Ashish K. Jha is dean of the Brown University School of Public Health.
These upcoming months will feel like a reprieve, and rightly so. Restrictions likely will be eased as we go back to a new sense of “normal.” But we also must remain prepared for what’s ahead — because there is little reason to believe that the pandemic is over.
What is ahead? First, it is possible, though unlikely, that the delta variant returns and co-circulates with omicron in different populations, contributing to ongoing infections and hospitalizations. Whether delta makes a comeback or not, cases are likely to remain seasonal. That means we are likely to see surges in Southern states this summer (as people there spend more time indoors) and in Northern states next fall and winter as the weather turns cold again. Further, we could easily see the rise of a new variant that might be more contagious or deadly.
The bottom line is that as the omicron surge subsides, we will enter a period of uncertainty, with low levels of infections but hard-to-predict surges, either from the current variants or new future variants. As such, we must use the months ahead to prepare.
First, tens of millions of Americans, including a majority of children, remain unvaccinated, and even more have not received a much-needed booster. Efforts to reach the un- and under-vaccinated must continue. Beyond that, we need an Operation Warp Speed 2.0 to aggressively study new variant-specific vaccines as well as intranasal vaccines that stimulate mucosal immunity, key for preventing infections and pan-coronavirus vaccines. We don’t know which of these will work, but we must make the investment to study and build them.
Second, testing is key to being prepared. Last year, as infections fell, testing production waned and eventually dried up. When more testing was urgently needed during the most recent surge, capacity had to ramp up almost from scratch. We can’t make that mistake again. We must ensure that we have a large national stockpile of in-home rapid tests, and we should continue to ramp up production of raw materials, including reagents. These efforts must also anticipate a transition toward broad tests capable of detecting not only the coronavirus but also other common respiratory ailments to help our health system triage different infections.
Third, new therapeutics from Pfizer and Merck, along with monoclonal antibodies and other intravenous antivirals, must be a cornerstone of managing infections during future surges. These treatments can substantially reduce the severity of infections, but while each of these therapies has demonstrated efficacy, we don’t have the doses we need, and the doses we do have are not being distributed equitably.
By the time the next variant arrives, all Americans should have access to antiviral treatments immediately after testing positive. We must have enough doses on hand, access to rapid tests (because these therapies must begin soon after symptoms emerge) and clear clinical pathways to ensure any American can access them. Their potential to substantially blunt the next wave justifies significant investments in effective protocols and stockpiles, including making treatments free to people who test positive.
Finally, there is the issue of communication. This pandemic has polarized our nation, with much of the United States splintering into two camps: those who believe the pandemic is over, and those who believe we will be in this pandemic forever. Unfortunately, the virus will continue to challenge us for some time, but it need not dominate our lives. We need to clearly communicate the moment we are in, the actions people should take during periods of low infection and the temporary measures we might need during future surges (mask-wearing, testing, etc.). The lack of clear communication has meant that at every point in the pandemic so far, we were either over- or underreacting, and both have costs. Our leaders must do a better job of communicating where we are, what is to come and how best to prepare.
Attention to these crucial areas will ensure that Americans need never return to the protracted disruptions of school, work and public life. It will also allow us to begin the long task of building a new, healthier normal, even as we continue to manage the virus. And we should help Americans understand that the worst of the pandemic is behind us and that we have the tools to manage future surges, no matter what Mother Nature sends our way.