We can live with viruses — COVID isn’t the first, or last, threat

Pfizer recently announced that the Food and Drug Administration (FDA) is reviewing data on its COVID-19 vaccine for children ages 5-11 and that authorization could be granted by Halloween. As more and more Americans are vaccinated, people’s plans and expectations are cautiously inching back towards normal. However, although vaccines have been effective at reducing death and serious illness from COVID, it is also clear that the virus can circulate among the vaccinated and will not be eradicated anytime soon. We want to get back to our lives, but how can we do that while COVID remains among us?

The answer lies in examining how we already live with other viruses, including viruses that at some point in history presented as much or more of a threat than this one.  

The first strategy is to neutralize the worst threats from the SARS-CoV-2 virus. This has been accomplished by developing vaccines for many viruses that once caused devastating illnesses — polio, measles, smallpox. It hasn’t been possible to make a vaccine against every dangerous virus, as in the case of HIV, the virus that causes AIDS. We are fortunate with COVID in that its vaccines can, by and large, prevent the worst outcomes and, if needed, booster shots and similar strategies offer the promise of maintaining this protection over time.

But is this enough? COVID still presents unanswered questions and carries unknown risks. What if I am one of those rare people who gets a serious breakthrough infection even after being vaccinated? What about my low-risk young child — could we be the unlucky family that has a bad outcome? If I get a mild infection, could I still get long COVID? These are real concerns, and reasons to justify taking reasonable precautions against getting infected. But many risks also exist for other viruses, and we have been living with them our whole lives, whether we knew it or not.

Most parents remember experiencing a near-constant string of infections with common cold-causing viruses during their children’s preschool years. The same viruses that cause usually innocuous colds also can cause serious breathing problems and lead to hospitalization for a small percentage of unlucky children each year — in some cases, they can trigger lifelong medical conditions such as asthma. There are also well-known but mysterious illnesses in medicine similar to MIS-C, a rare post-COVID illness in children, that are triggered by common viral infections. Biomedical researchers like me devote our careers to understanding the connections: What happens when there is a bad outcome? Who is at high risk and how can we prevent infection? These questions are unanswered but, for these and so many other diseases, life must go on while we look for the answers.

Here’s where the second strategy comes in: fighting the fight through scientific research and innovation. There will be bad outcomes — lifelong disabilities and even deaths — that might have been prevented if we had found more answers sooner. People in my profession have always known this, even before COVID, because COVID-19 isn’t the first, nor will it be the last, virus to threaten human health. This is why biomedical researchers want resources to do their work faster and better. It is a race between the countermeasures our society can develop and the damage that can be wrought by diseases that threaten humans.  

Despite the promise of biotechnology, current National Institutes of Health (NIH) funding levels are not positioning U.S. scientists to win this race. Right now, the typical time delay for NIH grant funding is months to years after an initial application, and about 80 percent of applications are never funded.  

Don’t be fooled by the rapid and impactful scientific advances made during the COVID-19 pandemic as an argument to maintain the status quo. There were huge investments in science during this time that are out of the ordinary — many scientists used any flexible funds they had to conduct COVID research without knowing if they would recompense these costs; the government allocated special, one-time funds to scientists and vaccine companies; and private funders such as FastGrants stepped up to provide rapid, flexible resources. But these emergency measures will not sustain us as we shift gears from a sprint to a marathon. 

While the pandemic is far from over, with vaccines the cost-benefit ratio of social isolation is beginning to shift.  No one can deny the huge social, economic and emotional costs to the mitigation measures of the past 18 months, and no one wants to endure those costs any longer than necessary. As vaccination becomes more widely available and population immunity slows the spread of the virus, I can envision COVID-19 transitioning into the category of diseases we keep fighting while life goes on. 

If the pandemic has a silver lining, I hope it is this — that it has led to a greater collective understanding of threats we have always faced, and a greater collective commitment to the biomedical research enterprise that strives to keep us one step ahead. 

Ellen F. Foxman, MD, PhD, is an assistant professor of Laboratory Medicine and Immunobiology at the Yale School of Medicine, and a Public Voices Fellow of the OpEd project.