T-cell cross-reactivity to other coronaviruses 1. Emerging data on these antibodies suggest that they can reduce the need for hospitalization of high-risk patients, and hold potential for post-exposure prophylaxis. It’s possible that regular revaccinations would be required to maintain immunity, and ongoing surveillance for COVID-19 will be required. All Rights Reserved. The virus was able to spread with ease last spring and cases, while remaining low, did start increasing again over the summer. Since then, several other vaccines have been authorized for use around the world. COVID-19 will not disappear during this transition, but will become a more normal part of the baseline disease burden in society (like flu, for example), rather than a special threat requiring exceptional societal response. 3 71. By current rates, the U.S. is on track to hit this percentage at the very end of 2021. It’s much too soon to declare victory, however. Please email us at: A McKinsey Live event on ‘COVID-19 vaccines are here. 53 More than eight months and 900,000 deaths into the COVID-19 pandemic, which could have contributed to higher seroprevalence to begin with. (For more on the potential for a faster resolution of the COVID-19 crisis in the United States, see “An optimistic scenario for the US response to COVID-19”.) These are estimates for the United States, which is likely to have fast and ready access to vaccines. Miriam Berger, “U.K. Joe Myers, “3 in 4 adults around the world say they would get a COVID-19 vaccine,” World Economic Forum, September 1, 2020, weforum.org. An annoying childhood infection,”, Jeffrey V. Lazarus et al., “A global survey of potential acceptance of a COVID-19 vaccine,”. 911–6. Virus-neutralizing antibodies could also confer immunity but are less likely to be deployed at sufficient scale to achieve herd immunity in large populations. "U.S. science officials such as Anthony Fauci have suggested it will take 70 percent to 85 percent coverage of the population for things to return to normal," the outlet explains. 5 Hannah Ritchie et al., “Coronavirus (COVID-19) vaccinations,” Our World in Data, last accessed March 15, 2021, ourworldindata.org. Increasing coverage from 70 to 80 percent is therefore harder than increasing from 60 to 70 percent. When we refer to herd-immunity timelines for a country, we mean the point at which the entire nation or a significant portion reaches herd immunity. Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment. Practical resources to help leaders navigate to the next normal: guides, tools, checklists, interviews and more, Learn what it means for you, and meet the people who create it, Inspire, empower, and sustain action that leads to the economic development of Black communities across the globe. 27 SARS-CoV-2 will continue to exist. (Exhibit 2). “Science brief: Background rationale and evidence for public health recommendations for fully vaccinated people,” Centers for Disease Control and Prevention, last updated March 8, 2021, cdc.gov. Second, herd immunity relies on the efficacy of vaccines at reducing transmission (rather than the usually reported efficacy at preventing disease in the vaccinated person). - BBC Science Focus Magazine Will COVID-19 be over by 2022? Nina Le Bert et al., “SARS-CoV-2-specific T cell immunity in cases of COVID-19 and SARS, and uninfected controls,” Nature, August 20, 2020, Volume 584, pp. People create and sustain change. 35 1 “Lockdown: Boris Johnson unveils plan to end England restrictions by 21 June,” February 22, 2021. 8 This is a fragile dawn, however, with transmission and deaths still high, unequal access to vaccines, and variants of concern threatening to undo progress to date. In this article, we’ll review the developments since our last perspective (January 21), offer an outlook for each of the three geographies, assess risks, and outline what the end of the pandemic might look like. If vaccines are efficacious, safe, and distributed to all ages, vaccine coverage rates of about 45 to 65 percent—in combination with projected levels of natural immunity—could achieve herd immunity (Exhibit 2). Please click "Accept" to help us improve its usefulness with additional cookies. 62. Age and sex composition in the United States: 2019, US Census Bureau, accessed November 15, 2020, census.gov. An earlier timeline to reach herd immunity—for example, Q1/Q2 of 2021—is now less likely, as is a later timeline (2022). 57. All else being equal, countries with a higher proportion of more-infectious variants—assuming they increase public-health measures to handle them—are likely to achieve herd immunity later. Other vaccine data, including those from Novavax and Johnson & Johnson, show a more modest reduction in efficacy, especially against severe disease caused by these variants. The timing of the end point will vary by country and will be affected by a number of factors: Consider the first and most crucial variables: the arrival of vaccines, their efficacy, and their adoption. Recent developments suggest that herd immunity is less likely to come in early 2021, given that vaccines are arriving roughly on the expected timeline; and the downside scenario stretching into 2022 is also less likely, since efficacy is clearer. our use of cookies, and 6 30. Get the vaccine to those who need it most and over time, the risk slowly decreases, Jüni said. Charlie Giattino, “How epidemiological models of COVID-19 help us estimate the true number of infections,” Our World in Data, August 24, 2020, ourworldindata.org; Hazhir Rahmandad, John Sterman, and