It's not guaranteed, but it's looking more like the winter months may become cold, flu and COVID-19 season.
Vaccines promise to defang the new coronavirus, taming it so that it's unable to cause serious disease and deaths, or threaten hospitals' ability to deal with patients.
Herd immunity may be reached in a few months, but what happens next isn't easy to predict.
Will COVID-19 ever go away entirely or is it here to stay?
Experts, including Dr. Anthony Fauci, say it’s likely to stay and become an endemic disease — one that occurs frequently at a predictable rate in a specific area, like the common cold in North America or malaria in Africa — though it will circulate at much lower levels, produce milder symptoms and become much more manageable than when it first emerged.
“I doubt we are going to eradicate this,” Fauci said in November.
When the journal Nature recently polled more than 100 immunologists, infectious disease researchers and virologists, 89% thought the new coronavirus would become endemic.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security in Baltimore and a spokesperson for the Infectious Diseases Society of America, agreed.
“I've never thought it would go away. This is an efficiently spreading respiratory virus that comes from a family of viruses, of which four others cause 25% of our common colds. It’s established itself in the human population,” Adalja told TODAY.
“But what will happen is that it will be no longer able to kill people at the rate that it is currently doing. It will still be here — we will still see cases, we will still have issues with it — but it will never be a public health emergency the way it is now.”
Adalja predicted the new coronavirus would become the fifth seasonal coronavirus people deal with every year, although the damage it causes will be severely limited.
If COVID-19 becomes seasonal, what will be the season?
It would likely coincide with the cold and flu season: “Coronaviruses in general tend to peak in the colder months,” Adalja said.
The U.S. didn't see that seasonality in 2020 because there was so much spread of COVID-19 and so little immunity to it when summer arrived that the warmer weather didn’t have much impact, he added.
Will people have to get an annual COVID-19 vaccine, similar to an annual flu shot?
That remains to be seen, with some experts leaning toward “yes.”
People may need to get vaccinated against COVID-19 annually over the next several years, Johnson & Johnson CEO Alex Gorsky told CNBC. The company applied for emergency authorization of its vaccine candidate this month.
“This virus is showing an incredible ability to mutate, to change, to adapt, in a sense, to everything we’re putting against it,” Dr. Richard Besser, a former acting director of the federal Centers for Disease Control and Prevention, told NBC News senior medical correspondent Dr. John Torres.
Even if the current COVID-19 vaccines are found to be less effective in blocking infection from the South African and Brazilian variants, they may still prevent hospitalization and death, so they may function more like a flu vaccine in preventing severe disease, Adalja noted.
Or it may be that one vaccine update will be required, and then the virus becomes more stable without the need for continually updating the shot, he added.
But when it comes to the vaccine experience, it's hard to compare it to what happens with influenza because the flu and COVID-19 are completely different viruses, Adalja cautioned.
What will happen with testing, mask wearing and restrictions?
Experts predicted COVID-19 testing would become more routine, similar to the way doctors test people for influenza. “I don't think you would see dedicated COVID-19 testing sites after this season,” Adalja said.
Mask mandates will likely fade away, but Americans will probably keep wearing face coverings during future cold and flu seasons — similar to what happens in many Asian countries, he added. The virtually non-existent 2020-2021 flu season has shown how effective mask-wearing and other precautions can be at stopping viral spread.
Once the vulnerable populations are vaccinated for COVID-19 and hospitals aren’t worried about being overwhelmed, the restrictions on restaurants, gyms and other businesses will be lifted, Adalja predicted. But many adaptations implemented during the crisis — such as better air filtration systems and enhanced sanitation — will likely stay in place; and telecommuting and telemedicine will continue to be popular.
“There are going to be lots of changes in society that that occur because of the pandemic,” Adalja said.