With a third pandemic winter on the horizon in the northern hemisphere, scientists are warning anxious governments and populations alike to prepare for more waves of the coronavirus.
In the US alone, as many as a million infections a day this winter are likely to be recorded, Chris Murray, the head of the University of Washington's Institute of Health Metrics and Evaluation (IHME), which is tracking the course of the pandemic, told Reuters.
This is equivalent to twice today's daily tally.
In the UK and Europe, scientists are predicting a series of new waves of the pandemic as citizens spend more time indoors during the colder months - this time almost everywhere without a mask and without social distancing rules in place.
But while cases may increase in the coming months, deaths and hospitalizations are unlikely to rise as sharply, scientists predict, helped by vaccinations and boosters, earlier infections, milder variants and the availability of highly effective treatments for COVID.
"Those who are most at risk are those who have not been exposed to the virus and there are hardly any left," Murray points out.
These predictions raise new questions about when countries will move out of the state of emergency due to COVID and when they will reach a stage where the disease will be endemic and communities with high vaccination rates will experience smaller outbreaks, possibly seasonally. base.
Many experts had predicted that this transition would begin in early 2022, but the arrival of the highly contagious Omicron variant of the coronavirus disproved their predictions.
"We have to give up the idea that 'is the pandemic over?' says Adam Kucharski, an epidemiologist at the London School of Hygiene and Tropical Medicine.
Both he and others see the coronavirus evolving into an endemic threat that will continue to cause a large burden of disease.
"Someone once told me that the definition of endemic is that life gets a little worse," he notes.
The question remains whether some new variant will appear that will surpass in gravity the current Omicron variants.
If this variant also causes more severe disease and escapes immunity more easily, that would be the “worst-case scenario,” according to a recent report by the European branch of the World Health Organization.
"All scenarios (with new variations) suggest the possibility of a major wave in the future, as severe or worse than the 2020/2021 epidemic waves," said the report, which is based on a model by Imperial University of London .
Many of the experts who spoke to Reuters said that predictions about COVID have become much more difficult as many people rely on self-tests they carry out at home, which are then not reported to health authorities, leaving unclear results. infection rates.
BA.5, the Omicron variant currently causing an increase in cases in many areas, is highly contagious, meaning that many patients treated for other conditions may test positive for this variant and be counted among those who are considered serious cases, even if they are not COVID-19 the cause of their poor health.
The scientists explain that other unknown factors complicating predictions include whether a combination of vaccination and infection with the coronavirus – so-called hybrid immunity – provides greater protection in humans as well as how effective booster vaccination campaigns might be.
"Anyone who says they can predict the future of this pandemic is either overconfident or lying," says David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.
Experts are also closely watching developments in Australia, where a resurgence of the flu epidemic combined with COVID is straining the hospital system.
They even say that it is possible for Western countries to experience the same after several periods of almost no flu.
"If it happens there, it can happen here. Let's prepare for a normal flu season," says John Macaulay, director of the Worldwide Influenza Center at the Francis Crick Institute in London.
The WHO has said that every country still needs to approach the new waves with all the tools in the pandemic toolbox – from vaccinations to interventions such as testing, social distancing and mask wearing.
Israel's government recently suspended routine coronavirus testing of travelers at its international airport, but is ready to start the practice "within days" if faced with a surge, says Sharon Alroy-Price, the head of the state public health service.
"When there is a wave of infections we have to wear the masks, we have to do tests. This means we live with COVID", he notes.