What do the next 6 months look like for the COVID pandemic?

Nothing about the future course of the COVID-19 pandemic is certain. The coronavirus called SARS-CoV-2, which causes COVID-19 infections, is really difficult to predict. “The absolute truth of the matter is no one knows,” says Dr. Gregory Poland, head of Mayo Clinic’s Vaccine Research Group. 

Coins2Day asked six leading infectious disease experts to weigh in on where they think COVID is going over the next six months and how Americans should be thinking about their protection from infection and severe illness at this point. 

COVID likely to be ‘quiet’ over the next few months

Nationally, COVID-19 cases are falling. There were about 110,453 new COVID cases reported on Feb. 15, according to Johns Hopkins. The seven-day moving average is now 96,477, a decrease of about 48.5% compared with the previous seven-day moving average of 187,509 reported a week ago. 

And experts expect that trend to continue. As a respiratory virus, COVID is likely going to follow a pattern in which it will be more prominent in cold months and winter months and probably less of an issue in the warmer months, says Dr. Tim Brewer, professor of medicine and epidemiology at the David Geffen School of Medicine at UCLA. This is because respiratory viruses tend to survive longer in colder temperatures and at lower humidities, Brewer adds. Plus people tend to spend more time indoors, and therefore in closer proximity, when the weather is colder. 

Another reason that experts predict a lull over the next few months is the previous COVID waves generally have been about six months apart. “We’re going to have another wave in six to eight months, and it’s likely to be more vaccine resistant. It’s likely to be more transmissible, but we don’t know about the severity,” says Mark Dybul, a Georgetown University professor and immunologist who serves as CEO of Enochian BioSciences.

“COVID may appear to go quiet in our communities, but it will still be there, we’ll still have people hospitalized, we’ll still have people die—but it will be at a level that will be substantially lower than we’ve seen,” says Dr. Michael Osterholm, a leading epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

But Omicron won’t be the last variant

Just because COVID cases will be down doesn’t mean that Americans don’t need to take COVID seriously anymore—or that it will disappear after this latest variant dies down. “It’s not the time to relax,” Osterholm says. 

That’s because despite the high number of Americans who were infected with Omicron or received COVID vaccines and boosters, it’s not enough. The U.S. Might have achieved some level of herd immunity with Omicron, but it likely won’t last. And there’s still a significant portion of the population that has no immunity or waning protection. 

“Every time we allow this virus to infect somebody, it’s like giving the virus a lottery ticket and increasing the chance that we’re gonna see mutations,” Poland says. “It’s a crapshoot.”

So it’s very likely a new variant will emerge, and the question then is how severe will it be. “We could face another variant that basically takes us back two years, and we start all over again. That’s one of the possibilities,” Poland says. 

COVID, as it turns out, doesn’t always evolve in a smooth progression. Typically a first virus appears and then mutates with a couple of changes and then mutates off that, and so on. 

“Omicron doesn’t seem to have developed that way. It seems to have developed from an earlier version of the virus,” says Catherine Troisi, an infectious disease epidemiologist with UTHealth School of Public Health in Houston. That is a little concerning, because it leads to the possibility that a brand-new variant may be very infectious like Omicron, and possibly cause more severe disease, she says. 

“We’re certainly not at a high enough level to stop transmission of the virus. So the big concern is another variant, and we just can’t predict it,” Troisi says. 

Take the common flu virus, for example. There are years when the dominant flu strain going around is really severe and even more deadly. “It’s not as if the flu gets milder and milder and milder every year,” Dr. Jessica Justman, associate professor of medicine in epidemiology at Columbia Mailman School of Public Health, tells Coins2Day.  

And this next variant could be even more resistant to the vaccines. Studies show that the current vaccines available offer poor immunity against an Omicron infection, though they do still offer protection against severe illness and death. 

“The probability of having additional variants that are even more vaccine resistant is relatively high. It’s almost an inevitability as long as we don’t have higher vaccination rates,” Dybul says. 

How do you best protect yourself?

With more variants likely to emerge, the question becomes what can Americans do to protect themselves while still living their lives? It’s all about risk management now. If you’re a young, healthy individual with no underlying health conditions and you’re fully vaccinated and boosted, then the chance you will have a severe infection is more limited.

“We’ve got to shift our thinking from pure infection control to public health,” Dybul says. “Personally, I’m scheduling vacations in the summer in Europe. We have to get on with our lives.” 

If a variant of concern emerges sooner, then the response should change. And it’s important to note that even healthy young people can develop long-term COVID symptoms. 

Experts still advise taking precautions—similar to the advice of wearing a seat belt when you drive. So even though some states and cities have dropped mask mandates, it’s smart to wear one when you’re around others; an N95 or a KN95 will provide the best protection. 

Several experts Coins2Day spoke with—including Troisi, Justman, and Poland—say they’re still wearing masks themselves when indoors. When outdoors, they’re skipping the mask unless it’s crowded.

It’s worth thinking about who’s in your network, Justman says. If you’re getting together with older Americans or those who are more medically vulnerable, it’s worth taking more precautions and perhaps even testing before meeting up. 

As for fourth doses and additional boosters, Dybul says that unless you’re immunocompromised or otherwise medically vulnerable, it may be worth waiting until Pfizer, Moderna, and others release updated vaccines. “We’re kind of at the end of this wave, so there’s no urgency to get a boost,” he says. 

Osterholm says that while he would likely recommend a fourth dose to those who want it, more boosters of the same vaccine likely provide little protection to the general public. “We can’t dose our way out of this pandemic,” he notes. 

Instead, he believes vaccine producers will need to formulate a second generation of the vaccine that’s more broad-based than the variant-specific doses being formulated now. 

Bottom line: The virus that causes COVID is here to stay for the foreseeable future, even if national case counts aren’t breaking records. This virus is well adapted for human to human transmission. “The reason why that’s so important is that it means it’s going to be next to impossible to eliminate,” Brewer says. 

“Your great, great, great grandchildren are going to be getting immunized against SARS-CoV-2 because of the way we responded to this. We will now never be rid of it,” Poland says.