https://www.washingtonpost.com/politics/2021/01/04/health-202-when-will-2021-feel-normal-again-here-what-eight-experts-predict/?utm_campaign=wp_the_health_202&utm_medium=email&utm_source=newsletter&wpisrc=nl_health202

Around half a million Americans are now getting a coronavirus vaccine shot every day. But that pace must accelerate considerably if the United States has any hope of quashing the virus in 2021.

Public health experts differ on how quickly that might happen — and when things might start to feel “normal” again around the country.

To inaugurate our first Health 202 of the new year, we asked eight experts for their predictions.

After all, we all want to know when we can go to concerts and ballgames again. Or even just go to the office. (Let’s start small.)

We asked two questions. The first has to do with when the United States will reach “herd immunity” — the point at which enough people are immune to a virus, either by recovering from it or getting vaccinated against it. Herd immunity generally kicks in when about 70 percent of people are immune, although experts differ on the precise threshold.

To reach herd immunity with the coronavirus, approximately 230 million Americans would need the vaccine. As of yesterday, just 4 million had gotten the first of two shots. Daily immunizations have increased considerably over the past few days, with about 500,000 people getting the shot each day, but experts say that number needs to at least double and ideally quadruple.

We also asked these experts when they personally expect their lives to return to normal.

Here are their responses, edited lightly for clarity and brevity.

When will enough Americans be vaccinated for the U.S. to reach herd immunity, based on how things look right now?

Carlos del Rio, professor of medicine and global health at Emory University: 

“At the current pace it will take a really long time. … I think if we can get our act together and start vaccinating 1 million people a day like President-elect Biden is promising, then we can get to 260 million people getting at least one dose … more or less or by late August or early September. If we really scale up and get to 3 million per day, then we can get to 260 million people in [less than] 100 days or three months. Can we do it? Yes! But it will require coordination, leadership and funding. So, as you see, my answer is: It depends.”

Eric Topol, director and founder of Scripps Research Translational Institute:

“I think by July, if we get 2 to 3 million people vaccinated per day, and even sooner, if we have a rapid neutralization antibody assay to be able to defer those who have had a prior infection and mounted a durable immune response. Yes, that is optimistic, but it can be done.”

Jay Bhattacharya, professor of medicine at Stanford University:

“There is a lot of disagreement in the scientific literature about the herd immunity threshold, which is certain to vary from place to place. I don’t think anyone responsible would confidently say what it is, and would never put forward a single number for the U.S. as a whole. Rather, the key question is how rapidly we inoculate people who have a high risk of mortality conditional on infection — most older folks and some late middle-aged folks with severe chronic conditions. Prioritizing them for vaccination will yield the greatest benefit in reducing covid-19-related mortality, regardless of when herd immunity is hit.”

Jesse Goodman, professor of medicine and infectious diseases at Georgetown University:

“I am not sure that in the near future we will reach a level of population immunity where the virus will be virtually shut down, as we are accustomed to with measles. Through immunity due to vaccination, combined, unfortunately, with infections in the unvaccinated, we should reach a state where the risk of exposure is reduced due to a mostly immune population. While cases will still occur, our health system will no longer be stressed and large outbreaks should be less common.

“I am hopeful we can get to such a situation in the last quarter of this year, provided vaccine production, access and acceptance go well and no mutant viruses arise that gain the ability to escape current vaccines.”

Kimberly Powers, associate professor of epidemiology at the University of North Carolina at Chapel Hill:

“That question is difficult to answer, as there is considerable uncertainty around the level of immunity we would need in the population to achieve herd immunity, along with the speed with which we can expect widespread vaccine uptake to occur.”

Leana Wen, public health professor at George Washington University and former Baltimore health commissioner:

“Right now, vaccine distribution is progressing at an unacceptably slow speed, and at this current rate, it will take years to reach herd immunity — if ever. If we are able to pick up speed by many times in January, there is still a chance we could substantially slow down the infection and perhaps approach herd immunity in 2021.”

Marc Lipsitch, professor of epidemiology at Harvard University:

“I think you mean ‘will enough Americans be vaccinated to reach the herd immunity threshold?’ My answer is possibly not because we don’t know if the vaccines protect enough against transmission for the threshold to be achievable, and because the new variant may increase that threshold substantially.”

Michael Osterholm, chairman of the Center for Infectious Disease Research and Policy at the University of Minnesota:

“There are three factors that will independently determine when enough Americans will either be protected from covid-19 via vaccination or development of antibody following actual infection.

“First, when will there be sufficient vaccine produced and distributed so everyone can receive their two doses? This includes vaccinating those who may have immune protection from actual infection but are vaccinated anyway to increase durable protection. Second, will enough people agree to be vaccinated? And finally, what is the durability of vaccine-induced protection over time? 

“Each of these factors will play a role in achieving local, regional or national herd immunity protection. I feel confident we can achieve the first factor of sufficient vaccine by the late summer or early fall. But ultimately, the second two factors, how many will be vaccinated and how durable is immune protection will determine the answer to this question. I hope, when considering all three factors, it will be late summer or early fall, but we all realize hope is not a strategy.”

When do you expect your own daily life to feel similar to pre-pandemic times?

Carlos del Rio:

“I am hoping to be ‘close to normal’ by December 2021 more or less. However, as a physician seeing patients, I will probably continue to wearing a face mask and goggles for much longer.”

Eric Topol:

“In 2022.”

Jay Bhattacharya: 

“Given the changes that the previous year has had on my professional and personal life, I do not expect my daily life to ever feel similar to pre-pandemic times. More broadly though and given the disappointingly slow roll out of the vaccine to the vulnerable in many states, I anticipate that American society will start to feel more like normal by April 2021.”

Jesse Goodman:

“Hopefully late this year, life should begin to feel similar to pre-pandemic times. However, it is likely that both great vigilance and some social distancing will still be needed, particularly if the population is not nearly all vaccinated. In addition, we may well require periodic immunization against the current and, possibly, other emerging coronavirus variants.”

Kimberly Powers: 

“I expect daily life to feel more normal by sometime this summer, but I think it will be 2022 before some mitigation measures can be fully relaxed.  And I expect that our society will feel ongoing consequences of this pandemic — physical, mental, emotional, and economic — for years to come.”

Leana Wen: 

“I don’t know. I was much more optimistic a few weeks ago. But given the lag in vaccine rollout thus far and how under-resourced our public health systems are, I am concerned things for much of 2021 will feel more like 2020 than 2019.”

Marc Lipsitch:

“I think that sometime in the second half of the year there will be enough vaccination in the U.S. and some other countries that we will begin to treat covid-19 more like seasonal flu, which is deadly to large numbers of people but does not overwhelm health care and does not cause us to curtail normal social contact. This is because with enough vaccine in those at high risk of death and hospitalization, transmission may continue (at a reduced level thanks to some immunity in the population from prior infection and vaccine) but the outcomes will be less severe.”

Michael Osterholm:

“I’m not sure it ever will. We will not go back to a pre-covid-19 normal. We will instead exist in world with a new normal. And even that will in part be determined by the availability of adequate vaccine supply to cover everyone in high, middle and low income countries. I look forward to the day when my office hours are as they were pre-covid-19.”