As the novel coronavirus approaches its second birthday, health experts and policymakers have been quietly wondering whether it may be time for the world’s population to begin adapting to the reality that the coronavirus will be present indefinitely. In other words, the virus may never be fully eradicated.
Another way of asking this question is to posit: In the future, will the SARS-CoV-2 virus be one of our endemic seasonal enemies, co-existing with us in the same way that we tolerate the ever-changing influenza virus?
Read on to learn why our world may need to adapt to the idea that the novel coronavirus will eventually be rolled into the fold of our perennial infectious disease foes.
The History of Coronaviruses in Our Society
Prior to the onset of the COVID-19 pandemic, healthcare providers in acute care settings across the United States were very familiar with a different kind of coronavirus, the type that could cause the common cold. Four coronavirus species (229E, NL63, OC43, and HKUI, to be specific) were often identified as culprits when people were struck with mild upper respiratory illnesses.
According to the US Centers for Disease Control and Prevention (CDC), these coronaviruses can cause symptoms such as runny nose, itchy eyes, and cough. However, for the large majority of people, they do not cause serious cases that result in hospitalization or death.
Three more sinister coronaviruses—the MERS-CoV virus that causes Middle Eastern Respiratory Syndrome, the SARS-CoV virus that causes Severe Acute Respiratory Syndrome, and the SARS-CoV-2 virus that causes COVID-19 illness—have certainly proven to cause more severe illness, and each one has wreaked havoc on our society in.
However, as time marches forward and more people gain immunity from natural COVID-19 infections or have completed the COVID-19 vaccine series, it may be worth asking if COVID-19 illness may one day be likened to influenza illness and other common viruses.
COVID-19 vs. The Flu
At the start of the pandemic, public health experts and clinicians alike were wary of equating the novel coronavirus with the influenza virus. From the data that was being collected in the early phases, it appeared that COVID-19 illness was much deadlier than seasonal influenza in certain populations, particularly in the elderly.
Additionally, scientists were not confident that COVID-19 illness was typically isolated to the respiratory system, as there were emerging reports of people developing problems in other places throughout the body, particularly with respect to blood clots, neuropsychiatric symptoms, the cytokine storms that accompanied severe illness, and lingering long-term symptoms.
However, nearly two years into the pandemic, scientists are beginning to become more comfortable acknowledging that, despite their differences, there are still many similarities between COVID-19 illness and influenza illness, including their mode of transmission, their most common symptoms, and complications.
While emerging variants of COVID-19 may prove to be more contagious and transmissible than the influenza virus, historical variants of the influenza virus have also demonstrated themselves to be variably dangerous when it comes to morbidity and mortality (recall the 2009 H1N1 Swine flu pandemic).
With the advent of effective therapeutics, numerous vaccines, booster shots, and a revolving door of emerging variants, combatting COVID-19 illness at a population level may ultimately be more of a cat-and-mouse game than a total eradication campaign.
The CDC also notes that as more people become fully vaccinated against the SARS-CoV-2 virus, the spread of COVID-19 illness should slow down in a meaningful way. This means that relief is near for our overburdened hospital systems, and we can begin shifting our focus toward viral surveillance and prevention.
Adapting to Our New Lives with the SARS-CoV-2 Virus
The coronavirus family of contagions has been co-existing with our species for many, many years. And, it is increasingly likely that the new strain of SARS-CoV-2 will be added to our panoply of routine coronavirus contagions.
As we begin to consider COVID-19 as another variation of the flu, there are a few considerations that may be helpful in the new normal:
- Until we have more historical data about the nature of variants, it may be worthwhile to advocate for societal change such as permanent mask-wearing in places where particularly vulnerable people are congregated, such as nursing homes or hospitals.
- We may consider managing COVID-19 prevention much in the same way that we manage influenza prevention, with advisements of heightened hygiene protocols during peak outbreak times (i.e., more hand-washing and awareness in the winter months), mask-wearing in crowded indoor spaces, and booster shots vs. ever-changing vaccine formulas on an annual basis.
- We may begin to see more combination approaches when it comes to managing annual influenza and COVID-19 outbreaks, including methods of dual detection, such as joint PCR tests, and combination flu vaccination, and COVID-19 booster shoots, such as the one currently being developed by Moderna.
While the SARS-CoV-2 virus and its associated COVID-19 illness are likely here to stay in one form or another, that does not mean that we, as global citizens, should throw up our hands, declare that we have surrendered, and let the virus ravage through populations unchecked. Instead, we should carefully reconsider our assessments of COVID-19 vs. the flu and develop strategies accordingly.
When merging COVID-19 and the flu in our collective consciousness, we should structure our public health campaigns in such a way that we can protect the segments of the population that are the most vulnerable—the elderly and immunosuppressed—at the most sensitive times of year (colder months), much in the same way that we protect these groups against influenza.
Spending untold amounts of resources with the goal of complete eradication of the SARS-CoV-2 virus from the planet will not only ultimately represent misdirected time and financial resources, but it will also be futile. COVID-19’s permanence appears increasingly inevitable, so we should prepare ourselves for different boosters or vaccine formulas annually and accept this battle like we have accepted our ongoing battle with the influenza virus.