Tse Yang Lim, “Estimating COVID-19 under-reporting across 86 nations: Implications for projections and control,” medRxiv, August 3, 2020, medrxiv.org. The situation may be dynamic as vaccines are approved at different times, each with its own considerations in manufacturing and distribution. It appears that the two vaccines mentioned will be indicated first for use in adults. Pfizer’s vaccine can be stored in conventional freezers for up to five days, or in its custom shipping coolers for up to 15 days with appropriate handling. Twelve months ago, most people weren’t thinking about COVID-19. This sneaky symptom can be harder to detect in people over 65. In England, more than 80% of over-75s are fully vaccinated while among the over … Most countries have deferred the hope of achieving herd immunity until the arrival of a vaccine. Duration of immunity matters, obviously; for instance, our modeling suggests that if natural immunity to COVID-19 lasts six to nine months, as opposed to multiple years (like tetanus) or lifelong (like measles), herd immunity is unlikely to be achieved unless adult vaccination rates approach 85 percent. Michelle R. Smith, “Governors scramble to speed vaccine effort after slow start,” Associated Press, January 6, 2021, apnews.com. We are as excited as others about the stunning developments in vaccines. Other research suggests that even with waning levels of COVID-19 antibodies, the immune system may still be able to mount a response through other specific B-cell and T-cell immune pathways, where emerging evidence shows much greater durability after six months. “Global attitudes: COVID-19 vaccines,” Ipsos, February 9, 2021, ipsos.com; Yasmeen Serhan, “The vaccine-hesitant man of Europe,”. 70 42. Premier Iain Rankin said that as of Wednesday at 8 a.m., all schools and non-essential indoor services will be closed across the province for the next two weeks. The degree to which T-cell cross-reactivity actually immunizes individuals hasn’t been proven. 44 69. While data indicate that the most likely scenario is to reach this state on the timelines described above, five risks could delay progress. 3 Our flagship business publication has been defining and informing the senior-management agenda since 1964. “Pfizer and BioNTech conclude Phase 3 study of COVID-19 vaccine candidate, meeting all primary efficacy endpoints,” Pfizer, November 18, 2020, pfizer.com. A basic formula for estimating that threshold is one minus the reciprocal of the basic reproductive number. Scientists race to find answers,”. As COVID-19’s impact on health wanes, we are likely to see greater normalization of social and economic life. Nicholas Davies et al., Estimated transmissibility and severity of novel SARS-CoV-2 Variant of Concern 202012/01 in England, Centre for Mathematical Modelling of Infectious Diseases, December 2020, cmmid.github.io. 61. On the other hand, if vaccine uptake is fast, New Zealand might achieve a longer-lasting vaccine-based herd immunity. Gaining that confidence will require a continuation of the progress made to reduce mortality and complications, as well as further scientific study regarding long-term health consequences for recovered patients. We will add a perspective for other parts of the world, including the rest of Western Europe, in future updates to this article. For this reason we include relatively wide ranges. Today, much of the world is intensely focused on it, but we can reasonably expect the imminent threat to abate. 50 70. 29. 21 declared Covid-19 a pandemic on March 11 one year ago. 64. It recorded 315 new coronavirus deaths in hospitals, down from 325yesterday. Peter Loftus, “Moderna is testing its COVID-19 vaccine on young children,”. Coronavirus Resource Center, Johns Hopkins University & Medicine, September 18, 2020, coronavirus.jhu.edu. A third is demographics: while the younger populations of many lower-income countries have led to lower COVID-19-associated mortality, they also make it harder for adult-only vaccination programs to drive herd immunity. These are projected to be the first and last countries to reach herd immunity. We estimate that the mostly likely time for this to occur is the first or second quarter of 2021 in the United States and other advanced economies. Miriam Berger, “U.K. Third, the duration of vaccine-mediated immunity may prove shorter than anticipated, making it hard to reach the necessary threshold for simultaneous immunity. Viruses mutate and adapt over time, and are more likely to have a chance to do so in places where they are left untreated, or where large numbers of people have the virus circulating in them. Transitions will be gradual. We’ll need a new game plan if this one sticks around. Today, nearly every country finds itself in a similar position. “COVID data tracker,” Centers for Disease Control and Prevention, last accessed March 20, 2021, cdc.gov; “Weekly U.S. influenza surveillance report,” Centers for Disease Control and Prevention, last reviewed March 19, 2021, cdc.gov. If we are able to pair these vaccines with more effective implementation of public-health measures and effective scale-up of new treatments and diagnostics, alongside the benefits of seasonality, we may also be able to reduce mortality enough in Q2 to enable the United States to transition toward normalcy. 