There is no denying that 2020 has been a terrible year. The coronavirus pandemic has created new challenges for almost everyone, has halted life as we knew it and has killed more than 235,000 Americans. As we near the end of this year (can you believe it?), we’re met with concerns about 2021 and a pandemic that is showing no signs of slowing down.
“2021 for me is really kind of a mystery,” said Susan Hassig, an associate professor in epidemiology at Tulane University. “Everything is conditional on so many factors.”
Many different scenarios can take place next year depending on what sort of vaccine and treatment options become available, in addition to how seriously the public follows rules set in place by public health officials.
It also depends on what experts learn about the virus as time goes on. Things change every day, and so much of the shape of 2021 is dependent on many moving parts.
But while there are no guarantees, there are some predictions. Below, we spoke with experts across the country about their expectations of what the pandemic will look like next year and what we can do as a society to make 2021 a more positive experience.
Life as we know it will continue to be disrupted, even after a vaccine is widely available
Some promising COVID-19 vaccine news was celebrated this week when Pfizer announced preliminary data from its current trial. The evidence suggests the company’s vaccine could be 90% effective in preventing COVID-19. (The data still needs to be independently reviewed. The trial is also still going on and needs to go through a more rigorous vetting process before being released to the public.)
Realistically, while a vaccine will solve many problems and help people complete their day-to-day responsibilities more safely, it won’t be a total salve right away. Richard Martinello, the medical director for infection prevention at Yale New Haven Health, stressed that it is going to take a significant amount of time to get the entire country vaccinated.
“With most of the vaccines that are being looked at right now, most of them will require a series of two shots and typically those shots are going to be one month apart. So, even if hundreds of millions of doses become available, it is going to take months for the population to get vaccinated,” Martinello said.
Additionally, about 70% to 80% of the population needs to be immune from COVID-19 to impact the virus’s spread within communities. Martinello said that if we have a vaccine that is even 80% effective, which is a very high efficacy rate, we would need 100% of the population to get the vaccine in order to reach 80% immunity.
That’s a tough task. It requires millions and millions of doses of a completed, safe vaccine. It also requires cooperation. With anti-vaccine individuals and vaccine doubters, it is going to be nearly impossible to get the entire population of the United States to get the vaccine at any point, let alone within the next year.
A vaccine for adults will likely be available before a vaccine for children
While COVID-19 vaccine trials have progressed in the adult population over the past few months, the first vaccine trial in kids ages 12 to 18 just started in late October and there have, understandably, been no trials for kids under 12.
Michael Levy, an associate professor of epidemiology at the University of Pennsylvania’s Perelman School of Medicine, noted that the virus will not disappear if we only vaccinate the groups that we think, as of right now, are driving the pandemic. He also voiced specific concern about the spread of the coronavirus in schools if a vaccine for children is not chased with the same urgency as a vaccine for adults.
“We need to figure out how to vaccinate kids because I don’t know that this virus is going to disappear just by vaccinating adults or by protecting the elderly and most vulnerable,” Levy said. “I don’t think we’ve figured out how to do schools and I don’t know that vaccination among the adults alone will be sufficient to solve the problem.”
We’ll get an up-close view of vaccine distribution, which may be messy
Since the pandemic began, most of the public has become, whether they like it or not, more familiar with public health measures and scientific processes.
“The American public and the global public has really learned far more about how science works,” Hassig said. “We learn a lot by trial and error in the scientific realm. You ask a question; you try to find an answer to the question and you may not get the answer you wanted — that’s just part of science.”
“I think people outside of science are really frustrated by things like, ‘Oh, this treatment looks promising’ but then it turns out not to be a good treatment,” she said. “That’s normal in science. That happens all the time.”
Hassig said this frustration may likely play out in how the vaccine is distributed, too. The public is going to have an up-close view of vaccine delivery in 2021, which ― like any major project ― comes with routine problems and holdups. For example, vaccines like Pfizer’s will require frozen storage, which many places may not have access to.
She added that she’s concerned about the public’s reaction to any problems that arise during shot delivery ― which is going to be a complicated, major undertaking ― because it may add to vaccine hesitancy.
Housing uncertainty is likely going to be a problem for COVID-19 spread in early 2021
Earlier this fall, the Centers for Disease Control and Prevention issued an eviction moratorium restricting landlords from evicting tenants for nonpayment of rent through Dec. 31 in an effort to reduce further spread of the coronavirus.
