In one scenario, there will be a series of outbreaks in the next one to two years, smaller than the ones currently crippling economies around the world


There are three ways that the COVID-19 pandemic may play out, and each of them indicates the virus will be infecting people well into 2021, according to a new report published by the Center for Infectious Disease Research and Policy (CIDRAP).

A number of working papers and prediction models have been published in recent weeks, offering guidance for how to restart economies, bring people back to work, and better protect public health as the virus continues to circulate in communities.

“There is no crystal ball to tell us what the future holds and what the ‘endgame’ for controlling this pandemic will be,” the CIDRAP authors wrote.

The center, which is part of the University of Minnesota, outlines three scenarios:

• There will be a series of outbreaks, smaller than the ones currently crippling economies around the world, over the next one to two years. In this scenario, mitigation measures like physical distancing may be relaxed and then reinstated.

• A larger wave of infections and deaths will occur in the fall or winter, mimicking the waves reporting during the 1918-1919 Spanish influenza pandemic and the 2009-2010 H1N1 influenza pandemic. Mitigation measures would be put back into place during those outbreaks.

• And, finally, COVID-19 becomes a “slow burn,” “without a clear wave pattern.” This would be different than past flu pandemics.

It has been four months, nearly to the day, since Chinese authorities notified the World Health Organization of a new type of pneumonia infecting residents in Wuhan, China, which later became the epicenter of the pandemic. More than three million people have tested positive for the virus, and at least 233,000 have died, according to data aggregated by Johns Hopkins University.

While researchers and public health experts are starting to better understand some characteristics of the virus, much is still unknown, including whether COVID-19 antibodies provide protection or whether warmer weather limits transmission of the virus.

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“I’m almost certain it will come back, because the virus is so transmissible,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Bloomberg TV. “It’s not going to disappear from the planet, which means as we get into the next season, in my mind, it’s inevitable that we will have a return of the virus.”

Dr. Marc Lipsitch, a professor of epidemiology at the Harvard T.H. Chan School of Public Health and co-author of the CIDRAP report, helped write another analysis that predicts “prolonged or intermittent social distancing” for at least two years on the expectation that there will be recurrent outbreaks in winters down the line.

“Intermittent distancing may be required into 2022 unless critical care capacity is increased substantially or a treatment or vaccine becomes available,” he wrote in the report published in Science in mid-April.

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