3. If early vaccine doses reach a significant percentage of high-risk elderly individuals by the end of quarter one, the combination of protecting these groups and the arrival of spring in the northern hemisphere should improve the situation compared with where the United States is now. Both Pfizer’s and Moderna’s would be two-dose vaccines, necessitating rigorous follow-up for series completion. We hope that our perspectives prove useful to leaders as they set policy and strategy; we will continue to update the series. The UK’s Covid vaccine roll-out continues at pace, with just over half of the population having now had their first dose. 4 We will consider timelines for other countries in forthcoming updates; they will vary based on the timing of access and distribution of vaccines and other factors. Washing hands is number 1 on the list. An epidemiological end point will be reached when herd immunity is achieved. 5. We expect this transition to continue in the second quarter of 2021 and will likely see many aspects of social and economic life return to the prepandemic normal, consistent with UK Prime Minister Johnson’s staged reopening plan for the United Kingdom Google data shows your state is crazy for this condiment. Please use UP and DOWN arrow keys to review autocomplete results. Third, the fraction of US and UK residents who already have natural immunity from prior infection is in the same range (with significant variability among regions within countries). Given all of these variables, where do we net out? Here we review five implications; each has helped refine our probability estimates for the COVID-19 pandemic timeline. 36 For more, see Eames, Fine, and Heymann, ‘‘‘Herd immunity’: A rough guide,” pp. At the latest, the transition to normal will come when herd immunity is reached. The trajectory of UK and US cases has enabled the beginnings of a transition toward normalcy, Depending on vaccination progress over the summer (whether the United States is on the earlier or later end of the herd immunity window), there may be a smaller fall wave of disease in third to fourth quarter 2021. All people aged 42 and over in England are now able to book covid-19 vaccination appointments, in a further extension of the vaccine rollout. Number of new Covid cases per day, Italy. 11/23/20 estimate. First, vaccine adoption may prove lower than expected. “Covid-19 vaccine: First person receives Pfizer jab in UK,” BBC, December 8, 2020, bbc.com/news. The speed of COVID-19 vaccine development has been an unqualified success. Some of those measures (such as full lockdowns and restrictions on certain industries) have significant social and economic consequences, and others (such as testing and tracing), while expensive, don’t. For example, Eli Lilly’s antibody bamlanivimab was granted Emergency Use Authorization (EUA) by the US Food and Drug Administration on November 9, Erik Volz et al., Transmission of SARS-CoV-2 Lineage B.1.1.7 in England: Insights from linking epidemiological and genetic data, Imperial College London, December 2020, imperial.ac.uk. But case counts matter primarily because people are dying from the disease and because those who survive it may suffer long-term health consequences after infection. 34. This is likely, but has not yet been proven at scale. 41 Smriti Mallapaty, “Can COVID vaccines stop transmission? “COVID-19 (coronavirus): Long-term effects,” Mayo Clinic, August 18, 2020, mayoclinic.org. However, China, Chile, and Canada are all tracking to take nearly five years to reach this total. "At this rate, it will take an estimated 4.9 years to cover 75 percent of the population with a two-dose vaccine." Bestlifeonline.com is part of the Meredith Health Group. From Q4 2020 to Q1 2021 the probability of herd immunity is negligible. Exhibit 4 provides a global view of seven factors that are likely to drive herd-immunity timelines for the rest of the world. The pandemic’s two endpoints, a transition toward normalcy and herd immunity, may look different in different places. 26 F. Javier Ibarrondo et al., “Rapid decay of anti-SARS-CoV-2 antibodies in persons with mild COVID-19,”, Rebecca Cox and Karl Brokstad, “Not just antibodies: B cells and T cells mediate immunity to COVID-19,”, Katie Thomas, “New Pfizer results: Coronavirus vaccine is safe and 95% effective,”. the first and more important of the pandemic’s two endpoints. And perhaps most importantly for timelines, access to vaccines is unequal. 37. John Quinn is a London-based writer and editor who specializes in lifestyle topics. However, the COVID-19 pandemic eventually will end. What does that mean for your organization?’, Key factors affecting the timeline to herd immunity. Levels of natural immunity from prior infection vary within the European Union but are generally in the same range as in the United Kingdom and the United States. 35. Read on to find out how much longer the pandemic will be with us, and for more on the latest vaccine news, check out The CDC Says These 3 Side Effects Mean Your Vaccine Is Working. Kevin Hartnett, “The tricky math of herd immunity for COVID-19,” Quanta Magazine, June 30, 2020, quantamagazine.org. Anthony Ives and Claudio Bozzuto, “State-by-state estimates of R0 at the start of COVID-19 outbreaks in the USA,” MedRxiv, May 27, 2020, medrxiv.org. Miriam Berger, “U.K. These factors include the following: Herd immunity requires that enough people be simultaneously immune to SARS-CoV-2 to prevent widespread ongoing transmission. The end of Europe’s pandemic may come somewhat later, and other countries’ outlooks will depend on several variables. The past five weeks have brought an array of conflicting news on the COVID-19 pandemic, affecting our estimates about when the coronavirus pandemic will end. 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