Life after COVID is becoming clearly visible. That is, after humankind, like Thor, defeats the World Serpent of coronavirus, hopefully without suffering Thor’s subsequent fate.

As promised in previous blogs, the media abound with good news about the coronavirus. Therefore, it’s now possible to anticipate how this crisis will be wrapped up, one anxiety at a time. Most of the resolution will occur before year end in the US, while internationally some changes will take longer.

Here are the main sections of this relatively hopeful report:

– Mutants? What, Me Worry?

– Bodacious Boosters Are a-Borning!

– Better Treatments After Infection

– Signposts Toward Life After COVID

– Post-COVID Life Beckons

– Conclusions

First we need to dispose of a few nagging problems that generate alarming headlines but which should not keep us awake.

Mutants? What, Me Worry?

Coronavirus, like the flu and other viruses, mutates as it replicates. Most of the variants generated are not significant but once in a while one comes along that causes concern, either because it spreads more easily or because it’s deadlier. And there’s concern about “viral escape,” the possibility that even after we are vaccinated, a mutated virus may yet infect us.

Fortunately, there are many reasons not to worry about variants:

• Both recovered coronavirus patients and vaccinated people have good protection against variants. Even though they may not show antibodies against the variants, they are protected by other parts of the immune system (T-cells and B-cells).
• If these immune people do contract a mutated viral infection, data shows that it is mild and does not result in hospitalization or death.
• There are promising strategies to strengthen vaccines against future mutations: vaccines tackling more than one portion of the virus; “mosaic” vaccines incorporating portions of many variants; and administering two different vaccines to the same individual. In addition, antibody mapping will help future vaccines anticipate and prevent viral escape.
• Eventually it may be feasible to develop a universal vaccine that protects against all likely coronavirus mutations.

Bodacious Boosters are a-Borning!

(Sorry, I couldn’t help myself.)

Besides worrying about variants, some people wonder when we will see booster shots. By this fall or winter, booster shots should become available to strengthen the vaccine we have already received. These boosters may use different or additional components (antigens and epitopes) that target virus variants. They may be as simple as one additional shot of the same vaccine, or one shot of a vaccine that’s different from the one you previously had. Drug makers are testing a variety of approaches.

Better Treatments After Infection

Last but not least among the worries: despite all precautions and vaccines, some folks will still catch coronavirus. Post-vaccination, it will probably be mild. But just in case it isn’t, health professionals are working hard to develop effective treatments for all stages of the disease:

• For early-stage coronavirus, there’s a new monoclonal antivirus, molnupiravir, in phase 2 and 3 trials. It cures the virus rapidly and as an oral medication, is easy to administer. So far, it does not target virus variants. And there is still hope for readily available drugs like azithromycin.
• For more advanced disease, as previously noted, detailed protocols are available to guide treatment, and those are significantly reducing COVID-19 mortality.
• What about “long haulers,” those recovered from coronavirus but experiencing side effects months later? It now appears that vaccinations can reduce or eliminate these long-lasting symptoms.

MedPageToday maintains an ongoing summary of treatment options, mostly involving advanced cases of COVID-19.

Signposts Toward Life After COVID

So much for the worries. Let’s look to the future, to life after COVID.

Coronavirus has surprised everyone, including disease experts. And it may still have some tricks to play. Therefore, predicting the future is folly. And it’s also folly to obsess about the bad-news headlines that the media will put forward to seize our attention.

Instead, let’s watch for legitimate and factual news. News that can serve as signposts toward a more normal life after COVID. Here are some candidates, in several categories:

– Reduced Coronavirus Threat

• Watch for national and state-specific data: drops in new cases, drops in deaths, increases in percentage of population vaccinated and/or recovered.
• Look for “excess deaths” to disappear, and for coronavirus to drop out of the top ten list of causes of death. (Coronavirus was #3 in 2020 and thus far in 2021 it’s #1.)
• Listen for cities, states, countries bragging about having reached herd immunity. Conversely, watch for areas that have to re-impose restrictions.
• See how CDC relaxes its recommendations for businesses, schools, gatherings.

