How does COVID-19 end? Experts offer predictions

How does COVID-19 end?  Experts offer predictions

Omicron triumphed over delta — another fast-spreading and most prevalent variant — because it spreads so quickly. While delta settles in the lungs, omicron favors the upper airways, where it can spew out copies of itself while we talk and breathe. Its incubation period is only three days, compared to 4.3 days for delta and five days for other variants. It also is more likely than other variants to be asymptomatic; rather than lying in bed, infected people tend to feel fine or only slightly ill, and spread it. “The virus is having to learn to navigate a different immune environment than it did in the beginning,” said Jeremy Kamil, a virologist at Louisiana State University Health Sciences Center Shreveport, who studies variant mutations. “We are well equipped to fight these things off. But time and time again, the viruses come up with countermeasures.” “One of the primary selective pressures on the virus for the last two years has been: ‘How do I get into as many people as quickly as possible?’ ” said Dr. Patrick Ayscue, an applied epidemiologist at San Francisco’s Chan Zuckerberg Biohub. ” ‘I could hop into anybody and have a great time.’ ”

If you’re a virus, your only goal is to make more of yourself. You don’t care how many people you kill — or merely inconvenience with a mild case of the sniffles. There’s no advantage, or disadvantage, to causing long COVID. “The virus will continue to try lots of things,” he said, “because that’s how they succeed.”

In the early days of the pandemic, what mattered to the virus was quick transmission. But now it faces a different landscape. We’re adapting, and soon nearly all of us will have protective antibodies from either vaccines or infections. “We’re still in the early days of the ‘getting to know you’ phase,” said Stanford microbiologist Dr. David Relman. “And it’s in this phase that things are the least predictable, the least well understood and the most dynamic.”

In the U.S., experts predict that we’ll see a precipitous decline in omicron cases starting the third or fourth week in January, if we follow trends seen in South Africa, Denmark and the United Kingdom. By mid-February, omicron will recede. But that isn’t necessarily cause to celebrate. “Omicron will run out of people to infect,” said Ayscue. “That can give the opportunity for something else to come in.” That’s because we’re changing, too. In most parts of the world, the majority of the population has been infected or had some form of vaccination, and has some immunity.

In its early days, this strategy worked for the variant, and it ran rampant. But that’s beginning to change now — and will force the virus to try to modify its approach. Luckily for humans, an omicron infection has meant less severe disease. Two new studies show that omicron doesn’t grab onto lung cells as tightly or quickly, and so is less likely to cause pneumonia. Instead, it prefers airways called the bronchus.

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