Anthony Fauci, the top infectious diseases public official in the US, said on Tuesday that if America further ramps up vaccination rates and those already immunized take booster shots that it is feasible Covid-19 could be reduced from a pandemic emergency to endemic status next year.

More than 70% of adults in the US are fully vaccinated. Fauci said if a lot more Americans take the vaccines, and if the US makes boosters available for everyone, the country could get control of the virus by spring of 2022.

But with his forecast Fauci, director of the National Institute of Allergy and Infectious Diseases and the chief medical advisor to Joe Biden, was acknowledging what experts now widely believe: that Covid-19 cannot be eliminated and will likely become endemic, meaning it will always be present in the population to some degree, such as the flu or chickenpox.

Booster doses of the vaccines are vital for reaching the point where falling infection rates allow the disease to be downgraded from the current pandemic public health emergency to the status of endemic, Fauci explained in an interview on Tuesday during the Reuters Total Health conference.

Cullen Veasley, 17, receives his second dose of the Covid vaccine at a mobile pop-up vaccination clinic in Detroit.
Cullen Veasley, 17, receives his second dose of the Covid vaccine at a mobile pop-up vaccination clinic in Detroit. Photograph: Emily Elconin/Reuters

“To me, if you want to get to endemic, you have got to get the level of infection so low that it does not have an impact on society, on your life, on your economy,” Fauci said.

“People will still get infected. People might still get hospitalized, but the level would be so low that we don’t think about it all the time and it doesn’t influence what we do.”

Even to get to that point, many more people need to take the vaccine for the first time and others need to get boosters, he added.

Booster shots are currently available – at least six months after completing prior vaccination – to the immunocompromised, those 65 and older and other people at high risk of severe disease or frequent exposure to the virus through their jobs or living situations.

Some states and New York City have already expanded booster availability more widely than the federal recommendations.

An influential US panel that advises the Centers for Disease Control and Prevention (CDC) will discuss on Friday expanding eligibility for booster shots to all adults, which could make the shots available as early as this weekend.

“Look what other countries are doing now about adopting a booster campaign virtually for everybody. I think if we do that … by the spring we can have pretty good control of this,” Fauci said.

Luis Arellano receives his first dose of the Covid vaccine from Liz Negron, a Kaiser medical assitant, during a clinic in Greeley, Colorado.
Luis Arellano receives his first dose of the Covid vaccine from Liz Negron, a Kaiser medical assitant, during a clinic in Greeley, Colorado. Photograph: Reuters

There is a wide range of opinion as to what might be considered getting the virus under control, Fauci noted.

“You could control it at 50,000 cases a day. To me, that’s not good control, and that’s not endemicity that I would accept.”

He disagrees with those who argue that it is time to start learning to live with the virus all around us all the time.

“I don’t want to sit back when we have 70,000 to 85,000 new infections a day and say, ‘Oh, well, we can’t do any better than that. Let’s live with that.’ Sorry, that’s not where we want to be,” he said.

That is why he keeps pushing to get as many people vaccinated as possible.

“For me, endemicity means a lot more people get vaccinated, a lot more people get boosted, and although you don’t eliminate or eradicate it, that infection is not dominating your life,” he said.

The number of new Covid cases is rising in more than half of US states amid fears of another winter surge. Infections were firmly falling from mid-September to late October but the US is now averaging more than 83,000 cases a day, up 14% from a week ago, NPR reported on Tuesday.

Minnesota has the worst infection rate in the US over the last week, the Star Tribune reported, and Michael Osterholm, director of the University of Minnesota’s center for infectious disease research and policy warned that the “whole Midwest is lighting up” with new coronavirus cases.

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