COVID-19 May Periodically Resurge for Two Years, Report by Infectious Disease Experts Says

Officials need to prepare the public for the prospect of a period of coronavirus resurgences over the next two years, infectious disease experts have said in a report.

A team from the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota also urged leaders to prepare for the "worst-case scenario" such as there being no vaccine; draw up plans to ensure healthcare workers are protected during spikes of disease; and map how to reinstate measures to prevent COVID-19 from spreading.

In the document titled The Future of the "COVID-19 Pandemic: Lessons Learned from Pandemic Influenza," the experts wrote: "Risk communication messaging from government officials should incorporate the concept that this pandemic will not be over soon and that people need to be prepared for possible periodic resurgences of disease over the next 2 years."

They said: "We must be prepared for at least another 18 to 24 months of significant COVID-19 activity, with hot spots popping up periodically in diverse geographic areas.

"As the pandemic wanes, it is likely that SARS-CoV-2 will continue to circulate in the human population and will synchronize to a seasonal pattern with diminished severity over time."

There are three potential ways the COVID-19 pandemic may pan out, according to the researchers. The current first wave may be followed by repetitive smaller waves over a 1- to 2-year period, before diminishing sometime in 2021. The second scenario would see the first wave followed by a larger wave in fall or winter 2020, and one or more smaller waves in 2021. In the third, a "slow burn" of cases would occur without a clear pattern of waves.

The authors wrote: "The virus caught the global community off guard, and its future course is still highly unpredictable; there is no crystal ball to tell us what the future holds and what the 'end game' for controlling this pandemic will be."

Since the pandemic started late last year, more than 3.2 million COVID-19 cases have been confirmed, over a million people are known to have recovered, and 233,416 people have died, according to Johns Hopkins University. The U.S. is currently the county with the most known cases, as shown by the Statista graph below.

covid19, coronavirus, statista
A graph showing the countries with the most known COVID-19 cases. Statista

While SARS-CoV-2 and flu viruses are different in many ways, such as the former's longer incubation period which enables it to "move silently" through populations, previous flu pandemics are a useful point of comparison for the current crisis, the authors said. For instance, a strain of flu with the potential to cause a pandemic and SARS-CoV-2 would both be new viruses to which humans have no immunity, and can spread asymptomatically through respiratory droplets.

The virus which causes COVID-19 is called SARS-CoV-2, and shouldn't be confused with the germ which causes the severe acute respiratory syndrome (SARS) disease. SARS-CoV-2 is a member of the large coronavirus family, which includes the viruses that cause diseases such as SARS, Middle East Respiratory Syndrome (MERS), and some common colds.

Flu viruses and SARS-CoV-2 have spread globally unlike the SARS and MERS viruses, "therefore, these pathogens do not provide useful models for predicting what to expect with this pandemic," the team said.

Outlining the forecast of his team's report, CIDRAP director Michael Osterholm told MSNBC's The Last Word on Thursday: "There's no question we're going to see many, many more infections."

Currently, around 5 to 15 percent of people in the U.S. are thought to have been infected by the virus, but the outbreak likely won't stop until the figure reaches 60 to 70 percent, he said.

"There's no question we're going to have major, major challenges with the number of cases, the serious disease. We're only in the second inning of a nine inning game so we've got a long way to go," he said.

Centers for Disease Control and Prevention Advice on Using Face Coverings to Slow Spread of COVID-19

  • CDC recommends wearing a cloth face covering in public where social distancing measures are difficult to maintain.
  • A simple cloth face covering can help slow the spread of the virus by those infected and by those who do not exhibit symptoms.
  • Cloth face coverings can be fashioned from household items. Guides are offered by the CDC. (
  • Cloth face coverings should be washed regularly. A washing machine will suffice.
  • Practice safe removal of face coverings by not touching eyes, nose, and mouth, and wash hands immediately after removing the covering.

World Health Organization advice for avoiding spread of coronavirus disease (COVID-19)

Hygiene advice

  • Clean hands frequently with soap and water, or alcohol-based hand rub.
  • Wash hands after coughing or sneezing; when caring for the sick; before, during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste.
  • Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing.
  • Avoid touching your hands, nose and mouth. Do not spit in public.
  • Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.

Medical advice

  • Avoid close contact with others if you have any symptoms.
  • Stay at home if you feel unwell, even with mild symptoms such as headache and runny nose, to avoid potential spread of the disease to medical facilities and other people.
  • If you develop serious symptoms (fever, cough, difficulty breathing) seek medical care early and contact local health authorities in advance.
  • Note any recent contact with others and travel details to provide to authorities who can trace and prevent spread of the disease.
  • Stay up to date on COVID-19 developments issued by health authorities and follow their guidance.

Mask and glove usage

  • Healthy individuals only need to wear a mask if taking care of a sick person.
  • Wear a mask if you are coughing or sneezing.
  • Masks are effective when used in combination with frequent hand cleaning.
  • Do not touch the mask while wearing it. Clean hands if you touch the mask.
  • Learn how to properly put on, remove and dispose of masks. Clean hands after disposing of the mask.
  • Do not reuse single-use masks.
  • Regularly washing bare hands is more effective against catching COVID-19 than wearing rubber gloves.
  • The COVID-19 virus can still be picked up on rubber gloves and transmitted by touching your face.