The Three COVID Developments I’m Still Holding Out Hope For

We don’t have to be in this COVID rut forever.

Animation of a smiley face emoji with a mask on, and then off.
John J Custer / The Atlantic

About the author: Andy Slavitt is a former White House senior adviser on the coronavirus response. He is the host of the podcast In the Bubble and the author of Preventable: The Inside Story of How Leadership Failures, Politics, and Selfishness Doomed the U.S. Coronavirus Response.

We are in a COVID rut. Early on in the pandemic, we could look forward to the arrival of vaccines. But the vaccines came, and though they did wonders in bringing down the daily death toll, COVID is ever present in our lives.

When we step back and assess the news in totality, we might feel that we are stuck, that things aren’t going to get better, and that, no matter what progress we make, the virus will outsmart us sooner or later.

With a virus that has evolved to morph and recirculate with the frequency of the common cold and far greater deadliness, many people are wondering if we’re going to have to live like this forever.

So what could still happen to fundamentally change the COVID big picture? I’ve been thinking about that question, and I’ve come up with three possible good developments that could come down the pike. Here’s what I’m holding out hope for:

1. The virus’s rate of change could slow down.

A virus of exactly the same rate of spread, immune-evasion properties, and severity as COVID-19 would be a lot more tolerable if it mutated at the rate of the flu and surged at more predictable times. Masking for one period a year (for those who still wish to avoid the virus) instead of constantly living in fear would be quite an improvement—and more people might be willing to do it.

Better yet, if the virus’s fluctuations came only annually and predictably, we could attack it with once-a-year boosters designed to match that year’s variant—something that’s essentially impossible today, when a booster developed in March is out of date by October. Planning and predictability would be nice for everyone, but especially so for people at high risk. Those who are immunocompromised or otherwise high-risk would be released from continual anxiety and could participate more freely in the activities that bring them joy.

So far, there aren’t signs of a slowdown in coronavirus mutations, and the alphanumeric soup of BA variants is coming at us fast. But COVID-19 tends to change in surprising ways that we can’t explain until later. Let’s hope this becomes one of them.

2. An accumulation of layered immunity might render COVID a more tepid illness.

The virus may not ever mutate at a slower pace, but those mutations could become a lot less important. This could happen as layers of immunity—from a combination of prior vaccinations and prior infection—give the virus less and less power to make us really sick. Over time, SARS-CoV-2’s effect on us may come to resemble something closer to the common cold, caused by another, more familiar, coronavirus. COVID-19 wouldn’t disappear, but it would be characterized by mild symptoms that for many would barely register.

This is the path many mistakenly believe is inevitable, one we have already started on. Yet we are not there. We still hold our breath each time a new variant of concern is spotted. In the U.S. alone, some estimates suggest that more than 90 percent of the population has been infected or vaccinated—and still hundreds are dying each day. Some people think this a tolerable state, but for that, you have to become numb to thousands upon thousands of COVID deaths a year, not to mention lots of missed school and work, a taxed medical system, and the long-term chronic illnesses that come from many cases. For us to be at a better place, everyone—including older, frailer, and sicker people—will need to be able to live like the pandemic is over.

3. Science could win.

Although we would all welcome a more predictable disease and more tolerable symptoms, the scenario we really hope for is one in which we don’t need to worry about getting infected at all. For that to happen, we need innovation in vaccines, to make better ones than we have today. A lot of innovations are being developed (including ones that handle a wider range of variants); the most helpful vaccine would prevent us from catching and spreading the virus in the first place.

A nasal vaccine, or one that could create mucosal immunity, could be the ticket to accomplishing this. Imagine being able to spray your nasal passages either prophylactically or upon a COVID exposure. In the best case, not only would that prevent us from getting sick, but the virus would have a tougher and tougher time taking root in the first place. There are other advantages. Medical professionals wouldn’t be needed to administer a nasal spray, and needle phobia and other barriers to vaccination could be avoided.

Such a vaccine is at least a few years away, but more than a dozen candidates are currently in various stages of clinical research (the Russian Ministry of Health claims to have one). These trials are difficult, as there is no accepted measure of immunity other than antibody titers in the blood, which aren’t as relevant here. For nasal vaccines to be maximally effective, they will need to be universally available at low cost and easy to ship around the world, requiring a financing and patent scheme that maximizes public benefit.

We, of course, have had plenty of good news during the life of the pandemic, much of it from the world of science—vaccines have made COVID far less lethal, therapies keep us out of the hospital, and treatments allow more people to leave the hospital if they’re admitted. But good news in the pandemic has had strange properties: Oftentimes it seems not to be exactly as advertised. The virus mounts its own reaction, mutating in ways that can increase severity, as with the Delta variant, or increase transmissibility, as with Omicron. As a result, we have seen enough good-news false starts to know that news can’t be officially declared “good” until months later.

But even if we have plenty of reason to distrust any seemingly good news, we also have plenty of reason to expect the situation to improve. History bears this out. COVID-19 isn’t the first and is hardly the worst virus to prey upon humans. To be sure, many earlier pandemic-causing viruses circulated long beyond their acute initial phase, but the pandemic stages eventually ended, and the damage ebbed as scientists developed better treatments and vaccines and the human body adjusted.

When will this happen with COVID-19? We’ll know six months after it already has.