How will pandemic end? Omicron clouds forecasts for endgame, experts say

Pandemics do eventually end, even if Omicron is complicating the question of when this one will. But it won't be like flipping a light switch: the world will have to learn to coexist with a virus that's not going away, experts say.

The ultra-contagious Omicron variant of the coronavirus is pushing cases to all-time highs and causing chaos as an exhausted world struggles, again, to stem the spread. But this time, we're not starting from scratch.

Vaccines offer strong protection from serious illness, even if they don't always prevent a mild infection. Omicron doesn't appear to be as deadly as some earlier variants. And those who survive it will have some refreshed protection against other forms of the virus that still are circulating — and maybe the next variant to emerge, too.

The newest variant is a warning about what will continue to happen "unless we really get serious about the endgame," said Dr. Albert Ko, an infectious disease specialist at the Yale School of Public Health.

"Certainly COVID will be with us forever. We're never going to be able to eradicate or eliminate COVID, so we have to identify our goals."

At some point, the World Health Organization will determine when enough countries have tamped down their COVID-19 cases sufficiently — or at least, hospitalizations and deaths — to declare the pandemic officially over. Exactly what that threshold will be isn't clear.

Even when that happens, some parts of the world still will struggle — especially low-income countries that lack enough vaccines or treatments — while others more easily transition to what scientists call an "endemic" state.

They're fuzzy distinctions, said infectious disease expert Stephen Kissler of the Harvard T.H. Chan School of Public Health. He defines the endemic period as reaching "some sort of acceptable steady state" to deal with COVID-19.

The Omicron crisis shows we're not there yet, but "I do think we will reach a point where SARS-CoV-2 is endemic much like flu is endemic," he said.

For comparison, COVID-19 has killed more than 800,000 Americans in two years while flu typically kills between 12,000 and 52,000 a year.

Exactly how much continuing COVID-19 illness and death the world will put up with is largely a social question, not a scientific one.

"We're not going to get to a point where it's 2019 again," said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. "We've got to get people to think about risk tolerance."

British Columbia Provincial Health Officer Dr. Bonnie Henry said last week that she believes the province will eventually see the end of the pandemic.

"The way the virus is changing with Omicron — that is leading us to that place sooner," she said in a year-end interview. "The type of illness it's causing, with most of us being protected through vaccination, means that we are going to get to that place."