What do you really actually think the future looks like with COVID?
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I need to disclaimer this a little. I am not an epidemiologist, and I have been wrong about COVID before. (See my TED talk) I have failed in my predictions both by being too optimistic and by being too pessimistic. My best guess is just that - a guess. And I am writing this in Spring 2022, in a time where COVID is constantly evolving and we’re constantly learning new things about COVID. New medical treatments, new information about how it affects the body. We’re also advancing the science all the time - learning about the virus itself.
So predictions are risky.
All that being disclaimed, I see three main things.
Reinfection among poor people. There is a class of people - mostly lower-income front-line workers - who will just get COVID all the time. Mask mandates are ending, and the virus evolves. People with high-contact jobs will face repeated reinfection, many of them will eventually become disabled by long COVID or the impact of a severe COVID infection.
Few consequences for the wealthy. Medical care for COVID will get better. The pace of research on COVID treatments has been really astonishing, and I believe that will continue. There’s a lot of money to be made from COVID treatments, and drug companies will follow that money.
Eventually - I’d say in 1-2 years - all COVID infections will be minor for people with no comorbidities and access to good quality medical care. This will relate to point #1 - people who know COVID will be minor for them will be disinclined to protect the people for whom COVID will be serious. We’ve seen that already and I don’t expect it to change. People at high risk for COVID complications will be increasingly unable to participate in regular society, because ordinary society won’t be interested in preventing COVID.
Long COVID is a long-haul problem. Long COVID will remain a problem for at least five years, and fear of long COVID will become the major reason most people take precautions against infection. Research on long COVID has been very slow out of the gate, and it continues to move at a glacial pace. We’re already behind and it’s very hard to speed up at this point. Inconsistent data on COVID infections and poor quality hospital diagnosis coding contributes to the problem.
Researching long COVID isn’t like finding new drugs for an infection. Identifying what characteristics make a case of COVID most likely to lead to long COVID is complicated. Is it about the profile of the patient or about the type of infection? Initial exposure viral load? Severity of the infection? Patient lifestyle, patient demographic, patient genotype? We don’t know and that’s a lot of factors to figure out.
Depending on where you stand, these predictions look cheerful or downright grim. Count me among the dystopians.
Yeah, this is exactly what's happening now, except that a LOT of people - including middle class and fairly wealthy - are getting infected or re-infected because they haven't figured out the whole fear of long COVID thing. (And our societies are willy-nilly throwing away mask requirements; it's wholly bizarre to me, but you know why it's bizarre to me, aka, high risk.) (Speaking of that, my own risk factor comes from a viral "complication" in the first place, so ... yeah.)