The World Health Organisation (WHO) has listed a number of scenarios for how the future could look as we continue to live with Covid-19.
As of March 29, more than six million people worldwide have died with coronavirus. The WHO has now set out "strategic adjustments" every country must make to lessen the impact of covid and the global emergency.
A worst case scenario, the report states, would be a complete "reset". This would happen if a new SARS-CoV-2 virus were to emerge, possibly from a patient being "co-infected" with two separate variants which would then produce new infectious particles with characteristics of both strains.
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This worst case would see a "more virulent and highly transmissible variant emerges against which vaccines are less effective, and/or immunity against severe disease and death wanes rapidly, especially in the most vulnerable groups". This, WHO says, would require "significant alterations to current vaccines and full redeployment and/or broader boosting of all high-priority groups"
The WHO has said, however, this scenario is not explicitly included as a planning scenario, but should be considered a background threat, and "all response and readiness capacities should be understood to yield a resilience dividend pertaining to that threat".
At the other end of the spectrum, a best case would see future variants to be significantly less severe. In this case, protection against severe disease would be maintained without the need for periodic boosting or significant alterations to current vaccines.
The WHO expects the virus will continue to evolve, with severity " significantly reduced over time due to sustained and sufficient immunity against severe disease and death, with a further decoupling between incidence of cases and severe disease leading to progressively less severe outbreaks". Periodic spikes, its report says, may occur as a result of an increasing proportion of susceptible individuals over time if waning immunity is significant, which may require periodic boosting "at least for high-priority populations".
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