– Vaccine Improvements

• Watch for positive test results from testing vaccines on children, pregnant women and other select groups.
• Take note of announcements concerning coronavirus booster shots, with or without integration with influenza boosters.
• Watch for FDA review of full Biologics License Applications for the coronavirus vaccines, which are currently approved only for emergency use.

– Vaccine Abundance

• Watch for vaccine abundance, in which the supply of vaccine seems to exceed the demand.
• Look for actions by the US and other developed countries to share their vaccine supply with countries in need. Coronavirus will always be a threat until it is under control world-wide. Therefore, sharing vaccine contributes to our own safety as well as supporting US international objectives.

– Vaccine Passports

• Be alert to announcements of government-approved or airline-required “vaccine passports” for proving that you have received a vaccine.
• Take note of company announcements requiring vaccines before providing services. To date, those have been discussed by cruise ship companies, tour operators and some international airlines.
• Watch for countries and noncontiguous US entities (such as Hawaii and Alaska) offering relaxed restrictions for visitors with proof of vaccination.

Post-COVID Life Beckons

Those are the signals to watch for. But how soon can we actually get back to normal?

It’s easy to find fear-mongers who don’t want you to have any fun. And you can find the opposite advice too: the nearest saloon is full of free-spirited folks who have abandoned all caution.

I recommend a middle pathway. Neither ignore, nor surrender to, the threat. Instead, manage the risk:

• Vax: First, get that vaccine, as soon as you are eligible!
• Rules: Then, follow the requirements imposed by your own city or state, both for your own safety and to be a responsible citizen.
• CDC: Add to these as many of CDC’s recommended precautions as you need to feel prudently safe.
• Ration Your Treats: Does this plan still leave you frustrated? Then consider allowing yourself some riskier activity as a treat, aka self-therapy: eating in a restaurant, or drinks with friends. If you limit your indulgence, it greatly reduces your risk: an hour with friends once a week is 20 times safer than 3 hours with them every evening!

– Experts Debate the Future

Dr Lee Riley of UC Berkeley sketches out four likely outcomes for the coronavirus, ranging from zero to OMG. However, as you would anticipate, I sit on the optimistic side of the middle.

I am persuaded by those who believe that once we conquer the pandemic emergency, coronavirus will become no more deadly, and hopefully less deadly, than influenza.

How deadly? That may be our choice. “Our” as in we, the human race. One expert says, “We’re not going to shut down this virus and end transmission. We have to make a decision as a society about how much of this we can and want to live with.”

People would like to downgrade coronavirus to the risk of flu. However, flu is not very appealing as a benchmark: it kills 60,000 people per year in the US alone.

Experts seem to believe that we can get coronavirus well below this level, provided that we care enough about that number of deaths. Until now, we haven’t pushed very hard against the flu. However, what we have learned from fighting COVID-19 may give us the tools and the motivation to make both flu and coronavirus “unimportant” diseases.

– Lingering Changes

After we return to near-normal in the US, things will still look different when we step outside the country. Various countries will place restrictions on incoming travelers, insisting on negative virus tests, proof of vaccination and/or quarantine.

Some of these restrictions are logical: after all, 130 countries have yet to administer a single shot of vaccine so they are vulnerable to infection. And some of the restrictions are emotional: the US has suffered so many coronavirus deaths that many people overseas consider us “unclean”: they fear getting sick if any Americans enter their country.

This is a fluid situation, and the best current advice I have seen comes from a 3/8/2021 Conde Nast article. I recommend reading it if you are itching to travel the globe during the next 12 months.

Conclusions

It’s difficult to forecast the future. As Yogi Berra might have said (but didn’t), “That’s because it hasn’t happened yet.” However, I hope this blog about Life After COVID has given you reassurance, some signposts to watch for, and increased confidence that life will be better, very soon.

Image Credits:
– Thor kills Jörmungandr, adapted from j4p4n on openclipart
– Vaccine vial adapted from Nataliya Vaitkevich on pexels
– Covid pattern by artpolka on pixabay
– Sunrise adapted from clipmaaaaan on openclipart