A Realistic Look at How Long the COVID-19 Pandemic Could Last

Being in the public health sphere, I get asked multiple times a day: “When will this end?” Thus, I thought I would share my predictions, which were made to the best of my ability, constructed from the information I have access to. Please keep in mind this is purely my opinion.

1. Non-essential businesses will not be back to normal any time soon. I originally predicted July, but we were too slow on lock downs in certain states and mask recommendations. Now I’m thinking late fall, depending on what businesses we are discussing. For example, elective surgery will be back sooner than luxury dining, which is a long time away from resuming normal operations.
2. Social distancing restrictions will not be lifted until we see significant and sustainable drops in COVID cases. Harder hit areas like New York City will be more cautious and conservative in lifting restrictions. As of now, New York wants to wait 45 days with depressed cases, while CA is citing 14 days. Politicians will not want to loosen restrictions with the consequence of having cases re-surge, resulting in more deaths. Further, if we loosen restrictions too early, all the pain will have been for little or no gain. We want our social distancing to be worth something; ending it too earlier could erase all progress. Likely, this will vary based on the cases in your region.
3. A vaccine will likely take longer than 12 to 18 months. We first need to test safety; make sure the vaccine is safe to give to immuno-compromised groups and vulnerable populations (elderly, kids, cancer patients, pregnant women). Then, we need to test efficacy. Furthermore, distributing the vaccine is a beast of a problem. First we need to develop an effective supply chain. Then we need to make enough to give to the general public, which requires developing reliable distribution processes. It is not as easy as just developing out the science and technology; it is a logistical problem as well. Vaccines will then need to be closely monitored to get a true rate of adverse effects, and for us to be able to understand the level of protection they provide in the real world (often very different than experimental conditions). This process will probably take at least two years, and restrictions will remain until a large enough number of people are vaccinated to evoke herd immunity.
4. When will things look like normal again? I think it will take two years for us to approximate normal. I predict people will go back to work in stages, more essential to be in the office business first. We may even have to stagger with office space. I don’t see major entertainment events picking up again for over a year, regardless of what happens with official restrictions. No one wants to kill grandma by going to a Cubs game. Non-essential in-person gatherings will probably cease to exist for the foreseeable future; likely until herd immunity and vaccination efficacy is well established. The coronavirus is also like to have seasonal resurgence in which we play this song and dance all over again, but it will be easier the second time. Communities will have threshold case numbers, which allow them to understand when infections are getting out of hand and when to initiate restrictions and lock downs again. The threshold numbers will likely be based on available hospital capacity, ICU capacity, and the ability to track, trace and contain.

I wanted to write this because a good number of people I discuss this with are under the impression it will be business as usual in a few weeks to a few months. But it is very clear to me as a public health professional that we are in this for the long haul: buckle up.

This piece was written by Jennifer, Dunphy, DrPH, MBA, Chief Population Health Officer and Senior VP, Regal Medical Group, one of the nation’s largest independent physician associations. To follow Dr. Dunphy on Twitter, click here.