If the coronavirus has a single goal – to infect us repeatedly – it is better to realize it from alpha to delta to omicron. And it is not done anywhere near. “Omicron is the worst thing we could ever have imagined,” said Jema Geogegan, an evolutionary virologist at the University of Otago in New Zealand. Somewhere out there, a Rho, a Tau, or even an Omega is already working

Although not all variants are built the same way. Our next problem may be delta-like, fast and a shadow more serious but still frightening with existing vaccines. It can be shattered on the motif of the Omicron, to the extent that it avoids the defenses raised by infection and shots that we have not yet seen. It can combine the worst aspects of it Both Find among those predecessors, or its own successful combo feature. Each recurrence of the virus will require a slightly different approach to dealing with it – the standard approach will depend on “how sick people are and which people are getting sick” depending on Angela Shane, a vaccine-policy specialist at Children’s Hospital. Philadelphia, tell me.

Our actual response will not only depend on the mixture of mutations that the virus gets in our way. How seriously we take those changes and what conditions the virus finds in us when it condemns us – will depend on immunologically, psychologically. While the next spotlight-hogging variant is still being created, we can sketch in broad and not-so-wide strokes, a subset of the cast of characters that can emerge and what it takes to intercept each.

Sharpshooter

Let’s start with the worst case scenario, because it is probably the least likely. A new variant tests each of the Big Three boxes: more contagious, more deadly, and much more avoidable than the vaccines and other SARS-CoV-2 flavors that define defenses.

In this version of the event, even vaccinated people can suffer from a high rate of serious illness; Extra boosters may not mount an adequate block. The safety net between vaccinated and non-vaccinated people will begin to close — perhaps faster, if the new form collides with us when many people are not up-to-date about their shots and the population has low immunity.

This type of virus can look so strange that some of our tests and many of our antibody-based treatments may stop working. Viral spreads will also surpass the diagnostic tools we have left behind, erasing communication-tracing efforts and making it difficult to cordon off the pathogen. A recent analysis suggests that millions of lives could be lost in the United States alone in just a few months. Countless more will be hospitalized or plagued with debilitating symptoms of chronic covid. This future will look like the past – a return to the “first year of the epidemic”, Crystal Watson, a senior associate at the Johns Hopkins Center for Health Security, told me. And, accordingly, this future will start the most dramatic reaction.

First, we need to start creating a new vaccine that fits sniper-style variants. According to the current best estimates of shot-makers only, updated vaccines will take at least three months without counting the difficult process of rolling out quickly and fairly. In the meantime, if we want to avoid the worst effects, we have to lean too much on the old standby: high-quality masks, potentially mandatory to use; Restricted travel; Restaurants, bars and gyms সম্ভবত possibly even in the case of brief closures. (Hopefully, at this point, good ventilation and air filtration will be more widespread.) Funding may be required from the government to develop and distribute new tests and treatments. If the outbreak is not controlled, necessary places like schools may consider closing their doors again – although Natalie Quillian, deputy co-ordinator of the White House COVID-19 response team, told me that, from the administration’s point of view, “we really see such a scenario.” Can’t find schools where to close. “

Fortunately, a variant would be quite difficult to come by this bad. Viruses cannot retrieve their genomes indefinitely – not if they want to efficiently infect their preferred hosts. Vineet Menachari, a virologist at the University of Texas Medical Branch, thinks the virus will probably provide a way to suppress immunity to a much greater extent than Omicron. But, he added, “the question is, do we have to give up something else to do it?”

Even if the virus regenerates itself many times over, we can expect that its crime will still strike against some multi-layered defense. It’s not that hard to slip away from antibodies, but “statistically speaking, I don’t think it’s possible to escape T-cell immunity,” said John Huiri, an immunologist at the University of Pennsylvania, in a recent report Modeled. Then, this strategy will arouse enough public desire to use those backstop tools and fight the virus again – not sure if a doom-esque variant will appear anytime soon. “The acceptance of policy X, Y, or Z will not be the same as before,” Shane told me.

Escape artist and brute

In a less catastrophic prediction, a variant would not pose an epic triple threat. But it could still push a significant fraction of the population by rattling One Features at a time. It could be any one of the Big Three, but consider two examples: juice-up, or viral growth, in case of immune deficiency. All other things being equal, every serious illness can spread and push the healthcare system to a breaking point.

