Welcome to 2022 — the year the COVID-19 pandemic ends.

Those of you who have been reading this blog faithfully and those who know me personally understand that I’m not someone who makes predictions lightly. In part it is because I have an aversion to being incorrect! Despite this, I am predicting that 2022 is the year that the COVID-19 pandemic burns out.

That doesn’t mean there won’t be SARS-CoV-2 infections in the coming year, or that news outlets won’t breathlessly announce every new variant. It means that by some time in 2022, for practical day-to-day living activities, COVID-19 will not define our actions.

Why am I so comfortable in saying this?

Recently on Flashpoint on WDIV, Devin Scillian asked me when we would “turn the corner” on the pandemic. My response was that it would be more like a downward slope in infection waves rather than an abrupt turn. The following graphs illustrate what I was suggesting.

Deaths per 1,000 individuals in the US during the 1918 flu pandemic. Notice the three waves.
Deaths in the UK during the 1918 flu pandemic. The pattern is identical to the one in US. This suggests it was biologically driven.

We have been focused on number of infections with COVID-19 because of the very sensitive and accurate diagnostic tests (PCR) we have developed. In contrast, as we look at the end of the pandemic, we now need to focus less on infections and more on deaths. That is truly the important marker of a pandemic’s impact and the only comparable measure to the 1918 flu epidemic where there were no diagnostic tests.

In the 1917 flu pandemic, after the initial burst of infections and deaths, two waves of deaths followed, each one less impactful. This is how pandemics end; two “echo” waves each being less and less significant. It is because in each wave the most susceptible individuals have been killed off as the rest of the population develops immunity. A similar pattern was seen in the 2011 Influenza A pandemic and it has now emerged with COVID-19 (figure below). This pattern shows the COVID-19 pandemic is burning out.

Deaths in the US from COVID-19 over the past 18 months. Note the three major waves, with the third one trailing downward following the emergence of different variants.

While the pandemic has had horrific costs, we have accomplished much with advanced care, vaccines and therapeutics. All immunity is the same whether from vaccine or virus. The concept of “natural” immunity being better is just not valid. Worldwide, the 5.5M excess deaths from COVID-19 are about 10% of the 50M deaths from flu in 1918-1919. That pandemic was “managed” with “natural” immunity. Thus, the improved outcome is in no small part due to vaccines.

These medical advances, however, are only partly why deaths are falling from their peak at the beginning of 2021 despite the current, huge increases in infections. The succeeding waves of death, while overall smaller, are still present and occurred with significant portions of the population (U.S. and world) being unvaccinated. Each wave of infection provided more exposure to the COVID-19 virus, leading to immunity that has helped protect the entire population.

At the same time the virus has been hysterically mutating to try to facilitate its survival. It has sacrificed pathogenicity (killing) for transmissibility to improve its chance of infecting people. Omicron is the latest and best example of this. As is always the case, however, the immune system eventually wins out. That is how the human race has survived.

Therefore, make a toast today to the coming end of the pandemic and honor those we have lost. And remember to be grateful for the remarkable capability of our immune system. It has provided us with the ability to survive the worst that nature can throw at us.

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

10 thoughts on “Welcome to 2022 — the year the COVID-19 pandemic ends.

  1. Dear Dr. Baker, I regularly read your posts and have found them extremely helpful. Thank you for this January 1 post. It gives me hope that we will one day move beyond this and begin living a normal life again.

    I’d be most grateful if you could clear something up for me. My cousin and his wife had COVID about a year ago. They both insist that they are immune and do not need to get vaccinated. Can you please tell me what the science is saying on this subject?

    Thank you, Kathleen Rogers kmrogers210@gmail.com

    On Sat, Jan 1, 2022 at 11:45 AM Pandemic Pondering wrote:

    > jbakerjrblog posted: ” Those of you who have been reading this blog > faithfully and those who know me personally understand that I’m not someone > who makes predictions lightly. In part it is because I have an aversion to > being incorrect! Despite this, I am predicting that 2022 i” >

    Liked by 1 person

    1. Most data suggest that you need at least a single dose of vaccine after infection for long term immunity. Otherwise the immunity quickly (3-4 months) dissipates.
      I wish them good luck.They should do fine with even a single dose of vaccine.
      Best,
      JB

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  2. If infection does not provide long term immunity, then how does the pandemic end? Won’t the reservoir of unvaccinated get sick every 3-6 months, keeping the virus cycling indefinitely?

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    1. A single infection does not provide complete immunity but multiple rounds of infection do. Thus the waves of infection are like boosters to improve infection. We prefer vaccination since the number of deaths by this route is much less.

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  3. I have had the chance to go back to some of your other entries on this blog. I can see that you are well-meaning and generally thoughtful, but frankly, some of your other posts have not aged well. I now don’t expect a reply to my previous queries will be forthcoming, which is not an insult to you or me, but personally, I offer an equally heuristic counterprediction to the one you made that was publicized at WDIV recently:

    Along the lines of Occam’s Razor, using just a purely arithmetical heuristic, suppose that deaths are the true indicator of saturation, and the overall average to-date morbidity of this disease continues to remain remarkably constant as it has for two years running at 2%, despite the entire variety of mitigations attempted over that time across the world, as well as numerous variants. Call it inclusive of all the variability to date. Then, a total of 6.63M people in the US will die from covid. 830K have already died in two years, leaving 5.8M to go. Using the arithmetic mean rate by the last two years of 415K deaths per year, the pandemic would end in December 2035.

    Intuitively, the future reality will probably lie somewhere between your prediction and mine, which is more of a simplified approximation of the worst-case scenario. I’d bet you a dollar, but I don’t like betting on deaths any more than I can see you don’t, either.

    Finally, I offer this article from The Guardian today for your consideration, in line with the concerns and questions I had for you prior to its publication:

    https://www.theguardian.com/world/2022/jan/11/will-covid-19-become-less-dangerous-as-it-evolves

    I wish you well, and particularly good health during this massive outbreak in progress. Thank you for any time and consideration you spent on my correspondence.

    Sincerely,

    Robert Young
    BS Biology 1997 Michigan Tech
    MA Mathematics 2017 Eastern Michigan

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    1. Several issues.

      Nature never follows a linear curve, and immunity was not achieved in the first year of this pandemic because we did a fair job of protecting people. So the lack of a fall in the second year is not surprising and similar to what was observed in 1919.

      Also, the Guardian article mixed 100% lethal blood transferred Ebola with respiratory RNA viruses. These are two very different things with mutations and immunity being totally unique. Ebola will never mutate like influenza and people won’t develop immunity to Ebola because they die first! If Ebola was a respiratory disease then humanity would develop immunity or would not exist.

      The worst pandemics always burn out because they kill off the succescible hosts while the remaining people develop immunity. We have altered the death numbers with COVID for the better with vaccines, but while we blunted the pandemic we have not changed the overall dynamic. I think we can all agree that short of infecting everyone the best way to assure the end of this is to vaccinated everyone.

      Let’s all hope I am right.

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