Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period

• Published in: Science (American Association for the Advancement of Science) Vol. 368; no. 6493; pp. 860 - 868
• Main Authors: Kissler, Stephen M., Tedijanto, Christine, Goldstein, Edward, Grad, Yonatan H., Lipsitch, Marc
• Format: Journal Article
• Language: English
• Published: United States The American Association for the Advancement of Science 22.05.2020; American Association for the Advancement of Science
• Subjects: Betacoronavirus - immunology; Betacoronavirus - physiology; Coronaviridae; Coronavirus Infections - epidemiology; Coronavirus Infections - transmission; Coronavirus Infections - virology; Coronavirus OC43, Human - physiology; Coronaviruses; COVID-19; Critical care; Disease control; Disease Outbreaks; Disease transmission; Disease Transmission, Infectious; Dynamics; Epidemiology; Herd immunity; Humans; Immune response; Immunity; Microbio; Models, Biological; Outbreaks; Pandemics; Pneumonia, Viral - epidemiology; Pneumonia, Viral - transmission; Pneumonia, Viral - virology; Respiratory diseases; SARS-CoV-2; Seasonal variations; Seasons; Severe acute respiratory syndrome coronavirus 2; Social distancing; Viral diseases; Viruses; United States > US
• ISSN: 0036-8075; 1095-9203; 1095-9203
• DOI: 10.1126/science.abb5793

Four months into the severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) outbreak, we still do not know enough about postrecovery immune protection and environmental and seasonal influences on transmission to predict transmission dynamics accurately. However, we do know that humans are seasonally afflicted by other, less severe coronaviruses. Kissler et al. used existing data to build a deterministic model of multiyear interactions between existing coronaviruses, with a focus on the United States, and used this to project the potential epidemic dynamics and pressures on critical care capacity over the next 5 years. The long-term dynamics of SARS-CoV-2 strongly depends on immune responses and immune cross-reactions between the coronaviruses, as well as the timing of introduction of the new virus into a population. One scenario is that a resurgence in SARS-CoV-2 could occur as far into the future as 2025. Science , this issue p. 860 If immunity wanes, SARS-CoV-2 could cause recurrent wintertime peaks and require sustained surveillance and intermittent social distancing. It is urgent to understand the future of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) transmission. We used estimates of seasonality, immunity, and cross-immunity for human coronavirus OC43 (HCoV-OC43) and HCoV-HKU1 using time-series data from the United States to inform a model of SARS-CoV-2 transmission. We projected that recurrent wintertime outbreaks of SARS-CoV-2 will probably occur after the initial, most severe pandemic wave. Absent other interventions, a key metric for the success of social distancing is whether critical care capacities are exceeded. To avoid this, prolonged or intermittent social distancing may be necessary into 2022. Additional interventions, including expanded critical care capacity and an effective therapeutic, would improve the success of intermittent distancing and hasten the acquisition of herd immunity. Longitudinal serological studies are urgently needed to determine the extent and duration of immunity to SARS-CoV-2. Even in the event of apparent elimination, SARS-CoV-2 surveillance should be maintained because a resurgence in contagion could be possible as late as 2024.