First, avoidance options. SARS-CoV-2 is now under tremendous pressure to find an immunological escape hatch. Many people have been infected, vaccinated or both, and the success of the coronavirus has begun to weigh heavily on our ability to avoid shields. This could be a more dramatic version of the recent Omicron wave of the future: None of us, no matter how many shots we have received, will be truly vulnerable to infection or even serious illness. By mere numbers, this variant would be ready to land a huge number of people in the hospital, even if it were not, particles for particles, a more deadly threat. Depending on how much the effectiveness of the alternative vaccine has eroded, especially against hospitalization and death, we still need to update our shots and launch a comprehensive recovery campaign. From a White House perspective, a variant would have to “cross a fairly strong threshold to do this,” Quillian told me. “It’s a fantastic effort to go back and re-vaccinate the entire population.”

In some ways, more Deadly The form that was still sensitive to vaccine-induced immunity may be easier to deal with. We can expect people who were up-to-date on their shots to be as well protected as they were against Delta. The focus will be on protecting the most at-risk: immunized, elderly, immunocompromised, those who are heavily or frequently exposed to the virus – all of whom will probably benefit from a higher dose of vaccine and additional focus around masks, distance, testing. , And treatment. And perhaps our responses to these parties will remain silent. “It will probably take some time for us to re-impose sanctions on the general public,” said Watson of Johns Hopkins.

Maybe it’s not surprising. If the majority of society is covered in security, many people will not see a point of reinvestment in caution. It may be easier to ignore the suffering of those we already see as sick or close to death – or those who are already concentrated in marginalized populations. “If it’s older, immunocompromised, unfortunately, I think we wouldn’t see them in the same light if we were the whole population,” said Menachari, UTMB virologist. Which groups will ultimately shoulder the burden of the virus will ultimately determine the amount of our response.

Most of us would probably be more friendly if a variant pulled a wild card and increased its awfulness in an unexpected group. For example, if young adults or children suddenly become a major target, “I have to believe the response will be different,” says Tom Boliki, director of the Council on Foreign Relations’ global-health program and its contributor to Future-Covid situations. (Menachari thinks it would be impossible for babies to go down suddenly – this is not a common practice for coronaviruses.)

Sprinter

There is a third axis on which the virus can be transmitted – sheer contagion. Some mutations, or a combination of them, can make the virus a bit more efficient to zip into the body. But without a concomitant supercharge of evading violence, or extreme immunity, “I’m not sure there would be much more response to be honest with you,” Watson said.

Some people Maybe Feel inspired to sign up for a booster. A few areas Maybe Press for the mask again. Or not. And if a jolt of the ability to spread is reduced to sabotage, the reaction of the masses may become even more muted. People may get sick, but with immunity on our side, Ratio The number of cases coming to the hospital will also decrease – deceptively comforting statistics. Adam Loring, a virologist at the University of Michigan, said: “It’s hard to believe anyone would care, unless there was more severity.” We may see the annual hospitalization and death burden of this variant equal to or below the flu, a level of distress that Americans have already inherently (and perhaps misleadingly) fixed.

But soup-up transmissibility is a tricky parlor strategy. It helps viruses protect the entire population. Even a slightly distorted form can sow the seeds of chaos if it is allowed to spread enough and find the weakest among us. And we would still be deeply troubled if a flat-footed variant hit us at a time when we let our warnings about vaccination slip, or if efforts to dose the world’s population evenly were still lagging behind. There can be a lot of suffering outside the hospital. Less-severe SARS-CoV-2 infection can still cause long covid seeds. Hours will still be lost for isolation and illness. And although population immunity may be higher than before NowProtection does not spread evenly: Many Americans do not receive any shots at all, and those who remain vulnerable due to their age or health condition.

Even if, somehow, the virus is completely, truly benign, complete complacency can be dangerous. Geogegan, a virologist at the University of Otago, told me that the virus we allow to spread is a virus that suddenly “has more hosts that need to evolve.” They may include immunocompromised individuals who may be harboring the virus in the long run. It could tinker with its genome until, “miraculously, it brings the perfect combo of mutations,” he said, and then roared massively into the population. Menachari is also concerned about the tendency of SARS-CoV-2 to stew and change shape in other animal species. He told me, we have a chance to give SARS-CoV-3. Next Coronavirus worldwide.

We can’t say when the next threat will occur, or how terrible it will be. However, we do have some control over its emergence: the more we allow the virus to infect, the more likely we are to change it again.

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