COVID-19: when do experts predict life will return to normal?

When will COVID-19 end?

It may be hard to believe, but the world has recently entered 'year 3' of coronavirus (COVID-19), with the first cases recorded over two years ago. The World Health Organization (WHO) first declared the novel COVID-19 strain a pandemic on 11th March 2020.

It's only natural to wonder with hope "When will COVID end?", or indeed to avoid asking the question altogether for fear of the answer. It is undoubtedly a complex question as there are many factors to consider: however, experts are now using their knowledge of both the COVID-19 pandemic and past pandemics to make predictions.

"Pandemics are hard to predict but our experience with past pandemics as well as two full years with SARS-CoV-2 (COVID-19) can help us make some educated guesses," says Professor Rodney E. Rohde, a professor of clinical laboratory science and an infectious disease specialist at Texas State University.

Three possible scenarios

In November 2021, the UK government shared three possible scenarios for the end of the COVID-19 pandemic. These Whitehall reports contain:

It's true that these three scenarios allow for a fairly wide scope of outcomes, but experts caution that this is necessary given the number of variables that can affect when the pandemic will end.

The new COVID-19 Omicron variant

The new Omicron variant - identified in South Africa on 24th November 2021 - perfectly demonstrates how analysis of these factors is constantly in flux, as this new COVID variant has come to light since the Whitehall scenarios were reported.

This said, it is too early in our understanding of Omicron to see if or how this may influence when COVID-19 ends, and we can settle into 'the new normal'.

It has been only a couple of weeks since Omicron infection was detected in the UK (on 27th November) and official rates state that it is not yet at the level of the current dominant Delta variant. However, a recent report by UK Health Security Agency (UKHSA) predicts that over one million people in the UK will be infected with Omicron by the end of December, if it continues to spread at the present rate.

It is predicted that Omicron will become the dominant variant in the UK before Christmas 2021, and as such scientists are predominantly concerned with the rate of transmission, to what extent current vaccines and boosters will protect against it, and whether it will evade detection through certain COVID-19 tests.

It is simply too early for experts to understand the symptoms of this new variant and how current measures will hold up against it. A wider pool of data is needed before we know if or how Omicron fits into the picture when asking "When will COVID end?"

Patient picks for COVID-19

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COVID-19: When should you do a lateral flow test and when should you do a PCR?

With the Omicron variant spreading rapidly, there is a high demand for both lateral flow and PCR tests to detect COVID-19. Double-vaccinated people in England are now being asked to take a lateral flow test daily for one week if they come into contact with someone with COVID-19, rather than self-isolate. But when else should you do a lateral flow test and when should you do a PCR?

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Long COVID

Most people with COVID-19 infection (SARS CoV-2 infection) feel better within a few days or weeks and recover completely within 12 weeks of the infection. However, some people have ongoing symptoms that remain for weeks, months, or longer, which is usually called "long COVID". For some, these long-term effects of COVID-19 can be debilitating. These effects can be very different from person to person, and it seems likely that there are different 'types' of long COVID, or different syndromes, which might behave in different ways.

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Will COVID-19 end by 2023?

The most optimistic scenario offered by the UK government sets out that the COVID-19 pandemic will end sometime between now and 2023. This is not to say that COVID-19 will have been eradicated, but rather the UK is able to settle in to 'the new normal' where the disease becomes endemic - treated as a routine infectious disease.

For COVID-19 not to be a major threat any longer, the virus would need not to cause surges in deaths or hospital admissions, or be placing the NHS under pressure. The 'new normal' would also mean no restrictions and a steady economic recovery. However, even in this optimistic timeframe, COVID-19 would still exist as a threat in countries with poor testing, vaccination, and antivirals coverage.

Rohde believes that we could get closer to 'the new normal' by 2023: "I believe things will continue as they are happening now throughout 2022 with ups and downs [surges]. Hopefully, as we enter late spring and summer of 2023, we may see things get closer to normal."

Rohde argues that historically pandemics last somewhere between 1.5-3.5 years. Over time, many pandemic viruses - such as the 1918 Spanish influenza pandemic - mutate and evolve into more manageable, less life-threatening diseases. We are currently dealing with new mutations, or 'variants, and current questions revolve around whether vaccines will need modification.

"Of course, this prediction is based on whether or not the world will move towards global vaccine equity and acceptance of the vaccination efforts. As long as we have large regions with unvaccinated populations, we will continue to give SARS-CoV-2 an opportunity to spoil our efforts via mutation."

Will COVID-19 end by 2024?

According to the Whitehall report, the likeliest scenario is that COVID-19 will become steady, manageable, and endemic between 2023 and 2024. Here, experts predict that next winter (2022-23) will most likely still see a surge in hospital admissions and pressure on the NHS.

This scenario, also known as the 'middle' scenario, envisages an end to lockdowns but the possible continuance of extra seasonal measures - such as mask wearing - to try to control winter surges. In some countries, COVID-19 infections would still be high and new variants may cause new waves.

However, a combination of good testing, vaccination, and antivirals would keep rates of serious COVID-19 infection to manageable levels.

Will the COVID-19 pandemic last until 2026?

Although the pandemic lasting until 2026 is a scary thought, it's important to note that the UK government considers this to be the least likely outcome. In this worst-case scenario, vaccinations and antivirals would cease to be effective against new COVID-19 variants.

If this is the case, restrictions and lockdowns could be used as new waves emerge up until 2026. This would have a significant impact on economic growth in the UK, and it would cause a major surge in job losses as companies struggle to cope with on-and-off closures.

It is worth stressing again that this scenario is considered highly unlikely. Although we are seeing the spread of the new COVID-19 variant Omicron, early reports are already suggesting that the booster vaccination can offer up to 75% protection against symptomatic Omicron infection.

In addition, vaccines can be adapted within a few months to counter new variants. Once developed, they still need to be manufactured and fully rolled out, but the timescale for this is months rather than years.