Not everyone will immediately resume all of their prepandemic activities; rather, there will be a noticeable shift toward more of them. The past month or two have seen seven important developments: Whats the net impact of all these developments? and the persistence of vaccine hesitancy.81 Jenny Cordina, Eric Levin, and George Stein, COVID-19 Consumer Healthcare Insights: What 2021 may hold, June 24, 2021, McKinsey.com. The positive readouts from the vaccine trials mean that the United States will most likely reach an epidemiological end to the pandemic (herd immunity) in Q3 or Q4 2021. Given all of these variables, where do we net out? It ricocheted across social media, on front pages and out of the mouths of dads deprived of more days on the couch in front of the cricket. Collectively, these treatments and changes in clinical practice have lowered mortality for those hospitalized by 18 percent or more.155Leora Horwitz et al., Trends in COVID-19 risk-adjusted mortality rates, Journal of Hospital Medicine, October 2020, journalofhospitalmedicine.com. Tracking SARS-CoV-2 variants, World Health Organization, who.int. We'd become used to seeing terrifying predictions at the start of a COVID wave, and then successfully avoiding the worst-case scenario. 8. We will add a perspective for other parts of the world, including the rest of Western Europe, in future updates to this article. Prospects for the rest of the year and beyond hinge on the questions of whether and when future variants will emerge. An annoying childhood infection, New York Times, January 12, 2021, nytimes.com. Immunity can only partly predict the burden of disease at any point in time. But as the more infectious Delta variant becomes more prevalent within a population, more people within that population must be vaccinated before herd immunity can be achieved (Exhibit 1). Its not clear when use in children will be indicated. While it is known to be highly prevalent in the United Kingdom and present in the United States, there is a significant chance that it will predominate throughout the United States over the coming months. They have already begun in some locations and could be well advanced in most countries by the first or second quarter of 2021. The researchers estimate that at least 17 per cent of Australian adults had been infected with SARS-CoV-2, the virus that causes COVID-19, by the end of February Our estimates of three to eight months for manufacturing, distribution, and adoption of sufficient vaccine doses to achieve herd immunity remain unchanged, and suggest that the milestone may be reached between July and December 2021. Early 2022 will see the return of migration, albeit not yet at pre-pandemic levels.