even one person, the story becomes newsworthy and generates a backlash of publicity and anti-vaccination outcry.

The benefit of the vaccine outweighs the risk at least 100-fold.

The number of boosters or third vaccinations is about to surpass the number of first-time vaccinations in the U.S. and in many cases, first-time vaccinations are probably because of mandates and job requirements. A significant part of the population will probably avoid getting vaccinated, probably 10%.
Unfortunately, this 10% will still be floating around in the community and every time the virus reproduces there’s another chance for a mutation, which is more dangerous than what we currently have. At some point, we may even get a mutation that defies all vaccinations and all treatments we currently have and we may develop.

About 20 scientific groups around the world are working on developing a universal vaccine that will work against all Corona viruses. Hopefully they will be successful, but we still don’t have a universal vaccine for all influenzas. Polio, which has been eradicated in 99% of the world, still exists in very small numbers in Afghanistan and Africa. There has been resistance to vaccinations in some groups in these areas. Therefore, the virus will survive and runs the risk of getting out to the general population, which is no longer getting vaccinated routinely.

With the current downward trend in the number of new cases and deaths, we have a chance to change the nature of COVID in our communities.

It’s a shame that we have so much resistance to doing so. Nevertheless, we could be seeing the end of the beginning.

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