Will SARS-CoV-2 become endemic?

In recent history we haven’t bothered fighting colds at all and this attitude has not served us well. Up until March 2020 it was socially acceptable to roll into your office, church, or school coughing and sneezing everywhere. In 2020 we even had to produce public health videos to teach people how to wash their hands and why it was a good idea to do so! This was taking place in high income, well educated countries that would consider themselves technologically advanced and socially sophisticated.

That casual posture is obviously gone for a generation, but what underpinned it was our collective delusion that we had conquered infectious disease while all visibly ill from all the infectious disease circulating in the population every year.

The research efforts are interesting because it seems to be a very tough vaccine candidate due in part to the sheer number of viruses and strains you’re dealing with. I’ve not seen the financials, but I’d be surprised if we were spending anything like the estimated costs of tens of billions of dollars on finding a solution. I guess it’s a case where the costs are borne in a very diffuse way but the solutions have to come out of specific research budgets. Why bother researching and getting approval for a vaccine, when you can just sell people over the counter snake oil like cough medicine?

We don’t have to shrug when our low baseline expectations for life get even worse. We can and must do better if we believe in progress.

At the medical science level, we absolutely do investigate common cold pathogens and others, and have developed a battery of techniques, all of which were very rapidly brought to bear on Covid-19.

Where I think we do need to do a lot better is in international co-operation and co-ordination. In the USA the CDC needs competent leadership again, they need their seat back at the US national Security Council and they need their international outreach budget back. Europe needs to develop their own equivalent to the CDC that's well funded and effective.

The WHO also needs thoroughly upgrading. I think given the way national governments have ensured the WHO stays a political football, they actually overall do a lot of good. A lot of nations are thoroughly reliant on them for advice and technical assistance, but clearly their chronic dependence on the good will of nation states has severely compromised their ability to act as an independent and effective organisation. They need more funding and more independence, not bullying by China and the USA to serve domestic agendas.