One of the biggest sources of uncertainty is whether winter — with its holiday parties and travel and, in cooler climates, indoor gatherings — will accelerate the current Covid surge. Osterholm predicts that about 50 to 70 million Americans lack Covid immunity from either natural infection or vaccination. That’s plenty of fuel, as he puts it, to keep the fires burning. Then there is the uncertainty of the dance between the vaccine and the virus, including new variants that arise from the vast unvaccinated parts of the globe. Vaccines still seem effective at preventing severe Covid cases. The unsettled debate over boosters is really an unsettled debate about how long that vaccine protection lasts. We know how Covid is transmitted, but we still don’t understand the pattern of cases, Osterholm said. It’s not seasonal like the flu. It’s unclear why West Virginia’s cases are surging now, weeks after cases peaked in the Southeast. Alessandro Sette, an infectious disease expert at the La Jolla Institute for Immunology, told Nightly that he thinks it’s unlikely Covid will evolve to evade vaccine defenses — that would require a lot of mutations and it’s not to the evolutionary advantage of the virus to become more lethal. It is, however, to the virus’s advantage to become more transmissible. Still, vaccinated people have less reason to worry about a breakthrough Covid case becoming fatal. Finally, humans are even more unpredictable than the virus. A winter Covid surge is entirely preventable, said Gigi Gronvall, an immunologist at the Johns Hopkins Center for Health Security. But it’s hard to believe that Americans who sat out the 2020 holiday season will turn down the invitations for Thanksgiving turkey and Christmas eggnog and New Year’s champagne this year. Travel has already bounced back. Nor has the United States adopted frequent, rapid testing, which could stem some spread. The country missed its chance to stomp out the virus early this year by failing to get vaccinated in high enough numbers, letting Delta run rampant. Experts hope that case surges, vaccine mandates and the authorization of a Covid shot for kids will lift the country’s vaccination rate. But it’s clear that vaccine resistance is entrenched in certain segments of the population. About a quarter of Texans said they likely won’t get vaccinated according to a recent poll from The Dallas Morning News and The University of Texas at Tyler. Things could have been different. Last year it seemed like we would be in a better place than we are now, with a disease that is manageable, like the flu. “This winter might mark a different turning point,” said Saskia Popescu, an epidemiologist and biostatician at George Mason University and the University of Arizona. Instead of the end of the pandemic and the start of an endemic, this winter might introduce us to a different, and unsettling, stage. One where we are no longer in lockdown but learning to treat a deadly virus as a normal part of our lives. One, where with any luck, the virus finally runs out of people to infect. Welcome to POLITICO Nightly. Reach out with news, tips and ideas for us at nightly@politico.com. Or contact tonight’s author at rrayasam@politico.com and on Twitter at @renurayasam.
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