There are loopholes that some landlords are finding but, overall, the moratorium protects a large number of renters across the U.S. from being homeless during the pandemic. But, with the moratorium ending on the last day of this year, Levy worries about the impact that evictions could have on the pandemic.
“When I think of Jan. 1, 2021, I think of the eviction moratorium and what happens after that.”
“The amount of pending evictions that would occur on New Year’s Eve is huge. And, historically, most people have been able to double up when they are evicted — move in with friends or family or whoever can take them — and that makes larger households,” Levy said. “When you get larger households, you get more opportunities for the ingress of the coronavirus into the house and then more spread within the house.”
Levy noted that household contact can be very dangerous. The type of contact within a home can sometimes be more risky than the type of contact that happens outside of a household — contact like hugging your partner or sitting next to your son or daughter on the couch is much riskier than walking by a stranger or coming into contact with a cashier at a grocery store. He stressed that larger households and increased spread within a home could propel an epidemic or rekindle an epidemic that may have been previously suppressed.
“When I think of Jan. 1, 2021, I think of the eviction moratorium and what happens after that,” Levy said.
Once we emerge from winter 2021, the public health community may reflect on decisions made throughout the pandemic
Increased coronavirus cases throughout the country are already our reality as we head into an expectedly bleak winter. Cases are not expected to decrease as we enter the coldest months of the year.
“I think this is going to be our situation for the foreseeable future which, to me, is really through May 2021,” Martinello said. “I think that is going to be a good time for us to reassess our situation as we go from spring into summer.”
He stressed that a reassessment does not mean major changes for pandemic precautions and noted that he does not expect to see huge differences in terms of mask-wearing or physical distancing after any sort of late-spring re-evaluation. Instead, he thinks this could be a good time for the public health community to pause and look at the approach the country has taken over the past season.
“It’s a good time to think about what aspects of our strategy have worked, what aspects have failed, if a vaccine is available and how a vaccine changes our approach,” he said.
So, don’t expect large-scale in-person concerts or huge gatherings to become the norm. Instead, look forward to updates to communications around things like general public health guidance to help people create safer situations, Martinello added.
Safety measures like wearing face masks won’t go away
At this point, we know that mask-wearing and physical distancing majorly reduce the spread of COVID-19, which is crucial if we ever want to contain this virus. As we move into next year, Martinello noted that he does not expect to see major changes in these public health recommendations.
In addition to helping curb the spread of the coronavirus, safety measures like mask-wearing and physical distancing also likely help lessen the spread of flu and other respiratory viruses, Martinello stated.
“If we used masks more, 2021 would look very different from 2020.”
“I think there will be some very long-term lessons learned here about how we protect ourselves from getting sick. I think we are going to see some changes that will go well beyond a time when we have an effective vaccine,” along with a shift toward more routine use of masks in public settings, he noted.
“Masking is what will allow 2021 to be a far more open society. It’s not a zero-sum game, it’s not masking or an open economy, it’s masking enabling an open economy,” Hassig added. “And if we used masks more, 2021 would look very different from 2020.”
If you miss your pre-pandemic life, make appropriate holiday plans so we can go into 2021 without heightened rates of spread, infection and death
With a cluster of holidays at the end of the year, Hassig voiced concern about COVID-19 spreading at family gatherings.
“If behaviors don’t change with regard to masking and distancing, we have several major holidays that could launch another huge surge of cases, illness, hospitalization and death,” she said.
And since COVID-19 symptoms can take up to 14 days to appear, Hassig added, people who get unknowingly infected at holiday celebrations will likely return to their normal activities, causing further spread of a virus that we already can’t control. “The virus will move, expand, spread and then erupt,” she said.
She stressed that we need to be more conscious and more mindful as we make day-to-day decisions in the coming months. “Our actions can have substantial consequences,” she added.
The major holidays that occur in the last six weeks of the year could set us up for serious failure as we enter the first days of 2021.
“2021 could be worse, quite honestly ― the pandemic is not just going to stop because it’s Dec. 31 and then Jan, 1,” Hassig said. ”The virus is going to be here until we stomp down, and that’s going to take collective, concerted effort — but it can be done.”
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.